Systemic Mastocytosis Causing Refractory Pruritus in a Liver Disease Patient.

Systemic mastocytosis (SM) results from clonal, neoplastic proliferation of abnormal mast cells. Patients become susceptible to itching, urticaria, and anaphylactic shock, which occurs due to histamine release from mast cells. SM may coexist alongside other systemic diseases, thus confounding the overall clinical presentation. We discuss a 23-year-old woman with refractory pruritus, which was initially attributed to primary sclerosing cholangitis but had a nonresponse to antihistaminics, ursodiol, and cholestyramine. Concurrent evaluation for polyarthritis revealed increased uptake in the proximal femur on a bone scan, and subsequent bone marrow biopsy revealed indolent SM, and this was understood to be the cause of her intractable pruritus.

The role of relationships in connecting social work research and evidence-based practice.

Critics of evidence-based practice (EBP) often challenge the efficacy of applying social work research in practice. Such skepticism underscores the historic chasm that still exists between social work researchers and practitioners. If taught and implemented consistently, the EBP model can mend the connection between researchers and practitioners by merging their roles. Merging their roles, however, requires a renewed emphasis on relationships in the research process. This article explores the role of relationships in social work research. Using a researcher/practitioner continuum, we assess the types of interactions faculty have with stakeholders. We then offer strategies for cultivating relationships with stakeholders that lead to community-derived and implemented research that is critical to advancing the widespread use of EBP in social work.

A randomized effectiveness trial of a sex education program for minority youth in Miami, Florida.

Through this study the authors assessed the outcomes of a randomized effectiveness trial of Project U-Turn, a comprehensive sex education program for at-risk youth in Miami, Florida. Data collection occurred at pretest, three month, and six month follow-ups with a sample of teenagers randomly selected and assigned to treatment (n = 549) and control (n = 424) groups. Results from logistical and generalized multilevel modeling indicated the program did not contribute to teen responses at three or six month follow-ups. Other variables, however, had some influence on predicting teen responses to questions about their current and future sexual activity. Gender, use of alcohol, and participation in religious services predicted responses from teens at pretest and at three and six month follow-ups. Discussion of the findings, as well as implications for evidence-based social work with teens conclude the article.

A technique for the identification and direct analysis of hexahydro-1,3,5-tris(2-hydroxyethyl)-s-triazine in metalworking fluids using electrospray-mass spectrometry.

Hexahydro-1,3,5-tris(2-hydroxyethyl)-s-triazine is a widely used biocide in metalworking fluids that resists direct quantification in many analytical methods due to instability. It can be detected in electrospray-mass spectrometry (ES-MS) due to the formation of a charged and relatively stable adduct with the sodium ion. This adduct produces a distinct ion spectrum via collision-induced fragmentation, which should promote specific detection of the analyte in complex matrices. ES-MS detection of the analyte added to, or already present in, metalworking fluid samples at microg mL(-1) levels is demonstrated. Parameters affecting the formation and detection of the sodium adduct, including choice of solvent, alkalinity, and sodium ion level are explored. Linearity of response in flow injection mode is demonstrated.