Puncture wound related pseudomonas infections of the foot in children

Eleven children with Pseudomonas aeruginosa infection complicating foot puncture wounds were reviewed. Delay in presentation (mean 2 days) and diagnosis (mean 9 days) due to a paucity of clinical signs of deep infection was characteristic of this condition. Septic arthritis (5 patients) and osteomyelitis (3 patients) were frequent complications. Treatment involved multiple surgical debridements and prolonged intravenous antibiotic therapy. The clinical outcome was good although long-term radiographic changes were common.     

Genotype determining low catechol-O-methyltransferase activity as a risk factor for obsessive-compulsive disorder

In the present study, we address the role of the gene for catechol-O-methyltransferase (COMT), a key modulator of dopaminergic and noradrenergic neurotransmission, in the genetic predisposition to obsessive-compulsive disorder (OCD). We show that a common functional allele of this gene, which results in a 3- to 4-fold reduction in enzyme activity, is significantly associated in a recessive manner with susceptibility to OCD, particularly in males. This association is further supported by psychiatric evaluation of patients who carry microdeletions encompassing the comt gene. The mechanism underlying this sex-selective association remains to be defined and may include a sexual dimorphism in COMT activity, although close linkage with a nearby disease susceptibility locus cannot be excluded at this point.     

School-Based Cardiovascular Health Promotion: The Child and Adolescent Trial for Cardiovascular Health (CATCH)

The Child and Adolescent Trial for Cardiovascular Health (CATCH) is a multisite intervention research study that builds on significant progress made in school health education research in the 1980s. The study has three phases: Phase I deals with study design, intervention, and measurement development, Phase II involves the main trial in 96 schools in four states, and Phase III focuses on analysis. The intervention program targets third-fifth grade students and focuses on multiple cardiovascular health behaviors, including eating habits, physical activity, and cigarette smoking. Classroom curricula, school environmental change, and family involvement programs are developed for each grade level and behavioral focus. This paper describes Phase II of CATCH with a rationale for cardiovascular health promotion with youth. The process of change that appears to be necessary for school-based health promotion and that will be tested in CATCH are presented as a framework to guide these efforts.     

Endometrial pipelle biopsy compared to conventional dilatation and curettage

Dilatation and curettage (D+C) is the most common operation performed in Britain. The liberal use of D+C has been criticised. The objective of this study was to evaluate the use of outpatient endometrial pipelle biopsy and determine its safety in terms of detecting abnormalities. Complications and financial costs were also evaluated. Data were reviewed from an active gynaecological unit from February 1993 to January 1995. A total of 303 D+Cs and 104 endometrial pipelle biopsies were performed in this period. Nine malignancies were detected by D+C and 1 by pipelle biopsy. A total of 24 and 3 benign abnormalities were detected by each method respectively. There was a higher complication rate in the D+C group but the failure rate was higher in the endometrial pipelle biopsy group. The monetary savings over this period is estimated at ￡20,307. There were no missed malignancies to our knowledge over the 8 yr period since endometrial pipelle biopsy was introduced to the hospital.