Comparison of two methods for assessing injuries among preschool children

BACKGROUND: Most studies of injuries use health services records or recall rather than prospective methods, and there is no information on how these different methods compare. This study was aimed at comparing a report (retrospective) with a diary (prospective) for recording childhood injuries. METHODS: The study included 1,273 and 620 children, the retrospective and prospective subsamples, respectively, from a population based birth cohort in Pelotas, southern Brazil. The reported incidence of injuries in the preceding month were compared with those reported over month by diary (prospective study). RESULTS: Both methods were well accepted and 92.7% of the diaries were returned. One or more injuries per child month were reported for 20.8% (retrospective) and 48.4% (prospective) of the children. The total number of reported injuries for the 620 children were 145 (retrospective) and 715 (prospective). Using the prospective method as the gold standard, the retrospective method detected only 20.2% of all injuries. Under-reporting did not vary significantly with maternal education, but was greater (51.8%) for injuries requiring medical care than for those managed at home (18.3%; p=0.003). CONCLUSIONS: The diary was well accepted and resulted in higher incidences of reported injuries than the recall method, particularly for injuries that did not require medical care. Use of this method should be promoted to provide more complete epidemiological information to guide preventive strategies.     

Hallucinogens on the Internet: a vast new source of underground drug information

OBJECTIVE: The illicit use of hallucinogens is reemerging in the United States, especially among well-educated adults and teenagers. These same groups are also frequent users of the Internet. The authors sought to characterize the extent of information about hallucinogens available to Internet users. METHOD: Using standard Internet search techniques, the authors located 81 hallucinogen-related sites and categorized the information provided. RESULTS: Internet sites offer thousands of pages of information-albeit of questionable accuracy-on how to obtain, synthesize, extract, identify, and ingest hallucinogens. Much of this information has yet to appear in textbooks. By contrast, the authors found few U.S. government agency sites offering cautionary material about hallucinogen use. CONCLUSIONS: Using the Internet, potential hallucinogen users can bypass traditional channels of medical information and learn in great detail how to obtain and use numerous drugs with unknown hazards.     

Trends in the frequencies of consanguineous marriages in the Israeli Arab community

To assess the trends in the frequency of consanguineous marriages in the Israeli Arab population in the last 40 years, we conducted a two-part study. For the first part, we re-analyzed data from a nationwide study carried out in 1992, and for the second part, we undertook a new survey in 1998 in four locations: Taibe, Tira, Kalansuwa and Kafr Bara. Data regarding the frequency of consanguineous marriage in these four locations for the years 1961-1985 was extracted from the original survey, and for the years 1986-1998, from new questionnaires. The frequency of consanguineous marriage was highest in the period 1961 1965 (50.6%), but by the period 1981-1985 it had decreased to 40.6%. Over the whole time span of the 1992 study, a significant decrease was observed between the periods 1961-1975 and 1976-1985 (p < 0.0001). In the four-location study, there was a significant decrease in the frequency of consanguineous marriage from 52.9%, in the period 1961-1970 to 32.8% in the period 1991-1998 (p = 0.0006). We conclude that the custom of consanguineous marriage in the studied population is still extremely high, and preventive measures should be taken to decrease its frequency and associated complications.     

Significance of Family History in Breast Cancer Treated with Breast Conservation Therapy

Abstract: The purpose of this study was to evaluate the impact of family history (FH) of breast cancer on the outcome of patients with local-regional breast cancer treated with breast conservation therapy. Of 974 patients treated with breast conservation therapy, a total of 794 consecutive cases were evaluable with adequate FH data and a greater-than-1-year follow-up. All patients had local-regional disease (stages O-IIIA) and underwent lumpectomy, axillary node dissection, and radiation therapy. Seventeen percent of patients had a positive family history of breast cancer, which was defined as a first degree relative (mother, sister, daughter). A significant difference was seen in overall survival in patients with and without an FH of breast cancer (p = 0.027). While FH did not correlate with differences in local failure, distant failure, disease specific survival, or overall survival in patients less than or equal to age 50, a positive FH correlated with a worse disease specific survival (p = 0.045) and a worse overall survival (p = 0.017) in patients over age 50. Multivariate (Cox) analysis confirmed the significance of FH (p = 0.008), tumor size (p = 0.001), and nodal status (p = 0.015). Comparing patients with and without an FH, no differences were seen in age at presentation, age of menarche, age of menopause, parity, tumor size, histologic and nuclear grade, nodal status, or estrogen receptor status. In patients with an FH of breast cancer, the most commonly affected relative was the mother (9.4%). While FH did not impact on outcome of patients age 50 or younger, it was prognostic for a poorer overall survival in older patients, and poorer disease-specific survival. Patients with an FH of breast cancer are similar to patients without a family history in tumor and patient characteristics. An FH of breast cancer does not correlate with an increased local or distant failure in our study population as a whole, but does correlate with a poorer overall survival when compared to patients without an FH of breast cancer.?     

In vitro biodegradation of chrysotile fibres by alveolar macrophages and mesothelial cells in culture: comparison with a pH effect

The modification of the chemistry of asbestos chrysotile fibres (Mg3(Si2O5)(OH)4) after their ingestion by cultured cells has been studied. Two types of cells involved in asbestos related pulmonary disease were used, rabbit alveolar macrophages (AM), recovered by bronchoalveolar lavage, and pleural mesothelial cells (PMC) obtained from the rat parietal pleura. Chemical characterisation of intracellular fibres was performed on unstained ultrathin sections by electron probe microanalysis. The results showed a progressive leaching of Mg, characterised by a time dependent decrease of Mg/Si. AM were more efficient than PMC at leaching intracellular chrysotile fibres since it took longer to obtain the same proportion of leached fibres with PMC than with AM. As in vitro Mg-leaching can be obtained by acid treatment, chrysotile fibres were incubated, either untreated or pretreated with cell membranes, at pH 4 or 7 for various times. The data show that the kinetic of leaching by AM was comparable with leaching at pH 4. The leaching by PMC was of the same order as leaching at pH 7. When membranes were adsorbed on to the fibres, a delayed leaching was observed. The results indicate that the solubilisation of chrysotile by AM could be an intraphagolysosomal event due to a pH effect. With PMC, however, it is not possible to draw this conclusion since nothing is known about the intracellular pH.     

In situ detection, by spin trapping, of hydroxyl radical markers produced from ionizing radiation in the tumor of a living mouse.

Hydroxyl radicals are thought to be responsible for the toxicity associated with ionizing radiation in tissues. Measurements of hydroxyl radicals generated by ionizing radiation in cellular systems have failed thus far to elucidate higher-level homeostatic responses to this and other reactive oxygen species. Careful assessment of prior indirect hydroxyl radical assays in living tissues indicates that they are prone to a variety of artifacts, making all but the most qualitative relationships difficult to establish. This paper describes the detection of hydroxyl radicals produced during radiation in the leg tumor of a living mouse, where the free radicals evolve; detection uses low-frequency electron paramagnetic resonance in combination with in vivo spin trapping. To our knowledge, this is the first report of such a direct measurement of free radical production in the tissues of a living animals.     

Relation of plasma prolactin to clinical response in schizophrenic patients.

It has been suggested that, if dopamine antagonism is a necessary condition for the antischizophrenic action of neuroleptics, the prolactin response, as an index of dopamine blockade, would correlate with clinical response. Morning prolactin and clinical symptomatology were measured in 15 schizophrenic patients before neuroleptic therapy, and after three and six weeks of high-dose butaperazine or loxapine treatment. Prolactin levels were transiently elevated during the unmedicated admission period, probably reflecting a normal stress response. Prolactin increased in all patients during neuroleptic therapy. There was, however, no correlation between magnitude of prolactin changes and clinical response, probably because the prolactin response achieved a maximum at relatively low doses of neuroleptics.