The role of head injury in cognitive functioning, emotional adjustment and criminal behaviour

In two investigations, 50 of non violent convicted felons, who avoided incarceration by participating in a day reporting programme, reported a prior history of head injury and current problems in cognitive and emotional functioning. Only 5 of a college sample in the first investigation and 15 of a community sample in the second investigation reported prior head injury. In a third investigation, 83 of felons who had reported a history of head injury also reported a date for their head injury that preceded the date of their first encounter with law enforcement. Some participants reported no trouble with the law until after experiencing a head injury that occurred in their late thirties. Considering the research reported here and elsewhere in the literature, it appears that many serious crimes follow a head injury. One implication of the findings reported here is that many crimes might not occur if people with head injury were given prompt and comprehensive treatment after the injury.     

Dental fear in Japan: Okayama Prefecture school study of adolescents and adults.

A total of 3,041 students and staff in middle school in Okayama Prefecture, Japan, were surveyed regarding dental fear. Over 88% reported fear, with 42.1% classified as having high fear. Almost 70% reported acquiring dental fear prior to junior high school. A majority reported being hurt at the last appointment. Delay of dental work was also reported for over 50% of the sample. Coping, pattern of physiological upset, nondental fears, and sex and age differences were also reported. Results suggest intervention is needed to address the major dental public health problems associated with dental fear.     

Squamous cell carcinoma in black patients with discoid lupus erythematosus

Squamous cell carcinoma has rarely been reported in black African people, with only 11 cases reported in the world literature to date. We report on 2 further cases, the first to be reported in southern Africa, of squamous cell carcinoma in lesions of discoid lupus erythematosus     

Complications of the Weil osteotomy

Introduction. The Weil osteotomy is commonly used for multiple forefoot pathologies yielding metatarsalgia. Despite its common use, the Weil osteotomy is associated with a high complication rate. Methods. A literature review was undertaken with predetermined criteria. To maximize the articles for review, prospective and retrospective studies were considered as well as multiple indications. Seventeen articles qualified for analysis, and study format, patient demographics, surgical indication, and complication rates were documented. The data obtained were totaled and evaluated for trends. Results. Details of 1131 Weil osteotomies are reported. The most commonly reported complication of the Weil osteotomy was floating toe, reported in 233 cases, with an overall occurrence of 36%. Recurrence was reported in 15% of the cases. Transfer metatarsalgia was reported in 7% of the cases, whereas delayed union, non-union, and malunion were collectively reported in 3% of the cases. Discussion. There is no consensus regarding utilization of the Weil osteotomy with prophylactic surgery, plantar plate repair, and adjunctive interphalangeal arthrodesis. These variables may alter complication rates and provide new avenues for research.     

Tuberculosis and HIV: estimates of the overlap in England and Wales.

BACKGROUND: A study was designed to determine the extent of the interaction between tuberculosis and human immunodeficiency virus infection in England and Wales. METHODS: Data were obtained from the United Kingdom national AIDS surveillance and the Medical Research Council tuberculosis notification surveys in England and Wales (1983 and 1988). The proportion of patients reported with AIDS known to have had tuberculosis and the proportion of patients notified with tuberculosis known to have HIV infection were estimated. RESULTS: Of the 4360 patients with AIDS reported by 30 June 1991, 200 (4.6%) were in patients reported to have had tuberculosis. Only one of the 3002 patients (0.03%) reported in the 1983 survey of tuberculosis notifications in England and Wales was known to be infected with HIV compared with nine of 2163 patients (0.42%) in the 1988 survey. CONCLUSION: Although the reported number of cases of HIV infection with tuberculosis in this country is increasing it remains small. Complete reporting of cases of AIDS and notification of cases of tuberculosis are essential to enable the two infections to be monitored as the HIV epidemic develops. Special studies, such as those reported here, will need to be undertaken regularly to assess the future extent of the interaction.     

Bilateral renal oncocytomatosis in a patient with renal failure

Bilateral multifocal renal oncocytomas are very rare disorders with only 6 previously reported cases in the world literature, of which only 3 have had pathologic confirmation. We present the first reported case of diffuse, bilateral, multifocal renal oncocytomatosis in a patient with end-stage renal disease requiring hemodialysis. Our patient was found to have hundreds of nodular tumors in both kidneys on exploration, representing the second such reported finding.     

Congenital mesenchymoma of tibia: Case report and review of literature

Fibrocartilaginous mesenchymoma is a rare bone tumor arising from long bones in children and adolescents. With only 21 cases reported in the literature, it is often not included in the differential diagnosis in patients with a bone tumor. Previously, the youngest case reported was in a 19-month-old boy, and a congenital variant had not been reported.     

Multicystic peritoneal mesothelioma in a 29 year old male

A case of multicystic peritoneal mesothelioma in a 29 year old white male is reported. This is the second reported case of cystic peritoneal mesothelioma in a male and the first case of cystic mesothelioma reported in Australia. Clinical, histopathologic and ultrastructural findings are discussed together with a review of previous cases.     

Scapular osteochondromas treated with surgical excision

A retrospective review was performed of all osteochondroma excisions at our institution from 1994 to 2007. Postoperative functional assessment was completed with use of the Disabilities of the Arm, Shoulder and Hand (DASH) survey and a self-report questionnaire. Eight osteochondromas were excised at a mean patient age of 21.63 years. Presenting reports included pain, mass, pseudowinging, and snapping of the scapula. Physical examination identified pseudowinging, palpable mass, and pain with shoulder motion. The lesions arose from the ventral surface of the scapula in 5 patients, the dorsal surface in 2, and the inferior acromion in 1. The resected specimen averaged 10.8cm(3). A reactive bursa was found and resected in 4 patients. At mean of 4.17 years postresection, no signs of recurrence were found in 7 patients (88%). The single patient with a recurrence had undergone 2 additional surgical procedures. Six patients (75%) reported no/mild pain with routine and strenuous activities. One patient reported moderate and 1 patient reported moderate/severe pain with routine and strenuous activities. Four patients reported post-resection function as excellent, 2 as good, 1 as average/good, and 1 as average/poor. Six patients (75%) reported feeling very satisfied with the results, 1 reported feeling satisfied, and 1 reported feeling unsatisfied. The average DASH score was 11.7 (range, 0.00-46.67). No winging or pseudowinging was identified in those available for examination, and no difference was identified in range of motion comparing the operative to the nonoperative upper extremity. Near normal functional outcomes can be expected following excision of scapular osteochondromas.     

Mental disorders in a population sample with musculoskeletal disorders

Background  

Studies using clinical and volunteer samples have reported an elevated prevalence of mood disorders in association with rheumatoid arthritis and osteoarthritis. Clinical studies using anxiety rating scales have reported inconsistent results, but studies using diagnostic instruments have reported that anxiety disorders may be even more strongly associated with arthritis than is depression. One study reported an association between lifetime substance use disorders and arthritis.     

Schwannoma of the gallbladder

Schwanomas of the biliary tract are very rare with about 55 reported cases. Schwanomas of the gallbladder are the rarest, probably with less then ten reported cases. We reported a 61 old woman in whom we did a cholecystectomy for a tumor of gallbladder 6.5 x 9 cm in diameter with a central softness which showed a histologic appearance of schwanoma. Ten years after surgery the patient is symptom-free and with no signs of recurrency.     

Tubulointerstitial nephritis in methylmalonic acidemia

We report two patients with methylmalonic acidemia (MMA) in whom renal biopsy demonstrated interstitial nephritis, bringing the total of such reported cases to four. In addition, hypertension, observed in one of our patients, has not been previously reported as the presentation of renal disease in MMA. The etiology of interstitial nephritis in MMA did not appear to be due to urate nephropathy. To date, 15 patients with MMA have been reported with renal complications, including chronic renal failure, making it imperative that children with MMA have their renal status evaluated.     

Carcinoid Tumours of the Biliary Tract

Data on 13 patients, including two not previously reported, with carcinoid tumours of the biliary tract are reported. In ten of them the primary tumour was located in the gallbladder and in three in the biliary duct. No specific symptoms were recorded, and the carcinoid syndrome has not been reported in carcinoid tumours of the biliary tract. In five patients the tumour was first found at autopsy. Metastases were found in three patients at operation or autopsy. Cholecystography can show either a functioning or a non-functioning gallbladder. Some patients had concretions in the gallbladder. The prognosis appears to be good, and one of the patients reported survived so years with metastases.     

Relation of urinary cotinine concentrations to cigarette smoking and to exposure to other people''s smoke.

The relation of urinary cotinine measurements to tobacco consumption in smokers and to exposure to other people's smoke in non-smokers was studied in 49 smokers and 184 reported non-smokers attending a health screening centre. The median urinary cotinine concentration was 1623 ng/ml in the smokers and 6.1 ng/ml in the non-smokers. In smokers the average urinary cotinine concentration increased with reported habitual cigarette consumption; in non-smokers it increased with the reported total seven day duration of exposure to other people's tobacco smoke. Cotinine concentrations were approximately three times higher in non-smokers living with a spouse or partner who was a smoker than in those living with a non-smoker; their reported duration of exposure to tobacco smoke was also three times higher. Non-smoking subjects who were exposed to any tobacco smoke and who lived with a smoker reported 70% of their exposure to be at home (56% for men and 86% for women); the men reported more exposure at work than non-smoking men who lived with a non-smoker. This study confirms the relation of urinary cotinine to stated tobacco smoke exposure in both smokers and non-smokers and further validates the use of information on the smoking habits of the spouse or partner as a measure of tobacco smoke exposure in epidemiological studies of non-smokers.     

Post-traumatic bifid condyle associated with temporomandibular joint ankylosis: report of a case and review of the literature.

Bifid condyle is a rare condition. Most initially reported cases were found in studies conducted on skeletal specimens. While increasing numbers are being reported on living persons, most of them are asymptomatic and have been found on routine dental radiographic examination for other dental complaints. Most of the cases of bifid condyle reported so far have occurred unilaterally and predominantly on the left side. Bifid condyle associated with temporomandibular joint ankylosis is very rare with only 2 cases reported in the English-language literature as far as we know. An additional case of bifid condyle associated with temporomandibular joint ankylosis, involving the right side of mandible, is presented as well as a review of the literature on bifid condyles including those associated with temporomandibular joint ankylosis.     

Foreign bodies in the alimentary tract. Surgical treatment

Gastro-intestinal foreign bodies are a by no means rare event in surgery and in the USA mortality is about 1500 people per annum. The surgical treatment of foreign bodies in the alimentary tract is reported here. Certain cases of voluntary ingestion in mental patients are reported, comparing personal experience with the data reported in the literature.     

Carcinoma of the esophagus engrafted on corrosive stricture of the esophagus

A highly significant incidence of esophageal cancer engrafted on corrosive stricture of the esophagus has been statistically evaluated. So far, only 8 cases in Japan and over 100 cases in foreign literatures have been reported. In 1976, we reported the first case of carcinoma of the esophagus associated with corrosive stricture of the esophagus in Japan. Our second case operated in 1975 was pathologically confirmed to be adenosquamous carcinoma of the esophagus which has never been reported in the literatures. In this paper surgical and pathological problems of the carcinoma of the esophagus associated with corrosive stricture of the esophagus were discussed adding to the analysis of 8 reported cases in Japan.     

Adverse events associated with intravenous regional anesthesia (Bier block): a systematic review of complications

Study ObjectiveTo characterize the complications reported with intravenous regional anesthesia (IVRA).DesignLiterature search.SettingUniversity-affiliated hospital.MeasurementsA search was done in the American National Library of Medicine's PUBMED, EMBASE (1980-2007, wk 11), and Medline (from 1950) in March 2007. All complications associated with IVRA were reviewed.Main ResultsThe lowest dose of local anesthetic associated with a seizure was 1.4 mg/kg for lidocaine; 4 mg/kg for prilocaine, and 1.3 mg/kg for bupivacaine. Cardiac arrests and deaths were reported with lidocaine and bupivacaine only. The lowest dose associated with a cardiac arrest was 2.5 mg/kg for lidocaine and 1.6 mg/kg for bupivacaine. Local anesthetic toxicity occurring during tourniquet inflation has been reported, with tourniquet pressure exceeding initial systolic arterial blood pressure by 150 mmHg. Seizures occurring after tourniquet deflation have been reported with a tourniquet time as long as 60 minutes. Ten cases of compartment syndrome are reported.ConclusionSeizures have been reported with lidocaine at its lowest effective dose (1.5 mg/kg).     

Carcinoid tumours of the biliary tract.

Data on 13 patients, including two not previously reported, with carcinoid tumours of the biliary tract are reported. In ten of them the primary tumour was located in the gallbladder and in three in the biliary duct. No specific symptoms were recorded, and the carcinoid syndrome has not been reported in carcinoid tumours of the biliary tract. In five patients the tumour was first found at autopsy. Metastases were found in three patients at operation or autopsy. Cholecystography can show either a functioning or a non-functioning gallbladder. Some patients had concretions in the gallbladder. The prognosis appears to be good, and one of the patients reported survived 20 years with metastases.     

A systematic review of reporting quality for anaesthetic interventions in randomised controlled trials

Interventions from randomised controlled trials can only be replicated if they are reported in sufficient detail. The results of trials can only be confidently interpreted if the delivery of the intervention was systematic and the protocol adhered to. We systematically reviewed trials of anaesthetic interventions published in 12 journals from January 2016 to September 2019. We assessed the detail with which interventions were reported, using the Consolidated Standards of Reporting Trials statement for non-pharmacological treatments. We analysed 162 interventions reported by 78 trials in 18,675 participants. Detail sufficiently precise to replicate the intervention was reported for 111 (69%) interventions. Intervention standardisation was reported for 135 (83%) out of the 162 interventions, and protocol adherence was reported for 20 (12%) interventions. Sixty (77%) out of the 78 trials reported the administrative context in which interventions were delivered and 36 (46%) trials detailed the expertise of the practitioners. We conclude that bespoke reporting tools should be developed for anaesthetic interventions and interventions in other areas such as critical care.