Gorlin's syndrome: ovarian fibromas at adolescence.

An adolescent with bilateral ovarian fibromas associated with Gorlin's or the multiple nevoid basal cell carcinoma syndrome is described. The syndrome should be considered and looked for when bilateral solid ovarian masses are found in young women.     

The economic impact of early life environmental tobacco smoke exposure: early intervention for developmental delay

BACKGROUND AND OBJECTIVES: Early-life exposure to environmental tobacco smoke (ETS) can result in developmental delay as well as childhood asthma and increased risk of cancer. The high cost of childhood asthma related to ETS exposure has been widely recognized; however, the economic impact of ETS-related developmental delay has been less well understood. METHODS AND RESULTS: The Columbia Center for Children's Environmental Health (CCCEH) has reported adverse effects of prenatal ETS exposure on child development in a cohort of minority women and children in New York City (odds ratio of developmental delay = 2.36; 95% confidence interval 1.22-4.58). Using the environmentally attributable fraction (EAF) approach, we estimated the annual cost of one aspect of ETS-related developmental delay: Early Intervention Services. The estimated cost of these services per year due to ETS exposure is > Dollars 50 million per year for New York City Medicaid births and Dollars 99 million per year for all New York City births. CONCLUSION: The high annual cost of just one aspect of developmental delay due to prenatal exposure to ETS provides further impetus for increased prevention efforts such as educational programs to promote smoke-free homes, additional cigarette taxes, and subsidizing of smoking cessation programs.     

Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players

STUDY DESIGN: Prospective cohort. OBJECTIVE: To determine if Star Excursion Balance Test (SEBT) reach distance was associated with risk of lower extremity injury among high school basketball players. BACKGROUND: Although balance has been proposed as a risk factor for sports-related injury, few researchers have used a dynamic balance test to examine this relationship. METHODS AND MEASURES: Prior to the 2004 basketball season, the anterior, posteromedial, and posterolateral SEBT reach distances and limb lengths of 235 high school basketball players were measured bilaterally. The Athletic Health Care System Daily Injury Report was used to document time loss injuries. After normalizing for lower limb length, each reach distance, right/left reach distance difference, and composite reach distance were examined using odds ratio and logistic regression analyses. RESULTS: The reliability of the SEBT components ranged from 0.82 to 0.87 (ICC3,1) and was 0.99 for the measurement of limb length. Logistic regression models indicated that players with an anterior right/left reach distance difference greater than 4 cm were 2.5 times more likely to sustain a lower extremity injury (P<.05). Girls with a composite reach distance less than 94.0% of their limb length were 6.5 times more likely to have a lower extremity injury (P<.05). CONCLUSIONS: We found components of the SEBT to be reliable and predictive measures of lower extremity injury in high school basketball players. Our results suggest that the SEBT can be incorporated into preparticipation physical examinations to identify basketball players who are at increased risk for injury.     

Contraception for the teenager.

Although adolescents are now fecund at an earlier age, they are not ready for parenthood financially, educationally, or socially until a much later time. More and more states directly or indirectly permit minors to consent for their own contraceptive needs, a trend that must be applauded. Studies of adolescent attitudes, knowledge, and use of contraceptives indicate a woeful ignorance and lack of use, even among college students. From a medical and practical point of view, the IUD is considered the most suitable contraceptive for the teen-ager. A well-established menstrual cycle of at least 2 years should be be present if oral contraceptives are used. Abstience, although medically ideal, must be initiated by the patient; otherwise, the failure rate is high. The failure rate for the condom, diaphragm, and spermicidal foam is high, except when 2 methods are used at the same time. Coitus interruptus, douche, and rhythm have no application for adolescents. Girls who have had an abortion should receive contraceptive counseling immediately following the abortion. Sterilization must be considered very cautiously for this age group.     

Olfactometrische Untersuchungen bei Patienten nach Tumorbehandlung im Nasen- und Nebenhöhlenbereich

Zusammenfassung Nach einem kurzen überblick über das Krankengut von 34 Patienten mit Nasen- und Nebenhöhlentumoren (Altersverteilung, Lokalisation der Tumoren, Behandlungsart, histologischer Befund) wird über die Ergebnisse der Prüfungen von Geruchsschwelle, Geruchsunterscheidungsvermögen und Geruchsermüdung berichtet. 6 Patienten (18%) mit Siebbeintumoren hatten eine Anosmie, 4 Patienten (12%) erhebliche einseitige Schwellenerhöhungen auf der operierten Seite. Bei 9 Patienten (27%) waren die Schwellenwerte und die Werte des Geruchsunterscheidungsvermögens trotz größerer Eingriffe normal. Der Rest der Patienten zeigte geringgradige einseitige oder doppelseitige Schwellenerhöhungen. Störungen des Geruchsunterscheidungsvermögens bei Patienten im hohen Alter wurden nicht als Folge des Tumorgeschehens bzw. der therapeutischen Maßnahmen, sondern als Ausdruck der Altersinvolution der Hirnrinde gewertet.Auszugsweise auf der Internationalen Konferenz der Otolaryngologen der DDR, der Tschechoslowakisch-sozialistischen Republik und der Ungarischen Volksrepublik im September 1963 in Budapest gehalten.Herrn Oberarzt Dr.Gerhardt möchte ich an dieser Stelle für wertvolle Hinweise und Ratschläge danken.     

Interaction of amoxapine with muscarinic cholinergic receptors: an in vitro assessment

Amoxapine, an antidepressant with a rapid onset of therapeutic efficacy and great utility in psychotic depression, has been reported to produce anticholinergic side effects in man similar to those observed with imipramine and amitriptyline. To establish its cholinergic disposition, amoxapine and its metabolites 7-hydroxyamoxapine and 8-hydroxyamoxapine, have been evaluated by determining their effects on quinuclidinyl benzilate (QNB) binding to membrane fractions of rat and human brain, on the carbamoylcholine-stimulated accumulation of inositol phosphates in rat cerebral cortex and on the acetylcholine-induced contraction of the guinea pig ileum. In all three preparations, amoxapine was found to be a considerably weaker antagonist of muscarinic cholinergic receptors than either imipramine (4-27 fold) or amitriptyline (51-300 fold). These results indicate that for amoxapine, no correlation exists between the magnitude of muscarinic receptor inhibition and the extent of 'anticholinergic' side effects found in the clinic. Neither the metabolites of amoxapine nor species differences could account for this discrepancy.