A Descriptive Analysis of the Epidemiology and Motivations for Laser Tattoo Removal in an Underserved Population

Journal of Community Health - Tattoos of formerly gang-involved and incarcerated individuals can negatively impact their ability to reintegrate into society. Laser tattoo removal is essential to...     

Fixation with autogenous osteochondral grafts for the treatment of osteochondritis dissecans (stages III and IV)

This paper presents a clinical and functional assessment of the cases of osteochondritis dissecans (OCD) treated with small mosaicplasty type osteochondral grafts. Between 1999 and 2004, we operated on 12 knees with OCD stages III and IV. They were assessed using the International Cartilage Research Society (ICRS) scale, the Visual Analogue Scale (VAS) scale, X-ray and magnetic resonance imaging (MRI). The study was carried out using a clinical series, was retrospective and had a level of evidence of 4. Before surgery, all patients were in classes III and IV on the ICRS scale (four in class III and eight in class IV). At the time of surgery, the patient age was 27.5 ± 7.9 years, with male predominance (75%). Eleven of the cases were assessed as classes I and II on the ICRS scale (seven in class I and four in class II), with one patient in class IV. X-ray assessment was less favourable, revealing alterations in the articular space in 75% of cases. The results show that this technique enables the biological fixation of fragments and, functionally, the clinical results obtained were very good. The osteochondral grafts avoid the implantation of foreign material and make use of bone fragments of the same rigidity as the OCD fragment. We conclude that the technique described is an excellent alternative to the techniques normally used for the fixation of stage III and IV OCD.

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Résumé  Les auteurs présentent une évaluation clinique et fonctionnelle des malades avec ostéochondrite disséquante du genou (OCD) traitées avec des greffons osteochondrales (mosaicplasty-lie).Entre 1999 et 2004, nous avons opéré 12 genoux avec ostéochondrite disséquante (étage 3 et 4). Ils ont été évaluées en utilisant l’échelle d'ICRS, VAS, les radiographies et la résonance magnétique. Série clinique, rétrospectif, niveau de évidence 4.Avant la chirurgie, tous les malades étaient dans les groupes III et IV de l'échelle ICRS (4 á l’étage III ; 8 à IV). Au moment de la chirurgie, l'age moyen était de ± 27.5 7.9 ans et prédominance masculine (75%). Au moment de la révision 11 des malades étaient dans les groupes I et II d'ICRS (7 I et 4 II), 1 malade dans le groupe IV. L'évaluation radiographique montrait altérations arthrosiques avec pincement d’interligne articulaire en 75% des cas.Cette technique permet la fixation biologique des fragments. Fonctionnellement, les résultats cliniques obtenus étaient très bons. Elle peut dispenser l'implantation d’autre matériel (un corp étranger) en même que les greffes de fixation présentent la même rigidité du fragment osteochondral.La technique décrite est une excellente alternative aux techniques normalement utilisées pour la fixation des Osteochondritis disséquantes dégrée III et IV.

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Cancellation of metal-induced MRI artifacts with dual-component paramagnetic and diamagnetic material: Mathematical modelization and experimental verification

A mathematical model of dual-component paramagnetic and diamagnetic material to cancel metal-induced MRI artifacts was developed and verified experimentally. The magnetization produced by metallic material and then the gradient linearity distortion can be cancelled by using such materials with opposing paramagnetic and diamagnetic properties. This concept of dual-component materials provides a novel solution to the problem of MRI artifacts.     

Integral method for numerical simulation of MRI artifacts induced by metallic implants.

Numerical simulation is a valuable tool for the study of magnetic susceptibility artifacts from metallic implants. A major difficulty in the simulation lies in the computation of the magnetic field induced by the metallic implant. A new method has been designed and implemented to compute the magnetic field induced by metallic objects of arbitrary shape. The magnetic field is expressed pointwise in terms of a surface integral. Efficient quadrature schemes are proposed to evaluate this integral. Finally, the method is linked to an artifact reconstruction model to simulate the images. Magn Reson Med 45:724-727, 2001.     

Child Intelligence and Reductions in Water Arsenic and Manganese: A Two-Year Follow-up Study in Bangladesh

Background:

Arsenic (As) exposure from drinking water is associated with modest intellectual deficits in childhood. It is not known whether reducing exposure is associated with improved intelligence.

Objective:

We aimed to determine whether reducing As exposure is associated with improved child intellectual outcomes.

Methods:

Three hundred three 10-year-old children drinking from household wells with a wide range of As concentrations were enrolled at baseline. In the subsequent year, deep community wells, low in As, were installed in villages of children whose original wells had high water As (WAs ≥ 50 μg/L). For 296 children, intelligence was assessed by WISC-IV (Wechsler Intelligence Scale for Children, 4th ed.), with a version modified for the study population, at baseline and approximately 2 years later; analyses considered standardized scores for both Full Scale IQ and Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed Indices. Creatinine-adjusted urinary arsenic (UAs/Cr), blood As (BAs), and blood manganese (BMn) were assessed at both times.

Results:

UAs/Cr concentrations declined significantly by follow-up for both the high (≥ 50 μg/L) and low (< 50 μg/L) WAs subgroups. At baseline, adjusting for maternal age and intelligence, plasma ferritin, head circumference, home environment quality, school grade, and BMn, UAs/Cr was significantly negatively associated with Full Scale IQ, and with all Index scores (except Processing Speed). After adjustment for baseline Working Memory scores and school grade, each 100-μg/g reduction in UAs/Cr from baseline to follow-up was associated with a 0.91 point increase in Working Memory (95% CI: 0.14, 1.67). The change in UAs/Cr across follow-up was not significantly associated with changes in Full Scale IQ or Index scores.

Conclusions:

Installation of deep, low-As community wells lowered UAs, BAs, and BMn. A greater decrease in UAs/Cr was associated with greater improvements in Working Memory scores, but not with a greater improvement in Full Scale IQ.

Citation:

Wasserman GA, Liu X, Parvez F, Factor-Litvak P, Kline J, Siddique AB, Shahriar H, Uddin MN, van Geen A, Mey JL, Balac O, Graziano JH. 2016. Child intelligence and reductions in water arsenic and manganese: a two-year follow-up study in Bangladesh. Environ Health Perspect 124:1114–1120; http://dx.doi.org/10.1289/ehp.1509974     

A study of Wilson disease mutations in Britain.

Wilson disease (WD) is an autosomal recessive disease of copper transport. The disease is caused by a large number of mutations in the ATP7B gene, some of which appear to be population specific, whereas others are found in probands from a variety of different ethnic backgrounds. This study presents the results of screening the ATP7B gene by SSCP and sequencing in order to define the spectrum of mutations seen in British referrals for WD. The 52 patients screened included 10 with a non-British mixed ethnicity origin. This study identified 19 novel mutations and 18 mutations that had been previously described. The novel mutations included seven nonconservative missense mutations, eight small insertions, or deletions causing frameshift, two nonsense mutations, and two splice-site mutations. Seven of the 10 mixed ethnicity patients harboured homozygous mutations, whereas only four of the larger British group were homozygotes. The detection rate by SSCP analysis in the British group of 42 consecutive unrelated WD probands was 70%. However, SSCP screening of just three exons (exons 8, 14, and 18) is predicted to identify 60% of mutations present in WD referrals.     

Nutritional status and certain risk factor for health status of youths in Subotica]

Nutritional status represents the satisfaction of the human body with nutritive and protective substances and is the reflection of these physical and physiological characteristics, bio-chemical composition, functional capability and the health status. The aim of the examinations and nutritional status monitoring was the early discovery of nutritive disorders in an individual and/or population and undertaking of the appropriate preventive measures. During 1996 in Subotica was performed the measuring of body height, body weight, and systolic and diastolic blood pressure in 887 youths, aged 17-24, during the systematic examinations. Analyzing the nutritional status of youths aged 17-24 in Subotica in relation to the reference values of body mass index--BMI (kg/m2) we have registered 25.03% of youth with values of BMI < 20, 55.81% with values of BMI 20-25. Overweight (BMI > 25) was discovered in 19.16%. We have registered 3.34% of young men with systolic hypertension and 1.67% with diastolic hypertension. Increased values of total cholesterol were found in 21.69% and hypertriglyceridemia compared in 20.40% to the total number of examinees. Monitoring of nutritional status of youths by the application of consistent methodology and information system, might represent the measure of health care and the potential of the population. Besides, on the national level, it is an important indicator of health status and the basis for population nutrition improvement through the interventive and preventive programs of nutrition.     

Surgeon-performed point-of-care ultrasound in severe eye trauma: Report of two cases

The indications of point-of-care ultrasound (POCUS) in the management of multiple trauma patients have been expanding. Although computed tomography (CT) scan of the orbit remains the gold standard for imaging orbital trauma, ultrasound is a quick, safe, and portable tool that can be performed bedside. Here we report two patients who had severe eye injuries with major visual impairment where surgeon-performed POCUS was very useful. One had a foreign body injury while the other had blunt trauma. POCUS was done using a linear probe under sterile conditions with minimum pressure on the eyes. Ultrasound showed a foreign body at the back of the left eye globe touching the eye globe in the first patient, and was normal in the second patient. Workup using CT scan, fundsocopy, optical coherence tomography, and magnetic resonance imaging of the orbits confirmed these findings. The first patient had vitreous and sub retinal haemorrhage and a full thickness macular hole of the left eye, while the second had traumatic optic neuropathy. POCUS gave accurate information concerning severe eye injuries. Trauma surgeons and emergency physicians should be trained in performing ocular ultrasound for eye injuries.     

Folic Acid and Creatine as Therapeutic Approaches to Lower Blood Arsenic: A Randomized Controlled Trial

Background

The World Health Organization estimates that > 140 million people worldwide are exposed to arsenic (As)–contaminated drinking water. As undergoes biologic methylation, which facilitates renal As elimination. In folate-deficient individuals, this process is augmented by folic acid (FA) supplementation, thereby lowering blood As (bAs). Creatinine concentrations in urine are a robust predictor of As methylation patterns. Although the reasons for this are unclear, creatine synthesis is a major consumer of methyl donors, and this synthesis is down-regulated by dietary/supplemental creatine.

Objectives

Our aim was to determine whether 400 or 800 μg FA and/or creatine supplementation lowers bAs in an As-exposed Bangladeshi population.

Methods

We conducted a clinical trial in which 622 participants were randomized to receive 400 μg FA, 800 μg FA, 3 g creatine, 3 g creatine+400 μg FA, or placebo daily. All participants received an As-removal filter on enrollment, and were followed for 24 weeks. After the 12th week, half of the two FA groups were switched to placebo to evaluate post-treatment bAs patterns.

Results

Linear models with repeated measures indicated that the decline in ln(bAs) from baseline in the 800-μg FA group exceeded that of the placebo group (weeks 1–12: β= –0.09, 95% CI: –0.18, –0.01; weeks 13–24: FA continued: β= –0.12, 95% CI: –0.24, –0.00; FA switched to placebo: β= –0.14, 95% CI: –0.26, –0.02). There was no rebound in bAs related to cessation of FA supplementation. Declines in bAs observed in the remaining treatment arms were not significantly different from those of the placebo group.

Conclusions

In this mixed folate-deficient/replete study population, 12- and 24-week treatment with 800 μg (but not 400 μg) FA lowered bAs to a greater extent than placebo; this was sustained 12 weeks after FA cessation. In future studies, we will evaluate whether FA and/or creatine altered As methylation profiles.

Citation

Peters BA, Hall MN, Liu X, Parvez F, Sanchez TR, van Geen A, Mey JL, Siddique AB, Shahriar H, Uddin MN, Islam T, Balac O, Ilievski V, Factor-Litvak P, Graziano JH, Gamble MV. 2015. Folic acid and creatine as therapeutic approaches to lower blood arsenic: a randomized controlled trial. Environ Health Perspect 123:1294–1301; http://dx.doi.org/10.1289/ehp.1409396