Polyvictimization and Psychiatric Sequelae Associated with Female Genital Mutilation/Cutting (FGM/C)

Female Genital mutilation/cutting (FGM/C) is associated with enduring psychiatric complications. In this study, we investigate the rates of co-morbid abuses and polyvictimization experienced by survivors of FGM/C. This is a sub-analysis of a cohort study examining the patient population at the EMPOWER Center for Survivors of Sex Trafficking and Sexual Violence in New York City. A retrospective chart-review of electronic medical records was conducted for all consenting adult patients who had FGM/C and had an intake visit between January 16, 2014 and March 6, 2020. Of the 80 participants, ages ranged from 20 to 62 years with a mean of 37.4 (SD?=?9.1) years. In addition to FGM/C, participants were victims of physical abuse (43; 53.8%), emotional abuse (35; 43.8%), sexual abuse (35; 43.8%), forced marriage (20; 25%), child marriage (13; 16.3%), and sex trafficking (1; 1.4%). There was a high degree of polyvictimization, with 41 (51.2%) experiencing 3 or more of the aforementioned abuses. Having FGM/C on or after age 13 or having a higher total abuse score was also found to be strong predictors of depression and PTSD. The high rates of polyvictimization among survivors of FGM/C are associated with development of depression and PTSD. Despite co-morbid abuses, patients still attribute substantial psychiatric symptoms to their FGM/C. Health care providers should understand the high risk of polyvictimization when caring for this patient population.

     

Prevalence and attitudes on female genital mutilation/cutting in Egypt since criminalisation in 2008

Female genital mutilation/cutting (FGM/C), which can result in severe pain, haemorrhage and poor birth outcomes, remains a major public health issue. The extent to which prevalence of and attitudes toward the practice have changed in Egypt since its criminalisation in 2008 is unknown. We analysed data from the 2005, 2008 and 2014 Egypt Demographic and Health Surveys to assess trends related to FGM/C. Specifically, we determined whether FGM/C prevalence among ever-married, 15–19-year-old women had changed from 2005 to 2014. We also assessed whether support for FGM/C continuation among ever-married reproductive-age (15–49 years) women had changed over this time period. The prevalence of FGM/C among adolescent women statistically significantly decreased from 94% in 2008 to 88% in 2014 (standard error [SE] = 1.5), after adjusting for education, residence and religion. Prevalence of support for the continuation of FGM/C also statistically significantly decreased from 62% in 2008 to 58% in 2014 (SE = 0.6). The prevalence of FGM/C among ever-married women aged 15–19 years in Egypt has decreased since its criminalisation in 2008, but continues to affect the majority of this subgroup. Likewise, support of FGM/C continuation has also decreased, but continues to be held by a majority of ever-married women of reproductive age.     

Polyvictimization and mental health consequences of female genital mutilation/circumcision (FGM/C) among Somali refugees in Kenya

ABSTRACT

Female genital mutilation or circumcision (FGM/C) is a perilous social and cultural practice that affects the physical, mental, and psychological health of affected women. It is widespread around the world, affecting 200 million women and girls. This study aimed to explore the relation of FGM/C to mental and physical conditions in Somali refugees displaced in a low-resource setting, applying the concept of poly-victimization to reveal multifaceted trauma sequelae. Data for this cross-sectional study with 143 female Somali youth living in Eastleigh, Kenya were collected between April and May in 2013. FGM/C was strongly associated with negative physical and mental health outcomes, including post-traumatic stress disorder and depressive, anxiety, and somatic symptoms. Logistic regression analysis revealed that separation from a parent and poly-victimization experiences were significantly associated with FGM/C experience. The results also showed that FGM/C and other traumas did not occur singly but were indicative of cumulative adversities, especially for women who were socially vulnerable and marginalized. The results of this study highlight the practice of FGM/C in the context of other adverse living conditions of refugees and the importance of attending to other co-occurring risk factors that prevail with FGM/C practice in the ecological system of refugee forced migration.     

Female genital mutilation and cutting: a systematic literature review of health professionals’ knowledge,attitudes and clinical practice

Background

The World Health Organisation (WHO) estimates that 100–140 million girls and women have undergone female genital mutilation or cutting (FGM/C). FGM/C is an ancient cultural practice prevalent in 26 countries in Africa, the Middle East and Asia. With increased immigration, health professionals in high income countries including UK, Europe, North America and Australia care for women and girls with FGM/C. FGM/C is relevant to paediatric practice as it is usually performed in children, however, health professionals’ knowledge, clinical practice, and attitudes to FGM/C have not been systematically described. We aimed to conduct a systematic review of the literature to address this gap.

Methods

The review was conducted according to guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42015015540, http://www.crd.york.ac.uk/PROSPERO/). Articles published in English 2000–2014 which used quantitative methods were reviewed.

Results

Of 159 unique articles, 18 met inclusion criteria. The methodological quality was poor - six studies met seven of the eight quality criteria. Study participants included mainly obstetricians, gynaecologists and midwives (15 studies). We found no papers that studied paediatricians specifically, but two papers reported on subgroups of paediatricians within a mixed sample of health professionals. The 18 articles covered 13 different countries: eight from Africa and 10 from high income countries. Most health professionals were aware of the practice of FGM/C, but few correctly identified the four FGM/C categories defined by WHO. Knowledge about FGM/C legislation varied: 25 % of professionals in a Sudanese study, 46 % of Belgian labour ward staff and 94 % of health professionals from the UK knew that FGM/C was illegal in their country. Health professionals from high income countries had cared for women or girls with FGM/C. The need to report children with FGM/C, or at risk of FGM/C, to child protection authorities was mentioned by only two studies.

Conclusion

Further research is needed to determine health professionals’ attitudes, knowledge and practice to support the development of educational materials and policy to raise awareness and to prevent this harmful practice.

     

Female Genital Mutilation/Cutting in the United States: Updated Estimates of Women and Girls at Risk, 2012

Objectives

In 1996, the U.S. Congress passed legislation making female genital mutilation/cutting (FGM/C) illegal in the United States. CDC published the first estimates of the number of women and girls at risk for FGM/C in 1997. Since 2012, various constituencies have again raised concerns about the practice in the United States. We updated an earlier estimate of the number of women and girls in the United States who were at risk for FGM/C or its consequences.

Methods

We estimated the number of women and girls who were at risk for undergoing FGM/C or its consequences in 2012 by applying country-specific prevalence of FGM/C to the estimated number of women and girls living in the United States who were born in that country or who lived with a parent born in that country.

Results

Approximately 513,000 women and girls in the United States were at risk for FGM/C or its consequences in 2012, which was more than three times higher than the earlier estimate, based on 1990 data. The increase in the number of women and girls younger than 18 years of age at risk for FGM/C was more than four times that of previous estimates.

Conclusion

The estimated increase was wholly a result of rapid growth in the number of immigrants from FGM/C-practicing countries living in the United States and not from increases in FGM/C prevalence in those countries. Scientifically valid information regarding whether women or their daughters have actually undergone FGM/C and related information that can contribute to efforts to prevent the practice in the United States and provide needed health services to women who have undergone FGM/C are needed.In 1997, Public Health Reports published the first U.S. estimates of the number of women and girls in the United States in 1990 (hereafter referred to as the 1990 estimates) who were at risk for female genital mutilation/cutting (FGM/C).¹ That study was conducted at the request of the U.S. Congress, which passed legislation making FGM/C illegal in the United States. Since 2012, various constituencies have again raised concerns about the practice of FGM/C in the United States.^2–6 New estimates are needed because of substantial growth in the immigrant population of the United States in recent decades and the need to support additional policies to reduce the occurrence of FGM/C.We updated the 1990 estimates of the number of women and girls in the United States who were at risk for FGM/C. We report only the number of women and girls at risk for FGM/C and do not estimate the number of women and girls who have actually undergone the procedure.     

Feelings of Masculinity and Accomplishment in Response to Penetrative versus Non-Penetrative Orgasms

Research indicates that men view their women partner’s orgasms as reflections of their masculinity and sexual esteem. The purpose of this study was to examine this phenomenon in more detail by exploring whether men’s feelings of masculinity and sexual esteem, as well as their feelings of accomplishment, were influenced by the method by which their woman partner experienced orgasm. Specifically, 193 young adult men (primarily between the ages of 18 and 24) read one of three vignettes (a partner orgasming from intercourse, from manual/oral stimulation, or from vibrator use) and then rated their imagined feelings of masculinity, accomplishment, and sexual esteem. Findings indicated that men who imagined their partner orgasmed from intercourse or manual/oral stimulation had higher feelings of masculinity and accomplishment than those who imagined their partner orgasmed from a vibrator. We found a significant interaction between clitoral knowledge and vignette condition in predicting masculinity, with clitoral knowledge only predicting masculinity for men in the manual/oral stimulation condition. The results of this study have important implications for sex education and the prevention of sexual problems, as well as for the future study of positive sexual functioning in women and men.

     

靶控输注右美托咪啶对机械性疼痛刺激镇痛效果的观察

目的观察靶控输注右旋美托咪啶对志愿者机械性疼痛刺激的镇痛效果。方法下肢择期骨科手术须行腰硬联合麻醉健康志愿者30名(ASAI级),随机分为D组(实验组)和C组(对照组),每组各15例;腰硬联合麻醉麻醉平面固定15 min后,D组志愿者接受手持式电子von Frey 150 g vFFs垂直刺激志愿者左手心及VAS评分,随后以初始血浆靶浓度(0.6 ng/ml)靶控输注DEX,持续输注稳定20 min后再次以150g vFFs刺激志愿者左手心及唤醒VAS评分。如果主诉无痛或唤之不醒,则该浓度梯度VAS评分为0,如果主诉疼痛并VAS>10 mm后,以0.3 ng/ml为梯度增加靶浓度重复上述实验,每个测试靶浓度至少持续稳定输注20 min,直至靶浓度递增至2.1 ng/ml共6个浓度梯度,分别为0.6 ng/ml(T1)、0.9 ng/ml(T2)、1.2 ng/ml(T3)、1.5 ng/ml(T4)、1.8 ng/ml(T5)和2.1 ng/ml(T6),C组(对照组)以相同模式靶控输注生理盐水及对应浓度梯度进行VAS评分,同时记录MAP、HR、SpO2及脑电双频谱指数(BIS)、警觉/镇静(OAA/S)评分,必要时干预处理低血压和心动过缓等不良反应。结果两组机械性疼痛VAS评分基础值相似,D组VAS评分随着浓度梯度增加逐渐下降(p<0.05),C组无明显变化(p>0.05)。与基础值比较,D组靶控输注初始剂量后BIS值、MAP和HR下降,随着浓度梯度增加分别逐渐下降21.3%～58.1%、21.1%～46.7%和12.3%～38.3%,OAA/S和Ramsay镇静评分也逐渐下降(p<0.05),C组无明显变化(p>0.05)。两组志愿者SpO2稳定,无明显变化(p>0.05)。结论右旋美托咪啶镇静随着血浆靶控输注浓度递增而加深,高浓度右旋美托咪啶对机械性疼痛刺激具有明显镇痛效应,但低血压和心率过缓的风险增加。     

Vitamin C Deficiency in a University Teaching Hospital

Objectives: There is almost no information regarding the vitamin C status of patients treated in Canadian and American hospitals. We determined the prevalence and predictors of vitamin C deficiency in patients hospitalized on the acute-care wards of a Canadian teaching hospital, and tracked their plasma vitamin C concentrations while they were there.

Methods: This was a population-based cross-sectional and time course survey of 149 medical patients shortly after admission to a university teaching hospital. The procedure for sample handling, storage and analysis was validated by measuring the vitamin C concentrations of a reference sample of 141 presumably well nourished people and comparing the results with published norms.

Results: In keeping with published norms, 13% of people in the reference group had a subnormal vitamin C concentration (<28.4 μmol/L) and 3% were vitamin C deficient (<11.4 μmol/L). By contrast, 60% of hospitalized patients had a subnormal vitamin C concentration and 19% were deficient. A history of inadequate nutrition or failure to use a vitamin supplement prior to admission, low serum albumin, and male sex predicted plasma vitamin C deficiency, whereas use of a vitamin supplement prior to admission was associated with adequate vitamin C status in hospital. In a second measurement, obtained in 52 patients after an average of 17 days in hospital, vitamin C status had not improved.

Conclusions: Vitamin C deficiency is prevalent and sustained in patients in a Canadian teaching hospital. The abnormality can be prevented by providing a diet sufficient in vitamin C or by prescribing a multiple vitamin tablet.     

Factors associated with female genital mutilation in Burkina Faso and its policy implications

Background  

Female genital mutilation (FGM) usually undertaken between the ages of 1-9 years and is widely practised in some part of Africa and by migrants from African countries in other parts of the world. Laws prohibit FGM in almost every country. FGM can cause immediate complications (pain, bleeding and infection) and delayed complications (sexual, obstetric, psychological problems). Several factors have been associated with an increased likelihood of FGM. In Burkina Faso, the prevalence of FGM appears to have increased in recent years.     

‘I want what every other woman has’: reasons for wanting clitoral reconstructive surgery after female genital cutting – a qualitative study from Sweden

Female genital cutting (FGC) involves the removal of women’s external genitalia for non-therapeutic reasons. An estimated 38,000 women living in Sweden have undergone some form of the procedure. These women often belong to marginalised minorities of immigrant women from countries where FGC is widespread. Clitoral reconstructive surgery following FGC has recently been introduced in Sweden. This study investigates women’s perceptions of FGC and clitoral reconstructive surgery with a particular focus on: (1) reasons for requesting reconstructive surgery, and (2) FGC-affected women’s expectations of the surgery. Seventeen women referred for clitoral reconstructive surgery at the Department of Plastic and Reconstructive Surgery, Karolinska University Hospital, Stockholm, participated in the study. Findings revealed five factors motivating women’s request for clitoral reconstruction (CR): (1) symbolic restitution – undoing the harm of FGC; (2) repairing the visible stigma of FGC; (3) improving sex and intimacy through physical, aesthetic and symbolic recovery; (4) eliminating physical pain; (5) and CR as a personal project offering hope. These factors were highly interconnected, suggesting that the reasons for seeking surgery were often multiple and complex.     

Female Genital Mutilation/Cutting in Mali and Mauritania: Understanding Trends and Evaluating Policies

Despite international commitments to end female genital mutilation/cutting (FGM/C), very little is known about the effectiveness of national policies in contributing to the abandonment of this harmful practice. To help address this gap in knowledge, we apply a quasi-experimental research design to study two west African countries, Mali and Mauritania. These countries have marked similarities with respect to practices of FGM/C, but differing legal contexts. A law banning FGM/C was introduced in Mauritania in 2005; in Mali, there is no legal ban on FGM/C. We use nationally representative survey data to reconstruct trends in FGM/C prevalence in both countries, from 1997 to 2011, and then use a difference-in-difference method to evaluate the impact of the 2005 law in Mauritania. FGM/C prevalence in Mauritania began to decline slowly for girls born in the early 2000s, with the decline accelerating for girls born after 2005. However, a similar trend is observable in Mali, where no equivalent law has been passed. Additional statistical analysis confirms that the 2005 law did not have a significant impact on reducing FGM/C prevalence in Mauritania. These findings suggest that legal change alone is insufficient for behavioral change with regard to FGM/C. This study demonstrates how it is possible to evaluate national policies using readily available survey data in resource-poor settings.     

Evidence for Anti-Inflammatory Effects of Combined Administration of Vitamin E and C in Older Persons with Impaired Fasting Glucose: Impact on Insulin Action

Objective: Vitamin E and C given separately improve insulin sensitivity due to an inhibitory effect on oxidative stress and inflammation, however their combined effect on glucose control and inflammation is unknown. To investigate combined effect of Vitamin E and C in elderly with Impaired Fasting Glucose (IFG) on insulin action and substrate oxidation.

Design: Controlled-trial administration of Vitamin E (1000 mg/day) and Vitamin C (1000 UI/day) for four weeks. Hyperinsulinemic euglycemic glucose clamp was performed before and following supplementation.

Setting: Out-patient clinic.

Participants: Thirteen older men with IFG.

Main Outcome Parameters: Variations in whole body glucose disposal (WBGD), anti-oxidant, and inflammatory cytokines plasma levels.

Results: An increase in plasma Vitamin E (8.3 + 0.8 vs. 64.9 + 2.1 μmol/l; p < 0.001] and C (35.9 + 5.4 vs. 79.4 + 7.4 μmol/l; p < 0.001) was found. Vitamin administration reduced insulin, glucose, lipid, TNF-α and [8-]isoprostane levels. Increase in plasma vitamin E levels correlated with decline in both plasma [8-]isoprostane levels (r = ?0.58; p = 0.048) and TNF-α levels (r = ? 0.62; p = 0.025), while no correlations were found for Vitamin C. Whole body glucose disposal (WBGD) (22.7 + 0.6 vs. 30.4 + 0.8 mmol × kg-1 × min-1; p = 0.001) and non-oxidative glucose metabolism rose after supplementation. Rise in plasma levels of Vitamin C and E correlated with WBGD. Multivariate linear regression models showed independent associations among the change in Vitamin E and the decline in TNF-α and [8-]isoprostane levels.

Conclusions: Combined administration of Vitamin E and C lowered inflammation and improved insulin action through a rise in non-oxidative glucose metabolism.     

谷氨酰胺保护严重烧伤病人肠粘膜屏障功能的研究

目的：观察严重烧伤病人肠粘膜屏障功能的变化及口服谷氨酰胺颗粒剂对它的影响。方法：采用随机双盲对照法,将烧伤总面积在30％－60％、三度烧伤面积在10％－30％的39例病人,随机分为谷氨酰胺治疗组（Gln组20例）和安慰剂对照组（C组19例）。Gln组每天服用谷氨酰胺颗粒剂0．5g/kg。C组服用同等剂量的安慰剂,疗程为7天。检测用药前后两组病人血中谷氨酰胺浓度、二胺氧化酶（DAO）活性、内毒素含量及肠粘膜通透性的变化,并记录一般情况和住院日。结果：Gln组病人用药7天后,血中谷氨酰胺含量明显高于C组（P＜0．01）,而血浆DAO活性、内毒素含量及肠粘膜通透性均显著低于C组（P＜0．01）,住院日显著短于C组。结论：服用谷氨酰胺颗粒剂能显著提高严重烧伤病人血中谷氨酰胺水平,减轻伤后肠道受损程度,保护肠粘膜屏障,并有助于缩短住院日。     

Ethnicity is associated with alterations in oxytocin relationships to pain sensitivity in women

It is well established that African Americans (AA) experience greater pain associated with a variety of clinical conditions, and greater pain sensitivity to experimental pain tasks relative to non-Hispanic Whites (W). Notably, African Americans do not show the same relationships involving endogenous pain regulatory mechanisms and pain sensitivity documented in Caucasians, including positive associations between blood pressure, norepinephrine, cortisol and greater pain tolerance.

Objectives. The purpose of this study was to examine the relationship between plasma oxytocin (OT) and pain sensitivity and to explore the relation of OT to other factors known to influence pain perception.

Design. OT concentration and sensitivity to ischemic, cold pressor, and thermal pain tasks were assessed in African American (n=25) and non-Hispanic White (n=23) pre-menopausal women.

Results. African American women demonstrated significantly lower pain tolerance across tasks compared with Whites (F _1,46=6.31, p=0.0156) and also exhibited lower plasma OT levels (AA: 3.90, W: 7.05 pg/mL; p=0.0014). Greater OT levels were correlated with greater tolerance to ischemic pain (r=0.36, p=0.013) and accounted for a marginally significant portion of the ethnic difference in ischemic pain tolerance (B=+0.29, p=0.06). Greater OT was also correlated with greater tolerance of cold pressor pain (r=0.31, p=0.03); however, this association was no longer seen after the variance due to ethnicity was accounted for.

Conclusion. These data suggest that reduced oxytocinergic function may be one of multiple biological factors contributing to the greater sensitivity to experimental ischemic pain, and to the greater burden of some types of clinical pain experienced by African Americans compared with Whites.     

红光联合皮肤缝合器用于跟骨皮肤切口的疗效观察

目的探讨红光照射联合皮肤缝合器应用于跟骨骨折手术切口的疗效。方法将我院2017年1月—2019年4月收治的跟骨骨折患者资料进行回顾性研究,按照纳入及排除标准,纳入患者135例,根据缝合及术后处理方式不同分为3组,A组(红光照射+钉合组)、B组(钉合组)和C组(缝合组),拆钉或拆线后平均随访3个月,分别对3组缝合速度、切口渗出及愈合时间,皮缘坏死、炎性反应、切口裂开、钢板外露、切口感染、过敏反应及术后3个月切口蜈蚣状瘢痕的发生率,术后第2、4天及拆钉(线)时的疼痛程度(采用VAS评分)进行统计学分析。结果A组较B组切口的炎性反应更轻,术后2、4天疼痛程度更低,切口渗出及愈合时间更短,差异有统计学意义(P<0.05)。A组较C组的缝合速度更快,炎性反应更少,皮缘坏死率更低,疼痛程度更轻,切口渗出及愈合的时间更短,蜈蚣症出现的更少,差异有统计学意义(P<0.05)。B组较C组的缝合速度更快,皮缘坏死率更低,拆钉时疼痛程度更轻,蜈蚣症出现的更少,差异有统计学意义(P<0.05)。在切口裂开、钢板外露、切口感染、过敏反应方面,3组结果比较差异无统计学意义(P>0.05)。结论红光照射联合皮肤缝合器应用于跟骨骨折手术切口能够减轻炎性反应、减少皮缘的坏死率、降低疼痛程度、缩短切口渗出及愈合的时间,且能加快缝合速度,降低手术并发症,达到较好的美容效果。     

The Effectiveness of a Community‐based Education Program on Abandoning Female Genital Mutilation/Cutting in Senegal

A pre‐ and post‐test comparison‐group design was used to evaluate the effect of a community education program on community members' willingness to abandon female genital mutilation/cutting (FGM/C) in rural areas of southern Senegal. Developed by TOSTAN (a Senegalese nongovernmental organization), the education program aimed to empower women through a broad range of educational and health‐promoting activities. Our findings suggest that information from the program was diffused widely within the intervention villages, as indicated by improvements in knowledge about and critical attitudes toward FGM/C among women and men who had and had not participated in the program, without corresponding improvement in the comparison villages. The prevalence of FGM/C among daughters aged ten years and younger decreased significantly over time as reported by women who were directly and indirectly exposed to the program, but not among daughters in the comparison villages, suggesting that the program had an impact on family behaviors as well as attitudes. Findings from this study provide evidence‐based information to program planners seeking to empower women and discourage a harmful traditional practice.     

Possible improvement of the clitoral and vaginal blood flow using a somatostatin analog in chronic spinalized Sprague-Dawley rats

We evaluated the effect of a somatostatin analog (octreotide) on clitoral and vaginal blood flow following suprasacral spinal cord injury (SCI) in rats. Twenty-four spinalized female Sprague-Dawley rats were randomized into 4 equal groups. The first group served as control paraplegics. The other three groups received octreotide (60 micrograms/day/4 weeks) immediately, 2 weeks, and 4 weeks following SCI. At the end of the experiment, a laser Dopper was used to measure blood flow changes following clitoral and pelvic nerve plexus stimulations. Marked decreases in both clitoral and vaginal blood flow in the control paraplegics were recorded. Significant increases (p < 0.05) in both clitoral and vaginal blood flow were recorded in animals that received octreotide; however, the increase was marked in the animals that received the drug immediately following SCI. Improvement in the clitoral and vaginal blood flow of spinalized rats using octreotide indicates that octreotide may be helpful for patients with SCI.     

A Tradition in Transition: Factors Perpetuating and Hindering the Continuance of Female Genital Mutilation/Cutting (FGM/C) Summarized in a Systematic Review

Understanding the forces underpinning female genital mutilation/ cutting (FGM/C) is a necessary first step to prevent the continuation of a practice that is associated with health complications and human rights violations. To this end, a systematic review of 21 studies was conducted. Based on this review, the authors reveal six key factors that underpin FGM/C: cultural tradition, sexual morals, marriageability, religion, health benefits, and male sexual enjoyment. There were four key factors perceived to hinder FGM/C: health consequences, it is not a religious requirement, it is illegal, and the host society discourse rejects FGM/C. The results show that FGM/C appears to be a tradition in transition.     

Effects of polyunsaturated fatty acids on cocaine-conditioned place preference in mice

Abstract

Objective

The objective of the present study was to assess whether the administration of polyunsaturated fatty acids (PUFAs) would lead to alterations in cocaine-conditioned place preference by correlating behavioral data and plasma levels of PUFAs.

Methods

Five groups of C57Bl/6J mice received a linseed oil supplement or a control solution for 19 days and were conditioned to cocaine.

Results

PUFAs did not exert a protective effect against cocaine-conditioned place-preference behavior, although there were significant differences in the levels of eicosapentaenoic acid (EPA) and linoleic acid among the groups tested. Higher doses of PUFAs might be necessary to induce a change in the plasma level of EPA in cocaine-conditioned mice.

Discussion

PUFAs had no effect on cocaine-conditioned place preference.     

Internal Ileostomy a Focus at Alimentary Surgeons' Session

A 63-year-old man was brought to the emergency department by paramedics after being found in an alley in back of a drinking establishment on an unusually cold winter night. The police recognized the patient as a homeless person who had been frequently arrested for drunkenness.

The patient was markedly obtunded; pulse was 38 beats per minute and regular. Blood pressure was 60/40 mm Hg, respirations were eight per minute, and rectal temperature was 29°C (84.2°F). He was flaccid and areflexic but moved all extremities in response to deep pain. Findings on general physical examination were otherwise unremarkable.

The ECG is shown.