Sex estimation of the humerus: A geometric morphometric analysis in an adult sample.

Sex estimation is the keystone for positive identification when an unidentified human body is recovered in forensic contexts. However, in complex death scenes such as mass disasters, the remains are often fleshed, mutilated, burned, and/or commingled. In situations such as these where it is not possible to analyze pelvis and/or cranium data, traditional metric and qualitative morphological methods on postcranial bones can yield unsatisfactory results. In such cases, geometric morphometric techniques offer an alternative to the analysis of both shape and size components of morphological variation that can be of great utility for sex estimation in forensic investigations. The study population consisted of 72 well-preserved adult humeri (40 males and 32 females; mean age of 62 years) that were photographed in standardized positions with landmarks located in four two-dimensional views of the humerus (anterior surface of the proximal epiphysis, and anterior, posterior and inferior surface of distal epiphysis). Principal components analysis, canonical variates analysis and discriminant analysis were applied. The data indicated that males and females were classified with low levels of accuracy (54.95-77.92% for males; 56.87-71.78% for females) based on shape variables. However, when the shape variable was combined with the centroid size, the levels of accuracy increased (81.86-94.92% for males; 84.08-94.88% for females). To obtain larger differences between males and females, it is necessary the combination of centroid size with shape variables; the shape of the humerus is insufficient to discriminate sex with accuracy.

[Climacturia, a symptom to take into account after radical prostatectomy]. / Climacturia, un sintoma a tener en cuenta tras prostatectomía radical.

INTRODUCTION AND OBJECTIVES: Patients after radical prostatectomy describe sexual dysfunctions such as orgasm-associated incontinence also termed climacturia. Our aim is to analyse incidence and data in relation with this symptom. METHODS: 119 phone surveys carried out to patients after radical prostatectomy to Know about climacturia incidence. We are trying to show the relationship between this symptom and the degree and type of incontinence, affectation at bladder neck and apex, and the age. RESULTS: The climacturia incidence came to 20%. The average age of the patients with this symptom was 59 years, the same as for those without it. The patients with both, incontinence and climacturia perform stress incontinence basically but urgency-incontinence to a greater extent (20%) that those with no climacturia (5%). Most patients with climacturia suffer a light leakage (87%) and a 62% always associated to orgasm. Negative effect of the symptom in the patient's and partner's sexual life appeared only in 2 cases (13%). CONCLUSIONS: We suggest the same term in Spanish than in English. Age and affectation of the bladder neck and apex do not have an effect on climacturia. Stress incontinence is more often related to patients with climacturia and the degree of incontinence is higher than in those without it.

[Infants aged 3-24 months with fever without source in the emergency room: characteristics, management and outcome]. / Lactante de 3-24 meses con fiebre sin foco en urgencias: características, tratamiento y evolución posterior.

OBJECTIVE: To determine the characteristics of infants aged 3-24 months admitted to a Hospital Pediatric Emergency Room with fever without source, the management of these infants and their subsequent outcome. PATIENTS AND METHOD: We performed a retrospective survey of 733 children aged 3-24 months with fever without source admitted to our Emergency Room between September 1, 2003 and December 31, 2003. Subsequently, the parents of all infants diagnosed with fever without source who were managed as outpatients were telephoned to ascertain their outcome and changes in the final diagnosis. RESULTS: Onset of fever occurred less than 6 hours before arrival at the hospital in 237 episodes (32.2%). The family reported a temperature of > or = 39 degrees C in 436 episodes. Diagnoses in the Emergency Room were the following: fever without source in 677 (92.3%), urinary tract infection in 53 (7.2%) and bacterial meningitis in three (0.4 %). Fifty-five infants with an altered dipstick were excluded and complete blood count (CBC) and blood culture were performed in 66 infants (9.7%). There was a significant negative association between the probability of a request for CBC and blood culture and higher age [6-11 months vs. 3-6 months OR 0.24 (95 % CI: 0.11-0.49); > or = 12 months vs. 3-6 months, OR 0.15 (0.07-0.3)] and a significant positive association with onset more than 12 hours previously [vs. less than 6 hours OR 2.3 (1.2-4.43)] and highest temperature registered at home > 40 degrees C [vs. less than 39 degrees C OR 4.22 (1.5-11.84)]. Follow-up was completed (by telephone or readmission to the Emergency Room) in 574 infants diagnosed with fever without source and managed as outpatients. The final diagnosis differed from that made in the Emergency Room in 158 infants (27.5%), and 70 received antibiotics (12.1%). CONCLUSIONS: A considerable percentage of infants aged 3-24 months with fever without source visits the Emergency Room with very short-term processes. Patient observation is very useful in the management of these infants, since the final diagnosis differed from that made in the emergency room in nearly 30% and 12% were treated with antibiotics.

[Prevalence of tuberculosis among the immigrant population in Ceuta, Spain]. / Prevalencia de infección tuberculosa en la población de inmigrantes en Ceuta, España.

BACKGROUND: The immigrant populations from sub-Saharan and Maghreb countries are groups in high risk of contracting tuberculosis. An analysis is made of the prevalence of tuberculosis infection among one group of these immigrants in Ceuta for the purpose of finding possible differences in their incidental behavior according to the country or geographical region from which they came. METHODS: A descriptive cross-sectional study of a sample of 2,223 immigrants (1979 males and 244 females) from different African countries (mainly Nigeria, Mali, Guinea-Bissau, Cameroon, Ghana, Sierra Leona, Democratic Republic of Congo and Liberia) at the Calamocarro refugee camp in Ceuta. A Mantoux intradermic reaction test was performed following the previously-established protocol, the data for three cut-off points being presented. RESULTS: The immigrants came from 36 African countries, 89.0% being males and 11.0% females (p < 0.001), respectively averaging in age from 24.9 +/- 4.3 to 23.4 +/- 4.1. A reaction to the Mantoux text of 10 mm or more was found in 32.6%, that is 33.2% among males and 27.9% among females (p = 0.09). Solely 1.1% showing 5-10 mm hardening of probable vaccination-related cause. By geographical regions, the highest rates were found among immigrants from the Democratic Republic of Congo (65.1%) and Cameroon (48.4%), followed far behind by Nigeria (34.0%), Liberia (32.7%), Mauritania (29.1%), Sierra Leona (28.8%), Ivory Coast (27.8%), Guinea-Bissau (27.4%), Ghana (26.3%), Algeria (25.6%), Mali (24.1%) and the Republic of Guinea (20.9%) (p < 0.0001). CONCLUSIONS: The immigrant population from central African countries shows a higher prevalence of tuberculosis infection, comprising a group at risk of contracting this disease. Therefore, it is of fundamental importance to implement specific programs to actively detect tuberculosis infection during their stay in our city, taking advantage of their being grouped together upon entry into our country, prior to their final emigration to localities throughout the mainland and subsequent mixing among the host country population.

[Bronchiolitis obliterans in a patient previously working as a printer in a textile factory]. / Bronquiolitis obliterante en un paciente trabajador de estampación en una fábrica textil.

We report the case of a 24-year-old man with a diagnosis of bronchiolitis obliterans, a rare clinical condition; the similarity to Ardystil syndrome was striking. Relevant occupational history included work in a textile air-brushing factory. Also noteworthy were lesions observed by CT scan in the form of cystic formations measuring less than 1 cm, a finding not previously described in the context of bronchiolitis obliterans. The patient improved immediately after starting corticoid treatment although scans failed to improve over several months of follow-up.

[The immotile cilia syndrome as a cause of sterility]. / El síndrome del cilio inmóvil como causa de esterilidad.

We investigated the relationship between ciliary dyskinesia--commonly referred to as inmotile cilia syndrome--and sterility. In the past two years, we have accurately diagnosed 6 new cases of a total of 20 suspected as having this condition. To make the diagnosis, complete clinical, radiological, ultrastructural and spermatic work up was performed. All males in the fertile age were found to be sterile with spermatozoides with no motility. Sterility may initially go undetected in these patients due to early intense ORL and respiratory symptoms they present. However, mild forms of this disease entity may be asymptomatic and patients may consult for sterility with a clinical picture of scantily florid chronic bronchitis like that of smokers. Coincidental situs inversus may be useful in making the diagnosis.

[Paratesticular rhabdomyosarcoma]. / Rabdomiosarcoma paratesticular.

We report a case of paratesticular rhabdomyosarcoma in a 5-year-old boy who was submitted to radical orchidectomy via the inguinal approach and high ligation of the spermatic cord. Clinical and retroperitoneal staging classify this case under group I of the Intergroup Rhabdomyoma Study. Adjuvan chemotherapy with 12 courses of VAC have achieved a good clinical course to date (14 months after surgery) and a good outcome is predicted. We review the literature and discuss the features of this mesenchymal tumor.

[Adriamycin versus ftorafur in the prevention of recurrence of superficial carcinoma of the bladder]. / Adriamicina versus ftorafur como profilaxis de recidiva en el carcinoma vesical superficial.

We performed a randomized prospective study in 40 patients with primary superficial carcinoma of the bladder who had been submitted to TUR. These patients were divided into two groups; one received intravesical adriamycin and the other oral ftorafur. We analyzed tumor size, number and grade and determined the recurrence rate (IR), recurrence rate/month (RR) recurrence rate/cystoscopy (RIC), disease-free interval, survival curves, and drug toxicity. After a mean follow-up of 19.7 months for the patient group that received adriamycin and 20.2 months for the group on oral ftorafur, the IR, RR, and RIC for the group on adriamycin were 40, 2.20 and 0.08%, respectively, and 33.3, 1.64 and 0.07% for the patient group on ftorafur (difference: NS). Drug toxicity was practically absent for the group on adriamycin whereas treatment had to be discontinued in two of the patients on ftorafur due to gastric intolerance. Furthermore, ftorafur was shown to cause a transient increase of transaminase levels in 4 patients, cutaneous changes and alterations in fingernails in 1 patient, and intense dermatitis during the last month of treatment in another patient. However, it was not necessary to discontinue treatment.

[Bladder carcinoma in patients under 40 years of age]. / Carcinoma vesical en pacientes menores de cuarenta años.

A retrospective study was undertaken on 147 cases of bladder tumors T1 GI-II that were treated over the period 1984-1987. Of these, 9 (6.1%) were tumors in patients under 40 years of age. All the foregoing 9 cases, and only 97 of the remaining 138 cases could be evaluated and compared. The male to female ratio was 8:1. Both patient groups were similar with respect to tumor grade, number, and size. All patients were treated by TUR and received chemotherapy post-operatively. Of the 9 patients under 40 years of age, 2 (22.2%) patients classed as GII had tumor recurrence and total cystectomy was performed in one (11.1%) due to tumor upgrading; whereas for the remaining patient group tumor recurrence was 37.7% and tumor progression was 6.6%. This finding shows that the choice of treatment or the decision to follow patients more or less closely cannot be based on patient age. Treatment should be based on patient overall condition and tumor grade and stage.