Severe end of Opitz trigonocephaly (C) syndrome or new syndrome?

We report on four unrelated cases of an Opitz trigonocephaly (C)-like syndrome with a highly characteristic combination of facial anomalies including prominent metopic suture, exophthalmos, hypertelorism, cleft lip and palate, flexion deformities of the upper limbs and multiple other anomalies. We also review two very similar published cases formerly considered to have the C syndrome. Although there is overlap, a clinical distinction from the Opitz trigonocephaly and other syndromes seems possible, and thus a specific causal entity may be postulated. Am. J. Med. Genet. 85:438–446, 1999. © 1999 Wiley-Liss, Inc.     

Protocol for hepatitis screening and follow-up of Southeast Asian refugees

Hepatitis B virus (HBV) infection is prevalent among Southeast Asian refugees. HBV infection causes acute and chronic hepatitis and cirrhosis, and is associated with primary hepatocellular carcinoma. Health care providers must be able to make an accurate diagnosis of acute or chronic HBV infection when performing medical evaluations of Southeast Asian refugees. It is essential that appropriate follow-up care and teaching regarding infection control be provided. In this article, a protocol is presented that aids interpretation of hepatitis B screening tests. The protocol uses testing for the immunoglobulin M antibody against hepatitis B core antigen (anti-HBc/IgM) to aid differentiation between acute and chronic HBV infection. If testing is interpreted to show the presence of the hepatitis B chronic carrier state, a second protocol is used to guide follow-up testing, treatment and referral of patients.     

Physical activity trends in South Carolina, 1994-2000

OBJECTIVES: During the 1990s, physical activity recommendations and surveillance methods were developed in an attempt to increase and monitor, respectively, regular physical activity prevalence rates. For this article, Behavioral Risk Factor Surveillance System data were analyzed to determine whether regular physical activity proportions in South Carolina adults changed from 1994 to 2000. The physical activity prevalence rates for South Carolina were compared with national rates and Healthy People 2000 goals to measure progress. The rate of physical activity counseling by physicians and other health professionals was also analyzed from 1998 to 1999. METHODS: Total subjects included 10,495 adults ages 18 years and older from South Carolina and 545,445 from the remainder of the United States. Using random-digit dialing procedures in 1994, 1996, 1998 and 2000, the two most frequent types of leisure-time physical activity performed in the past month were identified. For activities listed, the frequency (days/wk) and duration (minutes/d) were obtained. Linear regressions were performed on regular physical activity and inactivity for the total population and by gender, race, age, and body mass index (BMI). Data pertaining to whether or not a physician or other health professional had provided physical activity counseling were also obtained for 1998 and 1999. RESULTS: From 1994 to 2000, the proportion of South Carolina adults participating in regular leisure time physical activity significantly increased (10.8%). Interestingly, the prevalence of regular physical activity in the rest of the nation remained unchanged during this time. Although significant increases were observed in nearly all subgroups, physical activity prevalence rates for South Carolina adults lagged behind national levels and did not meet Healthy People 2000 goals. Physical activity counseling by physicians and other health professionals increased from 1998 (24.1%) to 1999 (30.4%). CONCLUSIONS: While it is not known what factors influenced regular physical activity from 1994 to 2000, they seem to have been equally effective in South Carolina adults of both genders, both races, regular and overweight status, and nearly all age groups. Despite these positive trends, additional efforts are needed to develop and implement effective community and primary care physical activity interventions that facilitate improvements among the nearly two-thirds of South Carolina adults who do not participate in sufficient physical activity to reap significant health benefits.     

Methylmethacrylate is a mutagen for Salmonella typhimurium.

The long-term effects of exposure to monomeric methylmethacrylate have yet to be established. We have measured the toxicity and mutagenicity of methylmethacrylate for Salmonella typhimurium. At levels of thirty-four millimolar, methylmethacrylate exhibited 28 per cent of the mutagenic activity of an equimolar dose of dimethylnitrosamine. Methylmethacrylate alone exhibited toxicity to the bacteria, but when the methylmethacrylate was incubated with a rat-liver enzyme metabolizing system, mutagenesis was induced. These findings suggest that an intermediate metabolite of methylmethacrylate is mutagenic to Salmonella typhimurium.     

Patient quality of life during the 12 months following joint replacement surgery

OBJECTIVE: To determine whether preoperative characteristics influence quality of life outcomes 1, 6, and 12 months after joint replacement surgery. METHODS: Patients (n = 222) with osteoarthritis undergoing primary joint replacement surgery at a university hospital between November 1990 and March 1993 were prospectively studied. Bodily pain and physical function were assessed preoperatively and at the 3 postoperative time points using the Medical Outcomes Study 36 Item Short Form Health Survey. RESULTS: Bodily pain and physical function improved after joint replacement. At 1 month after surgery, despite improvements in bodily pain, physical function deteriorated. Preoperative bodily pain and physical function, demographic characteristics, and social support were significant correlates of improvement in bodily pain and physical function. CONCLUSIONS: Patients experienced dramatic improvements in bodily pain and physical function after joint replacement. However, decline in physical function at 1 month implies significant need for prolonged informal or formal patient assistance with basic physical function after surgery. Greater preoperative social support was associated with improved bodily pain and physical function outcomes.     

Retroviral sero-reactivity in LGL leukaemia patients and family members

T-cell large granular lymphocyte (T-LGL) leukaemia is characterized by a clonal proliferation of cytotoxic T cells and is frequently associated with rheumatoid arthritis. Sera from some LGL leukaemia patients react to a portion of the human T-cell leukaemia virus (HTLV-1/2) transmembrane envelope protein, BA21, although HTLV-1/2 infection is rare in LGL leukaemia patients. Here we show that family members, including spouses, of an LGL leukaemia patient had elevated LGL counts, BA21 reactivity and, additionally, recognition of HIV-1 gp41. Thus, both LGL leukaemia patients and clinically normal contacts sharing the same environment have evidence of exposure to a retrovirus.     

The application of advanced CT imaging and computer graphics methods to reconstructive surgery of the hip

Advanced computed tomographic and computer graphic techniques enhance diagnostic accuracy and offer the means by which three-dimensional operative planning can be achieved. These techniques have been used to diagnose hip pathology, rehearse and evaluate surgical plans, assess postoperative results, and design individualized prostheses.