Omphaloliths: a case series and review of 29 cases in literature

Omphaloliths are uncommon benign umbilical lesions caused by the accumulation of sebum and keratin into a stone-like concretion. Recognition of this entity can prevent unnecessary procedures and imaging studies for uncomplicated cases. We present three cases of omphaloliths from our department and review all 26 cases previously reported in the English literature with regard to modes of presentation, potential risk factors, complications, and treatment options to guide clinicians. The mean age at presentation was 48 years. Of the 29 cases, 17 (59%) were asymptomatic. Male patients presented at a younger age and were more likely to present with complications compared to females who presented at an older age with asymptomatic lesions (P=0.006). Features of patients described included dementia, hirsutism, a deep or narrow umbilicus, multiple nevi, obesity, and poor hygiene. Two patients developed overlying pyogenic granulomas. Removal of asymptomatic lesions was uncomplicated and done using forceps or following irrigation, with no recurrence. Complications, including localized abscesses and peritonitis, were associated in 41% of patients who were treated surgically; recurrence was noted in one patient. Removal of omphaloliths is recommended, once identified, to reduce risks of complications and patients should be encouraged to improve their personal hygiene

KEBIJAKAN MANAJEMEN PELAYANAN PEMBELAJARAN PADA MASA PANDEMI COVID-19 TAHUN 2020-2021 (Studi Kasus di Fakultas Ilmu Administrasi Universitas Islam Malang Kota Malang)

Penelitian ini dilakukan atas dasar adanya Kebijakan Pemerintah Tentang Pembelajaran Pada Masa Pandemi Covid-19 di Fakultas Ilmu Administrasi Universitas Islam Malang. Kebijakan ini dilakukan oleh Fakultas Ilmu Administrasi Universitas Islam Malang yang mana memiliki kebijakan tentang pelayanan pembelajaran pada masa pandemi covid-19. Penelitian ini bertujuan untuk mengetahui kebijakan pelayanan pembelajaran, faktor pendukung dan penghambatnya, dan upaya untuk meningkatkan manajemen pelayanan pembelajaran Fakultas Ilmu Administrasi pada masa pandemi covid-19. Untuk mengetahuinya digunakan jenis penelitian deskriptif-kualitatif dengan teknik pengumpulan data wawancara, observasi, dan dokumentasi. Hasil penelitian ini menunjukan bahwa kebijakan Fakultas Ilmu Administrasi dalam pelayanan pembelajaran pada masa pandemi berjalan sesuai aturan dari pemerintah dan rektor yaitu dengan sistem daring. Faktor pendukung: pemotongan SPP, subsidi wisuda fakultas, link pembuatan surat permohonan secara online. Faktor penghambat: kendala jaringan internet, keterbatasan teknologi dari mahasiswa dan tidak bisa tatap muka. Upaya meningkatkan manajemen pelayanan pembelajaran, seperti program Merdeka Belajar Kampus Merdeka, KKN yang berkaitan dengan covid-19, link daring unisma.ac.id, dan pembuatan stampel basah berbasis online. Kesimpulannya bahwa Kebijakan Manajemen Pelayanan Pembelajaran Fakultas Ilmu Administasi UNISMA telah menjalankan dengan baik dan meminimalisir tidak efektifnya sistem pelayanan pembelajaran pada masa pandemi covid-19. Kata kunci: kebijakan publik, manajemen pelayanan publik, pembelajaran masa pandemi covid-1

Conspicuous by their abstinence: the limited engagement of heroin users in English and Welsh Drug Recovery Wings

Background In recent years, an abstinence-focused, ‘recovery’ agenda has emerged in UK drug policy, largely in response to the perception that many opioid users had been ‘parked indefinitely’ on Opioid Substitution Therapy (OST). The introduction of ten pilot ‘Drug Recovery Wings’ (DRWs) in 2011 represents the application of this recovery agenda to prisons. This paper describes the DRWs’ operational models, the place of opiate dependent prisoners within them, and the challenges of delivering ‘recovery’ in prison. Methods In 2013, the implementation and operational models of all ten pilot DRWs were rapidly assessed. Up to three days were spent in each DRW, undertaking semi-structured interviews with a sample of 94 DRW staff and 102 DRW residents. Interviews were fully transcribed, and coded using grounded theory. Findings from the nine adult prisons are presented here. Results Four types of DRW were identified, distinguished by their size and selection criteria. Strikingly, no mid- or large-sized units regularly supported OST recipients through detoxification. Type A were large units whose residents were mostly on OST with long criminal records and few social or personal resources. Detoxification was rare, and medication reduction slow. Type B's mid-sized DRW was developed as a psychosocial support service for OST clients seeking detoxification. However, staff struggled to find such prisoners, and detoxification again proved rare. Type C DRWs focused on abstinence from all drugs, including OST. Though OST clients were not intentionally excluded, very few applied to these wings. Only Type D DRWs, offering intensive treatment on very small wings, regularly recruited OST recipients into abstinence-focused interventions. Conclusion Prison units wishing to support OST recipients in making greater progress towards abstinence may need to be small, intensive and take a stepped approach based on preparatory motivational work and extensive preparation for release. However, concerns about post-release deaths will remain

Omphaloliths: a case series and review of 29 cases in literature

Omphaloliths are uncommon benign umbilical lesions caused by the accumulation of sebum and keratin into a stone-like concretion. Recognition of this entity can prevent unnecessary procedures and imaging studies for uncomplicated cases. We present three cases of omphaloliths from our department and review all 26 cases previously reported in the English literature with regard to modes of presentation, potential risk factors, complications, and treatment options to guide clinicians. The mean age at presentation was 48 years. Of the 29 cases, 17 (59%) were asymptomatic. Male patients presented at a younger age and were more likely to present with complications compared to females who presented at an older age with asymptomatic lesions (P=0.006). Features of patients described included dementia, hirsutism, a deep or narrow umbilicus, multiple nevi, obesity, and poor hygiene. Two patients developed overlying pyogenic granulomas. Removal of asymptomatic lesions was uncomplicated and done using forceps or following irrigation, with no recurrence. Complications, including localized abscesses and peritonitis, were associated in 41% of patients who were treated surgically; recurrence was noted in one patient. Removal of omphaloliths is recommended, once identified, to reduce risks of complications and patients should be encouraged to improve their personal hygiene

Poezia română clasică : de la Dosoftei la Octavian Goga.

Includes bibliographical references