Low back pain in pilots

A questionnaire on low back pain (LBP) was administered to 373 fighter pilots, 165 transport pilots, and 264 helicopter pilots. Helicopter pilots had more pain during flight than did fighter or transport pilots (34.5%, 12.9%, and 5.1%, respectively). A history of LBP temporally unassociated with flight was found in 26.5% of helicopter pilots, 31.5% of transport pilots and 25.2% of fighter pilots. We conclude that, despite the pain experienced by helicopter pilots in flight, they are not at increased risk for LBP unassociated with flight.     

The predictive value of cholesterol in young men for anelevated cholesterol ten to twelve years later

We reviewed the charts of 322 randomly selected male Airforce personnel with no known illnesses, who were first seen between 1970–1974 when aged 20–24 years. The results of all annual determinations of fasting serum total cholesterol (TC) during the following 10–12 years ending 1980–1984 were compiled. The cut-off point separating ‘normal’ from ‘elevated’ TC was arbitrarily set at the upper decile. The predictive value of the TC at entry for an elevated TC on follow-up was calculated. Subjects aged 20–24 years with a single elevated serum TC on entry had a 25% probability of having a similarly elevated TC 10–12 years later. Most of the decrease in positive predictive value could be accounted for by intra-individual variation. Subjects with elevated TC on 2 of 3 annual examinations after entry had a 50% probability of having a similarly elevated TC on 2 of 3 annual examinations 7–10 years later. We conclude that tracking of individuals with elevated TC is improved by multiple sampling.     

Management of upper airway obstruction in the Pierre Robin syndrome

Eight patients with Pierre Robin syndrome (PRS), were treated according to our management protocol. All our patients initially were given a trial of conservative, positional treatment, with high caloric gavage feeding. In five patients this therapeutic approach resulted in a good weight gain, with no significant respiratory distress. The remaining three patients showed no improvement, failed to thrive and therefore underwent the tongue to lip adhesion (TLA) procedure. Two patients then improved dramatically; whereas one continued with respiratory distress and failure to thrive and required tracheostomy. We conclude that when symptoms of respiratory distress and failure to thrive coexist in patients with PRS despite conservative management, surgical intervention to the airway is mandatory. TLA should be the first surgical procedure considered and if the ultimate goals of weight gain and respiratory comfort are still not achieved then tracheostomy seems inevitable.     

Obstructive renal failure and pleural effusion caused by the gravid uterus

Acute renal failure due to ureteral obstruction by the gravid uterus is considered to be a rare complication of late pregnancy. Pleural effusion caused by urinary tract obstruction is also extremely uncommon. This presentation reports what is believed to be the first case in which both these complications appeared at the same time in a pregnant patient.     

Auditory Brain Stem Responses in Schizophrenic Patients

Auditory brain stem responses (ABR) were recorded from 20 schizophrenic patients, of whom ten were medicated and ten were unmedicated. A matched control group consisted of ten normal subjects. A statistically significant difference in the latencies of N3 and N5 recordings was found among the three groups. The results suggest that unmedicated schizophrenics have a delayed latency for peaks N3 and N5, and that medication (with neuroleptic drugs) shortens these delayed latencies back to the normal range.     

The epidemiology of obsessive-compulsive disorder in children and adolescents.

Epidemiologic studies show that by late adolescence OCD has a lifetime prevalence of 2% to 3%. The age of onset is earlier in boys than in girls, and has a first peak around puberty and another in early adulthood. The natural course of the disorder is fairly stable, with a complete remission rate of 10% to 15%, although fluctuations in symptom level may make short-term apparent outcome unreliable. Comorbid conditions include depression, movement disorders, and anxiety disorders. Although the prevalence of OC symptoms and of OCD are not different for boys and girls, there may be gender differences in the symptom types. The boundary of the diagnosis of OCD is not always easy to determine, and individuals may meet threshold and subthreshold criteria at different times.     

The hereditary inclusion body myopathy enigma and its future therapy

Hereditary inclusion body myopathy (HIBM) is a genetic muscle disease due to mutations in the gene encoding the enzyme complex UDP-N-acetylglucosamine 2 epimerase-N-acetylmannosamine kinase (GNE), which catalyzes the rate-limiting step in sialic acid production. The review describes some of the disease features that may be relevant for further understanding of the metabolic impairment of HIBM and its future therapy. It also addresses the biochemical basis behind the substrate supplementation therapy designed for this condition.