Complications of Gold Weight Eyelid Implants for Treatment of Fifth and Seventh Nerve Paralysis

Complications occurred in six patients after gold weights were implanted into the upper eyelid tissues for fifth and seventh nerve palsies. These complications included implant infection without extrusion (in one patient); entropion with trichiasis and presumed inflammatory reaction to the gold weight material (in one patient); upper eyelid distortion and poor eyelid contour with corneal ulceration and scarring (in one patient); significant residual lagophthalmos with exposure keratitis (in one patient); and blepharoptosis obscuring the pupillary access (in two patients). Resolution of the complications required 1 . implant removal in four of six patients without reinsertion of a second weight, 2 . recession of the retractors of the upper eyelids with medial and lateral canthoplasty (in four patients), and 3 . permanent tarsorrhaphy (in one patient). The authors conclude that complications may be minimized by careful preoperative determination of the optimum implant size, weight, and placement within the eyelid as well as meticulous attention to the surgical technique of implantation. The use of other eyelid protective procedures is often necessary to augment corneal protection especially in patients with combined fifth and seventh cranial nerve palsies. Endogenous implant infection without extrusion of the gold weight may be distinguished from presumed inflammation due to gold allergy by clinical response to antibiotics in the former and requirements of steroids or removal of the implant in the latter.     

Experiences of special gynaecological services for children and adolescents: a descriptive study

Gynaecological examination of girls during childhood is undertaken somewhat infrequently. These genital examinations should not be taboo or a frightening experience for the girl, for her parents or for the physician. Studies of children suspected of sexual abuse have paid attention to the wide variety of gynaecological conditions already present in childhood. In 1988 we founded a special gynaecological outpatient clinic for girls under 16 y of age at a university hospital to develop the special knowledge and skills needed in children's gynaecology. In this gynaecological clinic for children and adolescents we were able to gain and offer expert knowledge of the problems of this age group. In this special clinic for children, gynaecological examination by special techniques and sonography led to a diagnosis in 71% of the patients without any instrumentation. Children and adolescent girls in need of special gynaecological care should be recognized specifically. Particular attention should be paid to the gynaecological care of victims of child sexual abuse and mentally or physically handicapped girls. In good co-operation with the girl, a gynaecological examination can become a positive experience during the development of female identity.     

Cough headache responsive to methysergide

Cough headache is a very distinct syndrome of headache precipitated by coughing, lifting, bending, sneezing, laughing, or straining. The pain can be severe and, if precipitation is difficult to avoid, certainly distressing. The usual treatment is indomethacin, which can be highly effective although recently lumbar puncture has again been advocated. We encountered a patient in whom indomethacin use was relatively contraindicated and who had an apparent response to methysergide.     

Traumatic dental injuries in 3- to 13-year-old boys in Monterrey, Mexico

Abstract The purpose of this retrospective study was to analyze, by age, the prevalence of traumatic injuries to primary and permanent incisors, and their distribution according to type in a group of boys from private schools in Monterrey, Mexico. The sample consisted of 1010 boys aged 3-13 years enrolled in 4 private schools in the city. Garcia-Godoy's classification for traumatic injuries was used. The prevalence of injuries was 28.4%; 72.2% of the 4-year-olds examined presented signs of traumatic dental injuries. Thirty-seven percent of the 11-year-olds examined had evidence of traumatic dental injuries. The most common type of injury in the primary and permanent dentitions was enamel fracture (58.5% and 69.6%, respectively).     

Dimensions of psychopathology in bipolar disorder versus other affective and non-affective psychoses among an epidemiologically complete population

Scully PJ, Owens JM, Kinsella A, Waddington JL. Dimensions of psychopathology in bipolar disorder versus other affective and non-affective psychoses among an epidemiologically complete population. Bipolar Disord 2002: 4(Suppl. 1): 43–44. © Blackwell Munksgaard, 2002     

Oral cancer risk perception among participants in an oral cancer screening program.

Oral cancer screening provides an opportunity for early detection and for education to high-risk tobacco and alcohol users. To plan interventions that would motivate oral cancer screening and risk reduction, we surveyed oral cancer risk perception and risk behaviors among participants in a free oral-cancer screening. Participants (N = 803) were racially diverse; 43% had a history of smoking and 9%, a history of alcohol abuse. Current smokers and those with higher lifetime tobacco exposure perceived themselves to be at higher risk for cancer than nonsmokers or those with less lifetime tobacco exposure (all ps, <0.01). Alcohol use was unrelated to oral cancer risk perception (p > 0.05). Compared with women, men (p = 0.01) felt more at risk; compared with other racial groups, Asians (p < 0.05) felt less at risk. Demographic differences were explained by differences in risk behaviors. Current smoking status (beta, 0.196; p < 0.001) and level of tobacco exposure (beta, 0.100; p < 0.05) were the only significant independent predictors of heightened risk perception (R(2) = 0.09). Those with alcohol abuse histories, and older smokers, may need increased education. These findings support the need for health education materials that incorporate the oral cancer risk perception of high-risk individuals.