Benefitting from Violence: A Preliminary Analysis of the Presence of Abuse in the Lives of the New SSI Disability Recipients

The number of individuals receiving benefits under the two disability programs that Social Security administers has increased dramatically over the past 25 years. This growth has generated hostility toward Social Security disability program recipients. To test the hypothesis that Social Security disability's recently awarded recipients may be undeserving of the benefits to which they have become entitled, fifty-three case files of new Supplemental Security Income disability recipients were analyzed to unmask what may lie behind their impairments. Particular emphasis was placed on whether recipients cases revealed a history of childhood or adult abuse—a feature which has been almost completely neglected by policymakers when determining who should and should not qualify for disability eligibility. In this small sample of cases, taken from Contra Costa County, California, childhood and adult abuse was a prevalent feature in the lives of these recently qualified SSI recipients. These findings suggest that if larger, more representative studies bear out similar results, that domestic violence and abuse activists may be well advised to unite with disability advocates to ensure the protection of SSI eligibility for applicants suffering from abuse-induced mental impairments.     

Incidence of and risk factors for surgical site infection in patients with radical cystectomy with urinary diversion

In radical cystectomy (RC), surgical-site infection (SSI) remains one of the most frustrating postoperative complications. Only a few reports have assessed SSI after RC according to the guideline authorized by the Centers for Disease Control and Prevention (CDC guideline). In this study, using the guideline, we assessed the incidence, causative organisms, classification, and risk factors for SSI in patients receiving RC with urinary diversion (UD). The subjects of this study were 104 patients who underwent RC with UD at the Department of Urology, Sapporo Medical University Hospital, between January 1996 and December 2003. As prophylactic antimicrobial agents, intravenous cephalosporins or penicillins were started before surgery and maintained until postoperative day 3. Patients who had preoperative bacteriuria were treated with antimicrobial agents before operation to eradicate the bacteria or reduce their number. The CDC guideline was used for the diagnosis of SSI. The overall incidence of SSI was 33%. The most frequent type of SSI was superficial incisional infection (71%). Methicillin-resistant Staphylococcus aureus (MRSA) was the most frequently isolated organism, accounting for 38% of the causative organisms. Operation time was shown to be a significant risk factor for SSI. Preoperative antibacterial chemotherapy for bacteriuria was not sufficiently efficacious to decrease the incidence of SSI. In our study, the incidence of SSI after RC was 33%, although 71% of the infections were superficial. It is necessary to establish more appropriate countermeasures to prevent SSI after RC with UD; in particular, that caused by MRSA.     

Effect of preadmission bowel preparation on outcomes of elective colorectal procedures in young children

Background

The utility of mechanical bowel preparation (MBP) to minimize infectious complications in elective colorectal surgery is contentious. Though data is scarce in children, adult studies suggest a benefit to MBP when administered with oral antibiotics (OAB).

Incentive to Remain Ill? How Disability Benefits Affect Health Status

Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) were created to provide a temporary safety net for people who become disabled to protect them from impoverishment. Currently, many people receive SSDI or SSI until they reach retirement age. This literature review explored the impact these programs have on people reaching their optimal level of health. Results show the number of people voluntarily returning to work is 0.2%, demonstrating that most people receiving disability benefits stay with the programs instead of returning to the workplace.     

乳腺癌手术中应用抗菌可吸收缝线与普通丝线的美容效果及外科手术部位感染的随机对照研究

Purpose The multicenter post-market study aims to compare the cosmetic outcome and the incidence of Surgical Site Infection of triclosan-coated VICRYL Plus Sutures with Chinese Silk Sutures for skin closure of modified radical mastectomy. Patients and Methods Patients undergoing modified radical mastectomy were randomly assigned to Coated VICRYL* Plus Antibacterial (polyglactin 910) Suture or Chinese Silk suture. Cosmetic outcomes were evaluated postoperatively at Days 12(±2) and 30(±5), and the evidence of SSI were assessed at Days 3, 5, 7, 12(±2), 30(±5), and 90(±7). Cosmetic outcomes were independently assessed via Visual Analogue Scale (VAS) scores evaluations of blinded incision photographs (primary endpoint) and surgeon-assessed modified Hollander Scale (mHCS) scores (secondary endpoint). Surgical Site Infection (SSI) assessments used both CDC criteria and ASEPSIS scores. Results Six Chinese sites randomized 101 women undergoing modified radical mastectomy to closure with Coated VICRYL* Plus suture (n=51) or Chinese Silk suture (n=50). Mean VAS cosmetic outcome scores for antibacterial suture (67.2) were better than for Chinese Silk (45.4) (p<0.0001)). mHCS cosmetic outcome total scores, were also higher for antibacterial suture (5.7) than for Chinese Silk (5.0) (p=0.002). Conclusions Patients using Coated VICRYL Plus Suture have obviously better cosmetic outcomes than those with Chinese Silk sutures. Patients using Coated VICRYL Plus Suture have a lower SSI incidence compared to the Chinese Silk sutures, although it did not reach statistical significance. The safety profiles of two groups were similar.     

Spinal epidural abscess: aetiology, predisponent factors and clinical outcomes in a 4-year prospective study

Spinal epidural abscess (SEA) is a rare, but serious, condition with multiple causes. We prospectively studied the aetiology, predisposing factors, and clinical outcomes of SEA in all patients with SEA treated in our hospital’s neurosurgical service from 2004 to 2008. For each patient, we recorded the medical history, comorbidities, focus of infection, pathogen(s), and outcome. The 36 patients (19 women and 17 men) ranged in age from 34 to 80 years old (mean 57; median 56). The SEA was primary (i.e., due to haematogenous spread) in 16 patients (44%); it was secondary to elective spinal procedures, either injections or surgery, in 20 patients (56%). The duration of follow-up was 12–60 months (mean 36; median 37.5). The most common pathogen, Staphylococcus aureus, was found in 18 patients (50%). Patients with primary SEA had different underlying diseases and a wider range of pathogens than those with secondary SEA. Only five patients (14%) had no major comorbidity; 16 of the 20 patients with secondary SEA (44% of the overall group) had undergone spinal surgery before developing the SEA; the treatment of the SEA involved multiple surgical operations in all 16 of these patients, and spinal instrumentation in 5 (14%); 22 patients (61% of the overall group) recovered fully.     

3-A卫生标准的由来及目录内容

鉴于目前我国很多业内人士对“3-A卫生标准”不是真正很了解,因此,简单介绍了3-A卫生标准的由来和发展历史,同时,详细介绍了现行全部3-A卫生标准的目录,其中包括标准号、名称、页数、生效日期以及其它相关的已被取消或取代的标准号。     

New insights on endocannabinoid transmission in psychomotor disorders

The endocannabinoids are lipid signaling molecules that bind to cannabinoid CB(1) and CB(2) receptors and other metabotropic and ionotropic receptors. Anandamide and 2-arachidonoyl glycerol, the two best-characterized examples, are released on demand in a stimulus-dependent manner by cleavage of membrane phospholipid precursors. Together with their receptors and metabolic enzymes, the endocannabinoids play a key role in modulating neurotransmission and synaptic plasticity in the basal ganglia and other brain areas involved in the control of motor functions and motivational aspects of behavior. This mini-review provides an update on the contribution of the endocannabinoid system to the regulation of psychomotor behaviors and its possible involvement in the pathophysiology of Parkinson's disease and schizophrenia.     

Treating chronic arsenic toxicity with high selenium lentil diets

Arsenic (As) toxicity causes serious health problems in humans, especially in the Indo-Gangetic plains and mountainous areas of China. Selenium (Se), an essential micronutrient is a potential mitigator of As toxicity due to its antioxidant and antagonistic properties. Selenium is seriously deficient in soils world-wide but is present at high, yet non-toxic levels in the great plains of North America. We evaluate the potential of dietary Se in counteracting chronic As toxicity in rats through serum biochemistry, blood glutathione levels, immunotoxicity (antibody response), liver peroxidative stress, thyroid response and As levels in tissues and excreta. To achieve this, we compare diets based on high-Se Saskatchewan (SK) lentils versus low-Se lentils from United States. Rats drank control (0 ppm As) or As (40 ppm As) water while consuming SK lentils (0.3 ppm Se) or northwestern USA lentils (< 0.01 ppm Se) diets for 14 weeks. Rats on high Se diets had higher glutathione levels regardless of As exposure, recovered antibody responses in As-exposed group, higher fecal and urinary As excretion and lower renal As residues. Selenium deficiency caused greater hepatic peroxidative damage in the As exposed animals. Thyroid hormones, triiodothyronine (T3) and thyroxine (T4), were not different. After 14 weeks of As exposure, health indicators in rats improved in response to the high Se lentil diets. Our results indicate that high Se lentils have a potential to mitigate As toxicity in laboratory mammals, which we hope will translate into benefits for As exposed humans.     

结直肠癌手术部位感染相关因素分析

目的探讨结直肠癌患者手术部位感染(SSI)的相关因素。方法回顾性调查2007年1月-2009年12月行结直肠癌择期手术的208例病例,并进行病例对照研究,采用单因素、多因素logistic回归分析的方法筛选与发生SSI相关的危险因素。结果大肠埃希菌是手术部位感染的主要病原菌,其中产超广谱β-内酰胺酶(ESBLs)的占88.24%;多因素分析显示,手术时间>3.5 h(P=0.001;OR=9.231)、术前空腹血糖>6.1 mmol/L(P=0.032;OR=2.555)、高密度脂蛋白<1.03 mmol/L(P=0.023;OR=2.098)是结直肠癌手术部位感染的危险因素,而腔镜手术(P=0.011;OR=0.092)则是保护因素。结论结直肠癌手术部位感染的主要病原菌是产ESBLs的大肠埃希菌,手术时间、术前空腹血糖、高密度脂蛋白和是否腔镜手术是SSI的影响因素。