Outcome of the lay open vs. excision and primary closure treatment modalities for chronic sacrococcygeal pilonidal sinus in the local Saudi Arabian community

2016-06-12T06-43-06Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Bader Hamza Shirah, Hamza Assad Shirah.
Background and Objectives: Sacrococcygeal pilonidal sinus is a chronic condition for which the treatment options remain controversial based on the high recurrence rates. Before 1997, excision and primary closure was the most popular method offered in our local community surgical practice. In this study, we aim to evaluate the results of treatment outcomes of the lay open method offered in 1997 to our local community patients and compare it to the excision and primary closure method, hoping it may help in opening up wider frontiers in the surgical practice on our local community to provide the best health care. Materials and Methods: Between January 1997 and December 2011, 600 patients with chronic sacrococcygeal pilonidal sinus were included in our study. 443 were male and 157 were female (age range: 1639). The lay open method was performed on 300 patients who agreed to the newly offered procedure, and excision with primary closure was performed on the other 300 patients that refused surgery with the lay open method. Results: The recurrence rate was 0% for the lay open technique, and 3% for the excision with primary closure method. All patients had undergone 5 years of follow-up. Conclusion: When the lay open technique is performed in a meticulous and carefully prepared manner with superb postoperative care and regular follow-up, it is more promising than excision with primary closure in treating chronic sacrococcygeal pilonidal sinus, and may successfully achieve a zero (0%) recurrence rate, low postoperative complications, and acceptable cosmetic wounds.


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Video: About 20 shot in Florida night club

Police: Mass shooting inside Florida night club being investigated as an 'act of terrorism'

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What Does it Mean to be Healthy? Hispanics in the Southeastern Idaho Agricultural Industry

Abstract

In contrast to many studies of first generation Hispanics residing in the U.S., our study focused on participants of both genders who were formally employed outside the home. The purpose of this study was to explore the meaning of health among southeast Idaho Hispanics employed in the agro-industry. Using qualitative methodology, we interviewed twenty participants employed at a potato processing plant. We found that men and women had differing concepts of health based upon their gender roles and the value placed on work outside the home, which influenced their willingness to access formal health care. Based on our findings, there is a need for public health officials in Idaho to collaborate with employers to develop and implement workplace clinics.

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Emotional processing and psychopathic traits in male college students: an event-related potential study

Publication date: Available online 11 June 2016
Source:International Journal of Psychophysiology
Author(s): Amy L. Medina, Elvira Kirilko, Jillian Grose-Fifer
Emotional processing deficits are often considered a hallmark of psychopathy. However, there are relatively few studies that have investigated how the late positive potential (LPP) elicited by both positive and negative emotional stimuli are modulated by psychopathic traits, especially in undergraduates. Attentional deficits have also been posited to be associated with emotional blunting in psychopathy, consequently, results from previous studies may have been influenced by task demands. Therefore, we investigated the relationship between the neural correlates of emotional processing and psychopathic traits by measuring event-related potentials (ERPs) during a task with a relatively low cognitive load. A group of male undergraduates were classified as having either high or low levels of psychopathic traits according to their total scores on the Psychopathic Personality Inventory-Revised (PPI-R). A subgroup of these participants then passively viewed complex emotional and neutral images from the International Affective Picture System (IAPS) while their EEG was recorded. As hypothesized, in general the late LPP elicited by emotional pictures was found to be significantly reduced for participants with high Total PPI-R scores relative to those with low scores, especially for pictures that were rated as less emotionally arousing. Our data suggest that male undergraduates with high, but subclinical levels of psychopathic traits did not maintain continued higher-order processing of affective information, especially when it was perceived to be less arousing in nature.



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Estimation of radionuclide (137Cs) emission rates from a nuclear power plant accident using the Lagrangian Particle Dispersion Model (LPDM)

Publication date: October 2016
Source:Journal of Environmental Radioactivity, Volumes 162–163
Author(s): Soon-Ung Park, In-Hye Lee, Jae-Won Ju, Seung Jin Joo
A methodology for the estimation of the emission rate of ¹³⁷Cs by the Lagrangian Particle Dispersion Model (LPDM) with the use of monitored ¹³⁷Cs concentrations around a nuclear power plant has been developed. This method has been employed with the MM5 meteorological model in the 600 km × 600 km model domain with the horizontal grid scale of 3 km × 3 km centered at the Fukushima nuclear power plant to estimate ¹³⁷Cs emission rate for the accidental period from 00 UTC 12 March to 00 UTC 6 April 2011. The Lagrangian Particles are released continuously with the rate of one particle per minute at the first level modelled, about 15 m above the power plant site. The presently developed method was able to simulate quite reasonably the estimated ¹³⁷Cs emission rate compared with other studies, suggesting the potential usefulness of the present method for the estimation of the emission rate from the accidental power plant without detailed inventories of reactors and fuel assemblies and spent fuels. The advantage of this method is not so complicated but can be applied only based on one-time forward LPDM simulation with monitored concentrations around the power plant, in contrast to other inverse models. It was also found that continuously monitored radionuclides concentrations from possibly many sites located in all directions around the power plant are required to get accurate continuous emission rates from the accident power plant. The current methodology can also be used to verify the previous version of radionuclides emissions used among other modeling groups for the cases of intermittent or discontinuous samplings.



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Environmental risks of radioactive discharges from a low-level radioactive waste disposal site at Dessel, Belgium

Publication date: October 2016
Source:Journal of Environmental Radioactivity, Volumes 162–163
Author(s): J. Vives i Batlle, L. Sweeck, J. Wannijn, H. Vandenhove
The potential radiological impact of releases from a low-level radioactive waste (Category A waste) repository in Dessel, Belgium on the local fauna and flora was assessed under a reference scenario for gradual leaching. The potential impact situations for terrestrial and aquatic fauna and flora considered in this study were soil contamination due to irrigation with contaminated groundwater from a well at 70 m from the repository, contamination of the local wetlands receiving the highest radionuclide flux after migration through the aquifer and contamination of the local river receiving the highest radionuclide flux after migration through the aquifer. In addition, an exploratory study was carried out for biota residing in the groundwater.All impact assessments were performed using the Environmental Risk from Ionising Contaminants: Assessment and Management (ERICA) tool. For all scenarios considered, absorbed dose rates to biota were found to be well below the ERICA 10 μGy h⁻¹ screening value. The highest dose rates were observed for the scenario where soil was irrigated with groundwater from the vicinity of the repository. For biota residing in the groundwater well, a few dose rates were slightly above the screening level but significantly below the dose rates at which the smallest effects are observed for those relevant species or groups of species. Given the conservative nature of the assessment, it can be concluded that manmade radionuclides deposited into the environment by the near surface disposal of category A waste at Dessel do not have a significant radiological impact to wildlife.



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Predictors of Exercise Adherence in Patients with Meniscal Tear and Osteoarthritis

Publication date: Available online 11 June 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Yetsa A. Tuakli-Wosornu, Faith Selzer, Elena Losina, Jeffrey N. Katz
ObjectiveTo identify predictors of poor exercise adherence in patients with osteoarthritis (OA) and meniscal tear.DesignSecondary analysis of data gathered over the first 12 weeks in the Meniscal Tear in Osteoarthritis Research (MeTeOR) Trial, a multicenter, randomized controlled trial.SettingSeven referral centers in the US.ParticipantsThis analysis was conducted in 325 of the 351 MeTeOR patients, each of whom was ≥ 45 years old and had meniscal tear and osteoarthritic changes on imaging studies; 26 were excluded due to missing data from which to derive the primary outcome variable.InterventionsAll patients received a structured supervised exercise program focused on strengthening, along with prescribed home exercises; half were randomized to also receive arthroscopic partial meniscectomy.Main Outcome MeasurePoor exercise adherence through 12 weeks, defined as performing <50% of prescribed exercise.Results38% of the MeTeOR cohort showed poor exercise adherence. In the multivariate model, adjusting for treatment group, those who earned ≤ $29,000/year had 1.64 times the risk of non-adherence (95% CI: 1.10, 2.43) than those who earned >$100,000 /year; and, those without baseline pain with pivoting and twisting had 1.60 times greater risk of non-adherence than those with these symptoms (95% CI: 1.14, 2.25).ConclusionLow income was associated with poor exercise adherence among patients ≥ 45 with osteoarthritis and meniscal tear, as was absence of pain with pivoting and twisting. Our findings highlight the need for further research into exercise adherence and for interventions to enhance adherence among those with low incomes.



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