Mesenteric infarction secondary to tumor emboli from primary aortic sarcoma. Guidelines for diagnosis and management

Primary aortic tumors are rare, difficult to diagnose, and often fatal. This case and a review of the literature identified aortic tumors as a potential source of emboli leading to acute mesenteric insufficiency. The case showed the efficacy of magnetic resonance imaging in diagnosing and determining the extent and location of an aortic tumor.     

Early Intervention for Trauma: Current Status and Future Directions

Although psychological debriefing (PD) represents the most common form of early intervention for recently traumatized people, there is little evidence supporting its continued use with individuals who experience severe trauma. This review identifies the core issues in early intervention that need to be addressed in resolving the debate over PD. It critiques the available evidence for PD and the early provision of cognitive-behavioral therapy (CBT). Based on available evidence, we propose that psychological first aid is an appropriate initial intervention, but that it does not serve a therapeutic or preventive function. When feasible, initial screening is required so that preventive interventions can be used for those individuals who may have difficulty recovering on their own. Evidence-based CBT approaches are indicated for people who are at risk of developing posttraumatic psychopathology. Guidelines for managing acutely traumatized people are suggested and standards are proposed to direct future research that may advance our understanding of the role of early intervention in facilitating adaptation to trauma.     

Emerging Patterns in Adolescent Drug Use: The Belfast Youth Development Study 2000-2002

This paper reports the findings from the first 2 years of the Belfast Youth Development Study. The Belfast Youth Development Study is a 5-year longitudinal investigation of the onset and development of adolescent drug using behaviours, the findings of the first 2 years from the study in relation to drug use patterns among the young people participating in the research are reported here. The findings show that while the majority of young people have not yet used an illicit substance, the study has seen a substantial increase in the numbers using such substances between year 1 and year 2. Boys still make up the majority of drug users in this period but there has been a substantial increase in the number of girls using illicit drugs and, more generally, an increase in the frequency of use among all those using such substances during this period.     

The Oddono's sulcus and its relation to the renal “junctional parenchymal defect” and the “interrenicular septum”

The anatomy responsible for the sonographic diagnosis of the renal “junctional parenchymal defect” and “interrenicular septum” is caused by perirenal fat along a line of incomplete fusion of two primary renal lobes. Studies using CT, MRI and cadaver observations are presented. “Oddono's sulcus” is suggested as a name for the changes in honor of the author who first described these anatomic findings. Received: 12 January 1996 Accepted: 16 January 1996     

Non-operative management of retroperitoneal fibrosis

It is generally recognized that in many patients the ureteric obstruction and other manifestations of non-malignant retroperitoneal fibrosis will respond to treatment with corticosteroids. However, most surgeons are reluctant to use steroids as the primary treatment for patients with this condition, mainly because of the risk of mismanagement of malignant retroperitoneal fibrosis. Our experience in the care of 17 patients with non-malignant retroperitoneal fibrosis has led us to believe that an initial non-surgical approach is both safe and preferable.