Violence in families of adolescent runaways.

Adolescents who run away from home frequently give many reasons for their behavior, but rarely has an examination of physical maltreatment as a precipitating factor for leaving home been carefully conducted. The Conflict Tactics Scale, a measure of how families resolve conflicts, was completed by 199 adolescents who ran away to a youth shelter. Some 78% of the adolescents self-reported significant physical violence directed toward themselves by a parent in the one year prior to their running away. There were no significant effects of age or sex on the amount of physical violence. A comparison between runaway adolescents and adolescents labeled abused reveals no significant differences in at-risk child abuse scores. An argument is presented for crisis counselors and youth shelter workers to more carefully examine and treat family violence in adolescents who run.

[Iodine and thyroid hormone status of mother pigs and their offspring]. / Zum Jod- und Schilddrüsenhormonstatus von Mutterschweinen und ihren Nachkommen.

The iodine concentration in the chain sow feed-->blood serum of dams-->milk-->blood serum of piglets (2 per litter) was determined in 36 litters in two experiments with different dietary iodine levels and in 16 litters in the framework of field studies in two piglet production farms in each case at weaning after four weeks lactation. In the blood serum also the concentration of thyroxine (T4) and triiodothyronine was determined. The serum concentration of iodine and T4 did not indicate dietary iodine administration (sows) or showed only a weak response (piglets). The iodine concentration of milk was very strongly affected by iodine administration and by the iodine status of sows prior to the experiments. The highest milk iodine concentration was found in the sows of piglet production farms, corresponding to the level of iodine administered. For diagnosis of the iodine supply status the iodine concentration of sow milk should be analyzed. The lower limit of milk iodine concentration is presently defined as 50 micrograms/l, and the mean of 5 random samples per sow herd should not fall below this limit. Serum concentrations of iodine and T4 may remain moderate even in case of a low iodine supply (sow serum: 30 micrograms iodine/l, 25 nmol T4/l; piglet's serum: 50 micrograms iodine/l, 55 nmol T4/l), and are unsuited for diagnosis of iodine status.

[Not Available]. / Konzentration an Deoxynivalenol (DON) in Thüringer Brot und Feinen Backwaren.

Since 2003 bread and fine bakery products must not contain more than 350 µg Deoxynivalenol (DON). As a prerequisite for the label "Geprüfte Qualität"-Thüringen [proved quality Thuringia] and since coming into force of the respective evaluation prescription a total of 25 breads and 41 fine bakery products was investigated by ELISA with regard of this compound. In the 66 samples of the year 2003 no DON concentrations above the limit were detected and in the preparation period 2001/2002 only one sample exceeded the maximum. In several samples, most narrow to the maximum limit, an additional determination by HPLC was performed which resulted in lower DON-concentrations as compared to the values analyzed by ELISA.

Anatomical variations of the semilunar notch in elbow dislocations.

The anatomical relations of the semilunar notch of the ulna were studied in radiographs, taken in a strict lateral view, from 100 patients with elbow dislocations. The results were compared with those from a control group of 150 patients without dislocation or other radiographic pathology. We found that the coronoid process and an angle (a) formed between the axis of the ulna and a line going through the tip of the coronoid process and the tip of the olecranon were significantly smaller than those in the control group (P = 0.02). The central angle of the semilunar notch was significantly larger in the dislocation group than in the control group (P = 0.009). The smaller angle (a) and larger central angle in the dislocation group are a result of a lower coronoid process, but they are also due to the prominent tip of the olecranon. The results suggest that the dislocation mechanism is partly a hyperextension, with the tip of the olecranon as the pivot point.

Biomechanics of the interlocking nail. A study of the proximal interlock.

Conventional interlocking nails for the femur use an inclined proximal interlocking screw; the AO/ASIF universal interlocking nail utilizes a transverse interlocking screw which is anchored in cortical bone. The transverse position of the screw allows one to employ the nail for either the right or left side. The yield strength of the thinner diameter transverse screw, (thread 4.5 mm. core 3.0 mm) was compared with that of the Grosse-Kempf nail oblique screw (thread 6.3 mm, core 4.5 mm) by testing in cadaver femora to evaluate the risk of fatigue failure. The test, performed using slow loading rates (50 N/s), simulated either a diaphyseal or a subtrochanteric fracture situation. The test rig applied a load corresponding to body weight and pull at the trochanter. Taking the highest load without plastic deformation as a criterion, the mechanical strength of the two screws was evaluated for each fracture situation. The thinner but shorter transverse interlocking screw demonstrated higher strength (4500 N vs. 3000 N; P less than or equal to 0.02) than the thicker inclined screw in the diaphyseal and the subtrochanteric fracture situation (2300 N vs. 1100 N; P less than or equal to 0.06). The biomechanical test showed the transverse screw to have sufficient and superior strength.

[Lymphomas of the parotid region]. / Linfomas de la región parotídea.

Parotid gland lymphomas are very uncommon. Two patients with this condition were treated in the last decade. Surgery should be used only for diagnosis and becomes unnecessary when adenopathy is present, since a lymph node biopsy will establish the diagnosis.

[Needle aspiration cytology in euthyroid uninodular goiter]. / Citologia por puncion aspirativa en el bocio uninodular eutiroideo.

Fine needle aspiration cytology (FNAC) has been shown to be second only to surgical biopsy for demonstration of malignancy in thyroid nodules. A prospective study of FNAC for euthyroid uninodular goiter (EUG) was conducted between January 1987 and June 1990, totaling 87 patients of which 61 were submitted to surgical biopsy. FNAC in the latter were interpreted as benign in 41 cases, suspected malignancy in 8, and definitely malignant in 7. The remaining 5 smears were considered technically inadequate for diagnosis. In 39 of the 41 patients with a benign (negative) cytology result, the histopathological diagnosis confirmed the absence of a neoplastic process (2 false negatives). In 12 of the 15 patients with a suspected malignant (positive) cytology result, a subsequent histopathological report confirmed a neoplastic process (3 false positives). Thus FNAC had a sensitivity of 86% and a specificity of 93%. We conclude that FNAC is a valuable tool for the diagnosis of erythroid goiter and could help reduce significantly the number of patients who need to be surgically intervened.

A comparative study of the initial stability of cementless hip prostheses.

In the process of prosthetic loosening, the initial motion of the implant relative to the bone is a key element. In order to provide quantitative information, three straight and one curved cementless hip stems were submitted to in vitro tests in autopsy specimens of the femur under dynamic axial and torsional loads with the displacements measured in several directions. The results were compared to those of an additional group of cemented straight stem prostheses providing reference values. Subsidence of cementless implants on the average was significantly higher than the cemented reference, but single implants were comparable to the reference. Rotational motion was distinctly higher than the reference values, with considerable differences between designs. When comparing displacements perpendicular to the main load direction, the sagittal plane motion was found to be at least double the motion in the frontal plane. Micromotions at the prosthesis/bone interfaces under the load case selected were smallest for the curved and highest for one of the straight prostheses.

Subtrochanteric fractures of the femur. Results of treatment with the 95 degrees condylar blade-plate.

The results were retrospectively analyzed of 47 subtrochanteric fractures of the femur treated with a 95 degrees condylar blade-plate to establish whether two different surgical techniques yielded different results. Before 1981, treatment consisted of extensive visualization of the fracture lines, permitting anatomic reduction of all fragments, stable internal fixation with the blade-plate, and optional autologous bone grafting as recommended by the AO group. Twenty-four fractures were treated accordingly and constituted Group I of this study. In 1981, visualization of the fracture lines was abandoned, especially at the medial cortex; an indirect reduction technique was used to gain optimal alignment and stability without aiming at anatomic reduction, and bone grafting was discontinued. Twenty-three patients were treated accordingly and constituted Group II. The use of prophylactic antibiotics as a routine for all major trauma was instituted at the time the surgical technique was changed. Thus, only two of the 24 patients in Group I received antibiotics as opposed to 20 of the 23 patients in Group II. Average time to bony union for those fractures that healed primarily was 5.4 months in Group I and 4.2 months in Group II. Delayed or nonunion was 16.6% in Group I and 0% in Group II, and the infection rate was 20.8% versus 0% in the two groups. The four cases with a delayed union were aseptic, but three of the four nonunions were infected. The functional end result was comparable for both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

[Shortened preoperative preparation in diffuse hyperthyroid goiter: experience in 34 patients]. / Preparación preoperatoria abreviada en los bocios difusos hipertiroídeos. Experiencia en 34 pacientes.

Conventional preparation of goitrous hyperthyroid patients using lugol and propranolol may take 2 weeks. This period may be shortened using sodium iopodate and dexamethasone. We used 500 mg of sodium iopodate and 1 mg dexamethasone for 4 days in 34 hyperthyroid patients. Surgical indication derived from failure to medical treatment (68%), large goiter (27%) or adverse reaction to PTU (6%). Clinical euthyroidism was achieved after 4 days in all patients. T3 levels decreased from 482 +/- 26.2 to 137.6 +/- 3.7 ng/dl and T4 from 20.6 +/- 1.04 to 15.2 +/- 0.5 micrograms/dl (p < 0.005). Surgery was uneventful in 33 patients, one subject developed supraventricular tachycardia responsive to verapamil. Electron microscopy of the removed thyroid tissue revealed marked decrease of superficial villi and large phagosomes. Thus, sodium iopodate and dexamethasone are effective and safe for preoperative preparation of hyperthyroid patients.

Citología por punción aspirativa en el bocio uninodular eutiroideo / Needle aspiration cytology in euthyroid uninodular goiter

Fine needloe aspiration cytology (FNAC) has been shown to be second only to surgical biopsy for demonstration of malignancy in thyroid nodules. A prospective study of FNAC for euthyroid uninodular goiter (EUG) was conducted between January 1987 and June 1990, totalizing 87 patients of which 61 were submitted to surgical biopsy. FNAC in the latter were interpreted as benign in 41 cases, suspected malignancy in 8, and definitely malignant in 7. The remaining 5 smears were considered technically inadecuate for diagnosis. In 39 of the 41 patients with a benign (negative- cytology result, the histopathological diagnosis confirmed the absenece of a neoplastic process (2 false negatives). In 12 of the 15 patients with a suspected amloignant (positive) cytology result, a subsequent histopathological report confirmed a neoplastic process (3 false positives). Thus FNAC had a sensitivity of 86% and a specificity of 93%. We conclude that FNAC is a valuable tool for the diagnosis of enthyroid goiter and could help reduce significantly the number of patients who need to be surgically intervened