Effect of UV radiation on habitat selection by Girella laevifrons and Graus nigra (Kyphosidae).

The effect of UV radiation on habitat use of two species of intertidal fishes that inhabit the same pools but exhibit different activity levels and diets was measured: the highly active omnivorous Girella laevifrons and the cryptic carnivorous Graus nigra. Individuals of each species were acclimated to a tank divided in three sections with different illumination; no light (NL), ultraviolet light (UV) and white light (WL), and the time spent and number of visits to each section were recorded. Although both species preferred the NL section, G. laevifrons spent more time in UV and less time in WL compared with G. nigra; G. laevifrons also displayed higher number of visits to UV, suggesting a different tendency in space use in response to UV exposure in intertidal fishes.

Effect of boldo (Peumus boldus Molina) infusion on lipoperoxidation induced by cisplatin in mice liver.

Peumus boldus Molina (Monimiaceae), commonly referred to as 'boldo', is used in traditional Chilean medicine to treat hepatic and gastrointestinal diseases. Its leaves are rich in antioxidant compounds, principally alkaloids and flavonoids. This study evaluates the protective effect of a complete boldo leaf infusion on lipoperoxidation (MDA determination at 532 nm) induced by cisplatin in mice liver. To determine if the observed effect can be explained by the action of boldine or catechin, each compound was studied separately. The mice were divided into 8 groups (n = 6): (I) not treated; (II) treated with cisplatin 6 mg/Kg b.w.; (III) treated with boldo leaf infusion 5%; (IV) pretreated with boldo leaf infusion 5% and treated with cisplatin 6 mg/Kg b.w.; (V) treated with boldine 50 mg/Kg b.w.; (VI) pretreated with boldine 50 mg/Kg b.w. and treated with cisplatin 6 mg/kg.b.w.; (VII) treated with catechin; and (VIII) pretreated with catechin 50 mg/Kg b.w. and treated with cisplatin 6 mg/Kg b.w. As expected, the treatment with cisplatin significantly increased (p < 0.01) lipoperoxidation in comparison with the non-treated group. Pretreatment with boldo leaf infusion significantly diminished (p < 0.05) the lipoperoxidation induced by cisplatin with respect to the animals not pretreated with the infusion. The pretreatments with boldine and catechin significantly diminished (p < 0.05) the lipoperoxidation induced by cisplatin with respect to the group treated only with cisplatin. The results suggest that the boldo infusion is acting as a protector with respect to the oxidative hepatic damage caused by cisplatin, and that this protective ability would be due to the presence in the infusion of the natural antioxidants boldine and principally catechin. These findings suggest the potential use of the infusion as a chemoprotector.

Abdominal wall endometriosis: report of two cases.

Endometriosis is the abnormal existence of functional uterine mucosal tissue outside the uterus. It is a usual disorder of women in reproductive age, which is mainly located in the female genital tract. We report the cases of two women with endometriosis of the abdominal wall; the first one in the rectus abdominis muscle and the second one in the surgical scar of previous caesarian incision. The diagnosis was made by the histopathological analysis of the surgical specimens.

Caracterización de la utilización de colistín en un hospital de alta complejidad / Evaluation of colistin use in a highly complex hospital

RESUMEN: El aumento de la resistencia y la escasez de nuevos antibacterianos ha requerido la reintroducción de antiguos antimicrobianos entre ellos colistín. OBJETIVO: Caracterizar la utilización de colistín durante el año 2017 en un hospital universitario, mediante la descripción de los pacientes, los tratamientos, la microbiología asociada y efectos adversos. PACIENTES Y MÉTODOS: Trabajo observacional retrospectivo. Se revisaron los datos de todos los pacientes que recibieron colistín intravenoso (IV) por al menos 48 horas, durante el año 2017. RESULTADOS: Se incluyeron 53 pacientes, equivalentes a 91 tratamientos. El foco respiratorio fue el principal (46,2%). El 68,1% de los tratamientos fue iniciado en la UCI. La mayoría de los pacientes tenía una hospitalización reciente (83,5%), y presentaban uso previo de antibacterianos (89%). Los dos patógenos mayoritariamente identificados fueron Pseudomonas aeruginosa y Klebsiella spp. El consumo promedio de colistín fue de 2,4 DDD/100 camas/día. El servicio que más consumió colistín fue la UCI, con 45,5 DDD/100 camas/día, usando generalmente la dosis de 3 MUI cada 8 horas IV y con una baja utilización de dosis de carga. CONCLUSIÓN: Colistín corresponde a un antimicrobiano de uso restringido a infecciones sospechadas o confirmadas por agentes bacterianos multi resistentes. En esta serie, su uso inicial fue principalmente empírico, en pacientes con factores de riesgo para resistencia antibacteriana; se usó en forma asociada a otros antimicrobianos, siendo el foco principal el respiratorio.

BACKGROUND: The increase in resistance and the shortage of new antibiotics has led to the reintroduction of old antimicrobials such as colistin. AIM: To evaluate the use of colistin during 2017 in a university hospital, through the characterization of patients and treatment, associated microbiology, response to treatment and adverse effects. METHODS: Retrospective observational design. The data of all patients who received colistin for at least 48 hours during the year 2017 were reviewed. RESULTS: 55 patients were included, equivalent to 144 treatments. The respiratory focus was the main one (57.9%). 64% of the treatments began in the ICU, while 7% in the ward. Most of the patients has a recent hospitalization (86.8%) and has previous use of antibiotics (90.4%). The two main pathogens identified were Pseudomonas aeruginosa and Klebsiella spp. In 87.1% of the cases with microbiological justifications for the use of colistin, a favorable response was obtained. The average consumption of colistin was 2.4 DDD/100 beds/day. The department that consumed the most colistin was the ICU, with 45,5 DDD/100 beds/day, generally using a dose of 3 MIU every 8 hours IV and with low use of loading doses. CONCLUSION: Colistin corresponds to an antibiotic whose use is restricted to infections suspected or confirmed by multi-resistant bacterial agents. Its initial use in this serie was mainly empirical, in patients with risk factors for antibiotics resistance, it was used in association with other antimicrobials, being the respiratory the main infectious focus.

Perfil de uso de tigeciclina en un hospital universitario en Chile / Profile of tigecycline use in a university hospital in Chile

INTRODUCCIÓN: El uso de tigeciclina ha ido en aumento en los últimos años, debido al incremento de la resistencia bacteriana y la escasez de alternativas terapéuticas. OBJETIVO: Caracterizar y evaluar las prescripciones de tigeciclina en pacientes internados en un hospital universitario, durante los años 2017 y 2018. METODOLOGÍA: Estudio observacional retrospectivo, donde se caracterizaron los pacientes, las terapias, la microbiología asociada, los desenlaces clínicos y las reacciones adversas asociadas a los tratamientos con tigeciclina. Se determinó la proporción de prescripciones apropiadas por un comité de expertos y el consumo de tigeciclina medido en DDD/100 camas-día. RESULTADOS: Se caracterizaron 89 pacientes, de los cuales 67 (75,3%) cumplieron los criterios de selección. El 53,7% de los pacientes eran hombres, con una edad promedio de 60 ± 15 años. El principal motivo de hospitalización fue quirúrgico (65,7%). El 67,1% de los tratamientos con tigeciclina se inició en una Unidad de Paciente Critico y el foco de infección predominante fue abdominal (64,3%). El 50% de las terapias con tigeciclina fueron dirigidas según la microbiología identificada. En 65,7% de los casos se usó tigeciclina como monoterapia en la dosis habitual (62,9%). Náuseas (8,6%), diarrea (7,1%) y vómitos (4,3%) fueron los efectos adversos más reportados. El 84,3% de los tratamientos se consideraron apropiados. El año 2017 se consumió 0,4 DDD/100 camas-día y 0,6 DDD/100 camas/día el 2018, siendo la UCI el servicio que presentó el mayor uso en ambos años. DISCUSIÓN: Tigeciclina fue utilizada principalmente en monoterapia para el tratamiento de infecciones intraabdominales en pacientes hospitalizados, por motivos quirúrgicos, en una unidad de paciente crítico, en las dosis habituales recomendadas de 100 mg como dosis de carga seguida de 50 mg cada 12 hs IV. En 50% de los casos, la terapia fue dirigida según microbiología. Los eventos adversos más habituales fueron los gastrointestinales. CONCLUSIÓN: La mayoría de las terapias prescritas fueron consideradas apropiadas por el comité de expertos.

BACKGROUND: The use of tigecycline has been increasing in recent years, due to increase in bacterial resistance and the scarcity of therapeutics alternatives. AIM: To characterize and evaluate the tigecycline prescriptions of patients hospitalized in a university hospital, during the years 2017 and 2018. METHODS: A retrospective observational study was carried out, where the patients, the therapies, the associated microbiology, the clinical outcomes and the adverse reactions associated with tigecycline were characterized. The proportion of appropriate prescriptions was determined by committee of experts and the consumption of tigecycline measure in DDD/100 bed-days. RESULTS: 89 patients who used tigecycline were characterized, of which 67 (75.3%) met the selection criteria. 53.7% of the patients were male, with a mean age of 60 +/- 15 years The main reason for hospitalization was surgical (65.7%). 67.1% of the treatments with tigecycline were started in a critical patient unit and the predominant focus of the infection was the abdomen (64.3%). 50% of the therapies with tigecycline were ordered according to the identified microbiology. In 65.7% of the cases, tigecyclin was used as monotherapy at the usual dose (62.9%). Nausea (8.6%), diarrhea (7.1%) and vomiting (4.3%) were the most reported adverse events. 84.3% of the treatments were considered appropriate. In 2017, 0.4 DDD/100 bed/days were consumed and 0.6 DDD/100 bed/days in 2018, with de ICU being the service that presented the highest use in both years. DISCUSSION: Tigecycline was mainly used as monotherapy for the treatment of intra-abdominal infections in patients hospitalized for surgical reasons in a critical patient unit at the usual doses of 100 mg loading followed by 50 mg every 12 hours IV. In 50% of the case the therapy was directed according to microbiology. The most common adverse events were gastrointestinal. CONCLUSION: Most of the prescribed therapies were considered appropriate by the expert committee.

Role of spinal nitric oxide synthase-dependent processes in the initiation of the micturition hyperreflexia associated with cyclophosphamide-induced cystitis.

The aim of this study was to examine the participation of nitrergic neurotransmission in the initiation of micturition hyperreflexia associated to cyclophosphamide (CP)-induced cystitis in rats. Micturition threshold volume was significantly reduced 4 h after CP administration (100 mg/kg, i.p.); this reduction was attenuated by intra-arterially injected N(G)-nitro-l-arginine-methyl ester (l-NAME), a non selective nitric oxide synthase (NOS) inhibitor, but not by intravesical infusion of S-methyl-l-thiocitrulline (l-SMTC), another structurally different NOS inhibitor. Interestingly, l-NAME failed to affect micturition threshold volume in normal rats. The magnitude of isolated detrusor strips contractions elicited by either carbachol or nerve activation was significantly reduced in CP-treated rats but was unaffected by the addition of N(G)-nitro-l-arginine (l-NOARG), a nonselective NOS inhibitor. In contrast, intrathecal l-NAME and l-SMTC but not N(G)-nitro-d-arginine-methyl ester (d-NAME) administration augmented the micturition threshold volume in CP-treated rats in an l-arginine preventable manner. As with the systemic injection, intrathecal l-NAME also did not affect the micturition threshold volume in normal rats. Four hours after CP injection, the number of neuronal NOS immunoreactive or nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d) positive neurons in spinal lumbosacral segments (L6-S2) was not altered whereas the number of c-Fos immunoreactive neurons increased significantly in the dorsal gray commissural nucleus (DGC), the parasympathetic sacral nucleus (PSN) and lamina X of these segments. Ca(2+)-dependent, but not Ca(2+)-independent NOS activity increased significantly in spinal L6-S2 segments but not in thoracic segments of CP-treated rats. These data indicate that the micturition hyperreflexia observed in the initial hours of CP-induced cystitis is associated with an increase in Ca(2+)-dependent NOS activity in spinal L6-S2 segments suggesting an increased production of nitric oxide (NO). The increased production of NO in these spinal segments appears to be necessary for the initiation of the micturition hyperreflexia.

Effects of accumbens m-chlorophenylbiguanide microinjections on sleep and waking in intact and 6-hydroxydopamine-treated rats.

Effects of the 5-HT3 receptor agonist, m-chlorophenylbiguanide (10.0-40.0 microg), on sleep and waking were studied in control, vehicle-treated and 6-hydroxydopamine-injected rats. Bilateral injections of m-chlorophenylbiguanide into the nucleus accumbens of the control and the vehicle-infused animals significantly increased waking and reduced slow wave sleep. Rapid eye movement sleep (REM sleep) remained unchanged. Pretreatment with the selective 5-HT3 receptor antagonist, MDL 72222 (1aH,3a,5a, H-tropan-3-yl-3,5-dichloro-benzoate) (0.5 mg/kg, s.c.), reversed the effects of m-chlorophenylbiguanide (10.0-20.0 microg) on sleep and waking in the control group. Administration of the 5-HT3 receptor agonist to the 6-hydroxydopamine-treated animals modified only slightly the time spent in wakefulness and slow wave sleep, while REM sleep was significantly and dose dependently reduced. Our findings further support the proposal that increase of wakefulness and reduction of slow wave sleep after activation of 5-HT3 receptors, is partly related to the release of endogenous dopamine.

Effects of the D3 preferring dopamine agonist pramipexole on sleep and waking, locomotor activity and striatal dopamine release in rats.

Quantitation of 2 h sessions after administration of the D3 preferring dopamine (DA) agonist pramipexole (10-500 microg/kg) showed dose-related effects on wakefulness (W), slow wave sleep (SWS) and REM sleep in rats. The 30 microg/kg dose of the DA agonist increased SWS and REM sleep and reduced W during the first recording hour, while the 500 microg/kg dose augmented W. On the other hand, W was increased while SWS and REMS were decreased after the 500 microg/kg dose during the second recording hour. The mixed D2- and D3 receptor antagonist YM-09151-2 (30-500 microg/kg), which per se affected sleep variables prevented the increase of REMS induced by pramipexole. Furthermore, the highest doses (500-1000 microg/kg) of the DA antagonist effectively antagonized the increase of W and reduction of SWS induced by the 500 microg/kg dose of the DA agonist. Pramipexole (30-100 microg/kg) induced a decrease of locomotor activity during the 2 h recording period. In addition, the 500 microg/kg dose gave rise to an initial reduction of motor behavior which was reverted 2 h later. Pramipexole (30 and 500 microg/kg) did not significantly affect striatal DA release during the first two hours following drug administration, as measured by microdialysis. It is tentatively suggested that D3 receptor could be involved in the pramipexole-induced increase of sleep and reduction of locomotor activity. On the other hand, the increase of W and of motor behavior after relatively high doses could be related to activation of postsynaptic D2 receptor.

Identification of hemolytic and neuroactive fractions in the venom of the sea anemone Bunodosoma cangicum.

Sea anemones are a rich source of biologically active substances. In crayfish muscle fibers, Bunodosoma cangicum whole venom selectively blocks the I K(Ca) currents. In the present study, we report for the first time powerful hemolytic and neuroactive effects present in two different fractions obtained by gel-filtration chromatography from whole venom of B. cangicum. A cytolytic fraction (Bcg-2) with components of molecular mass ranging from 8 to 18 kDa elicited hemolysis of mouse erythrocytes with an EC50 = 14 microg/ml and a maximum dose of 22 microg/ml. The effects of the neuroactive fraction, Bcg-3 (2 to 5 kDa), were studied on isolated crab nerves. This fraction prolonged the compound action potentials by increasing their duration and rise time in a dose-dependent manner. This effect was evident after the washout of the preparation, suggesting the existence of a reversible substance that was initially masking the effects of an irreversible one. In order to elucidate the target of Bcg-3 action, the fraction was applied to a tetraethylammonium-pretreated preparation. An additional increase in action potential duration was observed, suggesting a blockade of a different population of K+ channels or of tetraethylammonium-insensitive channels. Also, tetrodotoxin could not block the action potentials in a Bcg-3-pretreated preparation, suggesting a possible interaction of Bcg-3 with Na+ channels. The present data suggest that B. cangicum venom contains at least two bioactive fractions whose activity on cell membranes seems to differ from the I K(Ca) blockade described previously.

Flexure of thin rigid contact lenses.

The flexure of spherical rigid contact lenses was measured on the eyes of 10 young subjects using a videokeratoscope. Five subjects had little or no with-the-rule astigmatism (<0.75 D) andfive had moderate levels of with-the-rule astigmatism (1.00-2.00 D). Two lens materials (polymethylmethacrylate [PMMA] and Boston XO) in three centre thicknesses (0.05, 0.10 and 0.15 mm) were used in the study. No significant difference in the amount of flexure was found between the two materials tested. The degree of regular astigmatism on the lens front surface was found to increase as the centre thickness of the contact lens decreased. For the astigmatic group, the lenses with centre thicknesses of 0.05 mm had levels of front surface astigmatism similar to those of the underlying cornea. On spherical corneas the level of regular astigmatism can exceed that of the cornea for thinner lenses. When sphero-cylinder variations are accounted for, residual higher order aberration (root mean square) levels were found to approach those of the cornea when the lens thickness was reduced to 0.05 mm.

Melanin concentrating hormone (MCH) in the cerebrospinal fluid of ewes during spontaneous oestrous cycles and ram effect induced follicular phases.

The melanin-concentrating hormone (MCH) is a neuropeptide synthesized by neurons of the lateral hypothalamus and incerto-hypothalamic area that project throughout the central nervous system. The aims of the present report were: (1) to determine if MCH levels in cerebrospinal fluid (CSF) of ewes vary between the mid-luteal and the oestrous phase of spontaneous oestrous cycles; and (2) to study if MCH levels in CSF of ewes vary acutely during the follicular phase induced with the ram effect in anoestrous ewes. In the first experiment, CSF was collected from 8 adult ewes during spontaneous oestrous and during the mid-luteal phase (8-10 days after natural oestrus). In the second experiment, performed during the mid non-breeding season, a follicular phase was induced with the ram effect. After isolating a group of 16 ewes from rams, CSF was obtained from 5 of such ewes (control group). Three rams were joined with the ewes, and samples were obtained 12h (n=6) and 24h (n=5) later. In Experiment 1, there were no differences in MCH concentrations in CSF measured during the mid-luteal phase and spontaneous oestrus (0.14 ± 0.04 vs. 0.16 ± 0.05 ng/mL respectively). In Experiment 2, MCH concentrations tended to increase 12h after rams introduction (0.15 ± 0.08 vs. 0.35 ± 0.21 ng/mL, P=0.08), and increased significantly 24h after rams introduction (0.37 ± 0.15 ng/mL, P=0.02). We concluded that MCH concentration measured in the CSF from ewes increased markedly during the response to the ram effect but not during the natural oestrous cycle of ewes.

Experiencia subjetiva de estudiantes y docentes que vivencian un cambio curricular / Subjective experience of students and teachers who experience a curriculum change

Objetivo: Conocer la experiencia subjetiva de estudiantes y docentes respecto del cambio curricular. Metodología: Estudio transversal, muestra de 169 estudiantes de cuarto año curricular y 32 docentes. Información recogida en cuestionario “Inquietudes y procedimientos para adoptar Innovaciones Educativas” (IPIE) validado y adaptado al estudio. Análisis descriptivo. Estudio respetó normas éticas y consentimiento informado. Resultados: 26,0 por ciento de alumnos correspondió a Tecnología Médica; 22,5 por ciento Enfermería y Nutrición, respectivamente, y 29,0 por ciento Obstetricia. Edad media de 21,3+/-1,43 años. Mujeres 68,1 por ciento. En “Información”, los estudiantes mostraron el promedio más alto en el ítem “Quisiera saber lo que otros están haciendo en esta área” (4,1+/-0,9), y los docentes en “Me gustaría saber si se contará con los recursos para mantener esta innovación en un futuro inmediato” (4,7+/-0,4). En “Funcionalidad”, promedio más alto correspondió a “Me gustaría saber qué es lo que esta innovación va a requerir para mantenerla en el futuro” (4,3+/-0,8) y el más bajo en “Estoy totalmente ocupado/a en otras cosas, para mí la innovación no es prioridad” (2,4+/-1,4). En “Resultados”, los docentes presentaron el promedio más alto en “Me interesa evaluar mi impacto sobre los estudiantes” y “Quisiera que otros equipos de docentes se motiven con los logros que tenemos en este proceso de innovación curricular” (4,6+/-0,4; 4,6+/-0,4). Conclusiones: Estudiantes y docentes se mostraron conformes con la experiencia del cambio curricular. Aún existen dudas respecto de cómo este cambio afectará las competencias del estudiantado y la sustentabilidad en el tiempo. Es necesario continuar esta línea investigativa durante el ejercicio profesional de egresados.

Objective: To determine the subjective experience of students and teachers on curriculum change. Methodology: Cross-sectional study in a sample of 169 Regular fourth-year students and 32 teachers. Information collected in the survey “Concerns and procedures to adopt educational innovations” (IPIE) validated and adapted to the study. Descriptive analysis with means, medians, ranges, percentages and averages compared with t-test and ANOVA. Study respected ethical and informed consent. Results: 26.0 percent of students accounted for Medical Technology, Nursing and Nutrition 22.5 percent, 29.0 percent respectively and Obstetrics. Mean age 21.3 +/- 1.43 years. 68.1 percent women. In “Information”, students showed the highest average item “I want to know what others are doing in this area” (4.1 +/- 0.9), and teachers in “I wonder if they have the resources to keep this innovation in the immediate future “(4.7 +/- 0.4). In “Functionality” highest average corresponded to “I wonder what this innovation will be required to keep it in the future” (4.3 +/- 0.8) and lowest in the scale “I am fully occupied / to other things, for innovation is not my priority “(2.4 +/- 1.4). In teaching, in “Results” highest average “I am interested in evaluating my impact on students” and “I want other teachers to motivate teams with the achievements we have in this curricular innovation process” (4.6 +/- 0, 4, 4.6 +/- 0.4). Conclusions: students and teachers were satisfed with the experience of curriculum change. Still, there are doubts about how this will affect the student skills and sustainability over time. It is necessary to continue this line of research for the professional practice of graduates, to objectively assess the skills of the new student-centered curriculum.

Alkaline phosphatase levels in healthy Greek children an adolescents.

Serum alkaline phosphatase (A.P.) activity was assayed in 859 healthy children aged 6-18 years on the island of Euboea, Greece. Normal A.P. values (less than 100 U/l) were found in 673 (78.6%), borderline values (100-120 U/l) in 137 (15.7%) and increased values (greater than 120 U/l) in 49 children (5.7%). In both sexes the highest A.P. levels were observed at the age of 13 years followed by a gradual reduction to adult values at the age of 17 years. In general, A.P. levels were higher in boys (mean 64.4 +/- 23.3 U/l) than in girls (mean 56.3 +/- 21.6 U/l). After summer holidays the A.P. was reinvestigated in 36 children who had had high winter values. The levels had then considerably decreased (p less than 0.001); in all but three cases, A.P. levels had returned to normal. Fifteen children with normal A.P. activity at the time of the first examination were reinvestigated after summer holidays and showed also a decrease in A.P. activity.

Disseminated neonatal herpes simplex infection treated with levamisole. Report of a case.

Levamisole has been used to treat a patient with disseminated neonatal herpes simplex infection. The skin lesions and the convulsions disappeared completely 20 days after therapy. A trial to reduce the dose of levamisole resulted in a new episode of seizures and skin lesions. A similar relapse was observed at the age of 7 months, which resulted in control of symptoms by increasing the dose of levamisole. The patient has received levamisole for 20 months. She is now 29 months old and is doing well without levamisole, except for a slight motor deficity. If further investigations confirm the present findings, levamisole may well become a useful agent in the treatment of disseminated herpes simplex infection.

Hazards of baby walkers in a European context.

OBJECTIVES: To identify conditions related to baby walker injuries in a Greek population. DESIGN: Analysis of all baby walker related injuries recorded during a 12 month period by the childhood injury surveillance system established in one of the two teaching hospitals for children serving the population of Athens. SETTING: Emergency clinics of A Kyriakou Children's Hospital in Athens, Greece. SUBJECTS: 49 babies with baby walker related injuries brought to the emergency clinics during the period May 1994 to April 1995. RESULTS: The incidence of these injuries was 16 per thousand person years of users, or 3.5 per thousand babies per year. More boys than girls were brought to the hospital for these injuries and the incidence density was highest during the ninth and 10th month of age. Falls from heights, particularly stairs, were the most frequent cause of baby walker related injuries, especially among younger babies. The majority of these injuries were of minor severity, but three babies had bone fractures and one had a second degree facial burn. Six babies required hospitalization and for seven others, a follow up visit was needed. The higher proportion of hospitalization among girls than boys raises the possibility that boys with minor injuries are more frequently brought to the hospital. CONCLUSIONS: Baby walkers impart a significant risk of injury from a consumer product that provides no clearly identifiable benefit. As most baby walker injuries happen on stairs, modifications in product design are required to reduce these injuries. Moreover, parents should be forcefully advised of the risks and predisposing conditions, if baby walkers are to be used at all.

Age of pubertal stages including menarche in Greek girls.

The age at the different stages of pubertal development, including menarche, was assessed by the status quo method in 1366 middle-class girls living in Athens. The initial pubertal event in the average Athenian girl was the appearance of pubic hair along the labiae (P10:8.85, P50:10.47), followed shortly by breast budding (P10:9.39, P50:10.62), and later on by axillary hair growth (P10:10.55, P50:11.63). The age at menarche was 12.58 +/- 0.07 years. It seems tht Athenian girls of 1979 have one of the earliest ages of menarche reported. Recollected age data on menarche when compared to previous data from the Greek population show a decrease of 0.46 years/decade from 1935 to 1964 and no appreciable change from 1964 to 1979. Although these data are not absolutely comparable from the methodological point of view, they may indicate that the trend in menarcheal age in Athens is levelling off.