Arsenic in detergents: possible danger and pollution hazard.

Arsenic at a concentration of 10 to 70 parts per million has been detected in several common presoaks and household detergents. Arsenic values of 2 to 8 parts per billion have been measured in the Kansas River. These concentrations are close to the amount (10 parts per billion) recommended by the United States Public Health Service as a drinking-water standard.

"The VIHsibilite Project": HIV-positive people in the Quebec press and community responses.

The VIHsibilite Project is a community-based action-research initiative that examines newspaper coverage of HIV/AIDS issues in Quebec from 1988 to 2004. Using standard qualitative research methods, and in consultation with an advisory committee of people directly impacted by HIV/AIDS news coverage, the project discerns trends in reporting on HIV/AIDS and undertakes discursive content analysis of these, aiming to better understand in what normative ways seropositive people are represented in print media, and, ultimately, to reduce the stigma attendant upon HIV infection. Preliminary findings include indications that seropositive women tend to be represented markedly differently from men in the news.

The nature and designation of osteoarthritis determined by its histopathology.

Specimens of synovial tissue and articular cartilage removed at operations of patients with primary degenerative joint disease were scrutinized for defined histopathological parameters. The findings in the synovial membrane were subsequently compared as to frequency and intensity with identical parameters ascertained in specimens removed from patients with definite rheumatoid arthritis. These examinations disclosed the presence of synovial inflammatory features, although at lesser incidence and intensity than in rheumatoid arthritis; therefore the designation of arthritis is indicated. On the basis of the concurrently examined tissue specimens of the articular cartilage, and in consensus with the generally acknowledged start of the degenerative joint disease by disintegrating changes in the articular cartilage, the prefix of chondrosis is appropriate.

Radiation exposure during scoliosis screening radiography.

Screening programs to detect scoliosis in the adolescent population are active in most communities. Two percent of children screened will be referred for treatment or observation. Increasing concern has been voiced regarding the amount of the potential effects of the radiation administered in such screening programs. Radiation dosage was directly measured on 19 children participating in an established school scoliosis screening program, using lithium fluoride thermoluminescence dosimeters. The mean gonadal doses are measured to be 19 mrem in males and estimated at a maximum 95 mrem in females. The mean entrance skin dose was 174 mrem. A lack of uniformity in the radiographic techniques employed by individual technician was identified. The measured doses were within established acceptable limits and are comparable or below the average dose of 100 mrem received annually by the general public from the environment.

Laboratory evaluation of various cold therapy modalities.

An attempt to evaluate the potential of four modalities to cool soft tissue mass has been done under laboratory conditions using canines. The cooling of deep soft tissues within the thigh after application of various cooling devices was recorded over a 60-min exposure period. Under these circumstances, ice performed best, a frozen gel pack performed in a parallel but slightly less efficient manner. Two other modalities, an inflatable bladder filled with refrigerant gas and an endothermic chemical reaction, were least efficient in cooling.

Surgical management of osteochondritis dissecans of the capitellum.

Ten cases of osteochondritis dissecans of the humeral capitellum which were treated surgically are reviewed. All 10 cases were males and involved the dominant side. The ages at surgery ranged from 13 to 17 years. Follow-up ranged from 1 to 7 years. All of the youths had competed in organized athletics, either baseball or football. By position there were three pitchers, two catchers, two infielders, and one outfielder; in addition there were one quarterback and one linebacker. Only one patient presented with locking of the elbow, whereas the others presented with pain and limitation of extension. The locked elbow was explored immediately and the others were explored after immobilization failed to relieve their symptoms. In seven of the joints a loose fragment of the capitellum was found lying either in the joint or in a defect in the capitellum. The fragment had multiple small holes. In three cases there was no loose fragment. In this situation a corticol window was cut above the capitellum. The capitellum was then drilled and bone was grafted from above. Over all, there were one excellent, six good, one fair, and two poor results. There seemed to be little difference between curretting alone or curetting and drilling. The cases with the cartilage intact and bone grafted from above did worse, with one fair and one poor result of three cases. The two poor results required further surgery, which consisted of partial excision of the capitellum. All cases lacked elbow extension before and after surgery, but nine of 10 gained some motion after surgery. Pre- and postoperative x-rays are shown in this report and a brief review of the literature concerning osteochondritis dissecans is presented.

Total knee arthroplasty in 1984.

In total knee arthroplasty, as little bone as possible should be removed, all intact ligaments should be saved, and fixation by biologic ingrowth, rather than methylmethacrylate, should result in the lowest incidence of loosening.

Slipped capital femoral epiphysis, unsolved adolescent hip disorder.

Slipped capital femoral epiphysis remains the unsolved adolescent hip disorder. The epidemiology, clinical signs and symptoms, pathology, and radiographic findings have been well described and are reviewed. However, since we do not know the cause of the disorder, prevention is not possible and an ideal method of treatment has not yet been found. Goals of treatment, methods of treatment, as well as results and complications of treatment are discussed.

Acute bacterial arthritis in the adult.

Suppurative arthritis can be a complex and vexing problem. Formal arthrotomy is among the many successful approaches for the treatment of septic joints in the adult, however, it is not without morbidity and may not always be required. The clinical features, pathophysiology, and treatment of this disorder are reviewed.

The alterations of the synovial membrane in rheumatoid arthritis treated with corticosteroids.

Sections of synovial tissue removed from patients with rheumatoid arthritis treated, for a long period of time or a brief period of time or not at all, with corticosteroids were examined for the incidence of histopathologic changes. Comparison of the quantification of these changes in the differently treated groups revealed that prolonged administration of corticosteroids had an inhibiting effect on the occurrence of lymphocytes and histiocytes in inflammatory infiltrates as well as on the hypertrophy of synoviocytes, on the proliferation both of fibroblasts and fibrocytes, and on the formation of villi and collagen fibers.

[The pathology of ganglion]. / Die Pathologie des Ganglion.

Ganglia are cysts which frequently occur in the proximity of joints. Histopathologic examinations disclose that these formations do not originate from articular tissue, but independently of this develop from degenerating nonspecific connective tissue. By progressive myxoid decomposition of collagen fibers larger amounts of mucinous fluid accumulate, and spread the adjacent collagen fibers apart, thus forming cavities filled with thickening fluid. With further liquefaction of some interstitial septa some cysts coalesce and widen, until eventually other septa and the surrounding capsule become dense by increase of fibrocytes and thickening of the collagen bundles.

Parental involvement and the effectiveness of an adolescent day treatment program.

Results on an outcome study with adolescents in a partial hospitalization program reflect parental involvement during the treatment process. The study compared behavioral outcomes of adolescent patients with high parental involvement with outcomes of adolescent patients with low parental involvement. The partial hospitalization program led to improvement for adolescents aged 13-17 years with significant differences for improvement by parental involvement. Improvements were in primary function areas, school and home as perceived by the adolescent, and in a reduction in severity level and total pathology as rated by the parent. Further, adolescents with high parental involvement were less likely to need rehospitalization.

Gluteal compartment syndrome: case report.

A compartmental syndrome can occur in any space limited by fascia or skin. A case of a gluteal compartment syndrome is reported, apparently from prolonged pressure after a drug overdose. Clinical features were a painful expanding gluteal mass with sciatic nerve dysfunction. Fasciotomy of the tensor fascia lata and the overlying fascia of the gluteus maximus resulted in rapid relief of symptoms.

Management of arthritis of the ankle. An alternative of arthrodesis.

Twenty-eight patients treated by total ankle arthroplasty at the University of California, Irvine, were evaluated on a 100-point ankle analysis scale preoperatively and postoperatively. The average preoperative score was 35 and the average postoperative score was 74. Significant improvement occurred in function, pain relief and range of motion. The average follow-up period for these patients was 9 months. Although the number in each group is small, it does not appear that the procedure has merit for the treatment of ankle arthritis from such diverse causes as trauma, rheumatoid arthritis, aseptic necrosis of the talus and talectomy. Complications included wound healing problems in 3 patients. Malalignment of the prosthesis occurred in 2 other patients; one required revision. Ankle replacement failed in 2 patients. One patient required a fusion; the other an amputation following occlusion of the posterior tibial artery after surgery. At the present time, ankle replacement appears to be an acceptable alternative to ankle arthrodesis.