Most Viewed Articles

Purpose: Lower-extremity (LE) injuries due to prolonged surgery duration in the dorsal lithotomy (DL) position are often morbid and can significantly affect the patient’s short and long-term quality of life. These include the development of lower extremity pressure ulcers, neuropathies, rhabdomyolysis, and compartment syndromes. As compared to other surgeries, this risk is increased in patients undergoing genital gender-affirming surgery (gGAS) due to the relatively long operative time of these surgeries related to their high complexity. Our study aimed to describe our technique for preventing LE injuries in the DL position, and to evaluate our positioning-related post-operative complications and rates.Materials and Methods: We describe our technique for positioning in the dorsal lithotomy position, with an emphasis on injury prevention. We ensure a specific padding technique of the LE, we alert surgical assistants to not lean/rest on the LE, and we schedule LE checks and repositioning throughout the case to prevent and mitigate occult injuries. Herein, we report our clinical positioning-related outcomes and complications among all patients undergoing gGAS procedures lasting >300 minutes between January 2017 to March 2023. Results: A total of 227 patients underwent 310 surgical procedures (156 masculinizing, 154 feminizing gGAS procedures). Mean operative time was 495.5 minutes+/-156.5 minutes (SD) (Range 300–1095 minutes). A total of 6/227 (2.6%) patients (2 masculinizing and 4 feminizing surgical patients) had transient, self-limited LE pain post-op. No (0%) patients had major complications including chronic nerve injury, pressure ulcers, rhabdomyolysis, or compartment syndrome.Conclusions: Our study is the first to describe a replicable technique, and specifically which integrates the OR team and nursing staff, to prevent LE injuries during DL. We show that it is possible to achieve a 0%-to-rare incidence of major LE injury during long-duration surgeries.

Usually revealed by lower urinary tract symptoms, prostate neoplasms are the most frequent urological cancer.The patient was a 70-year-old man being explored for bicytopenia in the hematology department: anemia and bicytopenia with no urinary symptoms in the first plan.Bone marrow biopsy was done and the histological and immunohistochemical concluded in an intramedullary spinal cord metastasis of an undifferentiated prostatic carcinoma.We have reviewed the literature one other case of intramedullary metastasis of prostatic cancer was detected but the main symptoms were neurological and the patient was already diagnosed with his cancer.

The main purpose of the present study was to find out the differences on suicidal ideation, hostility, hopelessness and negative self-evaluation among heroin addicts with comorbid depression. After reviewing the literature, it was hypothesized that heroin addicts with high depression may have high scores on variable of suicidal ideation, hostility, hopelessness, and negative self-evaluation as compared to those with low depression. The sample was consisted of 60 males from Low-socioeconomic status (SES) (34 of them were screened as having high scores on the variable of depression and 26 were screened as low scorers). Siddiqui Shah Depression Scale (Siddiqui & Shah, 1997) and Urdu version of Suicide Probability Scale (Cull & Gill, 1982) was administered. To compare heroin addicts with high and low depression on various variables, t - test was applied. The research findings showed that heroin addicts with mean age of 30 years (range 20 to 40) having the mean duration of heroin dependence of 10 years with high depression were significantly high on the variable of suicidal ideation, hostility and hopelessness ((p < .05) as compared to those with low depression. And there was no significant difference on the variable of negative self-evaluation for both groups (p > .05). So it was concluded that services for patients with Heroin addiction should include periodic screening for suicidal behavior along with psychiatric treatment and psychosocial support.

Following the COVID-19 proliferation beyond China’s borders at the beginning of 2020, containment measures have been taken by different countries around the globe. Citizens were forced to stay at home. Specifically, on March 19th, the Argentine Government decided to implement the “Social, preventive and mandatory isolation”, strategy that unfortunately impacts on the lifestyle, the practise of physical activity and on the nutritional aspect of the population. The aim of this study was analize eating habits and lifestyle changes during the COVID-19 lockdown on the 9 de Julio city, Bs. As., Argentina. The survey was conducted using Google Form. The questionnaire was divided into different sections: sociodemographic data, eating habits, physical activity and concepts and emotions associated with isolation. The research reached 287 responses with a medium socioeconomic level. During isolation, the frequency of purchases decreased. It was observed an increase in the consumption of pasta, bread and cakes. Concerning the physical activity, approximately 70% declared to train before the COVID-19 lockdown, decreased by 13% during the lockdown. Other activities conducted during the COVID-19 lockdown; the most mentioned were cleaning the house, cooking, watching television, series and movies. A percentage greater than 50% of the surveyed population associated the situation of lockdown with positive emotions (share with my family, stay at home); while only 24% associate it with negative emotions (anxiety, anguish, fear). It is expected that most habits will return to normal, however, it would be interesting to know which of those developed, adopted and implemented during lockdown will remain in the new normality.

According to statistical data in Poland, sexual acts of minors account for about 3% of all criminal acts committed by minors and nearly 20% of all acts from the catalogue of crimes against sexual freedom and morality. The main objective of the study was to attempt to develop and present characteristics of minors who commit rape with particular cruelty. Taking into account the way the perpetrators act, the motivational background, and the circumstances of the crime. In particular, attention was paid to specific individual and family characteristics. Because it is not clear whether juvenile sex offenders are different from non-sex offenders. The aim of this article is an attempt to capture individual, family, and environmental differences. The study was also intended to provide information about who the victims are. The study was conducted on the basis of empirical material from court cases in which the basis of liability was Article 197§4 of the Penal Code, and the perpetrators or accomplices of the acts were minors who at the time of the act were over 15 years of age but under 17 years of age. The research material consisted of court case files that had been finally completed, including forensic psychological opinions prepared by court experts. Cases from 2015-2020 were analysed. The obtained results allowed us to capture some specific features of families in which minors were brought up and the characteristics of juvenile sex offenders themselves. This article raises the difficult issue of juvenile responsibility for sexual crimes and indicates areas in which it is necessary to regulate interactions and areas of possible preventive impacts.

Breast cancer associated with type-1 neurofibromatosis is a rare clinical entity. These patients have a higher risk of developing various types of cancers, especially tumors derived from the embryogenic neural crest, such as pheochromocytoma. This publication aims to add to the literature a rare association between Type-1 Neurofibromatosis, breast cancer, and pheochromocytoma.We present a rare case of a 51-year-old Tunisian woman with neurofibromatosis who was diagnosed with breast cancer and pheochromocytoma. The breast tumor was classified as T4b N1M0, and the discovery of the pheochromocytoma was incidental to thoracic-abdominal-pelvic CT. She underwent surgery to remove the adrenal gland and was referred to medical oncologists to receive chemotherapy for her breast cancer. Type-1 Neurofibromatosis disorder is a benign disease but can expose patients to numerous neoplasms. The challenging diagnosis at an early stage can worsen the prognosis and make medical care more difficult.

There are a number of key issues that matter to patients and General Physicians (GPs) in the primary care treatment system for severe depression. Patient and doctor narratives can contribute by highlighting these key issues. Various systems are employed in treating severe depression. However, there needs to be an investigation using systems failure methodology and how this methodology is applied which can help identify how and why the NHS treatment system for severe depression can fail patients in terms of provision of effective care.

COVID-19 emergency requests a new definition of security procedures adopted in Child and Adolescence Neuropsychiatric Services (CANS). The WHO recommends using Personal Protective Equipment (PPE) for preventing inter-human transmission of viral diseases [1]. These recommendations regard primarily hospitalized patients and ambulatory medical services for adults.

The aim of this work is to report some interesting references and documents related to the mRNA vaccine. Every cited reference can act as an instrument to better understand what some independent researchers find: this work is mainly focused on the public debate related presence/absence of graphene derivates in some vaccine vials for COVID-19. Relevant classic articles White Papers or other kinds of a document are useful instruments to better clarify some crucial aspects of this infectious disease, its epidemiology and the efficacy of the measure adopted (preventive, therapeutic, or vaccine).If the reviewed article show an intrinsic recognized international value other kinds of source like a White Paper or other documents can be of interest to generate hypotheses or to open public discussion on crucial topics. For this reason, it is useful to use this method also in the discussion related to impurity profiles in new innovative bio-pharmaceuticals like the mRNA vaccine. The fact that this product was introduced with an emergency authorization, whit reduced the time of experimentation and due to the lack of official quality information related to some raw materials used authorizes us to use also this method.Even if the international official regulatory agency does not find this substance in the control for release of the lots it is interesting to more deeply investigate what funded by an independent researcher in some vials of vaccine or sample patient’s blood after vaccination. This reference even if not a smoking gun the same can stimulate the reasoning about the general concept involved. It is needed, to read this work, to consider the intrinsic limitation of some of the study research reported (White Paper) or the other documents.

In the article presented the etiology of the so-called idiopathic scoliosis (Adolescent Idiopathic Scoliosis [AIS]), new classification, there are given rules of therapy and causal prophylaxis. This knowledge is based on observations from 1984, but essentially from the years 1995 – 2007. In 2001 it was given the first description in classification – “S” scoliosis in 1st group / type and “C” and “S” scoliosis in 2nd A / B group and types, in 2004 “I” scoliosis in 3rd group / type.