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Sample records for surgical sex reassignment

  1. The surgical management of sex reassignment surgery and its options

    OpenAIRE

    高橋,義雄; 難波,祐三郎; 岸本,晃司; 光嶋,勲

    2001-01-01

    GENDER IDENTITY DISORDER (GID) is a unique human condition that is classified behaviorally and treated medically with hormones and surgery in the severe form. This condition has been and still somewhat remains controversial by religious belief, social institutions and health care delivery systems. We described the surgical management of transsexuals, so called SEX REASSGINMENT SURGERY (SRS) and showed the team for gender treatment, GENDER CLINIC. A gender treatment team composing staff member...

  2. Sex reassignment surgery

    Directory of Open Access Journals (Sweden)

    Bižić Marta

    2015-01-01

    Full Text Available Transsexualism, or gender incongruence, presents a state in which a person's assigned sex at birth conflicts with their psychological gender. It is classified in International Classification of Diseases as F64. Treating these persons require multidisciplinary approach, including psychiatrist, endocrinologist, gynecologist, urologist, plastic and reconstructive surgeon. Genital reconstruction is the final step in transition, and can be performed when all other conditions required by World Professional Association for Transgender Health (WPATH are accomplished. Female to male sex reassignment surgery Several surgical procedures can be done in female to male transsexuals, including mastectomy, removal of female genitalia, metoidioplasty, scrotoplasty with implantation of testicular implants, as well as total phalloplasty. The current operative technique of metoidioplasty comprise the following steps: vaginal removal, the release of the ventral chordee and clitoral ligaments, straightening and lengthening of the clitoris, urethroplasty by combining buccal mucosa graft and genital flaps and scrotoplasty with insertion of testicle prostheses. The goal is to perform all these procedures in one stage, and that makes our team famous worldwide. Metoidioplasty results in excellent cosmetic outcome with completely preserved sensitivity and sexual arousal, enables voiding while standing, but without ability to penetrate due to small size of the neophallus. Considering these advantages, including low complication rate, patients often choose this option. For those who require bigger phallus which enables implantation of penile prosthesis, several surgical techniques have been reported using either available local vascularized tissue or microvascular tissue transfer. However, none of them satisfy all the goals of modern penile construction, i.e. reproducibility, tactile and erogenous sensation, a competent neourethra with a meatus at the top of the neophallus

  3. Sex reassignment surgery in Thailand.

    Science.gov (United States)

    Chokrungvaranont, Prayuth; Tiewtranon, Preecha

    2004-11-01

    reassignment surgery has been taught in Chulalongkorn University Hospital since 1983. (At present, it is the only medical school in Thailand that has sex reassignment surgery systematically taught and with good results). There have been many versions of development of the surgical techniques to gain better and better results.

  4. Sex-Reassignment Rules in Shiite Jurisprudence.

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    Kalbasi-Isfahani, Fahimeh; Deleer, Mohsen

    2016-01-01

    The "Sex-Reassignment Surgery" is a solution that besides behavioral therapy has been suggested to people suffering from gender identity disorders in recent years. In Iran, this trend has become more popular over the past years due to the inclination to reach to the goal rapidly with less effort and also the surgery has attracted many patients with the problem. Religious clerics have tried to determine the religious doctrines for this practice and as a result a group of them favor an absolute permission while others choose prohibition and some of them favor a middle path. The aim of this study was to determine the religious doctrines for Sex-Reassignment and legitimate treatment for GID. The research method was a library research based on which an investigation was done by analyzing the relevant books, articles and dissertations. Primary documents of Islamic sources (Quran and tradition) along with scientific, medical and psychological materials were used in this research. In this study, the survey shows that none of the reasons have the power to deliver a definitive and religious ruling on this issue because the validity of its reasons is related to the reality of "Sex-Reassignment". The results demonstrate that Sex-Reassignment is prohibited and it is not authorized. In case of urgency for doing the surgery, the gender of the person should not be changed.

  5. Long-Term Follow-Up of Individuals Undergoing Sex-Reassignment Surgery

    DEFF Research Database (Denmark)

    Simonsen, Rikke Kildevæld; Hald, Gert Martin; Kristensen, Ellids

    2016-01-01

    Introduction: Studies of mortality and somatic well-being after sex-reassignment surgery (SRS) of transsexual individuals are equivocal. Accordingly, the present study investigated mortality and somatic morbidity using a sample of transsexual individuals who comprised 98% (n = 104) of all surgica......, specific types of hormonal or surgical treatment received and somatic morbidity and mortality....

  6. Ambiguous genitalia, gender-identity problems, and sex reassignment.

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    Dittmann, R W

    1998-01-01

    This article discusses general issues with regard to gender-identity problems, sex reassignment, and clinical management in patients with ambiguous genitalia, based on a detailed case history of a patient with penile agenesis who has been followed more than 20 years. After initial uncertainty, the patient began to grow up as a boy, lived from the fourth year of life as a girl and young woman, and lived from late puberty on as a man. Over his lifetime he experienced extensive corrective surgery plus hormonal substitution therapy. Pre- and perinatal hormonal conditions, phenomenology of the genitalia, sex of rearing, timing of sex reassignment and corrective surgery, for example, appear to be important components for the development of gender-role behavior, gender identity, and sexual orientation of intersex patients. Findings and retrospective considerations for this patient suggest the need for careful differential activities in diagnostic workup, approaches to sex assignment and possible reassignment, and the clinical management of patients and families.

  7. Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden.

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    Cecilia Dhejne

    Full Text Available CONTEXT: The treatment for transsexualism is sex reassignment, including hormonal treatment and surgery aimed at making the person's body as congruent with the opposite sex as possible. There is a dearth of long term, follow-up studies after sex reassignment. OBJECTIVE: To estimate mortality, morbidity, and criminal rate after surgical sex reassignment of transsexual persons. DESIGN: A population-based matched cohort study. SETTING: Sweden, 1973-2003. PARTICIPANTS: All 324 sex-reassigned persons (191 male-to-females, 133 female-to-males in Sweden, 1973-2003. Random population controls (10:1 were matched by birth year and birth sex or reassigned (final sex, respectively. MAIN OUTCOME MEASURES: Hazard ratios (HR with 95% confidence intervals (CI for mortality and psychiatric morbidity were obtained with Cox regression models, which were adjusted for immigrant status and psychiatric morbidity prior to sex reassignment (adjusted HR [aHR]. RESULTS: The overall mortality for sex-reassigned persons was higher during follow-up (aHR 2.8; 95% CI 1.8-4.3 than for controls of the same birth sex, particularly death from suicide (aHR 19.1; 95% CI 5.8-62.9. Sex-reassigned persons also had an increased risk for suicide attempts (aHR 4.9; 95% CI 2.9-8.5 and psychiatric inpatient care (aHR 2.8; 95% CI 2.0-3.9. Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls. CONCLUSIONS: Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.

  8. Sexual desire in trans persons: associations with sex reassignment treatment.

    Science.gov (United States)

    Wierckx, Katrien; Elaut, Els; Van Hoorde, Birgit; Heylens, Gunter; De Cuypere, Griet; Monstrey, Stan; Weyers, Steven; Hoebeke, Piet; T'Sjoen, Guy

    2014-01-01

    Sex steroids and genital surgery are known to affect sexual desire, but little research has focused on the effects of cross-sex hormone therapy and sex reassignment surgery on sexual desire in trans persons. This study aims to explore associations between sex reassignment therapy (SRT) and sexual desire in a large cohort of trans persons. A cross-sectional single specialized center study including 214 trans women (male-to-female trans persons) and 138 trans men (female-to-male trans persons). Questionnaires assessing demographics, medical history, frequency of sexual desire, hypoactive sexual desire disorder (HSDD), and treatment satisfaction. In retrospect, 62.4% of trans women reported a decrease in sexual desire after SRT. Seventy-three percent of trans women never or rarely experienced spontaneous and responsive sexual desire. A third reported associated personal or relational distress resulting in a prevalence of HSDD of 22%. Respondents who had undergone vaginoplasty experienced more spontaneous sexual desire compared with those who planned this surgery but had not yet undergone it (P = 0.03). In retrospect, the majority of trans men (71.0%) reported an increase in sexual desire after SRT. Thirty percent of trans men never or rarely felt sexual desire; 39.7% from time to time, and 30.6% often or always. Five percent of trans men met the criteria for HSDD. Trans men who were less satisfied with the phalloplasty had a higher prevalence of HSDD (P = 0.02). Trans persons who were more satisfied with the hormonal therapy had a lower prevalence of HSDD (P = 0.02). HSDD was more prevalent in trans women compared with trans men. The majority of trans women reported a decrease in sexual desire after SRT, whereas the opposite was observed in trans men. Our results show a significant sexual impact of surgical interventions and both hormonal and surgical treatment satisfaction on the sexual desire in trans persons. © 2013 International Society for Sexual

  9. Sex Reassignment : Predictors and Outcomes Of Treatment for Transsexuals

    NARCIS (Netherlands)

    Smith, Yolanda Louise Susanne

    2002-01-01

    Prospective research supports the therapeutic effect of sex reassignment (SR) for adolescent and adult transsexuals. Data were used from 345 patients who applied for SR. Of these applicants, 232 started hormone treatment, 113 did not. The group who completed SR consisted of 196 transsexuals.

  10. Feminine transformations: gender reassignment surgical tourism in Thailand.

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    Aizura, Aren Z

    2010-10-01

    Every year, hundreds of transgendered people from the United States, Europe, Asia, Canada, and Australia travel to Thailand to undergo cosmetic and gender reassignment surgeries (GRS). Many GRS clinics market themselves almost exclusively to non-Thai trans women (people assigned a male sex at birth who later identify as female). This article draws on ethnographic research with patients visiting Thailand for GRS to explore how trans women patients related their experience of medical care in Thailand to Thai cultural traditions, in particular "traditional" Thai femininity and Theravada Buddhist rituals and beliefs. Foreign patients in Thai hospital settings engage not only with medical practices but also with their perceptions of Thai cultural traditions--which inflect their feminine identifications. I draw on two patients' accounts of creating personal rituals to mark their gender reassignment surgery, placing these accounts within the context of biomedical globalization and debates about the touristic appropriation of non-"Western" cultural practices.

  11. Sex Reassignment : Predictors and Outcomes Of Treatment for Transsexuals

    OpenAIRE

    Smith, Yolanda Louise Susanne

    2002-01-01

    Prospective research supports the therapeutic effect of sex reassignment (SR) for adolescent and adult transsexuals. Data were used from 345 patients who applied for SR. Of these applicants, 232 started hormone treatment, 113 did not. The group who completed SR consisted of 196 transsexuals. Follow-up data were gathered one to five years after SR. The results of 171 treated adult transsexuals showed improvement in many areas of functioning after SR. The main symptom for which the patients had...

  12. It is as it does: genital form and function in sex reassignment surgery.

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    Plemons, Eric D

    2014-03-01

    Surgeons who perform sex reassignment surgeries (SRS) define their goals and evaluate their outcomes in terms of two kinds of results: aesthetic and functional. Since the neogenitals fashioned through sex reassignment surgeries do not enable reproductive function, surgeons must determine what the function of the genitals is or ought to be. A review of surgical literature demonstrates that questions of what constitute genital form and function, while putatively answered in the operating room, are not answerable in the discourses of clinical evaluation used to define them. When the genitals--the word itself derived from the Latin genitas meaning to beget--are not reproductive, the question of their function shifts away from the biological and into other registers: pleasure, intimacy, sociality. As condensed sites of meaning and meaning-making around which selves, affects, resources, anxieties and futures are organized, the genitals signify in excess of the categories of "aesthetic" and "function" that surgeons use to assess them. Not reducible to either aesthetics or function, but constitutive of them both, this excess appears in surgical texts in the form of imagined futures of social and sexual engagement and demonstrates a powerful means by which properly sexed bodies are created.

  13. Gender reassignment surgery - a 13 year review of surgical outcomes

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    R. Rossi Neto

    2012-02-01

    Full Text Available PURPOSE: The aim of this study is to thoroughly report on surgical outcomes from 332 patients who underwent male to female gender reassignment surgery (GRS. MATERIAL AND METHODS: Records from 332 patients who underwent GRS from 1995 to 2008 were reviewed. All patients were submitted to penile inversion vaginoplasty with glans-derived sensate clitoroplasty. Mean age was 36.7 years (range 19-68 years. Surgical complications were stratified in 6 main groups: genital region, urinary tract, gastrointestinal events, wound healing disorders and unspecific events. RESULTS: Progressive obstructive voiding disorder due to meatal stenosis was the main complication observed in 40% of the patients, feasibly corrected during the second setting. Stricture recurrence was found in 15%. Stricture of vaginal introitus was observed in 15% of the cases followed by 12% and 8% of vaginal stenosis and lost of vaginal depth, respectively. Rectal injury was seen in 3% and minor wound healing disorders in 33% of the subjects. CONCLUSION: Regarding male to female GRS, a review of the current literature demonstrated scarce description of complications and their treatment options. These findings motivated a review of our surgical outcomes. Results showed a great number of adverse events, although functionality preserved. Comparision of our outcomes with recent publications additionally showed that treatment options provide satisfying results. Moreover, outcomes reaffirm penile inversion vaginoplasty in combination with glans-derived sensate clitoroplasty as a safe technique. Nevertheless, discussing and improving surgical techniques in order to reduce complications and their influence on patient's quality of life is still strongly necessary and theme of our future reports.

  14. Sex reassignment: outcomes and predictors of treatment for adolescent and adult transsexuals

    OpenAIRE

    Smith, Y. L. S.; Van Goozen, Stephanie Helena Maria; Kuiper, A. J.; Cohen-Kettenis, P. T.

    2005-01-01

    Background. We prospectively studied outcomes of sex reassignment, potential differences between subgroups of transsexuals, and predictors of treatment course and outcome.\\ud \\ud Method. Altogether 325 consecutive adolescent and adult applicants for sex reassignment participated: 222 started hormone treatment, 103 did not; 188 completed and 34 dropped out of treatment. Only data of the 162 adults were used to evaluate treatment. Results between subgroups were compared to determine post-operat...

  15. Quality of Life and Patient Satisfaction Following Male-to-Female Sex Reassignment Surgery.

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    Papadopulos, Nikolaos A; Lellé, Jean-Daniel; Zavlin, Dmitry; Herschbach, Peter; Henrich, Gerhard; Kovacs, Laszlo; Ehrenberger, Benjamin; Kluger, Anna-Katharina; Machens, Hans-Guenther; Schaff, Juergen

    2017-05-01

    Surveys on quality of life (QOL) of male-to-female (MTF) transsexuals have found low QOL scores before and increased satisfaction scores after sex-reassignment surgery (SRS). To our knowledge, many of them lack standardized questionnaires and comparisons with normative data to evaluate different vaginoplasty techniques. To analyze patient satisfaction and QOL after SRS. Forty-seven patients participated in this study. All patients had surgery with our self-developed combined technique on average 19 months before the survey. They completed a self-developed indication-specific questionnaire concerning demographic and socioeconomic issues and postoperative satisfaction. Furthermore, a standardized self-assessment questionnaire on satisfaction and QOL (Fragen zur Lebenszufriedenheit Module [FLZ M ]; Questions on Life Satisfaction Modules ) was used. The FLZ M consists of three modules (general life satisfaction, satisfaction with health, and satisfaction with body image) with scores of weighted satisfaction for each item. Results of the general and health modules were compared with normative data. Demographics, QOL, general life satisfaction, satisfaction with health, and satisfaction with body image. The self-developed indication-specific questionnaire showed that 91% experienced an improvement of QOL. All patients stated they would undergo SRS again and did not regret it at all. Patients stated their femininity significantly increased. For the FLZ M , the sum score for general life satisfaction (P patient satisfaction of this complex and non-standardized surgery. This is the first description of a new surgical technique (combined technique) for MTF SRS. QOL was assessed by a large number of patients by standardized questionnaires and could be compared with normative data. Because this is a retrospective study, we can draw only careful conclusions for pre- and postoperative changes. Our self-developed combined surgical technique seemed to have a positive influence on

  16. Controversies of Sex Re-assignment in Genetic Males with Congenital Inadequacy of the Penis.

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    Raveenthiran, Venkatachalam

    2017-09-01

    Sex assignment in 46XY genetic male children with congenital inadequacy of the penis (CIP) is controversial. Traditionally, children with penile length less than 2 cm at birth are considered unsuitable to be raised as males. They are typically re-assigned to female-sex and feminizing genitoplasty is usually done in infancy. However, the concept of cerebral androgen imprinting has caused paradigm shift in the philosophy of sex re-assignment. Masculinization of the brain, rather than length of the penis, is the modern criterion of sex re-assignment in CIP. This review summarizes the current understanding of the complex issue. In 46XY children with CIP, male-sex assignment appears appropriate in non-hormonal conditions such as idiopathic micropenis, aphallia and exstrophy. Female-sex re-assignment appears acceptable in complete androgen insensitivity (CAIS), while partial androgen insensitivity syndrome (PAIS) patients are highly dissatisfied with the assignment of either sex. Children with 5-alpha reductase deficiency are likely to have spontaneous penile lengthening at puberty. Hence, they are better raised as males. Although female assignment is common in pure gonadal dysgenesis, long-term results are not known to justify the decision.

  17. Long-Term Follow-Up of Individuals Undergoing Sex-Reassignment Surgery: Somatic Morbidity and Cause of Death.

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    Simonsen, Rikke Kildevæld; Hald, Gert Martin; Kristensen, Ellids; Giraldi, Annamaria

    2016-03-01

    Studies of mortality and somatic well-being after sex-reassignment surgery (SRS) of transsexual individuals are equivocal. Accordingly, the present study investigated mortality and somatic morbidity using a sample of transsexual individuals who comprised 98% (n = 104) of all surgically reassigned transsexual individuals in Denmark. To investigate somatic morbidity before and after SRS and cause of death and its relation to somatic morbidity after SRS in Danish individuals who underwent SRS from 1978 through 2010. Somatic morbidity and mortality in 104 sex-reassigned individuals were identified retrospectively by data from the Danish National Health Register and the Cause of Death Register. Somatic morbidity and cause of death. Overall, 19.2% of the sample were registered with somatic morbidity before SRS and 23.1% after SRS (P = not significant). In total, 8.6% had somatic morbidity before and after SRS. The most common diagnostic category was cardiovascular disease, affecting 18 individuals, 9 before and 14 after SRS, and 5 of those 14 who were affected after SRS had cardiovascular disease before and after SRS. Ten individuals died after SRS at an average age of 53.5 ± 7.9 years (male to female) and 53.5 ± 7.3 years (female to male). Of 98% of all Danish transsexuals who officially underwent SRS from 1978 through 2010, one in three had somatic morbidity and approximately 1 in 10 had died. No significant differences in somatic morbidity or mortality were found between male-to-female and female-to-male individuals. Despite the young average age at death and the relatively larger number of individuals with somatic morbidity, the present study design does not allow for determination of casual relations between, for example, specific types of hormonal or surgical treatment received and somatic morbidity and mortality. Copyright © 2016. Published by Elsevier Inc.

  18. Sex reassignment technology: the dilemma of transsexuals in Islam and Christianity.

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    Ishak, Mohd Shuhaimi Bin Haji; Haneef, Sayed Sikandar Shah

    2014-04-01

    The birth of people with confused or ambiguous sex makeup as a biological fact since the annals of history has posed the challenge of accommodating them within the binary gender of sociocultural systems. In this process, the role of religion as a defining factor in social engineering has been paramount. Major religions, such as Islam and Christianity, have addressed this issue within the frame of their God-ordained laws by devising a set of moral and legal imperatives specific to the "third gender." Modern developments in medicine and biology, however, have made sex reassignment possible for this category of people, today called transsexuals. The question is: How do Islam and Christianity respond to it. After presenting an analytical view of both Muslim scholars and Christian religious authorities on the legitimacy of sex reassignment for transsexuals, this paper attempts to explore if such a dilemma can be resolved.

  19. WHOQOL-100 Before and After Sex Reassignment Surgery in Brazilian Male-to-Female Transsexual Individuals.

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    Cardoso da Silva, Dhiordan; Schwarz, Karine; Fontanari, Anna Martha Vaitses; Costa, Angelo Brandelli; Massuda, Raffael; Henriques, Alexandre Annes; Salvador, Jaqueline; Silveira, Esalba; Elias Rosito, Tiago; Lobato, Maria Inês Rodrigues

    2016-06-01

    The 100-item World Health Organization Quality of Life Assessment (WHOQOL-100) evaluates quality of life as a subjective and multidimensional construct. Currently, particularly in Brazil, there are controversies concerning quality of life after sex reassignment surgery (SRS). To assess the impact of surgical interventions on quality of life of 47 Brazilian male-to-female transsexual individuals using the WHOQOL-100. This was a prospective cohort study using the WHOQOL-100 and sociodemographic questions for individuals diagnosed with gender identity disorder according to criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The protocol was used when a transsexual person entered the ambulatory clinic and at least 12 months after SRS. Initially, improvement or worsening of quality of life was assessed using 6 domains and 24 facets. Subsequently, quality of life was assessed for individuals who underwent new surgical interventions and those who did not undergo these procedures 1 year after SRS. The participants showed significant improvement after SRS in domains II (psychological) and IV (social relationships) of the WHOQOL-100. In contrast, domains I (physical health) and III (level of independence) were significantly worse after SRS. Individuals who underwent additional surgery had a decrease in quality of life reflected in domains II and IV. During statistical analysis, all results were controlled for variations in demographic characteristics, without significant results. The WHOQOL-100 is an important instrument to evaluate the quality of life of male-to-female transsexuals during different stages of treatment. SRS promotes the improvement of psychological aspects and social relationships. However, even 1 year after SRS, male-to-female transsexuals continue to report problems in physical health and difficulty in recovering their independence. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc

  20. Status of sex reassignment surgery for gender identity disorder in Japan.

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    Masumori, Naoya

    2012-05-01

    An incongruence between one's physiological sex and the gender identity that is one's basic sense of self as a man or a woman is known as gender identity disorder. In general, the conditions of physiological men having female gender identity and physiological women having male gender identity are called male-to-female and female-to-male gender identity disorder, respectively. Although the precise pathogenesis of gender identity disorder remains unclear, the prevalence of gender identity disorder is quite high, with the rates calculated for male-to-female to be 1:25,000 and female-to-male to be 1:12,000 in Hokkaido, Japan. The diagnosis and treatment of gender identity disorder in Japan are based on the Diagnostic and Therapeutic Guidelines for Patients with Gender Identity Disorder, 4th edition. Although gender identity disorder was previously thought to be a psychiatric condition, it is extremely difficult to assign gender identity to physiological sex by psychiatric and psychological treatments. To adapt the figure of the body to the native gender identity, physical treatments such as administration of cross-sex steroids and sex reassignment surgery are considered. However, there are very few institutions that routinely carry out sex reassignment surgery in Japan, even though it is mandatory for changing sex on the census register at the present time. Sex reassignment surgery for male-to-female and female-to-male patients includes orchiectomy, penectomy, clitoroplasty, vaginoplasty and vulvoplasty, and hysterectomy, ovariectomy, metoidioplasty and phalloplasty, respectively. To provide accurate information about physical treatment for patients with gender identity disorder, even urologists who are not actively involved in the diagnosis and treatment of gender identity disorder should understand the fundamental aspects and contemporary problems of gender identity disorder. © 2012 The Japanese Urological Association.

  1. Reversal Surgery in Regretful Male-to-Female Transsexuals After Sex Reassignment Surgery.

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    Djordjevic, Miroslav L; Bizic, Marta R; Duisin, Dragana; Bouman, Mark-Bram; Buncamper, Marlon

    2016-06-01

    Sex reassignment surgery (SRS) has proved an effective intervention for patients with gender identity disorder. However, misdiagnosed patients sometimes regret their decision and request reversal surgery. This review is based on our experience with seven patients who regretted their decision to undergo male-to-female SRS. To analyze retrospectively seven patients who underwent reversal surgery after regretting their decision to undergo male-to-female SRS elsewhere. From November 2010 through November 2014, seven men 33 to 53 years old with previous male-to-female SRS underwent reversal phalloplasty. Preoperatively, they were examined by three independent psychiatrists. Surgery included three steps: removal of female genitalia with scrotoplasty and urethral lengthening, total phalloplasty with microvascular transfer of a musculocutaneous latissimus dorsi flap, and neophallus urethroplasty with penile prosthesis implantation. Self-reported esthetic and psychosexual status after reversion surgery and International Index of Erectile Function scores for sexual health after phalloplasty and penile prosthesis implantation. Follow-up was 13 to 61 months (mean = 31 months). Good postoperative results were achieved in all patients. In four patients, all surgical steps were completed; two patients are currently waiting for penile implants; and one patient decided against the penile prosthesis. Complications were related to urethral lengthening: two fistulas and one stricture were observed. All complications were repaired by minor revision. According to patients' self-reports, all patients were pleased with the esthetic appearance of their genitalia and with their significantly improved psychological status. Reversal surgery in regretful male-to-female transsexuals after SRS represents a complex, multistage procedure with satisfactory outcomes. Further insight into the characteristics of persons who regret their decision postoperatively would facilitate better future

  2. Quality of life and sexual health after sex reassignment surgery in transsexual men.

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    Wierckx, Katrien; Van Caenegem, Eva; Elaut, Els; Dedecker, David; Van de Peer, Fleur; Toye, Kaatje; Weyers, Steven; Hoebeke, Piet; Monstrey, Stan; De Cuypere, Griet; T'Sjoen, Guy

    2011-12-01

    Although sexual health after genital surgery is an important outcome factor for many transsexual persons, little attention has been attributed to this subject. To provide data on quality of life and sexual health after sex reassignment surgery (SRS) in transsexual men. A single-center, cross-sectional study in 49 transsexual men (mean age 37 years) after long-term testosterone therapy and on average 8 years after SRS. Ninety-four percent of the participants had phalloplasty. Self-reported physical and mental health using the Dutch version of the Short Form-36 Health Survey; sexual functioning before and after SRS using a newly constructed specific questionnaire. Compared with a Dutch reference population of community-dwelling men, transsexual men scored well on self-perceived physical and mental health. The majority reported having been sexually active before hormone treatment, with more than a quarter having been vaginally penetrated frequently before starting hormone therapy. There was a tendency toward less vaginal involvement during hormone therapy and before SRS. Most participants reported an increase in frequency of masturbation, sexual arousal, and ability to achieve orgasm after testosterone treatment and SRS. Almost all participants were able to achieve orgasm during masturbation and sexual intercourse, and the majority reported a change in orgasmic feelings toward a more powerful and shorter orgasm. Surgical satisfaction was high, despite a relatively high complication rate. Results of the current study indicate transsexual men generally have a good quality of life and experience satisfactory sexual function after SRS. © 2011 International Society for Sexual Medicine.

  3. The Role of Clitoral Anatomy in Female to Male Sex Reassignment Surgery

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    Vojkan Vukadinovic

    2014-01-01

    Full Text Available Introduction. Controversies on clitoral anatomy and its role in female sexual function still make clitoral reconstructive surgery very challenging. We evaluated the role of clitoral anatomic features in female to male sex reassignment surgery. Material and Methods. The study included 97 female transsexuals, aged from 18 to 41 years, who underwent single stage metoidioplasty between March 2008 and January 2013. The operative technique involved vaginectomy, the release of clitoral ligaments and urethral plate, urethroplasty by combining buccal mucosa graft and genital flaps, and scrotoplasty with insertion of testicle prostheses. Postoperative questionnaire was used to evaluate aesthetic, functional, and sexual outcome. Results. The mean followup was 30 months. The mean length of the neophallus was 7 cm, compared to mean preoperative length of the hypertrophied clitoris of 3.3 cm. Complications occurred in 27.84% of all patients, related mostly to urethroplasty. Voiding while standing was achieved in all cases. None of the patients had problems in sexual arousal, masturbation, or orgasms. Conclusion. Accurate knowledge of the clitoral anatomy, physiology, and neurovascular supply is crucial for a successful outcome of female to male sex reassignment surgery. Our approach appears to ensure overall satisfaction and high quality of sexual life.

  4. Serum concentrations of brain-derived neurotrophic factor in patients diagnosed with gender dysphoria undergoing sex reassignment surgery

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    Maiko A. Schneider

    Full Text Available Abstract Introduction: Transsexualism (ICD-10 is a condition characterized by a strong and persistent dissociation with one's assigned gender. Sex reassignment surgery (SRS and hormone therapy provide a means of allowing transsexual individuals to feel more congruent with their gender and have played a major role in treatment over the past 70 years. Brain-derived neurotrophic factor (BDNF appears to play a key role in recovery from acute surgical trauma and environmentally mediated vulnerability to psychopathology. We hypothesize that BDNF may be a biomarker of alleviation of gender incongruence suffering. Objectives: To measure preoperative and postoperative serum BDNF levels in transsexual individuals as a biomarker of alleviation of stress related to gender incongruence after SRS. Methods: Thirty-two male-to-female transsexual people who underwent both surgery and hormonal treatment were selected from our initial sample. BDNF serum levels were assessed before and after SRS with sandwich enzyme linked immunosorbent assay (ELISA. The time elapsed between the pre-SRS and post-SRS blood collections was also measured. Results: No significant difference was found in pre-SRS or post-SRS BDNF levels or with relation to the time elapsed after SRS when BDNF levels were measured. Conclusion: Alleviation of the suffering related to gender incongruence after SRS cannot be assessed by BDNF alone. Surgical solutions may not provide a quick fix for psychological distress associated with transsexualism and SRS may serve as one step toward, rather than as the conclusion of, construction of a person's gender identity.

  5. The subjective cut: sex reassignment surgery in 1960s and 1970s science fiction.

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    Sellberg, Karin

    2016-12-01

    This article considers the way in which ethical concerns about sex reassignment surgery and especially the research and clinical practice of the sexologist Dr John Money (1921-2006) is being negotiated in the 1960s and 1970s novels Myra Breckinridge and Myron by Gore Vidal and The Passion of New Eve by Angela Carter. Drawing on the theories of gender and embodiment developed by Money, the article reads the novels as a critical response and discursive interaction with emergent sexological concepts. 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/.

  6. Long-term follow-up of individuals undergoing sex reassignment surgery: Psychiatric morbidity and mortality

    DEFF Research Database (Denmark)

    Simonsen, Rikke Kildevæld; Giraldi, Annamaria; Kristensen, Ellids

    2016-01-01

    the period of 1978–2010. Method: Psychiatric morbidity and mortality were identified by data from the Danish Psychiatric Central Research Register and the Cause of Death Register through a retrospective register study of 104 sex-reassigned individuals. Results: Overall, 27.9% of the sample were registered...... as deceased post-SRS with an average age of death of 53.5 years. Conclusions: No significant difference in psychiatric morbidity or mortality was found between male to female and female to male (FtM) save for the total number of psychiatric diagnoses where FtM held a significantly higher number of psychiatric...... diagnoses overall. Despite the over-representation of psychiatric diagnoses both pre- and post-SRS the study found that only a relatively limited number of individuals had received diagnoses both prior to and after SRS. This suggests that generally SRS may reduce psychological morbidity for some individuals...

  7. Gender identification and sex reassignment surgery in the trans population: a survey study in France.

    Science.gov (United States)

    Giami, Alain; Beaubatie, Emmanuelle

    2014-11-01

    Drawing from controversies between medical, legal, and associative actors about the obligation of sex reassignment surgeries (SRS) for people who intend to change their civil status, this article discusses the role that medical procedures, and particularly SRS, play in contemporary gender identifications and transition pathways in France. In 2010, the French National Institute of Health and Medical Research conducted a national survey in order to study the sociodemographic characteristics, access to medical, and psychological care, and state of health among trans individuals. After a long period of ethnographic work during which a partnership was established with trans actors to map the social, medical, and political landscape of trans communities, a questionnaire was developed and distributed between July and October 2010 in collaboration with most of the trans organizations and public and private health professionals operating in France. Overall, 381 self-identified trans individuals returned the anonymous self-administered questionnaire. The results highlighted the heterogeneity of the trans population, whose definition cannot be reduced to a group of individuals undergoing standardized hormonal treatments and SRS. Two central indicators, sex assigned at birth and gender self-identification, enabled us to describe and analyze different medical and legal pathways with a particular focus on SRS, which is often compulsory for a change of civil status in France. Although SRS remains an important factor in an individual's subjective evaluation of the success of the transition pathway, its practice varies depending on one's sex assigned at birth and gender identification.

  8. Psychosocial Adjustment to Sex Reassignment Surgery: A Qualitative Examination and Personal Experiences of Six Transsexual Persons in Croatia

    Science.gov (United States)

    Jokić-Begić, Nataša; Jurin, Tanja

    2014-01-01

    In Croatia, transgender individuals face numerous social and medical obstacles throughout the process of transition. The aim of this study was to depict the factors contributing to the psychosocial adjustment of six transsexual individuals living in Croatia following sex reassignment surgery (SRS). A combination of quantitative and qualitative self-report methods was used. Due to the specificity of the sample, the data were collected online. Standardized questionnaires were used to assess mental health and quality of life alongside a series of open-ended questions divided into 4 themes: the decision-making process regarding SRS; social and medical support during the SRS process; experience of discrimination and stigmatizing behaviors; psychosocial adjustment after SRS. Despite the unfavorable circumstances in Croatian society, participants demonstrated stable mental, social, and professional functioning, as well as a relative resilience to minority stress. Results also reveal the role of pretransition factors such as high socioeconomic status, good premorbid functioning, and high motivation for SRS in successful psychosocial adjustment. During and after transition, participants reported experiencing good social support and satisfaction with the surgical treatment and outcomes. Any difficulties reported by participants are related to either sexual relationships or internalized transphobia. The results also demonstrate the potentially protective role that a lengthier process of transition plays in countries such as Croatia. PMID:24790589

  9. Psychosocial Adjustment to Sex Reassignment Surgery: A Qualitative Examination and Personal Experiences of Six Transsexual Persons in Croatia

    Directory of Open Access Journals (Sweden)

    Nataša Jokić-Begić

    2014-01-01

    Full Text Available In Croatia, transgender individuals face numerous social and medical obstacles throughout the process of transition. The aim of this study was to depict the factors contributing to the psychosocial adjustment of six transsexual individuals living in Croatia following sex reassignment surgery (SRS. A combination of quantitative and qualitative self-report methods was used. Due to the specificity of the sample, the data were collected online. Standardized questionnaires were used to assess mental health and quality of life alongside a series of open-ended questions divided into 4 themes: the decision-making process regarding SRS; social and medical support during the SRS process; experience of discrimination and stigmatizing behaviors; psychosocial adjustment after SRS. Despite the unfavorable circumstances in Croatian society, participants demonstrated stable mental, social, and professional functioning, as well as a relative resilience to minority stress. Results also reveal the role of pretransition factors such as high socioeconomic status, good premorbid functioning, and high motivation for SRS in successful psychosocial adjustment. During and after transition, participants reported experiencing good social support and satisfaction with the surgical treatment and outcomes. Any difficulties reported by participants are related to either sexual relationships or internalized transphobia. The results also demonstrate the potentially protective role that a lengthier process of transition plays in countries such as Croatia.

  10. Male Prison Inmates With Gender Dysphoria: When Is Sex Reassignment Surgery Appropriate?

    Science.gov (United States)

    Osborne, Cynthia S; Lawrence, Anne A

    2016-10-01

    Gender dysphoria (GD), a feeling of persistent discomfort with one's biologic sex or assigned gender, is estimated to be more prevalent in male prison inmates than in nonincarcerated males; there may be 3000-4000 male inmates with GD in prisons in the United States. An increasing number of U.S. prison systems now offer gender dysphoric inmates diagnostic evaluation, psychotherapy, cross-sex hormone therapy, and opportunities, albeit limited, to enact their preferred gender role. Sex reassignment surgery (SRS), however, has not been offered to inmates except in response to litigation. In the first case of its kind, the California Department of Corrections and Rehabilitation recently agreed to provide SRS to an inmate and developed policy guidelines for its future provision. In other recent cases, U.S. courts have ruled that male inmates with GD are entitled to SRS when it is medically necessary. Although these decisions may facilitate the provision of SRS to inmates in the future, many U.S. prison systems will probably remain reluctant to offer SRS unless legally compelled to do so. In this review, we address the medical necessity of SRS for male inmates with GD. We also discuss eligibility criteria and the practical considerations involved in providing SRS to inmates. We conclude by offering recommendations for physicians, mental health professionals, and prison administrators, designed to facilitate provision of SRS to inmates with GD in a manner that provides humane treatment, maximizes the likelihood of successful outcomes, minimizes risk of regret, and generates data that can help inform future decisions.

  11. SEX REASSIGNMENT SURGERY WITH LAPAROSCOPIC SIGMOID COLON VAGINOPLASTY IN A MALE TO FEMALE TRANSSEXUAL: A CASE REPORT.

    Science.gov (United States)

    Ichihara, Koji; Masumori, Naoya

    2016-01-01

    We herein report and discuss our first experience about a sex reassignment surgery (SRS) with laparoscopic sigmoid colon vaginoplasty for a 40s male to female gender identity disorder. SRS for this subject included bilateral orchiectomy, penectomy, clitoroplasty, vaginoplasty, and vulvoplasty. About 20 cm of the sigmoid colon was harvested laparoscopicaly for the neovagina. Total operating time was about 9 hours, and the estimated blood loss was 900 ml without transfusion. There was no trouble during the postoperative course, and a sufficient length of vagina has been maintained.

  12. Experiences of Discrimination, Harassment, and Violence in a Sample of Italian Transsexuals Who Have Undergone Sex-Reassignment Surgery.

    Science.gov (United States)

    Prunas, Antonio; Bandini, Elisa; Fisher, Alessandra D; Maggi, Mario; Pace, Valeria; Quagliarella, Luca; Todarello, Orlando; Bini, Maurizio

    2018-07-01

    The present study aims to provide an overview of experiences of discrimination, harassment, and violence in a sample of Italian transsexuals who have undergone sex-reassignment surgery (SRS). Lack of support for gender transition from family members was also assessed, before and after SRS. Data were collected in the context of a multicentric study (Milan, Florence, and Bari) on SRS outcome. Patients who underwent SRS were contacted and asked to fill out a questionnaire concerning experiences of discrimination, harassment, violence, and crime they might have experienced in previous years. Seventy-two participants took part in the research: 46 were male-to-female (MtF; 64%) and 26 were female-to-male (FtM; 36%). Thirty-six percent of the total sample (with no differences between MtF and FtM) experienced at least one episode of harassment, violence, or discrimination. The workplace was reported to be the social area with the highest risk of discrimination and harassment (22% of participants). Reports of more than one incident of discrimination, harassment, and violence characterized the majority of participants in the MtF sample. Compared with previous studies carried out in other countries, a much larger proportion of participants could count on a supportive family environment before and after transition. Our results show that Italian society at large is prejudiced against transsexuals, but at a more "micro" level, having a trans person as a family member might result in a protective and tolerant attitude.

  13. Transgender women and the Gender Reassignment Process: subjection experiences, suffering and pleasure in body adaptation

    Directory of Open Access Journals (Sweden)

    Analídia Rodolpho Petry

    Full Text Available OBJECTIVE: This article seeks to understand the experiences of transgender women in relation to the hormone therapy and sex reassignment surgery that make up the Gender Reassignment Process. METHOD: It is a qualitative study inserted into the field of cultural and gender studies. Data collection used narrative interviews, conducted in 2010 and 2011, with seven transsexual women who had been undergoing the Gender Reassignment Process for at least two years. The data was submitted to a thematic analysis. RESULTS: The results show that the transformation processes for construction of the female body include behavior adaptation, posture modification, voice modulation, hormone use, vaginal canal dilation and surgical complications. Such processes subject the body to be built as idealized to fit the gender identity, infringing on pleasures and afflictions. CONCLUSION: We concluded that the discussion involving the Gender Reassignment Process brings allowances for nursing regarding body changes experienced by transgender women.

  14. Experiment of nurture: ablatio penis at 2 months, sex reassignment at 7 months, and a psychosexual follow-up in young adulthood.

    Science.gov (United States)

    Bradley, S J; Oliver, G D; Chernick, A B; Zucker, K J

    1998-07-01

    Guidelines of psychosexual management for infants born with physical intersex conditions are intended to assist physicians and parents in making decisions about sex of assignment and rearing including the following: 1) sex assignment should be to the gender that carries the best prognosis for good reproductive function, good sexual function, normal-looking external genitalia and physical appearance, and a stable gender identity; 2) the decision regarding sex assignment should be made as early as possible, preferably during the newborn period, with an upper age limit for reversal of an initial sex assignment no later than 18 to 24 months; and 3) there should be minimal uncertainty and ambiguity on the part of parents and professionals regarding the final decision about sex assignment and rearing. J. Money used these guidelines in a case of a biologically normal male infant (one of a pair of monozygotic twins) whose penis was accidentally ablated during a circumcision at the age of 7 months. The decision to reassign the infant boy to the female sex and to rear him as a girl was made at 17 months, with surgical castration and initial genital reconstruction occurring at 21 months. Money reported follow-up data on this child through the age of 9 years. Although the girl was described as having many "tomboyish" behavioral traits, a female gender identity had apparently differentiated. Thus, it was concluded that gender identity is sufficiently incompletely differentiated at birth as to permit successful assignment of a genetic male as a girl, in keeping with the experiences of rearing. Subsequent follow-up by other investigators reported that by early adolescence the patient had rejected the female identity and began to live as a male at the age of 14 years. In adulthood, the patient recalled that he had never felt comfortable as a girl, and his mother reported similar recollections. At age 25, the patient married a woman and adopted her children. The patient reported

  15. Gender reassignment surgery: an overview.

    Science.gov (United States)

    Selvaggi, Gennaro; Bellringer, James

    2011-05-01

    Gender reassignment (which includes psychotherapy, hormonal therapy and surgery) has been demonstrated as the most effective treatment for patients affected by gender dysphoria (or gender identity disorder), in which patients do not recognize their gender (sexual identity) as matching their genetic and sexual characteristics. Gender reassignment surgery is a series of complex surgical procedures (genital and nongenital) performed for the treatment of gender dysphoria. Genital procedures performed for gender dysphoria, such as vaginoplasty, clitorolabioplasty, penectomy and orchidectomy in male-to-female transsexuals, and penile and scrotal reconstruction in female-to-male transsexuals, are the core procedures in gender reassignment surgery. Nongenital procedures, such as breast enlargement, mastectomy, facial feminization surgery, voice surgery, and other masculinization and feminization procedures complete the surgical treatment available. The World Professional Association for Transgender Health currently publishes and reviews guidelines and standards of care for patients affected by gender dysphoria, such as eligibility criteria for surgery. This article presents an overview of the genital and nongenital procedures available for both male-to-female and female-to-male gender reassignment.

  16. Gender identity, gender assignment and reassignment in individuals with disorders of sex development: a major of dilemma.

    Science.gov (United States)

    Fisher, A D; Ristori, J; Fanni, E; Castellini, G; Forti, G; Maggi, M

    2016-11-01

    Disorders of Sex Development (DSD) are a wide range of congenital conditions characterized by an incongruence of components involved in sexual differentiation, including gender psychosexual development. The management of such disorders is complex, and one of the most crucial decision is represented by gender assignment. In fact, the primary goal in DSD is to have a gender assignment consistent with the underlying gender identity in order to prevent the distress related to a forthcoming Gender Dysphoria. Historically, gender assignment was based essentially on surgical outcomes, assuming the neutrality of gender identity at birth. This policy has been challenged in the past decade refocusing on the importance of prenatal and postnatal hormonal and genetic influences on psychosexual development. (1) to update the main psychological and medical issues that surround DSD, in particular regarding gender identity and gender assignment; (2) to report specific clinical recommendations according to the different diagnosis. A systematic search of published evidence was performed using Medline (from 1972 to March 2016). Review of the relevant literature and recommendations was based on authors' expertise. A review of gender identity and assignment in DSD is provided as well as clinical recommendations for the management of individuals with DSD. Given the complexity of this management, DSD individuals and their families need to be supported by a specialized multidisciplinary team, which has been universally recognized as the best practice for intersexual conditions. In case of juvenile GD in DSD, the prescription of gonadotropin-releasing hormone analogues, following the World Professional Association for Transgender Health and the Endocrine Society guidelines, should be considered. It should always be taken into account that every DSD person is unique and has to be treated with individualized care. In this perspective, international registries are crucial to improve the

  17. Long-Term Follow-Up of Individuals Undergoing Sex-Reassignment Surgery: Somatic Morbidity and Cause of Death

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    Rikke Kildevæld Simonsen, MA

    2016-03-01

    Conclusion: Of 98% of all Danish transsexuals who officially underwent SRS from 1978 through 2010, one in three had somatic morbidity and approximately 1 in 10 had died. No significant differences in somatic morbidity or mortality were found between male-to-female and female-to-male individuals. Despite the young average age at death and the relatively larger number of individuals with somatic morbidity, the present study design does not allow for determination of casual relations between, for example, specific types of hormonal or surgical treatment received and somatic morbidity and mortality.

  18. Prevalence of Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Infections Among Transgender Persons Referred to an Italian Center for Total Sex Reassignment Surgery.

    Science.gov (United States)

    Luzzati, Roberto; Zatta, Marta; Pavan, Nicola; Serafin, Maurizia; Maurel, Cristina; Trombetta, Carlo; Barbone, Fabio

    2016-07-01

    The burden of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections in transgender population is an underestimated issue. We performed a study to evaluate the prevalence of such infections in transgender persons addressed our center for total sex reassignment surgery (SRS). All transgender persons undergoing SRS from 2000 to 2014 were evaluated retrospectively. Participant characteristics and results of HIV, HBV, and HCV testing were collected. Exact Fisher test, Cochran-Armitage tests for trend and correct prevalence ratios were estimated. Among 498 transgender persons, 243 had confirmed serological data. Of them, 25 were female-to-male and 218 male-to-female (MtF) subjects. The prevalence of HIV, HBV and HCV infections was 0%, 4.0%, and 8.0% in female-to-male, and 12.1%, 4.6%, and 3.7% in MtF. Among MtF, younger age and earlier year of SRS were associated with lower HIV prevalence. From the multivariate model, the mutually adjustment prevalence ratios were 1.9 (95% confidence interval [95% CI], 1.2-3.1) for SRS in 2005-2010 and 3.6 (95% CI, 1.3-9.4) in 2010-2014, as compared with SRS in 2000-2004; and 4.7 (95% CI, 2.4-9.4) for South Americans as compared with others. Among the HCV-positive MtF, 57.1% were also HIV-positive. Regarding HBV, the immunity was 38.5% and, after mutual adjustment, the prevalence ratios were 2.1 (95% CI, 1.3-3.4) for South Americans versus others and 2.2 (95% CI, 1.6-3.1) for year of birth ≥ 1980. The prevalence of HBV and HCV infections among our transgender persons overlaps that reported in the general population, but HCV prevalence was much higher in HIV-infected MtF. The high burden of HIV infection among MtF and its recent incremented prevalence points out that social and medical support should be strongly promoted in such population.

  19. Gender identity disorder: general overview and surgical treatment for vaginoplasty in male-to-female transsexuals.

    Science.gov (United States)

    Selvaggi, Gennaro; Ceulemans, Peter; De Cuypere, Griet; VanLanduyt, Koen; Blondeel, Phillip; Hamdi, Moustapha; Bowman, Cameron; Monstrey, Stan

    2005-11-01

    After studying this article, the participant should be able to discuss: 1. The terminology related to male-to-female gender dysphoria. 2. The different theories regarding cause, epidemiology, and treatment of gender dysphoria. 3. The surgical goals of sex reassignment surgery in male-to-female transsexualism. 4. The surgical techniques available for sex reassignment surgery in male-to-female transsexualism. Gender identity disorder (previously "transsexualism") is the term used for individuals who show a strong and persistent cross-gender identification and a persistent discomfort with their anatomical sex, as manifested by a preoccupation with getting rid of one's sex characteristics, or the belief of being born in the wrong sex. Since 1978, the Harry Benjamin International Gender Dysphoria Association (in honor of Dr. Harry Benjamin, one of the first physicians who made many clinicians aware of the potential benefits of sex reassignment surgery) has played a major role in the research and treatment of gender identity disorder, publishing the Standards of Care for Gender Dysphoric Persons. The authors performed an overview of the terminology related to male-to-female gender identity disorder; the different theories regarding cause, epidemiology, and treatment; the goals expected; and the surgical technique available for sex reassignment surgery in male-to-female transsexualism. Surgical techniques available for sex reassignment surgery in male-to-female transsexualism, with advantages and disadvantages offered by each technique, are reviewed. Other feminizing nongenital operative interventions are also examined. This review describes recent etiopathogenetic theories and actual guidelines on the treatment of the gender identity disorder in male-to-female transsexuals; the penile-scrotal skin flap technique is considered the state of the art for vaginoplasty in male-to-female transsexuals, whereas other techniques (rectosigmoid flap, local flaps, and isolated skin

  20. Physical (Surgical) Castration as Treatment of Male Sex Offenders?

    Czech Academy of Sciences Publication Activity Database

    Škvain, Petr

    2014-01-01

    Roč. 97, č. 1 (2014), s. 40-47 ISSN 0026-9301 Institutional support: RVO:68378122 Keywords : sex offenders * treatment of sex offenders * Czech Republic Subject RIV: AG - Legal Sciences Impact factor: 0.136, year: 2014

  1. Using the Defensive Style Questionnaire to evaluate the impact of sex reassignment surgery on defensive mechanisms in transsexual patients Aplicação do Defensive Style Questionnaire para avaliar o impacto da cirurgia de redesignação sexual nos mecanismos de defesa de pacientes transexuais

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    Maria Inês Lobato

    2009-12-01

    Full Text Available Objective: To evaluate the impact of sex reassignment surgery on the defense mechanisms of 32 transsexual patients at two different points in time using the Defensive Style Questionnaire. Method: The Defensive Style Questionnaire was applied to 32 patients upon their admission to the Gender Identity Disorder Program, and 12 months after they had undergone sex reassignment surgery. Results: There were changes in two defense mechanisms: anticipation and idealization. However, no significant differences were observed in terms of the mature, neurotic and immature categories. Discussion: One possible explanation for this result is the fact that the procedure does not resolve gender dysphoria, which is a core symptom in such patients. Another aspect is related to the early onset of the gender identity disorder, which determines a more regressive defensive structure in these patients. Conclusion: Sex reassignment surgery did not improve the defensive profile as measured by the Defensive Style Questionnaire.Objetivo: Avaliar o efeito da cirurgia de redesignação sexual nos mecanismos de defesa de 32 pacientes transexuais em dois momentos do estudo usando o Defensive Style Questionnaire. Método: O Defensive Style Questionnaire foi aplicado a 32 pacientes quando ingressaram no Programa de Transtorno de Identidade de Gênero e 12 meses após a cirurgia de redesignação sexual. Resultados: Houve modificações em dois mecanismos de defesa: antecipação e idealização; porém, sem mudanças significativas nos fatores maduro, neurótico e imaturo. Discussão: Uma possibilidade para esse resultado é o fato de a intervenção cirúrgica não resolver a disforia de gênero (principal sintoma desses pacientes. Outro aspecto está relacionado com o fato de o transtorno de identidade de gênero ser instalado precocemente, o que determina uma estrutura defensiva mais regressiva para esses pacientes. Conclusão: A cirurgia de redesignação sexual não foi

  2. Sex-related differences in patients treated surgically for aneurysmal subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Horiuchi, Tetsuyoshi; Tanaka, Yuichiro; Hongo, Kazuhiro

    2006-01-01

    Sex-related differences were examined in the clinical course of patients treated surgically for aneurysmal subarachnoid hemorrhage. Retrospective analyses were carried out to evaluate sex-related differences in aneurysm location, aneurysm size, preoperative neurological condition, preoperative computed tomography findings, and outcome among 2577 patients who underwent surgical repair of ruptured aneurysms. The internal carotid artery was most frequently affected in women and the anterior cerebral artery in men. Intracerebral or intraventricular hematoma was more common in men than in women. Some differences may be related to the location of the aneurysm. Sex-related differences were prominent in the 5th decade of life. These findings might be related to the menopause. Sex hormones may be involved in aneurysm formation. (author)

  3. The Sex Difference in Basic Surgical Skills Learning: A Comparative Study.

    Science.gov (United States)

    Lou, Zheng; Yan, Fei-Hu; Zhao, Zhi-Qing; Zhang, Wei; Shui, Xian-Qi; Liu, Jia; Zhuo, Dong-Lan; Li, Li; Yu, En-da

    2016-01-01

    Very little is known of sex-related differences among medical students in the acquisition of basic surgical skills at an undergraduate level. The aim of this study was to investigate the sex differences in basic surgical skills learning and the possible explanations for sex disparities within basic surgical skills education. A didactic description of 10 surgical skills was performed, including knot tying, basic suture I, basic suture II, sterile technique, preoperative preparation, phlebotomy, debridement, laparotomy, cecectomy, and small bowel resection with hand-sewn anastomosis. The students were rated on a 100-point scale for each basic surgical skill. Later during the same semester all the students took the final theoretical examination. A total of 342 (male = 317 and female = 25) medical students participated in a single skills laboratory as part of their third-year medical student clerkship. The mean scores for each of the 10 surgical skills were higher in female group. The difference in sterile technique, preoperative preparation, cecectomy, and small bowel resection with hand-sewn anastomosis reached the significant level. Compared with male medical students, the mean theory examination score was significantly higher in female medical students. Approximately 76% of the (19 of 25) female students expressed their interest in pursuing a surgical career, whereas only 65.5% (207 of 317) male students wanted to be surgical professionals (p = 0.381). Female medical students completed basic surgical skills training more efficiently and passed the theoretical examination with significantly higher scores than male medical students. In the future, studies should be done in other classes in our institution and perhaps other schools to see if these findings are reliable or valid or just a reflection of this 1 sample. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  4. Assessment of School Principals' Reassignment Process

    Science.gov (United States)

    Sezgin-Nartgün, Senay; Ekinci, Serkan

    2016-01-01

    This study aimed to identify administrators' views related to the assessment of school principals' reassignment in educational organizations. The study utilized qualitative research design and the study group composed of 8 school administrators selected via simple sampling who were employed in the Bolu central district in 2014-2015 academic year.…

  5. Effects of Gender Reassignment on Quality of Life and Mental Health in People with Gender Dysphoria.

    Science.gov (United States)

    Özata Yıldızhan, Berna; Yüksel, Şahika; Avayu, Mirella; Noyan, Handan; Yıldızhan, Eren

    2018-01-01

    Our purpose was to compare the life style, family and social relationships (social adaptation) and the quality of life in people with gender dysphoria with and without history of sex reassignment surgery. Twenty  individuals (SR group) who were earlier followed   in Istanbul University Psychiatry Department Psychoneurosis and Psychotherapy Unit with gender dysphoria diagnosis in  order  to  have confirmative reports for the sex reassignment (SR) surgery were interviewed at least one year after the surgery. For comparison, 50 individuals with gender dysphoria (NSR group) who had recently applied to the same unit were interviewed. Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I), Family Assessment Device (FAD), Multidimensional Scale for Perceived Social Support (MSPSS), World Health Organization Quality of Life Scale (WHOQOL-BREF) were administered. In the SR group, concerns about gender related discrimination and victimization were lower, but concerns related to the disclosure of transgender identity were higher compared to the NSR group. The SR group scored lower on FAD Affective Involvement, Problem Solving, Affective Responsiveness subscales, but scored higher on MSPSS family subscale and psychological domain of WHOQOL-BREF. The sex reassignment surgeries (SRS) required for legal change in gender status of individuals with gender dysphoria are helpful in relieving the conflicts. SRS causes improvements in the quality of life, family support, interpersonal relationships and reduces the concerns about the gender related discrimination and victimization.

  6. Effect of age, sex and level of surgical difficulty on inflammatory complications after third molar surgery.

    Science.gov (United States)

    Osunde, Otasowie D; Saheeb, Birch D

    2015-03-01

    Patients' factors such as age and sex and surgical variables such as level of difficulty have been linked with surgical outcome in third molar surgery. The aim of this study was to determine the effect of these variables on inflammatory complications in patients undergoing third molar surgery. Patients referred to our institution for surgical extraction of their impacted lower third molar between January 2007 and December 2008 were the subjects of the study. Patients' demographics as well as types of impaction, indication and level of difficulty based on Pederson criteria were obtained. Post operative pain, swelling and mouth opening limitation were evaluated at day 1, day 2, day 3, day 5 and 1 week after the surgery and analyzed. A p value of less than 0.05 was considered significant. A total of 150 patients aged 16-38 years (25.9 ± 4.47) met the inclusion criteria. Male accounted for 66 (44.0 %) while females were 84 (56.0 %), giving male to female ratio of 1:1.3. Age, sex and difficulty index had no effect on pain and trismus throughout the periods of postoperative evaluation (p > 0.05). Postoperative swelling was not affected by gender but patients above 25 years who had high scores of difficulty index had more facial swelling. The results of this study shows that age, gender and the level of surgical difficulty have no effect on pain and mouth opening limitation after third molar surgery.

  7. Results from a pediatric surgical centre justify early intervention in disorders of sex development.

    Science.gov (United States)

    Crawford, Jennifer M; Warne, Garry; Grover, Sonia; Southwell, Bridget R; Hutson, John M

    2009-02-01

    Controversy persists surrounding early management of disorders of sex development. We assessed genital appearance, gender identity, and quality of life in prepubertal children who have had early surgical intervention. Children treated for disorders of sex development who were 5 to 10 years of age were eligible (n = 54). Children were scored (modified Creighton scale) for anatomical and cosmetic outcome, and both patients and parents completed PedsQL quality-of-life and gender identity questionnaires, with ethics approval. Of 54 patients, 41 presented for review. Treatment began at 13.2 (1.8-250.1) months (median; range) and were reviewed at 7.5 +/- 2.1 (mean +/- SD) years of age. Nineteen were raised as girls and 22 as boys. Girls had good (85%) or satisfactory (15%) anatomical/cosmetic outcome, whereas 52% boys had good, 38% satisfactory, and 10% poor cosmetic outcomes. On gender identity questionnaire, boys scored 3.9 +/- 0.4 (mean +/- SD) and girls 3.6 +/- 0.5; 1 of 19 boys and 3 of 19 girls had lower scores, suggesting risk of gender identity disorder. Quality-of-life scores were 80+ for physical and 65 to 80 for psychosocial scores. Early intervention is generally associated with positive outcomes for patients and parents. Girls had better anatomical outcomes than boys, and gender dysphoria risks were low in both sexes.

  8. Impact of sex on prognostic host factors in surgical patients with lung cancer.

    Science.gov (United States)

    Wainer, Zoe; Wright, Gavin M; Gough, Karla; Daniels, Marissa G; Choong, Peter; Conron, Matthew; Russell, Prudence A; Alam, Naveed Z; Ball, David; Solomon, Benjamin

    2017-12-01

    Lung cancer has markedly poorer survival in men. Recognized important prognostic factors are divided into host, tumour and environmental factors. Traditional staging systems that use only tumour factors to predict prognosis are of limited accuracy. By examining sex-based patterns of disease-specific survival in non-small cell lung cancer patients, we determined the effect of sex on the prognostic value of additional host factors. Two cohorts of patients treated surgically with curative intent between 2000 and 2009 were utilized. The primary cohort was from Melbourne, Australia, with an independent validation set from the American Surveillance, Epidemiology and End Results (SEER) database. Univariate and multivariate analyses of validated host-related prognostic factors were performed in both cohorts to investigate the differences in survival between men and women. The Melbourne cohort had 605 patients (61% men) and SEER cohort comprised 55 681 patients (51% men). Disease-specific 5-year survival showed men had statistically significant poorer survival in both cohorts (P < 0.001); Melbourne men at 53.2% compared with women at 68.3%, and SEER 53.3% men and 62.0% women were alive at 5 years. Being male was independently prognostic for disease-specific mortality in the Melbourne cohort after adjustment for ethnicity, smoking history, performance status, age, pathological stage and histology (hazard ratio = 1.54, 95% confidence interval: 1.10-2.16, P = 0.012). Sex differences in non-small cell lung cancer are important irrespective of age, ethnicity, smoking, performance status and tumour, node and metastasis stage. Epidemiological findings such as these should be translated into research and clinical paradigms to determine the factors that influence the survival disadvantage experienced by men. © 2016 Royal Australasian College of Surgeons.

  9. [Social support in gender reassignment surgery].

    Science.gov (United States)

    Hess, J; Kurth, I; Henkel, A; Panic, L; Rübben, H; Rossi Neto, R; Hess-Busch, Y

    2017-02-01

    Gender reassignment surgery (GRS) can lead to discrimination. This transition makes great demands on the individual and also affects the social environment. To evaluate the social support of male-to-female (MtF) transgender people. Group A comprised 254 consecutive MtF transsexuals, who received a penile inversion vaginoplasty between 2004 and 2010. These women were surveyed retrospectively. Group B comprised 144 consecutive MtF transsexuals who presented for preoperative counselling. These patients were asked to answer the survey in advance of the planned GRS. The return rate was 46.9 % (A) and 95.1 % (B). In both groups, approximately two-thirds lived with their parents or children at ease. About 13.4 % (A) and 16.9 % (B) estimated the relationship towards their parents and one- seventh (A) or one-sixth (B) woman rated their relationship towards their children as poor. The acceptance of the parents regarding GRS was 65.6 % (A) and 77.1 % (B). In total 20 % (A) and 9.2 % (B) did not, however, accept GRS in their children. The acceptance of children regarding GRS was 64.9 % (A) and 71.1 % (B) with 10.8 % (A) and 6.7 % (B) who did not approve the decision. Social support is an important resource in the context of gender reassignment surgery. Understanding can help to improve the situation for transsexuals and to reduce consecutive healthcare utilisation.

  10. Stop Codon Reassignment in the Wild

    Energy Technology Data Exchange (ETDEWEB)

    Ivanova, Natalia [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Schwientek, Patrick [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Tripp, H. James [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Rinke, Christian [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Pati, Amrita [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Huntemann, Marcel [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Visel, Axel [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Woyke, Tanja [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Kyrpides, Nikos [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Rubin, Edward [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.

    2014-03-21

    Since the discovery of the genetic code and protein translation mechanisms (1), a limited number of variations of the standard assignment between unique base triplets (codons) and their encoded amino acids and translational stop signals have been found in bacteria and phages (2-3). Given the apparent ubiquity of the canonical genetic code, the design of genomically recoded organisms with non-canonical codes has been suggested as a means to prevent horizontal gene transfer between laboratory and environmental organisms (4). It is also predicted that genomically recoded organisms are immune to infection by viruses, under the assumption that phages and their hosts must share a common genetic code (5). This paradigm is supported by the observation of increased resistance of genomically recoded bacteria to phages with a canonical code (4). Despite these assumptions and accompanying lines of evidence, it remains unclear whether differential and non-canonical codon usage represents an absolute barrier to phage infection and genetic exchange between organisms. Our knowledge of the diversity of genetic codes and their use by viruses and their hosts is primarily derived from the analysis of cultivated organisms. Advances in single-cell sequencing and metagenome assembly technologies have enabled the reconstruction of genomes of uncultivated bacterial and archaeal lineages (6). These initial findings suggest that large scale systematic studies of uncultivated microorganisms and viruses may reveal the extent and modes of divergence from the canonical genetic code operating in nature. To explore alternative genetic codes, we carried out a systematic analysis of stop codon reassignments from the canonical TAG amber, TGA opal, and TAA ochre codons in assembled metagenomes from environmental and host-associated samples, single-cell genomes of uncultivated bacteria and archaea, and a collection of phage sequences

  11. An unusual cause of vaginal discharge following gender reassignment.

    Science.gov (United States)

    Sukumaran, S; Moran, P A; Makar, A

    2009-02-01

    Neovaginal reconstruction is an important part of gender reassignment surgery. We report a case of stone formation at the apex of vaginal vault constructed with sigmoid colon segment. A 48-year-old woman presented with profuse vaginal discharge for 1 year. She had a history of gender reassignment surgery (male to female) in 1994, and the neovagina had been constructed with an isolated sigmoid colon. Vaginoscopy performed using a cystoscope revealed multiple calculi at the vaginal vault on the endoscopic gastrointestinal anastomosis staples that had been used to close the vault. Colon-vaginoplasty has the advantages of providing adequate lubrication, but excessive vaginal discharge could be a problem, as colon is a mucous membrane. Stone formation in the vaginal vault should be considered in cases of gender reassignment with persistent vaginal discharge. This case also highlights the use of cystoscope in visualising the upper vagina in difficult circumstances.

  12. Effects of different steps in gender reassignment therapy on psychopathology: a prospective study of persons with a gender identity disorder.

    Science.gov (United States)

    Heylens, Gunter; Verroken, Charlotte; De Cock, Sanne; T'Sjoen, Guy; De Cuypere, Griet

    2014-01-01

    At the start of gender reassignment therapy, persons with a gender identity disorder (GID) may deal with various forms of psychopathology. Until now, a limited number of publications focus on the effect of the different phases of treatment on this comorbidity and other psychosocial factors. The aim of this study was to investigate how gender reassignment therapy affects psychopathology and other psychosocial factors. This is a prospective study that assessed 57 individuals with GID by using the Symptom Checklist-90 (SCL-90) at three different points of time: at presentation, after the start of hormonal treatment, and after sex reassignment surgery (SRS). Questionnaires on psychosocial variables were used to evaluate the evolution between the presentation and the postoperative period. The data were statistically analyzed by using SPSS 19.0, with significance levels set at P < 0.05. The psychopathological parameters include overall psychoneurotic distress, anxiety, agoraphobia, depression, somatization, paranoid ideation/psychoticism, interpersonal sensitivity, hostility, and sleeping problems. The psychosocial parameters consist of relationship, living situation, employment, sexual contacts, social contacts, substance abuse, and suicide attempt. A difference in SCL-90 overall psychoneurotic distress was observed at the different points of assessments (P = 0.003), with the most prominent decrease occurring after the initiation of hormone therapy (P < 0.001). Significant decreases were found in the subscales such as anxiety, depression, interpersonal sensitivity, and hostility. Furthermore, the SCL-90 scores resembled those of a general population after hormone therapy was initiated. Analysis of the psychosocial variables showed no significant differences between pre- and postoperative assessments. A marked reduction in psychopathology occurs during the process of sex reassignment therapy, especially after the initiation of hormone therapy. © 2013

  13. 42 CFR 421.114 - Assignment and reassignment of providers by CMS.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Assignment and reassignment of providers by CMS. 421.114 Section 421.114 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH... Assignment and reassignment of providers by CMS. CMS may assign or reassign any provider to any intermediary...

  14. Military Families with Handicapped Children: The Reassignment Problem

    Science.gov (United States)

    1981-02-01

    of them ( education service center, Lub- bock Medical facilities , Lubbock State School, psychiatric facilities , etc.) 18. Additional comments: Rapidly...Attached DD ) AN 73 1473 EDITION OF I NOV6GS IS OBSOLETE UNCL 23 Oct 81 8 1 10 2oc 0 6 2 !CURITY CLASSIFICATION OF THIS PAGE (I7,n Data Entered) AIR WAR...COLLEGE AIR UNIVERSITY Report No. MS107-81 MILITARY FAMILIES WITH HANDICAPPED CHILDREN: THE REASSIGNMENT PROBLEM (A (WiDE TO SPECIAL EDUCATION AVAILABLE

  15. Gender Reassignment Surgery in Human Immunodeficiency Virus-Positive Patients: A Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Seok-Kwun Kim

    2015-11-01

    Full Text Available It is believed that surgery on human immunodeficiency virus (HIV-positive patients is dangerous and should be avoided due to the possibility of postoperative infection of the patients or HIV occupational transmission to the medical staff. We discuss here the preparations and measures needed to conduct surgery safely on HIV-positive patients, based on our experience. We performed sex reassignment surgery on two HIV-positive patients from January 2013 to January 2015. Both of them were receiving highly active antiretroviral therapy and were asymptomatic, with a normal CD4 count (>500 cells/µL. The HIV-RNA was undetectable within the bloodstream. All the staff wore protective clothing, glasses, and three pairs of protective gloves in the operating room because of the possibility of transmission. Prophylactic antibiotics were administered to the patients, and antiviral therapy was performed during their perioperative course. Neither of the patients had postoperative complications, and none of the medical staff experienced accidental exposure. Both patients had satisfactory surgery outcomes without complications. HIV-positive patients can undergo surgery safely without increased risk of postoperative complications or HIV transmission to the staff through the proper use of antibiotics, active antiretroviral therapy, and supplemental protective measures with post-exposure prophylaxis for the staff in case of HIV exposure.

  16. Reassignment of Drosophila willistoni Genome Scaffolds to Chromosome II Arms.

    Science.gov (United States)

    Garcia, Carolina; Delprat, Alejandra; Ruiz, Alfredo; Valente, Vera L S

    2015-10-04

    Drosophila willistoni is a geographically widespread Neotropical species. The genome of strain Gd-H4-1 from Guadeloupe Island (Caribbean) was sequenced in 2007 as part of the 12 Drosophila Genomes Project. The assembled scaffolds were joined based on conserved linkage and assigned to polytene chromosomes based on a handful of genetic and physical markers. This paucity of markers was particularly striking in the metacentric chromosome II, comprised two similarly sized arms, IIL and IIR, traditionally considered homologous to Muller elements C and B, respectively. In this paper we present the cytological mapping of 22 new gene markers to increase the number of markers mapped by in situ hybridization and to test the assignment of scaffolds to the polytene chromosome II arms. For this purpose, we generated, by polymerase chain reaction amplification, one or two gene probes from each scaffold assigned to the chromosome II arms and mapped these probes to the Gd-H4-1 strain's polytene chromosomes by nonfluorescent in situ hybridization. Our findings show that chromosome arms IIL and IIR correspond to Muller elements B and C, respectively, directly contrasting the current homology assignments in D. willistoni and constituting a major reassignment of the scaffolds to chromosome II arms. Copyright © 2015 Garcia et al.

  17. 75 FR 22095 - USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2010 Raw Sugar Tariff...

    Science.gov (United States)

    2010-04-27

    ... USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2010 Raw Sugar Tariff-Rate... announced a reassignment of surplus sugar under domestic cane sugar allotments of 200,000 short tons raw value (STRV) to imports, and increased the fiscal year (FY) 2010 raw sugar tariff-rate quota (TRQ) by...

  18. 75 FR 38764 - USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2010 Raw Sugar Tariff...

    Science.gov (United States)

    2010-07-06

    ... USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2010 Raw Sugar Tariff-Rate... announced a reassignment of surplus sugar under domestic cane sugar allotments of 300,000 short tons raw value (STRV) to imports, and increased the fiscal year (FY) 2010 raw sugar tariff-rate quota (TRQ) by...

  19. 76 FR 20305 - USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2011 Raw Sugar Tariff...

    Science.gov (United States)

    2011-04-12

    ... USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2011 Raw Sugar Tariff-Rate... announced a reassignment of surplus sugar under domestic cane sugar allotments of 325,000 short tons raw value (STRV) to imports, and increased the fiscal year (FY) 2011 raw sugar tariff-rate quota (TRQ) by...

  20. [Transsexualism or delusions of sex change? Avoiding misdiagnosis].

    Science.gov (United States)

    Urban, Małgorzata

    2009-01-01

    The aim of this paper was to present basic data about gender identity disorders and psychotic transsexual desires. From time to time in scientific literature there are descriptions of a diagnosis of psychotic disorders in persons previously diagnosed and treated as transsexuals, in whom the transsexual thinking disappears after using antipsychotic agents. Coexistence of transsexualism and schizophrenia causes a lot of doubt--it is observed in scientists opinions but also in the diagnostic criteria of DSM-IV and ICD-10. Moreover, delusions of sex change are probably more frequent than it is thought. It causes, that in some cases the differential diagnosis of psychosis and gender identity disorders may be very difficult. Transsexuals treatment is on one hand connected with expected effects but on the other hand with many serious, often irreversible health consequences (e.g. cardiovascular disease, risk of neoplasma development, infertility, consequences of surgical sex reassignment). That is why the differential diagnosis of transsexualism and schizophrenia should be made carefully and thoughtfully.

  1. 77 FR 23450 - USDA Increases and Reassigns Fiscal Year 2012 Overall Allotment Quantity and Increases Fiscal...

    Science.gov (United States)

    2012-04-19

    ... marketing allocations between beet processors, and a reassignment of surplus cane sugar marketing allotment...-0876; or by email to [email protected] . SUPPLEMENTARY INFORMATION: USDA today announced an... split in accordance with the Sugar Marketing Allotment program, 54.35/45.65 percent between the beet and...

  2. 41 CFR 302-2.1 - When may I begin my transfer or reassignment?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false When may I begin my transfer or reassignment? 302-2.1 Section 302-2.1 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES INTRODUCTION 2-EMPLOYEES ELIGIBILITY REQUIREMENTS General Rules § 302...

  3. Gender Re-assignment at 17; Medical, Ethical, Religious and Cultural Dilemma!

    Directory of Open Access Journals (Sweden)

    Ojo EO

    2009-01-01

    Full Text Available To The Editor: Gender re-assignment after attainment of puberty is a challenging exercise. The problem is further compounded in places with limited diagnostic and counseling facilities. We report on a teenager who was raised as a boy until he started to have regular menstruation. The difficulties encountered in the management of this case are highlighted.

  4. Mapping the Plasticity of the E. coli Genetic Code with Orthogonal Pair Directed Sense Codon Reassignment.

    Science.gov (United States)

    Schmitt, Margaret A; Biddle, Wil; Fisk, John Domenic

    2018-04-18

    The relative quantitative importance of the factors that determine the fidelity of translation is largely unknown, which makes predicting the extent to which the degeneracy of the genetic code can be broken challenging. Our strategy of using orthogonal tRNA/aminoacyl tRNA synthetase pairs to precisely direct the incorporation of a single amino acid in response to individual sense and nonsense codons provides a suite of related data with which to examine the plasticity of the code. Each directed sense codon reassignment measurement is an in vivo competition experiment between the introduced orthogonal translation machinery and the natural machinery in E. coli. This report discusses 20 new, related genetic codes, in which a targeted E. coli wobble codon is reassigned to tyrosine utilizing the orthogonal tyrosine tRNA/aminoacyl tRNA synthetase pair from Methanocaldococcus jannaschii. One at a time, reassignment of each targeted sense codon to tyrosine is quantified in cells by measuring the fluorescence of GFP variants in which the essential tyrosine residue is encoded by a non-tyrosine codon. Significantly, every wobble codon analyzed may be partially reassigned with efficiencies ranging from 0.8% to 41%. The accumulation of the suite of data enables a qualitative dissection of the relative importance of the factors affecting the fidelity of translation. While some correlation was observed between sense codon reassignment and either competing endogenous tRNA abundance or changes in aminoacylation efficiency of the altered orthogonal system, no single factor appears to predominately drive translational fidelity. Evaluation of relative cellular fitness in each of the 20 quantitatively-characterized proteome-wide tyrosine substitution systems suggests that at a systems level, E. coli is robust to missense mutations.

  5. Metoidioplasty as a single stage sex reassignment surgery in female transsexuals: Belgrade experience.

    Science.gov (United States)

    Djordjevic, Miroslav L; Stanojevic, Dusan; Bizic, Marta; Kojovic, Vladimir; Majstorovic, Marko; Vujovic, Svetlana; Milosevic, Alexandar; Korac, Gradimir; Perovic, Sava V

    2009-05-01

    Metoidioplasty represents one of the variants of phalloplasty in female transsexuals. Its main characteristic is that it is a one-stage procedure. It involves lengthening and straightening of hypertrophied clitoris to create a neophallus, urethral lengthening to enable voiding while standing, and scrotal reconstruction with insertion of testicle prostheses. Our aim is to describe our technique and highlight its advantages. Between September 2002 and April 2007, 82 female transsexuals, aged 18-54 years (mean age 31) underwent one-stage metoidioplasty. Clitoris is lengthened and straightened by division of clitoral ligaments and short urethral plate. Urethroplasty is done with combined buccal mucosa graft and genital skin flaps. Scrotum is created from labia majora in which two testicle prostheses are inserted. Simultaneously, female genitalia are removed. Patients' personal satisfaction about sensitivity and length of neophallus, possibility to void in standing position, real length of reconstructed urethra as well as complication rate comparing to other published data. The median follow-up was 32 months (range 14-69). The mean neophallic length was 5.7 cm (range 4-10). Voiding in standing position was reported in all patients, while dribbling and spraying were noticed in 23 cases and solved spontaneously. There were two urethral strictures and seven fistulas that required secondary minor revision. All patients reported preserved sensation and normal postoperative erection. Testicle prostheses rejection was not observed in any of the patients. Metoidioplasty is a single-stage and time-saving procedure. It could be an alternative to total phalloplasty in female transsexuals who do not wish to have sexual intercourse. Also, it represents a first step in cases where additional augmentation phalloplasty is required.

  6. Outcome of Vaginoplasty in Male-to-Female Transgenders: A Systematic Review of Surgical Techniques

    NARCIS (Netherlands)

    Horbach, S.E.R.; Bouman, M.B.; Smit, J.M.; Özer, M.; Buncamper, M.E.; Mullender, M.G.

    2015-01-01

    Introduction: Gender reassignment surgery is the keystone of the treatment of transgender patients. For male-to-female transgenders, this involves the creation of a neovagina. Many surgical methods for vaginoplasty have been opted. The penile skin inversion technique is the method of choice for most

  7. Barriers to Surgical Care and Health Outcomes: A Prospective Study on the Relation Between Wealth, Sex, and Postoperative Complications in the Republic of Congo.

    Science.gov (United States)

    Lin, Brian M; White, Michelle; Glover, Ana; Wamah, Greta Peterson; Trotti, Davi L; Randall, Kirstie; Alkire, Blake C; Cheney, Mack L; Parker, Gary; Shrime, Mark G

    2017-01-01

    Approximately thirty percent of the global burden of disease is comprised of surgical conditions. However, five billion people lack access to surgery, with complex factors acting as barriers. We examined whether patient demographics predict barriers to care, and the relation between these factors and postoperative complications in a prospective cohort. Participants included people presenting to a global charity in Republic of Congo with a surgical condition between August 2013 and May 2014. The outcomes were self-reported barrier to care and postoperative complications documented by medical record. Logistic regression was used to adjust for covariates. Of 1237 patients in our study, 1190 (96.2 %) experienced a barrier to care and 126 (10.2 %) experienced a postoperative complication. The most frequently reported barrier was cost (73 %), followed by lack of provider (8.2 %). Greater wealth was associated with decreased odds of cost as a barrier (OR 0.72 [0.57, 0.90]). Greater wealth (OR 1.52 [1.03, 2.25]) and rural home location (OR 3.35 [1.16, 9.62]) were associated with increased odds of no surgeon being available. Cost as a barrier (OR 2.82 [1.02, 7.77]), female sex (OR 3.45 [1.62, 7.33]), and lack of surgeon (OR 5.62 [1.68, 18.77]) were associated with increased odds of postoperative complication. Patient wealth was not associated with odds of postoperative complication. Barriers to surgery were common in Republic of Congo. Patient wealth and home location may predict barriers to surgery. Addressing gender disparities, access to providers, and patient perception of barriers in addition to removal of barriers may help maximize patient health benefits.

  8. Efficient Reassignment of a Frequent Serine Codon in Wild-Type Escherichia coli.

    Science.gov (United States)

    Ho, Joanne M; Reynolds, Noah M; Rivera, Keith; Connolly, Morgan; Guo, Li-Tao; Ling, Jiqiang; Pappin, Darryl J; Church, George M; Söll, Dieter

    2016-02-19

    Expansion of the genetic code through engineering the translation machinery has greatly increased the chemical repertoire of the proteome. This has been accomplished mainly by read-through of UAG or UGA stop codons by the noncanonical aminoacyl-tRNA of choice. While stop codon read-through involves competition with the translation release factors, sense codon reassignment entails competition with a large pool of endogenous tRNAs. We used an engineered pyrrolysyl-tRNA synthetase to incorporate 3-iodo-l-phenylalanine (3-I-Phe) at a number of different serine and leucine codons in wild-type Escherichia coli. Quantitative LC-MS/MS measurements of amino acid incorporation yields carried out in a selected reaction monitoring experiment revealed that the 3-I-Phe abundance at the Ser208AGU codon in superfolder GFP was 65 ± 17%. This method also allowed quantification of other amino acids (serine, 33 ± 17%; phenylalanine, 1 ± 1%; threonine, 1 ± 1%) that compete with 3-I-Phe at both the aminoacylation and decoding steps of translation for incorporation at the same codon position. Reassignments of different serine (AGU, AGC, UCG) and leucine (CUG) codons with the matching tRNA(Pyl) anticodon variants were met with varying success, and our findings provide a guideline for the choice of sense codons to be reassigned. Our results indicate that the 3-iodo-l-phenylalanyl-tRNA synthetase (IFRS)/tRNA(Pyl) pair can efficiently outcompete the cellular machinery to reassign select sense codons in wild-type E. coli.

  9. A novel nuclear genetic code alteration in yeasts and the evolution of codon reassignment in eukaryotes.

    Science.gov (United States)

    Mühlhausen, Stefanie; Findeisen, Peggy; Plessmann, Uwe; Urlaub, Henning; Kollmar, Martin

    2016-07-01

    The genetic code is the cellular translation table for the conversion of nucleotide sequences into amino acid sequences. Changes to the meaning of sense codons would introduce errors into almost every translated message and are expected to be highly detrimental. However, reassignment of single or multiple codons in mitochondria and nuclear genomes, although extremely rare, demonstrates that the code can evolve. Several models for the mechanism of alteration of nuclear genetic codes have been proposed (including "codon capture," "genome streamlining," and "ambiguous intermediate" theories), but with little resolution. Here, we report a novel sense codon reassignment in Pachysolen tannophilus, a yeast related to the Pichiaceae. By generating proteomics data and using tRNA sequence comparisons, we show that Pachysolen translates CUG codons as alanine and not as the more usual leucine. The Pachysolen tRNACAG is an anticodon-mutated tRNA(Ala) containing all major alanine tRNA recognition sites. The polyphyly of the CUG-decoding tRNAs in yeasts is best explained by a tRNA loss driven codon reassignment mechanism. Loss of the CUG-tRNA in the ancient yeast is followed by gradual decrease of respective codons and subsequent codon capture by tRNAs whose anticodon is not part of the aminoacyl-tRNA synthetase recognition region. Our hypothesis applies to all nuclear genetic code alterations and provides several testable predictions. We anticipate more codon reassignments to be uncovered in existing and upcoming genome projects. © 2016 Mühlhausen et al.; Published by Cold Spring Harbor Laboratory Press.

  10. Surgical Satisfaction, Quality of Life, and Their Association After Gender-Affirming Surgery: A Follow-up Study.

    Science.gov (United States)

    van de Grift, Tim C; Elaut, Els; Cerwenka, Susanne C; Cohen-Kettenis, Peggy T; Kreukels, Baudewijntje P C

    2018-02-17

    We assessed the outcomes of gender-affirming surgery (GAS, or sex-reassignment surgery) 4 to 6 years after first clinical contact, and the associations between postoperative (dis)satisfaction and quality of life (QoL). Our multicenter, cross-sectional follow-up study involved persons diagnosed with gender dysphoria (DSM-IV-TR) who applied for medical interventions from 2007 until 2009. Of 546 eligible persons, 201 (37%) responded, of whom 136 had undergone GAS (genital, chest, facial, vocal cord and/or thyroid cartilage surgery). Main outcome measures were procedure performed, self-reported complications, and satisfaction with surgical outcomes (standardized questionnaires), QoL (Satisfaction With Life Scale, Subjective Happiness Scale, Cantril Ladder), gender dysphoria (Utrecht Gender Dysphoria Scale), and psychological symptoms (Symptom Checklist-90). Postoperative satisfaction was 94% to 100%, depending on the type of surgery performed. Eight (6%) of the participants reported dissatisfaction and/or regret, which was associated with preoperative psychological symptoms or self-reported surgical complications (OR = 6.07). Satisfied respondents' QoL scores were similar to reference values; dissatisfied or regretful respondents' scores were lower. Therefore, dissatisfaction after GAS may be viewed as indicator of unfavorable psychological and QoL outcomes.

  11. Comparative Mitogenomics of Plant Bugs (Hemiptera: Miridae): Identifying the AGG Codon Reassignments between Serine and Lysine

    Science.gov (United States)

    Wang, Pei; Song, Fan; Cai, Wanzhi

    2014-01-01

    Insect mitochondrial genomes are very important to understand the molecular evolution as well as for phylogenetic and phylogeographic studies of the insects. The Miridae are the largest family of Heteroptera encompassing more than 11,000 described species and of great economic importance. For better understanding the diversity and the evolution of plant bugs, we sequence five new mitochondrial genomes and present the first comparative analysis of nine mitochondrial genomes of mirids available to date. Our result showed that gene content, gene arrangement, base composition and sequences of mitochondrial transcription termination factor were conserved in plant bugs. Intra-genus species shared more conserved genomic characteristics, such as nucleotide and amino acid composition of protein-coding genes, secondary structure and anticodon mutations of tRNAs, and non-coding sequences. Control region possessed several distinct characteristics, including: variable size, abundant tandem repetitions, and intra-genus conservation; and was useful in evolutionary and population genetic studies. The AGG codon reassignments were investigated between serine and lysine in the genera Adelphocoris and other cimicomorphans. Our analysis revealed correlated evolution between reassignments of the AGG codon and specific point mutations at the antidocons of tRNALys and tRNASer(AGN). Phylogenetic analysis indicated that mitochondrial genome sequences were useful in resolving family level relationship of Cimicomorpha. Comparative evolutionary analysis of plant bug mitochondrial genomes allowed the identification of previously neglected coding genes or non-coding regions as potential molecular markers. The finding of the AGG codon reassignments between serine and lysine indicated the parallel evolution of the genetic code in Hemiptera mitochondrial genomes. PMID:24988409

  12. TH-CD-209-01: A Greedy Reassignment Algorithm for the PBS Minimum Monitor Unit Constraint

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Y; Kooy, H; Craft, D; Depauw, N; Flanz, J; Clasie, B [Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)

    2016-06-15

    Purpose: To investigate a Greedy Reassignment algorithm in order to mitigate the effects of low weight spots in proton pencil beam scanning (PBS) treatment plans. Methods: To convert a plan from the treatment planning system’s (TPS) to a deliverable plan, post processing methods can be used to adjust the spot maps to meets the minimum MU constraint. Existing methods include: deleting low weight spots (Cut method), or rounding spots with weight above/below half the limit up/down to the limit/zero (Round method). An alternative method called Greedy Reassignment was developed in this work in which the lowest weight spot in the field was removed and its weight reassigned equally among its nearest neighbors. The process was repeated with the next lowest weight spot until all spots in the field were above the MU constraint. The algorithm performance was evaluated using plans collected from 190 patients (496 fields) treated at our facility. The evaluation criteria were the γ-index pass rate comparing the pre-processed and post-processed dose distributions. A planning metric was further developed to predict the impact of post-processing on treatment plans for various treatment planning, machine, and dose tolerance parameters. Results: For fields with a gamma pass rate of 90±1%, the metric has a standard deviation equal to 18% of the centroid value. This showed that the metric and γ-index pass rate are correlated for the Greedy Reassignment algorithm. Using a 3rd order polynomial fit to the data, the Greedy Reassignment method had 1.8 times better metric at 90% pass rate compared to other post-processing methods. Conclusion: We showed that the Greedy Reassignment method yields deliverable plans that are closest to the optimized-without-MU-constraint plan from the TPS. The metric developed in this work could help design the minimum MU threshold with the goal of keeping the γ-index pass rate above an acceptable value.

  13. Impacted Mandibular Third Molars: A Retrospective Study of 1198 Cases to Assess Indications for Surgical Removal, and Correlation with Age, Sex and Type of Impaction-A Single Institutional Experience.

    Science.gov (United States)

    Patel, Shital; Mansuri, Saloni; Shaikh, Faizan; Shah, Taksh

    2017-03-01

    To study the incidence of mandibular third molar impaction in relation to type and side of impaction, age and sex of patients and indications for its surgical removal through data collected from a single institute over a period of 3 and half years. The records of 1198 patients who underwent the surgical removal of impacted mandibular third molars were reviewed retrospectively. Records were divided into groups according to sex, age, type and side of impaction. Radiographs were studied to determine angular position of impacted mandible third molar. We found that there was a high incidence of mesioangular lower third molar impaction (33.97 %), highest number of patients were found in 15-30 years of age group (48.33 %), a left side (56.93 %) was more commonly involved, female predominance (63.44 %) was observed and recurrent pericoronitis (33.81 %) was the most common indication. Awareness of the indications for surgical removal of impacted mandibular third molar to the patients will help to avoid future risk of complications and morbidity associated with the same. This will not only help in saving time and money but also prevents the psychological trauma associated with delayed treatment. Removal of only symptomatic IMTM seems to be the logical choice in view of financial constraint in developing countries like India but at the same time early removal offers freedom from future complications in selected cases. So surgeons should apply a meticulous approach in selecting the patients for SRIMTM.

  14. Bearing Estimation Using Double Frequency Reassignment for a Linear Passive Array

    Directory of Open Access Journals (Sweden)

    Czarnecki Krzysztof

    2017-09-01

    Full Text Available The paper demonstrates the use of frequency reassignment for bearing estimation. For this task, signals derived from a linear equispaced passive array are used. The presented method makes use of Fourier transformation based spatial spectrum estimation. It is further developed through the application of two-dimensional reassignment, which leads to obtaining highly concentrated energy distributions in the joint frequency-angle domain and sharp graphical imaging. The introduced method can be used for analysing, a priori, unknown signals of broadband, nonstationary, and/or multicomponent type. For such signals, the direction of arrival is obtained based upon the marginal energy distribution in the angle domain, through searching for arguments of its maxima. In the paper, bearing estimation of three popular types of sonar pulses, including linear and hyperbolic frequency modulated pulses, as well as no frequency modulation at all, is considered. The results of numerical experiments performed in the presence of additive white Gaussian noise are presented and compared to conventional digital sum-delay beamforming performed in the time domain. The root-mean-square error and the peak-to-average power ratio, also known as the crest factor, are introduced in order to estimate, respectively, the accuracy of the methods and the sharpness of the obtained energy distributions in the angle domain.

  15. Surgical Assisting

    Science.gov (United States)

    ... instruction, including: Microbiology Pathophysiology Pharmacology Anatomy and physiology Medical terminology Curriculum . Course content includes: Advanced surgical anatomy Surgical microbiology Surgical pharmacology Anesthesia methods and agents Bioscience Ethical ...

  16. Abortion - surgical

    Science.gov (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  17. Reassigning stop codons via translation termination: How a few eukaryotes broke the dogma.

    Science.gov (United States)

    Alkalaeva, Elena; Mikhailova, Tatiana

    2017-03-01

    The genetic code determines how amino acids are encoded within mRNA. It is universal among the vast majority of organisms, although several exceptions are known. Variant genetic codes are found in ciliates, mitochondria, and numerous other organisms. All revealed genetic codes (standard and variant) have at least one codon encoding a translation stop signal. However, recently two new genetic codes with a reassignment of all three stop codons were revealed in studies examining the protozoa transcriptomes. Here, we discuss this finding and the recent studies of variant genetic codes in eukaryotes. We consider the possible molecular mechanisms allowing the use of certain codons as sense and stop signals simultaneously. The results obtained by studying these amazing organisms represent a new and exciting insight into the mechanism of stop codon decoding in eukaryotes. Also see the video abstract here. © 2017 WILEY Periodicals, Inc.

  18. The Islamic Perspectives of Gender-Related Issues in the Management of Patients With Disorders of Sex Development

    OpenAIRE

    Zainuddin, Ani Amelia; Mahdy, Zaleha Abdullah

    2016-01-01

    In Islam, the person with somatic sex ambiguity due to a disorder of sex development (DSD), such as 46,XX congenital adrenal hyperplasia or 46,XY androgen insensitivity, is recognized as khunsa. Two types of khunsa are distinguished: wadhih (discernible) and musykil (intractable). A recent fatwa (religious edict) in Malaysia decreed that it is permissible for male-assigned patients from these two groups to have gender reassignment surgery to female following diagnosis; however, the religious ...

  19. Safe sex

    Science.gov (United States)

    ... sex; Sexually transmitted - safe sex; GC - safe sex; Gonorrhea - safe sex; Herpes - safe sex; HIV - safe sex; ... contact. STIs include: Chlamydia Genital herpes Genital warts Gonorrhea Hepatitis HIV HPV Syphilis STIs are also called ...

  20. An Application of Reassigned Time-Frequency Representations for Seismic Noise/Signal Decomposition

    Science.gov (United States)

    Mousavi, S. M.; Langston, C. A.

    2016-12-01

    Seismic data recorded by surface arrays are often strongly contaminated by unwanted noise. This background noise makes the detection of small magnitude events difficult. An automatic method for seismic noise/signal decomposition is presented based upon an enhanced time-frequency representation. Synchrosqueezing is a time-frequency reassignment method aimed at sharpening a time-frequency picture. Noise can be distinguished from the signal and suppressed more easily in this reassigned domain. The threshold level is estimated using a general cross validation approach that does not rely on any prior knowledge about the noise level. Efficiency of thresholding has been improved by adding a pre-processing step based on higher order statistics and a post-processing step based on adaptive hard-thresholding. In doing so, both accuracy and speed of the denoising have been improved compared to our previous algorithms (Mousavi and Langston, 2016a, 2016b; Mousavi et al., 2016). The proposed algorithm can either kill the noise (either white or colored) and keep the signal or kill the signal and keep the noise. Hence, It can be used in either normal denoising applications or in ambient noise studies. Application of the proposed method on synthetic and real seismic data shows the effectiveness of the method for denoising/designaling of local microseismic, and ocean bottom seismic data. References: Mousavi, S.M., C. A. Langston., and S. P. Horton (2016), Automatic Microseismic Denoising and Onset Detection Using the Synchrosqueezed-Continuous Wavelet Transform. Geophysics. 81, V341-V355, doi: 10.1190/GEO2015-0598.1. Mousavi, S.M., and C. A. Langston (2016a), Hybrid Seismic Denoising Using Higher-Order Statistics and Improved Wavelet Block Thresholding. Bull. Seismol. Soc. Am., 106, doi: 10.1785/0120150345. Mousavi, S.M., and C.A. Langston (2016b), Adaptive noise estimation and suppression for improving microseismic event detection, Journal of Applied Geophysics., doi: http

  1. Simulated evolution applied to study the genetic code optimality using a model of codon reassignments.

    Science.gov (United States)

    Santos, José; Monteagudo, Angel

    2011-02-21

    As the canonical code is not universal, different theories about its origin and organization have appeared. The optimization or level of adaptation of the canonical genetic code was measured taking into account the harmful consequences resulting from point mutations leading to the replacement of one amino acid for another. There are two basic theories to measure the level of optimization: the statistical approach, which compares the canonical genetic code with many randomly generated alternative ones, and the engineering approach, which compares the canonical code with the best possible alternative. Here we used a genetic algorithm to search for better adapted hypothetical codes and as a method to guess the difficulty in finding such alternative codes, allowing to clearly situate the canonical code in the fitness landscape. This novel proposal of the use of evolutionary computing provides a new perspective in the open debate between the use of the statistical approach, which postulates that the genetic code conserves amino acid properties far better than expected from a random code, and the engineering approach, which tends to indicate that the canonical genetic code is still far from optimal. We used two models of hypothetical codes: one that reflects the known examples of codon reassignment and the model most used in the two approaches which reflects the current genetic code translation table. Although the standard code is far from a possible optimum considering both models, when the more realistic model of the codon reassignments was used, the evolutionary algorithm had more difficulty to overcome the efficiency of the canonical genetic code. Simulated evolution clearly reveals that the canonical genetic code is far from optimal regarding its optimization. Nevertheless, the efficiency of the canonical code increases when mistranslations are taken into account with the two models, as indicated by the fact that the best possible codes show the patterns of the

  2. Simulated evolution applied to study the genetic code optimality using a model of codon reassignments

    Directory of Open Access Journals (Sweden)

    Monteagudo Ángel

    2011-02-01

    Full Text Available Abstract Background As the canonical code is not universal, different theories about its origin and organization have appeared. The optimization or level of adaptation of the canonical genetic code was measured taking into account the harmful consequences resulting from point mutations leading to the replacement of one amino acid for another. There are two basic theories to measure the level of optimization: the statistical approach, which compares the canonical genetic code with many randomly generated alternative ones, and the engineering approach, which compares the canonical code with the best possible alternative. Results Here we used a genetic algorithm to search for better adapted hypothetical codes and as a method to guess the difficulty in finding such alternative codes, allowing to clearly situate the canonical code in the fitness landscape. This novel proposal of the use of evolutionary computing provides a new perspective in the open debate between the use of the statistical approach, which postulates that the genetic code conserves amino acid properties far better than expected from a random code, and the engineering approach, which tends to indicate that the canonical genetic code is still far from optimal. We used two models of hypothetical codes: one that reflects the known examples of codon reassignment and the model most used in the two approaches which reflects the current genetic code translation table. Although the standard code is far from a possible optimum considering both models, when the more realistic model of the codon reassignments was used, the evolutionary algorithm had more difficulty to overcome the efficiency of the canonical genetic code. Conclusions Simulated evolution clearly reveals that the canonical genetic code is far from optimal regarding its optimization. Nevertheless, the efficiency of the canonical code increases when mistranslations are taken into account with the two models, as indicated by the

  3. Surgical lighting

    NARCIS (Netherlands)

    Knulst, A.J.

    2017-01-01

    The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,

  4. Urethral Lengthening in metoidioplasty (female-to-male sex reassignment surgery) by combined buccal mucosa graft and labia minora flap.

    Science.gov (United States)

    Djordjevic, M L; Bizic, M; Stanojevic, D; Bumbasirevic, M; Kojovic, V; Majstorovic, M; Acimovic, M; Pandey, S; Perovic, S V

    2009-08-01

    To develop a technique for urethral reconstruction using a combined labia minora flap and buccal mucosa graft. Urethral lengthening is the most difficult part in female transsexuals and poses many challenges. From April 2005 to February 2008, 38 patients (aged 19-53 years) underwent single-stage metoidioplasty. The technique starts with clitoral lengthening and straightening by division of both clitoral ligaments dorsally and the short urethral plate ventrally. The buccal mucosa graft is quilted to the ventral side of the corpora cavernosa between the native orifice and the tip of the glans. The labia minora flap is dissected from its inner surface to form the ventral aspect of the neourethra. All suture lines are covered by the well-vascularized subcutaneous tissue originating from the labia minora. The labia majora are joined in the midline and 2 silicone testicular implants are inserted to create the scrotum. The neophallus is covered with the remaining clitoral and labial skin. The median follow-up was 22 months (range 11-42). The median neophallic length was 5.6 cm (range 4-9.2). The total length of the neourethra was 9.4-14.2 cm (median 10.8). Voiding while standing was reported by all 38 patients, and temporary dribbling and spraying were noted by 12. Two fistulas and one urethral erosion resulted from the testicular implant and required secondary revision. A combined buccal mucosa graft and labia minora flap present a good choice for urethral reconstruction in female-to-male transsexuals, with minimal postoperative complications.

  5. Surgical smoke.

    Science.gov (United States)

    Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

    2009-10-01

    Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.

  6. The role of mental health professionals in gender reassignment surgeries: unjust discrimination or responsible care?

    Science.gov (United States)

    Selvaggi, Gennaro; Giordano, Simona

    2014-12-01

    Recent literature has raised an important ethical concern relating to the way in which surgeons approach people with gender dysphoria (GD): it has been suggested that referring transsexual patients to mental assessment can constitute a form of unjust discrimination. The aim of this paper is to examine some of the ethical issues concerning the role of the mental health professional in gender reassignment surgeries (GRS). The role of the mental health professional in GRS is analyzed by presenting the Standards of Care by the World Professional Association of Transgender Health, and discussing the principles of autonomy and non-discrimination. Purposes of psychotherapy are exploring gender identity; addressing the negative impact of GD on mental health; alleviating internalized transphobia; enhancing social and peer support; improving body image; promoting resilience; and assisting the surgeons with the preparation prior to the surgery and the patient's follow-up. Offering or requesting psychological assistance is in no way a form of negative discrimination or an attack to the patient's autonomy. Contrarily, it might improve transsexual patients' care, and thus at the most may represent a form of positive discrimination. To treat people as equal does not mean that they should be treated in the same way, but with the same concern and respect, so that their unique needs and goals can be achieved. Offering or requesting psychological assistance to individuals with GD is a form of responsible care, and not unjust discrimination. 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.

  7. The Reduction of Faculty Reassigned Time as a Community College Cost Containment Initiative: A Case Study of the Maricopa County Community College District.

    Science.gov (United States)

    Petrowsky, Michael C.

    This paper argues that community colleges can contain costs by reducing faculty reassigned time, defined as a conscious or deliberate management action, either discretionary or mandated, that releases full-time faculty from teaching duties in order to perform other tasks. According to the paper, standard financial accounting systems have a…

  8. Surgical orthodontics.

    Science.gov (United States)

    Strohl, Alexis M; Vitkus, Lauren

    2017-08-01

    The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.

  9. Reassignment of oxygen-related defects in CdTe and CdSe

    Energy Technology Data Exchange (ETDEWEB)

    Bastin, Dirk

    2015-05-22

    This thesis reassigns the O{sub Te}-V{sub Cd} complex in CdTe and the O{sub Se}-V{sub Cd} complex in CdSe to a sulfur-dioxygen complex SO{sub 2}*, and the O{sub Cd} defect in CdSe to a V{sub Cd}H{sub 2} complex using Fourier transformed infrared absorption spectroscopy. The publications of the previous complexes were investigated by theoreticians who performed first-principle calculations of theses complexes. The theoreticians ruled out the assignments and proposed alternative defects, instead. The discrepancy between the experimentally obtained and theoretically proposed defects was the motivation of this work. Two local vibrational modes located at 1096.8 (ν{sub 1}) and 1108.3 cm{sup -1} (ν{sub 2}) previously assigned to an O{sub Te}-V{sub Cd} complex are detected in CdTe single crystals doped with CdSO{sub 4} powder. Five weaker additional absorption lines accompanying ν{sub 1} and ν{sub 2} could be detected. The relative intensities of the absorption lines match a sulfur-dioxygen complex SO{sub 2}* having two configurations labeled ν{sub 1} and ν{sub 2}. A binding energy difference of 0.5±0.1 meV between the two configurations and an energy barrier of 53±4 meV separating the two configurations are determined. Uniaxial stress applied to the crystal leads to a splitting of the absorption lines which corresponds to an orthorhombic and monoclinic symmetry for ν{sub 1} and ν{sub 2}, respectively. In virgin and oxygen-doped CdSe single crystals, three local vibrational modes located at 1094.1 (γ{sub 1}), 1107.5 (γ{sub 2}), and 1126.3 cm{sup -1} (γ{sub 3}) previously attributed to an O{sub Se}-V{sub Cd} complex could be observed. The signals are accompanied by five weaker additional absorption features in their vicinity. The additional absorption lines are identified as isotope satellites of a sulfur-dioxygen complex SO{sub 2}* having three configurations γ{sub 1}, γ{sub 2}, and γ{sub 3}. IR absorption measurements with uniaxial stress applied to the

  10. Reassignment of oxygen-related defects in CdTe and CdSe

    International Nuclear Information System (INIS)

    Bastin, Dirk

    2015-01-01

    This thesis reassigns the O_T_e-V_C_d complex in CdTe and the O_S_e-V_C_d complex in CdSe to a sulfur-dioxygen complex SO_2*, and the O_C_d defect in CdSe to a V_C_dH_2 complex using Fourier transformed infrared absorption spectroscopy. The publications of the previous complexes were investigated by theoreticians who performed first-principle calculations of theses complexes. The theoreticians ruled out the assignments and proposed alternative defects, instead. The discrepancy between the experimentally obtained and theoretically proposed defects was the motivation of this work. Two local vibrational modes located at 1096.8 (ν_1) and 1108.3 cm"-"1 (ν_2) previously assigned to an O_T_e-V_C_d complex are detected in CdTe single crystals doped with CdSO_4 powder. Five weaker additional absorption lines accompanying ν_1 and ν_2 could be detected. The relative intensities of the absorption lines match a sulfur-dioxygen complex SO_2* having two configurations labeled ν_1 and ν_2. A binding energy difference of 0.5±0.1 meV between the two configurations and an energy barrier of 53±4 meV separating the two configurations are determined. Uniaxial stress applied to the crystal leads to a splitting of the absorption lines which corresponds to an orthorhombic and monoclinic symmetry for ν_1 and ν_2, respectively. In virgin and oxygen-doped CdSe single crystals, three local vibrational modes located at 1094.1 (γ_1), 1107.5 (γ_2), and 1126.3 cm"-"1 (γ_3) previously attributed to an O_S_e-V_C_d complex could be observed. The signals are accompanied by five weaker additional absorption features in their vicinity. The additional absorption lines are identified as isotope satellites of a sulfur-dioxygen complex SO_2* having three configurations γ_1, γ_2, and γ_3. IR absorption measurements with uniaxial stress applied to the CdSe crystal yield a monoclinic C_1_h symmetry for γ_1 and γ_2. The SO_2* complex is stable up to 600 C. This thesis assigns the ν-lines in

  11. Clinicopathological review of surgically removed appendix in ...

    African Journals Online (AJOL)

    Babatunde M. Duduyemi

    2014-09-17

    Sep 17, 2014 ... It is the most common cause of acute surgical abdomen worldwide. ... Faculty of Medicine. Alexandria Journal of Medicine ... and sex distribution, nature of clinical signs and symptoms as .... radiological investigations.

  12. Sex Therapy

    Science.gov (United States)

    Sex therapy Overview Sex therapy is a type of psychotherapy — a general term for treating mental health problems by talking with a mental health professional. Through sex therapy, you can address concerns about sexual function, ...

  13. Re-description and Reassignment of the Damselfish Abudefduf luridus (Cuvier, 1830) Using Both Traditional and Geometric Morphometric Approaches

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, W. James [Washington State Univ., Pullman, WA (United States); Albertson, R Craig [Univ. of Massachusetts, Amherst, MA (United States); Jacob, Rick E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Westneat, Mark W. [Field Museum of Natural History, Chicago, IL (United States)

    2014-12-01

    Here we present a re-description of Abudefduf luridus and reassign it to the genus Similiparma. We supplement traditional diagnoses and descriptions of this species with quantitative anatomical data collected from a family-wide geometric morphometric analysis of head morphology (44 species representing all 30 damselfish genera) and data from cranial micro-CT scans of fishes in the genus Similiparma. The use of geometric morphometric analyses (and other methods of shape analysis) permits detailed comparisons between the morphology of specific taxa and the anatomical diversity that has arisen in an entire lineage. This provides a particularly useful supplement to traditional description methods and we recommend the use of such techniques by systematists. Similiparma and its close relatives constitute a branch of the damselfish phylogenetic tree that predominantly inhabits rocky reefs in the Atlantic and Eastern Pacific, as opposed to the more commonly studied damselfishes that constitute a large portion of the ichthyofauna on all coral-reef communities.

  14. Dynamically reassigning a connected node to a block of compute nodes for re-launching a failed job

    Science.gov (United States)

    Budnik, Thomas A [Rochester, MN; Knudson, Brant L [Rochester, MN; Megerian, Mark G [Rochester, MN; Miller, Samuel J [Rochester, MN; Stockdell, William M [Byron, MN

    2012-03-20

    Methods, systems, and products for dynamically reassigning a connected node to a block of compute nodes for re-launching a failed job that include: identifying that a job failed to execute on the block of compute nodes because connectivity failed between a compute node assigned as at least one of the connected nodes for the block of compute nodes and its supporting I/O node; and re-launching the job, including selecting an alternative connected node that is actively coupled for data communications with an active I/O node; and assigning the alternative connected node as the connected node for the block of compute nodes running the re-launched job.

  15. [Surgical complications of colostomies].

    Science.gov (United States)

    Ben Ameur, Hazem; Affes, Nejmeddine; Rejab, Haitham; Abid, Bassem; Boujelbene, Salah; Mzali, Rafik; Beyrouti, Mohamed Issam

    2014-07-01

    The colostomy may be terminal or lateral, temporary or permanent. It may have psychological, medical or surgical complications. reporting the incidence of surgical complications of colostomies, their therapeutic management and trying to identify risk factors for their occurrence. A retrospective study for a period of 5 years in general surgery department, Habib Bourguiba hospital, Sfax, including all patients operated with confection of a colostomy. Were then studied patients reoperated for stoma complication. Among the 268 patients who have had a colostomy, 19 patients (7%) developed surgical stoma complications. They had a mean age of 59 years, a sex ratio of 5.3 and a 1-ASA score in 42% of cases. It was a prolapse in 9 cases (reconfection of the colostomy: 6 cases, restoration of digestive continuity: 3 cases), a necrosis in 5 cases (reconfection of the colostomy), a plicature in 2 cases (reconfection of the colostomy) a peristomal abscess in 2 cases (reconfection of the colostomy: 1 case, restoration of digestive continuity: 1 case) and a strangulated parastomal hernia in 1 case (herniorrhaphy). The elective incision and the perineal disease were risk factors for the occurrence of prolapse stomial. Surgical complications of colostomies remain a rare event. Prolapse is the most common complication, and it is mainly related to elective approach. Reoperation is often required especially in cases of early complications, with usually uneventful postoperative course.

  16. Partial Treatment Requests and Underlying Motives of Applicants for Gender Affirming Interventions

    NARCIS (Netherlands)

    Beek, T.F.; Kreukels, B.P.C.; Cohen-Kettenis, P.T.; Steensma, T.D.

    2015-01-01

    Introduction: Historically, only individuals with a cross-gender identity who wanted to receive a full treatment, were eligible for "complete sex reassignment" consisting of feminizing/masculinizing hormone treatment and several surgical interventions including genital surgery (full treatment).

  17. Surgical competence.

    Science.gov (United States)

    Patil, Nivritti G; Cheng, Stephen W K; Wong, John

    2003-08-01

    Recent high-profile cases have heightened the need for a formal structure to monitor achievement and maintenance of surgical competence. Logbooks, morbidity and mortality meetings, videos and direct observation of operations using a checklist, motion analysis devices, and virtual reality simulators are effective tools for teaching and evaluating surgical skills. As the operating theater is also a place for training, there must be protocols and guidelines, including mandatory standards for supervision, to ensure that patient care is not compromised. Patients appreciate frank communication and honesty from surgeons regarding their expertise and level of competence. To ensure that surgical competence is maintained and keeps pace with technologic advances, professional registration bodies have been promoting programs for recertification. They evaluate performance in practice, professional standing, and commitment to ongoing education.

  18. [Gender identity disorder: challenges and specificity in the treatment of requests for sexual reassignment].

    Science.gov (United States)

    Pécoud, P; Pralong, F; Bauquis, O; Stiefel, F

    2011-02-16

    Gender identity disorder is defined as a permanent desire to relieve one's own sexual features to acquire the sexual features and line to life of the opposite sex. The diagnosis is based on the psychiatric evaluation and treatment on an interdisciplinary approach by endocrinologists, surgeons and psychiatrists, and can be conceptualized into distinct phases: diagnostic evaluation, real life experience, hormonal treatment and surgery. Multiples challenges have to be faced, especially by the psychiatrist who follows the patient during the whole process.

  19. Surgical Navigation

    DEFF Research Database (Denmark)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan

    2017-01-01

    Purpose: This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indicatio...

  20. Surgical Instrument

    NARCIS (Netherlands)

    Dankelman, J.; Horeman, T.

    2009-01-01

    The present invention relates to a surgical instrument for minimall-invasive surgery, comprising a handle, a shaft and an actuating part, characterised by a gastight cover surrounding the shaft, wherein the cover is provided with a coupler that has a feed- through opening with a loskable seal,

  1. Sex Headaches

    Science.gov (United States)

    Sex headaches Overview Sex headaches are brought on by sexual activity — especially an orgasm. You may notice a dull ache in your head ... severe headache just before or during orgasm. Most sex headaches are nothing to worry about. But some ...

  2. Sex ratios

    OpenAIRE

    West, Stuart A; Reece, S E; Sheldon, Ben C

    2002-01-01

    Sex ratio theory attempts to explain variation at all levels (species, population, individual, brood) in the proportion of offspring that are male (the sex ratio). In many cases this work has been extremely successful, providing qualitative and even quantitative explanations of sex ratio variation. However, this is not always the situation, and one of the greatest remaining problems is explaining broad taxonomic patterns. Specifically, why do different organisms show so ...

  3. Creating Sex

    DEFF Research Database (Denmark)

    Cahana, Jonathan

    2016-01-01

    Thomas Laqueur’s influential yet controversial study Making Sex has, in many ways, revolutionized our understanding of sexuality in antiquity. Yet, most of Laqueur’s critics and supporters stressed the one-sex body, while the crux of his argument is the primacy of gender. Moreover, a systematic...

  4. Sex determination

    Indian Academy of Sciences (India)

    The sex-determining system differs considerably among organisms. Even among insect species, the genetic system for sex-determination is highly diversified. In Drosophila melanogaster, somatic sexual differentiation is regulated by a well characterized genetic hierarchy X : A > Sxl > tra/tra2 > dsx and fru. This cascade ...

  5. One-Stage Gender-Confirmation Surgery as a Viable Surgical Procedure for Female-to-Male Transsexuals.

    Science.gov (United States)

    Stojanovic, Borko; Bizic, Marta; Bencic, Marko; Kojovic, Vladimir; Majstorovic, Marko; Jeftovic, Milos; Stanojevic, Dusan; Djordjevic, Miroslav L

    2017-05-01

    Female-to-male gender-confirmation surgery (GCS) includes removal of breasts and female genitalia and complete genital and urethral reconstruction. With a multidisciplinary approach, these procedures can be performed in one stage, avoiding multistage operations. To present our results of one-stage sex-reassignment surgery in female-to-male transsexuals and to emphasize the advantages of single-stage over multistage surgery. During a period of 9 years (2007-2016), 473 patients (mean age = 31.5 years) underwent metoidioplasty. Of these, 137 (29%) underwent simultaneous hysterectomy, and 79 (16.7%) underwent one-stage GCS consisting of chest masculinization, total transvaginal hysterectomy with bilateral adnexectomy, vaginectomy, metoidioplasty, urethral lengthening, scrotoplasty, and implantation of bilateral testicular prostheses. All surgeries were performed simultaneously by teams of experienced gynecologic and gender surgeons. Primary outcome measurements were surgical time, length of hospital stay, and complication and reoperation rates compared with other published data and in relation to the number of stages needed to complete GCS. Mean follow-up was 44 months (range = 10-92). Mean surgery time was 270 minutes (range = 215-325). Postoperative hospital stay was 3 to 6 days (mean = 4). Complications occurred in 20 patients (25.3%). Six patients (7.6%) had complications related to mastectomy, and one patient underwent revision surgery because of a breast hematoma. Two patients underwent conversion of transvaginal hysterectomy to an abdominal approach, and subcutaneous perineal cyst, as a consequence of colpocleisis, occurred in nine patients. There were eight complications (10%) from urethroplasty, including four fistulas, three strictures, and one diverticulum. Testicular implant rejection occurred in two patients and testicular implant displacement occurred in one patient. Female-to-male transsexuals can undergo complete GCS, including mastectomy

  6. Oral sex.

    Science.gov (United States)

    1996-04-05

    The Gay and Lesbian Medical Association urges HIV prevention specialists to regard male-to-male oral-genital sex as a low-risk activity and concentrate instead on the danger of unprotected anal intercourse. According to the association, the confusion and mixed messages surrounding oral sex are harming efforts to encourage gay men to make rational choices about truly risky behavior. The recommendations appear in the association's position paper issued March 19, 1996.

  7. Why Sex?

    DEFF Research Database (Denmark)

    Nielsen, Rasmus

    2006-01-01

    It is assumed that most organisms have sex because the resulting genetic recombination allows Darwinian selection to work better. It is now shown that in water fleas, recombination does lead to fewer deleterious mutations.......It is assumed that most organisms have sex because the resulting genetic recombination allows Darwinian selection to work better. It is now shown that in water fleas, recombination does lead to fewer deleterious mutations....

  8. Surgical castration, coercion and ethics

    DEFF Research Database (Denmark)

    Ryberg, Jesper; Petersen, Thomas Søbirk

    2014-01-01

    the only means by which these offenders are likely to be released from prison, it is reasonable—and close to the heart of modern medical ethics—to consider whether the offer involves some kind of coercion. However, despite McMillan's seemingly careful consideration of this question, it appears to us......John McMillan's detailed ethical analysis concerning the use of surgical castration of sex offenders in the Czech Republic and Germany is mainly devoted to considerations of coercion.1 This is not surprising. When castration is offered as an option to offenders and, at the same time, constitutes...

  9. Cross-sex pattern of bone mineral density in early onset gender identity disorder.

    Science.gov (United States)

    Haraldsen, I R; Haug, E; Falch, J; Egeland, T; Opjordsmoen, S

    2007-09-01

    Hormonally controlled differences in bone mineral density (BMD) between males and females are well studied. The effects of cross-sex hormones on bone metabolism in patients with early onset gender identity disorder (EO-GID), however, are unclear. We examined BMD, total body fat (TBF) and total lean body mass (TLBM) in patients prior to initiation of sex hormone treatment and during treatment at months 3 and 12. The study included 33 EO-GID patients who were approved for sex reassignment and a control group of 122 healthy Norwegians (males, n=77; females, n=45). Male patients (n=12) received an oral dose of 50 mug ethinylestradiol daily for the first 3 months and 100 mug daily thereafter. Female patients (n=21) received 250 mg testosterone enantate intramuscularly every third week. BMD, TBF and TLBM were estimated using dual energy X-ray absorptiometry (DXA). In male patients, the DXA measurements except TBF were significantly lower compared to their same-sex control group at baseline and did not change during treatment. In female patients, the DXA measurements were slightly higher than in same-sex controls at baseline and also remained unchanged during treatment. In conclusion, this study reports that body composition and bone density of EO-GID patients show less pronounced sex differences compared to controls and that bone density was unaffected by cross-sex hormone treatment.

  10. Micro-surgical endodontics.

    Science.gov (United States)

    Eliyas, S; Vere, J; Ali, Z; Harris, I

    2014-02-01

    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  11. Can Image-Defined Risk Factors Predict Surgical Complications in Localized Neuroblastoma?

    Science.gov (United States)

    Yoneda, Akihiro; Nishikawa, Masanori; Uehara, Shuichiro; Oue, Takaharu; Usui, Noriaki; Inoue, Masami; Fukuzawa, Masahiro; Okuyama, Hiroomi

    2016-02-01

    Image-defined risk factors (IDRFs) have been propounded for predicting the surgical risks associated with localized neuroblastoma (NB) since 2009. In 2011, a new guideline (NG) for assessing IDRFs was published. According to the NG, the situation in which "the tumor is only in contact with renal vessels," should be considered to be "IDRF-present." Previously, this situation was diagnosed as "IDRF absent." In this study, we evaluated the IDRFs in localized NB patients to clarify the predictive capability of IDRFs for surgical complications, as well as the usefulness of the NG. Materials and A total of 107 localized patients with NB were included in this study. The enhanced computed tomography and magnetic resonance images from the time of their diagnoses were evaluated by a single radiologist. We also analyzed the association of clinical factors, including the IDRFs (before and after applying the NG), with surgical complications. Of the 107 patients, 33 and 74 patients were diagnosed as IDRF-present (OP group), and IDRF-absent (ON group) before the NG, respectively. According to the NG, there were 76 and 31 patients who were classified as IDRF-present (NP group) and IDRF absent (NN group), respectively. Thus, 43 (40%) patients in the ON group were reassigned to the NP group after the NG. Surgical complications were observed in 17 of 82 patients who underwent surgical resection. Of the patients who underwent secondary operations, surgical complication rates were 55% in the OP group and 44% in the NP group. According to a univariate analysis, non-INSS 1, IDRFs before and after the NG and secondary operations were significantly associated with surgical complications. In a multivariate analysis, non-INSS 1 status and IDRFs after the NG were significantly associated with surgical complications. Georg Thieme Verlag KG Stuttgart · New York.

  12. Does surgical genitoplasty affect gender identity in the intersex infant?

    Science.gov (United States)

    Nihoul-Fékété, C

    2005-01-01

    There is no clear-cut answer to the question of whether surgical genitoplasty affects gender identity in the intersex infant. The debate centres around which is more important for the development of gender identity: the biological sex of a child or the sex in which a child is reared. We believe that the surgical achievement of a phenotype concordant with the sex of rearing is a tremendous help to the parents of an intersex infant. We do not consider that the 'neutral' upbringing of a child with ambiguous genitalia is a feasible option, first because of the parents' distress which prevents them from raising their child normally and second because in most cultures around the world gender variants are not treated as equals. A neutral upbringing may induce psychosocial consequences that are more pernicious than carefully considered neonatal sex attribution and concordant surgical genitoplasty. (c) 2005 S. Karger AG, Basel.

  13. Sex. Dev.

    OpenAIRE

    Jakubiczka, S.; Schröder, C.; Ullmann, R.; Volleth, M.; Ledig, S.; Gilberg, E.; Kroisel, P.; P. Wieacker, P.

    2010-01-01

    Campomelic dysplasia (MIM 114290) is a severe malformation syndrome frequently accompanied by male-to-female sex reversal. Causative are mutations within the SOX9 gene on 17q24.3 as well as chromosomal aberrations (translocations, inversions or deletions) in the vicinity of SOX9 . Here, we report on a patient with muscular hypotonia, craniofacial dysmorphism, cleft palate, brachydactyly, malformations of thoracic spine, and gonadal dysgenesis with female external genitalia and müllerian duct ...

  14. Uncommon surgical emergencies in neonatology

    Directory of Open Access Journals (Sweden)

    R. Angotti

    2014-12-01

    Full Text Available Objective. Over the past decade, multiple factors have changed the pattern of neonatal surgical emergencies. An increase in prenatal screenings and the development of neonatal tertiary care centres have changed the clinical approach to these kids. Materials and methods. Between 1995 to 2011 were retrospectively reviewed 34 patients with diagnosis of uncommon rare neonatal surgical emergencies at our institute. We analyzed: sex, gestational age, weight at birth, primary pathology, prenatal diagnosis, associated anomalies, age and weight at surgery, clinical presentation, start of oral feeding and hospitalization. The follow-up was performed at 6,12, 24 and 36 months. Results. There were 21 male and 13 female. The gestational age ranged between 28 and 36 weeks. The weight at birth ranged between 700 and 1400 grams. Oral feeding was started between 4th and 10th postoperative day. The average hospitalization was about 70.47 days. To date, all patients have finished the followup. They are healthy. Conclusion. The outcome of the patients with uncommon surgical emergencies is different based on the etiology. Overall survival is generally good but is influenced by the associated anomalies.

  15. The challenges in diagnosis and gender assignment in disorders of sex development presenting to a pediatric surgical unit in a developing country: the role of laparoscopy and simple tests for gender identity.

    Science.gov (United States)

    Chowdhury, Tanvir K; Kabir, Mahfuzul; Chowdhury, Md Zonaid; Hutson, John M; Banu, Tahmina

    2014-12-01

    We aimed to assess how the diagnosis and determination of gender identity of disorders of sex development (DSD) is different in a developing country from Western medicine, and whether a pediatric surgery department can determine the underlying diagnosis and use simple tools to determine the likely gender identity (GI). We reviewed the records of DSD patients admitted to the Department of Pediatric Surgery, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh, from January 2006 to December 2012 and performed a cross-sectional study on GI and gender-related behavior in these patients during the year 2012. DSD boys and girls answered a GI interview and had their gender role behavior assessed by observations of structural toy play and analyzed for differences in scores. This cohort of DSD patients presented in mid-childhood (6 months-16 years, mean 6.9 years) rather than infancy, and 30% came from consanguineous unions. Congenital adrenal hyperplasia (CAH) constituted only 11 of 50 (22%) of the DSD cohort, and not all families had access to steroid hormone replacement. A simple assessment of GI and gender-related behavior allowed effective gender assignment, as there was significant difference between DSD boys and girls in GI and gender-related behavior score. DSD management in Bangladesh provides some unique challenges because of limited resources. A national reference laboratory for biochemical and genetic testing and development of a quaternary referral center for DSD patients will be helpful. Continued use of the GI interview and gender-related behavior study will enable effective interim decisions about diagnosis and management. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  16. American Pediatric Surgical Association

    Science.gov (United States)

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  17. Abortion - surgical - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  18. Urogynecologic Surgical Mesh Implants

    Science.gov (United States)

    ... procedures performed to treat pelvic floor disorders with surgical mesh: Transvaginal mesh to treat POP Transabdominal mesh to treat ... address safety risks Final Order for Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair Final Order for Effective ...

  19. Ideal Body Weight Calculation in the Bariatric Surgical Population.

    Science.gov (United States)

    Kammerer, Michael R; Porter, Michelle M; Beekley, Alec C; Tichansky, David S

    2015-10-01

    In bariatric surgery, ideal body weight (IBW) is used to calculate excess body weight (EBW) and percent excess weight lost (%EWL). Bariatric literature typically uses the midpoint of the medium frame from older Metropolitan Life Insurance (MetLife) tables to estimate IBW. This is neither universal nor always clinically accurate. The objective of this study was to determine the accuracy of standard IBW formulas compared to MetLife data. Weight loss data from 200 bariatric surgical patients between 2009 and 2011 was used to assess the accuracy of IBW formulas. IBWs assigned from the midpoint of the medium frame and reassigned using different gender targets were compared to standard formulas and a new formula to assess the accuracy of all formulas to both targets. Using standard MetLife data, the mean IBW was 136 lb, the mean EBW was 153.6 lb, and the mean %EWL was 43.8 %. Using the new target baseline, the mean IBW was 137.1 lb, the mean EBW was 152.6 lb, and the mean %EWL was 44 %. Deitel and Greenstein's formula was accurate to 0.3 % of EBW using the standard method, while our new formula was accurate to 0.03 % of EBW. Deitel and Greenstein's formula is most accurate using standard target IBW. The most accurate is our formula using the new MetLife target IBW.

  20. When Sex Is Painful

    Science.gov (United States)

    ... AQ FREQUENTLY ASKED QUESTIONS GYNECOLOGIC PROBLEMS FAQ020 When Sex Is Painful • How common is painful sex? • What causes pain during sex? • Where is pain during sex felt? • When should ...

  1. Sex during Pregnancy

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Sex During Pregnancy KidsHealth / For Parents / Sex During Pregnancy ... satisfying and safe sexual relationship during pregnancy. Is Sex During Pregnancy Safe? Sex is considered safe during ...

  2. Fluidity models in ancient Greece and current practices of sex assignment.

    Science.gov (United States)

    Chen, Min-Jye; McCann-Crosby, Bonnie; Gunn, Sheila; Georgiadis, Paraskevi; Placencia, Frank; Mann, David; Axelrad, Marni; Karaviti, L P; McCullough, Laurence B

    2017-06-01

    Disorders of sexual differentiation such as androgen insensitivity and gonadal dysgenesis can involve an intrinsic fluidity at different levels, from the anatomical and biological to the social (gender) that must be considered in the context of social constraints. Sex assignment models based on George Engel's biopsychosocial aspects model of biology accept fluidity of gender as a central concept and therefore help establish expectations within the uncertainty of sex assignment and anticipate potential changes. The biology underlying the fluidity inherent to these disorders should be presented to parents at diagnosis, an approach that the gender medicine field should embrace as good practice. Greek mythology provides many accepted archetypes of change, and the ancient Greek appreciation of metamorphosis can be used as context with these patients. Our goal is to inform expertise and optimal approaches, knowing that this fluidity may eventually necessitate sex reassignment. Physicians should provide sex assignment education based on different components of sexual differentiation, prepare parents for future hormone-triggered changes in their children, and establish a sex-assignment algorithm. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Fluidity models in ancient Greece and current practices of sex assignment

    Science.gov (United States)

    Chen, Min-Jye; McCann-Crosby, Bonnie; Gunn, Sheila; Georgiadis, Paraskevi; Placencia, Frank; Mann, David; Axelrad, Marni; Karaviti, L.P; McCullough, Laurence B.

    2018-01-01

    Disorders of sexual differentiation such as androgen insensitivity and gonadal dysgenesis can involve an intrinsic fluidity at different levels, from the anatomical and biological to the social (gender) that must be considered in the context of social constraints. Sex assignment models based on George Engel’s biopsychosocial aspects model of biology accept fluidity of gender as a central concept and therefore help establish expectations within the uncertainty of sex assignment and anticipate potential changes. The biology underlying the fluidity inherent to these disorders should be presented to parents at diagnosis, an approach that the gender medicine field should embrace as good practice. Greek mythology provides many accepted archetypes of change, and the ancient Greek appreciation of metamorphosis can be used as context with these patients. Our goal is to inform expertise and optimal approaches, knowing that this fluidity may eventually necessitate sex reassignment. Physicians should provide sex assignment education based on different components of sexual differentiation, prepare parents for future hormone-triggered changes in their children, and establish a sex-assignment algorithm. PMID:28478088

  4. Sex Education

    Directory of Open Access Journals (Sweden)

    R N Srivastava

    1994-06-01

    Full Text Available Sex, though not everything in life, is a profoundly important aspect of human existence. It has evolved to serve more than reproductive functions; relational and recreational functions having taken precedence over procrea­tional. Sex has come to play a much wider socio-psychological function. Human sexuality is complex and multidimensional. It is subject to influence by multitude of factors often grouped as biological (e.g. genes, hormones, psychological (e.g. fear, anxiety, mood and socio-cultural (e.g. sex roles, values- religious/moral/ethical, customs. It is the interaction and interrelationship of these factors from the time of conception, through intrauterine life, infancy, childhood and adolescence, till adulthood (even later in life that determine the sexual development expressed as sexual attitudes and behaviour of the people. Learning, both social and cognitive, plays a significantly important role in such development. Sexual dysfunctions in men and women, result from factors often categorised as physical or organic and psychological; more often a combination may be involved. Experience has shown that in majority of men and women in India having sexual problems, ignorance misconceptions and prevailing myths are invariably responsible in the causation of Ihese problems. Sexual problems in individual man (e.g. erectile failure and woman (e.g. vaginismus cause anxiety, feelings of frustration, lowered self esteem and symptoms of depression. The condition may also affect the spouse; he/she, as a reaction to the problem in the partner, may develop sexual and psychosocial problems including distressed marital relationship. This may also have influence on general couple relationship, effecting adversely the quality of family life. Modern therapeutic endevours have made it possible now to offer effective therapy to most people who seek help for their sexual problems, thus preventing the consequences on couple relationship. However, there is

  5. SEX EDUCATION

    Directory of Open Access Journals (Sweden)

    R N Srivastava

    1994-06-01

    Full Text Available Sex, though not everything in life, is a profoundly important aspect of human existence. It has evolved to serve more than reproductive functions; relational and recreational functions having taken precedence over procrea­tional. Sex has come to play a much wider socio-psychological function.Human sexuality is complex and multidimensional. It is subject to influence by multitude of factors often grouped as biological (e.g. genes, hormones, psychological (e.g. fear, anxiety, mood and socio-cultural (e.g. sex roles, values- religious/moral/ethical, customs. It is the interaction and interrelationship of these factors from the time of conception, through intrauterine life, infancy, childhood and adolescence, till adulthood (even later in life that determine the sexual development expressed as sexual attitudes and behaviour of the people. Learning, both social and cognitive, plays a significantly important role in such development.Sexual dysfunctions in men and women, result from factors often categorised as physical or organic and psychological; more often a combination may be involved. Experience has shown that in majority of men and women in India having sexual problems, ignorance misconceptions and prevailing myths are invariably responsible in the causation of Ihese problems. Sexual problems in individual man (e.g. erectile failure and woman (e.g. vaginismus cause anxiety, feelings of frustration, lowered self esteem and symptoms of depression. The condition may also affect the spouse; he/she, as a reaction to the problem in the partner, may develop sexual and psychosocial problems including distressed marital relationship. This may also have influence on general couple relationship, effecting adversely the quality of family life.Modern therapeutic endevours have made it possible now to offer effective therapy to most people who seek help for their sexual problems, thus preventing the consequences on couple relationship. However, there is also

  6. Quantitative sexing (Q-Sexing) and relative quantitative sexing (RQ ...

    African Journals Online (AJOL)

    samer

    Key words: Polymerase chain reaction (PCR), quantitative real time polymerase chain reaction (qPCR), quantitative sexing, Siberian tiger. INTRODUCTION. Animal molecular sexing .... 43:3-12. Ellegren H (1996). First gene on the avian W chromosome (CHD) provides a tag for universal sexing of non-ratite birds. Proc.

  7. Surgical Outcome in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage

    Directory of Open Access Journals (Sweden)

    Rendevski Vladimir

    2017-12-01

    Full Text Available The aim of the paper was to evaluate the surgical outcome in patients with spontaneous supratentorial intracerebral hemorrhage (ICH after surgical intervention, in respect to the initial clinical conditions, age, sex, hemispheric side and anatomic localization of ICH. Thirty-eight surgically treated patients with spontaneous supratentorial intracerebral hemorrhage were included in the study. The surgical outcome was evaluated three months after the initial admission, according to the Glasgow Outcome Scale (GOS. The surgical treatment was successful in 14 patients (37%, whereas it was unsuccessful in 24 patients (63%. We have detected a significant negative correlation between the Glasgow Coma Scale (GCS scores on admission and the GOS scores after three months, suggesting worse neurological outcome in patients with initially lower GCS scores. The surgical outcome in patients with ICH was not affected by the sex, the hemispheric side and the anatomic localization of ICH, but the age of the patients was estimated as a significant factor for their functional outcome, with younger patients being more likely to be treated successfully. The surgical outcome is affected from the initial clinical state of the patients and their age. The treatment of ICH is still an unsolved clinical problem and the development of new surgical techniques with larger efficiency in the evacuation of the hematoma is necessary, thus making a minimal damage to the normal brain tissue, as well as decreasing the possibility of postoperative bleeding.

  8. Indications to radical surgical interventions in chondrosarcomas of the limbs

    International Nuclear Information System (INIS)

    Korolev, V.I.

    1988-01-01

    On the basis of analysis carried out in treatment of 229 patients suffering from chondrosarcomas of the limbs it is established that radical surgical intervention in bulk of amputation or exarticulation is the choice of the treatment method at the 3d clinical stage of disease. Sex does not influence the chondrosarcomas prognosis. 20-years age patients have the shortest life-time after operation. Radiotherapy and chemotherapy does not improve the results of surgical treatment

  9. Systematic revision of the adeleid haemogregarines, with creation of Bartazoon n. g., reassignment of Hepatozoon argantis Garnham, 1954 to Hemolivia, and molecular data on Hemolivia stellata

    Directory of Open Access Journals (Sweden)

    Karadjian Grégory

    2015-01-01

    Full Text Available Life cycles and molecular data for terrestrial haemogregarines are reviewed in this article. Collection material was re-examined: Hepatozoon argantis Garnham, 1954 in Argas brumpti was reassigned to Hemolivia as Hemolivia argantis (Garnham, 1954 n. comb.; parasite DNA was extracted from a tick crush on smear of an archived slide of Hemolivia stellata in Amblyomma rotondatum, then the 18S ssrRNA gene was amplified by PCR. A systematic revision of the group is proposed, based on biological life cycles and phylogenetic reconstruction. Four types of life cycles, based on parasite vector, vertebrate host and the characteristics of their development, are defined. We propose combining species, based on their biology, into four groups (types I, II, III and IV. The characters of each type are defined and associated with a type genus and a type species. The biological characters of each type are associated with a different genus and a type species. The phylogenetic reconstruction with sequences deposited in the databases and our own new sequence of Hemolivia stellata is consistent with this classification. The classification is as follows: Type I, Hepatozoon Miller, 1908, type species H. perniciosum Miller, 1908; Type II, Karyolysus Labbé, 1894, type species K. lacertae (Danilewsky, 1886 Reichenow, 1913; Type III Hemolivia Petit et al., 1990, type species H. stellata, Petit et al., 1990; and Type IV: Bartazoon n. g., type species B. breinli (Mackerras, 1960.

  10. Systematic revision of the adeleid haemogregarines, with creation of Bartazoon n. g., reassignment of Hepatozoon argantis Garnham, 1954 to Hemolivia, and molecular data on Hemolivia stellata

    Science.gov (United States)

    Karadjian, Grégory; Chavatte, Jean-Marc; Landau, Irène

    2015-01-01

    Life cycles and molecular data for terrestrial haemogregarines are reviewed in this article. Collection material was re-examined: Hepatozoon argantis Garnham, 1954 in Argas brumpti was reassigned to Hemolivia as Hemolivia argantis (Garnham, 1954) n. comb.; parasite DNA was extracted from a tick crush on smear of an archived slide of Hemolivia stellata in Amblyomma rotondatum, then the 18S ssrRNA gene was amplified by PCR. A systematic revision of the group is proposed, based on biological life cycles and phylogenetic reconstruction. Four types of life cycles, based on parasite vector, vertebrate host and the characteristics of their development, are defined. We propose combining species, based on their biology, into four groups (types I, II, III and IV). The characters of each type are defined and associated with a type genus and a type species. The biological characters of each type are associated with a different genus and a type species. The phylogenetic reconstruction with sequences deposited in the databases and our own new sequence of Hemolivia stellata is consistent with this classification. The classification is as follows: Type I, Hepatozoon Miller, 1908, type species H. perniciosum Miller, 1908; Type II, Karyolysus Labbé, 1894, type species K. lacertae (Danilewsky, 1886) Reichenow, 1913; Type III Hemolivia Petit et al., 1990, type species H. stellata, Petit et al., 1990; and Type IV: Bartazoon n. g., type species B. breinli (Mackerras, 1960). PMID:26551414

  11. Systematic revision of the adeleid haemogregarines, with creation of Bartazoon n. g., reassignment of Hepatozoon argantis Garnham, 1954 to Hemolivia, and molecular data on Hemolivia stellata.

    Science.gov (United States)

    Karadjian, Grégory; Chavatte, Jean-Marc; Landau, Irène

    2015-01-01

    Life cycles and molecular data for terrestrial haemogregarines are reviewed in this article. Collection material was re-examined: Hepatozoon argantis Garnham, 1954 in Argas brumpti was reassigned to Hemolivia as Hemolivia argantis (Garnham, 1954) n. comb.; parasite DNA was extracted from a tick crush on smear of an archived slide of Hemolivia stellata in Amblyomma rotondatum, then the 18S ssrRNA gene was amplified by PCR. A systematic revision of the group is proposed, based on biological life cycles and phylogenetic reconstruction. Four types of life cycles, based on parasite vector, vertebrate host and the characteristics of their development, are defined. We propose combining species, based on their biology, into four groups (types I, II, III and IV). The characters of each type are defined and associated with a type genus and a type species. The biological characters of each type are associated with a different genus and a type species. The phylogenetic reconstruction with sequences deposited in the databases and our own new sequence of Hemolivia stellata is consistent with this classification. The classification is as follows: Type I, Hepatozoon Miller, 1908, type species H. perniciosum Miller, 1908; Type II, Karyolysus Labbé, 1894, type species K. lacertae (Danilewsky, 1886) Reichenow, 1913; Type III Hemolivia Petit et al., 1990, type species H. stellata, Petit et al., 1990; and Type IV: Bartazoon n. g., type species B. breinli (Mackerras, 1960). © G. Karadjian et al., published by EDP Sciences, 2015.

  12. Deriving DICOM surgical extensions from surgical workflows

    Science.gov (United States)

    Burgert, O.; Neumuth, T.; Gessat, M.; Jacobs, S.; Lemke, H. U.

    2007-03-01

    The generation, storage, transfer, and representation of image data in radiology are standardized by DICOM. To cover the needs of image guided surgery or computer assisted surgery in general one needs to handle patient information besides image data. A large number of objects must be defined in DICOM to address the needs of surgery. We propose an analysis process based on Surgical Workflows that helps to identify these objects together with use cases and requirements motivating for their specification. As the first result we confirmed the need for the specification of representation and transfer of geometric models. The analysis of Surgical Workflows has shown that geometric models are widely used to represent planned procedure steps, surgical tools, anatomical structures, or prosthesis in the context of surgical planning, image guided surgery, augmented reality, and simulation. By now, the models are stored and transferred in several file formats bare of contextual information. The standardization of data types including contextual information and specifications for handling of geometric models allows a broader usage of such models. This paper explains the specification process leading to Geometry Mesh Service Object Pair classes. This process can be a template for the definition of further DICOM classes.

  13. Recognizing surgical patterns

    NARCIS (Netherlands)

    Bouarfa, L.

    2012-01-01

    In the Netherlands, each year over 1700 patients die from preventable surgical errors. Numerous initiatives to improve surgical practice have had some impact, but problems persist. Despite the introduction of checklists and protocols, patient safety in surgery remains a continuing challenge. This is

  14. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.

    2008-01-01

    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

  15. Endoscopic Sex Identification in Chelonians and Birds (Psittacines, Passerines, and Raptors).

    Science.gov (United States)

    Divers, Stephen J

    2015-09-01

    Despite the advent of DNA probes for sex identification of many avian and some reptile species, clinicians involved with zoos, conservation projects, or breeders may still be asked to perform "surgical sexing." This article describes the practical approach to performing endoscopic sex identification in psittacines and chelonians, including patient preparation, anesthesia, and endoscopic procedure. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Sex-linked dominant

    Science.gov (United States)

    Inheritance - sex-linked dominant; Genetics - sex-linked dominant; X-linked dominant; Y-linked dominant ... can be either an autosomal chromosome or a sex chromosome. It also depends on whether the trait ...

  17. Multiple sex partner

    African Journals Online (AJOL)

    User

    intercourse, about 60% reported having a single sexual partner and 40% reported having multiple ... masturbation, start having sex at a younger age, have sex with married people and/or .... sex were considered unacceptable by 89 vs.

  18. Surgical ethics: surgical virtue and more.

    Science.gov (United States)

    Vercler, Christian J

    2015-01-01

    The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.

  19. Understanding Sex for Sale

    DEFF Research Database (Denmark)

    This book Understanding Sex for Sale: Meanings and Moralities of Sexual Commerce is dedicated to the exploration of the ways in which sex prostitution, sex work or sex for sale are taken for granted by particularly looking at how the relation between sex and money is interpreted and enacted....... This interdisciplinary book aims to understand how prostitution, sex work or sex for sale are defined, delineated, contested and understood in different places and times. The book offers contributions from a number of scholars who, based on their on their own research, discuss on going theoretical issues and analytical...... challenges Some chapters focuses on how prostitution, sex work or sex for sale have been regulated by the authorities and what understandings this regulation builds on. Other chapters investigate the experiences of the sex workers and sex buyers asking how these actors adjust to or resist the categorisation...

  20. Surgical site infections

    African Journals Online (AJOL)

    Decrease the inflammatory response Vasodilatation leads to better perfusion and ... Must NOT be allowed to come in contact with brain, meninges, eyes or .... project (SCIP): Evolution of National Quality Measure. Surgical. Infection 2008 ...

  1. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  2. Ambulatory Surgical Measures - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  3. Surgical Management of Hemorrhoids

    Science.gov (United States)

    Agbo, S. P.

    2011-01-01

    Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding. PMID:22413048

  4. Surgical site infections

    African Journals Online (AJOL)

    Surgical site infections (SSIs) are a worldwide problem that has ... deep tissue is found on clinical examination, re-opening, histopathological or radiological investigation ..... Esposito S, Immune system and SSI, Journal of Chemotherapy, 2001.

  5. Surgical management of pain

    African Journals Online (AJOL)

    If these therapies fail, and with a thorough multidisciplinary approach involving carefully ... Generally, surgical pain management is divided into neuro- modulative .... 9 suggested. It is important to be sure that the underlying instability or.

  6. [Simulation in surgical training].

    Science.gov (United States)

    Nabavi, A; Schipper, J

    2017-01-01

    Patient safety during operations hinges on the surgeon's skills and abilities. However, surgical training has come under a variety of restrictions. To acquire dexterity with decreasingly "simple" cases, within the legislative time constraints and increasing expectations for surgical results is the future challenge. Are there alternatives to traditional master-apprentice learning? A literature review and analysis of the development, implementation, and evaluation of surgical simulation are presented. Simulation, using a variety of methods, most important physical and virtual (computer-generated) models, provides a safe environment to practice basic and advanced skills without endangering patients. These environments have specific strengths and weaknesses. Simulations can only serve to decrease the slope of learning curves, but cannot be a substitute for the real situation. Thus, they have to be an integral part of a comprehensive training curriculum. Our surgical societies have to take up that challenge to ensure the training of future generations.

  7. Seasonality and surgical management of intussusception over 10 ...

    African Journals Online (AJOL)

    47.5%of patients had resection and primary anastomosis while 24.0% had manual reduction at laparotomy. Conclusion: Intussusception is one of the most common paediatric surgical emergencies at Harare Central Hospital. The age and sex of patients are the same as those found in literature. In contrast with previous data ...

  8. Pattern of Presentation and Outcome of Surgical Management of ...

    African Journals Online (AJOL)

    ANNALS

    presentation and modality of surgical treatment in our environment. Methods: ... irréversible, et prévention du glaucome est l'une des priorités de l'Organisation Mondiale de la Santé. (OMS) ... some point in the disease (although 15% or more of .... Age and sex distribution of 63 patients with primary open angle glaucoma.

  9. 408 Cases of Genital Ambiguity Followed by Single Multidisciplinary Team during 23 Years: Etiologic Diagnosis and Sex of Rearing

    Directory of Open Access Journals (Sweden)

    Georgette Beatriz De Paula

    2016-01-01

    Full Text Available Objective. To evaluate diagnosis, age of referral, karyotype, and sex of rearing of cases with disorders of sex development (DSD with ambiguous genitalia. Methods. Retrospective study during 23 years at outpatient clinic of a referral center. Results. There were 408 cases; 250 (61.3% were 46,XY and 124 (30.4% 46,XX and 34 (8.3% had sex chromosomes abnormalities. 189 (46.3% had 46,XY testicular DSD, 105 (25.7% 46,XX ovarian DSD, 95 (23.3% disorders of gonadal development (DGD, and 19 (4.7% complex malformations. The main etiology of 46,XX ovarian DSD was salt-wasting 21-hydroxylase deficiency. In 46,XX and 46,XY groups, other malformations were observed. In the DGD group, 46,XY partial gonadal dysgenesis, mixed gonadal dysgenesis, and ovotesticular DSD were more frequent. Low birth weight was observed in 42 cases of idiopathic 46,XY testicular DSD. The average age at diagnosis was 31.7 months. The final sex of rearing was male in 238 cases and female in 170. Only 6.6% (27 cases needed sex reassignment. Conclusions. In this large DSD sample with ambiguous genitalia, the 46,XY karyotype was the most frequent; in turn, congenital adrenal hyperplasia was the most frequent etiology. Malformations associated with DSD were common in all groups and low birth weight was associated with idiopathic 46,XY testicular DSD.

  10. Post surgical complications from students' large animal surgical ...

    African Journals Online (AJOL)

    A retrospective study of post surgical complications was conducted on records of students' Large Animal Surgical Laboratories in the Faculty of Veterinary Medicine (F.V.M.), Ahmadu Bello University (A.B.U), Zaria from 1989 to 1993. Three hundred and eleven surgical complications were recorded from five surgical ...

  11. Outcome of Vaginoplasty in Male-to-Female Transgenders: A Systematic Review of Surgical Techniques.

    Science.gov (United States)

    Horbach, Sophie E R; Bouman, Mark-Bram; Smit, Jan Maerten; Özer, Müjde; Buncamper, Marlon E; Mullender, Margriet G

    2015-06-01

    Gender reassignment surgery is the keystone of the treatment of transgender patients. For male-to-female transgenders, this involves the creation of a neovagina. Many surgical methods for vaginoplasty have been opted. The penile skin inversion technique is the method of choice for most gender surgeons. However, the optimal surgical technique for vaginoplasty in transgender women has not yet been identified, as outcomes of the different techniques have never been compared. With this systematic review, we aim to give a detailed overview of the published outcomes of all currently available techniques for vaginoplasty in male-to-female transgenders. A PubMed and EMBASE search for relevant publications (1995-present), which provided data on the outcome of techniques for vaginoplasty in male-to-female transgender patients. Main outcome measures are complications, neovaginal depth and width, sexual function, patient satisfaction, and improvement in quality of life (QoL). Twenty-six studies satisfied the inclusion criteria. The majority of these studies were retrospective case series of low to intermediate quality. Outcome of the penile skin inversion technique was reported in 1,461 patients, bowel vaginoplasty in 102 patients. Neovaginal stenosis was the most frequent complication in both techniques. Sexual function and patient satisfaction were overall acceptable, but many different outcome measures were used. QoL was only reported in one study. Comparison between techniques was difficult due to the lack of standardization. The penile skin inversion technique is the most researched surgical procedure. Outcome of bowel vaginoplasty has been reported less frequently but does not seem to be inferior. The available literature is heterogeneous in patient groups, surgical procedure, outcome measurement tools, and follow-up. Standardized protocols and prospective study designs are mandatory for correct interpretation and comparability of data. © 2015 International Society for

  12. Why are junior doctors deterred from choosing a surgical career?

    Science.gov (United States)

    Rogers, Mary E; Creed, Peter A; Searle, Judy

    2012-05-01

    To identify the reasons why interns would not choose a surgical career. This qualitative study used semi-structured telephone interviews to explore the future career choices of 41 junior doctors (14 men, 27 women). Doctors were asked to identify specialties they would not take up, and state why this was the case. Thirty (73.2%) of the 41 interns nominated surgery as a specialty they would not choose. Themes relating to reasons for not wanting to pursue a surgical career included the lifestyle associated with surgery (66.7%), the culture within the surgical work environment (53.3%), the lack of interest in performing surgical work (36.7%), and the training requirements associated with surgery (33.3%). Both sexes had similar reasons for not wanting to choose a surgical career; but additionally, women referred to the male domination of surgery, and the difficulty and inflexibility of the training program as deterrents. Efforts are needed to promote interest in surgery as a career especially for women, to improve the surgical work environment so that medical students and junior doctors have exposure to positive role models and surgical placements, and to provide a more flexible approach to surgical training.

  13. 3D Surgical Simulation

    Science.gov (United States)

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2009-01-01

    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  14. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff

    2012-01-01

    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...

  15. SURGICAL SITE INFECTION: REVIEW

    Directory of Open Access Journals (Sweden)

    P. H. M. Bonai

    2016-07-01

    Full Text Available Nosocomial infection or nosocomial infection (NI is one of the factors that increase the cost of maintaining patients in the health system, even in processes that should safely occur, such as hospital patients and performing simple and routine surgical procedures surgical centers and clinics leading to complications resulting from these infections that prolong hospital stay and promote pain and suffering to the patient, resulting in the defense of the quality of services and influencing negatively the hospitals. Therefore, the aim of this study was to review the factors that result in surgical site infection, with the purpose of better understanding of the subject and the possibility of preventive actions to better treatment outcome of the patient.

  16. Retained surgical sponge

    International Nuclear Information System (INIS)

    Koyama, Masashi; Kurono, Kenji; Iida, Akihiko; Suzuki, Hirochika; Hara, Masaki; Mizutani, Hirokazu; Ohba, Satoru; Mizutani, Masaru; Nakajima, Yoichiro.

    1993-01-01

    The CT, US, and MRI findings of confirmed retained surgical sponges were reviewed. The CT examinations in eight lesions demonstrated round or oval masses with heterogeneous internal structures. The US examinations in 5 lesions demonstrated low echogenic masses with high echogenic internal structures, which suggested retained surgical sponges. MR imagings in three lesions showed slightly high intensity comparable to that of muscles on T1-weighted images and high signal intensity on T2-weighted images, suggesting fluid collections of high protein concentration. (author)

  17. Surgical Treatment for Pulmonary Hamartomas

    Directory of Open Access Journals (Sweden)

    Funda Ižncekara

    2015-11-01

    Full Text Available Aim: In this study, we evaluated the patients operated for hamartoma and treated endobronchially and the diagnostic value of this approach has been examined. Material and Method: 59 patients (24 females, 35 males; mean age 53 years, range 28-78 years which were operated and endobronchial treated for hamartoma in our clinic between January 2003 - January 2013 were analyzed retrospectively. Patient age, sex, symptoms, histopathological, surgical procedures and treatment outcomes were evaluated. Results: The most common complaint was shortness of breath, while 25 patients were asymptomatic. Thoracotomy and mass enucleation in 29 patients (%49,15, thoracotomy and wedge resection in 18 patients (%30.5, VATS and wedge resection in 4 patients (%6.77, thoracotomy and upper lobectomy in 4 patients (%6.77, thoracotomy and lower lobectomy in 2 patients (%3.38 and left upper lobe segmentectomy in 1 patient (%1.69 and right upper bronchial sleeve resection in 1 patient were performed. The postoperative pathology of lesions examined and diagnosis were chondroid hamartoma in 28 , pulmonary hamartoma in 20 , hamartoma chondrolypomatous in 11 and the bronchial hamartoma in 2 . No mortality was observed intraoperatively. Discussion: Although hamartomas are benign , diagnosis should be made because it can be confused with lung cancer. Definitive diagnosis and treatment can be performed successfully through VATS in primarily appropriate cases with minimal morbidity or thoracotomy or endobronchial treatment.

  18. Sex Education: Another View

    Science.gov (United States)

    Hamilton, Jennifer

    1977-01-01

    The mother of a 14-year-old mentally retarded boy comments on the viewpoints of Dr. Sol Gordon (a sex education columnist) regarding masturbation, questions on sex, marriage, and the parents' role. (SBH)

  19. Surgical infections with Mycoplasma

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Prag, Jørgen Brorson; Jensen, J S

    1997-01-01

    Mycoplasma hominis and Ureaplasma urealyticum are common inhabitants of the human genital tract. Evidence for an aetiological role in pyelonephritis, pelvic inflammatory disease, post-abortion and post-partum fever has been presented. There are sporadic reports of Mycoplasma causing serious...... extragenital infection such as septicemia, septic arthritis, neonatal meningitis and encephalitis. We review 38 cases of surgical infections with Mycoplasma....

  20. [Surgical therapy of gynecomastia].

    Science.gov (United States)

    Heckmann, A; Leclère, F M; Vogt, P M; Steiert, A

    2011-09-01

    Nowadays surgical intervention is an essential part of the treatment of idiopathic gynecomastia. Choosing the right method is crucial and is based on the current status in the clinical and histological evaluation. Before finalizing the process of choosing a specific method a prior interdisciplinary evaluation of the patient is necessary to ascertain clear indications for a surgical intervention. Liposuction is one of the methods which have become popular in recent years. The advantages are the possible combination with traditional techniques, such as subcutaneous mastectomy or periareolar mastopexy. The main indication is for gynecomastia stage IIa/b and is justifiable due to the reduction in surgical complications and scarring. Furthermore this technique provides an excellent aesthetical outcome for the patient. A total of 162 patients suffering from gynecomastia stages I-III (according to Simon) were surgically treated between 2000 and 2010 and these cases were retrospectively evaluated. The results showed a decline in the use of a T-shaped incision in combination with subcutaneous mastectomy with periareolar tightening compared to an increase in the use of subcutaneous mastectomy in combination with liposuction. The excised tissue should always be sent for histological examination to make sure no malignant cells were present.

  1. Surgical manifestations of filariasis

    Directory of Open Access Journals (Sweden)

    Subrahmanyam M

    1978-01-01

    Full Text Available Surgical manifestations of filariasis as seen in 150 cases over a period of three years in the department of Surgery, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha are reviewed. The genital manifestations are more common than the elephantiasis in this endemic zone.

  2. Improving surgical weekend handover.

    Science.gov (United States)

    Culwick, Caroline; Devine, Chris; Coombs, Catherine

    2014-01-01

    Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unified weekend list ordering all surgical patients by ward and bed number was introduced. Discrepancies in the layout of each team's weekday list necessitated the design of a new weekday list to match the weekend list to facilitate the easy transfer of information between the two lists. A colour coding system was also used to highlight specific jobs. Prior to this improvement project only 7.1% of those polled were satisfied with the existing system, after a series of interventions satisfaction increased to 85.7%. The significant increase in overall satisfaction with surgical handover following the introduction of the unified weekend list is promising. Locating patients and identifying jobs is easier and weekend ward rounds can conducted in a more logical and timely fashion. It has also helped facilitate the transition to consultant ward rounds of all surgical inpatients at the weekends with promising feedback from a recent consultants meeting.

  3. Sex in situ

    DEFF Research Database (Denmark)

    Krøgholt, Ida

    2017-01-01

    Sex er en del af vores sociale praksis og centralt for det, vi hver især er. Men bortset fra pornoindustrien, har vi ikke mange muligheder for at få adgang til billeder af sex. Teater Nordkrafts forestilling Sex in situ vil gøre seksuelle billeder til noget, der kan deles, udveksles og tales om, og...

  4. Coeducation and Sex Roles.

    Science.gov (United States)

    Harris, Mary B.

    1986-01-01

    A study of the sex role stereotypes held by 538 first-term Australian university students from single-sex and coeducational high schools is presented. Results suggest that coeducational schooling may have some advantages for fostering interactions with the opposite sex. (MSE)

  5. sex and Cannibalism

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 5; Issue 12. The Secret Sex Lives of Rotifers Sex - sex and Cannibalism. T Ramakrishna Rao. General Article Volume 5 Issue 12 December 2000 pp 41-47. Fulltext. Click here to view fulltext PDF. Permanent link:

  6. [da Vinci surgical system].

    Science.gov (United States)

    Watanabe, Gou; Ishikawa, Norihiro

    2014-07-01

    The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

  7. A Sex Work Research Symposium: Examining Positionality in Documenting Sex Work and Sex Workers’ Rights

    OpenAIRE

    Megan Lowthers; Magdalena Sabat; Elya M. Durisin; Kamala Kempadoo

    2017-01-01

    Historically, academic literature on sex work has documented the changing debates, policies, and cultural discourse surrounding the sex industry, and their impact on the rights of sex workers worldwide. As sex work scholars look to the future of sex workers’ rights, however, we are also in a critical moment of self-reflection on how sex work scholarship engages with sex worker communities, produces knowledge surrounding sex work, and represents the lived experiences of sex workers’ rights, or...

  8. Neuroprotection of Sex Steroids

    Science.gov (United States)

    Liu, Mingyue; Kelley, Melissa H.; Herson, Paco S.; Hurn, Patricia D.

    2011-01-01

    Sex steroids are essential for reproduction and development in animals and humans, and sex steroids also play an important role in neuroprotection following brain injury. New data indicate that sex-specific responses to brain injury occur at the cellular and molecular levels. This review summarizes the current understanding of neuroprotection by sex steroids, particularly estrogen, androgen, and progesterone, based on both in vitro and in vivo studies. Better understanding of the role of sex steroids under physiological and pathological conditions will help us to develop novel effective therapeutic strategies for brain injury. PMID:20595940

  9. Sex Reversal in Birds.

    Science.gov (United States)

    Major, Andrew T; Smith, Craig A

    2016-01-01

    Sexual differentiation in birds is controlled genetically as in mammals, although the sex chromosomes are different. Males have a ZZ sex chromosome constitution, while females are ZW. Gene(s) on the sex chromosomes must initiate gonadal sex differentiation during embryonic life, inducing paired testes in ZZ individuals and unilateral ovaries in ZW individuals. The traditional view of avian sexual differentiation aligns with that expounded for other vertebrates; upon sexual differentiation, the gonads secrete sex steroid hormones that masculinise or feminise the rest of the body. However, recent studies on naturally occurring or experimentally induced avian sex reversal suggest a significant role for direct genetic factors, in addition to sex hormones, in regulating sexual differentiation of the soma in birds. This review will provide an overview of sex determination in birds and both naturally and experimentally induced sex reversal, with emphasis on the key role of oestrogen. We then consider how recent studies on sex reversal and gynandromorphic birds (half male:half female) are shaping our understanding of sexual differentiation in avians and in vertebrates more broadly. Current evidence shows that sexual differentiation in birds is a mix of direct genetic and hormonal mechanisms. Perturbation of either of these components may lead to sex reversal. © 2016 S. Karger AG, Basel.

  10. Sexing young snowy owls

    Science.gov (United States)

    Seidensticker, M.T.; Holt, D.W.; Detienne, J.; Talbot, S.; Gray, K.

    2011-01-01

    We predicted sex of 140 Snowy Owl (Bubo scandiacus) nestlings out of 34 nests at our Barrow, Alaska, study area to develop a technique for sexing these owls in the field. We primarily sexed young, flightless owls (3844 d old) by quantifying plumage markings on the remiges and tail, predicting sex, and collecting blood samples to test our field predictions using molecular sexing techniques. We categorized and quantified three different plumage markings: two types of bars (defined as markings that touch the rachis) and spots (defined as markings that do not touch the rachis). We predicted sex in the field assuming that males had more spots than bars and females more bars than spots on the remiges and rectrices. Molecular data indicated that we correctly sexed 100% of the nestlings. We modeled the data using random forests and classification trees. Both models indicated that the number and type of markings on the secondary feathers were the most important in classifying nestling sex. The statistical models verified our initial qualitative prediction that males have more spots than bars and females more bars than spots on flight feathers P6P10 for both wings and tail feathers T1 and T2. This study provides researchers with an easily replicable and highly accurate method for sexing young Snowy Owls in the field, which should aid further studies of sex-ratios and sex-related variation in behavior and growth of this circumpolar owl species. ?? 2011 The Raptor Research Foundation, Inc.

  11. Paediatric Abdominal Surgical Emergencies in a General Surgical ...

    African Journals Online (AJOL)

    ... organized for general surgeons undertaking paediatric surgical emergencies. More paediatric surgeons should be trained and more paediatric surgical units should established in the country. Key Words: Paediatric Abdominal Surgical Emergencies; Paediatric Surgeons, General Surgeons. Journal of College of Medicine ...

  12. Osho - Insights on sex.

    Science.gov (United States)

    Nagaraj, Anil Kumar Mysore

    2013-01-01

    Sex is a mysterious phenomenon, which has puzzled even great sages. Human beings have researched and mastered the biology of sex. But that is not all. Sex needs to be understood from the spiritual perspective too. The vision of Osho is an enlightening experience in this regard. Out of the thousands of lectures, five lectures on sex made Osho most notorious. Born into a Jain family of Madhya Pradesh, Rajneesh, who later wanted himself to be called Osho, is a great master. He has spoken volumes on a wide range of topics ranging from sex to super-consciousness. His contributions in the area of sex are based on the principles of "Tantra" which has its origin from Buddhism. This article focuses on his life and insights on sex, which if understood properly, can be a stepping stone for enlightenment.

  13. Helping Behavior: Effects of Sex and Sex-Typing.

    Science.gov (United States)

    Basow, Susan A.; Crawley, Donna M.

    1982-01-01

    Male and female experimenters requested adult shoppers (N=178) to fill out a questionnaire. Refusal data showed shoppers helping other-sex more than same-sex experimenters. Other results showed a significant three-way interaction among helper and helpee sex and sex-typing and situation sex-typing and that helper sex-typing did not have significant…

  14. Leading with Dignity after Reassignment

    Science.gov (United States)

    Lommen, Kathleen

    2013-01-01

    Refreshed from a leadership summit, the author is determined to share her story so that effective school leaders can also learn to thrive in spite of leadership changes that may burden their administrative teams, whether it is due to budget cuts, program realignment, organizational changes or just plain bullying behaviors. The author has…

  15. Surgical camps: the Ugandan experience

    African Journals Online (AJOL)

    . The planned visits were advertised locally and in the national media. Screening of the patients was done first by the local medical teams and later by the visiting surgical teams. The surgical teams were comprised of the following personnel:.

  16. Improving surgical weekend handover

    OpenAIRE

    Culwick, Caroline; Devine, Chris; Coombs, Catherine

    2014-01-01

    Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unif...

  17. Acquiring minimally invasive surgical skills

    OpenAIRE

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room. This thesis has led to an enlarged insight in the organization of surgical skills training during residency training of surgical medical specialists.

  18. Robotic surgical training.

    Science.gov (United States)

    Ben-Or, Sharon; Nifong, L Wiley; Chitwood, W Randolph

    2013-01-01

    In July 2000, the da Vinci Surgical System (Intuitive Surgical, Inc) received Food and Drug Administration approval for intracardiac applications, and the first mitral valve repair was done at the East Carolina Heart Institute in May 2000. The system is now approved and used in many surgical specialties. With this disruptive technology and accepted use, surgeons and hospitals are seeking the most efficacious training pathway leading to safe use and responsible credentialing.One of the most important issues related to safe use is assembling the appropriate team of professionals involved with patient care. Moreover, proper patient selection and setting obtainable goals are also important.Creation and maintenance of a successful program are discussed in the article focusing on realistic goals. This begins with a partnership between surgeon leaders, hospital administrators, and industry support. Through this partnership, an appropriate training pathway and clinical pathway for success can be outlined. A timeline can then be created with periods of data analysis and adjustments as necessary. A successful program is attainable by following this pathway and attending to every detail along the journey.

  19. Surgical experts: born or made?

    Science.gov (United States)

    Sadideen, Hazim; Alvand, Abtin; Saadeddin, Munir; Kneebone, Roger

    2013-01-01

    The concept of surgical expertise and the processes involved in its development are topical, and there is a constant drive to identify reliable measures of expert performance in surgery. This review explores the notion of whether surgical experts are "born" or "made", with reference to educational theory and pertinent literature. Peer-reviewed publications, books, and online resources on surgical education, expertise and training were reviewed. Important themes and aspects of expertise acquisition were identified in order to better understand the concept of a surgical expert. The definition of surgical expertise and several important aspects of its development are highlighted. Innate talent plays an important role, but is insufficient on its own to produce a surgical expert. Multiple theories that explore motor skill acquisition and memory are relevant, and Ericsson's theory of the development of competence followed by deliberate self-practice has been especially influential. Psychomotor and non-technical skills are necessary for progression in the current climate in light of our training curricula; surgical experts are adaptive experts who excel in these. The literature suggests that surgical expertise is reached through practice; surgical experts are made, not born. A deeper understanding of the nature of expert performance and its development will ensure that surgical education training programmes are of the highest possible quality. Surgical educators should aim to develop an expertise-based approach, with expert performance as the benchmark. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  20. Surgical navigation with QR codes

    Directory of Open Access Journals (Sweden)

    Katanacho Manuel

    2016-09-01

    Full Text Available The presented work is an alternative to established measurement systems in surgical navigation. The system is based on camera based tracking of QR code markers. The application uses a single video camera, integrated in a surgical lamp, that captures the QR markers attached to surgical instruments and to the patient.

  1. Nigerian Journal of Surgical Research

    African Journals Online (AJOL)

    The Nigerian Journal of Surgical Research is a publication of the Surgical Research Society with main office in Zaria, Nigeria. Zaria is home to Ahmadu Bello University (ABU), a premier university in Nigeria. The aim of The Nigerian Journal of Surgical Research is to cover developments and advances in the broad field of ...

  2. Doing gender in sex and sex research.

    Science.gov (United States)

    Vanwesenbeeck, Ine

    2009-12-01

    Gender is central to sexuality, and vice versa, but there are a number of difficulties with the treatment of gender in sex research. Apparently, it is hard to find a balance between two conflicting needs. First, obviously, it is necessary to make distinctions between women and men, for political as well as research-technical and theoretical reasons. A second requirement, at odds with the first one, is the necessity to understand gender and its relation to sexuality and the body as much more complex than simplistically referring to two sets of individuals. This is all the more necessary when one realizes the possible drawbacks of exaggerating the differences between the sexes (in particular when they are biologically explained), because of stereotyping, stigmatizing, and expectancy confirmatory processes. This essay identifies and discusses 10 difficulties in the treatment of gender in sex research, reflects on their origins, and reviews theory and evidence with the aim to (1) consider the relative strength of gender/sex as an explanatory variable compared to other factors and processes explaining differences between men and women on a number of sexual aspects, (2) inform an understanding of gender and its relation to sexuality as an ongoing, open-ended, multi-determined, situated, interactional process, with the body as a third player, and (3) argue in favor of a nuanced, well-balanced treatment of gender in sex research.

  3. Predicted versus executed surgical orthognathic treatment.

    Science.gov (United States)

    Falter, B; Schepers, S; Vrielinck, L; Lambrichts, I; Politis, C

    2013-10-01

    This study aimed to analyse combined surgical-orthodontic treatment plans, compare them with the actual surgery performed, and define factors resulting in changes of the original plan during orthodontic pre-surgical preparation. The clinical files of 312 orthognathic surgery patients, operated between January 2008 and December 2010, were retrospectively reviewed. Of these 312 patients, 129 had a bimaxillary operation. One hundred sixty patients had osteotomy of the lower jaw only and 23 had osteotomy of the upper jaw only. Factors analysed in the study include Angle Class malocclusion, patient sex, and age. Lip-to-incisor relationship, overjet, overbite and midline deviations of the upper and lower jaw were recorded. Effects of surgical assisted rapid palatal expansion (SARPE) on the eventual surgery were also investigated. Reasons for changing the original treatment plan at the time of the finished pre-surgical-orthodontic alignment were analysed. The original treatment plan was changed in 42 of the 312 patients (13.5%). Changes occurred generally in case of a larger interval between set-up of the first treatment plan and the eventual operation (average 22.4 versus 16.4 months for patients with changed versus unchanged treatment plan, respectively). All Class I patients had surgery performed as planned. Class III patients had a significantly higher rate of altered treatment plan (27.3%) than Class II patients (7.6%). More men (52.4%) saw their treatment plan changed, although there were more women than men in the study population (59.6 versus 40.4%). One in seven patients (13.5%) had a different operation than was planned at the start of treatment. Class III patients with small overjet and overbite commonly have a treatment plan for a monomaxillary operation that, after decompensation, needs to be adapted to a bimaxillary operation. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  4. Sex reversal in vertebrates

    OpenAIRE

    2016-01-01

    This special topic issue of Sexual Development gives an overview of sex reversal in vertebrates, from fishes naturally changing their sex, to rodents escaping the mammalian SRY-determining system. It offers eight up-to-date reviews on specific subjects in sex reversal, considering fishes, amphibians, reptiles, birds, marsupials, and placental mammals, including humans. The broad scope of represented animals makes this ideal for students and researchers, especially those interested in the...

  5. The seventh penis: towards effective psychoanalytic work with pre-surgical transsexuals.

    Science.gov (United States)

    Withers, Robert

    2015-06-01

    The author reflects on his contrasting analytic work with two transsexual patients. He uses three previous psychoanalytic studies (Stoller, Morel and Lemma) to explore whether effective analytic work with the issues driving a person's determined wish for sex reassignment surgery (SRS) is possible. Particular consideration is given to how such work might navigate a path between traumatizing and pathologizing the patient on the one hand and avoiding important analytic material out of fear of so doing on the other. The author proceeds to ask whether it is possible to tell in advance, with any degree of reliability, who is and who is not likely to benefit from surgery. He considers certain diagnostic issues in relation to these questions. Illustrations are given of how, in practice, countertransference anxieties about psychopathologizing transsexual patients can contribute to significant difficulties in working clinically with them. It is argued that the understanding and containment of such anxieties could eventually lead to more effective analytic work, and that such work might be further facilitated by considering the contribution of mind-body dissociation to transsexualism. © 2015, The Society of Analytical Psychology.

  6. Surgical management of hyperthyroidism.

    Science.gov (United States)

    Quérat, C; Germain, N; Dumollard, J-M; Estour, B; Peoc'h, M; Prades, J-M

    2015-04-01

    Hyperthyroidism includes several clinical and histopathological situations. Surgery is commonly indicated after failure of medical treatment. The aim of this study was to analyze the indications and complications of surgery as well as endocrine results. Patients operated on for hyperthyroidism between 2004 and 2012 were included in a retrospective study. Total thyroidectomy was performed for Graves' disease, toxic multinodular goiter and amiodarone-associated thyrotoxicosis; patients with toxic nodule underwent hemithyroidectomy. Pathologic analysis assessed surgical specimens; postoperative complications and resolution of hyperthyroidism were noted. Two hundred patients from 15 to 83 years old were included. One hundred and eighty-eight underwent primary surgery and 12 were re-operated for recurrent goiter (6 with subtotal thyroidectomy for multinodular goiter 25 years previously; 6 with hemithyroidectomy for solitary nodule 15 years previously). Eighty-two patients suffered from toxic multinodular goiter, 78 from Graves' disease, 35 from solitary toxic nodules and 5 from amiodarone-associated thyrotoxicosis. Fourteen papillary carcinomas (including 11 papillary microcarcinomas) and 34 healthy parathyroid glands (17%) were identified in the pathological specimens. Postoperative complications comprised 4% permanent recurrent laryngeal nerve palsy (1 year follow-up), 9% hematoma requiring surgical revision, and 3% definitive hypocalcemia. Normalization of thyroid hormone levels was observed in 198 patients. Two recurrences occurred due to incomplete resection (1 case of Graves' disease and 1 intrathoracic toxic goiter that occurred respectively 18 and 5 months after resection). Postoperative complications were more frequent in multinodular goiter (23%) than in Graves' disease (13%) (ns: P>0.05). Surgical management of hyperthyroidism enables good endocrinal control if surgery is complete. Patients need to be fully informed of all possible postoperative complications

  7. [Duane vertical surgical treatment].

    Science.gov (United States)

    Merino, M L; Gómez de Liaño, P; Merino, P; Franco, G

    2014-04-01

    We report 3 cases with a vertical incomitance in upgaze, narrowing of palpebral fissure, and pseudo-overaction of both inferior oblique muscles. Surgery consisted of an elevation of both lateral rectus muscles with an asymmetrical weakening. A satisfactory result was achieved in 2 cases, whereas a Lambda syndrome appeared in the other case. The surgical technique of upper-insertion with a recession of both lateral rectus muscles improved vertical incomitance in 2 of the 3 patients; however, a residual deviation remains in the majority of cases. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  8. Sex tourism in Thailand.

    Science.gov (United States)

    Van Kerkwijk, C

    1992-01-01

    Many foreigners visit Thailand in search of sex. While long-distance tourism was long enjoyed by members of more privileged social classes, even the lower economical classes of Japan, Malaysia, Europe, America, and Australia can now afford to travel over long distances. This relatively new breed of tourist is more likely to be of lower socioeconomic and educational status and less likely to use condoms when having sex. An estimated 30,000 sex workers are active in Bangkok, of whom 7000/10,000 are females who work specifically in the tourism sector. 1/2-1/3 of the 600 commercial sex establishments in the city are visited by foreigners. Phuket, Pattaya, Koh Samui, and Chiangmai are also well-frequented by sex tourists. Overall, a large, diverse, inexpensive, and accessible commercial sex market exists in Thailand. One may meet sex workers quasi-ubiquitously and be assured to find someone capable of meeting one's sexual needs. With these attributes, Thailand strongly attracts tourists in search of sex. A certain degree of recklessness also prevails among those on vacation. Away from the peers and social mores of their native lands, tourists may engage in sexually activities without criticism. Likewise, Thai sex workers who cater to foreigners, especially females, enjoy more freedom and control in sexual relations than their peers who work among nationals. Neither single nor married women in Thailand are allowed much sexual freedom and are traditionally expected to be obliging docile, and submissive. The greater than normal personal latitude enjoyed by both sex worker and foreigner lead to more negotiation on condom use and overall lower use. As such, Thailand's commercial sex market with foreigners' involvement therein threatens to spread HIV to many other countries throughout the world.

  9. The evolution of sex ratios and sex-determining systems

    NARCIS (Netherlands)

    Uller, Tobias; Pen, Ido; Wapstra, Erik; Beukeboom, Leo W.; Komdeur, Jan

    Sex determination is a fundamental process governed by diverse mechanisms. Sex ratio selection is commonly implicated in the evolution of sex-determining systems, although formal models are rare. Here, we argue that, although sex ratio selection can induce shifts in sex determination, genomic

  10. [Surgical treatment of gynecomastia].

    Science.gov (United States)

    Târcoveanu, E; Lupaşcu, C; Vasilescu, A; Moldovanu, R; Ichim, Mihaela; Georgescu, St; Niculescu, D; Dănilă, N; Dimofte, G; Anton, Raluca; Crumpei, Felicia; Florea, Niculina; Ungureanu, Cristina

    2008-01-01

    Gynecomastia describes a benign increase of the mammary gland in men. When medical treatment fails, the surgical procedure is the treatment of choice. There are two main surgical procedures: subdermal mastectomy and liposuction. To evaluate the results after surgical treatment (mastectomy) performed in a general surgery unit. We performed a retrospective study; all the patients operated for gynecomastia were reviewed. The clinical, imaging, biological, intraoperative and histological data were included into a MS Access database and statistical analyzed. From 1990-2007, 114 patients were admitted in the First Surgical Clinic Iaşi for gynecomastia. Only 12.6% from the patients were with bilateral gynecomastia. The mean age was 40.54 +/- 1.83 years old (range 12-84). Mean body mass was 26.72 +/- 0.46 kg/m2 (range 18.5-41), and about 20% from the patients had a BMI of over 30 kg/m2. We also noted that 46.5% were smokers. Simon classification was used for preoperative staging: 2.6% from the cases (N = 3) were included in stage I, 16.7% (N = 19) in stage IIa, 50% (N = 57) in stage IIb and 30.7% in stage III. The patients included in stages IIa and I are younger then the patients included in stage III (p = 0.024). Mastodynia was noted in 46 cases (40.4%). Ultrasound exam was performed in all the cases, and the larger diameter of the nodule measured was 3.75 +/- 0.18 cm (range 0.5-9.7). Only three cases were preoperatively treated with tamoxifen. Most of the cases were operated using general anesthesia (53.5%). Mastectomy was performed by peri-areolar (70.2%), elliptical (28.9%) or radial (0.9%) incisions. The subdermal mastectomy using peri-areolar approach was performed especially for the cases included in stages I, IIa and IIb--p gynecomastia in 6 cases; the other cases presented dilated ducts. We also noted intraductal papillary hyperplasia in 87 cases and chronic inflammation in 35 cases. The histological exam also revealed intraductal papilloma--9 cases, fibro

  11. Sex Determination, Sex Ratios, and Genetic Conflict

    NARCIS (Netherlands)

    Werren, John H.; Beukeboom, Leo W.

    1998-01-01

    Genetic mechanisms of sex determination are unexpectedly diverse and change rapidly during evolution. We review the role of genetic conflict as the driving force behind this diversity and turnover. Genetic conflict occurs when different components of a genetic system are subject to selection in

  12. Insects and sex

    NARCIS (Netherlands)

    Beukeboom, Leo

    2005-01-01

    Most organisms reproduce sexually, but the evolution of sexual reproduction is not yet well understood. Sexual reproduction leads to new variation and adaptations to the environment, but sex is also costly. Some insects reproduce without sex through parthenogenesis or paedogenesis. Almost all sexual

  13. Sex Away from Home

    Science.gov (United States)

    Greenwald, Harold

    1971-01-01

    The reasons why people who are normally truthful to their spouses engage in sex away from home are discussed. These reasons can include loneliness, ego building or the opportunity to have homosexual relations. Sex away from home is likely to increase since the number of people traveling is increasing. (Author/CG)

  14. Single-Sex Classrooms

    Science.gov (United States)

    Protheroe, Nancy

    2009-01-01

    Although single-sex education was once the norm in the U.S., the practice has largely been confined to private schools for more than a century. However, with the introduction of the final version of the U.S. Department of Education's so-called single-sex regulations in 2006, public schools were allowed greater flexibility to offer single-sex…

  15. Sex Education Materials.

    Science.gov (United States)

    Singer-Magdoff, Laura

    1969-01-01

    After briefly discussing the philosophy of sex education and appraising generally the nature of the instructional methods and materials currently in use in the schools, the author provides brief but incisive reviews of a number of films, filmstrips, and other instructional materials dealing with sex. The reviews are continued in the succeeding…

  16. Surgical Instrument Sets for Special Operations Expeditionary Surgical Teams.

    Science.gov (United States)

    Hale, Diane F; Sexton, Justin C; Benavides, Linda C; Benavides, Jerry M; Lundy, Jonathan B

    The deployment of surgical assets has been driven by mission demands throughout years of military operations in Iraq and Afghanistan. The transition to the highly expeditious Golden Hour Offset Surgical Transport Team (GHOST- T) now offers highly mobile surgical assets in nontraditional operating rooms; the content of the surgical instrument sets has also transformed to accommodate this change. The 102nd Forward Surgical Team (FST) was attached to Special Operations assigned to southern Afghanistan from June 2015 to March 2016. The focus was to decrease overall size and weight of FST instrument sets without decreasing surgical capability of the GHOST-T. Each instrument set was evaluated and modified to include essential instruments to perform damage control surgery. The overall number of main instrument sets was decreased from eight to four; simplified augmentation sets have been added, which expand the capabilities of any main set. The overall size was decreased by 40% and overall weight decreased by 58%. The cardiothoracic, thoracotomy, and emergency thoracotomy trays were condensed to thoracic set. The orthopedic and amputation sets were replaced with an augmentation set of a prepackaged orthopedic external fixator set). An augmentation set to the major or minor basic sets, specifically for vascular injuries, was created. Through the reorganization of conventional FST surgical instrument sets to maintain damage control capabilities and mobility, the 102nd GHOST-T reduced surgical equipment volume and weight, providing a lesson learned for future surgical teams operating in austere environments. 2017.

  17. Social media in the mentorship and networking of physicians: Important role for women in surgical specialties.

    Science.gov (United States)

    Luc, Jessica G Y; Stamp, Nikki L; Antonoff, Mara B

    2018-04-01

    Social media may be a useful supplement to physician and trainee interactions; however, its role in enhancing mentorship has not been described. A 35-item survey investigating trainee and physician social media use was distributed. Responses were analyzed using descriptive statistics. 282 respondents completed the survey, among whom 136 (48.2%) reported careers in surgical specialties. Women in surgical specialties were more likely to describe the specialty as being dominated by the opposite sex (p media to build a network of same-sex mentorship (p = 0.031). Social media serves as a valuable tool to enhance the networking and mentorship of surgeons, particularly for women in surgical specialties who may lack exposure to same-sex mentors at their own institution. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. Global curriculum in surgical oncology.

    Science.gov (United States)

    Are, C; Berman, R S; Wyld, L; Cummings, C; Lecoq, C; Audisio, R A

    2016-06-01

    The significant global variations in surgical oncology training paradigms can have a detrimental effect on tackling the rising global cancer burden. While some variations in training are essential to account for the differences in types of cancer and biology, the fundamental principles of providing care to a cancer patient remain the same. The development of a global curriculum in surgical oncology with incorporated essential standards could be very useful in building an adequately trained surgical oncology workforce, which in turn could help in tackling the rising global cancer burden. The leaders of the Society of Surgical Oncology and European Society of Surgical Oncology convened a global curriculum committee to develop a global curriculum in surgical oncology. A global curriculum in surgical oncology was developed to incorporate the required domains considered to be essential in training a surgical oncologist. The curriculum was constructed in a modular fashion to permit flexibility to suit the needs of the different regions of the world. Similarly, recognizing the various sociocultural, financial and cultural influences across the world, the proposed curriculum is aspirational and not mandatory in intent. A global curriculum was developed which may be considered as a foundational scaffolding for training surgical oncologists worldwide. It is envisioned that this initial global curriculum will provide a flexible and modular scaffolding that can be tailored by individual countries or regions to train surgical oncologists in a way that is appropriate for practice in their local environment. Copyright © 2016 Society of Surgical Oncology, European Society of Surgical Oncology. Published by Elsevier Ltd.. All rights reserved.

  19. Clinic-surgical characterization of the colorectal cancer in inpatients

    International Nuclear Information System (INIS)

    Alejo Concepcion, Osvaldo; Castillo Lamas, Libardo; Umpierrez Garcia, Ibis

    2009-01-01

    The colorectal cancer presents high incidence. This pathology occupies the fifth place among the neoplasias in both sexes in Cuba. With the objective of characterizing this disease we carried out a descriptive transversal study at the service of General Surgery of the University Military Hospital of Matanzas 'Dr. Mario Munnoz Monroy', in the period from January 2001 to January 2005, studying age, sex, familiar oncological antecedents, presentation form, localization and diagnosis of the tumor, and also the surgical technique used in the treatment. The results showed predominance of the male sex in ages between 60 and 69 years old, different symptoms depending on the localization, predominance of the rectal cancer, and others. It was concluded that there is a delay between the beginning of the symptoms and the diagnosis, considerably diminishing the healing possibilities and survival

  20. VEIL Surgical Steps.

    Science.gov (United States)

    Raghunath, S K; Nagaraja, H; Srivatsa, N

    2017-03-01

    Inguinal lymphadenectomy remains the standard of care for metastatic nodal disease in cases of penile, urethral, vulval and vaginal cancers. Outcomes, including cure rates and overall and progression-free survivals, have progressively improved in these diseases with extending criteria to offer inguinal lymph node dissection for patients 'at-risk' for metastasis or loco-regional recurrence. Hence, despite declining incidence of advanced stages of these cancers, many patients will still need to undergo lymphadenectomy for optimal oncological outcomes. Inguinal node dissection is a morbid procedure with operative morbidity noted in almost two third of the patients. Video endoscopic inguinal lymphadenectomy (VEIL) was described and currently practiced with proven equivalent oncological outcomes. We describe our technique of VEIL using laparoscopic and robotic access as well as various new surgical strategies.

  1. Aggressive surgical management of craniopharyngiomas

    Directory of Open Access Journals (Sweden)

    Manmohan Singh

    2013-01-01

    Full Text Available Surgical treatment of craniopharyngiomas is challenging and despite advancements it continues to pose a challenge. Proponents of subtotal resection in conjunction with radiotherapy argue that this less aggressive approach can yield appropriate results with the lower morbidity. On the contrary, other argument is that gross total resection is superior. Though surgical management of craniopharyngioma is challenging due to its location and important surrounding neurovascular structures, optimal surgical results can be expected following radical surgical excision. Radical excision of craniopharyngiomas is associated with excellent long-term recurrence free survival. Radiation induced long-term complications can be altogether avoided by excising these tumors completely.

  2. Surgical treatment of parastomal hernia

    International Nuclear Information System (INIS)

    Basti, Z.; Mayer, A.

    2013-01-01

    Stoma construction is among standard surgical skills and is performed for many indications. Every stoma means huge impact on quality of life for patients even with great improvement in surgical technique and ostomy devices. All patients are very sensitive to complication of stoma and the most frequent complication is parastomal hernia. Incidence reported in literature is very high and unacceptable, it is 30-70%. Surgical approach is very demanding on technical equipment and experiences of surgeon. Authors focus on each surgical approach for treating this complication weather it´s using mesh or laparoscopic or open approach. (author)

  3. Sex: a sensitive issue.

    Science.gov (United States)

    1997-01-01

    Health care workers and educators may need to improve their skills in discussing sensitive issues in order to elicit and understand what influences people's attitudes toward sex. While the health worker may be bent upon preventing HIV infection, advising on family planning, or teaching youth about sexual relationships, his or her audience may have other priorities. A good counselor/teacher must learn what people's concerns are and discuss sexual health within that context. It can be difficult talking about sex because sex is a private concern and many people are embarrassed discussing it. Even sex partners often find it difficult to talk to each other about sex. Appropriate communication techniques vary depending upon the situation. It depends upon whether one is addressing people on an individual basis or in groups, which people are being addressed, which organization one is representing, and what one's role is. Good communication is a two-way sharing of information. The different stages of life, common beliefs and myths, culture and religion, relationships between men and women, reasons for having sex, and sex practices are discussed.

  4. Making Healthy Decisions About Sex

    Science.gov (United States)

    ... For Teens: How to Make Healthy Decisions About Sex Page Content Article Body Before you decide to ... alcohol or use drugs. Are You Ready for Sex? Sex can change your life and relationships. Having ...

  5. Dyspareunia: Painful Sex for Women

    Science.gov (United States)

    ... Safety Injury Rehabilitation Emotional Well-Being Mental Health Sex and Birth Control Sex and Sexuality Birth Control Family Health Infants and ... Share Print What is dyspareunia? Dyspareunia is painful sex for women. Also, it causes pain during tampon ...

  6. Hepatitis C: Sex and Sexuality

    Science.gov (United States)

    ... with Hepatitis » Sex and Sexuality: Entire Lesson Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For ... hepatitis C virus through sex. Can you pass hepatitis C to a sex partner? Yes, but it ...

  7. Sex education in Portugal.

    Science.gov (United States)

    Frade, A; Vilar, D

    1991-05-01

    The article on sex education in Portugal covers background, the educational system, the clashes of the 1960's over sex education, the Committee for the Study of Sexuality and Education (CSSE), the policies, politics and social movements during the period 1974 - 1984, the discussions in Parliament, the 1988 Reform of the Educational System, the Family Planning Association (FPA) and sex education, and the future role of the FPA. It was not until the institution of the multiparity parliamentary system in 1974 that discussing social and political changes was possible, culminating in 1984 with new legislation on abortion, family planning, and sex education. School reform came in 1987/8 with the Ministry of Education primarily responsible for curricula. The 1960's brought with it the influence of the Catholic Church. Change came in the form of progressivism among Catholics who replaced dogma with dialogue and listening. Sex education was considered as preparation for marriage, but masturbation, contraception, and prostitution were also discussed. In addition, the founder of FPA chaired the CSSE in 1971 and opened up debate on sex issues and drafted a bill to establish co-education in Portuguese schools. The revolution of 1974 brought an end to censorship and brought forth a policy of developing family planning. Changed in the Family Code gave women greater equality. UNFPA supported teacher training in non-sexist education. With human reproduction included in the natural sciences, there was still no school sex education policy and contraception was only sometimes represented in the biology curriculum. The focus of FPA was on contraception and abortion. Finally in the 1980's, the first sex education programs were developed for out-of-school youth. Even though in the 1970's there were leftists groups promoting sex education, it took leftist parliamentary power to get legislation on sex education in the schools adopted. The Ministry of Education however was pressured by the

  8. Sex, Deportation and Rescue

    DEFF Research Database (Denmark)

    Plambech, Sine

    2017-01-01

    recirculating the claim that human trafficking is the “third largest” criminal economy after drugs and weapons. Based on ethnographic fieldwork among Nigerian sex worker migrants conducted in Benin City, Nigeria, in 2011 and 2012, this study brings together four otherwise isolated migration economies......This contribution explores the economies interlinked by the migration of Nigerian women sex workers. The literature and politics of sex work migration and human trafficking economies are commonly relegated to the realm that focuses on profits for criminal networks and pimps, in particular...... – facilitation, remittances, deportation, and rescue – and suggests that we have to examine multiple sites and relink these in order to more fully understand the complexity of sex work migration. Drawing upon literature within transnational feminist analysis, critical human trafficking studies, and migration...

  9. Commentary Sex determination

    Indian Academy of Sciences (India)

    PRAKASH KUMAR G

    2008-01-31

    Jan 31, 2008 ... years old (Charnier 1966 reported it in an African agamid lizard), although it was ... people's attention in Susumu Ohno's now famous book on .... If they do enhance male and female fitness, sex chromosomes would then be.

  10. Commentary Sex determination

    Indian Academy of Sciences (India)

    PRAKASH KUMAR G

    2008-01-31

    ZW is reserved for female heterogamety.) The Radder et al study used lab incubation regimes that mimic temperature profiles of cool natural nests, so temperature probably determines sex at least occasionally in nature.

  11. Access to Specialized Surgical Care

    African Journals Online (AJOL)

    The ANNALS of AFRICAN SURGERY. January 2016 Volume 13 Issue 1 1. EDITORIAL. Access to Specialized Surgical Care. Saidi H. University of Nairobi. Correspondence to: Prof Hassan Saidi, P.O Box 30196-00100, Nairobi. Email: hsaid2ke@yahoo.com. Ann Afr Surg. 2016;13(1):1-2. The narrative of surgical disease in ...

  12. Surgical residency: A tenant's view

    African Journals Online (AJOL)

    'To sleep: perchance to dream', is the frequent mantra of the surgical resident. However, unlike. Hamlet, there is no ensuing speculation as to what dreams may come as there are seldom any!! Surgical residency has been both vilified and immortalized, but the fact remains that it is one of the most challenging, provocative ...

  13. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated

  14. Acquiring minimally invasive surgical skills

    NARCIS (Netherlands)

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room.

  15. Female Sex Tourism

    OpenAIRE

    Mc Intyre, Maria Kleivan

    2017-01-01

    ABSTRACT This project explores the phenomenon of North American and Western European women, who travel to the Global South and engage in sexual encounters with the local men. This project has positioned itself as a postcolonial critique, arguing that female sex tourism is a form of neocolonialism. It has also investigated the term romance tourism, where it has found that as a result of essentialist gender stereotyping, the female version of sex tourism has been titled ‘romance tourism’. The p...

  16. Sex and Horror

    OpenAIRE

    Jones, Steve

    2017-01-01

    The combination of sex and horror may be disquieting to many, but the two are natural (if perhaps gruesome) bedfellows. In fact, sex and horror coincide with such regularity in contemporary horror fiction that the two concepts appear to be at least partially intertwined. The sex–horror relationship is sometimes connotative rather than overt; examples of this relationship range from the seduction overtones of 'Nosferatu' and the juxtaposition of nudity and horror promised by European exploitat...

  17. Combined Surgical Treatment of Gynecomastia

    Directory of Open Access Journals (Sweden)

    Yordanov Y.

    2015-05-01

    Full Text Available Surgical treatment of gynecomastia could present unique challenges for the plastic surgeon. Achieving a good balance between effectiveness of the selected approach and the satisfactory aesthetic outcome often is a difficult endeavor. Optimal surgical treatment involves a combination of liposuction and direct excision. In the present study the charts of 11 patients treated with suction-assisted liposuction and direct surgical excision were retrospectively reviewed; a special emphasis is placed on the surgical technique. The mean follow-up period of the patients was 11.6 months. No infection, hematoma, nipple-areola complex necrosis and nipple retraction was encountered in this series. The combined surgical treatment of gynecomastia has shown to be a reliable technique in both small and moderate breast enlargement including those with skin excess.

  18. [Neuroendocrine effect of sex hormones].

    Science.gov (United States)

    Babichev, V N

    2005-01-01

    The paper provides a generalization of data and the results of own experiments on influence ovarian steroids on the hypothalamus and other brain areas related to reproduction. Ovarian hormones have widespread effects throughout the brain: on catecholaminergic neurons and serotonergic pathways and the basal forebrain cholinergic system, as well as the hipocampus, spinal cord, nigrostriatal and mesolimbic system, in addition to glial cells and blood-brain barrier. The widespread influences of these various neuronal systems ovarian steroids have measurable effects on mood and affect as well as on cognition, with implications for dementia. There are developmentally programmed sex differenced in hippocampal structure that may help to explain differences in the strategies which male and female rats use to solve spatial navigation problems. The multiple sites and mechanisms of estrogen action in brain underlie a variety of importants effects on cognitive and other brain functions--coordination of movement, pain, affective state, as well as possible protection in Alzheimer's disease. Estrogen withdrawal after natural or surgical menopause can lead to a host of changes in brain function and behavior.

  19. Output control of da Vinci surgical system's surgical graspers.

    Science.gov (United States)

    Johnson, Paul J; Schmidt, David E; Duvvuri, Umamaheswar

    2014-01-01

    The number of robot-assisted surgeries performed with the da Vinci surgical system has increased significantly over the past decade. The articulating movements of the robotic surgical grasper are controlled by grip controls at the master console. The user interface has been implicated as one contributing factor in surgical grasping errors. The goal of our study was to characterize and evaluate the user interface of the da Vinci surgical system in controlling surgical graspers. An angular manipulator with force sensors was used to increment the grip control angle as grasper output angles were measured. Input force at the grip control was simultaneously measured throughout the range of motion. Pressure film was used to assess the maximum grasping force achievable with the endoscopic grasping tool. The da Vinci robot's grip control angular input has a nonproportional relationship with the grasper instrument output. The grip control mechanism presents an intrinsic resistant force to the surgeon's fingertips and provides no haptic feedback. The da Vinci Maryland graspers are capable of applying up to 5.1 MPa of local pressure. The angular and force input at the grip control of the da Vinci robot's surgical graspers is nonproportional to the grasper instrument's output. Understanding the true relationship of the grip control input to grasper instrument output may help surgeons understand how to better control the surgical graspers and promote fewer grasping errors. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Patient Satisfaction of Surgical Treatment of Clitoral Phimosis and Labial Adhesions Caused by Lichen Sclerosus

    Directory of Open Access Journals (Sweden)

    Anne N. Flynn, MD

    2015-12-01

    Conclusions: This study shows high patient satisfaction and low complication risk associated with surgical correction of clitoral phimosis and lysis of vulvar adhesions for VGF caused by LS. Patients reported improvement in clitoral sensation and ability to achieve orgasm, as well as decreased dyspareunia. Surgical correction of vulvar scarring is a viable option to restore vulvar anatomy and sexual function in appropriate candidates with anogenital LS. Flynn AN, King M, Rieff M, Krapf J, and Goldstein AT. Patient satisfaction of surgical treatment of clitoral phimosis and labial adhesions caused by lichen sclerosus. Sex Med 2015;3:251–255.

  1. AIDS and sex tourism.

    Science.gov (United States)

    Herold, E S; Van Kerkwijk, C

    1992-01-01

    Tourists traveling internationally lower their inhibitions and take greater risks than they would typically in their home cultures. Loneliness, boredom, and a sense of freedom contribute to this behavioral change. Some tourists travel internationally in search of sexual gratification. This motivation may be actively conscious or subconscious to the traveler. Billed as romantic with great natural beauty, Thailand, the Philippines, Brazil, the Dominican Republic, and Kenya are popular destinations of tourists seeking sex. The Netherlands and countries in eastern Europe are also popular. With most initial cases of HIV infection in Europe having histories of international travel, mass tourism is a major factor in the international transmission of AIDS. While abroad, tourists have sex with casual partners, sex workers, and/or other tourists. Far from all tourists, however, carry and consistently use condoms with these partners. One study found female and non white travelers to be less likely than Whites and males to carry condoms. The risk of HIV infection increases in circumstances where condoms are not readily available in the host country and/or are of poor quality. Regarding actual condom use, a study found only 34% of sex tourists from Switzerland to consistently use condoms while abroad. 28% of men in an STD clinic in Melbourne, Australia, reported consistent condom use in sexual relations while traveling in Asia; STDs were identified in 73% of men examined. The few studies of tourists suggest that a significant proportion engage in risky behavior while traveling. HIV prevalence is rapidly increasing in countries known as destinations for sex tourism. High infection rates are especially evident among teenage sex workers in Thailand. Simply documenting the prevalence of risky behavior among sex tourists will not suffice. More research is needed on travelers and AIDS with particular attention upon the motivating factors supporting persistent high-risk behavior.

  2. Bacteriological aspects implicated in abdominal surgical emergencies.

    Science.gov (United States)

    Israil, A M; Delcaru, C; Palade, R S; Chifiriuc, C; Iordache, C; Vasile, D; Grigoriu, M; Voiculescu, D

    2010-01-01

    The purpose of the present study was to establish the microbial etiology of abdominal surgical emergencies as well as the relationship between the bacterial etiology and the virulence factors produced by the respective isolated strains. 110 bacterial strains were isolated from 100 randomized clinical cases, operated during 2009-2010 in the First Surgical Clinic of the University Hospital of Bucharest. The clinical cases (sex ratio 52 M/48F aged between 22-85 years old) were classified into three risk groups, as related to their severity. The isolated strains were characterized by cultural, microscopic and biochemical methods. After identification, the bacterial strains were investigated for their virulence potential (adherence to abiotic surface and production of soluble virulence factors). The specimens were collected from different clinical pathologies: diffuse acute peritonitis, biliary duct infections, severe acute pancreatitis followed by septic processes etc. The 110 bacterial (72 aerobic and 38 anaerobic) strains were isolated only in 70 out of 100 cases. Out of these 70 cases, in 45 already submitted to pre-operatory empiric broad spectrum antibiotic therapy, there were isolated 74 strains, whereas in 25 cases without any treatment, there were isolated 36 strains. The etiology was either mono-specific or multi-specific (aerobic-anaerobic associations, especially in old persons). Out of the 30 negative culture cases, 16 were already submitted to pre-operatory parenteral empiric antibiotic therapy at the moment of specimen collection. The aerobic etiology was dominated by Enterobacteriaceae. The most frequent anaerobic species belonged to Clostridium, Peptococcus and Bacteroides genera. It is to be mentioned that the isolation of Bifidobacterium and Veillonella spp. in 11 (10%) severe cases of the studied abdominal surgical emergencies is pleading for the fact that in certain conditions, bacteria belonging usually to commensal gut flora can turn to pathogenic

  3. Surgical therapy in chronic pancreatitis.

    Science.gov (United States)

    Neal, C P; Dennison, A R; Garcea, G

    2012-12-01

    Chronic pancreatitis (CP) is an inflammatory disease of the pancreas which causes chronic pain, as well as exocrine and endocrine failure in the majority of patients, together producing social and domestic upheaval and a very poor quality of life. At least half of patients will require surgical intervention at some stage in their disease, primarily for the treatment of persistent pain. Available data have now confirmed that surgical intervention may produce superior results to conservative and endoscopic treatment. Comprehensive individual patient assessment is crucial to optimal surgical management, however, in order to determine which morphological disease variant (large duct disease, distal stricture with focal disease, expanded head or small duct/minimal change disease) is present in the individual patient, as a wide and differing range of surgical approaches are possible depending upon the specific abnormality within the gland. This review comprehensively assesses the evidence for these differing approaches to surgical intervention in chronic pancreatitis. Surgical drainage procedures should be limited to a small number of patients with a dilated duct and no pancreatic head mass. Similarly, a small population presenting with a focal stricture and tail only disease may be successfully treated by distal pancreatectomy. Long-term results of both of these procedure types are poor, however. More impressive results have been yielded for the surgical treatment of the expanded head, for which a range of surgical options now exist. Evidence from level I studies and a recent meta-analysis suggests that duodenum-preserving resections offer benefits compared to pancreaticoduodenectomy, though the results of the ongoing, multicentre ChroPac trial are awaited to confirm this. Further data are also needed to determine which of the duodenum-preserving procedures provides optimal results. In relation to small duct/minimal change disease total pancreatectomy represents the only

  4. Surgical Skills Beyond Scientific Management.

    Science.gov (United States)

    Whitfield, Nicholas

    2015-07-01

    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel's attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel-Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice.

  5. Teleology and Defining Sex.

    Science.gov (United States)

    Gamble, Nathan K; Pruski, Michal

    2018-07-01

    Disorders of sexual differentiation lead to what is often referred to as an intersex state. This state has medical, as well as some legal, recognition. Nevertheless, the question remains whether intersex persons occupy a state in between maleness and femaleness or whether they are truly men or women. To answer this question, another important conundrum needs to be first solved: what defines sex? The answer seems rather simple to most people, yet when morphology does not coincide with haplotypes, and genetics might not correlate with physiology the issue becomes more complex. This paper tackles both issues by establishing where the essence of sex is located and by superimposing that framework onto the issue of the intersex. This is achieved through giving due consideration to the biology of sexual development, as well as through the use of a teleological framework of the meaning of sex. Using a range of examples, the paper establishes that sex cannot be pinpointed to one biological variable but is rather determined by how the totality of one's biology is oriented towards biological reproduction. A brief consideration is also given to the way this situation could be comprehended from a Christian understanding of sex and suffering.

  6. Same sex families and children

    OpenAIRE

    Mršević Zorica

    2009-01-01

    Introduction comprises the information on two main forms of same sex families, civic partnership (same sex partnership) and same sex marriage. Countries and various status modalities of legal regulations are mentioned. The main part of the text is dedicated to presentation of the findings of the most recent research on various aspects regarding children of same sex partnerships. It comprises presentations grouped in four main chapters: acceptance of same sex partnerships, acceptance of legal ...

  7. Sex Hormones and Tendon

    DEFF Research Database (Denmark)

    Hansen, Mette; Kjaer, Michael

    2016-01-01

    The risk of overuse and traumatic tendon and ligament injuries differ between women and men. Part of this gender difference in injury risk is probably explained by sex hormonal differences which are specifically distinct during the sexual maturation in the teenage years and during young adulthood....... The effects of the separate sex hormones are not fully elucidated. However, in women, the presence of estrogen in contrast to very low estrogen levels may be beneficial during regular loading of the tissue or during recovering after an injury, as estrogen can enhance tendon collagen synthesis rate. Yet...... has also been linked to a reduced responsiveness to relaxin. The present chapter will focus on sex difference in tendon injury risk, tendon morphology and tendon collagen turnover, but also on the specific effects of estrogen and androgens....

  8. ANAESTHESIA FOR OPHTHALMIC SURGICAL PROCEDURES

    African Journals Online (AJOL)

    Objective: To review factors influencing the choice of anaesthesia for ophthalmic surgical procedures. ... as risk associated with general anaesthesia (8) they are more .... Wilson ME, Pandey SK, Thakur J. Paediatric cataract blindness in the ...

  9. uniportal vats for surgical repair

    African Journals Online (AJOL)

    2017-03-23

    Mar 23, 2017 ... aDepartamet of Pediatric Surgery, Hospital Teresa Herrera, Complejo Hospitalario. Universitario de A ... Advances in anesthesia, neonatal intensive, surgical, and cardiac care have ... First, these patients are at risk of airway ...

  10. Spinal surgery: non surgical complications

    African Journals Online (AJOL)

    Adele

    surgical procedure). Arterial cannulation ... Acute retinal necrosis syndrome after epidural corticos- teroid injections ... prevented, or respond to early recognition and treatment. ..... drugs should only be administered if there are no alternatives.

  11. Patient-specific surgical simulation.

    Science.gov (United States)

    Soler, Luc; Marescaux, Jacques

    2008-02-01

    Technological innovations of the twentieth century have provided medicine and surgery with new tools for education and therapy definition. Thus, by combining Medical Imaging and Virtual Reality, patient-specific applications providing preoperative surgical simulation have become possible.

  12. Sex Disparities in Stroke

    DEFF Research Database (Denmark)

    Dehlendorff, Christian; Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2015-01-01

    between 2003 and 2012 (N=79 617), and the Danish Register of Causes of Death. Information was available on age, sex, marital status, stroke severity, stroke subtype, socioeconomic status, and cardiovascular risk profile. We studied only deaths due to the index stroke, with the assumption that death.......5%) or 1 month (6.9%), respectively. After the age of 60 years, women had more severe strokes than men. Up to ages in the mid-60s, no difference in the risk of death from stroke was seen between the 2 sexes. For people aged >65 years, however, the risk gradually became greater in men than in women...

  13. Surgical management of Crohn's disease.

    Science.gov (United States)

    Lu, Kim C; Hunt, Steven R

    2013-02-01

    Although medical management can control symptoms in a recurring incurable disease, such as Crohn's disease, surgical management is reserved for disease complications or those problems refractory to medical management. In this article, we cover general principles for the surgical management of Crohn's disease, ranging from skin tags, abscesses, fistulae, and stenoses to small bowel and extraintestinal disease. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Surgical innovations in canine gonadectomy

    OpenAIRE

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated negative consequences (lengthy placement, impaired wound healing around bulky knots, and the effect of unsightly knots on cosmetics). A study in 9 dogs found that celiotomy closure was easily achiev...

  15. The influence of physiological and surgical menopause on coronary heart disease risk markers

    NARCIS (Netherlands)

    Verhoeven, Marieke O.; van der Mooren, Marius J.; Teerlink, Tom; Verheijen, Rene H. M.; Scheffer, Peter G.; Kenemans, Peter

    2009-01-01

    Objective: To investigate the influence of physiological and surgical menopause oil Serum concentrations of corollary heart disease (CHD) risk markers and sex hormones. Design: Physiological menopausal transition was investigated in two studies. In a longitudinal Study, 16 women were followed from 2

  16. Evolution of surgical skills training

    Science.gov (United States)

    Roberts, Kurt E; Bell, Robert L; Duffy, Andrew J

    2006-01-01

    Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients. Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated “tissue” in a box trainer. More advanced, virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations. The Accreditation Council of Graduate Medical Education’s (ACGME) has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and to credential surgeons as technically competent. Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery. An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training, ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients. PMID:16718842

  17. Minimizing surgical skin incision scars with a latex surgical glove.

    Science.gov (United States)

    Han, So-Eun; Ryoo, Suk-Tae; Lim, So Young; Pyon, Jai-Kyung; Bang, Sa-Ik; Oh, Kap-Sung; Mun, Goo-Hyun

    2013-04-01

    The current trend in minimally invasive surgery is to make a small surgical incision. However, the excessive tensile stress applied by the retractors to the skin surrounding the incision often results in a long wound healing time and extensive scarring. To minimize these types of wound problems, the authors evaluated a simple and cost-effective method to minimize surgical incision scars based on the use of a latex surgical glove. The tunnel-shaped part of a powder-free latex surgical glove was applied to the incision and the dissection plane. It was fixed to the full layer of the dissection plane with sutures. The glove on the skin surface then was sealed with Ioban (3 M Health Care, St. Paul, MN, USA) to prevent movement. The operation proceeded as usual, with the retractor running through the tunnel of the latex glove. It was possible to complete the operation without any disturbance of the visual field by the surgical glove, and the glove was neither torn nor separated by the retractors. The retractors caused traction and friction during the operation, but the extent of damage to the postoperative skin incision margin was remarkably less than when the operation was performed without a glove. This simple and cost-effective method is based on the use of a latex surgical glove to protect the surgical skin incision site and improve the appearance of the postoperative scar. 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 .

  18. Bacterial migration through punctured surgical gloves under real surgical conditions

    Directory of Open Access Journals (Sweden)

    Heidecke Claus-Dieter

    2010-07-01

    Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

  19. SURGICAL TREATMENT OF TROCHANTERIC FRACTURES BY GAMMA3 NAIL

    Directory of Open Access Journals (Sweden)

    Aleksandar Vukićević

    2010-09-01

    Full Text Available Fractures of the greater trochanter rank amongst severe injuries of bone tissue. They occur most frequently in patients over 65 years of age, nearly all of whom are diagnosed with osteoporosis. Non-surgical treatment does not prove to be satisfactory and results in high mortality rate. Surgical treatment is a method of fracture treatment of the trochanteric region, which enables early activation and thus prevents numerous complications in bedridden patients. Gamma3 nails are one of the most state-of-the-art implants for trochanteric fracture fixation. The implant is easy to embed, which does not require a large surgical team. This implant embedding requires the least invasive surgery and complications are rare.This paper describes 47 patients who received surgical treatment and is focused on the first nine months of 2009. The patients were treated at the Orthopaedics Ward of Health Centre Valjevo. They were in their seventies, average age: 72.21 years, with female sex prevailing (63.82%. The outcome was as follows: excellent in 65.96%, good in 17.02% and satisfactory in 4.25% of patients. Surface infections occurred in 6.38% of patients. One implant broke.We had one death outcome in the early post-surgical treatment.Surgical treatment of trochanteric fractures by Gamma3 implants proved very effective as it resulted in few complications and numerous excellent functional and anatomic outcomes. Thus we recommend it as an option when decision on treatment of this type of fractures is made.

  20. Characteristics of uveitic glaucoma and evaluation of its surgical treatment

    Directory of Open Access Journals (Sweden)

    Shimizu A

    2014-11-01

    Full Text Available Ai Shimizu, Kazuichi Maruyama, Yu Yokoyama, Satoru Tsuda, Morin Ryu, Toru Nakazawa Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan Purpose: To investigate the characteristics of uveitic glaucoma (UG and evaluate surgical treatments.Methods: This study examined a retrospective, nonrandomized comparative interventional case series of 105 UG patients (141 eyes followed between April 1, 2001 and July 30, 2014 at the outpatient clinic of Tohoku University Hospital. The study group included 47 patients (47 eyes who underwent glaucoma surgery: trabeculectomy, trabeculotomy, and trabectome surgery. The analysis used Kaplan–Meier life tables, with surgical failure defined as intraocular pressure ≧21 mmHg or the need for additional glaucoma surgery.Results: UG patients represented 9.73% of our database of glaucoma patients. The mean follow-up period was 40.32±32.53 months. Seventy-one patients had granulomatous uveitis (67.62% and 34 had nongranulomatous uveitis (32.38%. The causes of uveitis included sarcoidosis (n=25, Behçet’s disease (n=11, Vogt–Koyanagi–Harada disease (n=9, Posner–Schlossman syndrome (n=12, herpes simplex virus infectious uveitis (n=7, acute anterior uveitis (n=5, intermediate uveitis (n=4, scleritis (n=4, inflammatory bowel disease (n=4, varicella zoster virus uveitis (n=2, and others (n=6. An additional 16 patients were diagnosed with idiopathic UG. Surgical success rates were 82.86% for trabeculectomy, 62.50% for trabeculotomy, and 75.00% for trabectome. Significant risk factors for surgical failure included male sex (P=0.02, age less than 45 years (P=0.0009, nongranulomatous uveitis (P=0.04, and postoperative inflammation (P=0.01.Conclusion: Young male patients with nongranulomatous uveitis had a significant risk of surgical failure. Moreover, prolonged postoperative inflammation created a susceptibility to surgical failure, indicating the importance of postoperative

  1. Sex steroids and neurogenesis.

    Science.gov (United States)

    Heberden, Christine

    2017-10-01

    The brain has long been known as a dimorphic organ and as a target of sex steroids. It is also a site for their synthesis. Sex steroids in numerous ways can modify cerebral physiology, and along with many processes adult neurogenesis is also modulated by sex steroids. This review will focus on the effects of the main steroids, estrogens, androgens and progestogens, and unveil some aspects of their partly disclosed mechanisms of actions. Gonadal steroids act on different steps of neurogenesis: cell proliferation seems to be increased by estrogens only, while androgens and progestogens favor neuronal renewal by increasing cell survival; differentiation is a common target. Aging is characterized by a cognitive deficiency, paralleled by a decrease in the rate of neuronal renewal and in the levels of circulating gonadal hormones. Therefore, the effects of gonadal hormones on the aging brain are important to consider. The review will also be expanded to related molecules which are agonists to the nuclear receptors. Sex steroids can modify adult neuronal renewal and the extensive knowledge of their actions on neurogenesis is essential, as it can be a leading pathway to therapeutic perspectives. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. How Sex Attitudes Develop

    Science.gov (United States)

    Arnstein, Helene S.

    1976-01-01

    Excerpt from "The Roots of Love" (Helene S. Arnstein, 1975). Book is concerned with feelings that are part of child's developmental stages. Included in excerpt are: genital self-discovery, masturbation, discovery of sex differences, and birth fantasies. Stresses importance of parent's feelings which are communicated to child.

  3. Sex differences in addiction.

    Science.gov (United States)

    Becker, Jill B

    2016-12-01

    Women exhibit more rapid escalation from casual drug taking to addiction, exhibit a greater withdrawal response with abstinence, and tend to exhibit greater vulnerability than men in terms of treatment outcome. In rodents, short-term estradiol intake in female rats enhances acquisition and escalation of drug taking, motivation for drugs of abuse, and relapse-like behaviors. There is also a sex difference in the dopamine response in the nucleus accumbens. Ovariectomized female rats exhibit a smaller initial dopamine increase after cocaine treatment than castrated males. Estradiol treatment of ovariectomized female rats enhances stimulated dopamine release in the dorsolateral striatum, but not in the nucleus accumbens, resulting in a sex difference in the balance between these two dopaminergic projections. In the situation where drug-taking behavior becomes habitual, dopamine release has been reported to be enhanced in the dorsolateral striatum and attenuated in the nucleus accumbens. The sex difference in the balance between these neural systems is proposed to underlie sex differences in addiction.

  4. Battle of the Sexes

    NARCIS (Netherlands)

    Bulte, E.H.; Tu, Q.; List, J.

    2015-01-01

    A vibrant literature has emerged that explores the economic implications of the sex ratio (the ratio of men to women in the population), including changes in fertility rates, educational outcomes, labor supply, and household purchases. Previous empirical efforts, however, have paid less attention to

  5. Sex education and ideals

    NARCIS (Netherlands)

    de Ruyter, D.J.; Spiecker, B.

    2008-01-01

    This article argues that sex education should include sexual ideals. Sexual ideals are divided into sexual ideals in the strict sense and sexual ideals in the broad sense. It is argued that ideals that refer to the context that is deemed to be most ideal for the gratification of sexual ideals in the

  6. Reassignment of the land tortoise haemogregarine Haemogregarina fitzsimonsi Dias 1953 (Adeleorina: Haemogregarinidae) to the genus Hepatozoon Miller 1908 (Adeleorina: Hepatozoidae) based on parasite morphology, life cycle and phylogenetic analysis of 18S rDNA sequence fragments.

    Science.gov (United States)

    Cook, Courtney A; Lawton, Scott P; Davies, Angela J; Smit, Nico J

    2014-06-13

    SUMMARY Research was undertaken to clarify the true taxonomic position of the terrestrial tortoise apicomplexan, Haemogregarina fitzsimonsi (Dias, 1953). Thin blood films were screened from 275 wild and captive South African tortoises of 6 genera and 10 species between 2009-2011. Apicomplexan parasites within films were identified, with a focus on H. fitzsimonsi. Ticks from wild tortoises, especially Amblyomma sylvaticum and Amblyomma marmoreum were also screened, and sporogonic stages were identified on dissection of adult ticks of both species taken from H. fitzsimonsi infected and apparently non-infected tortoises. Parasite DNA was extracted from fixed, Giemsa-stained tortoise blood films and from both fresh and fixed ticks, and PCR was undertaken with two primer sets, HEMO1/HEMO2, and HepF300/HepR900, to amplify parasite 18S rDNA. Results indicated that apicomplexan DNA extracted from tortoise blood films and both species of tick had been amplified by one or both primer sets. Haemogregarina  fitzsimonsi 18S rDNA sequences from tortoise blood aligned with those of species of Hepatozoon, rather than those of species of Haemogregarina or Hemolivia. It is recommended therefore that this haemogregarine be re-assigned to the genus Hepatozoon, making Hepatozoon fitzsimonsi (Dias, 1953) the only Hepatozoon known currently from any terrestrial chelonian. Ticks are its likely vectors.

  7. Sex education in Cyprus.

    Science.gov (United States)

    Patsalides, N

    1991-05-01

    The objective of educating people on family planning and sexuality issues has been carried forth by the Family Planning Association of Cyprus (FPAC) since 1971. The promotion of sex education in schools has generated respect for their expertise. Sex education has reached the agenda of the General Assembly of Parliament only to be postponed due to the April 1991 end of term dismissal. A newly elected Parliament are not expected to act immediately. The Ministry of Education Committee on Health Education has been actively counseled since 1974, and most recently in their examination of the possibilities of school sex education and training of high school teachers. The Ministry of Education has authority over primary and secondary education, which is compulsory up to 3 years of secondary education. The approach of FPAC has been to work with parents first in education lectures at various well publicized locations. The agenda was to inform about FPAC, explain the purpose and meaning of sex education, and show the Merry-Go-Round educational film followed by a question and answer session. Eventually, presentations involved children with parent observation. In 1977, authorization from the Ministry of Education gave official approval to FPAC, but not on school premises. FPAC went directly to headmasters and gained support in primary schools to organize sessions on school premises, which successfully involved many primary schools even in the much needed rural areas. Home Economics and Child Care, offered in the 5th and 6th grades was the only vehicle for gaining permission to enter secondary schools. In Larnaca, secondary school headmasters at the 3rd and 6th grade levels permitted invitations which requested parental permission. Lecture topics on human reproduction, sex roles, and disease and contraception were also provided in a follow-up letter. Higher education levels were involved through youth clubs and evening lectures. In 1988, FPAC urged the Director General of the

  8. Sex and life expectancy.

    Science.gov (United States)

    Seifarth, Joshua E; McGowan, Cheri L; Milne, Kevin J

    2012-12-01

    A sexual dimorphism in human life expectancy has existed in almost every country for as long as records have been kept. Although human life expectancy has increased each year, females still live longer, on average, than males. Undoubtedly, the reasons for the sex gap in life expectancy are multifaceted, and it has been discussed from both sociological and biological perspectives. However, even if biological factors make up only a small percentage of the determinants of the sex difference in this phenomenon, parity in average life expectancy should not be anticipated. The aim of this review is to highlight biological mechanisms that may underlie the sexual dimorphism in life expectancy. Using PubMed, ISI Web of Knowledge, and Google Scholar, as well as cited and citing reference histories of articles through August 2012, English-language articles were identified, read, and synthesized into categories that could account for biological sex differences in human life expectancy. The examination of biological mechanisms accounting for the female-based advantage in human life expectancy has been an active area of inquiry; however, it is still difficult to prove the relative importance of any 1 factor. Nonetheless, biological differences between the sexes do exist and include differences in genetic and physiological factors such as progressive skewing of X chromosome inactivation, telomere attrition, mitochondrial inheritance, hormonal and cellular responses to stress, immune function, and metabolic substrate handling among others. These factors may account for at least a part of the female advantage in human life expectancy. Despite noted gaps in sex equality, higher body fat percentages and lower physical activity levels globally at all ages, a sex-based gap in life expectancy exists in nearly every country for which data exist. There are several biological mechanisms that may contribute to explaining why females live longer than men on average, but the complexity of the

  9. [Academic medicine and gender: women in surgical specialities].

    Science.gov (United States)

    Cortés-Flores, Ana Olivia; Fuentes-Orozco, Clotilde; López-Ramírez, María Karina Lizbeth; Veláquez-Ramírez, Gabriela Abigail; Farías-Llamas, Oscar Alejandro; Olivares-Becerra, Juan José; González-Ojeda, Alejandro

    2005-01-01

    Scientific advances have always been used as a measure to place societies in the context of developed and developing countries. This circumstance has directly influenced the division among the sexes and among social strata. Traditionally women have been relegated to an inferior status and in some instances their role as active participants in social and economic development has been annulled. In professional spheres, women have reached positions that previously seemed unattainable due to social and cultural limitations imposed by men and sometimes by women themselves. Medical school is currently no longer an obstacle for women to gain entry to, approximately 50% of medical students are women. On the other hand, surgical residences constitute a more complex situation. In order for women to decide to apply to a surgical residence, they have to take into account a variety of factors, among them, the difficulty of joining a male dominated environment where women have to demonstrate they are able and capable of performing sometimes at the expense of having to carry an additional work load. Women admitted to surgical residences will have to face gender discrimination, pregnancy and family responsibilities as well as salary inequities and sometimes even sexual harassment. We aimed to show the circumstances and obstacles that women are confronted with during surgical training and the influence these have in their personal and professional development.

  10. Evidence-based medical review update: pharmacological and surgical treatments of Parkinson's disease: 2001 to 2004.

    Science.gov (United States)

    Goetz, Christopher G; Poewe, Werner; Rascol, Olivier; Sampaio, Cristina

    2005-05-01

    The objective of this study is to update a previous evidence-based medicine (EBM) review on Parkinson's disease (PD) treatments, adding January 2001 to January 2004 information. The Movement Disorder Society (MDS) Task Force prepared an EBM review of PD treatments covering data up to January 2001. The authors reviewed Level I (randomized clinical trials) reports of pharmacological and surgical interventions for PD, published as full articles in English (January 2001-January 2004). Inclusion criteria and ranking followed the original program and adhered to EBM methodology. For Efficacy Conclusions, treatments were designated Efficacious, Likely Efficacious, Non-Efficacious, or Insufficient Data. Four clinical indications were considered for each intervention: prevention of disease progression; treatment of Parkinsonism, as monotherapy and as adjuncts to levodopa where indicated; prevention of motor complications; treatment of motor complications. Twenty-seven new studies qualified for efficacy review, and others covered new safety issues. Apomorphine, piribedil, unilateral pallidotomy, and subthalamic nucleus stimulation moved upward in efficacy ratings. Rasagiline, was newly rated as Efficacious monotherapy for control of Parkinsonism. New Level I data moved human fetal nigral transplants, as performed to date, from Insufficient Data to Non- efficacious for the treatment of Parkinsonism, motor fluctuations, and dyskinesias. Selegiline was reassigned as Non-efficacious for the prevention of dyskinesias. Other designations did not change. In a field as active in clinical trials as PD, frequent updating of therapy-based reviews is essential. We consider a 3-year period a reasonable time frame for published updates and are working to establish a Web-based mechanism to update the report in an ongoing manner. Copyright 2005 Movement Disorder Society.

  11. Sex and Gender Differences in Prevention of Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Jürgen Harreiter

    2018-05-01

    Full Text Available Lifestyle intervention programs are effective in the prevention of type 2 diabetes mellitus (T2DM in high risk populations. However, most studies only give limited information about the influence of sex and/or gender effectiveness of these interventions. So far, similar outcome was reported for diabetes progression and weight loss. Nevertheless, long-term data on cardiovascular outcome are sparse but favoring women regarding all-cause and cardiovascular mortality. In both men and women, sex hormone imbalances and reproductive disorders are associated with a higher risk of T2DM development. Diabetes prevention approaches are reported for polycystic ovary syndrome, gestational diabetes mellitus, and erectile dysfunction and are presented in this review. In the surgical treatment options for morbid obese patients, sex and gender differences are present. Choices and preferences of adherence to lifestyle and pharmacological interventions, expectations, treatment effects, and complications are influenced by sex or gender. In general, bariatric surgery is performed more often in women seeking medical/surgical help to lose weight. Men are older and have higher comorbidities and mortality rates and worse follow-up outcome after bariatric surgery. A more gender-sensitive clinical approach, as well as consideration of ethnicity may improve quality of life and increase health and life expectancy in men and women with a high risk for subsequent progression to T2DM.

  12. Disestablishing Sex: The Case for Released-Time Sex Education

    Science.gov (United States)

    Glanzer, Perry L.

    2011-01-01

    Allowing nonschool organizations to provide sex education in a released-time format would disestablish state-funded sex education and give families a choice in the sex education that would be provided for their children. Released-time programs, as originally conceived and currently practiced, allow students to be released for a period of time…

  13. Sex identification of Nigerian indigenous chicks using Auto-sexing ...

    African Journals Online (AJOL)

    Sexing has been a challenging task in Nigerian indigenous chickens due to the monomorphism of chicks which makes it impossible to distinguish the male from the female until eight weeks. . Therefore, this study was carried out to determine the sex of Nigerian indigenous chicks using the common auto-sexing methods.

  14. Surgical strategies in childhood craniopharyngioma

    Directory of Open Access Journals (Sweden)

    Jörg eFlitsch

    2011-12-01

    Full Text Available Craniopharyngiomas are biologically benign lesions (WHO Grade 1 of the sellar and suprasellar region, associated with a serious morbidity. About 50% of these tumors become clinically apparent during childhood. Clinical symptoms include headaches, chiasm syndrome, hydrocephalus, pituitary insufficiencies, and obesity. Growth arrest is a typical symptom in children. The treatment of craniopharyngiomas includes surgery as well as radiotherapy. The goal of surgery varies according to the tumor location and extension and may range from complete resection to biopsy. Surgical complications are well known and cause constant evaluation of surgical strategies. Diencephalic obesity is related to surgical manipulation of hypothalamic tissue. Therefore, a classification system for craniopharyngiomas based on preoperative MRI is suggested by the authors, which may help assess the surgical risk. Recurrences are frequent in craniopharyngiomas, even after complete or gross-total resection. Radiotherapy is therefore recommended to patients with incomplete resections. However, the ideal time for radiotherapy after surgery is under discussion.The treatment of craniopharyngiomas requires an interdisciplinary and multimodal approach. Each patient should receive an individually tailored treatment. Surgically, different approaches as well as different degrees of resection can be considered, depending on tumor location and tumor extension.

  15. Surgical Management of Localized Scleroderma.

    Science.gov (United States)

    Lee, Jae Hyun; Lim, Soo Yeon; Lee, Jang Hyun; Ahn, Hee Chang

    2017-09-01

    Localized scleroderma is characterized by a thickening of the skin from excessive collagen deposits. It is not a fatal disease, but quality of life can be adversely affected due to changes in skin appearance, joint contractures, and, rarely, serious deformities of the face and extremities. We present six cases of localized scleroderma in face from our surgical practice. We reviewed six localized scleroderma cases that were initially treated with medication and then received follow-up surgery between April 2003 and February 2015. Six patients had facial lesions. These cases presented with linear dermal sclerosis on the forehead, oval subcutaneous and dermal depression in the cheek. En coup de sabre (n=4), and oval-shaped lesion of the face (n=2) were successfully treated. Surgical methods included resection with or without Z-plasty (n=3), fat graft (n=1), dermofat graft (n=1), and adipofascial free flap (n=1). Deformities of the affected parts were surgically corrected without reoccurrence. We retrospectively reviewed six cases of localized scleroderma that were successfully treated with surgery. And we propose an algorithm for selecting the best surgical approach for individual localized scleroderma cases. Although our cases were limited in number and long-term follow-up will be necessary, we suggest that surgical management should be considered as an option for treating scleroderma patients.

  16. Three-dimensional surgical simulation.

    Science.gov (United States)

    Cevidanes, Lucia H C; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2010-09-01

    In this article, we discuss the development of methods for computer-aided jaw surgery, which allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3-dimensional surface models from cone-beam computed tomography, dynamic cephalometry, semiautomatic mirroring, interactive cutting of bone, and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intraoperative guidance. The system provides further intraoperative assistance with a computer display showing jaw positions and 3-dimensional positioning guides updated in real time during the surgical procedure. The computer-aided surgery system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training, and assessing the difficulties of the surgical procedures before the surgery. Computer-aided surgery can make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  17. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... Cord Injury Medical Expert Videos Topics menu Topics Sex and Fertility After Spinal Cord Injury Adult Injuries ... Coping with a New Injury Robin Dorman, PsyD Sex and Fertility After Spinal Cord Injury Diane M. ...

  18. Sex and Fertility After SCI

    Science.gov (United States)

    ... Cord Injury Medical Expert Videos Topics menu Topics Sex and Fertility After Spinal Cord Injury Adult Injuries ... Coping with a New Injury Robin Dorman, PsyD Sex and Fertility After Spinal Cord Injury Diane M. ...

  19. Low Sex Drive in Women

    Science.gov (United States)

    Low sex drive in women Overview Women's sexual desires naturally fluctuate over the years. Highs and lows commonly coincide ... used for mood disorders also can cause low sex drive in women. If your lack of interest ...

  20. SHBG (Sex Hormone Binding Globulin)

    Science.gov (United States)

    ... Links Patient Resources For Health Professionals Subscribe Search Sex Hormone Binding Globulin (SHBG) Send Us Your Feedback ... As Testosterone-estrogen Binding Globulin TeBG Formal Name Sex Hormone Binding Globulin This article was last reviewed ...

  1. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... Medical Expert Videos Topics menu Topics Sex and Fertility After Spinal Cord Injury Adult Injuries Spinal Cord ... a New Injury Robin Dorman, PsyD Sex and Fertility After Spinal Cord Injury Diane M. Rowles, MS, ...

  2. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... sex after a spinal cord injury? play_arrow Can men and women still have sex after a ... menstruation after a spinal cord injury? play_arrow Can women still get pregnant after a spinal cord ...

  3. Hypnotic Psychotherapy with Sex Offenders

    Science.gov (United States)

    Moseley, Sullivan; Briggs, Wanda P.; Magnus, Virginia

    2005-01-01

    The authors review the literature on the prevalence of sex offenders; multiple treatment modalities; and implications of the use of hypnotic psychotherapy, coupled with cognitive behavioral treatment programs, for treating sex offenders. (Contains 2 tables.)

  4. Surgical Approaches to Chronic Pancreatitis

    Directory of Open Access Journals (Sweden)

    Daniel Hartmann

    2015-01-01

    Full Text Available Chronic pancreatitis is a progressive inflammatory disease resulting in permanent structural damage of the pancreas. It is mainly characterized by recurring epigastric pain and pancreatic insufficiency. In addition, progression of the disease might lead to additional complications, such as pseudocyst formation or development of pancreatic cancer. The medical and surgical treatment of chronic pancreatitis has changed significantly in the past decades. With regard to surgical management, pancreatic head resection has been shown to be a mainstay in the treatment of severe chronic pancreatitis because the pancreatic head mass is known to trigger the chronic inflammatory process. Over the years, organ-preserving procedures, such as the duodenum-preserving pancreatic head resection and the pylorus-preserving Whipple, have become the surgical standard and have led to major improvements in pain relief, preservation of pancreatic function, and quality of life of patients.

  5. Surgical management of Gerhardt syndrome.

    Science.gov (United States)

    Chirilă, M; Mureşan, R; Cosgarea, M; Tomescu, E

    2010-01-01

    Adduction bilateral vocal fold immobility syndrome may be due by both recurrent laryngeal nerves paralysis--Gerhardt syndrome--and all intrinsic laryngeal muscles paralysis--Riegel syndrome. Etiology of Gerhardt syndrome is thyroid surgery, intubation's maneuver, trauma, neurological disorders, extrala-ryngeal malignancies. The manifestations of Gerhardt syndrome are inspiratory dyspnea and slightly influenced voicing by paramedian vocal folds paralysis with an important narrowing of the airway at the glottic level. The surgical procedures for enlargement of the glottic space can be classified in many ways and their major characteristics are: changes at the glottic level; surgical approach: open neck or endoscopic, with or without opening of the mucosal lining; the need for tracheostomy; the equipment used. The aim of this review is to expound the variety of interventions through the last century marked by the development of the diagnostic methods, the anesthesia and the surgical armament with sophisticated instruments and technologies.

  6. Surgical ethics: today and tomorrow.

    Science.gov (United States)

    Sade, Robert M; Kavarana, Minoo N

    2017-11-01

    Ethical behavior has always been deeply ingrained in surgical culture, but ethical deliberation has only recently become an important component of cardiac surgical practice. In our earlier review, we covered a range of issues including several related to informed consent, conflict of interest, professional self-regulation and innovation, among many others. This update covers several topics of interest to cardiac surgeons and cardiologists, focusing on controversial issues specific to the practice of cardiothoracic surgery: informed consent, relations with hospitals and euthanasia and physician-assisted suicide. The future holds much uncertainty for cardiac surgical practice, research and culture, and we provide an update on ethical issues to serve as a platform for envisioning what is to come.

  7. Sex Education with Young Children.

    Science.gov (United States)

    Koblinsky, Sally; And Others

    1980-01-01

    Discusses guidelines (developed by the Oregon State University Early Childhood Sex Education Project) for developing teacher-parent cooperation in providing sex education to young children. The guidelines concern how to talk about body differences and body functions; how to deal with masturbation, sex play and obscene language; and how to involve…

  8. YY Sex: a Polar Candidate

    Science.gov (United States)

    Gabdeev, M. M.; Shimanskiy, V. V.; Borisov, N. V.; Tazieva, Z. R.

    2017-06-01

    We present spectroscopic investigations of a cataclysmic variable star, YY Sex. There are some uncertainties in the classification of this object. We calculate Doppler maps for Hβ and HeII λ4686Å and show that there is no sign of disk accretion in YY Sex. Consequently, we conclude that YY Sex is a polar.

  9. Sex Education: Challenges and Choices

    Science.gov (United States)

    MacKenzie, Alison; Hedge, Nicki; Enslin, Penny

    2017-01-01

    Noting public concern about sexual exploitation, abuse and sexualisation, we argue that sex education in the UK needs revision. Choice is a feature of current sex education policy and, acknowledging that choice can be problematic, we defend its place in an approach to sex education premised on informed deliberation, relational autonomy, a…

  10. Sex Stereotyping Hurts All Kids.

    Science.gov (United States)

    Cutright, Melitta J.

    1991-01-01

    Sex stereotyping (raising boys and girls to be different because of their sex) begins at birth. The article reviews studies detailing sex stereotyping practices and offers suggestions on what parents can do to avoid them. A list of suggestions for raising children in a nonsexist way is included. (SM)

  11. Surgically Assisted Rapid Maxillary Expansion: surgical and orthodontic aspects

    NARCIS (Netherlands)

    M.J. Koudstaal (Maarten)

    2008-01-01

    textabstractThe scope of this thesis is to shed more light, from a number of perspectives, on surgically assisted rapid maxillary expansion (SARME). The primary questions this thesis set out to answer were; ‘is there a difference in stability between bone-borne and tooth-borne distraction?’ and ‘can

  12. Emotions in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Pedersen, Lene Tanggaard

    2012-01-01

    A surgical educational environment is potentially stressful and can negatively affect students' learning. The aim of the present study was to investigate the emotions experienced by veterinary students in relation to their first encounter with live-animal surgery and to identify possible sources...... of positive and negative emotions, respectively. During a Basic Surgical Skills course, 155 veterinary fourth-year students completed a survey. Of these, 26 students additionally participated in individual semi-structured interviews. The results of the study show that students often experienced a combination...

  13. Non-vascular surgical mediastinum

    International Nuclear Information System (INIS)

    Schiavon, S.; Trenaghi, P.; Nardini, S.; Pagan, V.

    1989-01-01

    A review was made of the chest X-ray features of 120 patients who underwent surgical treatment for mediastinal non-vascular pathologies over the past 12 years in the Mestre Hospital. A method of analysis is proposed which takes into account not only the differences between the immediate post-operative period and the follow-up, but also the anatomotopographic partition and the surgical practice. Normal and pathological patterns for both of the above periods are described. The ''dimness'' of the arial tracheogram is emphasized as a usefull and early sign of mediastinal recurrence

  14. Surgical options after Fontan failure

    DEFF Research Database (Denmark)

    van Melle, Joost P; Wolff, Djoeke; Hörer, Jürgen

    2016-01-01

    by the European Congenital Heart Surgeons Association among 22 member centres. Outcome of surgery to address failing Fontan was collected in 225 patients among which were patients with Fontan takedown (n=38; 17%), Fontan conversion (n=137; 61%) or HTX (n=50; 22%). RESULTS: The most prevalent indication...... for failing Fontan surgery was arrhythmia (43.6%), but indications differed across the surgical groups (p...OBJECTIVE: The objective of this European multicenter study was to report surgical outcomes of Fontan takedown, Fontan conversion and heart transplantation (HTX) for failing Fontan patients in terms of all-cause mortality and (re-)HTX. METHODS: A retrospective international study was conducted...

  15. Innovation in pediatric surgical education.

    Science.gov (United States)

    Clifton, Matthew S; Wulkan, Mark L

    2015-06-01

    Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Knee Luxation - Surgical treatment in acute cases

    International Nuclear Information System (INIS)

    De los Rios Giraldo, Adolfo

    2005-01-01

    Introduction: Traumatic luxation of the knee is an infrequent pathology with low number of reported cases. That implies a true challenge for the orthopedic surgeon due to its great of presentation. Objective: Establish a scheme of surgical management for this complex injury. Methodology: Observational study with different kinds of cases of patients from Universitario Del Valle Hospital and from the Imbanaco Medical Center. These surgeries occurred from December of 1999 to February of the 2003. Patients: 16. Age average: 31 years old. Age group: 13 to 64 years. Sex: 14 male and 2 female. Luxation Types: 15 closed and 1 exposed. Procedures: Correction of the extra-capsular structures and reintegration of the crossed ligaments in cases of avulsion using an acute management approach. In the two last patients, it was performed a simultaneous reconstruction of the crossed posterior and anterior with an auto-graft followed by patients monitoring from 12 to 50 months. The most common luxation type was KDIII L according to anatomical classification. A patient with vascular injury, two with external popliteo ciatic nerve injury and one broken patellar tendon, the results were evaluated according to the scale of Lysholm, IKDC and For Special Surgery. Conclusions: The acute management of the extra-articular structures gives the best results; therefore, if the surgeon does not have enough experience, this procedure should be to left for secondary reconstruction when the patient has normal arch of mobility

  17. The tropical diabetic hand syndrome: a surgical perspective.

    Science.gov (United States)

    Nthumba, Peter; Cavadas, Pedro C; Landin, Luis

    2013-01-01

    Tropical diabetic hand syndrome (TDHS) is an aggressive type of hand sepsis that results in significant morbidity and mortality among patients with diabetes in the tropics. This study set out to establish a protocol for the holistic management of TDHS to improve digit/hand salvage and function at AIC Kijabe Hospital. This prospective study examined the following demographics of patients presenting to the authors institution between October 2009 and September 2010 with TDHS: their sex, age, comorbidities, length of in-hospital stay, surgical and medical treatment, total cost of treatment, and immediate postdischarge outcomes. A total of 10 patients (3 men and 7 women) were presented with TDHS during the study period. Surgical procedures included a thorough debridement of the hand at initial presentation, followed by procedures aimed at preserving length and hand function, with digit or hand amputation when there was no possibility of salvage. Three hands were salvaged, without the need for an amputation; 2 of these, however, developed severe stiffness with resultant poor function. Fifty percent of the patients developed considerable disability; 3 of these patients had disabilities of the arm, shoulder, and hand, (DASH) scores of >90 at 6 months after treatment. TDHS appears to be more aggressive in some patients than in others; a multidisciplinary approach, with early involvement of the surgical team, and a radical surgical debridement are essential to improved outcomes. Although the goal of medical treatment (ie, glycemic control) is simple and easily achieved, surgical goals (salvage of limb or life, preservation of hand function) are more complex, costly, and difficult to achieve. Educating health care workers, diabetic patients, and their relatives on hand care is an important preventive measure. Diligence in taking antidiabetic medicine, early presentation, and appropriate care of TDHS are required for meaningful improvement in outcomes of patients with

  18. Surgical approach to pineal tumours.

    Science.gov (United States)

    Pluchino, F; Broggi, G; Fornari, M; Franzini, A; Solero, C L; Allegranza, A

    1989-01-01

    During a period of 10 years (1977-1986) 40 cases of tumour of the pineal region have been treated at the Istituto Neurologico "C. Besta"-of Milan. Out of these 40 cases, 27 (67.5%) were in the paediatric (10-15 years) or juvenile (15-20 years) age at the time of operation. Since 1983 a specific diagnostic and therapeutic protocol has been adopted and thereafter direct surgical removal of the tumour was performed only when the neuroradiological investigations were highly suggestive of a benign extrinsic lesion. Sixteen cases in this series underwent direct surgical removal; in the remaining 24 cases stereotactic biopsy of the tumour was performed in the first instance. On the basis of the histological diagnosis obtained by this procedure surgical excision of the tumour (9 cases) or radiotherapy (15 cases) was then performed. 25 cases underwent surgical removal of the lesion. In all the cases the infratentorial supracerebellar approach as introduced by Krause and then modified by Stein was adopted. On analysis of the data of this series it was observed that in 25% of the cases completely benign resectable tumours were found; in 25% of the cases astrocytoma (grade I-II) which could be treated at least by partial removal were present; in 30% of the cases radiosensitive lesions were encountered. In the remaining 20% of the cases highly malignant tumours were found which should be treated only by radiotherapy and/or chemotherapy.

  19. The dutch surgical colorectal audit

    NARCIS (Netherlands)

    Leersum, N.J. van; Snijders, H.S.; Henneman, D.; Kolfschoten, N.E.; Gooiker, G.A.; Berge, M.G. Ten; Eddes, E.H.; Wouters, M.W.; Tollenaar, R.A.E.M.; Bemelman, W.A.; Dam, R.M. van; Elferink, M.A.; Karsten, T.M.; Krieken, J.H. van; Lemmens, V.E.; Rutten, H.J.; Manusama, E.R.; Velde, C.J. van de; Meijerink, W.J.H.J.; Wiggers, T.; Harst, E. van der; Dekker, J.W.T.; Boerma, D.

    2013-01-01

    INTRODUCTION: In 2009, the nationwide Dutch Surgical Colorectal Audit (DSCA) was initiated by the Association of Surgeons of the Netherlands (ASN) to monitor, evaluate and improve colorectal cancer care. The DSCA is currently widely used as a blueprint for the initiation of other audits, coordinated

  20. Surgical treatment of buried penis.

    Science.gov (United States)

    Lipszyc, E; Pfister, C; Liard, A; Mitrofanoff, P

    1997-10-01

    The buried penis is a rare congenital entity, whose treatment is surgical. There are few publications concerning this matter. The authors report on their experience in 10 cases (1990-1995). In this abnormality, the tip of the glans does not project from the pubic or scrotal skin. It is due to: 1) an excessive development of the penile fascia which retracts the penis; 2) insufficient attachment of the penile skin at the base of the penis; 3) often excessive prepubic fat worsens the appearance of the abnormality but does not by itself totally explain it; 4) a tight phimosis is often present. Surgical treatment is necessary because this aspect tends to persist even after puberty. One cannot indeed count on the development at the age of puberty, neither on the diminution of the fat, nor on the simple cure of the phimosis. One must above all ban circumcision which causes the risk of eliminating the skin necessary for reconstruction. The surgical procedure will comprise: 1) a longitudinal dorsal incision extended circumferentially; 2) resection of the thickened fascia penis; 3) anchoring of the deep face of the dermis to the proximal part of the fascia penis at the base of the penis. This surgical procedure has always brought a significant improvement to the appearance of the penis.

  1. Surgical management of tubal pregnancy

    NARCIS (Netherlands)

    Mol, F.

    2013-01-01

    The work presented in this thesis first addresses the magnitude of the clinical problem of surgically treated tubal pregnancy in The Netherlands. Next, we studied the adherence to recommendations from the Dutch guideline on diagnosis and management of ectopic pregnancy. A systematic review and

  2. The Dutch surgical colorectal audit

    NARCIS (Netherlands)

    van Leersum, N. J.; Snijders, H. S.; Henneman, D.; Kolfschoten, N. E.; Gooiker, G. A.; ten Berge, M. G.; Eddes, E. H.; Wouters, M. W. J. M.; Tollenaar, R. A. E. M.; Bemelman, W. A.; van Dam, R. M.; Elferink, M. A.; Karsten, Th M.; van Krieken, J. H. J. M.; Lemmens, V. E. P. P.; Rutten, H. J. T.; Manusama, E. R.; van de Velde, C. J. H.; Meijerink, W. J. H. J.; Wiggers, Th; van der Harst, E.; Dekker, J. W. T.; Boerma, D.

    2013-01-01

    In 2009, the nationwide Dutch Surgical Colorectal Audit (DSCA) was initiated by the Association of Surgeons of the Netherlands (ASN) to monitor, evaluate and improve colorectal cancer care. The DSCA is currently widely used as a blueprint for the initiation of other audits, coordinated by the Dutch

  3. Surgical smoke and infection control.

    NARCIS (Netherlands)

    Alp, E.; Bijl, D.; Bleichrodt, R.P.; Hansson, B.M.; Voss, A.

    2006-01-01

    Gaseous byproducts produced during electrocautery, laser surgery or the use of ultrasonic scalpels are usually referred to as 'surgical smoke'. This smoke, produced with or without a heating process, contains bio-aerosols with viable and non-viable cellular material that subsequently poses a risk of

  4. Surgical training in the Netherlands

    NARCIS (Netherlands)

    Borel-Rinkes, Inne H. M.; Gouma, Dirk J.; Hamming, Jaap F.

    2008-01-01

    Surgical training in the Netherlands has traditionally been characterized by learning on the job under the classic master-trainee doctrine. Over the past decades, it has become regionally organized with intensive structural training courses, and a peer-based quality control system. Recently, the

  5. The many costs of sex.

    Science.gov (United States)

    Lehtonen, Jussi; Jennions, Michael D; Kokko, Hanna

    2012-03-01

    Explaining the evolution of sex is challenging for biologists. A 'twofold cost' compared with asexual reproduction is often quoted. If a cost of this magnitude exists, the benefits of sex must be large for it to have evolved and be maintained. Focusing on benefits can be misleading, as this sidelines important questions about the cost of sex: what is the source of the twofold cost: males, genome dilution or both? Does the cost deviate from twofold? What other factors make sex costly? How should the costs of sex be empirically measured? The total cost of sex and how it varies in different contexts must be known to determine the benefits needed to account for the origin and maintenance of sex. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Sex Differences in HIV Infection.

    Science.gov (United States)

    Scully, Eileen P

    2018-04-01

    This review will outline the multilevel effects of biological sex on HIV acquisition, pathogenesis, treatment response, and prospects for cure. Potential mechanisms will be discussed along with future research directions. HIV acquisition risk is modified by sex hormones and the vaginal microbiome, with the latter acting through both inflammation and local metabolism of pre-exposure prophylaxis drugs. Female sex associates with enhanced risk for non-AIDS morbidities including cardiovascular and cerebrovascular disease, suggesting different inflammatory profiles in men and women. Data from research on HIV cure points to sex differences in viral reservoir dynamics and a direct role for sex hormones in latency maintenance. Biological sex remains an important variable in determining the risk of HIV infection and subsequent viral pathogenesis, and emerging data suggest sex differences relevant to curative interventions. Recruitment of women in HIV clinical research is a pathway to both optimize care for women and to identify novel therapeutics for use in both men and women.

  7. The effect of cross-sex hormonal treatment on gender dysphoria individuals' mental health: a systematic review.

    Science.gov (United States)

    Costa, Rosalia; Colizzi, Marco

    2016-01-01

    Cross-sex hormonal treatment represents a main aspect of gender dysphoria health care pathway. However, it is still debated whether this intervention translates into a better mental well-being for the individual and which mechanisms may underlie this association. Although sex reassignment surgery has been the subject of extensive investigation, few studies have specifically focused on hormonal treatment in recent years. Here, we systematically review all studies examining the effect of cross-sex hormonal treatment on mental health and well-being in gender dysphoria. Research tends to support the evidence that hormone therapy reduces symptoms of anxiety and dissociation, lowering perceived and social distress and improving quality of life and self-esteem in both male-to-female and female-to-male individuals. Instead, compared to female-to-male individuals, hormone-treated male-to-female individuals seem to benefit more in terms of a reduction in their body uneasiness and personality-related psychopathology and an amelioration of their emotional functioning. Less consistent findings support an association between hormonal treatment and other mental health-related dimensions. In particular, depression, global psychopathology, and psychosocial functioning difficulties appear to reduce only in some studies, while others do not suggest any improvement in these domains. Results from longitudinal studies support more consistently the association between hormonal treatment and improved mental health. On the contrary, a number of cross-sectional studies do not support this evidence. This review provides possible biological explanation vs psychological explanation (direct effect vs indirect effect) for the hormonal treatment-induced better mental well-being. In conclusion, this review indicates that gender dysphoria-related mental distress may benefit from hormonal treatment intervention, suggesting a transient reaction to the nonsatisfaction connected to the incongruent body

  8. The effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review

    Science.gov (United States)

    Costa, Rosalia; Colizzi, Marco

    2016-01-01

    Cross-sex hormonal treatment represents a main aspect of gender dysphoria health care pathway. However, it is still debated whether this intervention translates into a better mental well-being for the individual and which mechanisms may underlie this association. Although sex reassignment surgery has been the subject of extensive investigation, few studies have specifically focused on hormonal treatment in recent years. Here, we systematically review all studies examining the effect of cross-sex hormonal treatment on mental health and well-being in gender dysphoria. Research tends to support the evidence that hormone therapy reduces symptoms of anxiety and dissociation, lowering perceived and social distress and improving quality of life and self-esteem in both male-to-female and female-to-male individuals. Instead, compared to female-to-male individuals, hormone-treated male-to-female individuals seem to benefit more in terms of a reduction in their body uneasiness and personality-related psychopathology and an amelioration of their emotional functioning. Less consistent findings support an association between hormonal treatment and other mental health-related dimensions. In particular, depression, global psychopathology, and psychosocial functioning difficulties appear to reduce only in some studies, while others do not suggest any improvement in these domains. Results from longitudinal studies support more consistently the association between hormonal treatment and improved mental health. On the contrary, a number of cross-sectional studies do not support this evidence. This review provides possible biological explanation vs psychological explanation (direct effect vs indirect effect) for the hormonal treatment-induced better mental well-being. In conclusion, this review indicates that gender dysphoria-related mental distress may benefit from hormonal treatment intervention, suggesting a transient reaction to the nonsatisfaction connected to the incongruent body

  9. Adolescents' reported consequences of having oral sex versus vaginal sex.

    Science.gov (United States)

    Brady, Sonya S; Halpern-Felsher, Bonnie L

    2007-02-01

    The present study examined whether adolescents' initial consequences of sexual activity differ according to type of sexual activity and gender. Surveys were administered to 618 adolescents recruited from 2 public high schools in the autumn of ninth grade (2002) and at 6-month intervals until the spring of tenth grade (2004). Analyses were limited to the 275 adolescents (44%) who reported engaging in oral sex and/or vaginal sex at any assessment. Participants were 14 years of age at study entry, 56% female, and of diverse socioeconomic and ethnic backgrounds. In comparison with adolescents who engaged in oral sex and/or vaginal sex, adolescents who engaged only in oral sex were less likely to report experiencing a pregnancy or sexually transmitted infection, feeling guilty or used, having their relationship become worse, and getting into trouble with their parents as a result of sex. Adolescents who engaged only in oral sex were also less likely to report experiencing pleasure, feeling good about themselves, and having their relationship become better as a result of sex. Boys were more likely than girls to report feeling good about themselves, experiencing popularity, and experiencing a pregnancy or sexually transmitted infection as a result of sex, whereas girls were more likely than boys to report feeling bad about themselves and feeling used. Adolescents experience a range of social and emotional consequences after having sex. Our findings have implications for clinical practice and public health campaigns targeted toward youth.

  10. Sex Determination, Sex Chromosomes, and Karyotype Evolution in Insects.

    Science.gov (United States)

    Blackmon, Heath; Ross, Laura; Bachtrog, Doris

    2017-01-01

    Insects harbor a tremendous diversity of sex determining mechanisms both within and between groups. For example, in some orders such as Hymenoptera, all members are haplodiploid, whereas Diptera contain species with homomorphic as well as male and female heterogametic sex chromosome systems or paternal genome elimination. We have established a large database on karyotypes and sex chromosomes in insects, containing information on over 13000 species covering 29 orders of insects. This database constitutes a unique starting point to report phylogenetic patterns on the distribution of sex determination mechanisms, sex chromosomes, and karyotypes among insects and allows us to test general theories on the evolutionary dynamics of karyotypes, sex chromosomes, and sex determination systems in a comparative framework. Phylogenetic analysis reveals that male heterogamety is the ancestral mode of sex determination in insects, and transitions to female heterogamety are extremely rare. Many insect orders harbor species with complex sex chromosomes, and gains and losses of the sex-limited chromosome are frequent in some groups. Haplodiploidy originated several times within insects, and parthenogenesis is rare but evolves frequently. Providing a single source to electronically access data previously distributed among more than 500 articles and books will not only accelerate analyses of the assembled data, but also provide a unique resource to guide research on which taxa are likely to be informative to address specific questions, for example, for genome sequencing projects or large-scale comparative studies. © The American Genetic Association 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Sex selection and restricting abortion and sex determination.

    Science.gov (United States)

    Zilberberg, Julie

    2007-11-01

    Sex selection in India and China is fostered by a limiting social structure that disallows women from performing the roles that men perform, and relegates women to a lower status level. Individual parents and individual families benefit concretely from having a son born into the family, while society, and girls and women as a group, are harmed by the widespread practice of sex selection. Sex selection reinforces oppression of women and girls. Sex selection is best addressed by ameliorating the situations of women and girls, increasing their autonomy, and elevating their status in society. One might argue that restricting or prohibiting abortion, prohibiting sex selection, and prohibiting sex determination would eliminate sex selective abortion. But this decreases women's autonomy rather than increases it. Such practices will turn underground. Sex selective infanticide, and slower death by long term neglect, could increase. If abortion is restricted, the burden is placed on women seeking abortions to show that they have a legally acceptable or legitimate reason for a desired abortion, and this seriously limits women's autonomy. Instead of restricting abortion, banning sex selection, and sex determination, it is better to address the practice of sex selection by elevating the status of women and empowering women so that giving birth to a girl is a real and positive option, instead of a detriment to the parents and family as it is currently. But, if a ban on sex selective abortion or a ban on sex determination is indeed instituted, then wider social change promoting women's status in society should be instituted simultaneously.

  12. Talking to Your Kids about Sex

    Science.gov (United States)

    ... Safety Injury Rehabilitation Emotional Well-Being Mental Health Sex and Birth Control Sex and Sexuality Birth Control Family Health Infants and ... Kids and Teens Talking to Your Kids About Sex Talking to Your Kids About Sex Share Print ...

  13. Surgical travellers: tapestry to Bayeux.

    Science.gov (United States)

    Hedley-Whyte, John; Milamed, Debra R

    2014-09-01

    The planning for surgery in war was revisited in 1937 when Ian Fraser was elected a member of the Surgical Travellers. At their 1938 Surgical Travellers meeting in Vienna, Ian and Eleanor Fraser were evicted from their hotel room by the Nazis. The 1939 meeting in Belfast discussed the organization of surgery and the conduct of Emergency Medical Service Hospitals in the United Kingdom; the vast majority were to be under civilian government and military control. From 1943 lengthy and informative organizational meetings were held at least monthly under the chairmanship of Sir Alexander Hood, KBE, Head of the RAMC. Surgical Consultants, now Major Generals, Brigadiers or Full Colonels in the British and U.S. Armies stationed in the UK, prepared for the invasion of Europe. The allocation of medical, surgical, nursing and auxiliary responsibilities was delineated. Liaison with the RAF and US Army Air Force was close as it was with the proposed leaders, Ulstermen Brooke and Montgomery. Montgomery chose Arthur Porritt as Surgeon in Chief to Supreme Headquarters Allied Expeditionary Force (SHAEF), and Eisenhower, General Albert W. Kenner. Just after D-Day, Porritt met Ian Fraser, who had waded in on Arromanches Beach. The triage and evacuation plans for Allied casualties had been controversial, particularly as regards Landing Ship Tanks (LSTs). The dispute with the Hood-selected surgeons on one side, against medical and surgical deployment of LSTs, and Admiral Ernest King and Winston Churchill on the other, favouring LST use for surgery and evacuation. King and Churchill were correct but total Allied air superiority allowed wide use of many of the Allies' Dakotas; 10,000 DC-3s were eventually in service. Supported by forty Allied combat planes to each Luftwaffe, the dispute about Landing Ship Tank use in about a fortnight became moot. The multifaceted role of the Princess Royal in the Emergency Medical Services of the United Kingdom and her close liaison with the Consultant

  14. Virtual reality in surgical education.

    Science.gov (United States)

    Ota, D; Loftin, B; Saito, T; Lea, R; Keller, J

    1995-03-01

    Virtual reality (VR) is an emerging technology that can teach surgeons new procedures and can determine their level of competence before they operate on patients. Also VR allows the trainee to return to the same procedure or task several times later as a refresher course. Laparoscopic surgery is a new operative technique which requires the surgeon to observe the operation on a video-monitor and requires the acquisition of new skills. VR simulation could duplicate the operative field and thereby enhance training and reduce the need for expensive animal training models. Our preliminary experience has shown that we have the technology to model tissues and laparoscopic instruments and to develop in real time a VR learning environment for surgeons. Another basic need is to measure competence. Surgical training is an apprenticeship requiring close supervision and 5-7 years of training. Technical competence is judged by the mentor and has always been subjective. If VR surgical simulators are to play an important role in the future, quantitative measurement of competence would have to be part of the system. Because surgical competence is "vague" and is characterized by such terms as "too long, too short" or "too close, too far," it is possible that the principles of fuzzy logic could be used to measure competence in a VR surgical simulator. Because a surgical procedure consists of a series of tasks and each task is a series of steps, we will plan to create two important tasks in a VR simulator and validate their use. These tasks consist of laparoscopic knot tying and laparoscopic suturing. Our hypothesis is that VR in combination with fuzzy logic can educate surgeons and determine when they are competent to perform these procedures on patients.

  15. Sex workers talk about sex work: six contradictory characteristics of legalised sex work in Melbourne, Australia.

    Science.gov (United States)

    Begum, Sufia; Hocking, Jane S; Groves, Jan; Fairley, Christopher K; Keogh, Louise A

    2013-01-01

    Despite research suggesting that legal sex work is safe and that emotional risks and social stigma are of greater concern than health risks, much research on sex work has focused on health risks. Given the legalisation of sex work in Victoria, Australia, it is timely to look beyond health. Three focus groups were conducted with a total of 14 female sex workers on their experience of legal sex work, both positive and negative, and the social acceptability of their profession. Thematic analysis was used to identify the key ways that sex workers described sex work. Women saw legal sex work as safer than illegal sex work, but still not socially acceptable. However, they also described six contradictory elements of sex work, which was seen as: financially rewarding and entrapping; empowering and demeaning; increasing some opportunities while reducing others; flexible and demanding; offering both intimacy and competition; and leading to a 'double life'. While legalisation has improved the safety of sex work, stigma and discrimination persist.

  16. Surgical Masculinization of the Breast: Clinical Classification and Surgical Procedures.

    Science.gov (United States)

    Cardenas-Camarena, Lazaro; Dorado, Carlos; Guerrero, Maria Teresa; Nava, Rosa

    2017-06-01

    Aesthetic breast area improvements for gynecomastia and gender dysphoria patients who seek a more masculine appearance have increased recently. We present our clinical experience in breast masculinization and a classification for these patients. From July 2003 to May 2014, 68 patients seeking a more masculine thorax underwent surgery. They were divided into five groups depending on three factors: excess fatty tissue, breast tissue, and skin. A specific surgical treatment was assigned according to each group. The surgical treatments included thoracic liposuction, subcutaneous mastectomy, periareolar skin resection in one or two stages, and mastectomy with a nipple areola complex graft. The evaluation was performed 6 months after surgery to determine the degree of satisfaction and presence of complications. Surgery was performed on a total of 68 patients, 45 male and 22 female, with ages ranging from 18 to 49 years, and an average age of 33 years. Liposuction alone was performed on five patients; subcutaneous mastectomy was performed on eight patients; subcutaneous mastectomy combined with liposuction was performed on 27 patients; periareolar skin resection was performed on 11 patients; and mastectomy with NAC free grafts was performed on 16 patients. The surgical procedure satisfied 94% of the patients, with very few complications. All patients who wish to obtain a masculine breast shape should be treated with only one objective regardless patient's gender: to obtain a masculine thorax. We recommend a simple mammary gland classification for determining the best surgical treatment for these patients LEVEL OF EVIDENCE V: 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 .

  17. The pregnant female surgical resident

    Directory of Open Access Journals (Sweden)

    Shifflette V

    2018-05-01

    Full Text Available Vanessa Shifflette,1 Susannah Hambright,2 Joseph Darryl Amos,1 Ernest Dunn,3 Maria Allo4 1Associates in Surgical Acute Care, Methodist Dallas Medical Center, Dallas, TX, USA; 2Methodist Surgical Associates, Methodist Dallas Medical Center, Dallas, TX, USA; 3Graduate Medical Education - General Surgery, Methodist Dallas Medical Center, Dallas, TX, USA; 4Santa Clara Valley Medical Center, San Jose, CA, USA Background: Surgery continues to be an intense, time-consuming residency. Many medical students decide against surgery as a profession due to the long work hours and family strain. The pregnant female surgical resident has an added stress factor compared to her male counterpart. Methods: We distributed an electronic, online 26-question survey to 32 general surgery programs in the southwestern region of the United States. Each program distributed our survey to the female surgical residents who had been pregnant during residency in the last 5 years. Each program was re-contacted 6 weeks after the initial contact. Most questions were in a 5-point Likert scale format. The responses were collected and analyzed using the Survey Monkey website. Results: An unvalidated survey was sent to 32 general surgery programs and 26 programs responded (81%. Each program was asked for the total number of possible responses from female residents that met our criteria (60 female residents. Seven of the programs (27% stated that they have had zero residents pregnant. We had 22 residents respond (37%. Over half of the residents (55% were pregnant during their 2nd or 3rd year of residency, with only 18% pregnant during a research year. Thirty-one percent had a lower American Board of Surgery In-Training Exam (ABSITE score. Ninety percent of the residents were able to take 4 weeks or more for maternity leave. Most of the residents (95% stated that they would do this again during residency given the opportunity, but many of the residents felt that returning back to work

  18. Fungal Sex: The Mucoromycota.

    Science.gov (United States)

    Lee, Soo Chan; Idnurm, Alexander

    2017-03-01

    Although at the level of resolution of genes and molecules most information about mating in fungi is from a single lineage, the Dikarya, many fundamental discoveries about mating in fungi have been made in the earlier branches of the fungi. These are nonmonophyletic groups that were once classified into the chytrids and zygomycetes. Few species in these lineages offer the potential of genetic tractability, thereby hampering the ability to identify the genes that underlie those fundamental insights. Research performed during the past decade has now established the genes required for mating type determination and pheromone synthesis in some species in the phylum Mucoromycota, especially in the order Mucorales. These findings provide striking parallels with the evolution of mating systems in the Dikarya fungi. Other discoveries in the Mucorales provide the first examples of sex-cell type identity being driven directly by a gene that confers mating type, a trait considered more of relevance to animal sex determination but difficult to investigate in animals. Despite these discoveries, there remains much to be gleaned about mating systems from these fungi.

  19. Sex and Age Differences in Body-Image, Self-Esteem, and Body Mass Index in Adolescents and Adults After Single-Ventricle Palliation

    OpenAIRE

    Pike, Nancy A.; Evangelista, Lorraine S.; Doering, Lynn V.; Eastwood, Jo-Ann; Lewis, Alan B.; Child, John S.

    2012-01-01

    Single-ventricle congenital heart disease (SVCHD) requires multiple palliative surgical procedures that leave visible surgical scars and physical deficits, which can alter body-image and self-esteem. This study aimed to compare sex and age differences in body-image, selfesteem, and body mass index (BMI) in adolescents and adults with SVCHD after surgical palliation with those of a healthy control group. Using a comparative, cross-sectional design, 54 adolescent and adult (26 male and 28 femal...

  20. Sex Ratio Elasticity Influences the Selection of Sex Ratio Strategy

    Science.gov (United States)

    Wang, Yaqiang; Wang, Ruiwu; Li, Yaotang; (Sam) Ma, Zhanshan

    2016-12-01

    There are three sex ratio strategies (SRS) in nature—male-biased sex ratio, female-biased sex ratio and, equal sex ratio. It was R. A. Fisher who first explained why most species in nature display a sex ratio of ½. Consequent SRS theories such as Hamilton’s local mate competition (LMC) and Clark’s local resource competition (LRC) separately explained the observed deviations from the seemingly universal 1:1 ratio. However, to the best of our knowledge, there is not yet a unified theory that accounts for the mechanisms of the three SRS. Here, we introduce the price elasticity theory in economics to define sex ratio elasticity (SRE), and present an analytical model that derives three SRSs based on the following assumption: simultaneously existing competitions for both resources A and resources B influence the level of SRE in both sexes differently. Consequently, it is the difference (between two sexes) in the level of their sex ratio elasticity that leads to three different SRS. Our analytical results demonstrate that the elasticity-based model not only reveals a highly plausible mechanism that explains the evolution of SRS in nature, but also offers a novel framework for unifying two major classical theories (i.e., LMC & LRC) in the field of SRS research.

  1. Stress and sex: does cortisol mediate sex change in fish?

    Science.gov (United States)

    Goikoetxea, Alexander; Todd, Erica V; Gemmell, Neil J

    2017-12-01

    Cortisol is the main glucocorticoid (GC) in fish and the hormone most directly associated with stress. Recent research suggests that this hormone may act as a key factor linking social environmental stimuli and the onset of sex change by initiating a shift in steroidogenesis from estrogens to androgens. For many teleost fish, sex change occurs as a usual part of the life cycle. Changing sex is known to enhance the lifetime reproductive success of these fish and the modifications involved (behavioral, gonadal and morphological) are well studied. However, the exact mechanism behind the transduction of the environmental signals into the molecular cascade that underlies this singular process remains largely unknown. We here synthesize current knowledge regarding the role of cortisol in teleost sex change with a focus on two well-described transformations: temperature-induced masculinization and socially regulated sex change. Three non-mutually exclusive pathways are considered when describing the potential role of cortisol in mediating teleost sex change: cross-talk between GC and androgen pathways, inhibition of aromatase expression and upregulation of amh (the gene encoding anti-Müllerian hormone). We anticipate that understanding the role of cortisol in the initial stages of sex change will further improve our understanding of sex determination and differentiation across vertebrates, and may lead to new tools to control fish sex ratios in aquaculture. © 2017 Society for Reproduction and Fertility.

  2. Surgical management of bronchiectasis. The indications and outcomes

    International Nuclear Information System (INIS)

    Gursoy, S.; Ozturk, A.A.; Ucvet, A.; Erbaycu, A.E.

    2010-01-01

    Social limitations in addition to treatment failure, despite preventive precautions and aggressive medical treatment, are the main indications for surgery in patients with bronchiectasis. The aim of this study was to evaluate all aspects of treatment outcomes in surgically treated patients with bronchiectasis. Ninety-two patients with bronchiectasis treated by a surgical resection between January 2002 and June 2007 were included in the study. Age, sex, symptoms, etiologic factors, radiological findings, surgical procedures, postoperative morbidity and mortality, and hospital stay were analyzed. Fifty-four patients were female and 38 were male, with an average age of 38.7 (range, 10-67) years, and 84.8% were symptomatic. The etiologic factors included frequent infections (37%), childhood infections (22%), tuberculosis (12%), foreign bodies (3%), and unknown causes (26%). Ten pneumonectomies, 36 lobectomies, 2 bilobectomies, 32 lobectomies and segmentectomies, and 12 segmentectomies were performed. The morbidity was 16%, the mortality was 1%, and the mean follow-up duration was 15.3 months. Follow-up data were obtained in 75 patients of whom 63 (84%) were asymptomatic, 8 (10.7%) were symptomatic with clinical improvement, and 4 (5.3%) had had no clinical improvement. Despite the advances in preventive precautions, medical treatment, and follow-up, surgery, with its low mortality and morbidity rates, remains a good alternative in selected patients in the treatment of bronchiectasis, and fulfills the clinical and social improvement expectations of patients. (author)

  3. Complex Pulmonary Aspergilloma: Surgical Challenges in a Third World Setting

    Directory of Open Access Journals (Sweden)

    Bernadette Ngo Nonga

    2018-01-01

    Full Text Available Background. Surgery for pulmonary aspergilloma (PA, especially complex forms, is greatly challenging in a resource-poor setting such as Cameroon. We report our experience of surgical management of PA in this environment. Method. We prospectively assessed patients who underwent surgery for PA from January 2012 to May 2015, at the University Hospital Center of Yaoundé. Records were reviewed for demographics, history and physical examinations, radiological findings, surgical procedures, and outcomes. The study has received approval from the institutional ethics committees. Results. In total, 20 patients (17 males and 3 females (sex ratio, 5.66; mean age, 30 years; range, 23–65 years with a past history of tuberculosis were assessed. The median follow-up was 21.5 months. The primary symptom was hemoptysis, followed by cough and chest pain. All patients underwent surgical treatment and lung resection. Postoperative complications (bleeding, air leak, empyema, and severe anemia occurred in 4 patients and 1 patient died. Although 3 patients were lost to follow-up, the survival rate was 80% with improvement of the preoperative symptoms. Conclusion. Although surgery for complex aspergilloma is very challenging in environments such as ours, we believe that it is the best treatment modality for symptomatic diseases in our setting.

  4. Surgical versus non-surgical management of abdominal injury.

    Science.gov (United States)

    Oyo-Ita, Angela; Chinnock, Paul; Ikpeme, Ikpeme A

    2015-11-13

    Injury to the abdomen can be blunt or penetrating. Abdominal injury can damage internal organs such as the liver, spleen, kidneys, intestine, and large blood vessels. There are controversies about the best approach to manage abdominal injuries. To assess the effects of surgical and non-surgical interventions in the management of abdominal trauma in a haemodynamically stable and non-peritonitic abdomen. We searched the Cochrane Injuries Group's Specialised Register, The Cochrane Library, Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), EMBASE Classic+EMBASE (Ovid), ISI WOS (SCI-EXPANDED, SSCI, CPCI-S & CPSI-SSH), CINAHL Plus (EBSCO), and clinical trials registers, and screened reference lists. We ran the most recent search on 17 September 2015. Randomised controlled trials of surgical interventions and non-surgical interventions involving people with abdominal injury who were haemodynamically stable with no signs of peritonitis. The abdominal injury could be blunt or penetrating. Two review authors independently applied the selection criteria. Data were extracted by two authors using a standard data extraction form, and are reported narratively. Two studies are included, which involved a total of 114 people with penetrating abdominal injuries. Both studies are at moderate risk of bias because the randomisation methods are not fully described, and the original study protocols are no longer available. The studies were undertaken in Finland between 1992 and 2002, by the same two researchers.In one study, 51 people were randomised to surgery or an observation protocol. None of the participants in the study died. Seven people had complications: 5 (18.5%) in the surgical group and 2 (8.3%) in the observation group; the difference was not statistically significant (P = 0.42; Fischer's exact). Among the 27 people who had surgery, 6 (22.2%) surgeries were negative laparotomies, and 15 (55.6%) were non

  5. Surgical intervention in patients with necrotizing pancreatitis

    NARCIS (Netherlands)

    Besselink, MG; de Bruijn, MT; Rutten, JP; Boermeester, MA; Hofker, HS; Gooszen, HG

    Background: This study evaluated the various surgical strategies for treatment of (suspected) infected necrotizing pancreatitis (INP) and patient referrals for this condition in the Netherlands. Methods: This retrospective study included all 106 consecutive patients who had surgical treatment for

  6. Deep Neuromuscular Blockade Improves Laparoscopic Surgical Conditions

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Herring, W Joseph; Blobner, Manfred

    2017-01-01

    INTRODUCTION: Sustained deep neuromuscular blockade (NMB) during laparoscopic surgery may facilitate optimal surgical conditions. This exploratory study assessed whether deep NMB improves surgical conditions and, in doing so, allows use of lower insufflation pressures during laparoscopic cholecys...

  7. Surgical Treatment of Tattoo Complications.

    Science.gov (United States)

    Sepehri, Mitra; Jørgensen, Bo

    2017-01-01

    With a continuing increase in the number of tattoos performed worldwide, the need to treat tattoo complications is growing. Earlier treatments of chronic inflammatory tattoo reactions were dominated by a medical approach, or with no active intervention. In this chapter, we will address modern surgical approaches applied to situations when medical treatment is inefficient and lasers are not applicable. Dermatome shaving is positioned as first-line treatment of allergic tattoo reactions and also indicated in a number of other tattoo reactions, supplemented with excision in selected cases. The methods allow fundamental treatment with removal of the culprit pigment from the dermis. The different instruments, surgical methods, and treatment schedules are reviewed, and a guide to surgeons is presented. Postoperative treatments and the long-term outcomes are described in detail. An algorithm on specialist treatment and follow-up of tattoo reactions, which can be practiced in other countries, is presented. © 2017 S. Karger AG, Basel.

  8. Surgical tools and medical devices

    CERN Document Server

    Jackson, Mark

    2016-01-01

    This new edition presents information and knowledge on the field of biomedical devices and surgical tools. The authors look at the interactions between nanotechnology, nanomaterials, design, modeling, and tools for surgical and dental applications, as well as how nanostructured surfaces can be created for the purposes of improving cell adhesion between medical devices and the human body. Each original chapter is revised in this second edition and describes developments in coatings for heart valves, stents, hip and knee joints, cardiovascular devices, orthodontic applications, and regenerative materials such as bone substitutes. There are also 8 new chapters that address: Microvascular anastomoses Inhaler devices used for pulmonary delivery of medical aerosols Surface modification of interference screws Biomechanics of the mandible (a detailed case study) Safety and medical devices The synthesis of nanostructured material Delivery of anticancer molecules using carbon nanotubes Nano and micro coatings for medic...

  9. Surgical treatment of pathological obesity

    International Nuclear Information System (INIS)

    Portie Felix, Antonio; Navarro Sanchez, Gustavo; Hernandez Solar, Abel; Grass Baldoquin, Jorge Alberto; Domloge Fernandez, Joana

    2011-01-01

    The obesity is the chronic non-communicable disease with a higher rate of growth in past 20 years. It is a risk factor for type 2 diabetes mellitus, high blood pressure, cardiovascular and respiratory affections, infertility, sexual and functional impotence, metabolic syndrome, load joint disorders and some types of cancer (breast, colon, prostate). The metabolic bariatric surgery is the surgical treatment more effective for the morbid obesity at long -and medium- term and not the pharmacologic treatment and the isolated diets. The aim of present historical review of the international literature on the evolution of surgical techniques of the bariatric surgery (malabsorption techniques, gastric restrictive techniques and mixed techniques), is to make available to those interested in this subject, a valuable therapeutic tool to be rationally used. (author)

  10. [Surgical correction of cleft palate].

    Science.gov (United States)

    Kimura, F T; Pavia Noble, A; Soriano Padilla, F; Soto Miranda, A; Medellín Rodríguez, A

    1990-04-01

    This study presents a statistical review of corrective surgery for cleft palate, based on cases treated at the maxillo-facial surgery units of the Pediatrics Hospital of the Centro Médico Nacional and at Centro Médico La Raza of the National Institute of Social Security of Mexico, over a five-year period. Interdisciplinary management as performed at the Cleft-Palate Clinic, in an integrated approach involving specialists in maxillo-facial surgery, maxillar orthopedics, genetics, social work and mental hygiene, pursuing to reestablish the stomatological and psychological functions of children afflicted by cleft palate, is amply described. The frequency and classification of the various techniques practiced in that service are described, as well as surgical statistics for 188 patients, which include a total of 256 palate surgeries performed from March 1984 to March 1989, applying three different techniques and proposing a combination of them in a single surgical time, in order to avoid complementary surgery.

  11. Techniques for Optimizing Surgical Scars, Part 2: Hypertrophic Scars and Keloids.

    Science.gov (United States)

    Potter, Kathryn; Konda, Sailesh; Ren, Vicky Zhen; Wang, Apphia Lihan; Srinivasan, Aditya; Chilukuri, Suneel

    2017-01-01

    Surgical management of benign or malignant cutaneous tumors may result in noticeable scars that are of great concern to patients, regardless of sex, age, or ethnicity. Techniques to optimize surgical scars are discussed in this three-part review. Part 2 focuses on scar revision for hypertrophic and keloids scars. Scar revision options for hypertrophic and keloid scars include corticosteroids, bleomycin, fluorouracil, verapamil, avotermin, hydrogel scaffold, nonablative fractional lasers, ablative and fractional ablative lasers, pulsed dye laser (PDL), flurandrenolide tape, imiquimod, onion extract, silicone, and scar massage.

  12. Open surgical simulation--a review.

    Science.gov (United States)

    Davies, Jennifer; Khatib, Manaf; Bello, Fernando

    2013-01-01

    Surgical simulation has benefited from a surge in interest over the last decade as a result of the increasing need for a change in the traditional apprentice model of teaching surgery. However, despite the recent interest in surgical simulation as an adjunct to surgical training, most of the literature focuses on laparoscopic, endovascular, and endoscopic surgical simulation with very few studies scrutinizing open surgical simulation and its benefit to surgical trainees. The aim of this review is to summarize the current standard of available open surgical simulators and to review the literature on the benefits of open surgical simulation. Open surgical simulators currently used include live animals, cadavers, bench models, virtual reality, and software-based computer simulators. In the current literature, there are 18 different studies (including 6 randomized controlled trials and 12 cohort studies) investigating the efficacy of open surgical simulation using live animal, bench, and cadaveric models in many surgical specialties including general, cardiac, trauma, vascular, urologic, and gynecologic surgery. The current open surgical simulation studies show, in general, a significant benefit of open surgical simulation in developing the surgical skills of surgical trainees. However, these studies have their limitations including a low number of participants, variable assessment standards, and a focus on short-term results often with no follow-up assessment. The skills needed for open surgical procedures are the essential basis that a surgical trainee needs to grasp before attempting more technical procedures such as laparoscopic procedures. In this current climate of medical practice with reduced hours of surgical exposure for trainees and where the patient's safety and outcome is key, open surgical simulation is a promising adjunct to modern surgical training, filling the void between surgeons being trained in a technique and a surgeon achieving fluency in that

  13. Surgical resection of synchronously metastatic adrenocortical cancer.

    Science.gov (United States)

    Dy, Benzon M; Strajina, Veljko; Cayo, Ashley K; Richards, Melanie L; Farley, David R; Grant, Clive S; Harmsen, William S; Evans, Doug B; Grubbs, Elizabeth G; Bible, Keith C; Young, William F; Perrier, Nancy D; Que, Florencia G; Nagorney, David M; Lee, Jeffrey E; Thompson, Geoffrey B

    2015-01-01

    Metastatic adrenocortical carcinoma (ACC) is rapidly fatal, with few options for treatment. Patients with metachronous recurrence may benefit from surgical resection. The survival benefit in patients with hematogenous metastasis at initial presentation is unknown. A review of all patients undergoing surgery (European Network for the Study of Adrenal Tumors) stage IV ACC between January 2000 and December 2012 from two referral centers was performed. Kaplan-Meier estimates were analyzed for disease-free and overall survival (OS). We identified 27 patients undergoing surgery for stage IV ACC. Metastases were present in the lung (19), liver (11), and brain (1). A complete resection (R0) was achieved in 11 patients. The median OS was improved in patients undergoing R0 versus R2 resection (860 vs. 390 days; p = 0.02). The 1- and 2-year OS was also improved in patients undergoing R0 versus R2 resection (69.9 %, 46.9 % vs. 53.0 %, 22.1 %; p = 0.02). Patients undergoing neoadjuvant therapy (eight patients) had a trend towards improved survival at 1, 2, and 5 years versus no neoadjuvant therapy (18 patients) [83.3 %, 62.5 %, 41.7 % vs. 56.8 %, 26.6 %, 8.9 %; p = 0.1]. Adjuvant therapy was associated with improved recurrence-free survival at 6 months and 1 year (67 %, 33 % vs. 40 %, 20 %; p = 0.04) but not improved OS (p = 0.63). Sex (p = 0.13), age (p = 0.95), and location of metastasis (lung, p = 0.51; liver, p = 0.67) did not correlate with OS after operative intervention. Symptoms of hormonal excess improved in 86 % of patients. Operative intervention, especially when an R0 resection can be achieved, following systemic therapy may improve outcomes, including OS, in select patients with stage IV ACC. Response to neoadjuvant chemotherapy may be of use in defining which patients may benefit from surgical intervention. Adjuvant therapy was associated with decreased recurrence but did not improve OS.

  14. Surgical Treatment of Hepatocellular Carcinoma

    Science.gov (United States)

    Zamora-Valdes, Daniel; Taner, Timucin; Nagorney, David M.

    2017-01-01

    Hepatocellular carcinoma (HCC) is a major cause of cancer-related death worldwide. In select patients, surgical treatment in the form of either resection or transplantation offers a curative option. The aims of this review are to (1) review the current American Association for the Study of Liver Diseases/European Association for the Study of the Liver guidelines on the surgical management of HCC and (2) review the proposed changes to these guidelines and analyze the strength of evidence underlying these proposals. Three authors identified the most relevant publications in the literature on liver resection and transplantation for HCC and analyzed the strength of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification. In the United States, the liver allocation system provides priority for liver transplantation to patients with HCC within the Milan criteria. Current evidence suggests that liver transplantation may also be indicated in certain patient groups beyond Milan criteria, such as pediatric patients with large tumor burden or adult patients who are successfully downstaged. Patients with no underlying liver disease may also benefit from liver transplantation if the HCC is unresectable. In patients with no or minimal (compensated) liver disease and solitary HCC ≥2 cm, liver resection is warranted. If liver transplantation is not available or contraindicated, liver resection can be offered to patients with multinodular HCC, provided that the underlying liver disease is not decompensated. Many patients may benefit from surgical strategies adapted to local resources and policies (hepatitis B prevalence, organ availability, etc). Although current low-quality evidence shows better overall survival with aggressive surgical strategies, this approach is limited to select patients. Larger and well-designed prospective studies are needed to better define the benefits and limits of such approach. PMID:28975836

  15. Towards Safe Robotic Surgical Systems

    DEFF Research Database (Denmark)

    Sloth, Christoffer; Wisniewski, Rafael

    2015-01-01

    a controller for motion compensation in beating-heart surgery, and prove that it is safe, i.e., the surgical tool is kept within an allowable distance and orientation of the heart. We solve the problem by simultaneously finding a control law and a barrier function. The motion compensation system is simulated...... from several initial conditions to demonstrate that the designed control system is safe for every admissible initial condition....

  16. Surgical treatment of chest instability

    International Nuclear Information System (INIS)

    Kitka, M.; Masek, M.

    2015-01-01

    Fractures of the ribs is the most common thoracic injury after blunt trauma. Chest wall instability (flail chest) is a common occurrence in the presence of multiple ribs fracture. Unilateral or bilateral fractures more ribs anteriorly or posteriorly will produce enough instability that paradoxical respiratory motion results in hypoventilation of an unacceptable degree. Open approach and surgical stabilisation of the chest preserved pulmonary function, improved pain control, minimized posttraumatic deformities and shorter back to work time. (author)

  17. Surgical management of venous malformations.

    Science.gov (United States)

    Loose, D A

    2007-01-01

    Among vascular malformations, the predominantly venous malformations represent the majority of cases. They form a clinical entity and therefore need clear concepts concerning diagnosis and treatment. This paper presents an overview of contemporary classification as well as tactics and techniques of treatment. According to the Hamburg Classification, predominantly venous malformations are categorized into truncular and extratruncular forms, with truncular forms distinguished as obstructions and dilations, and extratruncular forms as limited or infiltrating. The tactics of treatment represent surgical and non-surgical methods or combined techniques. Surgical approaches utilize different tactics and techniques that are adopted based on the pathologic form and type of the malformation: (I) operation to reduce the haemodynamic activity of the malformation; (II) operation to eliminate the malformation; and (III) reconstructive operation. As for (I), a type of a tactic is the operation to derive the venous flow. In (II), the total or partial removal of the venous malformation is demonstrated subdivided into three different techniques. In this way, the infiltrating as well as the limited forms can be treated. An additional technique is dedicated to the treatment of a marginal vein. Approach (III) involves the treatment of venous aneurysms, where a variety of techniques have been successful. Long-term follow-up demonstrates positive results in 91% of the cases. Congenital predominantly venous malformations should be treated according to the principles developed during the past decades in vascular surgery, interventional treatment and multidisciplinary treatment. The days of predominantly conservative treatment should be relegated to the past. Special skills and experiences are necessary to carry out appropriate surgical strategy, and the required operative techniques should be dictated by the location and type of malformation and associated findings.

  18. Frugal Design and Surgical Robotics

    OpenAIRE

    McKinley, Stephen Alan

    2016-01-01

    A new era of robotic surgery is poised to begin when critical patents held by Intuitive Surgical (IS) expire in 2016. IS market dominance for decades has led to an effective monopoly that will be challenged by several commercial enterprises working on next generation general robotic surgery systems. Robotic surgery has the potential to alleviate the skill-gap between experienced and inexperienced surgeons through the automation of sub-tasks within surgicalprocedures.The primary objective of...

  19. Surgical treatment of radiation proctitis

    Energy Technology Data Exchange (ETDEWEB)

    Maruyama, Izumi; Sato, Gohei; Okaue, Toyotake; Isobe, Yoshinari; Ohtsu, Akira; Sugimoto, Yuzo (Kansai Electric Power Co., Inc., Osaka (Japan))

    1982-08-01

    Severe radiation proctitis was surgically treated in 8 cases. Colostomy was performed in 2 cases, total resection of the rectum in 2 and proctectomy with colostomy in 4. Perineal abscess developed in the 2 cases with total resection of the rectum. Rather than completely resection of the lesion, a procedure leaving no dead space i.e. proctectomy with colostomy, is desirable for radiation proctitis. Complete preoperative examination of the condition of the underlying disease and possible urinary tract complications is important.

  20. Surgical checklists: the human factor.

    LENUS (Irish Health Repository)

    O Connor, Paul

    2013-05-14

    BACKGROUND: Surgical checklists has been shown to improve patient safety and teamwork in the operating theatre. However, despite the known benefits of the use of checklists in surgery, in some cases the practical implementation has been found to be less than universal. A questionnaire methodology was used to quantitatively evaluate the attitudes of theatre staff towards a modified version of the World Health Organisation (WHO) surgical checklist with relation to: beliefs about levels of compliance and support, impact on patient safety and teamwork, and barriers to the use of the checklist. METHODS: Using the theory of planned behaviour as a framework, 14 semi-structured interviews were conducted with theatre personnel regarding their attitudes towards, and levels of compliance with, a checklist. Based upon the interviews, a 27-item questionnaire was developed and distribute to all theatre personnel in an Irish hospital. RESULTS: Responses were obtained from 107 theatre staff (42.6% response rate). Particularly for nurses, the overall attitudes towards the effect of the checklist on safety and teamworking were positive. However, there was a lack of rigour with which the checklist was being applied. Nurses were significantly more sensitive to the barriers to the use of the checklist than anaesthetists or surgeons. Moreover, anaesthetists were not as positively disposed to the surgical checklist as surgeons and nurse. This finding was attributed to the tendency for the checklist to be completed during a period of high workload for the anaesthetists, resulting in a lack of engagement with the process. CONCLUSION: In order to improve the rigour with which the surgical checklist is applied, there is a need for: the involvement of all members of the theatre team in the checklist process, demonstrated support for the checklist from senior personnel, on-going education and training, and barriers to the implementation of the checklist to be addressed.

  1. [Surgical treatment of supraventricular tachycardia].

    Science.gov (United States)

    Vigano, A N; Minzioni, G; Graffigna, A; Paganini, F; Salerno, J A

    1991-10-01

    The article deals with the modern approaches to the treatment of supraventricular tachycardia . The authors analyse the results of operations in ectopic atrial tachycardias, the Wolff-Parkinson-White syndrome, modal re-entry tachycardias, and atrial fibrillation . The last-named is of most interest because the authors possess experience in a new operation for isolation of the internodal tracts. In all conditions the authors obtained convincing evidence on the efficacy of modern surgical treatment in supraventricular tachycardias.

  2. Quantification of surgical blood loss.

    Science.gov (United States)

    Lee, Marcel H; Ingvertsen, Britt T; Kirpensteijn, Jolle; Jensen, Asger L; Kristensen, Annemarie T

    2006-06-01

    To compare gravimetric and colorimetric methods of quantifying surgical blood loss, and to determine if there is a correlation between preoperative hemostatic tests (buccal mucosa bleeding time [BMBT] and intraoperative blood loss). Prospective clinical study. Dogs (n=15) admitted for cutaneous tumor excision, orthopedic procedure, or exploratory laparotomy. Intraoperative blood loss was quantified by measuring irrigation fluid and weighing surgical sponges used for blood and fluid collection during surgery. Results of gravimetric measurements were then correlated to blood loss quantified using spectrophotometric analysis of hemoglobin (Hb) content. Hemostatic variables including BMBT were measured before surgery and compared with the calculated amount of blood loss. Blood loss quantified by gravimetric measurement showed a significant correlation with colorimetric determination of Hb content in surgical sponges and collected irrigation fluid (r=0.93, P<.0001). BMBT correlated weakly but significantly with intraoperative blood loss (r=0.56, P<.05). Quantifying intraoperative blood loss using spectrophotometric Hb analysis accurately assessed the amount of blood loss; however, it is a time-consuming procedure, primarily applicable as a research tool. Gravimetric evaluation of intraoperative blood loss was found to be an accurate method, which can be recommended for use in a clinical setting. Estimation of blood loss using a gravimetric method is accurate and applicable in the clinical setting and provides surgeons with a simple and objective tool to evaluate intraoperative blood loss.

  3. Is surgical workforce diversity increasing?

    Science.gov (United States)

    Andriole, Dorothy A; Jeffe, Donna B; Schechtman, Kenneth B

    2007-03-01

    We sought to determine the extent to which recent increases in levels of gender and racial diversity in the overall resident-physician workforce were evident among core-surgical specialty resident workforces. Chi-square tests for trend assessed the importance of changes from 1996 to 2004 in proportions of women and African Americans in the surgery-resident workforce. Surgery-resident trends were compared with overall resident workforce trends using two-tailed t-tests to compare regression slopes that quantified rates of change over time. Chi-square tests assessed differences between proportions of women and African Americans in the current overall board-certified workforce and their proportions in the surgery board-certified workforce. From 1996 to 2004, proportions of women increased in all seven surgical specialties studied. Compared with the overall trend toward increasing proportions of women in the resident workforce, the trend in one surgical specialty was larger (obstetrics/gynecology, p 0.05), and two were smaller (each p 0.05). Proportions of African Americans decreased in three specialties (each p workforce, except obstetrics/gynecology, remained lower than in the overall board-certified workforce (each p workforces have persisted since 1996 and will likely perpetuate ongoing surgery board-certified workforce disparities.

  4. [Surgical managment of retinal detachment].

    Science.gov (United States)

    Haritoglou, C; Wolf, A

    2015-05-01

    The detachment of the neurosensory retina from the underlying retinal pigment epithelium can be related to breaks of the retina allowing vitreous fluid to gain access to the subretinal space, to exudative changes of the choroid such as tumours or inflammatory diseases or to excessive tractional forces exerted by interactions of the collagenous vitreous and the retina. Tractional retinal detachment is usually treated by vitrectomy and exudative detachment can be addressed by treatment of the underlying condition in many cases. In rhegmatogenous retinal detachment two different surgical procedures, vitrectomy and scleral buckling, can be applied for functional and anatomic rehabilitation of our patients. The choice of the surgical procedure is not really standardised and often depends on the experience of the surgeon and other more ocular factors including lens status, the number of retinal breaks, the extent of the detachment and the amount of preexisting PVR. Using both techniques, anatomic success rates of over 90 % can be achieved. Especially in young phakic patients scleral buckling offers the true advantage to prevent the progression of cataract formation requiring cataract extraction and intraocular lens implantation. Therefore, scleral buckling should be considered in selected cases as an alternative surgical option in spite of the very important technical refinements in modern vitrectomy techniques. Georg Thieme Verlag KG Stuttgart · New York.

  5. Surgical smoke and ultrafine particles

    Directory of Open Access Journals (Sweden)

    Nowak Dennis

    2008-12-01

    Full Text Available Abstract Background Electrocautery, laser tissue ablation, and ultrasonic scalpel tissue dissection all generate a 'surgical smoke' containing ultrafine ( Methods To measure the amount of generated particulates in 'surgical smoke' during different surgical procedures and to quantify the particle number concentration for operation room personnel a condensation particle counter (CPC, model 3007, TSI Inc. was applied. Results Electro-cauterization and argon plasma tissue coagulation induced the production of very high number concentration (> 100000 cm-3 of particles in the diameter range of 10 nm to 1 μm. The peak concentration was confined to the immediate local surrounding of the production side. In the presence of a very efficient air conditioning system the increment and decrement of ultrafine particle occurrence was a matter of seconds, with accumulation of lower particle number concentrations in the operation room for only a few minutes. Conclusion Our investigation showed a short term very high exposure to ultrafine particles for surgeons and close assisting operating personnel – alternating with longer periods of low exposure.

  6. Surgical management of radiation enterocolitis

    International Nuclear Information System (INIS)

    Sakaguchi, Masahiro; Katsumi, Masaharu; Ishimoto, Kiwao; Yamamoto, Shinji; Yukawa, Hirofumi; Koh, Kenzo; Yamaguchi, Kazuya; Ohta, Masataka; Hayashido, Motonori

    1986-01-01

    Radiotherapy for malignant tumors is effective and established. However, there are many complications in radiotherapy. A typical complication is radiation enterocolitis. It is difficult to treat severe histological damage to the irradiated tissues. This paper reports our experience with 26 patients with radiation enterocolitis for whom surgical treatment was given during a period of 16 years in our surgical department. The most frequent original disease requiring irradiation was cancer of the cervix uteri (15 cases) which was followed by cancer of the urinary bladder (7 cases). All of these patients had received external 60 Co irradiation. The ileum was the most frequent site of the lesion, followed by the rectum, sigmoid and descending colon. The period between the end of irradiation and the onset of enterocolitis ranged from 2 months to 10 years, with an average of 28 months. The main symptoms were intestinal obstruction in the ileum, and melena and fistula in the rectum and sigmoid colon. Intestinal resection was performed in 10 patients, a bypass operation in 4, and colostomy in 12. As to types of intestinal suture in these cases, Gambee's single layer method was thought useful from our experience. Colostomy as surgical management of melena and fistula did not yield satisfactory results. (author)

  7. Simulation-based surgical education.

    Science.gov (United States)

    Evgeniou, Evgenios; Loizou, Peter

    2013-09-01

    The reduction in time for training at the workplace has created a challenge for the traditional apprenticeship model of training. Simulation offers the opportunity for repeated practice in a safe and controlled environment, focusing on trainees and tailored to their needs. Recent technological advances have led to the development of various simulators, which have already been introduced in surgical training. The complexity and fidelity of the available simulators vary, therefore depending on our recourses we should select the appropriate simulator for the task or skill we want to teach. Educational theory informs us about the importance of context in professional learning. Simulation should therefore recreate the clinical environment and its complexity. Contemporary approaches to simulation have introduced novel ideas for teaching teamwork, communication skills and professionalism. In order for simulation-based training to be successful, simulators have to be validated appropriately and integrated in a training curriculum. Within a surgical curriculum, trainees should have protected time for simulation-based training, under appropriate supervision. Simulation-based surgical education should allow the appropriate practice of technical skills without ignoring the clinical context and must strike an adequate balance between the simulation environment and simulators. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  8. Surgical correction of postoperative astigmatism

    Directory of Open Access Journals (Sweden)

    Lindstrom Richard

    1990-01-01

    Full Text Available The photokeratoscope has increased the understanding of the aspheric nature of the cornea as well as a better understanding of normal corneal topography. This has significantly affected the development of newer and more predictable models of surgical astigmatic correction. Relaxing incisions effectively flatten the steeper meridian an equivalent amount as they steepen the flatter meridian. The net change in spherical equivalent is, therefore, negligible. Poor predictability is the major limitation of relaxing incisions. Wedge resection can correct large degrees of postkeratoplasty astigmatism, Resection of 0.10 mm of tissue results in approximately 2 diopters of astigmatic correction. Prolonged postoperative rehabilitation and induced irregular astigmatism are limitations of the procedure. Transverse incisions flatten the steeper meridian an equivalent amount as they steepen the flatter meridian. Semiradial incisions result in two times the amount of flattening in the meridian of the incision compared to the meridian 90 degrees away. Combination of transverse incisions with semiradial incisions describes the trapezoidal astigmatic keratotomy. This procedure may correct from 5.5 to 11.0 diopters dependent upon the age of the patient. The use of the surgical keratometer is helpful in assessing a proper endpoint during surgical correction of astigmatism.

  9. [Surgical tactics in duodenal trauma].

    Science.gov (United States)

    Ivanov, P A; Grishin, A V

    2004-01-01

    Results of surgical treatment of 61 patients with injuries of the duodenum are analyzed. The causes of injuries were stab-incised wounds in 24 patients, missile wound -- in 7, closed abdominal trauma -- in 26, trauma of the duodenum during endoscopic papillosphincterotomy -- in 4. All the patients underwent surgery. Complications were seen in 32 (52.5%) patients, 21 patients died, lethality was 34.4%. Within the first 24 hours since the trauma 7 patients died due to severe combined trauma, blood loss, 54 patients survived acute period of trauma, including 28 patients after open trauma, 26 -- after closed and 4 -- after trauma of the duodenum during endoscopic papillosphincterotomy. Diagnostic and surgical policies are discussed. Results of treatment depending on kind and time of surgery are regarded. It is demonstrated that purulent complications due to retroperitoneal phlegmona, traumatic pancreatitis, pneumonia are the causes of significant number of unfavorable outcomes. Therefore, it is important to adequately incise and drainage infected parts of retroperitoneal fat tissue with two-lumen drainages. Decompression through duodenal tube is the effective procedure for prophylaxis of suture insufficiency and traumatic pancreatitis. Suppression of pancreatic and duodenal secretion with octreotid improves significantly surgical treatment results.

  10. Surgical Management of Chronic Pancreatitis.

    Science.gov (United States)

    Parekh, Dilip; Natarajan, Sathima

    2015-10-01

    Advances over the past decade have indicated that a complex interplay between environmental factors, genetic predisposition, alcohol abuse, and smoking lead towards the development of chronic pancreatitis. Chronic pancreatitis is a complex disorder that causes significant and chronic incapacity in patients and a substantial burden on the society. Major advances have been made in the etiology and pathogenesis of this disease and the role of genetic predisposition is increasingly coming to the fore. Advances in noninvasive diagnostic modalities now allow for better diagnosis of chronic pancreatitis at an early stage of the disease. The impact of these advances on surgical treatment is beginning to emerge, for example, patients with certain genetic predispositions may be better treated with total pancreatectomy versus lesser procedures. Considerable controversy remains with respect to the surgical management of chronic pancreatitis. Modern understanding of the neurobiology of pain in chronic pancreatitis suggests that a window of opportunity exists for effective treatment of the intractable pain after which central sensitization can lead to an irreversible pain syndrome in patients with chronic pancreatitis. Effective surgical procedures exist for chronic pancreatitis; however, the timing of surgery is unclear. For optimal treatment of patients with chronic pancreatitis, close collaboration between a multidisciplinary team including gastroenterologists, surgeons, and pain management physicians is needed.

  11. Sex differentials in mortality.

    Science.gov (United States)

    1970-06-01

    The questions leing considered are whether a higher female than male mortality rate exists in Ceylon, India, and Pakistan, and whether this sex differential can account for the observed high male sex ratios. There is a choice between explaining the recorded masculinity of the Indian population by assuming that the subordinate position of women caused their omission from the census or that it caused their unrecorded death in childhood. The 1951 census report of India states that there is a traditional fondness for male issues in most parts of the country and a corresponding dislike for female children. However, a life table for India applied to the 1951 census gave a higher average female age at death 34.7 years as opposed to 33.5 years for male. Other estimates for India and Pakistan for the period 1951-1961 give 37.8 years for life expectancy for males and 36.98 for females. In 1953 the female death rate in Ceylon was over 80% higher than that of the males in the most reproductive ages, 20-29. In 1963 the female excess mortality at the same ages was still 25%, and in the age group 30-34 almost a 1/3 higher. In India the female death rate at ages 15-44 was 38% higher than that of the males in the 1958-1959 survey and as much as 174% higher in the Khanna rural survey, 1956-1960. In Pakistan a Population growth Estimate experiment conducted during 1962-1965 on a national probability sample has shown that in the ages 15-44 the female death rate was 75% higher than that of the males. High maternal mortality was the major reason. In addition, female mortality among young children over age 1 year was 24% higher in 1965 and 1963. There was little difference between the rates of mortality of the 2 sexes at age 45 and above. Recent trends in Ceylon show considerable improvement in maternal mortality which has reduced by 22% the ratio of female to male mortality at age 15-44. Also the ratio at ages 1-9 fell by 8%. to .1 of a year for every calendar year to 1980.

  12. Fighting surgical site infections in small animals

    DEFF Research Database (Denmark)

    Verwilghen, Denis; Singh, Ameet

    2015-01-01

    A diverse array of pathogen-related, patient-related, and caretaker-related issues influence risk and prevention of surgical site infections (SSIs). The entire surgical team involved in health care settings in which surgical procedures are performed play a pivotal role in the prevention of SSIs. ...

  13. Journal of Surgical Technique and Case Report

    African Journals Online (AJOL)

    The aim of Journal of Surgical Technique and Case Report is to advance surgical knowledge and practice by promoting the reporting of innovative and reproducible surgical techniques ... Anterior palatal island advancement flap for bone graft coverage: technical note · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  14. Surgical versus non-surgical management for pleural empyema.

    Science.gov (United States)

    Redden, Mark D; Chin, Tze Yang; van Driel, Mieke L

    2017-03-17

    Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment. To assess the effectiveness and safety of surgical versus non-surgical treatments for complicated parapneumonic effusion or pleural empyema. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 9), MEDLINE (Ebscohost) (1946 to July week 3 2013, July 2015 to October 2016) and MEDLINE (Ovid) (1 May 2013 to July week 1 2015), Embase (2010 to October 2016), CINAHL (1981 to October 2016) and LILACS (1982 to October 2016) on 20 October 2016. We searched ClinicalTrials.gov and WHO International Clinical Trials Registry Platform for ongoing studies (December 2016). Randomised controlled trials that compared a surgical with a non-surgical method of management for all age groups with pleural empyema. Two review authors independently assessed trials for inclusion and risk of bias, extracted data, and checked the data for accuracy. We contacted trial authors for additional information. We assessed the quality of the evidence using the GRADE approach. We included eight randomised controlled trials with a total of 391 participants. Six trials focused on children and two on adults. Trials compared tube thoracostomy drainage (non-surgical), with or without intrapleural fibrinolytics, to either VATS or thoracotomy (surgical) for the management of pleural empyema. Assessment of risk of bias for the included studies was generally unclear for selection and blinding but low for attrition and reporting bias. Data analyses compared

  15. Sex differences in drug abuse.

    Science.gov (United States)

    Becker, Jill B; Hu, Ming

    2008-01-01

    Sex differences are present for all of the phases of drug abuse (initiation, escalation of use, addiction, and relapse following abstinence). While there are some differences among specific classes of abused drugs, the general pattern of sex differences is the same for all drugs of abuse. Females begin regularly self-administering licit and illicit drugs of abuse at lower doses than do males, use escalates more rapidly to addiction, and females are at greater risk for relapse following abstinence. In this review, sex differences in drug abuse are discussed for humans and in animal models. The possible neuroendocrine mechanisms mediating these sex differences are discussed.

  16. Sex Reversal in Amphibians.

    Science.gov (United States)

    Flament, Stéphane

    2016-01-01

    Amphibians have been widely used to study developmental biology due to the fact that embryo development takes place independently of the maternal organism and that observations and experimental approaches are easy. Some amphibians like Xenopus became model organisms in this field. In the first part of this article, the differentiation of the gonads in amphibians and the mechanisms governing this process are reviewed. In the second part, the state of the art about sex reversal, which can be induced by steroid hormones in general and by temperature in some species, is presented. Also information about pollutants found in the environment that could interfere with the development of the amphibian reproductive apparatus or with their reproductive physiology is given. Such compounds could play a part in the amphibian decline, since in the wild, many amphibians are endangered species. © 2016 S. Karger AG, Basel.

  17. Sex ratio variation and sex determination in Urtica dioica

    NARCIS (Netherlands)

    Glawe, Grit Anja

    2006-01-01

    This thesis will first document on variation in progeny sex ratios among individual female plants of Urtica dioica at our field site in Meijendel (Chapter 2). Next, we show that there is also considerable sex ratio variation among male and female flowering shoots in 26 natural populations studied

  18. Sense about Sex: Media, Sex Advice, Education and Learning

    Science.gov (United States)

    Attwood, Feona; Barker, Meg John; Boynton, Petra; Hancock, Justin

    2015-01-01

    The media are widely acknowledged as important in sex and relationship education, but they are usually associated with "bad" effects on young people in contrast to the "good" knowledge represented by more informational and educational formats. In this paper we look at sex advice giving in newspapers, magazines and television in…

  19. Sex differences in adolescent depression: do sex hormones determine vulnerability?

    NARCIS (Netherlands)

    Naninck, E.F.G.; Lucassen, P.J.; Bakker, J.

    2011-01-01

    Depression is one of the most common, costly and severe psychopathologies worldwide. Its incidence, however, differs significantly between the sexes, and depression rates in women are twice those of men. Interestingly, this sex difference emerges during adolescence. Although the adolescent period is

  20. Sex and Age Differences in Attitude toward the Opposite Sex.

    Science.gov (United States)

    Silver, Rawley

    1997-01-01

    Examines fantasies about the opposite sex expressed by 116 children, adolescents, and adults responding to the Drawing from Imagination task of the Silver Drawing Test of Cognition and Emotion. Results indicate that both males and females expressed more negative than positive feelings toward subjects of the opposite sex. Males were more negative.…

  1. Sex Education: Talking to Toddlers and Preschoolers about Sex

    Science.gov (United States)

    Healthy Lifestyle Sexual health Sex education often begins with a child's curiosity about his or her body. Here's how to set the stage for ... Original article: http://www.mayoclinic.org/healthy-lifestyle/sexual-health/in-depth/sex-education/art-20044104 . Mayo Clinic Footer Legal Conditions and ...

  2. Hypothermia in a surgical intensive care unit.

    Science.gov (United States)

    Abelha, Fernando J; Castro, Maria A; Neves, Aida M; Landeiro, Nuno M; Santos, Cristina C

    2005-06-06

    Inadvertent hypothermia is not uncommon in the immediate postoperative period and it is associated with impairment and abnormalities in various organs and systems that can lead to adverse outcomes. The aim of this study was to estimate the prevalence, the predictive factors and outcome of core hypothermia on admission to a surgical ICU. All consecutive 185 adult patients who underwent scheduled or emergency noncardiac surgery admitted to a surgical ICU between April and July 2004 were admitted to the study. Tympanic membrane core temperature (Tc) was measured before surgery, on arrival at ICU and every two hours until 6 hours after admission. The following variables were also recorded: age, sex, body weight and height, ASA physical status, type of surgery, magnitude of surgical procedure, anesthesia technique, amount of intravenous fluids administered during anesthesia, use of temperature monitoring and warming techniques, duration of the anesthesia, ICU length of stay, hospital length of stay and SAPS II score. Patients were classified as either hypothermic (Tc 35 degrees C). Univariate analysis and multiple regression binary logistic with an odds ratio (OR) and its 95% Confidence Interval (95%CI) were used to compare the two groups of patients and assess the relationship between each clinical predictor and hypothermia. Outcome measured as ICU length of stay and mortality was also assessed. Prevalence of hypothermia on ICU admission was 57.8%. In univariate analysis temperature monitoring, use of warming techniques and higher previous body temperature were significant protective factors against core hypothermia. In this analysis independent predictors of hypothermia on admission to ICU were: magnitude of surgery, use of general anesthesia or combined epidural and general anesthesia, total intravenous crystalloids administrated and total packed erythrocytes administrated, anesthesia longer than 3 hours and SAPS II scores. In multiple logistic regression analysis

  3. Hypothermia in a surgical intensive care unit

    Directory of Open Access Journals (Sweden)

    Landeiro Nuno M

    2005-06-01

    Full Text Available Abstract Background Inadvertent hypothermia is not uncommon in the immediate postoperative period and it is associated with impairment and abnormalities in various organs and systems that can lead to adverse outcomes. The aim of this study was to estimate the prevalence, the predictive factors and outcome of core hypothermia on admission to a surgical ICU. Methods All consecutive 185 adult patients who underwent scheduled or emergency noncardiac surgery admitted to a surgical ICU between April and July 2004 were admitted to the study. Tympanic membrane core temperature (Tc was measured before surgery, on arrival at ICU and every two hours until 6 hours after admission. The following variables were also recorded: age, sex, body weight and height, ASA physical status, type of surgery, magnitude of surgical procedure, anesthesia technique, amount of intravenous fluids administered during anesthesia, use of temperature monitoring and warming techniques, duration of the anesthesia, ICU length of stay, hospital length of stay and SAPS II score. Patients were classified as either hypothermic (Tc ≤ 35°C or normothermic (Tc> 35°C. Univariate analysis and multiple regression binary logistic with an odds ratio (OR and its 95% Confidence Interval (95%CI were used to compare the two groups of patients and assess the relationship between each clinical predictor and hypothermia. Outcome measured as ICU length of stay and mortality was also assessed. Results Prevalence of hypothermia on ICU admission was 57.8%. In univariate analysis temperature monitoring, use of warming techniques and higher previous body temperature were significant protective factors against core hypothermia. In this analysis independent predictors of hypothermia on admission to ICU were: magnitude of surgery, use of general anesthesia or combined epidural and general anesthesia, total intravenous crystalloids administrated and total packed erythrocytes administrated, anesthesia longer

  4. Alcohol skin preparation causes surgical fires.

    Science.gov (United States)

    Rocos, B; Donaldson, L J

    2012-03-01

    Surgical fires are a rare but serious preventable safety risk in modern hospitals. Data from the US show that up to 650 surgical fires occur each year, with up to 5% causing death or serious harm. This study used the National Reporting and Learning Service (NRLS) database at the National Patient Safety Agency to explore whether spirit-based surgical skin preparation fluid contributes to the cause of surgical fires. The NRLS database was interrogated for all incidents of surgical fires reported between 1 March 2004 and 1 March 2011. Each report was scrutinised manually to discover the cause of the fire. Thirteen surgical fires were reported during the study period. Of these, 11 were found to be directly related to spirit-based surgical skin preparation or preparation soaked swabs and drapes. Despite manufacturer's instructions and warnings, surgical fires continue to occur. Guidance published in the UK and US states that spirit-based skin preparation solutions should continue to be used but sets out some precautions. It may be that fire risk should be included in pre-surgical World Health Organization checklists or in the surgical training curriculum. Surgical staff should be aware of the risk that spirit-based skin preparation fluids pose and should take action to minimise the chance of fire occurring.

  5. Hysterectomy and Bilateral Salpingoovariectomy in a Transsexual Subject without Visible Scaring

    OpenAIRE

    Perrone, Anna Myriam; Scifo, Maria Cristina; Martelli, Valentina; Casadio, Paolo; Morselli, Paolo Giovanni; Pelusi, Giuseppe; Meriggiola, Maria Cristina

    2010-01-01

    Objective. To report on the use of laparoendoscopic single-site surgery (LESS) for the management of total hysterectomy (TH) with bilateral salpingoovariectomy (BSO) in a subject affected by gender identity disorder. Design. Case report. Setting. University Hospital. Patient(s). A 27-year-old affected by Gender Identity Disorder underwent a hysterectomy and BSO as part of surgical sex reassignment. Intervention(s). Laparoendoscopic single-site surgery access for TH and BSO. Main Outcome ...

  6. Prevalence of blindness and cataract surgical outcomes in Takeo Province, Cambodia.

    Science.gov (United States)

    Mörchen, Manfred; Langdon, Toby; Ormsby, Gail M; Meng, Ngy; Seiha, Do; Piseth, Kong; Keeffe, Jill E

    2015-01-01

    To estimate the prevalence of blindness and cataract surgical outcomes in persons 50 years or older above in Takeo Province, Cambodia. A population based survey. A total of 93 villages were selected through probability proportionate to size using the Rapid Assessment of Avoidable Blindness methodology. Households from 93 villages were selected using compact segment sampling. Visual acuity (VA) of 4650 people 50 years or older was tested and lens status and cause of visual impairment were assessed. The response rate was 96.2%. The age- and sex-adjusted prevalence of bilateral blindness [presenting visual acuity (PVA) blind in Takeo Province. The age- and sex-adjusted prevalence of low vision (PVA blind was 64.7% (female 59.5%, male 78.1%). Cataract surgical outcome was poor (best-corrected visual acuity blindness. A repeated survey using the same methodology after 8-12 years might be helpful in proving genuine change over time.

  7. Accomplishments and challenges of surgical simulation.

    Science.gov (United States)

    Satava, R M

    2001-03-01

    For nearly a decade, advanced computer technologies have created extraordinary educational tools using three-dimensional (3D) visualization and virtual reality. Pioneering efforts in surgical simulation with these tools have resulted in a first generation of simulators for surgical technical skills. Accomplishments include simulations with 3D models of anatomy for practice of surgical tasks, initial assessment of student performance in technical skills, and awareness by professional societies of potential in surgical education and certification. However, enormous challenges remain, which include improvement of technical fidelity, standardization of accurate metrics for performance evaluation, integration of simulators into a robust educational curriculum, stringent evaluation of simulators for effectiveness and value added to surgical training, determination of simulation application to certification of surgical technical skills, and a business model to implement and disseminate simulation successfully throughout the medical education community. This review looks at the historical progress of surgical simulators, their accomplishments, and the challenges that remain.

  8. Using dummies for surgical skills training

    DEFF Research Database (Denmark)

    Langebæk, Rikke

    2011-01-01

    Effective acquisition of a skill requires practise. Therefore it is of great importance to provide veterinary students with opportunities to practice their surgical skills before carrying out surgical procedures on live patients. Some veterinary schools let students perform entire surgical...... procedures on research animals, in order to learn the basic skills along the way. From an ethical point of view it is questionable however to use live research animals for the sole purpose of practising surgery, and also, research animals are very costly. It is therefore necessary to identify alternative...... teaching methods for veterinary surgical training. At the Department of Small Animal Clinical Sciences, Faculty of Life Sciences, a number of low fidelity, stuffed toy animal dummies was developed for the Surgical Skills Lab in order to teach 4th year students the basic surgical skills. In the Surgical...

  9. The trouble with sex differences.

    Science.gov (United States)

    Eliot, Lise

    2011-12-22

    Sex differences in the brain are real and clinically important but often grossly distorted in popular discourse. Considering the public's deep fascination with sex difference research and its impact on issues from mental health to education and workplace equity, neuroscientists should pay greater heed to its misappropriation and to studying how gender enculturation shapes neural function. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Sex-work harm reduction.

    Science.gov (United States)

    Rekart, Michael L

    2005-12-17

    Sex work is an extremely dangerous profession. The use of harm-reduction principles can help to safeguard sex workers' lives in the same way that drug users have benefited from drug-use harm reduction. Sex workers are exposed to serious harms: drug use, disease, violence, discrimination, debt, criminalisation, and exploitation (child prostitution, trafficking for sex work, and exploitation of migrants). Successful and promising harm-reduction strategies are available: education, empowerment, prevention, care, occupational health and safety, decriminalisation of sex workers, and human-rights-based approaches. Successful interventions include peer education, training in condom-negotiating skills, safety tips for street-based sex workers, male and female condoms, the prevention-care synergy, occupational health and safety guidelines for brothels, self-help organisations, and community-based child protection networks. Straightforward and achievable steps are available to improve the day-to-day lives of sex workers while they continue to work. Conceptualising and debating sex-work harm reduction as a new paradigm can hasten this process.

  11. [Sex-linked juvenile retinoschisis].

    Science.gov (United States)

    François, P; Turut, P; Soltysik, C; Hache, J C

    1976-02-01

    About 13 observations of sexe linked juvenile retinoschisis, the authors describe the ophthalmoscopic, fluorographic and functional aspects of the disease whose caracteristics are:--its sexe linked recessive heredity; --its clinical characterestics associating: a microcystic macular degeneration, peripheral retinal lesions, vitreous body alterations, --an electroretinogram of the negative type.

  12. Sex Differences Reappraised: A Rebuttal

    Science.gov (United States)

    Tolor, Alexander; Brannigan, Gary G.

    1975-01-01

    This rebuttal of the criticisms made by Evans and Sperekas points to the fact that sex differences have been found by the authors on locus of control scales, that the purported sex-biased items in the Future Events Test are not necessarily outside the response repetoire of women, and the criticism of including female relevant items cannot be…

  13. Teaching Sex Education in Thailand

    Science.gov (United States)

    Kay, Noy S.; Jones, Megan R.; Jantaraweragul, Sudgasame

    2010-01-01

    The purposes of this study were to examine the current situation pertaining to the teaching of sex education and identify barriers to teaching sex education among Thai health education teachers. A survey questionnaire was administered to 193 health education teachers who participated in this study. The questionnaire was comprised of three parts:…

  14. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... arrow How should people deal with spasticity during sex? play_arrow What about positions and foreplay after a spinal cord injury? play_arrow What about orgasms and sensation during sex after a spinal cord injury? play_arrow What ...

  15. Moral Pluralism and Sex Education

    Science.gov (United States)

    Corngold, Josh

    2013-01-01

    How should common schools in a liberal pluralist society approach sex education in the face of deep disagreement about sexual morality? Should they eschew sex education altogether? Should they narrow its focus to facts about biology, reproduction, and disease prevention? Should they, in addition to providing a broad palette of information about…

  16. Sex in a test tube

    NARCIS (Netherlands)

    Pesce, Diego; Lehman, Niles; Visser, de Arjan

    2016-01-01

    The origin and evolution of sex, and the associated role of recombination, present a major problem in biology. Sex typically involves recombination of closely related DNA or RNA sequences,which is fundamentally a randomprocess that creates but also breaks up beneficial allele combinations.

  17. The role of student surgical interest groups and surgical Olympiads in anatomical and surgical undergraduate training in Russia.

    Science.gov (United States)

    Dydykin, Sergey; Kapitonova, Marina

    2015-01-01

    Traditional department-based surgical interest groups in Russian medical schools are useful tools for student-based selection of specialty training. They also form a nucleus for initiating research activities among undergraduate students. In Russia, the Departments of Topographical Anatomy and Operative Surgery play an important role in initiating student-led research and providing learners with advanced, practical surgical skills. In tandem with department-led activities, student surgical interest groups prepare learners through surgical competitions, known as "Surgical Olympiads," which have been conducted in many Russian centers on a regular basis since 1988. Surgical Olympiads stimulate student interest in the development of surgical skills before graduation and encourage students to choose surgery as their postgraduate specialty. Many of the participants in these surgical Olympiads have become highly qualified specialists in general surgery, orthopedic surgery, neurosurgery, urology, gynecology, and emergency medicine. The present article emphasizes the role of student interest groups and surgical Olympiads in clinical anatomical and surgical undergraduate training in Russia. © 2015 American Association of Anatomists.

  18. Surgical management of spasmodic torticollis

    Directory of Open Access Journals (Sweden)

    Wael Fouad

    2011-12-01

    Full Text Available Introduction: Spasmodic torticollis (ST is a neuromuscular disorder characterized by uncontrolled clonic and intermittently tonic spasm of the neck muscles. Objective: This retrospective study was done to study clinical picture and to evaluate the surgical results of different surgical procedures in 11 patients who had spasmodic torticollis. Methods: The male to female ratio was 1–2 (4 males and 7 females and their ages ranged from 18 to 65 years. The X-ray of the cervical spine was performed before the operation to exclude cervical disorders that can cause symptoms similar to spasmodic torticollis. MRI of the head and neck was performed in all patients, without finding significant brain lesions. Electromyography of the cervical muscles was performed preoperatively and postoperatively. All cases underwent surgery in the form of variable combinations of ventral rhizotomy of C1, C2+ selective peripheral denervation of neck muscles involved according to the type of torticollis. Mean postoperative follow up period was 24 months. Results: There was no operative mortality. As regards the morbidity, one patient had deficiency of shoulder elevation that was transient and improved after 3 months; one patient had wound infection that responded well to antibiotics after culture and sensitivity. Postoperative dysphagia was found in two cases that improved in one of them after two months. At the last follow up examination period, excellent results were obtained in 55% of patients, good results in 18% of patients, fair results in 18% of patients, and poor results in 9% of cases. Conclusion: There is no standard surgical procedure for treatment of ST; this is adapted to each patient according to type of torticollis. Better results were obtained in simple torticollis (excellent results in 100%, than in complex type (excellent and good results in 33.3%. Keywords: Focal dystonia, Spasmodic torticollis, Anterior rhizotomy, Selective denervation

  19. The surgical treatment of acromegaly.

    Science.gov (United States)

    Buchfelder, Michael; Schlaffer, Sven-Martin

    2017-02-01

    Surgical extraction of as much tumour mass as possible is considered the first step of treatment in acromegaly in many centers. In this article the potential benefits, disadvantages and limitations of operative acromegaly treatment are reviewed. Pertinent literature was selected to provide a review covering current indications, techniques and results of operations for acromegaly. The rapid reduction of tumour volume is an asset of surgery. To date, in almost all patients, minimally invasive, transsphenoidal microscopic or endoscopic approaches are employed. Whether a curative approach is feasible or a debulking procedure is planned, can be anticipated on the basis of preoperative magnetic resonance imaging. The radicality of adenoma resection essentially depends on localization, size and invasive character of the tumour. The normalization rates of growth hormone and IGF-1 secretion, respectively, depend on tumour-related factors such as size, extension, the presence or absence of invasion and the magnitude of IGF-1 and growth hormone oversecretion. However, also surgeon-related factors such as experience and patient load of the centers have been shown to strongly affect surgical results and the rate of complications. As compared to most medical treatments, surgery is relatively cheap since the costs occur only once and not repeatedly. There are several new technical gadgets which aid in the surgical procedure: navigation and variants of intraoperative imaging. For the mentioned reasons, current algorithms of acromegaly management suggest an initial operation, unless the patients are unfit for surgery, refuse an operation or only an unsatisfactory resection is anticipated. A few suggestions are made when a re-operation could be considered.

  20. Disc degeneration: current surgical options

    Directory of Open Access Journals (Sweden)

    C Schizas

    2010-10-01

    Full Text Available Chronic low back pain attributed to lumbar disc degeneration poses a serious challenge to physicians. Surgery may be indicated in selected cases following failure of appropriate conservative treatment. For decades, the only surgical option has been spinal fusion, but its results have been inconsistent. Some prospective trials show superiority over usual conservative measures while others fail to demonstrate its advantages. In an effort to improve results of fusion and to decrease the incidence of adjacent segment degeneration, total disc replacement techniques have been introduced and studied extensively. Short-term results have shown superiority over some fusion techniques. Mid-term results however tend to show that this approach yields results equivalent to those of spinal fusion. Nucleus replacement has gained some popularity initially, but evidence on its efficacy is scarce. Dynamic stabilisation, a technique involving less rigid implants than in spinal fusion and performed without the need for bone grafting, represents another surgical option. Evidence again is lacking on its superiority over other surgical strategies and conservative measures. Insertion of interspinous devices posteriorly, aiming at redistributing loads and relieving pain, has been used as an adjunct to disc removal surgery for disc herniation. To date however, there is no clear evidence on their efficacy. Minimally invasive intradiscal thermocoagulation techniques have also been tried, but evidence of their effectiveness is questioned. Surgery using novel biological solutions may be the future of discogenic pain treatment. Collaboration between clinicians and basic scientists in this multidisciplinary field will undoubtedly shape the future of treating symptomatic disc degeneration.

  1. Constructions of Sex and Gender

    DEFF Research Database (Denmark)

    Schleicher, Marianne

    2011-01-01

    Responding to the ethical and performative call of Judith Butler not to propagate the sex- and gender-related violence of the imbedded discourse that we study, this article inquires into the discursive strategies of Jewish scripture by analysing how it orchestrates certain norms of sex and gender...... and make them serve the overall aim of securing cultural survival. Following this, it traces reflections on persons of ambiguous or indeterminate sex from rabbinic to modern Judaism so as to inquire into the rabbinic dependency on scripture when non-conforming individuals challenge its bipolar sex...... Jews and non-Jews are able to influence their own representations of sex and gender and thus liberate themselves from the normativity implied by scriptural discourse....

  2. Sex differences in primary hypertension

    Science.gov (United States)

    2012-01-01

    Men have higher blood pressure than women through much of life regardless of race and ethnicity. This is a robust and highly conserved sex difference that it is also observed across species including dogs, rats, mice and chickens and it is found in induced, genetic and transgenic animal models of hypertension. Not only do the differences between the ovarian and testicular hormonal milieu contribute to this sexual dimorphism in blood pressure, the sex chromosomes also play a role in and of themselves. This review primarily focuses on epidemiological studies of blood pressure in men and women and experimental models of hypertension in both sexes. Gaps in current knowledge regarding what underlie male-female differences in blood pressure control are discussed. Elucidating the mechanisms underlying sex differences in hypertension may lead to the development of anti-hypertensives tailored to one's sex and ultimately to improved therapeutic strategies for treating this disease and preventing its devastating consequences. PMID:22417477

  3. [Sex role and sports].

    Science.gov (United States)

    Darlison, E

    2000-11-01

    Gender inequality in all areas of life remains a global problem despite efforts over the past twenty years in particular to address the situation. In physical activity and sport the inequality between women and men is particularly pronounced in almost all countries, although it differs in degree. Two of the main reasons why inequality between women and men physical activity and sport is more extreme than in many other areas of social life are the result of the close association between the attributes required for sport and those associated with traditional concepts of stereotypical, hegemonic masculinity, and a lack of understanding of the difference between sex and gender. In sport and physical activity physical differences between men and women have been confused with socially constructed differences i.e. physical differences have been confused with gender differences, and this confusion has been used to justify women's lesser and limited participation at all levels. To achieve equality between women and men in physical activity and sport it will be essential that gender is identified and understood as a socially constructed and fluid concept which is a product of the relations between women and men. The fact that women bear children or are generally less physically powerful than men is not sufficient to justify why it is not considered appropriate for women to participate in certain forms of physical activity or why their participation is less valued than the participation of men. An understanding of gender and of the construction of gender relations is an important pre-requisite to addressing the inequality between women and men in physical activity and sport and in developing policies and programs which include, and are of equal benefit to both sexes. While more research on the benefits of participation in physical activity is needed, there is currently sufficient information available to identify the health related and social value of participation to both

  4. Surgical treatment of cleft lip

    Directory of Open Access Journals (Sweden)

    Mateus Domingues Miachon

    Full Text Available We performed a systematic review of the literature on the surgical treatment of cleft lip, emphasizing the prevalence, complications associated with the treatment and the points of disagreement between authors. We conducted a literature cross-sectional search that analyzed publications in books, articles and on the databases SciELO - Scientific Electronic Library Online, PubMed, of the National Center for Biotechnology Information. We conclude that: 1 the severity of the cleft will indicate the technique presenting more advantages; 2 the different approaches indicate that there is no consensus on the optimal technique; and 3 the surgeon experience contributes to choosing the best option.

  5. Surgical treatment of radiation proctitis

    International Nuclear Information System (INIS)

    Maruyama, Izumi; Sato, Gohei; Okaue, Toyotake; Isobe, Yoshinari; Ohtsu, Akira; Sugimoto, Yuzo

    1982-01-01

    Severe radiation proctitis was surgically treated in 8 cases. Colostomy was performed in 2 cases, total resection of the rectum in 2 and proctectomy with colostomy in 4. Perineal abscess developed in the 2 cases with total resection of the rectum. Rather than completely resection of the lesion, a procedure leaving no dead space i.e. proctectomy with colostomy, is desirable for radiation proctitis. Complete preoperative examination of the condition of the underlying disease and possible urinary tract complications is important. (Chiba, N.)

  6. Surgical packages for laparoscopic surgery

    Directory of Open Access Journals (Sweden)

    Bhattacharya K

    2005-01-01

    Full Text Available ′Packages′ are in fashion today for most surgical procedures in various corporate hospitals and this has included laparoscopic procedures too. A package system enables the hospitals to get cost settlements done more easily. Also, it is more convenient for the patients who are aware upfront of the charges. The principal disadvantages seems to be for the surgeon, who may face displeasure of the patient, hospital or insurance agencies apart from forfeiting his personal charges if (a he is a novice in laparoscopic surgery and takes extra time to complete a procedure, (b unforeseen problems occur during surgery, or (c new pathologies are discovered on exploration.

  7. Non-surgical radiofrequency facelift.

    Science.gov (United States)

    Narins, David J; Narins, Rhoda S

    2003-10-01

    There has been considerable interest in using non-ablative methods to rejuvenate the skin. The ThermaCool TC (Thermage Inc.) is a radiofrequency (RF) device that has been introduced to induce tightening of the address the problem of skin via a uniform volumetric heating into the deep dermis tightening, resulting in a 'non-surgical facelift'. Radiofrequency produces a uniform volumetric heating into the deep dermis. Twenty treatment areas in 17 patients were treated to evaluate the efficacy and safety of RF treatment to the brow and jowls. The technique was found to produce gradual tightening in most patients, and there were no adverse effects.

  8. Surgical resection versus radiofrequency ablation in treatment of small hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    HE Xiuting

    2013-08-01

    Full Text Available ObjectiveTo compare clinical efficacy and recurrence between surgical resection and radiofrequency ablation (RFA in the treatment of small hepatocellular carcinoma (HCC. MethodsThe clinical data of 97 patients with small HCC, who underwent surgical resection or RFA as the initial treatment in The First Hospital of Jilin University from January 2002 to December 2008, were collected. Sixty-three cases, who survived 2 years after treatment, were followed up; of the 63 cases, 34 underwent surgical resection, and 29 underwent RFA. The recurrence of these patients was analyzed retrospectively. The measurement data were analyzed by chi-square test. The Cox regression analysis was used for determining the risk factors for recurrence. The log-rank test was used for disease-free survival (DFS difference analysis. ResultsThe 3-month, 1-year, and 2-year intrahepatic recurrence rates for the patients who underwent surgical resection were 15%, 38%, and 64%, respectively, versus 21%, 35%, and 45% for those who underwent RFA, without significant differences between the two groups of patients. The intrahepatic recurrence after initial treatment was not significantly associated with treatment method, sex, age, Child-Pugh grade, tumor size, number of nodules, presence of cirrhosis, and alpha-fetoprotein level. There was no significant difference in DFS between the two groups of patients. ConclusionRFA produces a comparable outcome to that by surgical resection in the treatment of small HCC. RFA holds promise as a substitute for surgical resection.

  9. Same sex families and children

    Directory of Open Access Journals (Sweden)

    Mršević Zorica

    2009-01-01

    Full Text Available Introduction comprises the information on two main forms of same sex families, civic partnership (same sex partnership and same sex marriage. Countries and various status modalities of legal regulations are mentioned. The main part of the text is dedicated to presentation of the findings of the most recent research on various aspects regarding children of same sex partnerships. It comprises presentations grouped in four main chapters: acceptance of same sex partnerships, acceptance of legal recognition of the same sex partnerships, family plans of homosexual teenagers, and raising children within and by the same sex partners. Also the real life cases mirroring legal changes through their life destinies are presented, such is e.g. the Irish way to legalization of the same sex partnerships. In addition, a love story of two women crowned by giving birth of their four children is mentioned. Reasons against and negative reactions the author puts under the title Homophobia. In the Concluding remarks, the author presents the most recent examples of legal changes happened in Norway, Ecuador, and in the American states of California and Connecticut. It was also stated that in European countries of low birth rate, the same sex families are inevitably identified as one of demographically valuable source of creating and raising children, which is worthy to be supported, rather than being hindered without reason and discriminated. Although different than a model of heterosexual family, same sex partnerships neither are harrowing to traditional family values, nor reflex of any kind of promiscuous, antisocial behavior, avoidance of parenthood, and negation of family. Quite opposite, these families are an outcome of endeavors of homosexuals not to be deprived of family, parenthood and all of other values of stabile, monogamous, emotional/sexual socially accepted and legally recognized and regulated conventional family. .

  10. The sex and sex determination in Pyropia haitanensis (Bangiales, Rhodophyta).

    Science.gov (United States)

    Zhang, Yuan; Yan, Xing-hong; Aruga, Yusho

    2013-01-01

    Pyropia haitanensis has a biphasic life cycle with macroscopic gametophytic blade (n) and microscopic filamentous conchocelis (2n) phase. Its gametophytic blades have long been believed to be mainly dioecious. However, when crossing the red mutant (R, ♀) with the wild type (W, ♂), the parental colors were segregated in F1 blades, of which 96.1% were linearly sectored with 2-4 color sectors. When color sectors were excised from the color-sectored blades and cultured singly, 99.7% of the color sectors appeared to be unisexual with an equal sex ratio. Although the sex of color sector did not genetically link with its color, the boundaries of both sex and color sectors coincided precisely. About 87.9% of the examined color-sectored blades were monoecious and the percentage increased with the number of color sectors of a blade. The gametophytic blades from each conchocelis strain produced by parthenogenesis of the excised color sectors were unisexual and unicolor, showing the same sex and color as their original sectors. These results indicate that most of the sexually reproduced Py. haitanensis blades are monoecious, and their sex is controlled by segregation of a pair of alleles during meiosis of conchospore, forming a sex-sectored tetrad. During the subsequent development of blades, one or two lower cell(s) of the tetrad contribute mainly to rhizoid formation, and rarely show their sexual phenotype, leading to reduced frequency of full sex phenotype of the meiotic blades. Moreover, the aberrant segregations of sex genes or color genes in a few of F1 blades were probably due to gene conversions, but there was no sex transfer in Py. haitanensis.

  11. Radiation-induced bystander effects in vivo are sex specific

    International Nuclear Information System (INIS)

    Koturbash, Igor; Kutanzi, Kristy; Hendrickson, Karl; Rodriguez-Juarez, Rocio; Kogosov, Dmitry; Kovalchuk, Olga

    2008-01-01

    Ionizing radiation (IR) effects span beyond the area of direct exposure and can be observed in neighboring and distant naive cells and organs. This phenomenon is termed a 'bystander effect'. IR effects in directly exposed tissue in vivo are epigenetically mediated and distinct in males and females. Yet, IR-induced bystander effects have never been explored in a sex-specificity domain. We used an in vivo mouse model, whereby the bystander effects are studied in spleen of male and female animals subjected to head exposure when the rest of the body is protected by a medical-grade lead shield. We analyzed the induction of DNA damage and alterations in global DNA methylation. Molecular parameters were correlated with cellular proliferation and apoptosis levels. The changes observed in bystander organs are compared to the changes in unexposed animals and animals exposed to predicted and measured scatter doses. We have found the selective induction of DNA damage levels, global DNA methylation, cell proliferation and apoptosis in exposed and bystander spleen tissue of male and female mice. Sex differences were significantly diminished in animals subjected to a surgical removal of gonads. These data constitute the first evidence of sex differences in radiation-induced bystander effects in mouse spleen in vivo. We show the role of sex hormones in spleen bystander responses and discuss implications of the observed changes

  12. Radiation-induced bystander effects in vivo are sex specific

    Energy Technology Data Exchange (ETDEWEB)

    Koturbash, Igor; Kutanzi, Kristy; Hendrickson, Karl; Rodriguez-Juarez, Rocio; Kogosov, Dmitry [Department of Biological Sciences, University of Lethbridge, Alberta T1K 3M4 (Canada); Kovalchuk, Olga [Department of Biological Sciences, University of Lethbridge, Alberta T1K 3M4 (Canada)], E-mail: olga.kovalchuk@uleth.ca

    2008-07-03

    Ionizing radiation (IR) effects span beyond the area of direct exposure and can be observed in neighboring and distant naive cells and organs. This phenomenon is termed a 'bystander effect'. IR effects in directly exposed tissue in vivo are epigenetically mediated and distinct in males and females. Yet, IR-induced bystander effects have never been explored in a sex-specificity domain. We used an in vivo mouse model, whereby the bystander effects are studied in spleen of male and female animals subjected to head exposure when the rest of the body is protected by a medical-grade lead shield. We analyzed the induction of DNA damage and alterations in global DNA methylation. Molecular parameters were correlated with cellular proliferation and apoptosis levels. The changes observed in bystander organs are compared to the changes in unexposed animals and animals exposed to predicted and measured scatter doses. We have found the selective induction of DNA damage levels, global DNA methylation, cell proliferation and apoptosis in exposed and bystander spleen tissue of male and female mice. Sex differences were significantly diminished in animals subjected to a surgical removal of gonads. These data constitute the first evidence of sex differences in radiation-induced bystander effects in mouse spleen in vivo. We show the role of sex hormones in spleen bystander responses and discuss implications of the observed changes.

  13. Radiation-induced bystander effects in vivo are sex specific.

    Science.gov (United States)

    Koturbash, Igor; Kutanzi, Kristy; Hendrickson, Karl; Rodriguez-Juarez, Rocio; Kogosov, Dmitry; Kovalchuk, Olga

    2008-07-03

    Ionizing radiation (IR) effects span beyond the area of direct exposure and can be observed in neighboring and distant naïve cells and organs. This phenomenon is termed a 'bystander effect'. IR effects in directly exposed tissue in vivo are epigenetically mediated and distinct in males and females. Yet, IR-induced bystander effects have never been explored in a sex-specificity domain. We used an in vivo mouse model, whereby the bystander effects are studied in spleen of male and female animals subjected to head exposure when the rest of the body is protected by a medical-grade lead shield. We analyzed the induction of DNA damage and alterations in global DNA methylation. Molecular parameters were correlated with cellular proliferation and apoptosis levels. The changes observed in bystander organs are compared to the changes in unexposed animals and animals exposed to predicted and measured scatter doses. We have found the selective induction of DNA damage levels, global DNA methylation, cell proliferation and apoptosis in exposed and bystander spleen tissue of male and female mice. Sex differences were significantly diminished in animals subjected to a surgical removal of gonads. These data constitute the first evidence of sex differences in radiation-induced bystander effects in mouse spleen in vivo. We show the role of sex hormones in spleen bystander responses and discuss implications of the observed changes.

  14. Surgical Treatment of Acute Pancreatitis.

    Science.gov (United States)

    Werner, Jens; Uhl, Waldemar; Büchler, Markus W.

    2003-10-01

    Patients with predicted severe necrotizing pancreatitis as diagnosed by C-reactive protein (>150 mg/L) and/or contrast-enhanced computed tomography should be managed in the intensive care unit. Prophylactic broad-spectrum antibiotics reduce infection rates and survival in severe necrotizing pancreatitis. Endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy is a causative therapy for gallstone pancreatitis with impacted stones, biliary sepsis, or obstructive jaundice. Fine needle aspiration for bacteriology should be performed to differentiate between sterile and infected pancreatic necrosis in patients with sepsis syndrome. Infected pancreatic necrosis in patients with clinical signs and symptoms of sepsis is an indication for surgery. Patients with sterile pancreatic necrosis should be managed conservatively. Surgery in patients with sterile necrosis may be indicated in cases of persistent necrotizing pancreatitis and in the rare cases of "fulminant acute pancreatitis." Early surgery, within 14 days after onset of the disease, is not recommended in patients with necrotizing pancreatitis. The surgical approach should be organ-preserving (debridement/necrosectomy) and combined with a postoperative management concept that maximizes postoperative evacuation of retroperitoneal debris and exudate. Minimally invasive surgical procedures have to be regarded as an experimental approach and should be restricted to controlled trials. Cholecystectomy should be performed to avoid recurrence of gallstone-associated acute pancreatitis.

  15. Cardiothoracic surgical experience in Ghana.

    Science.gov (United States)

    Tettey, Mark; Tamatey, Martin; Edwin, Frank

    2016-10-01

    Ghana is one of the few low-to-middle-income countries in sub-Saharan Africa able to consistently sustain a cardiothoracic program with locally trained staff for more than two decades. Cardiothoracic surgery practice in Ghana started in 1964 but faltered from a combination of political and the economic problems. In 1989, Dr. Kwabena Frimpong-Boateng, a Ghanaian cardiothoracic surgeon trained in Hannover, rekindled interest in cardiothoracic surgery and in establishing a National Cardiothoracic Centre. His vision and leadership has brought cardiothoracic surgery practice in Ghana to its current high level. As a result, the medical landscape of what is achievable locally in both pediatric and adult patients has changed substantially: outbound medical travel that used to be common among Ghanaian cardiovascular patients has been reduced drastically. Ghana's National Cardiothoracic Center (NCTC), the only tertiary center in the country for cardiothoracic surgical pathology manages all such patients that were previously referred abroad. The NCTC has become a medical/surgical hub in the West African sub-region providing service, training, and research opportunities to neighboring countries. The Centre is accredited by the West African College of Surgeons as a center of excellence for training specialists in cardiothoracic surgery. Expectedly, practicing cardiothoracic surgery in such a resource-poor setting has peculiar challenges. This review focuses on the history, practice, successes, and challenges of cardiovascular and thoracic surgery in Ghana.

  16. Informed consent in surgical trials.

    Science.gov (United States)

    Etchells, E

    1999-12-01

    All participants must provide a valid consent to surgical clinical trials. A valid consent requires patient capacity, adequate disclosure of information, and voluntariness. Capacity is the ability to understand information relevant to making a decision and to appreciate the reasonably foreseeable consequences of a decision or lack of decision. To protect vulnerable persons, an incapable person should not be enrolled in most clinical trials. The only exception is if the study can only be conducted on incapable persons. If the willing research participant is incapable, consent must be obtained from others through a process called substitute (or proxy) consent. Disclosure refers to the provision of relevant information to the patient and its comprehension by the patient. Most surgical trials carry more than minimal risks, so the requirement for careful disclosure of these risks to potential participants is generally stringent. Voluntariness refers to the freedom of a person to make a treatment decision. In specific circumstances related to emergency research, the requirement for consent may be waived. Waiver can be justified only if the delay required to obtain consent would prevent the research from occurring and only after prior consultation with from the "community" of potential research participants.

  17. Surgical infections: a microbiological study

    Directory of Open Access Journals (Sweden)

    Santosh Saini

    Full Text Available Surgical infections are mostly polymicrobial, involving both aerobes and anaerobes. One hundred seventeen cases comprised of abscesses (n=51, secondary peritonitis (n=25, necrotizing fascitis (n=22 and wounds with devitalized tissues (n=19 were studied. The number of microorganisms isolated per lesion was highest in secondary peritonitis (2.32. The aerobe/ anaerobe ratio was 0.81 in secondary peritonitis and 1.8 in necrotizing fascitis. Most secondary peritonitis (80%, necrotizing fascitis (75% and wounds with devitalized tissues (66.7% were polymicrobial. Common microorganisms isolated in our study were E. coli, Staphylococcus aureus, Klebsiella spp., Pseudomonas aeruginosa, Bacteroides fragilis and Peptostreptococcus spp. The most effective antibiotics for S. aureus were clindamycin (79.1% and cefuroxime (70.8%. For Gram-negatives (Klebsiella spp., E. coli and Proteus spp., the most effective antibiotics were cefotaxime, ceftizoxime, amikacin and ciprofloxacin. Pseudomonas aeruginosa was maximally sensitive to amikacin (35.2% and ciprofloxacin (35.2%. The greatest degree of multidrug resistance to all the drugs was found in P. aeruginosa (52.9%, followed by Klebsiella spp. (33.3%, Proteus spp. (33.3%, E. coli (22.2%, and S. aureus (12.5%. All the anaerobes that we isolated were 100% sensitive to metronidazole and chloramphenicol, followed by clindamycin (95% to 100%. Apart from antibiotic therapy, non-antimicrobial methods, such as hyperbaric oxygen therapy and debridement also play an important role in the treatment of surgical infections.

  18. Pediatric surgical diseases. A radiological surgical case study approach

    International Nuclear Information System (INIS)

    Esposito, Ciro; Esposito, Giovanni

    2009-01-01

    Radiologic evaluation of an infant or child suspected of having a surgical disease can be a complex problem. With this volume, the editors have created a book focused on pediatric imaging written by pediatricians, pediatric surgeons and pediatric radiologists. This book is a collection of over 200 case reports. The concept is a case study approach: The reader is given radiologic images (plain radiography, computed tomography, magnetic resonance imaging, ultrasonography, etc.) and the clinical history of the patient. On the basis of this information, the reader is asked to identify a diagnostic and therapeutic strategy. Each case is complemented by information on the disease affecting the patient and the management of the case shown, including therapy and follow-up. This educational text is targeted at all medical professionals faced with a variety of diagnostic and therapeutic problems affecting infants and children. (orig.)

  19. Pediatric surgical diseases. A radiological surgical case study approach

    Energy Technology Data Exchange (ETDEWEB)

    Esposito, Ciro [Federico II Univ. of Naples (Italy). Chair of Pediatric Surgery; Esposito, Giovanni (eds.) [Federico II Univ. of Naples (Italy). School of Medicine

    2009-07-01

    Radiologic evaluation of an infant or child suspected of having a surgical disease can be a complex problem. With this volume, the editors have created a book focused on pediatric imaging written by pediatricians, pediatric surgeons and pediatric radiologists. This book is a collection of over 200 case reports. The concept is a case study approach: The reader is given radiologic images (plain radiography, computed tomography, magnetic resonance imaging, ultrasonography, etc.) and the clinical history of the patient. On the basis of this information, the reader is asked to identify a diagnostic and therapeutic strategy. Each case is complemented by information on the disease affecting the patient and the management of the case shown, including therapy and follow-up. This educational text is targeted at all medical professionals faced with a variety of diagnostic and therapeutic problems affecting infants and children. (orig.)

  20. Comparison of stress and burnout among anesthesia and surgical residents in a tertiary care teaching hospital in North India.

    Science.gov (United States)

    Gandhi, K; Sahni, N; Padhy, S K; Mathew, P J

    2017-10-23

    The residents undergoing training at hospitals in our country face challenges in terms of infrastructure and high workload with undefined working hours. The aim of the study was to compare the stress and burnout levels in trainee doctors doing residency in surgical fields and anesthesia at a tertiary care academic center in North India. A comparative, observational study was conducted in a tertiary care teaching hospital in North India. After Ethics Committee approval, 200 residents (100 each from surgical branches and anesthesia) were required to fill a questionnaire with information about age, sex, year of residency, marital status, and the Perceived Stress Scale-10, and Burnout Clinical Subtype Questionnaire-12. Burnout and perceived stress were compared between residents of anesthesia and surgical specialties. Residents of both surgical and anesthesia branches scored high in perceived stress, namely 21 and 18, respectively. The score was significantly higher in surgical residents (P = 0.03) and increased progressively with the year of residency. The majority of residents (90% surgical, 80% anesthesia) felt that they were being overloaded with work. However, only 20%-30% of respondents felt that there was lack of development of individual skills and still fewer (<10%) reported giving up in view of difficulties. There is high level of stress and overload dimension of burnout among the residents of anesthesia and surgical branches at our tertiary care academic institution and the surgical residents score marginally higher than anesthesia residents.

  1. Talk to Your Kids about Sex

    Science.gov (United States)

    ... Topic En español Talk to Your Kids about Sex Browse Sections The Basics Overview Bodies and Puberty ... healthy expectations for their relationships. Talk about opposite-sex and same-sex relationships. When you talk about ...

  2. Fungal Sex: The Basidiomycota.

    Science.gov (United States)

    Coelho, Marco A; Bakkeren, Guus; Sun, Sheng; Hood, Michael E; Giraud, Tatiana

    2017-06-01

    Fungi of the Basidiomycota, representing major pathogen lineages and mushroom-forming species, exhibit diverse means to achieve sexual reproduction, with particularly varied mechanisms to determine compatibilities of haploid mating partners. For species that require mating between distinct genotypes, discrimination is usually based on both the reciprocal exchange of diffusible mating pheromones, rather than sexes, and the interactions of homeodomain protein signals after cell fusion. Both compatibility factors must be heterozygous in the product of mating, and genetic linkage relationships of the mating pheromone/receptor and homeodomain genes largely determine the complex patterns of mating-type variation. Independent segregation of the two compatibility factors can create four haploid mating genotypes from meiosis, referred to as tetrapolarity. This condition is thought to be ancestral to the basidiomycetes. Alternatively, cosegregation by linkage of the two mating factors, or in some cases the absence of the pheromone-based discrimination, yields only two mating types from meiosis, referred to as bipolarity. Several species are now known to have large and highly rearranged chromosomal regions linked to mating-type genes. At the population level, polymorphism of the mating-type genes is an exceptional aspect of some basidiomycete fungi, where selection under outcrossing for rare, intercompatible allelic variants is thought to be responsible for numbers of mating types that may reach several thousand. Advances in genome sequencing and assembly are yielding new insights by comparative approaches among and within basidiomycete species, with the promise to resolve the evolutionary origins and dynamics of mating compatibility genetics in this major eukaryotic lineage.

  3. Sex Hormones and Ischemic Stroke

    DEFF Research Database (Denmark)

    Holmegard, Haya N; Nordestgaard, Børge G; Jensen, Gorm B

    2016-01-01

    CONTEXT AND OBJECTIVE: Whether endogenous sex hormones are associated with ischemic stroke (IS) is unclear. We tested the hypothesis that extreme concentrations of endogenous sex hormones are associated with risk of IS in the general population. DESIGN, SETTING, AND PARTICIPANTS: Adult men (n...... = 4615) and women (n = 4724) with measurements of endogenous sex hormones during the 1981-1983 examination of the Copenhagen City Heart Study, Denmark, were followed for up to 29 years for incident IS, with no loss to follow-up. Mediation analyses assessed whether risk of IS was mediated through...

  4. Adolescents, sex, and the media.

    Science.gov (United States)

    Strasburger, Victor C

    2012-04-01

    In the absence of effective sex education in the United States, the media have arguably become the leading sex educator for children and teenagers. Considerable research now exists that attests to the ability of the media to influence adolescents' attitudes and beliefs about sex and sexuality. In addition, new research has found a significant link between exposure to sexual content in the media and earlier onset of sexual intercourse. Although there is little research on the behavioral effects of "new" media, they are discussed as well. Suggestions for clinicians, parents, the federal government, and the entertainment industry are provided.

  5. Whose crazy investment in sex?

    Science.gov (United States)

    Mandlis, Lane R

    2011-01-01

    By probing the processes of exclusion of transsexuals from the political sphere, this article offers contributions to social and political theory through an examination of the processes of exclusion from the category "human." This article considers how the erasure of investment in their own embodied sex constructs a platform from which to blame others for sex/gender variance, as well as to justify that blaming. Bringing together Giorgio Agamben, Georges Bataille, Judith Butler, and Nikolas Rose with transphobia, medicalization in psychiatry, law, and ethopolitics, this article questions whose investment in sexed embodiment counts and why that investment might be seen as "crazy."

  6. Clinical outcome in acute small bowel obstruction after surgical or conservative management.

    Science.gov (United States)

    Meier, Raphael P H; de Saussure, Wassila Oulhaci; Orci, Lorenzo A; Gutzwiller, Eveline M; Morel, Philippe; Ris, Frédéric; Schwenter, Frank

    2014-12-01

    Small bowel obstruction (SBO) is characterized by a high rate of recurrence. In the present study, we aimed to compare the outcomes of patients managed either by conservative treatment or surgical operation for an episode of SBO. The outcomes of all patients hospitalized at a single center for acute SBO between 2004 and 2007 were assessed. The occurrence of recurrent hospitalization, surgery, SBO symptoms at home, and mortality was determined. Among 221 patients admitted with SBO, 136 underwent a surgical procedure (surgical group) and 85 were managed conservatively (conservative group). Baseline characteristics were similar between treatment groups. The median follow-up time (interquartile range) was 4.7 (3.7-5.8) years. Nineteen patients (14.0 %) of the surgical group were hospitalized for recurrent SBO versus 25 (29.4 %) of the conservative group [hazard ratio (HR), 0.5; 95 % CI, 0.3-0.9]. The need for a surgical management of a new SBO episode was similar between the two groups, ten patients (7.4 %) in the surgical group and six patients (7.1 %) in the conservative group (HR, 1.1; 95 % CI, 0.4-3.1). Five-year mortality from the date of hospital discharge was not significantly different between the two groups (age- and sex-adjusted HR, 1.1; 95 % CI, 0.6-2.1). A follow-up evaluation was obtained for 130 patients. Among them, 24 patients (34.8 %) of the surgical group and 35 patients (57.4 %) of the conservative group had recurrent SBO symptoms (odds ratio, 0.4; 95 % CI, 0.2-0.8). The recurrence of SBO symptoms and new hospitalizations were significantly lower after surgical management of SBO compared with conservative treatment.

  7. Retrospective analysis of factors affecting the efficacy of surgical treatment of the scar.

    Science.gov (United States)

    Yang, Z; Shi, X; Zhang, Y; Wang, S; Lei, Z; Liu, X; Fan, D

    2014-04-01

    The scar is a major problem in the medical profession. Its timely treatment is very important for the better outcome of the scar treatment and for the improvement of the life quality of the patients. The aim of this study was retrospectively analyzed the epidemiological characteristics affecting the efficacy of the scar surgical treatment of the people in the western part of China. Total 414 scar cases were retrospectively analyzed to clarify the epidemiological characteristics and the factors affecting the scar surgical treatment efficacy. The factors included were sex, age, area distribution, treatment seasons, injury sites, injury causes, and the time from scarring to the surgical treatment. All scar cases were surgically treated with the repairing technology including skin graft, flap and soft tissue dilation. There were 206 males and 208 females with the average age 20.53±12.9 years (age range 1-68 years). The patient proportions in the age groups of 0-20, 21-40 and >40 years were 61.4% (254 cases), 29.2% (121 cases), and 9.4% (39 cases) respectively. The patient's attendance rate reached the highest during the summer and winter. Most patients were from the rural areas with an increasing tendency each year. The burn scars were the most abundant and the injury sites were mostly the head and face. Univariate analysis showed that the time from scarring to the surgical treatment and the injury sites were significantly influenced the scar surgical treatment efficacy. Logistic regression analysis demonstrated that the injured sites of the head and face significantly influenced the scar surgical treatment efficacy. With the development of economy in China, more scar patients especially younger and children visit doctors predominantely from the rural areas. Usually, they get their scars in the exposed area of their bodies (head and face) which seriously affect the patient's appearance and function. Factors influencing the scar surgical treatment efficacy has

  8. What are estimated reimbursements for lower extremity prostheses capable of surgical and nonsurgical lengthening?

    Science.gov (United States)

    Henderson, Eric R; Pepper, Andrew M; Letson, G Douglas

    2012-04-01

    Growing prostheses accommodate skeletally immature patients with bone tumors undergoing limb-preserving surgery. Early devices required surgical procedures for lengthening; recent devices lengthen without surgery. Expenses for newer expandable devices that lengthen without surgery are more than for their predecessors but overall reimbursement amounts are not known. We sought to determine reimbursement amounts associated with lengthening of growing prostheses requiring surgical and nonsurgical lengthening. We retrospectively reviewed 17 patients with growing prostheses requiring surgical expansion and eight patients with prostheses capable of nonsurgical expansion. Insurance documents were reviewed to determine the reimbursement for implantation, lengthening, and complications. Growth data were obtained from the literature. Mean reimbursement amounts of surgical and nonsurgical lengthenings were $9950 and $272, respectively. Estimated reimbursements associated with implantation of a growing prosthesis varied depending on age, sex, and location. The largest difference was found for 4-year-old boys with distal femoral replacement where reimbursement for expansion to maturity for surgical and nonsurgical lengthening prostheses would be $379,000 and $208,000, respectively. For children requiring more than one surgical expansion, net reimbursements were lower when a noninvasive lengthening device was used. Annual per-prosthesis maintenance reimbursements to address complications for surgical and nonsurgical lengthening prostheses were $3386 and $1856, respectively. This study showed that reimbursements for lengthening of growing endoprostheses capable of nonsurgical expansion may be less expensive in younger patients, particularly male patients undergoing distal femur replacement, than endoprostheses requiring surgical lengthening. Longer outcomes studies are required to see if reimbursements for complications differ between devices. Level III, economic and decision

  9. First Hemolivia from southern Africa: reassigning chelonian ...

    African Journals Online (AJOL)

    To date, only a single species of Hemolivia, Hemolivia mauritanica (Sergent & Sergent, 1904), has been described from African terrestrial tortoises. Although various haemogregarines have been described from southern African terrapins and tortoises, including species from the genus Haemogregarina and one from the ...

  10. 32 CFR 1656.12 - Job reassignment.

    Science.gov (United States)

    2010-07-01

    ... ethical beliefs or convictions as to participation in a war that led to his classification as a... Order to Perform Alternative Service under § 1656.15; (4) The ASW's employer ceases to operate an approved program or activity; (5) The ASW's employer fails to comply with terms and conditions of these...

  11. New multimedia advances in surgical information.

    Science.gov (United States)

    Glenn, Ian C; Abdulhai, Sophia; Lamoshi, Abdulraouf; Ponsky, Todd A

    2018-06-01

    When discussing new trends in pediatric surgery, the tendency is to focus on novel surgical technology and techniques. However, it is equally important to examine how the practicing surgeon stays abreast in an ever-changing field. This article serves as a brief guide to the future of surgical education for the attending surgeon. Broadly, advances in surgical education consist of new methods of filtration and delivery of knowledge.

  12. Surgical management of nasal obstruction.

    Science.gov (United States)

    Moche, Jason A; Palmer, Orville

    2012-05-01

    The proper evaluation of the patient with nasal obstruction relies on a comprehensive history and physical examination. Once the site of obstruction is accurately identified, the patient may benefit from a trial of medical management. At times however, the definitive treatment of nasal obstruction relies on surgical management. Recognizing the nasal septum, nasal valve, and turbinates as possible sites of obstruction and addressing them accordingly can dramatically improve a patient's nasal breathing. Conservative resection of septal cartilage, submucous reduction of the inferior turbinate, and structural grafting of the nasal valve when appropriate will provide the optimal improvement in nasal airflow and allow for the most stable results. Copyright © 2012. Published by Elsevier Inc.

  13. [Surgical laboratory in pregraduate medicine.

    Science.gov (United States)

    Tapia-Jurado, Jesús

    2011-01-01

    Surgical laboratory in pregraduate students in medicine is beneficial and improves learning processes in cognitive aspects and skills acquisition. It is also an early initiation into scientific research. The laboratory is the introductory pathway into basic concepts of medical science (meaningful learning). It is also where students gain knowledge in procedures and abilities to obtain professional skills, an interactive teacher-student process. Medicine works rapidly to change from an art to a science. This fact compromises all schools and medical faculties to analyze their actual lesson plans. Simulators give students confidence and ability and save time, money and resources, eliminating at the same time the ethical factor of using live animals and the fear of patient safety. Multimedia programs may give a cognitive context evolving logically with an explanation based on written and visual animation followed by a clinical problem and its demonstration in a simulator, all before applying knowledge to the patient.

  14. Surgical Management of Enterocutaneous Fistula

    International Nuclear Information System (INIS)

    Lee, Suk Hwan

    2012-01-01

    Enterocutaneous (EC) fistula is an abnormal connection between the gastrointestinal (GI) tract and skin. The majority of EC fistulas result from surgery. About one third of fistulas close spontaneously with medical treatment and radiologic interventions. Surgical treatment should be reserved for use after sufficient time has passed from the previous laparotomy to allow lysis of the fibrous adhesion using full nutritional and medical treatment and until a complete understanding of the anatomy of the fistula has been achieved. The successful management of GI fistula requires a multi-disciplinary team approach including a gastroenterologist, interventional radiologist, enterostomal therapist, dietician, social worker and surgeons. With this coordinated approach, EC fistula can be controlled with acceptable morbidity and mortality.

  15. Surgical managements of radiation enteritis

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Tsuguo; Naito, Kazuyo; Noomi, Shinppachiro; Kurioka, Hideaki; Yamagishi, Hisakazu (Kyoto Prefectural Univ. of Medicine (Japan))

    1983-02-01

    Radiation injury to the digestive tract was surgically treated in 22 cases. Six of them died shortly after surgery. Major symptoms were ileus or perforative peritonitis in 20 of the 22 cases, and surgery was performed for ileal lesion in 18 cases, indicating the significance of lesions in the small intestine. Seven patients underwent resection of the injured portion of the intestinal tract and anastomotic reconstruction in one stage, but 3 of them died from rupture of sutures. It was highly probable that anastomosis was made using an injured portion of the intestine. Intraoperative judgement of intestinal injury is made by palpation and inspection. If judgement is difficult, an artificial anus should be constructed first, and anastomotic reconstruction should be done in the 2nd stage. Since delayed injury of this disease is an ischemic change due to vascular obliteration, conservative therapy never leads to complete recovery, but active resection and anastomosis seem to produce a satisfactory result.

  16. Surgical managements of radiation enteritis

    International Nuclear Information System (INIS)

    Tanaka, Tsuguo; Naito, Kazuyo; Noomi, Shinppachiro; Kurioka, Hideaki; Yamagishi, Hisakazu

    1983-01-01

    Radiation injury to the digestive tract was surgically treated in 22 cases. Six of them died shortly after surgery. Major symptoms were ileus or perforative peritonitis in 20 of the 22 cases, and surgery was performed for ileal lesion in 18 cases, indicating the significance of lesions in the small intestine. Seven patients underwent resection of the injured portion of the intestinal tract and anastomotic reconstruction in one stage, but 3 of them died from rupture of sutures. It was highly probable that anastomosis was made using an injured portion of the intestine. Intraoperative judgement of intestinal injury is made by palpation and inspection. If judgement is difficult, an artificial anus should be constructed first, and anastomotic reconstruction should be done in the 2nd stage. Since delayed injury of this disease is an ischemic change due to vascular obliteration, conservative therapy never leads to complete recovery, but active resection and anastomosis seem to produce a satisfactory result. (Chiba, N.)

  17. Virtual reality in surgical training.

    Science.gov (United States)

    Lange, T; Indelicato, D J; Rosen, J M

    2000-01-01

    Virtual reality in surgery and, more specifically, in surgical training, faces a number of challenges in the future. These challenges are building realistic models of the human body, creating interface tools to view, hear, touch, feel, and manipulate these human body models, and integrating virtual reality systems into medical education and treatment. A final system would encompass simulators specifically for surgery, performance machines, telemedicine, and telesurgery. Each of these areas will need significant improvement for virtual reality to impact medicine successfully in the next century. This article gives an overview of, and the challenges faced by, current systems in the fast-changing field of virtual reality technology, and provides a set of specific milestones for a truly realistic virtual human body.

  18. Evolving Educational Techniques in Surgical Training.

    Science.gov (United States)

    Evans, Charity H; Schenarts, Kimberly D

    2016-02-01

    Training competent and professional surgeons efficiently and effectively requires innovation and modernization of educational methods. Today's medical learner is quite adept at using multiple platforms to gain information, providing surgical educators with numerous innovative avenues to promote learning. With the growth of technology, and the restriction of work hours in surgical education, there has been an increase in use of simulation, including virtual reality, robotics, telemedicine, and gaming. The use of simulation has shifted the learning of basic surgical skills to the laboratory, reserving limited time in the operating room for the acquisition of complex surgical skills". Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Disentangling the benefits of sex.

    Science.gov (United States)

    Roze, Denis

    2012-01-01

    Understanding the evolutionary advantage of sexual reproduction remains one of the most fundamental questions in evolutionary biology. Most of the current hypotheses rely on the fact that sex increases genetic variation, thereby enhancing the efficiency of natural selection; an important body of theoretical work has defined the conditions under which sex can be favoured through this effect. Over the last decade, experimental evolution in model organisms has provided evidence that sex indeed allows faster rates of adaptation. A new study on facultatively sexual rotifers shows that increased rates of sex can be favoured during adaptation to new environmental conditions and explores the cause of this effect. The results provide support for the idea that the benefits of increasing genetic variation may compensate for the short-term costs of sexual reproduction.

  20. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... a spinal cord injury? play_arrow What about oral sex after a spinal cord injury? ... injuries. The website does not provide medical advice, recommend or endorse health care products or services, or control the information ...

  1. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... Spinal Cord Injury Guy W. Fried, MD Substance Abuse and Spinal Cord Injury Allen Heinemann, PhD How ... spinal cord injury? play_arrow Can men and women still have sex after a spinal cord injury? ...

  2. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Sex and Fertility ... injury? What is a Spinal Cord Injury? SCI Medical Experts People Living With SCI Personal Experiences By ...

  3. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... spinal cord injury? play_arrow Can men and women still have sex after a spinal cord injury? play_arrow How is sexual function in women affected by a spinal cord injury? play_arrow ...

  4. Sex differences, gender and addiction.

    Science.gov (United States)

    Becker, Jill B; McClellan, Michele L; Reed, Beth Glover

    2017-01-02

    This review discusses alcohol and other forms of drug addiction as both a sociocultural and biological phenomenon. Sex differences and gender are not solely determined by biology, nor are they entirely sociocultural. The interactions among biological, environmental, sociocultural, and developmental influences result in phenotypes that may be more masculine or more feminine. These gender-related sex differences in the brain can influence the responses to drugs of abuse, progressive changes in the brain after exposure to drugs of abuse and whether addiction results from drug-taking experiences. In addition, the basic laboratory evidence for sex differences is discussed within the context of four types of sex/gender differences. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  5. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... Resources Peer Counseling Blog About Media Donate close search Understanding Spinal Cord Injury What is a Spinal ... male fertility? play_arrow Where can people get information on sex and fertility after a spinal cord ...

  6. Sex differences in cardiovascular function

    Czech Academy of Sciences Publication Activity Database

    Kolář, František; Ošťádal, Bohuslav

    2013-01-01

    Roč. 207, č. 4 (2013), s. 584-587 ISSN 1748-1708 Institutional support: RVO:67985823 Keywords : heart * vascular * risk factors * sex Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 4.251, year: 2013

  7. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Sex and Fertility After Spinal Cord Injury Adult Injuries Spinal Cord Injury 101 David Chen, ...

  8. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... Expert Videos Topics menu Topics Sex and Fertility After Spinal Cord Injury Adult Injuries Spinal Cord Injury ... 2525 info@facingdisability.com SIGN UP FOR OUR NEWSLETTER Your email address * This iframe contains the logic ...

  9. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... male fertility? play_arrow Where can people get information on sex and fertility after a spinal cord ... health care products or services, or control the information found on external websites. The Hill Foundation is ...

  10. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Sex and Fertility After Spinal Cord Injury Adult Injuries Spinal Cord Injury 101 David ...

  11. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... after a spinal cord injury? play_arrow Can men and women still have sex after a spinal ... injury? play_arrow How is sexual function in men affected by a spinal cord injury ? play_arrow ...

  12. Result of surgical therapy in esophagogastric junction adenocarcinoma

    International Nuclear Information System (INIS)

    Shirinzadeh, A.; Fakhrjoo, E.

    2007-01-01

    To assess the outcome of surgical therapy and choice of surgical strategy for patients with adenocarcinoma of the gastroesophageal junction. Between February 1989 and January 2005 during 16 years, 335 patients (65 female, 270 male, mean age 56 years) with esophagogastric junction adenocarcinoma underwent surgical operation. The choice of surgical approach was based on the anatomical location of the tumor mass. Outcome of surgery, histopathologic characteristics, demographic data and long term survival rates were compared among three types of tumor defined as follows. Type I: Adenocarcinoma of the distal esophagus which infiltrates the esophagogastric junction from above. Type II: True carcinoma of the cardia arising immediately at the esophagogastric junction. Type III: Subcardial gastric carcinoma that infiltrates the esophagogastric junction and distal esophagus from below. Of the 335 patients undergoing resection, 110 (33%) had type I, 96 (28%) had type II, and 129 (39%) had type III. The preponderance of the male sex and the prevalence of metaplasia in distal esophagus decreased from type I to type III tumors (P<0.01). The prevalence of undifferentiated tumors increased from type I to type III tumors (P<0.01). Esophagectomy with resection of the proximal stomach for type I and extended total gastrectomy with transhiatal resection of the distal esophagus for type II and III were the primary procedures. The mean number of removed lymph node was higher in type III and II compared to type I tumors. The overall postoperative 30-day mortality was 8.4%. The death rate in transthoracic esophagectomy was higher than with extended total gastrectomy. The classification of adenocarcinoma of the esophagogastric junction into type I, II and III tumors helps in the selection of surgical approach. Type I tumors are approached as distal esophageal cancer. Type III tumors are a special form of gastric cancer and treated as a gastric cancer. The relation of type II tumors to

  13. Surgical treatment of oral leukoplakia

    Directory of Open Access Journals (Sweden)

    Yuliia Kolenko

    2017-04-01

    Full Text Available Background: The effectiveness of care for patients with leukoplakia depends on how timely and accurately the disease was diagnosed and also by the subsequent choice of the optimal method of treatment. In recent decades, surgery is increasingly using methods that are alternative to standard surgical methods. Purpose: to justify, develop and evaluate treatment algorithm of verrucous and erosive-ulcerative forms of oral leukoplakia with a SIN2 histological structure. Materials and Methods: to achieve this goal, a comprehensive clinical and laboratory examination of 155 patients with oral leukoplakia was performed, which appealed to the Department of Therapeutic Dentistry of the  Bogomolets National Medical University in the period from 2011 to 2015. All patients underwent clinical and laboratory tests. Results: after removal of the affected area of the mucosa by radiation of an erbium laser, wound healing under fibrinous plaque was observed at 7.0 ± 0.5 days. When excision of the mucous membrane with a scalpel, the healing took place under the iodinine swab through the granulation phase for 14.0 ± 1.5 days. In patients after the operation of excision of the area of verrucous or erosive-ulcerative oral mucosa leukoplakia with laser radiation without antimicrobial and anti-inflammatory therapy on the third day, in 95% of cases there is no pain syndrome and collateral edema in the postoperative area. After traditional treatment, despite the use of antibiotics and non-steroidal anti-inflammatory drugs, 56% of patients complained of pain, and 62% had collateral edema. Conclusions: the use of ErrYAG laser laser radiation in the surgical treatment of patients with verrucous and erosive-ulcerative forms of leukoplakia promotes acceleration of healing processes of a postoperative wound twice as fast as in the control group. The use of laser technology reduces the risk of inflammatory purulent complications and helps to prevent the recurrence of the

  14. Gender socialization and sex affilation

    Directory of Open Access Journals (Sweden)

    Redžić Saduša F.

    2014-01-01

    Full Text Available The author's depth interviews with students of the University of Nis checked for the possibility of receptivity to sexual stereotypes and conditioning of sexual/gender socialization by sexual group affiliation. Examined the experiences and attitudes of students of both sexes regarding early gender socialization and it's characteristically stereotypes, stereotypes about dressing, instrumentalization of sexuality, the influence of parents/environment on the formation of sexual morality, own the gender socialization in the family, twin rules for the socialization of children of different gender and sex/gender roles in marriage. Belonging to the sex group has no effect on susceptibility to sexual stereotypes regarding early gender socialization and dressing. Difference may be seen in the effort to comment on and evaluate the wear behavior of girls more than a young man dressing, which may be an indicator for further research had sexual dimorphism in terms of dressing and nudity. It seems that the experience of respondents of both sexes are dependent primarily from the general family atmosphere (closeness, openness to communicate with each other, the absence of the traditional gender division of roles in the family/emotional distance from the parent of the opposite sex or of both parents, the rigidity, the strict division of gender roles in the family. In the first case, where both parents are involved in the upbringing of the child, relationships are intimate with both, and vice versa. Therefore, we can conclude about the lack of connection between the sex of the child and separated upbringing (traditional: the mother confides sexual education of women, a father of male child in the first case, and a link to another should only check to prove it. Sex does not condition susceptibility to stereotypes about education and gender roles. Traditionally, transitional and modern attitudes are equally represented in subjects of both sexes.

  15. Sex Differences in Drug Abuse

    OpenAIRE

    Becker, Jill B.; Hu, Ming

    2007-01-01

    Sex differences are present for all of the phases of drug abuse (initiation, escalation of use, addiction, and relapse following abstinence). While there are some differences among specific classes of abused drugs, the general pattern of sex differences is the same for all drugs of abuse. Females begin regularly self-administering licit and illicit drugs of abuse at lower doses than do males, use escalates more rapidly to addiction, and females are at greater risk for relapse following abstin...

  16. SEX DIFFERENCES, GENDER AND ADDICTION

    OpenAIRE

    Becker, Jill B.; McClellan, Michele L.; Reed, Beth Glover

    2017-01-01

    This review discusses alcohol/other drug addiction as both a sociocultural and biological phenomenon. Sex differences and gender are not solely determined by biology, nor are they entirely sociocultural. The interactions among biological, environmental, sociocultural and developmental influences result in phenotypes that may be more masculine or more feminine. These gender-related sex differences in the brain can influence the responses to drugs of abuse, progressive changes in the brain afte...

  17. Prevalence of the middle mesial canal in non surgical root canal treated mandibular first and second molars in a local military population

    Science.gov (United States)

    2016-06-13

    or second mandibular molar), sex, and age. Materials and Methods Approximately 7, 000 dental records in paper chart format were reviewed at a...Army Post Graduate Dental School Douglas D. Lancaster, COL, DC 3 August 2016 Prevalence of the middle mesial canal in non-surgical root canal...Methods: 7000 dental records were reviewed for non-surgical root canals performed from October 1970 to October 2015. The data collected included

  18. Outcomes of Complete Versus Partial Surgical Stabilization of Flail Chest.

    Science.gov (United States)

    Nickerson, Terry P; Thiels, Cornelius A; Kim, Brian D; Zielinski, Martin D; Jenkins, Donald H; Schiller, Henry J

    2016-01-01

    Rib fractures are common after chest wall trauma. For patients with flail chest, surgical stabilization is a promising technique for reducing morbidity. Anatomical difficulties often lead to an inability to completely repair the flail chest; thus, the result is partial flail chest stabilization (PFS). We hypothesized that patients with PFS have outcomes similar to those undergoing complete flail chest stabilization (CFS). A prospectively collected database of all patients who underwent rib fracture stabilization procedures from August 2009 until February 2013 was reviewed. Abstracted data included procedural and complication data, extent of stabilization, and pulmonary function test results. Of 43 patients who underwent operative stabilization of flail chest, 23 (53%) had CFS and 20 (47%) underwent PFS. Anterior location of the fracture was the most common reason for PFS (45%). Age, sex, operative time, pneumonia, intensive care unit and hospital length of stay, and narcotic use were the same in both groups. Total lung capacity was significantly improved in the CFS group at 3 months. No chest wall deformity was appreciated on follow-up, and no patients underwent additional stabilization procedures following PFS. Despite advances in surgical technique, not all fractures are amenable to repair. There was no difference in chest wall deformity, narcotic use, or clinically significant impairment in pulmonary function tests among patients who underwent PFS compared with CFS. Our data suggest that PFS is an acceptable strategy and that extending or creating additional incisions for CFS is unnecessary.

  19. Family planning / sex education / teenage pregnancy.

    Science.gov (United States)

    1993-02-01

    The Alan Guttmacher Institute's State Reproductive Health Monitor provides legislative information on family planning, sex education, and teenage pregnancy. The listing contains information on pending bills; the state, the identifying legislation number, the sponsor, the committee, the date the bill was introduced, a description of the bill, and when available, the bill's status. From January through February, 1993, the bills cover a wide range of regulation and social policy including: appropriations for family planning services; Norplant implants for women receiving AFDC benefits; the requirement that health insurance policies provide coverage for contraception services; the repeal of the sterilization procedure review committee; since a need for such a committee has vanished; requiring hotels, motels, and innkeepers to offer condoms for sale to registered guests; allowing male and female public assistance recipients between ages 18-35 who submit to sterilization operations to be eligible to receive a $2,000 grant; a provision that no more children may be included in the size of the family, for the purpose of determining the amount of AFDC benefits that a family may receive, than at the time that eligibility was determined, and that before a family with 2 or more children can receive AFDC benefits, the woman must consent to and have surgically implanted Norplant or a similar reversible birth control device with a 5-year or longer effectiveness.

  20. Capping of the radicular exposed surface (part II). Surgical and not surgical treatment

    OpenAIRE

    Grados Pomarino, Sixto; Estrada, Andrew Alejandro; Maetahara Rubio, Denis Miguel; Guzmán Vera, Yanina Sara; Tello Barbarán, Javier

    2014-01-01

    The gingival recession treatment can be made surgical1y with a high predictability of success due to the great advance during the last ones of the mucogingival surgical techniques. The use of connective grafts in coverage of recessions has obtained high rates of success reason why these procedures are common within the modern periodontal surgical practice. Knowing that all patients do not accept the surgical treatment, many investigators have come studying the possibility of treating non-surg...

  1. Adaptive value of sex in microbial pathogens.

    Science.gov (United States)

    Michod, Richard E; Bernstein, Harris; Nedelcu, Aurora M

    2008-05-01

    Explaining the adaptive value of sex is one of the great outstanding problems in biology. The challenge comes from the difficulty in identifying the benefits provided by sex, which must outweigh the substantial costs of sex. Here, we consider the adaptive value of sex in viruses, bacteria and fungi, and particularly the information available on the adaptive role of sex in pathogenic microorganisms. Our general theme is that the varied aspects of sex in pathogens illustrate the varied issues surrounding the evolution of sex generally. These include, the benefits of sex (in the short- and long-term), as well as the costs of sex (both to the host and to the pathogen). For the benefits of sex (that is, its adaptive value), we consider three hypotheses: (i) sex provides for effective and efficient recombinational repair of DNA damages, (ii) sex provides DNA for food, and (iii) sex produces variation and reduces genetic associations among alleles under selection. Although the evolution of sex in microbial pathogens illustrates these general issues, our paper is not a general review of theories for the evolution of sex in all organisms. Rather, we focus on the adaptive value of sex in microbial pathogens and conclude that in terms of short-term benefits, the DNA repair hypothesis has the most support and is the most generally applicable hypothesis in this group. In particular, recombinational repair of DNA damages may substantially benefit pathogens when challenged by the oxidative defenses of the host. However, in the long-term, sex may help get rid of mutations, increase the rate of adaptation of the population, and, in pathogens, may infrequently create new infective strains. An additional general issue about sex illustrated by pathogens is that some of the most interesting consequences of sex are not necessarily the reasons for which sex evolved. For example, antibiotic resistance may be transferred by bacterial sex, but this transfer is probably not the reason sex

  2. The Virtual Surgical Pelvis : Anatomy Visualization for Education and Surgical Planning

    NARCIS (Netherlands)

    Smit, N.N.

    2016-01-01

    This thesis deals with visualizing anatomical data for medical education and surgical planning purposes. To this end, we have developed a detailed virtual atlas, the Virtual Surgical Pelvis (VSP),which unifies surgically relevant knowledge on pelvic anatomy. We provide methods to share the knowledge

  3. SURVIVAL OF CONTINUOUS AMBULATORY PERITONEAL DIALYSIS CATHETERS: AN EVALUATION OF SURGICAL AND NON-SURGICAL FACTORS (SINGLE CENTER STUDY

    Directory of Open Access Journals (Sweden)

    A. Keshvari

    2006-06-01

    Full Text Available Peritoneal dialysis is an established form of renal replacement therapy used in many patients with end-stage renal disease. The key to a successful chronic peritoneal dialysis is a permanent and safe access to the peritoneal cavity. This study was conducted in order to evaluate the catheter survival and its related factors in Imam Khomeini Hospital. A total of 80 catheters were inserted into 69 patients (52 men and 28 women with end-stage chronic renal failure during a period of 84 months. Retrospectively the correlation between catheter survival (overall and event free with demographic factors (sex and age, surgical factors (surgeons and surgical methods, nephrologic factors (the causes of peritoneal dialysis selection and the history of hemodialysis and peritonitis factors (the history and number of peritonitis has been evaluated. The mean age of the patients was 48.35 years (16 to 79 years. The overall survival of catheters or the probability of having a functioning catheter after one, two and three years was 53%, 41%, 22%, respectively. The event free survival of the catheter or the probability of having a functioning catheter without any problems after one year was 14%. It has been found out that among all factors in this study only history of hemodialysis had statistically significant effect on the overall survival of continuous ambulatory peritoneal dialysis catheter (P = 0.04. It seems that the overall survival of catheters is better when CAPD is started before any other attempts for hemodialysis.

  4. Sex differences in the brain-an interplay of sex steroid hormones and sex chromosomes.

    Science.gov (United States)

    Grgurevic, Neza; Majdic, Gregor

    2016-09-01

    Although considerable progress has been made in our understanding of brain function, many questions remain unanswered. The ultimate goal of studying the brain is to understand the connection between brain structure and function and behavioural outcomes. Since sex differences in brain morphology were first observed, subsequent studies suggest different functional organization of the male and female brains in humans. Sex and gender have been identified as being a significant factor in understanding human physiology, health and disease, and the biological differences between the sexes is not limited to the gonads and secondary sexual characteristics, but also affects the structure and, more crucially, the function of the brain and other organs. Significant variability in brain structures between individuals, in addition to between the sexes, is factor that complicates the study of sex differences in the brain. In this review, we explore the current understanding of sex differences in the brain, mostly focusing on preclinical animal studies. © 2016 The Author(s). published by Portland Press Limited on behalf of the Biochemical Society.

  5. Real-time inextensible surgical thread simulation.

    Science.gov (United States)

    Xu, Lang; Liu, Qian

    2018-03-27

    This paper discusses a real-time simulation method of inextensible surgical thread based on the Cosserat rod theory using position-based dynamics (PBD). The method realizes stable twining and knotting of surgical thread while including inextensibility, bending, twisting and coupling effects. The Cosserat rod theory is used to model the nonlinear elastic behavior of surgical thread. The surgical thread model is solved with PBD to achieve a real-time, extremely stable simulation. Due to the one-dimensional linear structure of surgical thread, the direct solution of the distance constraint based on tridiagonal matrix algorithm is used to enhance stretching resistance in every constraint projection iteration. In addition, continuous collision detection and collision response guarantee a large time step and high performance. Furthermore, friction is integrated into the constraint projection process to stabilize the twining of multiple threads and complex contact situations. Through comparisons with existing methods, the surgical thread maintains constant length under large deformation after applying the direct distance constraint in our method. The twining and knotting of multiple threads correspond to stable solutions to contact and friction forces. A surgical suture scene is also modeled to demonstrate the practicality and simplicity of our method. Our method achieves stable and fast simulation of inextensible surgical thread. Benefiting from the unified particle framework, the rigid body, elastic rod, and soft body can be simultaneously simulated. The method is appropriate for applications in virtual surgery that require multiple dynamic bodies.

  6. Optimisation of surgical care for rectal cancer

    NARCIS (Netherlands)

    Borstlap, W.A.A.

    2017-01-01

    Optimisation of surgical care means weighing the risk of treatment related morbidity against the patients’ potential benefits of a surgical intervention. The first part of this thesis focusses on the anaemic patient undergoing colorectal surgery. Hypothesizing that a more profound haemoglobin

  7. Communication Skills among Surgical Trainees: Perceptions of ...

    African Journals Online (AJOL)

    Objective Communication between the surgeon and the patient is a core clinical skill. The ability to communicate with patients and their family members is very important in the optimum care of the surgical patient. Few studies have assessed communication between surgical trainees and their patients in sub-Saharan Africa.

  8. Surgical evaluation of acute abdomen in pregnancy

    International Nuclear Information System (INIS)

    Kovarova, P.

    2013-01-01

    Acute abdomen in pregnancy is a disease with a low incidence. The purpose of this work was therefore to create a review of current recommended practice in diagnostics and surgical solution. I also mention surgically relevant physiological and pathological changes specific to pregnancy, differential diagnostics of acute abdomen in pregnancy and impact of the disease and its treatment on the fetus. (author)

  9. Evolution of hemostatic agents in surgical practice

    Directory of Open Access Journals (Sweden)

    Chandru P Sundaram

    2010-01-01

    Conclusions : A review of the evolution of topical hemostatic agents highlights opportunities for potential novel research. Fibrin sealants may have the most opportunity for advancement, and understanding the history of these products is useful. With the drive in urology for minimally invasive surgical techniques, adaptation of topical hemostatic agents to this surgical approach would be valuable and offers an opportunity for novel contributions.

  10. Surgical treatment of gynecomastia: complications and outcomes.

    Science.gov (United States)

    Li, Chun-Chang; Fu, Ju-Peng; Chang, Shun-Cheng; Chen, Tim-Mo; Chen, Shyi-Gen

    2012-11-01

    Gynecomastia is defined as the benign enlargement of the male breast. Multiple surgical options have been used to improve outcomes. The aim of this study was to analyze the surgical approaches to the treatment of gynecomastia and their outcomes over a 10-year period. All patients undergoing surgical correction of gynecomastia in our department between 2000 and 2010 were included for retrospective evaluation. The data were analyzed for etiology, stage of gynecomastia, surgical technique, complications, risk factors, and revision rate. The surgical result was evaluated with self-assessment questionnaires. A total of 41 patients with 75 operations were included. Techniques included subcutaneous mastectomy alone or with additional ultrasound-assisted liposuction (UAL) and isolated UAL. The surgical revision rate for all patients was 4.8%. The skin-sparing procedure gave good surgical results in grade IIb and grade III gynecomastia with low revision and complication rates. The self-assessment report revealed a good level of overall satisfaction and improvement in self-confidence (average scores 9.4 and 9.2, respectively, on a 10-point scale). The treatment of gynecomastia requires an individualized approach. Subcutaneous mastectomy combined with UAL could be used as the first choice for surgical treatment of grade II and III gynecomastia.

  11. Surgical Site Infection among Patients Undergone Orthopaedic ...

    African Journals Online (AJOL)

    ADMIN

    with surgical site infection at Muhimbili Orthopedic Institute. ... Determination of the relationship between outcome and exposure variables ... determined by more than 2 hours length of surgical procedure (AOR= 1.4; 95%CI 1.14-6.69; ... hospital, those with metastatic fractures, back, spine were not included as they fall under.

  12. SURGICAL ORTHODONTICS: LITERATURE REVIEW AND CASE REPORT

    OpenAIRE

    Piyush HEDA; Babita RAGHUWANSHI; Amit PRAKASH; Kishore SONAWANE

    2013-01-01

    Orthognathic surgery is a surgical procedure largely practiced throughout the world for the correction of various maxillofacial deformities. The procedure for correcting a particular deformity will be done after proper evaluation, which includes cephalometric, dental model analysis and photographs. The patient undergoes pre-surgical orthodontic correction for dental compensation, after which surgery is planned. During the last few decades, the profession has witnessed ...

  13. Systems for tracking minimally invasive surgical instruments

    NARCIS (Netherlands)

    Chmarra, M. K.; Grimbergen, C. A.; Dankelman, J.

    2007-01-01

    Minimally invasive surgery (e.g. laparoscopy) requires special surgical skills, which should be objectively assessed. Several studies have shown that motion analysis is a valuable assessment tool of basic surgical skills in laparoscopy. However, to use motion analysis as the assessment tool, it is

  14. Surgical site infection among patients undergone orthopaedic ...

    African Journals Online (AJOL)

    Surgical site infection among patients undergone orthopaedic surgery at Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania. ... of surgical site infection at Muhimbili Orthopedic Institute was high. This was associated with more than 2 hours length of surgery, lack of prophylaxis use, and pre-operative hospital stay.

  15. Radiodiagnosis of lung syndrome in surgical sepsis

    International Nuclear Information System (INIS)

    Dvojnykh, V.P.; Palagin, E.K.

    1991-01-01

    The results of treatment of 23 patients with acute surgical sepsis were analysed. It was shown that the X-ray examination must be obligatory in surveillance of patients with purulent foci. Two roentgenological variants are possible in surgical sepsis: central and perepheric. X-ray examinations of chest organs should be conducted every 2-3 day

  16. Assessment of Educational Environment of Surgical Theatre at a Teaching Hospital of a Saudi University: Using Surgical Theatre Educational Environment Measures

    Directory of Open Access Journals (Sweden)

    Mona Faisal Al-Qahtani

    2012-05-01

    Full Text Available Objectives: This study was aimed to determine how medical interns perceive the important factors of the learning environment the surgical theatre at the teaching hospital of the medical school, University of Dammam (UoD. The study also investigated the relationships between the learning environment and academic achievements. Finally, it determined the role and significance of gender on the above perceptions and relationships.Methods: The Surgical Theatre Educational Environment Measure (STEEM was used to identify the perceptions of interns on the most important factors prevalent in the surgical theatre as an educational environment. STEEM was administered to all interns during the period of June-September 2009. Ninety-one out of 145 students completed the questionnaire representing a response rate of 63%. Non-parametric statistical analysis was performed using Statistical Package for the Social Sciences (SPSS Version 17.Results: The STEEM was shown to be internally consistent for the assessment of the overall educational environment in the surgical theatre of UoD. The overall STEEM mean score was 110. For male and female students, the mean scores were 114 and 107 respectively. There were statistically significant gender differences in the perceptions of "learning opportunities" and "teaching and training". Females rated these subscales lower than males. There were no significant associations between academic achievements and perceptions of the educational environment.Conclusion: The interns perceived the learning environment of the surgical theatre as less than satisfactory. In comparison with the males; the perception of the females was less positive, particularly in the areas of learning opportunities, and teaching and training. The study also revealed some other problematic areas in the learning environment of surgical theatre of the teaching hospital of UoD. The results imply that there is much room for improvement. They also indicate that

  17. Prepubertal gonadectomy in cats: different surgical techniques and comparison with gonadectomy at traditional age.

    Science.gov (United States)

    Porters, N; Polis, I; Moons, C; Duchateau, L; Goethals, K; Huyghe, S; de Rooster, H

    2014-09-06

    Feasibility, surgical time and complications of different surgical techniques for prepubertal gonadectomy (PPG; 8-12 weeks of age) in cats were studied and compared to gonadectomy at traditional age (TAG; 6-8 months of age). Kittens were randomly assigned to PPG or TAG. Ovarian pedicle haemostasis for PPG was achieved by ligatures (n=47), vascular clips (n=50), bipolar electrocoagulation (n=50), or pedicle tie (n=50); for TAG (n=34) ligatures were used. In male cats, PPG consisted of closed castration by spermatic cord knot (n=92) or ligature (n=91) while TAG (n=34) was an open castration by spermatic cord knot. A linear (surgical time) and a logistic regression (complications) model were designed. Significance was set at 0.05. For female PPG, clips and coagulation were the fastest procedures; placement of ligatures was most time-consuming. In male PPG, knot placement was significantly faster than ligation. In both sexes, very few intraoperative or wound complications were observed, irrespective of the surgical technique used. Surgical times in females (ligatures) as well as in males (knot) were significantly shorter for PPG than for TAG. PPG was as safe as TAG, yet took less time to perform and did not result in a greater rate of postoperative complications. British Veterinary Association.

  18. Surgical management for displaced pediatric proximal humeral fractures: a cost analysis.

    Science.gov (United States)

    Shore, Benjamin J; Hedequist, Daniel J; Miller, Patricia E; Waters, Peter M; Bae, Donald S

    2015-02-01

    The purpose of this investigation was to determine which of the following methods of fixation, percutaneous pinning (PP) or intramedullary nailing (IMN), was more cost-effective in the treatment of displaced pediatric proximal humeral fractures (PPHF). A retrospective cohort of surgically treated PPHF over a 12-year period at a single institution was performed. A decision analysis model was constructed to compare three surgical strategies: IMN versus percutaneous pinning leaving the pins exposed (PPE) versus leaving the pins buried (PPB). Finally, sensitivity analyses were performed, assessing the cost-effectiveness of each technique when infection rates and cost of deep infections were varied. A total of 84 patients with displaced PPHF underwent surgical stabilization. A total of 35 cases were treated with IMN, 32 with PPE, and 17 with PPB. The age, sex, and preoperative fracture angulation were similar across all groups. A greater percentage of open reduction was seen in the IMN and PPB groups (p = 0.03), while a higher proportion of physeal injury was seen in the PPE group (p = 0.02). Surgical time and estimated blood loss was higher in the IMN group (p exposed implants approached 55 %. Leaving pins exposed after surgical fixation of PPHF is more cost-effective than either burying pins or using intramedullary fixation.

  19. Attitudes of Lebanese university students towards surgical hymen reconstruction.

    Science.gov (United States)

    Awwad, Johnny; Nassar, Anwar; Usta, Ihab; Shaya, Monique; Younes, Zeina; Ghazeeri, Ghina

    2013-11-01

    Many cultural and religious beliefs place virginity at a high level of social significance, in that women who lose their virginity before marriage may face humiliation, ostracism, divorce, and extreme violence. This led to an increase in the demand for virginity restoration through surgical hymen reconstruction among these cultures. However, data regarding the acceptance of hymenoplasty in societies that consider sexuality a taboo are scarce. In this cross-sectional study, we investigated the effects of gender and religion on sexual attitudes towards hymenoplasty, premarital sex, and virginity in a sample of 600 Lebanese university students. Our findings showed that approval of hymenoplasty was low among participants regardless of gender (25.7 % men vs. 19.1 % women) and religious affiliations (22.5 % Muslims vs. 22.3 % Christians). Arguments for rejection were rooted in moral ethics and personal convictions: "form of deceiving and cheating" (80.7 %) and "betrayal of honesty in the relationship" (80.4 %). Reasons for acceptance included: personal belief in "women's rights, autonomy, and freedom" (72.2 %) and "physical harm and death" (63.5 %).Male participants were more likely to approve premarital coital sex than females (61.0 vs. 27.3 %). Muslims were also more likely to reject marrying a non-virgin than Christians (39.9 vs. 18.0 %). Female participants expressed more tolerance towards marrying a non-virgin male partner (78.3 vs. 57.3 %). Low acceptance of hymenoplasty among Lebanese university students was found to be related to moral ethics and personal convictions independently from gender and religious affiliation. Differences in sexual attitudes towards premarital coital sex and virginity, however, were more significantly influenced by culture and religion.

  20. Surgical treatment for residual or recurrent strabismus

    Directory of Open Access Journals (Sweden)

    Tao Wang

    2014-12-01

    Full Text Available Although the surgical treatment is a relatively effective and predictable method for correcting residual or recurrent strabismus, such as posterior fixation sutures, medial rectus marginal myotomy, unilateral or bilateral rectus re-recession and resection, unilateral lateral rectus recession and adjustable suture, no standard protocol is established for the surgical style. Different surgical approaches have been recommended for correcting residual or recurrent strabismus. The choice of the surgical procedure depends on the former operation pattern and the surgical dosages applied on the patients, residual or recurrent angle of deviation and the operator''s preference and experience. This review attempts to outline recent publications and current opinion in the management of residual or recurrent esotropia and exotropia.

  1. The effect of fasting on surgical performance

    DEFF Research Database (Denmark)

    Schefte, David Fenger; Rosenstock, Steffen Jais

    2016-01-01

    BACKGROUND: It is unknown whether fasting has any impact on surgical performance. This simulator-based study investigates whether fasting affects surgical performance. METHODS: Twelve healthy medical students [seven women, mean age 26.5 years (range 23-34)] with no prior experience with surgical...... simulators underwent a short course introduction to the LapSim(®) simulator. After having reached a predefined level, the participants performed five simulated salpingectomies on the LapSim(®) simulator 5-30 days after the initial introduction. The procedures took place at 9 a.m. and 2 p.m. after fasting...... in the longitudinal axis with the left hand. CONCLUSION: The simulator-based study suggests that 17 h of fasting does not deteriorate surgical performance. Further studies on the effect of fasting on surgical performance are needed....

  2. Multimodal strategies to improve surgical outcome

    DEFF Research Database (Denmark)

    Kehlet, Henrik; Wilmore, Douglas W

    2002-01-01

    OBJECTIVE: To evaluate the effect of modifying perioperative care in noncardiac surgical patients on morbidity, mortality, and other outcome measures. BACKGROUND: New approaches in pain control, introduction of techniques that reduce the perioperative stress response, and the more frequent use...... anesthesia in elective operations, and pilot studies of fast track surgical procedures using the multimodality approach. RESULTS: The introduction of newer approaches to perioperative care has reduced both morbidity and mortality in surgical patients. In the future, most elective operations will become day...... surgical procedures or require only 1 to 2 days of postoperative hospitalization. Reorganization of the perioperative team (anesthesiologists, surgeons, nurses, and physical therapists) will be essential to achieve successful fast track surgical programs. CONCLUSIONS: Understanding perioperative...

  3. A Review of The Sex EDcyclopedia

    Science.gov (United States)

    Herman, Jeff; Andelloux, Megan

    2012-01-01

    While virtually all sex education books for teenagers focus on sexual health, Jo Langford's "The Sex EDcyclopedia" offers comprehensive and empowering information specifically for teen males about their sexuality and how it may be positively experienced. This review examines the strengths of "The Sex EDcyclopedia" as a sex education resource and…

  4. Buried penis: classification surgical approach.

    Science.gov (United States)

    Hadidi, Ahmed T

    2014-02-01

    The purpose of this study was to describe morphological classification of congenital buried penis (BP) and present a versatile surgical approach for correction. Sixty-one patients referred with BP were classified into 3 grades according to morphological findings: Grade 1-29 patients with Longer Inner Prepuce (LIP) only, Grade II-20 patients who presented with LIP associated with indrawn penis that required division of the fundiform and suspensory ligaments, and Grade III-12 patients who had in addition to the above, excess supra-pubic fat. A ventral midline penile incision extending from the tip of prepuce down to the penoscrotal junction was used in all patients. The operation was tailored according to the BP Grade. All patients underwent circumcision. Mean follow up was 3 years (range 1 to 10). All 61 patients had an abnormally long inner prepuce (LIP). Forty-seven patients had a short penile shaft. Early improvement was noted in all cases. Satisfactory results were achieved in all 29 patients in grade I and in 27 patients in grades II and III. Five children (Grades II and III) required further surgery (9%). Congenital buried penis is a spectrum characterized by LIP and may include in addition; short penile shaft, abnormal attachment of fundiform, and suspensory ligaments and excess supra-pubic fat. Congenital Mega Prepuce (CMP) is a variant of Grade I BP, with LIP characterized by intermittent ballooning of the genital area. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Surgical treatment of radiation enteritis

    Energy Technology Data Exchange (ETDEWEB)

    Cross, M.J.; Frazee, R.C. (Department of General Surgery, Scott and White Memorial Hospital, Temple TX (United States))

    1992-02-01

    Radiation enteritis is a progressive, disease process that causes intestinal fibrosis and obliterative endarteritis, which results in significant morbidity and mortality. The authors' clinical experience involving 20 patients over a 22-year period from 1967 through 1989 who underwent various surgical procedures to alleviate chronic symptoms secondary to radiation enteritis is described. Eight men and 12 women with a mean age of 52 years (24 to 81 years) underwent a total of 27 procedures for complications of radiation enteritis. Radiation therapy was delivered for treatment of gynecologic malignancies (55%), colorectal cancer (20%), prostate malignancies (10%), and others (15%). The mean average dose of radiation delivered was 5,514 rads with a range of 2,613 to 7,000 rads. The interval from radiation treatment to time of surgery averaged 9 years. Operative procedures consisted of 12 resection and primary anastomosis procedures and 15 resections with stoma creation. Formation of a stoma was used in patients with more severe disease. The 30-day operative mortality was 0% and morbidity was 55%. There were no anastomotic leaks or intra-abdominal abscesses. The authors conclude that resection and primary anastomosis can safely be performed in selected patients but that judicious use of stoma formation can avoid major mortality and morbidity associated with surgery in this setting.

  6. Surgical treatment of radiation enteritis

    International Nuclear Information System (INIS)

    Cross, M.J.; Frazee, R.C.

    1992-01-01

    Radiation enteritis is a progressive, disease process that causes intestinal fibrosis and obliterative endarteritis, which results in significant morbidity and mortality. The authors' clinical experience involving 20 patients over a 22-year period from 1967 through 1989 who underwent various surgical procedures to alleviate chronic symptoms secondary to radiation enteritis is described. Eight men and 12 women with a mean age of 52 years (24 to 81 years) underwent a total of 27 procedures for complications of radiation enteritis. Radiation therapy was delivered for treatment of gynecologic malignancies (55%), colorectal cancer (20%), prostate malignancies (10%), and others (15%). The mean average dose of radiation delivered was 5,514 rads with a range of 2,613 to 7,000 rads. The interval from radiation treatment to time of surgery averaged 9 years. Operative procedures consisted of 12 resection and primary anastomosis procedures and 15 resections with stoma creation. Formation of a stoma was used in patients with more severe disease. The 30-day operative mortality was 0% and morbidity was 55%. There were no anastomotic leaks or intra-abdominal abscesses. The authors conclude that resection and primary anastomosis can safely be performed in selected patients but that judicious use of stoma formation can avoid major mortality and morbidity associated with surgery in this setting

  7. [Surgical treatment of anal fistula].

    Science.gov (United States)

    Zeng, Xiandong; Zhang, Yong

    2014-12-01

    Anal fistula is a common disease. It is also quite difficult to be solved without recurrence or damage to the anal sphincter. Several techniques have been described for the management of anal fistula, but there is no final conclusion of their application in the treatment. This article summarizes the history of anal fistula management, the current techniques available, and describes new technologies. Internet online searches were performed from the CNKI and Wanfang databases to identify articles about anal fistula management including seton, fistulotomy, fistulectomy, LIFT operation, biomaterial treatment and new technology application. Every fistula surgery technique has its own place, so it is reasonable to give comprehensive individualized treatment to different patients, which may lead to reduced recurrence and avoidance of damage to the anal sphincter. New technologies provide promising alternatives to traditional methods of management. Surgeons still need to focus on the invention and improvement of the minimally invasive techniques. Besides, a new therapeutic idea is worth to explore that the focus of surgical treatment should be transferred to prevention of the formation of anal fistula after perianal abscess.

  8. Audit of Orthopaedic Surgical Documentation

    Directory of Open Access Journals (Sweden)

    Fionn Coughlan

    2015-01-01

    Full Text Available Introduction. The Royal College of Surgeons in England published guidelines in 2008 outlining the information that should be documented at each surgery. St. James’s Hospital uses a standard operation sheet for all surgical procedures and these were examined to assess documentation standards. Objectives. To retrospectively audit the hand written orthopaedic operative notes according to established guidelines. Methods. A total of 63 operation notes over seven months were audited in terms of date and time of surgery, surgeon, procedure, elective or emergency indication, operative diagnosis, incision details, signature, closure details, tourniquet time, postop instructions, complications, prosthesis, and serial numbers. Results. A consultant performed 71.4% of procedures; however, 85.7% of the operative notes were written by the registrar. The date and time of surgery, name of surgeon, procedure name, and signature were documented in all cases. The operative diagnosis and postoperative instructions were frequently not documented in the designated location. Incision details were included in 81.7% and prosthesis details in only 30% while the tourniquet time was not documented in any. Conclusion. Completion and documentation of operative procedures were excellent in some areas; improvement is needed in documenting tourniquet time, prosthesis and incision details, and the location of operative diagnosis and postoperative instructions.

  9. Sex work: a comparative study.

    Science.gov (United States)

    McCarthy, Bill; Benoit, Cecilia; Jansson, Mikael

    2014-10-01

    Explanations of adult involvement in sex work typically adopt one of two approaches. One perspective highlights a variety of negative experiences in childhood and adolescence, including physical and sexual abuse, family instability, poverty, associations with "pimps" and other exploiters, homelessness, and drug use. An alternative account recognizes that some of these factors may be involved, but underscores the contribution of more immediate circumstances, such as current economic needs, human capital, and employment opportunities. Prior research offers a limited assessment of these contrasting claims: most studies have focused exclusively on people working in the sex industry and they have not assessed the independent effects of life course variables central to these two perspectives. We add to this literature with an analysis that drew on insights from life course and life-span development theories and considered the contributions of factors from childhood, adolescence, and adulthood. Our comparative approach examined predictors of employment in sex work relative to two other low-income service or care work occupations: food and beverage serving and barbering and hairstyling. Using data from a study of almost 600 workers from two cities, one in Canada and the other in the United States, we found that both immediate circumstances and negative experiences from early life are related to current sex work involvement: childhood poverty, abuse, and family instability were independently associated with adult sex work, as were limited education and employment experience, adult drug use, and marital status.

  10. Surgical Outcomes After Open, Laparoscopic, and Robotic Gastrectomy for Gastric Cancer.

    Science.gov (United States)

    Yang, Seung Yoon; Roh, Kun Ho; Kim, You-Na; Cho, Minah; Lim, Seung Hyun; Son, Taeil; Hyung, Woo Jin; Kim, Hyoung-Il

    2017-07-01

    In contrast to the significant advantages of laparoscopic versus open gastrectomy, robotic gastrectomy has shown little benefit over laparoscopic gastrectomy. This study aimed to compare multi-dimensional aspects of surgical outcomes after open, laparoscopic, and robotic gastrectomy. Data from 915 gastric cancer patients who underwent gastrectomy by one surgeon between March 2009 and May 2015 were retrospectively reviewed. Perioperative parameters were analyzed for short-term outcomes. Surgical success was defined as the absence of conversion to open surgery, major complications, readmission, positive resection margin, or fewer than 16 retrieved lymph nodes. This study investigated 241 patients undergoing open gastrectomy, 511 patients undergoing laparoscopic gastrectomy, and 173 patients undergoing robotic gastrectomy. For each approach, the respective incidences were as follows: conversion to open surgery (not applicable, 0.4%, and 0%; p = 0.444), in-hospital major complications (5.8, 2.7, and 1.2%; p = 0.020), delayed complications requiring readmission (2.9, 2.0, and 1.2%; p = 0.453), positive resection margin (1.7, 0, and 0%; p = 0.003), and inadequate number of retrieved lymph nodes (0.4, 4.1, and 1.7%; p = 0.010). Compared with open and laparoscopic surgery, robotic gastrectomy had the highest surgical success rate (90, 90.8, and 96.0%). Learning-curve analysis of success using cumulative sum plots showed success with the robotic approach from the start. Multivariate analyses identified age, sex, and gastrectomy extent as significant independent parameters affecting surgical success. Surgical approach was not a contributing factor. Open, laparoscopic, and robotic gastrectomy exhibited different incidences and causes of surgical failure. Robotic gastrectomy produced the best surgical outcomes, although the approach method itself was not an independent factor for success.

  11. Sex selection: treating different cases differently.

    Science.gov (United States)

    Dickens, B M; Serour, G I; Cook, R J; Qiu, R-Z

    2005-08-01

    This paper contrasts ethical approaches to sex selection in countries where discrimination against women is pervasive, resulting in selection against girl children, and in countries where there is less general discrimination and couples do not prefer children of either sex. National sex ratio imbalances where discrimination against women is common have resulted in laws and policies, such as in India and China, to deter and prevent sex selection. Birth ratios of children can be affected by techniques of prenatal sex determination and abortion, preconception sex selection and discarding disfavored embryos, and prefertilization sperm sorting, when disfavored sperm remain unused. Incentives for son preference are reviewed, and laws and policies to prevent sex selection are explained. The elimination of social, economic and other discrimination against women is urged to redress sex selection against girl children. Where there is no general selection against girl children, sex selection can be allowed to assist families that want children of both sexes.

  12. Journal of Surgical Technique and Case Report: Editorial Policies

    African Journals Online (AJOL)

    Focus and Scope. The aim of Journal of Surgical Technique and Case Report is to advance surgical knowledge and practice by promoting the reporting of innovative and reproducible surgical techniques and illustrative surgical cases on various surgical disciplines. The journal encourages authoritative synthesis of current ...

  13. Wrong-Site Surgery, Retained Surgical Items, and Surgical Fires : A Systematic Review of Surgical Never Events.

    Science.gov (United States)

    Hempel, Susanne; Maggard-Gibbons, Melinda; Nguyen, David K; Dawes, Aaron J; Miake-Lye, Isomi; Beroes, Jessica M; Booth, Marika J; Miles, Jeremy N V; Shanman, Roberta; Shekelle, Paul G

    2015-08-01

    Serious, preventable surgical events, termed never events, continue to occur despite considerable patient safety efforts. To examine the incidence and root causes of and interventions to prevent wrong-site surgery, retained surgical items, and surgical fires in the era after the implementation of the Universal Protocol in 2004. We searched 9 electronic databases for entries from 2004 through June 30, 2014, screened references, and consulted experts. Two independent reviewers identified relevant publications in June 2014. One reviewer used a standardized form to extract data and a second reviewer checked the data. Strength of evidence was established by the review team. Data extraction was completed in January 2015. Incidence of wrong-site surgery, retained surgical items, and surgical fires. We found 138 empirical studies that met our inclusion criteria. Incidence estimates for wrong-site surgery in US settings varied by data source and procedure (median estimate, 0.09 events per 10,000 surgical procedures). The median estimate for retained surgical items was 1.32 events per 10,000 procedures, but estimates varied by item and procedure. The per-procedure surgical fire incidence is unknown. A frequently reported root cause was inadequate communication. Methodologic challenges associated with investigating changes in rare events limit the conclusions of 78 intervention evaluations. Limited evidence supported the Universal Protocol (5 studies), education (4 studies), and team training (4 studies) interventions to prevent wrong-site surgery. Limited evidence exists to prevent retained surgical items by using data-matrix-coded sponge-counting systems (5 pertinent studies). Evidence for preventing surgical fires was insufficient, and intervention effects were not estimable. Current estimates for wrong-site surgery and retained surgical items are 1 event per 100,000 and 1 event per 10,000 procedures, respectively, but the precision is uncertain, and the per

  14. Mobile surgical skills education unit: a new concept in surgical training.

    Science.gov (United States)

    Shaikh, Faisal M; Hseino, Hazem; Hill, Arnold D K; Kavanagh, Eamon; Traynor, Oscar

    2011-08-01

    Basic surgical skills are an integral part of surgical training. Simulation-based surgical training offers an opportunity both to trainees and trainers to learn and teach surgical skills outside the operating room in a nonpatient, nonstressed environment. However, widespread adoption of simulation technology especially in medical education is prohibited by its inherent higher cost, limited space, and interruptions to clinical duties. Mobile skills laboratory has been proposed as a means to address some of these limitations. A new program is designed by the Royal College of Surgeons in Ireland (RCSI), in an approach to teach its postgraduate basic surgical trainees the necessary surgical skills, by making the use of mobile innovative simulation technology in their own hospital settings. In this article, authors describe the program and students response to the mobile surgical skills being delivered in the region of their training hospitals and by their own regional consultant trainers.

  15. Comparison of three surgical treatment options for unicameral bone cysts in humerus.

    Science.gov (United States)

    Mavčič, Blaž; Saraph, Vinay; Gilg, Magdalena M; Bergovec, Marko; Brecelj, Janez; Leithner, Andreas

    2018-04-23

    Treatment of unicameral bone cysts (UBC) in the humerus with drainage screws is scarcely reported in the literature. The aim of this retrospective study was to compare drainage screws and alternative treatment methods with respect to the number of required surgical procedures to achieve sufficient UBC healing, postoperative fractures/recurrences/complications, and radiological outcome. Medical archives of two tertiary orthopedic referral centers were screened for all patients who were treated surgically for humeral UBC in the period 1991-2015 with a histologically/cytologically confirmed diagnosis. Sex, age, all surgical procedures, fractures, complications, recurrences, and the final radiological outcome were compared between patients treated with drainage screws, elastic intramedullary nails, or curettage with optional grafting. The study included 106 operated patients with a mean age of 10.3 years, with a mean follow-up of 5.7 years. The average number of UBC-related surgical procedures in sex-matched and age-matched treatment groups was 2.7 with drainage screws, 2.8 with intramedullary nails, and 3.5 with curettage/grafting (P=0.54). Intramedullary nails (odds ratio 0.20) and older age (odds ratio for each year 0.83) predicted a lower risk of postoperative UBC recurrence. Patients with drainage screws had the highest UBC recurrence rates and the lowest rates of changed initial treatment method. There was no difference between the treatment groups in the postoperative fracture rate, complications, or the final radiological outcome. UBC treatment in the humerus therefore requires approximately three surgical procedures, irrespective of the treatment modality chosen. Adding an elastic intramedullary nail to a humeral UBC cyst may reduce recurrence risk and prevent further fractures. Level III - therapeutic retrospective comparative study.

  16. STUDY OF THE CLINICAL PROFILE AND AETIOLOGY OF VARIOUS DISORDERS OF SEX DEVELOPMENT PRESENTING TO ENDOCRINE OPD OF A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Ipsita Mishra

    2017-10-01

    only in terms of gender role, identity and sex reassignment, but also in terms of fertility issues, social acceptance and risk of gonadal malignancy in certain subtypes.

  17. Sex hormone binding globulin phenotypes

    DEFF Research Database (Denmark)

    Cornelisse, M M; Bennett, Patrick; Christiansen, M

    1994-01-01

    Human sex hormone binding globulin (SHBG) is encoded by a normal and a variant allele. The resulting SHBG phenotypes (the homozygous normal SHBG, the heterozygous SHBG and the homozygous variant SHBG phenotype) can be distinguished by their electrophoretic patterns. We developed a novel detection....... This method of detection was used to determine the distribution of SHBG phenotypes in healthy controls of both sexes and in five different pathological conditions characterized by changes in the SHBG level or endocrine disturbances (malignant and benign ovarian neoplasms, hirsutism, liver cirrhosis...... on the experimental values. Differences in SHBG phenotypes do not appear to have any clinical significance and no sex difference was found in the SHBG phenotype distribution....

  18. Sex differences in cough reflex.

    Science.gov (United States)

    Plevkova, J; Buday, T; Kavalcikova-Bogdanova, N; Ioan, I; Demoulin-Alexikova, S

    2017-11-01

    Majority of patients visiting cough clinics are postmenopausal women, who are affected by intractable cough for years. Why the cough reflex becomes exaggerated in women is not known. Basic research excludes females from the studies contributing to the sex bias which may be responsible for lack of understanding of "hypersensitive" cough in women. Biological and behavioural differences between women and men are the factors affecting cough physiology. Gender also shapes the patterns of behaviour and determines the character of environmental exposures which differs between sexes. The article offers an insight into the physiology of the cough, differences in the maturation of it and biological, social and behavioural factors contributing to the sex differences in cough. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Incarcerated Dutch Juvenile Sex Offenders Compared with Non-Sex Offenders

    Science.gov (United States)

    van Wijk, Anton Ph.; Vreugdenhil, Coby; van Horn, Joan; Vermeiren, Robert; Doreleijers, Theo A. H.

    2007-01-01

    There is some debate about whether or not sex offenders are similar to non-sex offenders with regard to family background (parental characteristics), personality, and psychopathology. The central aim of this study focused on the comparison of juvenile sex offenders and non-sex offenders. The sample consisted of incarcerated juvenile male sex (n =…

  20. The Stability of Same-Sex Cohabitation, Different-Sex Cohabitation, and Marriage

    Science.gov (United States)

    Lau, Charles Q.

    2012-01-01

    This study contributes to the emerging demographic literature on same-sex couples by comparing the level and correlates of union stability among 4 types of couples: (a) male same-sex cohabitation, (b) female same-sex cohabitation, (c) different-sex cohabitation, and (d) different-sex marriage. The author analyzed data from 2 British birth cohort…

  1. A review of clinical approaches to gender dysphoria.

    Science.gov (United States)

    Brown, G R

    1990-02-01

    Gender dysphoric patients are not infrequently encountered in the clinical practice of psychiatry. A comprehensive review of the world literature reveals that the systematic study of severe gender disorders--as exemplified by transsexualism--is relatively new, consisting of just over 25 years of collective experience. While the formal diagnosis of transsexualism is rare, this disorder represents the most severe form of the gender dysphoric conditions. Many nontranssexual patients with a variety of other psychiatric disorders present to psychiatrists desperately requesting somatic treatments (cross-gender hormones, sex reassignment surgery, and other cosmetic surgical procedures). A lengthy differential diagnosis needs to be considered, and a specialized approach to interviewing gender dysphoric patients is highly recommended. Available treatments and their efficacy are discussed. Large prospective controlled studies of treatments for gender dysphoria, such as sex reassignment surgery and psychotherapy, are lacking. Countertransference issues are noted to be particularly relevant in the care of gender dysphoric individuals.

  2. Three-Dimensional Printing Surgical Applications.

    Science.gov (United States)

    AlAli, Ahmad B; Griffin, Michelle F; Butler, Peter E

    2015-01-01

    Three-dimensional printing, a technology used for decades in the industrial field, gains a lot of attention in the medical field for its potential benefits. With advancement of desktop printers, this technology is accessible and a lot of research is going on in the medical field. To evaluate its application in surgical field, which may include but not limited to surgical planning, surgical education, implants, and prosthesis, which are the focus of this review. Research was conducted by searching PubMed, Web of science, and other reliable sources. We included original articles and excluded articles based on animals, those more than 10 years old, and those not in English. These articles were evaluated, and relevant studies were included in this review. Three-dimensional printing shows a potential benefit in surgical application. Printed implants were used in patient in a few cases and show successful results; however, longer follow-up and more trials are needed. Surgical and medical education is believed to be more efficient with this technology than the current practice. Printed surgical instrument and surgical planning are also believed to improve with three-dimensional printing. Three-dimensional printing can be a very powerful tool in the near future, which can aid the medical field that is facing a lot of challenges and obstacles. However, despite the reported results, further research on larger samples and analytical measurements should be conducted to ensure this technology's impact on the practice.

  3. Surgical care in the isolated military hospital.

    Science.gov (United States)

    Lukish, J R; Gill, G G; McCoy, T R

    2001-01-01

    To maintain the health of service members and their families throughout the world, the Department of Defense has established several isolated military hospitals (IHs). The operational environment of IHs is such that illness and traumatic injury requiring surgical intervention is common. This study sought to examine the general and orthopedic surgical experience at an IH to determine whether surgical care could be provided in an effective and safe manner. All patients evaluated by the general and orthopedic surgeon at Guantanamo Bay Naval Hospital from October 1, 1998, to April 1, 1999, were included in this study. The following data were retrospectively reviewed: patient demographic data, diagnosis, initial and follow-up care, medical evacuation data, operative procedures, and complications. There were 336 patients who presented for surgical evaluation, resulting in 660 follow-up appointments during the study period. There were 31 medical evacuations (3 emergent). The surgical services performed 122 major operative procedures. There were 58 inpatient admissions. There was 1 death, and surgical complications occurred in 2 patients, for an overall morbidity and mortality of 1.4% and 0.7%, respectively. Our data show that an IH is capable of providing surgical care, including care for traumatic injuries, in a safe manner. This is the first study that provides objective evidence that general and orthopedic surgery at an IH can be provided within the standard of care.

  4. Do psychological variables affect early surgical recovery?

    Directory of Open Access Journals (Sweden)

    Michael N Mavros

    Full Text Available BACKGROUND: Numerous studies have examined the effect of psychological variables on surgical recovery, but no definite conclusion has been reached yet. We sought to examine whether psychological factors influence early surgical recovery. METHODS: We performed a systematic search in PubMed, Scopus and PsycINFO databases to identify studies examining the association of preoperative psychological variables or interventions with objectively measured, early surgical outcomes. RESULTS: We identified 16 eligible studies, 15 of which reported a significant association between at least one psychological variable or intervention and an early postoperative outcome. However, most studies also reported psychological factors not influencing surgical recovery and there was significant heterogeneity across the studies. Overall, trait and state anxiety, state anger, active coping, subclinical depression, and intramarital hostility appeared to complicate recovery, while dispositional optimism, religiousness, anger control, low pain expectations, and external locus of control seemed to promote healing. Psychological interventions (guided relaxation, couple support visit, and psychiatric interview also appeared to favor recovery. Psychological factors unrelated to surgical outcomes included loneliness, perceived social support, anger expression, and trait anger. CONCLUSION: Although the heterogeneity of the available evidence precludes any safe conclusions, psychological variables appear to be associated with early surgical recovery; this association could bear important implications for clinical practice. Large clinical trials and further analyses are needed to precisely evaluate the contribution of psychology in surgical recovery.

  5. Mastoidectomy: anatomical parameters x surgical difficulty

    Directory of Open Access Journals (Sweden)

    Pereira Júnior, Anastácio Rodrigues

    2012-01-01

    Full Text Available Introduction: The lowered temporal meninges and/ or anterior sigmoid sinus are contiditions that can determine surgical difficulties in performing mastoidectomy. Objective: To correlate in the tomography the extent of the prolapse of the sigmoid sinus and of temporal meninges with the surgical difficulty in the mastoidectomy. Method: The tomographic measurements of prolapse sigmoid and of temporal meninges were correlated with the presence or non-presence of the surgical difficulty observed during the mastoidectomy procedure in patients with ostomatoiditis chronic (n=30. Form of study: Contemporary cohort transverse. Results: In 10 patients were observed surgical difficulty distributed as: due to prolapse of the sigmoid sinus (n = 2 or temporal meninges prolapse (n = 7 or both (n = 1. In patients in which the surgical difficulty was due to sigmoid sinus prolapse, the tomography distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm. In patients in which surgical difficulty was due to temporal meninges prolapse, the tomographic distance to the upper plane of the petrous bone was 7 mm. Conclusion: The computerized tomography distance between the temporal meninges and the upper plane of the petrous bone 7 mm and the distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm are predictive to the surgical difficulties to perform mastoidectomy.

  6. Learning about Sex: Resource Guide for Sex Educators. Revised Edition

    Science.gov (United States)

    Huberman, Barbara

    2011-01-01

    Whether you are someone new to the field of sex education, trying to start a library or resource center on adolescent sexual health, or an old pro, this guide should give you a basic orientation to what's available to support your work. These resources are important to advancing positive attitudes toward adolescent sexual health and the author…

  7. Sex Education: Talking to Your Teen about Sex

    Science.gov (United States)

    ... might miss the best opportunities. Instead, think of sex education as an ongoing conversation. Here are some ideas to help you get started — and keep the discussion going. Seize the moment. When a TV program or music video raises issues about responsible sexual behavior, use it ...

  8. Sex differences and sex similarities in disgust sensitivity

    NARCIS (Netherlands)

    Tybur, J.M.; Bryan, A.D.; Lieberman, D.L.; Caldwell Hooper, A.E.; Merriman, L.A.

    2011-01-01

    Across two studies, we test for sex differences in the factor structure, factor loadings, concurrent validity, and means of the Three Domain Disgust Scale. In Study 1, we find that the Three Domain Disgust Scale has indistinguishable factor structure and factor loadings for men and women. In Study

  9. Elusive Sex Acts: Pleasure and Politics in Norwegian Sex Education

    Science.gov (United States)

    Svendsen, Stine H. Bang

    2012-01-01

    While there is little political opposition towards sex education as such in Norway, recent attempts at reforming the subject reveal underlying heteronormative presumptions that seem resistant to reform. While a focus on homosexuality is included in the national curriculum at all levels of compulsory education, the sexual practices involved in…

  10. Destabilising Sex work and Intimacy?

    DEFF Research Database (Denmark)

    Spanger, Marlene

    politikfelt prostitution. Undersøgelsen trækker på poststrukturalistisk feministisk teori og er baseret på interviews med kvindelige thailandske migranter, der sælger sex, og socialarbejdere samt deltagende observationer og diverse dokumenter. Afhandlingen falder i to dele. Den første del er rammen for de...... fire artikler, som består af en introduktion, en teoretisk ramme, metodeovervejelser og konklusion samt et overordnet forskningsspørgsmål: Hvordan destabiliserer og reproducerer kvindelige thailandske migranter, der sælger sex i Danmark, det danske prostitutionspolitikfelts kategorier ’sexarbejde’ og...

  11. Beard reconstruction: A surgical algorithm.

    Science.gov (United States)

    Ninkovic, M; Heidekrueger, P I; Ehrl, D; von Spiegel, F; Broer, P N

    2016-06-01

    Facial defects with loss of hair-bearing regions can be caused by trauma, infection, tumor excision, or burn injury. The presented analysis evaluates a series of different surgical approaches with a focus on male beard reconstruction, emphasizing the role of tissue expansion of regional and free flaps. Locoregional and free flap reconstructions were performed in 11 male patients with 14 facial defects affecting the hair-bearing bucco-mandibular or perioral region. In order to minimize donor-site morbidity and obtain large amounts of thin, pliable, hair-bearing tissue, pre-expansion was performed in five of 14 patients. Eight of 14 patients were treated with locoregional flap reconstructions and six with free flap reconstructions. Algorithms regarding pre- and intraoperative decision making are discussed and long-term (mean follow-up 1.5 years) results analyzed. Major complications, including tissue expander infection with the need for removal or exchange, partial or full flap loss, occurred in 0% (0/8) of patients with locoregional flaps and in 17% (1/6) of patients undergoing free flap reconstructions. Secondary refinement surgery was performed in 25% (2/8) of locoregional flaps and in 67% (4/6) of free flaps. Both locoregional and distant tissue transfers play a role in beard reconstruction, while pre-expansion remains an invaluable tool. Paying attention to the presented principles and considering the significance of aesthetic facial subunits, range of motion, aesthetics, and patient satisfaction were improved long term in all our patients while minimizing donor-site morbidity. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. Surgical management of radiation enterocolitis

    International Nuclear Information System (INIS)

    Ieda, Katsuyuki; Katsumi, Masaharu; Ura, Shinzoh

    1980-01-01

    We reviewed 17 cases of severe radiation enterocolitis caused by tele-cobalt treatment for pelvic malignancies. They consisted of six males and nine females, ranging from 32 to 77 years old. The duration between the completion of radiation and the onset of symptoms varied from two months to ten years. Only two cases of them were treated conservatively and the other 15 cases were managed surgically. Six cases of the latter underwent an urgent surgery because of severe obstructive symptoms. Totally, 19 injuries to the intestine were revealed. The ileum was involved in eight patients, the rectum in seven and the sigmoid colon in four. Operative procedures carried out were intestinal resection with primary anastomosis in seven, colostomy alone in six and bypass operation in three. The resected segments of the ileum measured 40 cm long in two and 70 cm, 90 cm and 100 cm long in three respectively and the resected segments of the colon measured 15 cm and 45 cm long respectively. Three out of the seven cases with bowel resection were reconstructed with Gambee's single layer anastomosis and four with Albert-Lembert's two layer anastomosis. Type of anastomosis was end-to-end in six and end-to-side in one. Three cases underwent bypass operations because the injured intestines were densely adhered to the surroundings. Only one minor leakage occurred in seven primary anastomosis. Radiation doses ranged from 3000 to 9300 R. There was no relation between doses and severity of damage, clinical symptoms and site of injuries. There was no malignant findings around the damaged intestine. Many of the literatures report a high anastomotic leak in radiation enterocolitis, primary anastomosis can be carried out more safely if wide resection and reasonable anastomosis are performed. (author)

  13. Surgical patient selection and counseling.

    Science.gov (United States)

    Ziegelmann, Matt; Köhler, Tobias S; Bailey, George C; Miest, Tanner; Alom, Manaf; Trost, Landon

    2017-08-01

    The objectives of patient selection and counseling are ultimately to enhance successful outcomes. However, the definition for success is often narrowly defined in published literature (ability to complete surgery, complications, satisfaction) and fails to account for patient desires and expectations, temporal changes, natural history of underlying diseases, or independent validation. Factors associated with satisfaction and dissatisfaction are often surgery-specific, although correlation with pre-operative expectations, revisions, and complications are common with most procedures. The process of appropriate patient selection is determined by the integration of patient and surgeon factors, including psychological capacity to handle unsatisfactory results, baseline expectations, complexity of case, and surgeon volume and experience. Using this model, a high-risk scenario includes one in which a low-volume surgeon performs a complex case in a patient with limited psychological capacity and high expectations. In contrast, a high-volume surgeon performing a routine case in a male with low expectations and abundant psychiatric reserve is more likely to achieve a successful outcome. To further help identify patients who are at high risk for dissatisfaction, a previously published mnemonic is recommended: CURSED Patient (compulsive/obsessive, unrealistic, revision, surgeon shopping, entitled, denial, and psychiatric). Appropriate patient counseling includes setting appropriate expectations, reviewing the potential and anticipated risks of surgery, post-operative instruction to limit complications, and long-term follow-up. As thorough counseling is often a time-consuming endeavor, busy practices may elect to utilize various resources including educational materials, advanced practice providers, or group visits, among others. The consequences for poor patient selection and counseling may range from poor surgical outcomes and patient dissatisfaction to lawsuits, loss of

  14. [Quality of surgical continuing education in Germany].

    Science.gov (United States)

    Ansorg, J; Hassan, I; Fendrich, V; Polonius, M J; Rothmund, M; Langer, P

    2005-03-11

    One of the reasons for young doctors to leave the clinical work to go abroad or into non-clinical fields is insufficient quality of training under bad circumstances. Aim of the study was to evaluate the surgical training in Germany from the viewpoint of the residents. A questionnaire was prepared by residents and consultants and approved by the German surgical societies (Deutsche Gesellschaft fur Chirurgie und Berufsverband der Deutschen Chirurgen). It was sent to surgical residents between June 2003 and June 2004, published in "Der Chirurg BDC" and distributed among residents taking part in courses conducted by the BDC. It could be answered anonymously by email, mail or online. The questionnaire was sent back by 584 surgical residents (about 30 % of all). 58 % of the residents declared that they finished the training in the intended time (6 years). Rotation-systems as part of a structured residency program existed for 43 %. Standard surgical procedures were discussed or explained before the procedure in only 46 %. 61 % of the residents were not satisfied with the teaching assistance by their clinical teachers in the OR. Only 33 % had regular talks with the Chief about their progress in surgical training. 18 % of residents felt, that the hospital is interested in their progress in training. Indication-conferences took place in 52 % and mortality-conferences in only 20 % of programs. Regular seminars on recent issues took place in 62 %, and 61 % of residents did not get financial support to attend congresses. 36 % of residents had to use their holidays to attend congresses. Surgical training structures are not well established in about 50 % of the training hospitals from where we got answers to our survey. The training potential of daily surgical work is not used appropriately. It is therefore imperative to develop guidelines for surgical training, the use of log-books and rotation-programs.

  15. Factors influencing the surgical decision for the treatment of degenerative lumbar stenosis in a preference-based shared decision-making process.

    Science.gov (United States)

    Kim, Ho-Joong; Park, Jae-Young; Kang, Kyoung-Tak; Chang, Bong-Soon; Lee, Choon-Ki; Yeom, Jin S

    2015-02-01

    In a preference-based shared decision-making system, several subjective and/or objective factors such as pain severity, degree of disability, and the radiological severity of canal stenosis may influence the final surgical decision for the treatment of lumbar spinal stenosis (LSS). However, our understanding of the shared decision-making process and the significance of each factor remain primitive. In the present study, we aimed to investigate which factors influence the surgical decision for the treatment of LSS when using a preference-based, shared decision-making process. We included 555 patients, aged 45-80 years, who used a preference-based shared decision-making process and were treated conservatively or surgically for chronic leg and/or back pain caused by LSS from April 2012 to December 2012. Univariate and multivariable-adjusted logistic regression analyses were used to assess the association of surgical decision making with age, sex, body mass index, symptom duration, radiologic stenotic grade, Oswestry Disability Index (ODI), visual analog scale (VAS) scores for back and leg pain, Short Form-36 (SF-36) subscales, and motor weakness. In univariate analysis, the following variables were associated with a higher odds of a surgical decision for LSS: male sex; the VAS score for leg pain; ODI; morphological stenotic grades B, C, and D; motor weakness; and the physical function, physical role, bodily pain, social function, and emotional role of the SF-36 subscales. Multivariate analysis revealed that male sex, ODI, morphological stenotic grades C and D, and motor weakness were significantly associated with a higher possibility of a surgical decision. Motor weakness, male sex, morphological stenotic grade, and the amount of disability are critical factors leading to a surgical decision for LSS when using a preference-based shared decision-making process.

  16. AIDS prevention in the sex industry.

    Science.gov (United States)

    Morgan-thomas, R; Overs, C

    1992-01-01

    Most sex work research examines the impact of HIV on prostitutes and on society and involves testing prostitutes for HIV antibodies, but it does not examine the role of others in the sex industry. Sex industry workers include female prostitutes, transvestites, transsexuals, and male prostitutes, bar and brothel owners, taxi drivers, sex workers' partners, and sex business managers. Since sex workers provide sexual services to clients, they are in a perfect position to teach them about sexual health. Society must recognize that we cannot wish the sex industry away and that we need an effective health promotion strategy now. Some successful relevant AIDS education campaigns provide us some guidelines on how to develop campaigns. Any campaign targeting the sex industry should also target the public. Sex workers should participate in developing health messages and educational activities. They should also participate in the project. Any campaign must deal with major obstacles to safer sexual practices of which sex workers are aware and be consulted. Common obstacles are client demand for unprotected sex and irregular and inadequate supply of inexpensive condoms. A health promotion strategy cannot be effective, however, if sex workers do not have access to social support and health care services. Health promotion workers should also encourage local authorities to end discrimination of sex workers so they can freely obtain needed services. In some countries, sex workers operate fantasy workshops providing peers with ideas to sell sex services which reduce the risk of HIV transmission. Other campaigns distribute safer sex messages on small cards, cigarette lighters, key rings, condom packages, and T shirts. Training of sex workers other than prostitutes to reinforce safer sex messages to clients is also effective, e.g., taxi drivers can say they will take a client to a woman who uses condoms rather than to a clean girl. Street theater and puppets have also successfully

  17. Retained Surgical Foreign Bodies after Surgery

    Directory of Open Access Journals (Sweden)

    Valon A. Zejnullahu

    2017-01-01

    Full Text Available The problem of retained surgical bodies (RSB after surgery is an issue for surgeons, hospitals and the entire medical team. They have potentially harmful consequences for the patient as they can be life threatening and usually, a further operation is necessary. The incidence of RSB is between 0.3 to 1.0 per 1,000 abdominal operations, and they occur due to a lack of organisation and communication between surgical staff during the process. Typically, the RSB are surgical sponges and instruments located in the abdomen, retroperitoneum and pelvis.

  18. Assessment of Surgical Skills and Competency.

    Science.gov (United States)

    Bhatti, Nasir I

    2017-10-01

    Evaluation of surgical skills and competency are important aspects of the medical education process. Measurable and reproducible methods of assessment with objective feedback are essential components of surgical training. Objective Structured Assessment of Technical Skills (OSATS) is widely used across the medical specialties and otolaryngology-specific tools have been developed and validated for sinus and mastoid surgery. Although assessment of surgical skills can be time-consuming and requires human and financial resources, new evaluation methods and emerging technology may alleviate these barriers while also improving data collection practices. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Simulators and virtual reality in surgical education.

    Science.gov (United States)

    Chou, Betty; Handa, Victoria L

    2006-06-01

    This article explores the pros and cons of virtual reality simulators, their abilities to train and assess surgical skills, and their potential future applications. Computer-based virtual reality simulators and more conventional box trainers are compared and contrasted. The virtual reality simulator provides objective assessment of surgical skills and immediate feedback further to enhance training. With this ability to provide standardized, unbiased assessment of surgical skills, the virtual reality trainer has the potential to be a tool for selecting, instructing, certifying, and recertifying gynecologists.

  20. Surgical Site Infection Rate and Risk Factors among Obstetric Cases ...

    African Journals Online (AJOL)

    2009-04-01

    Among surgical patients in obstetrics, Surgical Site Infections were the most ... for delivery from April 1, 2009 to March 31, 2010 in obstetric ward of the Hospital. ... applying improved surgical techniques and improving infection prevention ...

  1. SAGES TAVAC safety and effectiveness analysis: da Vinci ® Surgical System (Intuitive Surgical, Sunnyvale, CA).

    Science.gov (United States)

    Tsuda, Shawn; Oleynikov, Dmitry; Gould, Jon; Azagury, Dan; Sandler, Bryan; Hutter, Matthew; Ross, Sharona; Haas, Eric; Brody, Fred; Satava, Richard

    2015-10-01

    The da Vinci(®) Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) is a computer-assisted (robotic) surgical system designed to enable and enhance minimally invasive surgery. The Food and Drug Administration (FDA) has cleared computer-assisted surgical systems for use by trained physicians in an operating room environment for laparoscopic surgical procedures in general, cardiac, colorectal, gynecologic, head and neck, thoracic and urologic surgical procedures. There are substantial numbers of peer-reviewed papers regarding the da Vinci(®) Surgical System, and a thoughtful assessment of evidence framed by clinical opinion is warranted. The SAGES da Vinci(®) TAVAC sub-committee performed a literature review of the da Vinci(®) Surgical System regarding gastrointestinal surgery. Conclusions by the sub-committee were vetted by the SAGES TAVAC Committee and SAGES Executive Board. Following revisions, the document was evaluated by the TAVAC Committee and Executive Board again for final approval. Several conclusions were drawn based on expert opinion organized by safety, efficacy, and cost for robotic foregut, bariatric, hepatobiliary/pancreatic, colorectal surgery, and single-incision cholecystectomy. Gastrointestinal surgery with the da Vinci(®) Surgical System is safe and comparable, but not superior to standard laparoscopic approaches. Although clinically acceptable, its use may be costly for select gastrointestinal procedures. Current data are limited to the da Vinci(®) Surgical System; further analyses are needed.

  2. [Sex differences and anesthesiology: preface and comments].

    Science.gov (United States)

    Nishno, Takashi

    2009-01-01

    In this special issue, the topic of sex difference in the field of anesthesiology is featured. Eight subtopics are discussed including 1) sex differences in cardiovascular medicine, 2) perioperative cardiovascular management, 3) sex differences in the respiratory functions of the upper airway, 4) sex differences in the anesthetic management, 5) sex differences in pain, 6) sex differences in laboratory medicine, 7) sex differences in pharmacokinetics of anesthetics, and 8) postoperative nausea and vomiting. Although recent clinical and experimental studies have shown the existence of sex and/or gender differences in many fields of medicine, our knowledge of sex differences in anesthesiology is apparently insufficient. I believe that anesthesiologists should pay more attention to this topic to improve our daily practice of anesthesia.

  3. Sex, Lies and Video Games

    Science.gov (United States)

    Kearney, Paul; Pivec, Maja

    2007-01-01

    Sex and violence in video games is a social issue that confronts us all, especially as many commercial games are now being introduced for game-based learning in schools, and as such this paper polls teenage players about the rules their parents and teachers may or may not have, and surveys the gaming community, ie, game developers to parents, to…

  4. Will sex selection reduce fertility?

    Science.gov (United States)

    Leung, S F

    1994-01-01

    Population control is one of the primary policies applied against poverty in many low income countries. The widespread prevalence of son preference in some countries such as China and India, however, works against any reduction of fertility. This is so because parents often continue to have children until they obtain the number of sons which they desire. The bias against girls has also led to higher abortion and mortality rates of female children. It is frequently argued that if sex selection methods are made available to parents so that they can control the gender of their children, population growth would be lowered and women's welfare improved. The author investigates both theoretically and numerically the impact of sex selection on fertility. A static quantity-quality model of fertility is used to compare fertility choices when parents cannot choose the gender of children versus a situation in which parents can choose gender. Empirical data are drawn from the 1976 Malaysian Family Life Survey. Analysis found that whether sex selection reduces fertility depends upon the second and third derivatives of the utility function and the child expenditure function. A numerical dynamic analysis is also presented. The simulation shows, using empirical dynamic models of fertility and the Monte Carlo integration technique, that sex selection on the firstborn child among the Chinese in Malaysia could reduce fertility by about 3%.

  5. Studying Sex Prejudice in Children.

    Science.gov (United States)

    Olsen, Nancy J.; Willemsen, Eleanor W.

    1978-01-01

    Explores a methodology for studying sex prejudice in children. First-, third-, and fifth-grade students were asked to rate the performance of an eight-year-old child identified as a girl for half of the subjects and as a boy for the remaining half. (BD)

  6. A Talk on Sex Discrimination.

    Science.gov (United States)

    Evers, Irving C.

    The topic of this speech covers the 1972 amendments to Title VII of the Civil Rights Act of 1964 and the subsequent court cases dealing with sex discrimination. The cases discussed cover maternity leaves for tenured as well as untenured teachers and other public employees. The issues basic to these cases involve mandatory maternity leaves at…

  7. Sex, spite, and selfish genes

    Indian Academy of Sciences (India)

    Nature's oracle: the life and work of W. D. Hamilton. Ullica Segerstrale .... Stemming partly from his study of sex ratios, Hamilton later began moving on to .... any scientific biography, has to strike a balance between sci- ence and the personal ...

  8. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... oral medications for erectile dysfunction? play_arrow What do people do with a catheter during sex? play_arrow How ... after a spinal cord injury? play_arrow How do women deal with menstruation after a spinal cord ...

  9. Sex and the Imperfect Fungi.

    Science.gov (United States)

    Dyer, Paul S; Kück, Ulrich

    2017-06-01

    Approximately 20% of species in the fungal kingdom are only known to reproduce by asexual means despite the many supposed advantages of sexual reproduction. However, in recent years, sexual cycles have been induced in a series of emblematic "asexual" species. We describe how these discoveries were made, building on observations of evidence for sexual potential or "cryptic sexuality" from population genetic analyses; the presence, distribution, and functionality of mating-type genes; genome analyses revealing the presence of genes linked to sexuality; the functionality of sex-related genes; and formation of sex-related developmental structures. We then describe specific studies that led to the discovery of mating and sex in certain Candida , Aspergillus , Penicillium , and Trichoderma species and discuss the implications of sex including the beneficial exploitation of the sexual cycle. We next consider whether there might be any truly asexual fungal species. We suggest that, although rare, imperfect fungi may genuinely be present in nature and that certain human activities, combined with the genetic flexibility that is a hallmark of the fungal kingdom, might favor the evolution of asexuality under certain conditions. Finally, we argue that fungal species should not be thought of as simply asexual or sexual, but rather as being composed of isolates on a continuum of sexual fertility.

  10. Creativity and Psychopathology: Sex Matters

    Science.gov (United States)

    Martín-Brufau, Ramón; Corbalán, Javier

    2016-01-01

    The association between creativity and psychopathology has, for decades, been a focus of heated debate fuelled by contradictory findings. Nevertheless, the findings suggest complex associations between creativity and psychopathology. Other studies have investigated the association between creativity and sex, with inconsistent results. The aim of…

  11. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... arrow How does caregiving for your partner often affect romantic relationships? play_arrow What are the common treatments for ... play_arrow How does a spinal cord injury affect male fertility? play_arrow Where can people get information on sex and ... Contact Us Terms of Use Site Map ...

  12. Great tit hatchling sex ratios

    NARCIS (Netherlands)

    Lessells, C.M.; Mateman, A.C.; Visser, J.

    1996-01-01

    The sex of Great Tit Parus major nestlings was determined using PCR RAPDs. Because this technique requires minute amounts of DNA, chicks could be sampled soon (0-2d) after hatching, before any nestling mortality occurred. The proportion of males among 752 chicks hatching in 102 broods (98.9% of

  13. Sex chromosomes in Ephestia kuehniella

    Czech Academy of Sciences Publication Activity Database

    Marec, František; Sahara, K.; Traut, W.

    2001-01-01

    Roč. 44, č. 1 (2001), s. 131 ISSN 0003-3995. [European Cytogenetics Conference /3./. 07.07.2001-10.07.2001, Paris] Institutional research plan: CEZ:AV0Z5007907 Keywords : Telomere * sex chromosomes * chromosome fragments Subject RIV: EB - Genetics ; Molecular Biology

  14. Sex Discrimination in Employment Practices.

    Science.gov (United States)

    California Univ., Los Angeles. Univ. Extension.

    The conference on sex discrimination in employment practices was held at the University of California at Los Angeles in cooperation with the Women's Bureau of the Department of Labor. Speeches included: (1) "New Legislation--New Action" by Rosalind K. Loring and William Foster, (2) "Compliance Policies and Procedures for Business and Industry" by…

  15. Sex determination in the Hymenoptera

    NARCIS (Netherlands)

    Heimpel, George E.; de Boer, Jetske G.

    2008-01-01

    The dominant and ancestral mode of sex determination in the Hymenoptera is arrhenotokous parthenogenesis, in which diploid females develop from fertilized eggs and haploid males develop from unfertilized eggs. We discuss recent progress in the understanding of the genetic and cytoplasmic mechanisms

  16. The prostitutions: power and sex

    Directory of Open Access Journals (Sweden)

    Adele Nunziante Cesaro

    2013-06-01

    Full Text Available The contemporary scenario features many and unusual versions of the sexual mercenary exchange, articulating new dynamics of desire. Prostitution remains a “question” which interrogates the gender and the difference between the sexes. According to a Freudian perspective, the authors present some reflection on the forms of sexuality today.

  17. Usage of the Terms Prostitution, Sex Work, Transactional Sex, and Survival Sex: Their Utility in HIV Prevention Research.

    Science.gov (United States)

    McMillan, Karen; Worth, Heather; Rawstorne, Patrick

    2018-07-01

    This article considers the terms prostitution, sex work, transactional sex, and survival sex, the logic of their deployment and utility to research concerned with people who are paid for sex, and HIV. The various names for paid sex in HIV research are invested in strategically differentiated positionings of people who receive payment and emphasize varying degrees of choice. The terminologies that seek to distinguish a range of economically motivated paid sex practices from sex work are characterized by an emphasis on the local and the particular, efforts to evade the stigma attached to the labels sex worker and prostitute, and an analytic prioritizing of culture. This works to bestow cultural legitimacy on some locally specific forms of paid sex and positions those practices as artifacts of culture rather than economy. This article contends that, in HIV research in particular, it is necessary to be cognizant of ways the deployment of alternative paid sex categories relocates and reinscribes stigma elsewhere. While local identity categories may be appropriate for program implementation, a global category is necessary for planning and funding purposes and offers a purview beyond that of isolated local phenomena. We argue that "sex work" is the most useful global term for use in research into economically motivated paid sex and HIV, primarily because it positions paid sex as a matter of labor, not culture or morality.

  18. Same Sex Marriage and the Perceived Assault on Opposite Sex Marriage

    OpenAIRE

    Dinno, Alexis; Whitney, Chelsea

    2013-01-01

    BACKGROUND: Marriage benefits both individuals and societies, and is a fundamental determinant of health. Until recently same sex couples have been excluded from legally recognized marriage in the United States. Recent debate around legalization of same sex marriage has highlighted for anti-same sex marriage advocates and policy makers a concern that allowing same sex couples to marry will lead to a decrease in opposite sex marriages. Our objective is to model state trends in opposite sex mar...

  19. Surgical Excision Of A Craniopharynginoma By Transcallosal ...

    African Journals Online (AJOL)

    complaints included: polydipsia and polyuria in one case, progressive hypopsia in the second case; headache in the third case; and hormonal manifestations in the .... Intraventricular craniopharyngiomas: topographical classification and surgical approach selection based on an extensive overview. Acta Neurochir , 2004 ,.

  20. Surgical manipulation of mammalian embryos in vitro.

    Science.gov (United States)

    Naruse, I; Keino, H; Taniguchi, M

    1997-04-01

    Whole-embryo culture systems are useful in the fields of not only embryology but also teratology, toxicology, pharmacology, and physiology. Of the many advantages of whole-embryo culture, we focus here on the surgical manipulation of mammalian embryos. Whole-embryo culture allows us to manipulate mammalian embryos, similarly to fish, amphibian and avian embryos. Many surgical experiments have been performed in mammalian embryos in vitro. Such surgical manipulation alters the destiny of morphogenesis of the embryos and can answer many questions concerning developmental issues. As an example of surgical manipulation using whole-embryo culture systems, one of our experiments is described. Microsurgical electrocauterization of the deep preaxial mesodermal programmed cell death zone (fpp) in the footplate prevented the manifestation of polydactyly in genetic polydactyly mouse embryos (Pdn/Pdn), in which fpp was abolished.