Meniscal pathology in children: differences and similarities with the adult meniscus

The normal meniscus undergoes typical developmental changes during childhood, reaching a mature adult appearance by approximately 10 years of age. In addition to recognizing normal meniscal appearances in children, identifying abnormalities — such as tears and the different types of discoid meniscus and meniscal cysts, as well as the surgical implications of these abnormalities — is vital in pediatric imaging. The reported incidence of meniscal tears in adolescents and young adults has increased because of increased sports participation and more widespread use of MRI. This review discusses the normal appearance of the pediatric meniscus, meniscal abnormalities, associated injuries, and prognostic indicators for repair.     

Complicated grief in Bosnian refugees: associations with posttraumatic stress disorder and depression

Complicated grief is likely to be common among refugee populations exposed to war trauma. However, there have been few studies investigating the traumatic antecedents and correlates of complicated grief in refugees, and the relationship of that symptom pattern with other common disorders such as posttraumatic stress disorder (PTSD) and depression. We studied Bosnian refugees recruited from a community center in Sydney, Australia, with the sample being supplemented by a snowball method (N = 126; response rate, 86%). Measures included a trauma inventory, the Clinician Administered PTSD Scale (CAPS), the depression module of the Structured Clinical Interview (SCID), and the Core Bereavement Items (CBI). A dimension of traumatic loss derived from the trauma inventory was a specific predictor of complicated grief, with exposure to human rights violations being associated with images of the traumatic events surrounding the lost person. There was no link between PTSD and grief other than for a low-order association with the PTSD intrusion dimension. In contrast, depression was strongly associated with grief and its subscales. Only the subgroup with comorbid grief and depression reported higher levels of traumatic loss. The results suggest that complicated grief in refugees can become persistent and associated with depression. While PTSD and grief share common symptoms of intrusion, the two symptom domains are sufficiently distinct to warrant independent assessment of grief in refugee populations.     

The microbiology and outcome of sepsis in Victoria, Australia

We analysed data from 33741 patients with ICD-10-AM-defined sepsis from an Australian hospital morbidity dataset to investigate the relationships between specific types of organisms, potential risk factors for infection, organ dysfunction, ICU utilization and hospital mortality. A total of 24% of patients received some of their care in an intensive care unit, and the overall hospital mortality rate was 18%. Gram-positive bacteria were isolated in 27% of cases and Gram-negative bacteria in 20%. Sepsis due to Staphylococcus aureus was associated with vascular and joint devices whereas Pseudomonas aeruginosa and Gram-negative rods were more common with genitourinary devices and lymphoproliferative disease. Sepsis-associated organ dysfunction most commonly involved the respiratory system, followed by the renal and circulatory systems. These patterns may provide useful clues to the pathogenesis and therapy of this often fatal syndrome which is a major ongoing problem for hospitalized patients.     

Separation anxiety in the elderly

Separation anxiety has been studied in children and young adults but little is known about this form of anxiety in older people. This study aimed to examine socio-demographic, psychological and physical health correlates of separation anxiety in the elderly. Eighty-six ambulatory subjects aged 62-87 years were recruited from primary medical care practices to participate in this study. The presence of lifetime DSM-IV affective and anxiety disorders was determined by structured clinical interview. Subjects also completed a battery of self-report questionnaires measuring levels of state and trait anxiety, juvenile and adult separation anxiety. Adult separation anxiety scores were moderately correlated with juvenile separation anxiety scores (r= .52, P < .001), trait anxiety (r = .55, P < .001) and state anxiety scores (r = .66, P < .001), as well as younger age (r = .39, P < .001). Higher adult separation anxiety scores were also associated with a lifetime history of any anxiety disorder (t = 3.74, df = 84, P < .001) or any affective disorder (t = 2.12, df = 84, P < .05). However, adult separation anxiety was not associated with increasing age, being widowed, living alone or poorer physical health. Clinicians working with the elderly need to routinely explore this form of anxiety as it may complicate the pattern of presentation of other anxiety and affective disorders, and require specific forms of intervention.     

Chromium picolinate does not produce chromosome damage.

Chromium picolinate (CrPic) is used as a dietary supplement and has beneficial effects in reducing diabetes risk factors. The present study evaluated the cytogenetic effects of CrPic in bone marrow cells of Sprague-Dawley rats (5 animals/sex/group). Test animals were dosed orally with 33, 250 or 2000 mg/kg of CrPic, which corresponded to doses of 4.1, 30.8 and 246 mg/kg of chromium. The lowest dose of CrPic, 33 mg/kg is estimated to be the human equivalent for a 50 kg person (200 mcg Cr). The animals were dosed once, and sacrificed either 18 or 42 hours (h) later. The mitotic index was determined for each rat. Metaphase cells (50 or 100/rats) were examined for interstitial deletions, chromatid and chromosome gap, breaks or other anomalies. The average percentage of damaged cells at 18 h in vehicle treated males and females were 1.2% and 0.6%, respectively. The mean values at 18 h for doses of 33, 250 and 2000 mg/kg, were 0.4%, 0.8%, 0.4% for males and 0.6%, 0.2% and 0.6% for females, respectively. At 42 h, the mean values for vehicle treated males and females were 0.4% and 0.2%, respectively. For doses of 33, 250 and 2000 mg/kg at 42 h the average percent damage was 14%, 0.8% and 0.4% for males and 0.2%, 0.2% and 0.0% for females, respectively. None of these values were statistically increased compared to the vehicle controls. The positive control Cyclophosphamide (CPM) induced a significant increase in chromosomal damage at 18 h averaging 30% in males and 37% in females, respectively (p<0.001). In the current study CrPic did not induce chromosomal damage in bone marrow cells at single doses of 33, 250 and 2000 mg/kg of body weight and thus there was no indication of any toxicity of CrPic.     

Catquest questionnaire: re-validation in an Australian cataract population

Background:  The Catquest questionnaire was developed using traditional methodology to enable cataract surgery outcomes assessment in European countries. Recently, it has been validated using Rasch analysis in a Swedish population resulting in the Catquest-9SF. The aim of the present study was to assess the performance of the Catquest and the Catquest-9SF questionnaires using Rasch analysis in Australian cataract patients.
Methods:  A total of 217 cataract patients awaiting surgery at Flinders Medical Centre, Adelaide, South Australia self-administered the Catquest questionnaire. This is a 19-item instrument containing frequency, difficulty, symptoms and global rating items. Rasch analysis was undertaken to assess the unidimensionality (whether all the items are measuring a single underlying construct using principal components analysis or PCA), person separation (ability of the questionnaire to distinguish between strata of patient ability) and targeting of item difficulty to person ability.
Results:  Similar to the previous validation study, the original Catquest questionnaire required revision because of misfit and multidimensionality necessitating removal of the frequency items. The revised version was similar to the Catquest-9SF although an extra driving item was a valid optional inclusion. The Catquest-9SF performed well in the Australian cohort satisfying all criteria for valid measurement including unidimensionality. However, targeting of item difficulty to person ability was marginally worse compared with the Swedish cataract population indicating the Australian cataract patients present for surgery at lower levels of visual disability.
Conclusions:  The Catquest-9SF is a reliable and valid measure of visual disability in the Australian cataract population.     

The effect of static and dynamic visual gestures on stuttering inhibition

The aim of the study was to evaluate the role of steady-state and dynamic visual gestures of vowels in stuttering inhibition. Eight adults who stuttered recited sentences from memory while watching video presentations of the following visual speech gestures: (a) a steady-state /u/, (b) dynamic production of /a-i-u/, (c) steady-state /u/ with an accompanying audible 1 kHz pure tone, and (d) dynamic production of /a-i-u/ with an accompanying audible 1 kHz pure tone. A 1 kHz pure tone and a no-external signal condition served as control conditions. Results revealed a significant main effect of auditory condition on stuttering frequency. Relative to the no-external signal condition, the combined visual plus pure tone conditions resulted in a statistically significant reduction in stuttering frequency. In addition, a significant difference in stuttering frequency was also observed when the visual plus pure tone conditions were compared to the visual only conditions. However, no significant differences were observed between the no-external signal condition and visual only conditions, or the no-external signal condition and pure tone condition. These findings are in contrast to previous findings demonstrated by similar vowel gestures presented via the auditory modality that resulted in high levels of stuttering inhibition. The differential role of sensory modalities in speech perception and production as well as their individual capacities to transfer gestural information for the purposes of stuttering inhibition is discussed.