Attitudes of therapists toward holocaust survivors

This study examined current feelings and attitudes toward Holocaust survivors in a sample of 205 Israeli mental health professionals. Subjects were asked to read two vignettes each describing an aged trauma victim who has recently applied for treatment. The first vignette presented a Holocaust survivor and the second a war veteran. The two patients were otherwise similar in background and clinical picture. After reading each vignette, subjects were asked to report their feelings toward the patient. Subjects also completed a detailed questionnaire that assessed attitudes on several issues related to the Holocaust. Feelings toward the Holocaust survivor were found to be more intense and more positive than feelings toward the combat veteran. Therapists' attitudes toward Holocaust survivors were also found to be highly and consistently positive. Compared to previous reports, they appear to reflect a change of heart in relation to the past. Therapist background variables were not found to play a major role in determining attitudes toward Holocaust survivors.     

Acute Changes in Endometrial Thickness After Aspiration of Functional Ovarian Cysts

Objective: To evaluate the influence of aspiration of functional ovarian cysts on endometrial thickness.

Design: Prospective study.

Setting: An IVF Unit of an academic medical center.

Patient(s): Twenty-two patients from our IVF program, in whom administration of a gonadotropin-releasing hormone agonist preparation in the “long protocol” failed to induce pituitary desensitization, as evidenced by a serum E₂ concentration of >55 pg/mL and the presence of an ovarian cyst of >20 mm in diameter.

Intervention(s): Transvaginal ultrasonographic-guided cyst aspiration was performed, and 2 days later, serum E₂ concentration and endometrial thickness were reassessed.

Main Outcome Measure(s): The values of serum E₂ concentration and endometrial thickness before and after cyst aspiration were compared.

Result(s): Two days after ovarian cyst aspiration, the serum E₂ concentration dropped from a mean (±SD) of 203 ± 93 to 37 ± 34 pg/mL. The mean (±SD) endometrial thickness was 9.6 ± 2.0 mm before cyst aspiration and decreased to 5.9 ± 2.4 mm after the procedure.

Conclusion(s): Within 48 hours after ovarian cyst aspiration, a significant reduction in endometrial thickness occurs concomitant with a sharp decline in serum E₂ levels. The phenomenon of acute reduction in endometrial thickness in response to acute estrogen withdrawal has not been described previously. The exact mechanism and endometrial component involved in the “shrinking” process should be further investigated.     

Regulation of VEGF in Diabetic Patients with Critical Limb Ischemia

Diabetic patients are at a 10- to 20-fold increased risk for the development of critical limb ischemia. Vascular endothelial growth factor (VEGF) is critical for the development of collateral blood vessels, which can effectively bypass peripheral arterial occlusions. We therefore set out to determine if the regulation of VEGF in patients with peripheral vascular disease differs in diabetic and nondiabetic patients. Diabetic and nondiabetic patients with peripheral vascular disease were divided into those with or without critical limb ischemia as defined by clinical criteria (rest pain, nonhealing ulcer). Monocytes from peripheral blood were isolated from all patients and the hypoxic induction of VEGF was determined in vitro. In patients without diabetes, we found that there was no significant difference in the hypoxic induction of VEGF between patients with or without critical limb ischemia. However, in diabetic patients we found that patients with critical limb ischemia produced significantly more VEGF than patients without critical limb ischemia (6.3 +/- 1.3 vs. 2.1 +/- 0.3, p < 0.015). We conclude that diabetic patients with critical limb ischemia do not have an impairment in the ability to produce VEGF with hypoxia. Contrary to current dogma, treatment paradigms directed at increasing VEGF production in the diabetic patient with critical limb ischemia might not be beneficial.     

Descemet-stripping automated endothelial keratoplasty after bee sting of the cornea

We present a case of corneal decompensation and cataract formation following a corneal bee sting in a patient with a history of drug abuse. Clinical findings, anterior segment photographs, and medical and surgical treatment are presented. The stinger was removed from the cornea. Systemic and topical steroids, topical antibiotics, and systemic and topical antiglaucoma medication and antihistamines were prescribed. After 3 months, combined Descemet-stripping automated endothelial keratoplasty (DSAEK), phacoemulsification, and intraocular lens implantation were performed, with significant improvement in visual acuity and corneal edema. To our knowledge, this is the first report of DSAEK combined with cataract surgery for this condition. It was found to be a safe and effective treatment for corneal decompensation secondary to a bee sting.     

Residential Staff’s Changing Attitudes Toward Parents of Children in their Care: Rationale and Healing Effects on Children,Parents, and Staff

A pilot project in Israel, regarding parent’s involvement in their children’s education in residential care was evaluated. The dual goals were changing staff’s attitudes toward parents, and empowering parents. During the school year, parents were invited to participate in bi-weekly dynamic group workshops in the residence (parents only and parents–children), and to 3–4 “Family Days,” in addition to sharing special parent–child summer camps. Results indicate considerable success: children, parents, and staff felt that the project had improved their ability to deal successfully with their everyday challenges, with parents viewing themselves as having been most rewarded.

The interactions between spatial summation and DNIC: Effect of the distance between two painful stimuli and attentional factors on pain perception

The ability of a painful stimulus to suppress pain in another, remote area (DNIC) has been intensely studied. However, the effect of the distance between the two painful stimuli and the attentional factors during the measurement of pain perception received minimal treatment. We evaluated the effect of these factors on DNIC and on the interaction between DNIC and spatial summation (SS) of pain. Subjects rated the intensity of a test stimulus (applied to one hand) alone and simultaneously with conditioning stimuli applied to four different locations; 5 and 30 cm from the test stimulus on the same hand, the contralateral hand and contralateral leg. In each location, ratings were performed under three different instructions: summation, attention to test stimulus, attention to conditioning stimulus. The distance between the conditioning and test stimulus significantly affected pain perception (p < 0.01) regardless of the instructions; SS occurred only at a distance of 5 cm and DNIC occurred only in the remaining distances. DNIC’s magnitude increased as the distance between the two stimuli increased (p < 0.01). However, the instruction to summate attenuated DNIC and the DNIC instruction attenuated SS of pain. Attention to the conditioning stimulus induced a stronger DNIC than attention to the test stimulus (p < 0.001). We conclude that (1) DNIC and SS of pain appear to be antagonistic processes. (2) DNIC is affected by the distance between two noxious stimuli and to a lesser extent, by attention. (3) The interaction between DNIC, SS and attention is complex and reflects the role of sensory-cognitive integration in pain perception.