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Threatening
Kinds of Threatening Terms modified by Threatening Selected AbstractsTemperature Effects on Anti-Predator Behaviour in Rhabdophis tigrinus, a Snake with Toxic Nuchal GlandsETHOLOGY, Issue 9 2001Akira Mori Many contextual factors affect the anti-predator behaviour of animals. In ectotherms, in which most physiological activities depend on body temperature, ambient temperature is one of the most important of these factors. We examined the effects of temperature on the anti-predator behaviour of an ectotherm, the Japanese grass snake (Rhabdophis tigrinus). This species has a large repertoire of anti-predator behavioural responses. Among these responses are several anti-predator displays that appear to be unique to this species and perhaps others in a small group of closely related species possessing nuchal glands containing toxic secretions that may be derived from their toxic toad diet. Snakes were tested at room temperatures of 14, 22 and 30°C with order of temperatures balanced. A long wand modified to simulate initial contact by a predator was used as the stimulus. Snakes exhibited rather passive responses (neck flatten, body flatten, neck arch and immobile) more frequently at low temperatures, and fled more frequently at high temperatures. The dorsal facing posture, a characteristic posture directed against the stimulus, was observed more frequently at low temperatures. Threatening, assertive responses such as strike were rarely observed. These results showed that R. tigrinus shifts its anti-predator behaviour from multiple passive responses to active flight responses with increasing temperature. This snake species thus appears to rely more on its nuchal glands as a predator deterrent at low ambient temperatures. Consistent individual variation was also observed, and its adaptive and causal bases are discussed. [source] The ,pros' and ,cons' of joint EMS and group certification: a Swedish case studyCORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 3 2007Thomas Zobel Abstract Small and medium-sized enterprises (SMEs) are collectively responsible for a significant portion of the total environmental burden worldwide. A common tool used by SMEs to improve their environmental performance is the environmental management system (EMS), which has the disadvantage that it has been developed with larger organizations in mind. A common approach used by Swedish SMEs to facilitate the implementation of an EMS is joint EMS and group certification. This paper evaluates this approach by means of a case study. It is found that the approach is effective for small and micro-sized companies in achieving ISO 14001 certification as fast and cost effectively as possible. A few short cuts including joint environmental policy and objectives and insufficient environmental organization are however threatening to undermine the trustworthiness of the approach. Notwithstanding these flaws, however, it must be concluded that the joint EMS approach is a good alternative for small and micro-sized companies. Copyright © 2006 John Wiley & Sons, Ltd and ERP Environment. [source] Gram-negative meningitis and infections in individuals treated with intrathecal baclofen for spasticity: a retrospective studyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 6 2006Colleen A Wunderlich MD MSc The aim of this retrospective study was to describe signs, symptoms, and clinical outcomes of individuals undergoing intrathecal baclofen (ITB) therapy who experienced pumprelated Gram-negative infections including meningitis. Participants included 12 individuals (nine males, three females) aged 10 to 32 years (mean 17y 9mo), nine of whom had quadriplegic CP. A total of 571 baclofen pump surgeries were performed with 45 total infections. Of the 45 infections, 12 were by Gram-negative organisms, two resulting in meningitis. Ten of 12 Gram-negative infections (21 site encounters) occurred within 60 days of surgery. Eleven of 12 pumps were explanted. By site encounters, Pseudomonas aeruginosa accounted for eight Gram-negative infections, Escherichia coli for five, Proteus for three, Enterobacter cloacae for two, and Klebsiella, Enterobacter aerogenes, and Enterobacter vulnaris for one each. Two individuals with Gram-negative meningitis were admitted 72 to 96 hours after hospital discharge following pump replacement. Both patients had rapid deterioration requiring transfer to the pediatric intensive care unit, and developed coagulopathy and decrease in responsiveness. Both have improved and have elected not to replace the ITB pump. In Gram-negative infections in ITB therapy, the progression of signs and symptoms can be swift and devastating. Identification of the infectious agent in such cases is imperative; these infections can quickly become life threatening. [source] Examining dispositional and situational effects on outgroup attitudes,EUROPEAN JOURNAL OF PERSONALITY, Issue 4 2009Joke Meeus Two research lines have dominated the quest for the antecedents of outgroup attitudes. Whereas the first has viewed outgroup attitudes as a result of individual differences, the second stressed the importance of the intergroup situation. In order to investigate the interplay of individual differences and situational characteristics, key predictors of the individual differences perspective (i.e. right-wing authoritarianism or RWA, and social dominance orientation or SDO) and the intergroup relations perspective (i.e. ingroup identification and ingroup threat) were simultaneously tested. Two studies revealed additive but no interaction effects of RWA and SDO, ingroup identification and threat. Additionally, Study 1 showed that threat effects remain limited to the outgroup that is portrayed as threatening and do not generalize to other outgroups. Copyright © 2009 John Wiley & Sons, Ltd. [source] The Defence Mechanism Test (DMT) revisited: experimental validation using threatening and non-threatening picturesEUROPEAN JOURNAL OF PERSONALITY, Issue 4 2002Bo Ekehammar Although the Defence Mechanism Test (DMT) has been in use for almost half a century, it is still unclear what it actually measures. The psychodynamic theory on which the test is based states that the threatful DMT pictures activate various defence mechanisms. To test this proposition, the original DMT pictures were redrawn by a professional artist, changing the emotional content without altering the structural properties. In this way, a neutral and a friendly variant were shaped. Sixty participants were randomly assigned to the threatful, neutral, and friendly stimulus conditions. In contrast to predictions made from psychodynamic theory, that the threatful picture would activate more ,signs of defence' than the others, the results disclosed that the three conditions activated the same amounts of ,signs of defence' and the same levels of various perceptual thresholds. Thus, rather than capturing psychodynamic defence mechanisms, our results suggest that the DMT taps perceptual or information-processing difficulties in correct identification of brief stimulus exposures regardless of their emotional contents. Copyright © 2002 John Wiley & Sons, Ltd. [source] Rethinking Law and Violence: The Domestic Violence (Prevention) Bill in India, 2002GENDER & HISTORY, Issue 3 2004Rajeswari Sunder Rajan This essay focuses on the controversy generated by recent proposed legislation on domestic violence in India. An alternative draft bill on domestic violence prepared by the feminist legal NGO, the Lawyers' Collective, and supported by women's groups nationally, includes a demand that victims of domestic violence (usually wives) be permitted by law to continue to occupy the domestic home, a demand that the Government bill has refused to include. This demand is theoretically informed by a politics of space. Bodies and space are linked, to the extent that each is an abstraction without the concept of the other to ground it. The feminist legal proposal challenges property-as-absolute-(male) ownership by conceptualising the household as, instead, shared domestic space. The proposal does not dissimulate common sense , it is conscious of being radical, in part at least because it demystifies the ,domestic' as an ideological construct and offers it instead realistically and minimally as simply an alternative to destitution. The recognition that there are no support structures for dependant women outside the family (such as, for example, state-sponsored welfare institutions), so that destitution can be both sudden and real for women of any class and circumstances, has led to the conceptualisation of a law that formulates a right to shared space as one that makes no claim to shared ownership , while at the same time questioning the other's absolute property right. Despite the limited nature of the claim it makes, this proposal has been viewed as threatening by Indian law-makers. [source] Frontolimbic responses to emotional face memory: The neural correlates of first impressionsHUMAN BRAIN MAPPING, Issue 11 2009Theodore D. Satterthwaite Abstract First impressions, especially of emotional faces, may critically impact later evaluation of social interactions. Activity in limbic regions, including the amygdala and ventral striatum, has previously been shown to correlate with identification of emotional content in faces; however, little work has been done describing how these signals may influence emotional face memory. We report an event-related functional magnetic resonance imaging study in 21 healthy adults where subjects attempted to recognize a neutral face that was previously viewed with a threatening (angry or fearful) or nonthreatening (happy or sad) affect. In a hypothesis-driven region of interest analysis, we found that neutral faces previously presented with a threatening affect recruited the left amygdala. In contrast, faces previously presented with a nonthreatening affect activated the left ventral striatum. A whole-brain analysis revealed increased response in the right orbitofrontal cortex to faces previously seen with threatening affect. These effects of prior emotion were independent of task performance, with differences being seen in the amygdala and ventral striatum even if only incorrect trials were considered. The results indicate that a network of frontolimbic regions may provide emotional bias signals during facial recognition. Hum Brain Mapp, 2009. © 2009 Wiley-Liss, Inc. [source] Intravascular haemolysis in a patient on ceftriaxone with demonstration of anticeftriaxone antibodiesINTERNAL MEDICINE JOURNAL, Issue 6a 2008D. Dinesh Abstract Drug-induced haemolytic anaemia can be life threatening. We report a case of ceftriaxone-induced severe haemolytic anaemia in a previously healthy 68-year-old woman. The patient had a positive direct antiglobulin test (anti-C3d positive, anti-immunoglobulin G negative). Serological tests showed ceftriaxone-specific antibodies. The patient recovered after cessation of the drug. This complication may cause milder anaemia and thus be poorly recognized. [source] A Rogue is a Rogue is a Rogue: US Foreign Policy and the Korean Nuclear CrisisINTERNATIONAL AFFAIRS, Issue 4 2003Roland Bleiker Two nuclear crises recently haunted the Korean peninsula, one in 1993/4, the other in 2002/3. In each case the events were strikingly similar: North Korea made public its ambition to acquire nuclear weapons and withdrew from the Nonproliferation Treaty. Then the situation rapidly deteriorated until the peninsular was literally on the verge of war. The dangers of North Korea's actions, often interpreted as nuclear brinkmanship, are evident and much discussed, but not so the underlying patterns that have shaped the conflict in the first place. This article sheds light on some of them. It examines the role of the United States in the crisis, arguing that Washington's inability to see North Korea as anything but a threatening ,rogue state' seriously hinders both an adequate understanding and possible resolution of the conflict. Particularly significant is the current policy of pre-emptive strikes against rogue states, for it reinforces half a century of American nuclear threats towards North Korea. The problematic role of these threats has been largely obscured, not least because the highly technical discourse of security analysis has managed to present the strategic situation on the peninsula in a manner that attributes responsibility for the crisis solely to North Korea's actions, even if the situation is in reality far more complex and interactive. [source] Russia's non-strategic nuclear forcesINTERNATIONAL AFFAIRS, Issue 3 2001David S. Yost Several factors explain the high level of support for non-strategic nuclear forces(NSNF) in Russia and the correspondingly limited interest in NSNF arms control. These include Russia's conventional military weakness, NATO's conventional military superiority, political assessments that portray NATO as threatening to Russia, and the several important functions assigned to Russia's nuclear weapons and to NSNF in particular by Russian military doctrine and policy. The Russians have made it clear that they attach great importance to NSNF in a number of ways: in their preoccupations during the NATO-Russia Founding Act negotiations in 1996-7; in their recent military exercises; in their decisions regarding NSNF modernization; in their lack of transparency in implementing their 1991-2 commitments to reduce and eliminate certain types of NSNF; and in their discussions about possibly abandoning certain nuclear arms control commitments. Russian interests in using NSNF to deter powers other than NATO (such as China), to substitute for advanced non-nuclear precision-strike systems, and to ,de-escalate' regional conflicts (among other functions attributed to NSNF) would not be modified by the course of action some observers have advocated,a unilateral withdrawal of US NSNF from Europe. Such a withdrawal would, however, damage the Western alliance's security interests. NATO has adopted the most practical objective currently available: pursuing greater transparency regarding NSNF in the NATO-Russia Permanent Joint Council. [source] A case of paroxysmal nocturnal hemoglobinuria presenting with intra-abdominal bleeding due to splenic rupture, developing renal infarctINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 3 2008S. UZUN Summary Paroxysmal nocturnal hemoglobinuria (PNH) is a rare disorder characterized by intravascular hemolysis, hemoglobinuria, and thrombosis. Thrombotic attacks are life threatening and are responsible for nearly 50% of PNH-related deaths. Compared with thrombotic events, bleeding related to thrombocytopenia in PNH is quite rare. This report describes an atypical clinical presentation with problems in the diagnosis and management of a woman who presented with a splenic infarct followed by massive intra-abdominal bleeding due to splenic rupture. She also developed a renal infarct during hospitalization after diagnosis. [source] Immediate haemostasis with recombinant factor VIIa for haemorrhage following Hickman line insertion in acute myeloid leukaemiaINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 3 2004W. Osborne Summary Bleeding following Hickman line insertion is not uncommon but can be life threatening, especially in the presence of coagulopathy and thrombocytopenia following chemotherapy. Treatment to control the bleeding can be challenging and treatment options are limited. We present our experience of a patient who had persisting haemorrhage immediately following Hickman line insertion for administration of chemotherapy for relapsed acute myeloid leukaemia. Haemostasis could not be achieved after FFP and platelet administration. A single dose of recombinant factor VIIa (rhFVIIa) stopped the bleeding immediately, avoiding the need for surgical intervention or line removal. Our experience indicates rhFVIIa may be an effective option for bleeding related to Hickman line insertion. [source] Impact of recurrent changes in the work environment on nurses' psychological well-being and sickness absenceJOURNAL OF ADVANCED NURSING, Issue 6 2006Rik Verhaeghe MSc RN Aim., This paper is a report of a study of how the occurrence and appraisal of recurrent changes in the work environment of hospital nurses affect psychological well-being (i.e. job satisfaction, eustress and distress) and absence through illness. Background., Many researchers have demonstrated the impact of major organizational changes on employees' psychological well-being, but only a few have focused on the permanent consequences in work conditions. In a contemporary healthcare setting, an increased number of recurrent operational changes has become a normal characteristic of nurses' work environment. Specific work situations have frequently been associated with occupational stress, whereas employees' appraisal of recurrent changes as stressors and their relation to psychological well-being and health outcomes (i.e. sickness absence) have been dismissed. Methods., A cross-sectional questionnaire survey was conducted in 2003 with 2094 Registered Nurses in 10 general hospitals. Logistic regressions were used to investigate the impact on psychological well-being and prospectively measured rates of sickness absence (frequency and duration). Results., The occurrence of changes in the work environment (in the past 6 months) had had a negative impact on staff psychological well-being. Nurses who had been confronted with changes scored statistically significantly higher for distress. Changes appraised as threatening were negatively related to job satisfaction and eustress, and positively related to distress and sickness absence (frequency and duration). Changes appraised as challenging were positively related to job satisfaction and eustress but had no impact on distress and sickness absence. Conclusion., Future research should take into consideration the impact of the occurrence and appraisal of recurrent changes in the work environment of healthcare employees (i.e. Registered Nurses) on psychological well-being and sickness absence. This should also be considered by managers when dealing with these nursing workforce issues. [source] Coercive and Face-Threatening Questions to Left-Wing and Right-Wing Politicians During Two Italian Broadcasts: Conversational Indexes of Par Conditio for Democracy Systems,JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 5 2008Augusto Gnisci Indexes of political interviewers' neutrality, proposed in the face model, capture the treatment reserved in televised interviews for politicians or parties. This contribution proposes that they should be introduced in the official survey of political appearances on television and be prescribed by law. The research compares questions of 2 Italian interviewers to the same 13 politicians (7 left-wing, 6 right-wing). In over 11 hr of interviews (7 months' sampling), 804 questions were codified. Italian interviewers were less threatening than their Anglo Saxon colleagues, even if just as coercive. They treated the government less coercively than the opposition, even if they were just as threatening; and they seemed sensitive to the prestige of politicians. Implications of the proposal are discussed. [source] Infection frequently triggers thrombotic microangiopathy in patients with preexisting risk factors: A single-institution experienceJOURNAL OF CLINICAL APHERESIS, Issue 2 2010Kenneth W. Douglas Abstract Thrombotic microangiopathies are rare conditions characterized by microangiopathic hemolytic anemia, microthrombi, and multiorgan insult. The disorders, which include hemolytic uremic syndrome and thrombotic thrombocytopenic purpura, are often acute and life threatening. We report a retrospective analysis of 65 patients presenting to our institution from 1997 to 2008 with all forms of thrombotic microangiopathy. Therapeutic plasma exchange was a requirement for analysis and 65 patients were referred to our institution; 66% of patients were female and median age at presentation was 52 years. Bacterial infection was the most commonly identified etiologic factor and in the multivariate model was the only significant variable associated with survival outcome (odds ratio 5.1, 95% confidence interval, 1.2,21.7). As infection can be considered a common trigger event for thrombotic microangiopathy, patients with hepatobiliary sepsis may benefit from elective cholecystectomy. We conclude that bacterial infection frequently triggers TTP and other thrombotic microangiopathies in patients with preexisting risk factors and propose a model for the development of these syndromes. © J. Clin. Apheresis 2010. © 2010 Wiley-Liss, Inc. [source] Hostility- and gender-related differences in oscillatory responses to emotional facial expressionsAGGRESSIVE BEHAVIOR, Issue 6 2009Gennady G. Knyazev Abstract Hostility is associated with biases in the perception of emotional facial expressions, such that ambiguous or neutral expressions tend to be perceived as threatening or angry. In this study, the effects of hostility and gender on the perception of angry, neutral, and happy faces and on the oscillatory dynamics of cortical responses elicited by these presentations were investigated using time,frequency decomposition by means of wavelet transforms. Feelings of hostility predisposed subjects to perceive happy and neutral faces as less friendly. This effect was more pronounced in women. In hostile subjects, presentation of emotional facial expressions also evoked stronger posterior synchronization in the theta and diminished desynchronization in the alpha band. This may signify a prevalence of emotional responding over cognitive processing. These effects were also more pronounced in females. Hostile females, but not hostile males, additionally showed a widespread synchronization in the alpha band. This synchronization is tentatively explained as a manifestation of inhibitory control which is present in aggressive females, but not in aggressive males. Aggr. Behav. 35:502,513, 2009. © 2009 Wiley-Liss, Inc. [source] The Politics of Hostage Rescue: Is Violence a Route to Political Success?JOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 2 2001Joseph Scanlon Over the years, law enforcement agencies have acquired extensive experience with hostage incidents, and most Western countries have officers trained in all aspects of hostage resolution. There are also articles and manuals outlining how to deal with the media coverage of hostage takings (Scanlon, 1989). However, because hostage rescue efforts can provide dramatic visuals that attract enormous audiences, the media have steadily intensified their coverage of such incidents. Today, a group of previously obscure persons can suddenly dominate the media agenda by successfully resisting an armed assault or by seizing hostages and calling themselves terrorists. After defining a hostage incident and looking at the strategy for dealing with such incidents, this article examines the implications of two fatal incidents: the stand-off involving religious fanatics at Waco, Texas; and the Air France hijacking that started in Algiers and ended in Marseille, France. Both became number one on the Western media agenda, and both became political crises involving the head of state; one threatening a president's credibility, the other enhancing a president's status. Together they suggest that the escalating media coverage of such incidents raises questions not only about the effectiveness of current response strategies, but also about political leadership. This article discusses a number of strategies that have been tried or suggested. It also debates whether involvement has a positive or negative effect on political leaders. It concludes that, from the evidence available, a successful hostage rescue can yield political rewards. [source] Imaging of the haemorrhagic complications of the haemophiliasJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 1 2009S Constantine Summary Haemorrhage is the main manifestation of the haemophilias. Although acute haemorrhages can be life threatening, especially if involving the central nervous system, repeated haemorrhages involving the musculoskeletal system lead to two conditions unique to patients with haemophilias. This pictorial essay reviews the typical imaging appearances of haemorrhages and consequences in those with haemophilias, with particular emphasis on haemophilic arthropathy and pseudotumours. [source] Deviant Forms of Aggression in Glucocorticoid Hyporeactive Rats: A Model for ,Pathological' Aggression?JOURNAL OF NEUROENDOCRINOLOGY, Issue 1 2001J. Haller Abstract Deviant forms of aggressiveness have been associated with low plasma glucocorticoid concentrations in humans. Here, we report data on the development of aggressive behaviour in rats in which glucocorticoid secretion was inhibited by adrenalectomy. Such rats were compared with both sham operated rats and adrenalectomized rats in which the fight-induced elevation of plasma glucocorticoids was mimicked by acute injections. Low and stable corticosterone plasma concentrations were maintained by subcutaneous glucocorticoid pellets in adrenalectomized rats. The development of aggressive behaviour was followed over three trials performed at 2-day intervals. Adrenalectomy lead to high aggressiveness already at the first encounter, a decreased threatening (attack signalling) behaviour and a change in attack targeting. While control rats targeted biting attacks towards less vulnerable dorsal parts of the opponent's body, adrenalectomized rats attacked the head frequently. Corticosterone injections that mimicked the fight induced adrenocortical reaction abolished this behavioural pattern. Thus, a reduced responsiveness of the adrenocortical system may be causally linked to deviant forms of aggression in rats. [source] Call for a national plan for rare diseasesJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1-2 2010Adam Jaffe Abstract Australia requires a national plan, similar to plans developed internationally, to address the impacts of rare diseases on individuals, the community and health services. Rare diseases often present in childhood, many are chronic, some life threatening and others associated with significant disability. However, diagnosis is often delayed, because of lack of knowledge and experience of health professionals and uncertainty about where to refer. Specialised health services are frequently lacking and specific therapies are often not available, partly because of lack of research funding directed towards rare diseases. A national plan would facilitate a coordinated response to service development, carer support, and health professional and community education, and would promote research and advocacy for affected children and their families. [source] Aggression and violence in mental health services: categorizing the experiences of Irish nursesJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2007J. MAGUIRE msc ba(hons) ffnrcsi rpn rgn dip There is growing evidence that nurses in mental health services are likely to be victims of violence or aggression. One of the key difficulties in comparing international findings, however, has been that there has been an inadequate categorization of the types of incident to which staff are exposed. The current study aimed to identify the types of violent or aggressive incidents that staff in Irish Mental Health Services were exposed to within a 1-month long period. A cross-sectional study was undertaken with all nurses working in one of the Mental Health Services in Ireland, serving both an urban and rural population. Data were collected through a questionnaire (Scale of Aggressive and Violent Experiences) adapted from the Perceptions of Prevalence of Aggression Scale. The questionnaire was designed to collect data relating to both personal and professional demographics of the sample as well as experiences of aggressive or violent incidents respondents may have encountered in their work situation. There was a response rate of 31%. Data were analysed utilizing SPSS-11. Both descriptive and inferential analyses were undertaken. The relevant data were subjected to a series of one-way anovas and chi-squared analysis. The findings suggest that nursing staff in this Mental Health Service experienced high levels of verbal aggression, with distinctions obvious between threatening and non-threatening aggression, suggesting discernment in terms of intentionality. Additionally, respondents encountered greater levels of covert or indirect violence or aggression than forms that were overtly directed towards staff. The implications are discussed in relation to both policy and practice. [source] Results of pacemaker implantation in 104 dogsJOURNAL OF SMALL ANIMAL PRACTICE, Issue 1 2007M. S. Johnson Objectives: To document the outcome, survival and complications involved in pacemaker implantation in dogs in a retrospective study. Methods: Case records for all dogs in which pacemaker implantation was performed were reviewed. Results: A total of 104 dogs underwent pacemaker implantation. Dogs were presented with atrioventricular (AV) block (71), sick sinus syndrome (25) or vasovagal syncope (eight). Age at presentation varied from six months to 13 years with a median age of seven years and two months. The Labrador was the most commonly represented breed (17 cases). All but one dog survived pacemaker implantation, with 93 showing resolution of their clinical signs while 10 dogs showed intermittent residual signs. One-, three- and five-year survival estimates were 86, 65 and 39 per cent, respectively. Major complications after implantation were documented in 15 dogs and three of these led to fatalities. Minor complications were noted in 23 dogs. Sudden death occurred in six dogs three to 55 months following successful pacemaker implantation. Clinical Significance: Transvenous pacemaker implantation was successful in reducing or eliminating clinical signs in over 90 per cent of dogs with third-degree atrioventricular (AV) block or sick sinus syndrome. In dogs with vasovagal syncope, six of eight dogs had greatly reduced frequency of collapse and two became asymptomatic. Although the procedure was associated with complications, these were rarely life threatening and good survival was documented in the majority of cases. [source] Obtaining a thorough sleep history and routinely screening for obstructive sleep apneaJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 4 2008FNP-BC, Jamie Lamm RN Abstract Purpose: To present a clinical case study of obstructive sleep apnea (OSA) and discuss a potential correlation between OSA, unexplained distal pain symptoms, and pyschoemotional concerns. Data sources: A review of the scientific literature was performed on OSA using the Cumulative Index of Nursing and Allied Health Literature and MEDLINE. Conclusions: OSA is potentially life threatening and can have serious consequences to a patient's health. Many of the obvious signs of OSA occur at night, and the symptoms of OSA may correspond to a variety of other diseases. Clinicians should recognize a possible correlation between OSA and unexplained distal pain symptoms as well as psychoemotional concerns. These clinically associated conditions may be less apparent but may dramatically affect quality of life. By improving recognition and treatment of OSA, morbidity and mortality can be reduced and quality of life can be improved for patients and their families. Implications for practice: It is imperative that clinicians are attentive and take detailed histories to recognize the clinical signs and symptoms of OSA, paying more attention to the less obvious symptomatology that may be significantly impacting quality of life. [source] Clinicopathologic presentations of dermatomycoses in cancer patientsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 8 2008P Quatresooz Abstract Many of the skin fungal infections in cancer patients may look similar to those infections in non-cancer patients. However, in some cases, they become more extensive and even life threatening. Prolonged and severe neutropenia is the main risk factor for the dramatic issue of fungal infections. The dermatomycoses in cancer patients can be classified in four broad groups: primary superficial dermatophytoses, primary superficial yeast infections, opportunistic mold infections with distinct potential for dissemination and secondary cutaneous manifestations of fungaemia. Occasionally, more than one fungus are found inside a given skin lesion. A special condition is represented by the mycotic colonization of mucosal squamous cell carcinomas. Angio-invasion by fungi accounts for the frequency of disseminated infections prevailing in immunocompromised cancer patients. In case of skin involvement, the dermatologist may assist by recognizing subtle semiological signs and performing biopsies for swift histological examination, molecular biology and/or culture. [source] Review article: strategies to determine whether hypergastrinaemia is due to Zollinger,Ellison syndrome rather than a more common benign causeALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 10 2009S. V. M. MURUGESAN Summary Background, As there is considerable overlap between the fasting serum gastrin concentrations found in Zollinger,Ellison syndrome and various common conditions such as Helicobacter pylori infection and acid suppressing medication use, establishing the cause of hypergastrinaemia in individual cases can sometimes be difficult. Aim, To review the causes of hypergastrinaemia and the role of additional non-invasive investigations in hypergastrinaemic patients. Methods, Review of articles following a Pubmed search. Results, As gastrinomas may cause serious complications and be potentially life threatening, investigation of hypergastrinaemic patients should particularly focus on confirming or refuting the diagnosis of Zollinger,Ellison syndrome. Establishing the cause of hypergastrinaemia may be difficult when there is only a mild-to-moderate elevation of fasting serum gastrin concentration and concurrent treatment with proton pump inhibitor drugs and the presence of H. pylori infection can both confuse the clinical picture. A variety of provocative tests are therefore useful for establishing whether a hypergastrinaemic patient has a gastrinoma and current evidence suggests that the secretin test should be used first line. Conclusions, We suggest an algorithm for the investigation of patients found to have an elevated fasting serum gastrin concentration and address the roles of gastrin stimulation tests in current clinical practice. [source] Third-Degree Atrioventricular Block in 21 Cats (1997,2004)JOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 1 2006H.B. Kellum The effect of 3rd-degree atrioventricular block on long-term outcome in cats is unknown. Clinical findings and long-term outcome of 21 cats with 3rd-degree atrioventricular block were studied retrospectively. Median age of cats studied was 14 years (range 7,19 years). Presenting signs included respiratory distress or collapse, but 6 cats had no clinical signs of disease. Eight cats had congestive heart failure (CHF) at the time that 3rd-degree atrioventricular block was detected. Heart rates ranged from 80 to 140 beats per minute (bpm; median 120 bpm) with no difference in heart rate between cats with and those without CHF. Eleven of 18 cats that had echocardiograms had structural cardiac disease, and 6 cats had cardiac changes consistent with concurrent systemic disease. No atrioventricular nodal lesions were detected by echocardiography. One cat had atrioventricular nodal lesions detected on histologic examination. Median survival of 14 cats that died or were euthanized was 386 days (range 1,2,013 days). Survival did not differ between cats with or without CHF or between cats with or without structural cardiac disease. Thirteen cats with 3rd-degree atrioventricular block survived >1 year after diagnosis, regardless of presenting signs or underlying cardiac disease. Third-degree heart block in cats is often not immediately life threatening. Survival was not affected by the presence of underlying heart disease or congestive heart failure at the time of presentation. Even cats with collapse might survive >1 year without pacemaker implantation. [source] Economic Shocks and Democratic Vulnerabilities in Latin America and the CaribbeanLATIN AMERICAN POLITICS AND SOCIETY, Issue 2 2010Abby Córdova ABSTRACT Historical evidence suggests that bad economic times often mean bad times for democracy, but prior research has given us little guidance on how this process may work. What economic conditions are most threatening, and how might they weaken consolidating democracies? This article uses the AmericasBarometer conducted by the Latin American Public Opinion Project (LAPOP) to answer these questions by focusing on core attitudes for the consolidation of democracy. We use survey data at the level of the individual and economic data at the country level to help detect democratic vulnerabilities in Latin America and the Caribbean. The study finds that conditions of low levels of economic development, low economic growth, and high levels of income inequality increase those vulnerabilities substantially, but the effects are not uniform across individuals. Some groups, especially the young and the poor, are particularly vulnerable to some antidemocratic appeals. [source] Use of yttrium-90 microspheres (TheraSphere®) in a patient with unresectable hepatocellular carcinoma leading to liver transplantation: A case reportLIVER TRANSPLANTATION, Issue 9 2005Laura M. Kulik Prior to therapy, model for end stage liver disease (MELD) scoring, diagnostic imaging and tumor staging were performed in a patient with T3 HCC. The patient received an orthotopic liver transplant (OLT) 42 days after treatment. The explant specimen showed complete necrosis of the target tumor. Follow-up of this patient has demonstrated no evidence of recurrence. There was no life threatening or fatal adverse experiences related to treatment. This case report documents the natural course, history and outcome of a patient treated with yttrium-90 for unresectable HCC. The patient was downstaged from T3 to T2 and was subsequently transplanted. (Liver Transpl 2005;11:1127,1131.) [source] Skin cancer in liver transplant recipientsLIVER TRANSPLANTATION, Issue 3 2000Clark C. Otley Skin cancer is the most common malignancy arising in the posttransplantation setting. Multiple factors contribute to the high risk for cutaneous carcinoma in immunosuppressed organ-transplant recipients. We review the phenomenon of skin cancer in solid-organ transplant recipients and further delineate the problem in the context of liver transplantation. Skin cancer is a significant medical and surgical problem for organ-transplant recipients. With prolonged allograft function and patient survival, the majority of solid-organ transplant recipients will eventually develop skin cancer. Although squamous cell carcinoma is the most common cutaneous malignancy in this population, basal cell carcinoma, melanoma, and Kaposi's sarcoma, as well as uncommon skin malignancies, may occur. Highly susceptible patients may develop hundreds of squamous cell carcinomas, which may be life threatening. Management strategies focus on regular full-skin and nodal examination, aggressive treatment of established malignancies, and prophylactic measures to reduce the risk for additional photodamage and malignant transformation. Skin cancer is a substantial cause of morbidity and even mortality among solid-organ transplant recipients. As a byproduct of immunosuppression, liver transplant recipients experience a high incidence of skin cancer and should be educated and managed accordingly. [source] In vitro studies of steroid hormones in neurofibromatosis 1 tumors and schwann cellsMOLECULAR CARCINOGENESIS, Issue 7 2007Lauren Fishbein Abstract The most common NF1 feature is the benign neurofibroma, which consists predominantly of Schwann cells. Dermal neurofibromas usually arise during puberty and increase in number throughout adulthood. Plexiform neurofibromas, associated with larger nerves, are often congenital and can be life threatening. Malignant peripheral nerve sheath tumors (MPNST) in NF1 are believed to arise from plexiforms in 5%,10% of patients. There are reports of increased potential for malignant transformation of plexiform tumors and increase in dermal neurofibromas, during pregnancy. These observations suggest that steroid hormones influence neurofibroma growth, and our work is the first to examine steroid hormone receptor expression and ligand-mediated cell growth and survival in normal human Schwann cells and neurofibroma-derived Schwann cell cultures. Immunohistochemistry and real-time PCR showed that estrogen receptors (ERs), progesterone receptor (PR), and androgen receptor are differentially expressed in primary neurofibromas and in NF1 tumor-derived Schwann cell cultures compared to normal Schwann cells. However, there is substantial heterogeneity, with no clear divisions based on tumor type or gender. The in vitro effects of steroid hormone receptor ligands on proliferation and apoptosis of early passage NF1 tumor-derived Schwann cell cultures were compared to normal Schwann cell cultures. Some statistically significant changes in proliferation and apoptosis were found, also showing heterogeneity across groups and ligands. Overall, the changes are consistent with increased cell accumulation. Our data suggest that steroid hormones can directly influence neurofibroma initiation or progression by acting through their cognate receptor, but that these effects may only apply to a subset of tumors, in either gender. © 2007 Wiley-Liss, Inc. [source] | |||||||||||||||||||||||||||||||||||||