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In this essay I examine the ethics of offensive humor through the lens of the Benign Violation Theory, which posits that humor arises when something seems wrong (a violation) but also okay (benign). I argue that while offensive humor can cause harm by promoting stereotypes and disengaging compassion, ultimately the arguments for free speech justify allowing it, as restricting such speech could lead to a slippery slope of unjustified censorship. Instead of restriction, the better response is more speech and efforts to address the root causes inspiring offensive humor.

Aims: The overall aim was to determine how lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO) affect sleep, health related quality of life and disease specific quality of life, and how the men’s urinary symptoms affect their partners. Subjects and methods: In papers I–II, a descriptive design with a pre-test and post-test was used and in papers III-IV the design was descriptive and comparative. The method was self-administered questionnaires. In papers I- II: The questionnaires were translated in the ethnographic mode. In paper I the reliability of the questionnaire was tested in 122 patients with LUTS/ BPO. The disease specific quality of life was studied before and after intervention in 572 consecutive patients with BPO, aged 45-94 yrs. In paper II, the partner specific quality of life was studied in partners to men with BPO before and after TURP. The reliability and the responsiveness of the questionnaire were tested in two groups with 51 partners each. Papers III-IV: A study of 239 men with LUTS, aged 45-80 yrs, and their partners (n=126) who were compared to randomly selected men from the population (n=213) and their partners (n=131). The men had an extra control group, men with inguinal hernia (n=200). Sleep and health related quality of life was studied in both men and their partners. The partners’ specific quality of life was also studied and the men with LUTS answered questions about urinary symptoms and disease specific quality of life. Results: Papers I-II: All the tested questionnaires showed an acceptable reliability and responsiveness. I: Before and after intervention the prevalence of urinary incontinence was 46 % and 16 % respectively. II: Partners were affected by the patients’ BPO symptoms before and improved after the patients TURPs. III: Most sleep variables were significantly impaired in men with LUTS compared to one or both of the control groups. The men with LUTS had a significantly higher prevalence of insomnia (40 %) than both control groups and significantly lower sleep efficiency (49 %) than men with hernia. The men with LUTS were significantly impaired in most domains of the health related quality of life compared to men in the population. IV: There were no significant differences between the two partner groups regarding the quantity and quality of sleep or the health related quality of life. Conclusions: All tested questionnaires showed an acceptable reliability and responsiveness. The prevalence of urinary incontinence before and after intervention was higher than earlier reported. Men with LUTS had significantly poorer sleep quality, reduced sleep efficiency and a higher prevalence of insomnia than men in the population and men with inguinal hernia. The HRQOL is impaired in men with LUTS compared to men in the population and men with inguinal hernia. Partners are affected by the patients’ symptoms, and it is emotional rather than practical aspects that affect them most. Partners of men with LUTS did not differ significantly from partners in the population with regard to sleep and health related quality of life.

Objective: To assess in a prospective trial the influence of the amount of tissue resected at transurethral resection of the prostate (TURP) for benign prostatic enlargement on the symptom improvement as assessed by symptom scores. Methods: Between December 1996 and August 1998 a total of 138 men (mean age 68.2, range 53–89) with symptomatic benign prostatic enlargement who underwent TURP participated in this prospective study. Patients were assessed preoperatively with the International Prostate Symptom Score (IPSS), the American Urological Association Bother Score (AUA–BS) and the Benign Prostatic Hyperplasia Impact Index (BPH–II) as well as urinary flow rate measurements (Qmax) and prostate volume (PV) and residual urine determination by ultrasound. The amount of tissue resected was weighed. Patients were followed with reevaluation of Qmax, residual urine and the symptom and bother scores at 3 and 6 months. Results: A close correlation between preoperative PV (mean 49.0 ml, SD 22.0, range 13–140) and the resected tissue weight (RTW, mean 24.7 g, SD 18.0, range 6–128) was seen (r = 0.75, p<0.001). Age was correlated with preoperative PV (r = 0.23, p<0.05). While significant mean improvements in Qmax, residual volume and IPSS, AUA–BS and BPH–II were found 3 and 6 months postoperatively, a negative correlation was seen between the RTW and the IPSS, the AUA–BS and the BPH–II 3 months after TURP (r = –0.23, p<0.024; r = –0.23, p<0.025; r = –0.20, p = 0.05). No statistically significant correlation was seen between symptom change and the percentage of PV removed or the residual prostatic weight. Classification of the patients into groups depending on preoperative PV (<30, 31–50, 51–70 and >70 ml) showed a tendency for patients with larger PV to gain more symptom improvement postoperatively. Conclusions: Early symptom improvement after TURP will depend on the amount of tissue removed but the relationship is weak and affected by several other confounding factors. Apparently, the symptomatic improvement after TURP is not primarily dependent on the relative completeness of the resection. Patients with larger prostates and larger RTW tend to gain more symptomatic benefit from TURP than do patients with smaller prostates. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Objective: To assess in a prospective trial the influence of the amount of tissue resected at transurethral resection of the prostate (TURP) for benign prostatic enlargement on the symptom improvement as assessed by symptom scores. Methods: Between December 1996 and August 1998 a total of 138 men (mean age 68.2, range 53–89) with symptomatic benign prostatic enlargement who underwent TURP participated in this prospective study. Patients were assessed preoperatively with the International Prostate Symptom Score (IPSS), the American Urological Association Bother Score (AUA–BS) and the Benign Prostatic Hyperplasia Impact Index (BPH–II) as well as urinary flow rate measurements (Qmax) and prostate volume (PV) and residual urine determination by ultrasound. The amount of tissue resected was weighed. Patients were followed with reevaluation of Qmax, residual urine and the symptom and bother scores at 3 and 6 months. Results: A close correlation between preoperative PV (mean 49.0 ml, SD 22.0, range 13–140) and the resected tissue weight (RTW, mean 24.7 g, SD 18.0, range 6–128) was seen (r = 0.75, p<0.001). Age was correlated with preoperative PV (r = 0.23, p<0.05). While significant mean improvements in Qmax, residual volume and IPSS, AUA–BS and BPH–II were found 3 and 6 months postoperatively, a negative correlation was seen between the RTW and the IPSS, the AUA–BS and the BPH–II 3 months after TURP (r = –0.23, p<0.024; r = –0.23, p<0.025; r = –0.20, p = 0.05). No statistically significant correlation was seen between symptom change and the percentage of PV removed or the residual prostatic weight. Classification of the patients into groups depending on preoperative PV (<30, 31–50, 51–70 and >70 ml) showed a tendency for patients with larger PV to gain more symptom improvement postoperatively. Conclusions: Early symptom improvement after TURP will depend on the amount of tissue removed but the relationship is weak and affected by several other confounding factors. Apparently, the symptomatic improvement after TURP is not primarily dependent on the relative completeness of the resection. Patients with larger prostates and larger RTW tend to gain more symptomatic benefit from TURP than do patients with smaller prostates. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Hintergrund: Der genaue Pathomechanismus zur Entstehung des benignen Faszikulations- Crampus-Syndrom ist nicht bekannt, und es wurde noch nie eine größere Anzahl dieser Patienten mittles des threshold trackings untersucht. Material und Methoden: 18 Patienten mit einem BFCS und 15 gesunde Probanden wurden mithilfe des threshold trackings, welches eine Methode zur Messung von Exzitabilitätsparametern von peripheren Nerven in vivo ist, untersucht und die Ergebnisse verglichen. Ergebnisse: Die stärksten Unterschiede zeigten sich im threshold electrotonus, der current/threshold relationship und der stimulus-response-curve. Im threshold electrotonus war insbesondere die Schwellenwertzunahme auf hyperpolarisierende Reize signifikant geringer bei einer Reizstärke von -40%, -70% und -100% des Kontrollimpulses (p < 0,01). Die current/threshold relationship war in hyperpolasierender Richtung bei den BFCS Patienten steiler als bei der gesunden Kontrollgruppe (p < 0,05). Außerdem benötigten sie eine deutlich geringere Reizintensität, um 50% des maximalen Summenaktionspotentials des Muskels auszulösen (p < 0,05). Schlussfolgerung: Die Ergebnisse weisen auf eine veränderte Expression oder Kinetik der HCN-Kanäle an peripheren Nerven der Patienten mit einem BFCS hin und geben folglich neue Hinweise auf die Entstehung dieser Erkrankung. Da zum ersten Mal ein Zusammenhang zwischen der Veränderung der HCN-Kanäle und dem BFCS gezeigt werden konnte, sollten sich zukünftige Studien darauf konzentrieren, genauere Informationen über diese Pathologie zu erlangen.

Malware or malicious code is design to gather sensitive information without knowledge or permission of the users or damage files in the computer system. As the use of computer systems and Internet is increasing, the threat of malware is also growing. Moreover, the increase in data is raising difficulties to identify if the executables are malicious or benign. Hence, we have devised a method that collects features from portable executable file format using static malware analysis technique. We have also optimized the important or useful features by either normalizing or giving weightage to the feature. Furthermore, we have compared accuracy of various unsupervised learning algorithms for clustering huge dataset of samples. So once the clusters are created we can use antivirus (AV) to identify one or two file and if they are detected by AV then all the files in cluster are malicious even if the files contain novel or unknown malware; otherwise all are benign.

A Hiperplasia Prostática Benigna (HPB) é a doença benigna mais freqüente na terceira idade. A Ressecção Transuretral (RTU) de próstata constitui-se na técnica operatória mais empregada atualmente para o tratamento da HPB. A anestesia para este procedimento possui características próprias, tornando-se um desafio para o anestesiologista o manejo de suas particularidades. Com o objetivo de avaliar a conduta anestésica, comparando técnicas empregadas, drogas e doses, eventuais complicações e respectivos tratamentos, revisou-se 300 prontuários de pacientes submetidos a RTU de próstata no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HC-FMRP-USP). Optou-se por dois períodos de quatro anos com intervalo de dez anos entre eles (1989-1992 (período 1) e 1999-2002 (período 2)) para tentar estabelecer uma suposta relação entre a evolução das técnicas anestésicas e a possível redução na incidência de complicações. Foram incluídos no estudo apenas os pacientes portadores de neoplasias benignas da próstata. Algumas características dos pacientes (média de idade e estado físico ASA) foram semelhantes entre os grupos. A média de peso foi superior no período 2. Foram pedidos menos exames pré-operatórios para os pacientes do período 1. Quanto ao tipo de anestesia houve um predomínio absoluto, nos dois períodos, da anestesia regional (sendo que o bloqueio raquidiano foi o mais utilizado). O anestésico local mais empregado foi a bupivacaína nos dois períodos. Observou-se uma maior incidência de falhas nos bloqueios realizados no período 1, com maior índice de conversão para anestesia geral. O fato pode em parte ser atribuído ao não uso de agentes opióides nas punções nessa época, que sabidamente melhoram a qualidade do bloqueio. A duração média do procedimento foi maior no período 2 (considerando 45 minutos como tempo padrão). A incidência de eventos adversos intra-operatórios, como como hipotensão, arritmias cardíacas e hipotermia foi semelhante entre os períodos. No entanto, houve um maior número de pacientes com diagnóstico de infarto agudo do miocárdio no pós-operatório de até 24 horas no período1. Provavelmente esse fato aconteceu pela falta de exames complementares e avaliação cardiológica prévia nos pacientes submetidos à cirurgia nesse período. No tocante as transfusões sangüíneas, a proporção entre os períodos foi semelhante, embora fosse prática costumeira no período 1 que os pacientes realizassem autotransfusão prévia. A autotransfusão não se mostrou eficaz, na população estudada, como fator redutor do número de transfusões sangüíneas. Na sala de recuperação anestésica o tempo de permanência foi semelhante entre os períodos, no entanto, observou-se uma maior incidência de eventos adversos no período 1. A mortalidade foi maior no período 2 mas essa diferença não foi estatisticamente significante. Palavras- chave: 1. Anestesia 2. Hiperplasia Benigna da Próstata 3. Ressecção Transuretral de Próstata 4. Síndrome da Intoxicação Hídrica / Benign Prostatic Hyperplasia (BPH) is the most common disease in the third ages. Transurethral Resection of the Prostate (TRP) is the surgery technique most frequently used for the treatment of BPH. Anaesthesia for this procedure has its own features becoming a challenge for the anaesthesiologist to manage with its peculiarities. In order to evaluate the anaesthetic behavior, to compare the techniques used, drugs and doses, possible complications and their treatments, three hundreds of medical records of patients submitted to TRP in the University Hospital, Faculty of Medicine of Ribeirão Preto (FM-USP). Two periods of four years were chosen (1989-1992 (period 1) and 1999-2002 (period 2)) in order to establish some evolution between the anaesthetics techniques used and possible reduction in the incidence of complications. Only patients who had benign prostatic hyperplasia were included in this study. Some patients characteristics were similar between the two groups (mean ages and physical status ASA). Mean weight were higher in the period 2. Less preoperative exams were applied in the period 1. In both periods, the regional anaesthesia was predominant (the spinal anaesthesia was the most used). Hyperbaric bupivacaine was the most commonly used agent for regional anaesthesia in both periods. More failed blocks were seen in the period 1 with an increased number of conversion to general anaesthesia. This fact may be attached with the lack of use of opioids agents in that period, which are known to complement and improve the quality of the block. Mean duration of the procedure were higher in period 2 (taking 45 minutes as standard time). The incidence of intra-operative adverse events like hypotension, cardiac arrhythmias and hypothermia were similar in both periods. However more patients had acute heart infarct in the 24 hours of postoperative period 1. Probably this happens because of the lack of preoperative exams and cardiology evaluation in patients submitted to surgery in this period. The proportion of blood transfusions were similar in two periods although it was usual to make an autotransfusion in the patients of the first period. Autotransfusion previous to the surgery were not an effective method to reduce the number of transfusions. In postanaesthesia care unit the length of stay was similar between the periods but the incidence of adverse events was higher in the period 1. The mortality was bigger in the period 2 but this difference were not significant. Key-words: 1. Anaesthesia 2. Benign Prostatic Hyperplasia 3. Transurethral Resection of the Prostate 4. The TURP Syndrome