Terminal transverse limb defects and early chorionic villus sampling: Evaluation of 4,300 cases with completed follow-up

Data from 4,300 consecutive cases following prenatal diagnosis by transcervical (TC) CVS (n = (1,570) and transabdominal (TA) CVS (n = 2,370) were evaluated. In the follow-up study only infants examined by a physician were included. Gestational age varied between 8.5 and 11.6 weeks (mean 10.3 weeks) for TC-CVS and between 9.3 and 20 weeks (mean 12.3 weeks) for TA-CVS 98% of TC-CVS was performed at 9–10 weeks, 80.7% of TA-CVS procedures were carried out at 12–15 weeks. Selective termination took place in 97 cases of TC-CVS (6.1%) and in 72 cases of TA-CVS (2.6%). Another 8 Women had a termination for psychosocial reasons, resulting in 4,123 (1,469 TC, 2,645 TA) continuing pregnancies. The overall fetal loss rare <28 weeks was 5.4% (n = 80) for TC-CVS and 2.6% (n = 70) for TA-CVS. The overall incidence of congenital abnormalities after birth was 0.9%. Two terminal transversal limb defects were detected in the TC-CVS group (0.14%) against one (0.04%) in the TA-CVS group. © 1993 Wiley-Liss, Inc.     

Pelvic Pain Complicating LHRH Analogue Treatment of Fibroids

We present these 3 cases to alert others to the possibility of severe pain with rapid shrinkage of fibroids occurring during LHRH analogue treatment. We suggest management of such events should not be surgical except for vaginal excision of prolapsed fibroid polyps.     

Community nutrition education for people with coronary heart disease—who attends?

Abstract: A qualitative food-frequency questionnaire was administered by mail to a representative sample of 137 people previously diagnosed with possible or definite myocardial infarct. Seventy-eight per cent of subjects returned a completed questionnaire and were subsequently invited to attend local tastings of foods with the National Heart Foundation Tick of Approval. These tastings were organised and promoted with the active involvement of the local branch of the Australian Cardiac Association. The purpose of this study was to measure voluntary participation by people with coronary heart disease in community nutrition education and to identify any self-selection bias with respect to eating habits among the participants. A dietary risk score, which was the proportion of all food choices that were high in fat, was calculated from the data. Eighteen per cent of subjects who answered also participated in the food tastings; there was a statistically significant association between membership of the Australian Cardiac Association and being a participant. Participants had a significantly lower risk score (P < 0.01) after adjustment for age, sex and membership of the association. The results suggest that voluntary participation by people with heart disease in community nutrition education is low and that there is a self-selection bias, with those at highest dietary risk being least likely to attend. The use of existing community networks to recruit participants is also discussed.     

Low-density lipoprotein subfraction profiles in dialysis patients

Summary: Uraemic dyslipidaemia is a major risk factor for cardiovascular disease in end-stage renal failure patients. In patients without renal failure, high levels and qualitative abnormalities of low-density lipoprotein (LDL) are known to be atherogenic. Recently, LDL subfraction analysis has associated premature coronary artery disease with a high prevalence of small, dense LDL particles characterizing the LDL subclass phenotype B. We therefore examined the lipid profiles, LDL subfraction distribution and phenotypes in our population of haemodialysis (HD; n = 30) and peritoneal dialysis patients (PD; n = 17), and compared them to 40 asymptomatic, non-uraemic volunteers. Dialysis patients had significantly higher triglyceride and VLDL cholesterol concentrations and lower HDL cholesterol and smaller LDL peak particle diameters. PD patients had significantly higher total cholesterol, glycated haemoglobin and fasting blood glucose levels with smaller LDL peak particle diameters (24.4 [0.1] vs 24.8 [0.1 nm] than HD. Both groups showed significant negative correlations between plasma triglyceride and LDL peak particle diameter, and positive correlations between HDL cholesterol and LDL peak particle diameter. All the PD patients expressed the B phenotype (LDL peak diameter ± 25.5 nm) compared to 73% of HD patients. This study demonstrates that HD and especially PD patients have atherogenic lipid profiles which are associated with a predominance of small dense LDL particles and the highly atherogenic LDL subclass phenotype B.     

Brain plasticity following psychophysiological treatment in learning disabled/ADHD pre-adolescents.

This research investigated the effects of a psychophysiological treatment methodology on brain plasticity as reflected in event-related brain potential topographic mapping and morphology along with School-marks and Mangina-Test performance in three different groups of pre-adolescents at baseline and 8 months later: (a) Learning Disabled/ADHD pre-adolescents who were treated; (b) Non-treated Learning Disabled/ADHD pre-adolescents; (c) Normal controls. Results indicate that: (1) the Event-Related Brain Potentials topographic mapping was significantly modified in post-treatment condition for the treated Learning/Disabled/ADHD group as opposed to pre-treatment baseline (P < 0.001). This was mainly due to the enhanced pre-frontal and frontal N450 amplitudes along with higher P450 components over posterior regions in post-treatment condition (P < 0.001); (2) for group comparisons at baseline, no significant topographic mapping differences were found between the treated Learning Disabled/ADHD group and the non-treated Learning Disabled/ADHD control group (P > 0.05) and significant differences were present between the treated Leaning Disabled/ADHD and the normal control group (P < 0.001); (3) 8 months later, in post-treatment condition, group comparisons revealed significant topographic mapping differences between the treated Learning Disabled/ADHD group and the non-treated Learning Disabled/ADHD control group (P < 0.001) and none between the treated Learning Disabled/ADHD group and the normal control group (P > 0.05); (4) the topographic mapping of both components was similar at baseline and 8 months later in both control groups (P > 0.05); (5) at baseline, school-marks and Mangina-Test performance of treated Learning Disabled/ADHD were not significantly different than those of the non-treated Learning Disabled/ADHD (P > 0.05) and significantly lower than those of the normal control group (P < 0.001); (6) the treated Learning Disabled/ADHD group in post-treatment condition had significantly higher school-marks and Mangina-Test performance than those of non-treated Learning Disabled/ADHD controls (P < 0.001) and were similar to those of normal controls 8 months later (P > 0.05); (7) school-marks and Mangina-Test performance at baseline for non-treated Learning Disabled/ADHD controls were not modified 8 months later (P > 0.05) and normal controls maintained their high performance within the same time interval (P > 0.05). These findings provide evidence of the impact of the psychophysiological treatment methodology on brain plasticity and regulation as reflected in significantly improved neurophysiology of pre-frontal, frontal and posterior brain regions concomitantly with higher school-marks and neuropsychometric performance in the Mangina-Test.     

The narcissistically vulnerable system: A case study of the public mental hospital

The present paper introduces the concept of the narcissistically vulnerable system by suggesting that organizations may manifest some of the same pathological characteristics as narcissistic individuals. The public mental hospital was chosen as an example of such a system. Reasons for its vulnerability were suggested and specific defenses, employed at the system level, were discussed. Finally, remedies for the repair of the narcissistically vulnerable system were considered.