Hip dislocation after modular unipolar hemiarthroplasty

An institutional review board-approved retrospective review of hip fractures in elderly patients treated with a modular unipolar implant was carried out to identify factors predisposing to dislocation of a hemiarthroplasty. The main outcome measure evaluated was dislocation vs nondislocation. Two hundred seventeen patients underwent the surgery, and 174 were available for review at 6 weeks and 144 at 1 year. The incidence of dislocation was 6%. The average time of dislocation after surgery was 19.3 days. Clinical factors significant for dislocation were male sex and mental disease. Radiographic factors in dislocated hips included a smaller femoral neck and contralateral femoral neck offset. The center edge angle was also smaller in the dislocated patients. These patients had a higher mortality rate.     

Mode of attachment and histopathological effects of Macrogyrodactylus clarii, a monogenean gill parasite of the catfish Clarias gariepinus, with a report on host response

A detailed account is given about the mode of attachment and histopathological effects of Macrogyrodactylus clarii Gussev, 1961, a viviparous monogenean from the gills of the catfish Clarias gariepinus. Most parasites attach their haptors to the proximal region of the gill filament (primary gill lamellae), while few specimens were seen attached to the distal region. Attachment of the haptor was achieved mainly by the blade of the hamuli, but no evidence was found indicating the participation of marginal hooklets in the attachment. The hamuli of M. clarii penetrate into the interlamellar epithelium of the gill tissue. Some evidences were found to indicate that M. clarii may also utilize suction force during haptoral attachment. The pathological effects of M. clarii are manifested by breakdown of the coating epithelium, necrosis of the epithelial cells, vacuolations inside and outside the host cells, fusion of the gill lamellae, rupture of blood capillaries, infiltration of erythrocytes and degeneration and fibrosis of the interlamellar epithelium. The host response includes the appearance of lymphocytes, mucoid secretions and hyperplasia of the tissue at the site of attachment.     

A proposed taxonomy for characterization and assessment of avian influenza outbreaks

PURPOSE: The speed and high potential impact of avian influenza's (AI) on local bird populations, poultry economies and human health make timely and coordinated characterization, assessment and response to possible threats essential. To collaborate effectively, stakeholders (public health, medical, veterinary, and agricultural professionals) must be able to communicate and record findings, assessments, and actions in a standard fashion. We seek to discern a taxonomy of concepts and relationships that are important to the stakeholder community when sharing information about the characterization and assessment of an AI outbreak, according to a consistent and common perspective, interpretation, and level of detail. METHODS: To derive concepts relevant to AI characterization and assessment, we reviewed selected journal articles, reporting and laboratory forms, and public health websites associated with AI case reporting. We mapped concepts to existing medical terminologies within the Unified Medical Language System when possible, using the National Library of Medicine's MetaMap program. RESULTS: From 54 distinct information sources, we extracted 1113 concepts, of which 533 mapped to 15 medical terminologies; 580 did not map to specific terminologies. Using a combination of semantic type-relationship matching and expert consensus, we constructed the proposed taxonomy, with linkages to existing terminologies where pragmatic. CONCLUSION: The proposed taxonomy describes core knowledge, data and communication needs for the characterization and assessment of AI outbreaks in the context of existing medical terminologies across different domains. We also describe areas for further work.     

Antenatal depression and suicidal ideation among rural Bangladeshi women: a community-based study

Depression during pregnancy is a significant public health problem because of its negative effects on the health of both mother and infant. Data on its prevalence and determinants are lacking in Bangladesh. To estimate the prevalence of depression during pregnancy and to identify potential contributory factors among rural Bangladeshi women, a community-based study was conducted during 2005 in Matlab sub-district, a rural area of eastern Bangladesh. Three hundred and sixty-one pregnant women were identified through an existing health and demographic surveillance system covering a population of 110,000 people. The women were interviewed at home at 34–35 weeks of pregnancy. Information on risk factors was collected through structured questionnaires, with the Bangla version of the Edinburgh Postnatal Depression Scale (EPDS-B) used to measure their psychological status. Both univariate analysis and multivariate logistic regression were applied using the SPSS 15.0 statistical software. The prevalence of depression at 34–35 weeks pregnancy was 33% (95% CI, 27.6–37.5). After adjustment in a multivariate logistic regression model, a history of being beaten by her husband either during or before the current pregnancy had the highest association with depression followed by having an unhelpful or unsupportive mother-in-law or husband, and family preference for a male child. Of the antenatally depressed women, 17 (14%) admitted to thoughts of self-harm during the pregnancy. This paper further explores the reasons why women have considered some form of self-harm during pregnancy. Depression during pregnancy is common among Bangladeshi women, with about a third being affected. The study highlights the need to allocate resources and develop strategies to address depression in pregnancy.     

Definitive test to diagnose median arcuate ligament syndrome: injection of vasodilator during angiography

The diagnosis of median arcuate ligament (MAL) syndrome and its correlation with symptoms has been controversial since the disease entity was described. The authors describe a technique that will identify patients who will benefit from intervention. Eight patients with isolated celiac artery compression from MAL were identified by the authors. Their technique involved selective cannulation of the superior mesenteric artery (SMA) and injection of a vasodilator during angiography. Symptom reproduction and loss of collateral filling of the celiac territory represented a positive test: 4 of the 8 patients had a positive test and underwent successful surgical treatment of the condition; 3 of them remained asymptomatic at follow-up; 1 patient continues to have mild abdominal discomfort. Of the 4 patients with a negative test, 2 were found to have other conditions causing their symptoms. Vasodilator injection into the SMA is a useful diagnostic test to identify patients with symptomatic MAL syndrome.