Positive and negative religiousness and search for meaning: Impact on treatment of substance abuse after 6 months.

Background: Religiousness and meaning in life are protective factors against addiction. Understanding this relationship may help to improve treatment. The aim of the current study was to assess the associations of positive and negative religiousness and search for meaning with treatment outcome, for patients with substance disorder (SUD).

Experiences with stigmatization among transgender individuals after transition: A qualitative study in the Netherlands.

Transgender individuals belong to one of the most stigmatized groups in society. Although the social stigma of transgender individuals has been examined many times, post transition stigma experiences among transgender individuals have received limited research attention. The aim of this study was to examine experiences with stigmatization among Dutch transgender individuals after their transition.

The Potential for Decision Support Tools to Improve the Management of Root-Feeding Fly Pests of Vegetables in Western Europe.

Several important vegetable crops grown outdoors in temperate climates in Europe can be damaged by the root-feeding larvae of Diptera ( , Delia floralis, , , , ). Knowledge of pest insect phenology is a key component of any Integrated Pest Management (IPM) strategy, and this review considers the methods used to monitor and forecast the occurrence of root-feeding flies as a basis for decision-making by growers and the ways that such information can be applied. It has highlighted some current management approaches where such information is very useful for decision support, for example, the management of with insecticidal sprays and the management of all of these pests using crop covers.

[Gender dysphoria: approach in complex cases].

Gender dysphoria can be a devastating condition but the symptoms are not always straightforward or visible. In this clinical lesson three cases are presented in which GPs suspect gender dysphoria in their patient but are not sure of the best approach. These cases illustrate how gender identity can sometimes vary or develop over time, and how in complex cases psychiatric co-morbidity can interfere with gender identity development and with the treatment of gender dysphoria.

Contemporary damage control surgery outcomes: 80 patients with severe abdominal injuries in the right upper quadrant analyzed.

Background: Damage control laparotomy (DCL) is a well-established surgical strategy in the management of the severely injured abdominal trauma patients. The selection of patients by intra-abdominal organs involvement for DCL remains controversial. The aim of this study was to assess the injury to the abdominal organs that causing severe metabolic failure, needing DCL.

Morphology and identification of the mature larvae of several species of the genus Otiorhynchus (Coleoptera, Curculionidae, Entiminae) from Central Europe with an update of the life history traits.

The mature larvae of 14 Otiorhynchus taxa are described: O. (Otiorhynchus) armadillo (Rossi, 1792), O. (Nehrodistus) armatus Boheman, 1846, O.

Screening for occult penetrating cardiac injuries.

Objective: To determine the sensitivity of emergency department ultrasonography (US) in the diagnosis of occult cardiac injuries.

Background: Internationally, US has become the investigation of choice in screening patients for a possible cardiac injury after penetrating chest trauma by detecting blood in the pericardial sac.

Methods: Patients presenting with a penetrating chest wound and a possible cardiac injury to the Groote Schuur Hospital Trauma Centre between October 2001 and February 2009 were prospectively evaluated.

Management of blunt liver trauma in 134 severely injured patients.

Background: In haemodynamic stable patients without an acute abdomen, nonoperative management (NOM) of blunt liver injuries (BLI) has become the standard of care with a reported success rate of between 80 and 100%. Concern has been expressed about the potential overuse of NOM and the fact that failed NOM is associated with higher mortality rate. The aim of this study was to evaluate factors that might indicate the need for surgical intervention, and to assess the efficacy of NOM.

Management of biliary complications in 412 patients with liver injuries.

Background: Bile leaks occur in 4% to 23% of patients after major liver injuries. The role of conservative management versus internal biliary drainage has not been clearly defined. The safety and efficacy of nonoperative management of bile leaks were studied.

Management of a pneumopericardium due to penetrating trauma.

Introduction: A pneumopericardium presenting after penetrating chest trauma is a rare event. The surgical management of this clinical problem has not been clearly defined. The aim of this study was to document the mode of presentation and to suggest a protocol for management.

Management of biliary complications following damage control surgery for liver trauma.

Background: The liver is the most frequently injured solid intra-abdominal organ. The major cause of early death following severe liver trauma is exsanguination. Although perihepatic packing improves survival in severe liver trauma, this leaves parenchymal damage untreated, often resulting in post-traumatic biliary leakage and a subsequent rise in morbidity.

Subxiphoid pericardial window to exclude occult cardiac injury after penetrating thoracoabdominal trauma.

Background: An occult cardiac injury may be present in patients with an acute abdomen after penetrating thoracoabdominal trauma. This study assessed the use of a subxiphoid pericardial window (SPW) as a diagnostic manoeuvre in this setting.

Methods: This was a retrospective review of a trauma database (2001-2009).

Sternotomy or drainage for a hemopericardium after penetrating trauma: a randomized controlled trial.

Objective: To determine if stable patients with a hemopericardium detected after penetrating chest trauma can be safely managed with pericardial drainage alone.

Background: The current international practice is to perform a sternotomy and cardiac repair if a hemopericardium is detected after penetrating chest trauma. The experience in Cape Town, South Africa, on performing a mandatory sternotomy in hemodynamically stable patients was that a sternotomy was unnecessary and the cardiac injury, if present, had sealed.

Large differences between test strategies for the detection of anti-Borrelia antibodies are revealed by comparing eight ELISAs and five immunoblots.

We investigated the influence of assay choice on the results in a two-tier testing algorithm for the detection of anti-Borrelia antibodies. Eighty-nine serum samples from clinically well-defined patients were tested in eight different enzyme-linked immunosorbent assay (ELISA) systems based on whole-cell antigens, whole-cell antigens supplemented with VlsE and assays using exclusively recombinant proteins. A subset of samples was tested in five immunoblots: one whole-cell blot, one whole-cell blot supplemented with VlsE and three recombinant blots.

Native parasitoids and their potential to control the invasive leafminer, Cameraria ohridella DESCH. & DIM. (Lep.: Gracillariidae).

In spite of the fact that since the end of the eighties, the horse chestnut leafminer, Cameraria ohridella, has established itself throughout Europe, native predators such as ants and birds are not attuned to this neozoic species. In contrast, several parasitic wasp species already started to exploit the invasive horse chestnut leafminer, but until now parasitation rates are quite low, mainly because of asynchrony in the lifecycles of parasitoids and host. Only the removal of leaf litter, in which pupae hibernate, is at the moment a strategy to reduce the infestation level in the next year.

[Strategies for action to tackle health inequalities in Germany].

Against the background of health inequalities, the German Federal Centre for Health Education (BZgA) has coordinated the European project 'Closing the Gap: Strategies for Action to Tackle Health Inequalities in Europe'. Describing the state of the art of reducing health inequalities in each participating country has been one output of the EU project. The aim of this contribution is to present information for Germany with regard to research, political background, initiatives, quality and evaluation of interventions and public awareness.

Packing for control of hemorrhage in major liver trauma.

Background: Packing for complex liver injuries has been associated with an increased risk of abdominal sepsis and bile leaks. The aim of the present study was to determine the optimum timing of pack removal and to assess whether the total duration of packing increases the incidence of these complications.

Methods: The study was based on a retrospective review of all patients requiring liver packing over an 8-year period in a level 1 trauma center.

[Diagnostic image (189). A man with a tongue disorder. Black hairy tongue].

In a 59-year-old man with a swallowing problem and loss of weight, who used fluoxetine because of depression, gastroscopy revealed a black hairy structure on the dorsum of the tongue, known as black hairy tongue.

Mycophenolic acid is a potent inhibitor of the expression of tumour necrosis factor- and tumour necrosis factor-receptor superfamily costimulatory molecules.

The tumour necrosis factor (TNF) ligands CD154, CD70 and TNF receptors CD134 and CD137 are all involved in allograft rejection. Because these molecules are not present on resting T cells, we investigated whether immunosuppressive drugs could inhibit their induction. Expression was induced in vitro on T cells by phorbol 12-myristate 13-acetate and ionomycin or by allogeneic dendritic cells in the presence or absence of cyclosporin A (CsA), tacrolimus (TAC), rapamycin derivative (SDZ RAD), or mycophenolic acid (MPA), and determined by flow cytometry.

Circadian growth hormone secretion in asymptomatic human immune deficiency virus infection and acquired immunodeficiency syndrome.

Although anabolic effects of GH supplementation have been reported in acquired immune deficiency syndrome (AIDS) patients, the effects of human immunodeficiency virus (HIV) infection per se on GH secretion are unknown. Therefore, we evaluated the characteristics of GH secretion in eight asymptomatic HIV-infected men, eight clinically stable male AIDS patients, and eight healthy controls. Wasting AIDS patients were not included to circumvent the confounding effects of opportunistic disease on GH secretion.

Hypothyroid-like regulation of the pituitary-thyroid axis in stable human immunodeficiency virus infection.

Thyroid function and regulation were studied in 14 consecutive male outpatients with asymptomatic human immunodeficiency virus (HIV) infection (CDC II/III, n = 8) or AIDS (CDC IV, n = 6) who were free of concomitant infections and hepatic dysfunction, and in eight healthy, age- and weight-matched male controls. Blood was sampled every 10 minutes over 24 hours for measurement of thyrotropin (TSH). Thereafter, thyroid hormones and TSH responsiveness to thyrotropin-releasing hormone (TRH) were measured.

Non-insulin-mediated glucose uptake in human immunodeficiency virus-infected men.

1. One of the metabolic features of acquired immunodeficiency syndrome is increased tissue glucose uptake documented by euglycaemic-hyperinsulinaemic clamp studies, suggesting increased insulin sensitivity. However, these results may also be related to the confounding effect of increased non-insulin-mediated glucose uptake in acquired immunodeficiency syndrome, which will result in an erroneously presumed increased insulin sensitivity.