Fatal intoxications in the age group 15–34 years in Denmark in 1984 and 1985

Summary This survey deals with the Danish part of a study on fatal intoxications conducted in the Nordic countries in 1984 and 1985 with special reference to drug addicts. There were 315 cases of fatal intoxications in people 15–34 years of age. These were examined at the Forensic Institutes in Denmark and described with reference to cause of death, sex, age and drug addiction. Of the deceased, 194 were drug addicts according to a specific definition of this term. Women accounted for 28% of all the fatalities investigated in the study and 24% of those in addicts. More than 90% of the deaths were caused by drugs, with ethanol as a contributory factor in approximately 40% of cases. Deaths caused by heroin/morphine predominated, causing 50% of the deaths among drug addicts, but legal drugs, such as dextropropoxyphene, methadone and ketobemidone were also frequent causes of death in this group. In half the cases the concentration of morphine in blood following injection of heroin/morphine was found to be equal to or less than 0.5 mol/ kg, and in only about one-tenth of cases was the blood concentration above 2.0 mol/kg.     

An analysis of the murder of women in a 10-year period in Eskişehir Province located in western Anatolia in Turkey

Murder of women generally occurs as a result of violence by their husbands and relatives. We evaluated the female victims of murder in Eski?ehir, located in western Anatolia, where the education level is high in this study. Our aim was to assess and discuss data related to the victims and murderers.A total of 141 women's murder cases were analysed in the study. After a legal process and the results of the autopsies during 2002–2011 in Eski?ehir, 715 subjects found to have died as a result of murder were chosen. Cases were evaluated in terms of their age, marital status, education level, relationship to the murderer, reasons for violence, type of action and reasons for death.It was determined that 48.2% (n = 68) of the victims had been killed by the husband and 7.8% (n = 11) by the ex-husband. Murderers generally stated that the reason of murder was the woman's request for divorce or breaking up (n = 40, 28.4%).In compliance with the literature, the women were most commonly killed by their husbands in our study. Enhancing women's status and preventing violence against women will decrease such murders.     

Is the nasopharynx warmer in children than in adults?

Recent studies on the aetiology of the Sudden Infant Death Syndrome (SIDS) have suggested that some of these deaths are the consequence of an overwhelming inflammatory response to the production of pyrogenic toxins from bacteria colonizing the upper respiratory tract, particularly the nasopharynx. The pyrogenic toxins of Staphlococcus aureus, one of the likelier bacterial candidates, are only produced in temperatures of over 37 degrees C. This study examined nasopharyngeal temperatures in children. It is a preliminary study to develop an accurate means to measure how close to 37 degrees C the nasopharyngeal temperature lies in infants at the age when SIDS deaths occur. Following a pilot study and power calculation, measurements of nasopharyngeal temperature were made on 30 apyrexial children aged 4-10 years and 30 adults with no nasal pathology, undergoing surgery under general anaesthesia, using an accurately sited thermocouple probe. The mean temperature in children (35.64 degrees C) was significantly higher than in adults (34.01 degrees C). Comparable measurements attempted with the same subjects awake gave similar results.     

Posterior-anterior weight-bearing radiograph in 15° knee flexion in medial osteoarthritis

OBJECTIVE: To evaluate the degree of knee flexion at which: (1) degenerative joint space narrowing is best seen, (2) the tibial plateau is best visualized and (3) the tibiofemoral angle is most correct, in order to assess the degree of flexion in the anteroposterior radiographic view that is most useful for assessing medial compartment osteoarthritis (OA) of the knee. DESIGN AND PATIENTS: We compared the conventional extended view of the knee and views at 15 degrees, 30 degrees, and 45 degrees of flexion with respect to joint space narrowing, alignment of the medial tibial plateau (MTP), and tibiofemoral angles in 113 knees of 95 patients with medial osteoarthritis of the knee (22 men, 73 women; mean age 67 years). RESULTS: At the midpoint and the narrowest point of the medial compartment, joint space narrowing values at 15 degrees, 30 degrees, and 45 degrees of flexion of the knee were smaller than that of the conventional extended view. Superimposition of the margins of the tibial plateau was satisfactory in 12% of patients in the conventional extended view, in 36% at 15 degrees of flexion, in 20% at 30 degrees of flexion, and in 19% at 45 degrees of flexion of the knee. When the knee was at 15 degrees of flexion there was a smaller difference in the tibiofemoral angle, in comparison with the knee extended, than was the case at 30 degrees and 45 degrees of flexion in patients with medial OA. CONCLUSION: A posteroanterior view with 15 degrees of flexion of the knee was able to detect joint space narrowing accurately, to achieve good alignment of the MTP in the medial compartment, and to reduce the difference in tibiofemoral angle compared with a view of the knee in conventional extension, and may be an alternative view in cases of medial OA of the knee.     

Xeroradiography in β-thalassaemia

Xeroradiographic investigations of the skull, hand, and elbow were performed on 27 patients with homozygous -thalassaemia. The results were compared with plain radiographic examinations. Xeroradiography, because of its technical properties (i.e. edge contrast enhancement and wide latitude), was shown to demonstrate cortical thinning of long bones, swelling of the diploic space in the skull, and reticulated patterns in the elbow better than standard radiography. Moreover, the use of positive mode imaging was shown to have advantages in the study of the skull and extremities.     

Dopamine-mediated improvements in dynamic balance control in Parkinson’s disease

BackgroundImpaired dynamic balance control increases fall risk and contributes to immobility in individuals with Parkinson’s disease (PD). It is unclear whether higher-level neural processes of the central nervous system contribute to impaired balance control.Research QuestionAre dopamine-mediated neural processes of the higher-level central nervous system important for dynamic balance control in PD?Methods21 individuals with idiopathic PD performed step-threshold assessments before and after self-administered dopaminergic medication. Individuals withstood progressively larger postural perturbations, during which they were explicitly instructed to avoid stepping to recover balance. The perturbation magnitude which elicited stepping responses on four consecutive trials is referred to as the step-threshold. Dynamic balance control was quantified as the minimum margin of stability captured during the largest sub-threshold trial (i.e., the maximum amount of compensated postural instability during the task). We compared dynamic balance between off and on medication states and between individuals who exhibited motor adaptive behavior and those who did not.ResultsDopaminergic medications significantly improved step-thresholds and allowed individuals to withstand greater amounts of instability without stepping, indicating dopamine-mediated improvement in dynamic balance control. Individuals who displayed behavioral evidence for higher-level neural processes (motor adaptation across repeated perturbations) displayed superior dynamic balance control versus those who did not. Anteroposterior ground reaction forces captured during perturbations suggest that individuals alter force profiles to avoid stepping at ∼200 ms after perturbation onset–a latency consistent with a transcortical process.SignificanceCombined, our results indicate that higher-level, dopamine-mediated neural processes are responsible for dynamic balance control in PD. We hypothesize that this process incorporates sensorimotor integration, motor response initiation/inhibition, and goal- and reward-driven behaviors. Interventions targeting these processes may improve dynamic postural control in individuals with PD.     

Tumor ablations in IMRI

IntroductionMagnetic resonance imaging based guidance control and monitoring of minimally invasive intervention has developed from a hypothetical concept to a practical possibility. Magnetic-resonance-guided interstitial therapy in principle is defined as a treatment technique for ablating deepseated tumors in the human body.     

‘Current trends in lower limb Doppler scanning in Ireland’

IntroductionThe clinical need to diagnose and treat above knee deep vein thrombosis (AKDVT) has long been established in literature and in practice. On the other hand, the need to diagnose and treat below knee deep vein thrombosis (BKDVT) continues to be debated in literature. This has resulted in variation in clinical guidelines and protocols nationwide. This research aims to establish if there is a standard practice in Irish ultrasound departments and if so, what that practice is and where sonographers are getting information to inform this.MethodsA questionnaire was designed using SurveyMonkey and distributed using online platforms. The questionnaire aimed to establish the experience of the sonographer, the types of exams performed, protocols/guidelines used as well as scenarios where the sonographer might deviate from protocol.ResultsThe study yielded 90 responses. The research found 49% of sites perform whole leg ultrasound routinely and 46% perform proximal ultrasound only. 41% of respondents said their protocols were based on clinical guidelines however, 22% of participants didn't know what these guidelines were. 49% of respondents were unaware of what treatment a patient would receive in cases where there is a high clinical suspicion of DVT, but the ultrasound is negative for DVT.ConclusionThe research has established a lack of consistency amongst sonographers and scanning practices with a fairly even split (49% of respondents perform whole leg ultrasound and 46% perform proximal only). Not only has the research identified a lack of standardised scanning approach nationwide, but inconsistencies are also seen in the guidelines that inform our department's protocols as well as inconspicuous terms used in radiology reporting and jargon in literature in relation to DVT.Implications for practice1. An inconsistency in practice has been established. Discussions are now needed to decide what guidelines should be implemented into Irish Ultrasound DVT protocols. 2. A national protocol for BKDVT would result in all patients in Ireland having access to the same standard of care. 3. Call for consensus on appropriate training for sonographers undertaking LLDs.     

In vivo changes in microglial activation and amyloid deposits in brain regions with hypometabolism in Alzheimer��s disease

Purpose

Amyloid ?? protein (A??) is known as a pathological substance in Alzheimer??s disease (AD) and is assumed to coexist with a degree of activated microglia in the brain. However, it remains unclear whether these two events occur in parallel with characteristic hypometabolism in AD in vivo. The purpose of the present study was to clarify the in vivo relationship between A?? accumulation and neuroinflammation in those specific brain regions in early AD.

Methods

Eleven nootropic drug-na?ve AD patients underwent a series of positron emission tomography (PET) measurements with [¹¹C](R)PK11195, [¹¹C]PIB and [¹⁸F]FDG and a battery of cognitive tests within the same day. The binding potentials (BPs) of [¹¹C](R)PK11195 were directly compared with those of [¹¹C]PIB in the brain regions with reduced glucose metabolism.

Results

BPs of [¹¹C](R)PK11195 and [¹¹C]PIB were significantly higher in the parietotemporal regions of AD patients than in ten healthy controls. In AD patients, there was a negative correlation between dementia score and [¹¹C](R)PK11195 BPs, but not [¹¹C]PIB, in the limbic, precuneus and prefrontal regions. Direct comparisons showed a significant negative correlation between [¹¹C](R)PK11195 and [¹¹C]PIB BPs in the posterior cingulate cortex (PCC) (p?<?0.05, corrected) that manifested the most severe reduction in [¹⁸F]FDG uptake.

Conclusion

A lack of coupling between microglial activation and amyloid deposits may indicate that A?? accumulation shown by [¹¹C]PIB is not always the primary cause of microglial activation, but rather the negative correlation present in the PCC suggests that microglia can show higher activation during the production of A?? in early AD.     

Metabolic Factors in Fatigue

KEYPOINTS Sustainedproductionofmuscularforceduringexercise dependsonthegenerationofchemicalenergy(ATP)bynonoxidative(anaerobic)andoxidative(aerobic)metabolism.Fatiguedevelopswhenthecompoundsneededtopro duceATParedepletedorwhenby-productsof metabolismaccumulateinmuscle.Thesemetabolicchangescancausefatiguebyactingon nerveprocessesthatactivatemuscles.Bothcentral andperipheralnervoussystemsmaybeimpaired.ReductionsinmusclelevelsofATP,phosphocreatine,andglycogen,andlowbloodglucoseavailabilit…     

Can optical imaging assist in characterization of the onset of angiogenesis in developing hepatic metastases in mice livers?

Optical imaging currently can be used to characterize some of the early steps in the angiogenic pathway in vivo in animals. Liu and Matsui have provided valuable information in regard to the sequential changes in the origin and nature of newly formed blood vessels during progressive stages of growth of hepatic colorectal cancer metastases. The short-term challenge is to image cellular events that precede visible vessel formation and that occur during drug-induced vascular regression.     

Calcification in cystic renal masses: is it important in diagnosis?

PURPOSE: To determine whether the presence of calcifications in cystic renal masses is important in diagnosis and to suggest an approach to the management of calcified cystic renal masses. MATERIALS AND METHODS: Eighty-one cystic renal masses containing calcification in a wall or septum were evaluated by means of review of computed tomographic (CT) images (n = 81), follow-up CT images (n = 28), and results of pathologic examination (n = 40) by the authors in consensus. Images were evaluated for lesion size, amount and morphology of calcification, and any association of calcification with soft-tissue structures. Lesions were categorized according to the Bosniak cyst classification system; the amount of calcification was determined with a subjective grading system. Progression of calcification was qualitatively determined with available follow-up CT scans. RESULTS: Twenty-one lesions were Bosniak category II (benign) and showed small amounts and thin strands of calcification. Nineteen lesions containing more extensive calcification but no enhancing tissue were category IIF. Follow-up CT results available for 16 of these lesions (average follow-up length, 5 years 8 months) showed no substantial change. The three remaining lesions were proved benign at surgery. Twenty-five lesions were category III; surgical intervention was performed in 21 of these (benign, n = 12; malignant, n = 9). Sixteen lesions that contained obvious areas of enhancing soft tissue were category IV and proved malignant at surgery. CONCLUSION: Calcification in a cystic renal mass is not as important in diagnosis as is the presence of associated enhancing soft-tissue elements. This information should enable a reasonable approach to the management of calcium-containing renal cystic lesions.     

Ganzk?rper-MRT in der ?Study of Health in Pomerania��

Population-based whole-body MRI examinations have been evaluated for the first time within the Study of Health in Pomerania (SHIP). This ongoing cohort study investigates associations of overweight (57.9% of the female and 74.1% of the male population) and obesity (25.1% and 26.0%, respectively) with cardiovascular and metabolic diseases in a population with decreased life expectancy compared to the total German average. Whole-body MRI offers the possibility to evaluate parameters, such as the amount of visceral and liver fat and can contribute to further conclusions on these common diseases.     

Is the appearance of microcalcifications on mammography useful in predicting histological grade of malignancy in ductal cancer in situ?

It has been proposed that the grade of malignancy of ductal carcinoma in situ (DCIS) of the breast can be estimated by the morphology of microcalcifications found on mammography. We correlated microcalcifications and histopathology in a retrospective blinded review. We reviewed all patients who underwent excisional breast biopsy over a 5 1/2-year period. Mammograms and pathology slides of all patients (n = 49) with DCIS of the breast were included in a blinded retrospective analysis. Mammographic microcalcifications were divided into four categories, "linear branching", "coarse granular", "fine granular" or "no microcalcification". Independently, pathology specimens were assigned to poorly, intermediately and well differentiated categories according to the consensus classification of DCIS introduced by the European Organisation for the Research and Treatment of Cancer. Two patients had no microcalcifications. 25 (53%) of the remaining 47 patients had "linear branching" microcalcifications, 10 (21%) had "coarse granular" and 12 (25.5%) had "fine granular" microcalcifications. 19 patients (40%) had poorly differentiated, 23 (49%) intermediately differentiated and 5 (11%) well differentiated subtypes of DCIS. 14 (56%) of the 25 patients with "linear branching" microcalcifications had poorly differentiated DCIS, 10 (40%) had intermediately differentiated and 1 (4%) had well differentiated DCIS. 3 (30%) of 10 patients with "coarse granular" microcalcifications had poorly differentiated DCIS, 5 (50%) had intermediately differentiated and 2 (20%) had well differentiated DCIS. 2 (17%) of 12 patients with "fine granular" microcalcifications had poorly differentiated DCIS, 8 (67%) had intermediately differentiated and 2 (17%) had well differentiated DCIS. These findings were not statistically significant. In conclusion, "linear branching" microcalcifications tended to be associated with higher pathological grading. However, correlation was poor and there was considerable overlap between categories. Histological type of DCIS cannot be predicted prospectively on mammographic appearances.     

Changes in mucosal and humoral atopic-related markers and immunoglobulins in elite cyclists participating in the Vuelta a España

Atopic-related factors, humoral and mucosal immunoglobulins (Ig), and cortisol were measured in 17 professional cyclists competing in the 2003 Vuelta a Espa?a (a three-week multi-stage race). Venous blood and saliva samples were obtained the morning before the start of the race (T0), on the first rest day after 10 days of racing (T1), and before the start of the last stage after 21 days of racing (T2). Atopic-related factors, IgE, eosinophil cationic protein (ECP), and eosinophils, were significantly altered during the race. Serum IgE (T1: + 10 %) and ECP (salivary, T1: 113 % and serum, T2: 155 %) were significantly increased, while eosinophils (T1: - 32 %, T2: - 55 %) were significantly lower, than pre-race levels. Salivary sIgA secretion rate was significantly decreased at T2 (- 36 %). Pearson product-moment correlations revealed a modest correlation between salivary sIgA and salivary ECP (T1: r = 0.30; T2: r = 0.48; p < 0.01). Serum IgM, total IgG, IgG1, IgG2, IgA levels, at T1 and T2, and cortisol at T2, were significantly lower than pre-race levels. In conclusion, the elevation in IgE and ECP suggests an up-regulation of atopic-related factors in professional cyclists participating in the Vuelta a Espa?a. The correlation between salivary sIgA and salivary ECP indicates a role for sIgA in mediating mucosal inflammation. The alterations in Ig levels may indicate Ig isotype switching. An increasing state of hormonal fatigue may have influenced the observed immune alterations.