BCG vaccination of the newborn infant with the 131 Copenhagen strain

From October 1, 1979 to September 30, 1981 a prospective study on the side-effects of BCG inoculation was conducted in the cities of Duisburg, Essen, and Mülheim, in very close cooperation with practising pediatricians, public health authorities, and obstetric departments. Particular consideration was given to suppurating regional lymphadenitis. In the period covered by the study 21.294 infants from 23.390 live births (i.e., 89%) were BCG-vaccinated using the Copenhagen 1331 strain manufactured by Behringwerke. A suppurating regional lymphadenitis occurred in 66 cases, i.e., a complication rate of 0.3%. The conversion ratio was high. Out of 8.144 documentation forms that could be assessed 6.840 (84%) attested to a positive tuberculin reaction caused by prophylactic test U 4. If the result of this test was negative a second test, after Mendel-Mantoux, strength 10, was used. According to this a total of 7.311, i.e., altogether 98.4% of the inoculation results evaluated, were positive. Both the conversion ratio as well as the incidence of ulcers at the vaccination site depend to a slight degree on the concentration of units in the vaccine which are capable of reproduction, to the extent that at higher concentrations the conversion ratio increases, as does the number of ulcers at the vaccination site.     

Ultrasound imaging of pneumonia

One hundred forty-three consecutive patients with clinically and radiologically confirmed pneumonia were examined by ultrasound. In 127 cases (88.8%), a consolidation could be visualised in the sonogram. Eight patients (5.6%) had a pleural effusion only. The remaining eight (5.6%) had no pathological findings. The characteristic features of pneumonia were a hypoechoic consolidation with numerous small hyperechoic structures (112 patients, 88.1%) and a blurred margin. In eight cases abscess formation could be detected and treated by ultrasound-guided drainage. We conclude that sonography can visualise pneumonic consolidations in a high percentage, and gives additional information concerning the diagnosis, follow-up and treatment of pneumonia.     

Etiologic Studies of Adolescent Drug Use: A Compendium of Data Resources and Their Implications for Prevention

Etiological studies canvassing five major domains of risk are reviewed. The five domains reflect unique facets of risk that are central to many current prevention approaches and include: peer social influences, family (parenting) processes, expectancies (cognitive motivations), social skills and personal self-management strategies, and personality factors. Each domain is discussed with regard to major theoretical issues, important studies that help to clarify risk mechanisms, and major findings. A sixth area covering studies of multi-ethnic youth and ethnic-specific risk mechanisms also is reviewed in the context of augmenting previous empirical findings. A final section addresses two important concerns: (1) the need for a comprehensive model of developmental vulnerability; and (2) utilization of information stemming from a long tradition of developmental etiology to enhance the efficacy of drug abuse prevention.     

Behandlung des Morbus Scheuermann

Zusammenfassung Der Scheuermannschen Erkrankung der Wirbelsäule liegt ein Mißverhältnis von Belastung und Tragfähigkeit der wachsenden Wirbelsäule zugrunde. Für die Verminderung der Tragfähigkeit sind Gefäßdurchtrittsstellen durch die knorpelige Wachstumsplatte, Lücken im Lamellensystem dieser Knorpelplatte und Ossifikationslücken unter derselben verantwortlich. Das dauernde Sitzen und die Unterentwicklung der Rükkenmuskulatur infolge Bewegungsarmut führen zu vermehrter Belastung der Wirbelkörper. Die Prophylaxe hat sich in erster Linie auf die Ausschaltung der Bewegungsarmut resp. Kompensation des langen Sitzens zu konzentrieren. Die Behandlung einer Kyphose ist durch passive Redression möglich, doch ist sie nur während der Wachstumsperiode sinnvoll.     

Long-term effects of self-control on alcohol use and sexual behavior among urban minority young women

High risk alcohol use and sexual behaviors peak in young adulthood and often occur in the same individuals. Alcohol use has been found to impair decision-making and contribute to high risk sexual activity. However, the association between alcohol use and risky sexual behavior may also reflect enduring individual differences in risk taking, sociability, self-control, and related variables. Both behaviors can serve similar functions related to recreation, interpersonal connection, and the pursuit of excitement or pleasure. The present study examined the extent to which high risk drinking and sexual behavior clustered together in a sample of urban minority young adult women, a demographic group at elevated risk for negative outcomes related to sexual health. We tested whether psychosocial functioning measured at the beginning of high school predicted classes of risk behaviors when girls were tracked longitudinally into young adulthood. Latent class analysis indicated three distinct profiles based on high risk drinking and sexual behavior (i.e., multiple sex partners) in young adulthood. The largest class (73% of the sample) reported low levels of risky drinking and sexual behavior. The next largest class (19%) reported high risk drinking and low risk sexual behavior, and the smallest class (8%) reported high levels of both behaviors. Compared to women from other racial/ethnic groups, black women were more likely to be categorized in the high risk drinking/low risk sex class. Multinomial logistic regression indicated that self-control in adolescence had a broad and enduring protective effect on risk behaviors eight years later and was associated with a greater probability of being in the low risk drinking/low risk sex class. Findings are discussed in terms of understanding the phenotypic expressions of risk behavior as they relate to early psychosocial development and the long-term protective function of self-control in reducing high risk drinking and sexual behaviors.     

Fetal middle cerebral artery peak systolic velocity in the investigation of non-immune hydrops.

OBJECTIVE: In some cases of non-immune hydrops there is congenital or acquired fetal anemia. The aim of this study was to investigate the potential value of fetal middle cerebral artery peak systolic velocity (MCA-PSV) in the assessment and management of non-immune hydrops due to anemia. METHODS: Fetal MCA-PSV and fetal hemoglobin concentration, in blood obtained by cordocentesis, were measured in 16 singleton pregnancies referred to our unit for further investigations because of a diagnosis of non-immune hydrops fetalis. In all cases a detailed ultrasound examination demonstrated moderate or severe ascites, with or without skin edema, and pericardial or pleural effusions. Furthermore, there were no obvious malformations to account for the hydrops. In each fetus the measured MCA-PSV and hemoglobin concentration were expressed as delta values (the difference in SD from the normal mean for gestation). Regression analysis was used to determine the significance of the association between delta MCA-PSV and delta fetal hemoglobin concentration. In addition, we searched our database to identify the sonographic features and hemoglobin concentration of fetuses with congenital infection. RESULTS: In the 16 cases of non-immune hydrops there were seven with parvovirus B19 infection, one each of alpha-thalassemia and primary cardiomyopathy and seven with no obvious explanation for the hydrops. There was a significant association between delta MCA-PSV and delta hemoglobin concentration (delta hemoglobin = (delta MCA-PSV + 0.1437)/-0.4154; R(2) = 0.7202; P < 0.0001). In 10 of the cases the fetal hemoglobin concentration was more than 4 SD below the normal mean for gestation and in all these cases the MCA-PSV was more than 2 SD above the normal mean for gestation. Our computer search identified an additional nine fetuses with parvovirus B19 infection and in all cases the predominant sonographic finding was ascites and the hemoglobin concentration was more than 4 SD below the normal mean. In contrast, only 3/14 fetuses with cytomegalovirus, toxoplasmosis, coxsackie B or Treponema infection had ascites and only 2/14 had a hemoglobin deficit of 4-6 SD. CONCLUSION: In the management of non-immune hydrops, measurement of fetal MCA-PSV can help identify the subgroup with fetal anemia.     

Tri-city study of Ecstasy use problems: a latent class analysis

This study used latent class analysis to examine distinctive subtypes of Ecstasy users based on 24 abuse and dependence symptoms underlying standard DSM-IV criteria. Data came from a three site, population-based, epidemiological study to examine diagnostic nosology for Ecstasy use. Subject inclusion criteria included lifetime Ecstasy use exceeding five times and once in the past year, with participants ranging in age between 16 and 47 years of age from St. Louis, Miami, U.S. and Sydney, Australia. A satisfactory model typified four latent classes representing clearly differentiated diagnostic clusters including: (1) a group of sub-threshold users endorsing few abuse and dependence symptoms (negatives), (2) a group of 'diagnostic orphans' who had characteristic features of dependence for a select group of symptoms (mild dependent), (3) a 'transitional group' mimicking the orphans with regard to their profile of dependence also but reporting some abuse symptoms (moderate dependent), and (4) a 'severe dependent' group with a distinct profile of abuse and dependence symptoms. A multinomial logistic regression model indicated that certain latent classes showed unique associations with external non-diagnostic markers. Controlling for demographic characteristics and lifetime quantity of Ecstasy pill use, criminal behavior and motivational cues for Ecstasy use were the most efficient predictors of cluster membership. This study reinforces the heuristic utility of DSM-IV criteria applied to Ecstasy but with a different collage of symptoms that produced four distinct classes of Ecstasy users.