Temporomandibular joint: morphology and signal intensity characteristics of the disk at MR imaging

Magnetic resonance (MR) imaging has been used in the temporomandibular joint (TMJ) primarily to define the disk position. This report examines altered morphology and signal intensity characteristics of the TMJ disk as they relate to the severity of internal derangement. Two hundred sixteen joints in 133 patients with a history of such derangement. were imaged with MR. Disk position, signal intensity, morphology, and the presence of osteoarthritis were determined for each joint. The normal disk was not anteriorly displaced and had a normal "bow-tie" shape. A grade 1 disk was anteriorly displaced and had a normal shape; a grade 2 disk was anteriorly displaced and had an abnormal shape. Forty (19%) joints were considered normal; none of these exhibited osteoarthritis. One hundred thirty-nine (64%) joints were grade 1; osteoarthritis was found in 17%. Thirty-seven (17%) were grade 2; osteoarthritis was found in 95%. All forty normal joints had high or intermediate signal intensity in the disk. Osteoarthritic joints had a higher percentage of disks with diminished intensity (P less than .0001). Severe or untreated osteoarthritis is known to be a complication of TMJ internal derangements; hence this grading system seems to correlate with the severity of internal derangement.     

Effects of Electroconvulsive Therapy on the Electrocardiogram in Geriatric Patients with Stable Cardiovascular Diseases

Eight elderly patients (mean age +/- SD, 73.2 +/- 9.5 years) were studied with Holter electrocardiographic monitoring for 24 h before and 24 h after an electroconvulsive therapy (ECT) treatment. Patients with a history of cardiac disease but who were not experiencing any active cardiac symptoms were chosen for study. They were not receiving either cardioactive medications or psychotropic agents that can effect cardiac rhythm or conduction. Each patient served as his own control, with direct comparison of the periods before and after the treatment. There were no differences before and after ECT in the electrocardiogram. One minute after the seizure, patients were hypertensive and tachycardic. ECT does not appear to pose additional risk in stable, elderly patients with a history of cardiac disease.     

Overview

The 2nd issue of The Alan Guttmacher Institute's 1993 "State Reproductive Health Monitor: Legislative Proposals and Actions" chronicles and summarizes reproductive health-related legislation introduced and acted on in the 50 US states from January 1 to May 31, 1993. Topics covered include abortion, family planning, sex and health education, teenage pregnancy, infertility, maternal and infant care, sexually transmitted diseases, and AIDS. Legislatures in every state but Kentucky convened sessions in 1993. By the end of May, 29 legislatures had adjourned. Abortion legislation included: the status of legal abortion, counseling and/or waiting periods, parental involvement, public funding for low income women, harassment of providers. Family planning, sex and health education, and teenage pregnancy legislation covered: family planning, Norplant implants, and teenage pregnancy prevention. Legislation on maternal and infant health care included prenatal care and medicaid, perinatal drug and alcohol abuse (with proposals to make available or expand treatment and rehabilitative services to mount public education campaigns on the effects of alcohol and drug use while pregnant, and to punish women for drug use during pregnancy), and maternity and family medical leave. Infertility legislation covered medical insurance, the legality and regulation of surrogate contracts, other kinds of assisted reproductive technology arrangements, and the licensing of fertility clinics. Under the subject of sexually transmitted diseases and AIDS, legislation included education and prevention strategies, setting guidelines and requirements for testing and reporting, criminal penalties, treatment services and insurance, health care providers and patients, discrimination, and the establishment of study commissions.     

Overview

This paper reviews reproductive health-related legislation introduced and acted on in the 50 states of the US to August 31, 1992. California, Illinois, Massachusetts, Michigan, New Jersey, New York, Ohio, Pennsylvania, and Wisconsin had not, however, closed session as of the end of August, and the legislatures of Arkansas, Montana, Nevada, North Dakota, Oregon, and Texas did not convene in 1992. Subjects addressed include abortion, family planning services, sex education, teenage pregnancy, adoption, infertility, maternal and infant care, and sexually transmitted diseases/AIDS. Specifically under abortion, the paper considers the status of legal abortion, parental consent, informed consent and waiting periods, and clinic licensing and harassment of providers. Subtopics on family planning, NORPLANT, welfare reform, sex education, and teen pregnancy prevention are then presented, followed by a review of current issues in adoption, infertility, and surrogacy contracts. Prenatal and infant care, perinatal drug and alcohol abuse, and family/medical leave are also covered. Closing section address HIV testing, consent, and notification; education and prevention strategies; treatment, insurance coverage, and discrimination.     

The Relationship Between Social Support,HIV Serostatus,and Perceived Likelihood of Being HIV Positive Among Self-Settled Female,Foreign Migrants in Cape Town,South Africa

Female cross-border migrants experience elevated risks for HIV, and migrants in South Africa may face additional risks due to the country’s underlying HIV prevalence. These risks may be mitigated by the receipt of social support. A behavioral risk-factor survey was administered using respondent-driven sampling. Multivariable regression models assessed the relationships between social support and two HIV outcomes: HIV serostatus and perceived HIV status. Low social support was not significantly associated with HIV status (aOR?=?1.03, 95?% CI 0.43–2.46), but was significantly related to a perception of being HIV positive (aPR?=?1.36, 95?% CI 1.04–1.78). Age, marital status, and education level were significantly associated with HIV serostatus. Illegal border-crossing, length of time in South Africa, anal sex, and transactional sex were significantly associated with aperception of being HIV positive. Future research should investigate how HIV risks and the receipt of social support change throughout the migration process.