Positive Chlamydia culture with normal ano-genital findings following single incident of incestuous abuse.

Since 1994 the Institute of Forensic Medicine, Aarhus University, has performed colposcopic examinations of children suspected of sexual abuse or assault. The institute serves an area with approximately 2.5 million inhabitants and performs 50-75 colposcopic examinations per year. When indicated the children are tested for Chlamydia trachomatis. Vaginal samples are observed for growth in culture and DNA-amplification tests are performed. So far we have found only one positive culture. This was a now 11-yr-old girl who allegedly was assaulted once at the age of eight. The colposcopic examination showed normal ano-genital findings. The fact that the girl had tested positive for Chlamydia trachomatis is a strong indicator of abuse, and in the case of normal ano-genital findings, serves as an important evidence factor in court. In the future it may be possible to trace the infection to the alleged perpetrator by specific sub typing of Chlamydia Trachomatis.

Intratracheal Seal Disc: A Novel Tracheostoma Closure Device.

BACKGROUND: Tracheostomy decannulation is accompanied by several clinical concerns due to air leakage. In this study, we introduced a novel tracheostoma closure device that facilitates the use of noninvasive ventilation, improvement of pulmonary function, and vocalization in the newly decannulated patient. The biosafety and feasibility of the device were evaluated in an animal model. METHODS: Five Danish Landrace pigs were subjected to tracheostomy followed by decannulation and insertion of the tracheostoma closure device. Correct placement of the device was ensured by flexible tracheoscopy. The device consisted of an intratracheal silicone seal disc fixated by a cord through the stoma to an external part. At day 14, computed tomography (CT) was performed before the device was extracted. With the pulling of a cord, the disc unraveled into a thin thread and was extracted through the stoma. At day 21, CT was repeated before euthanasia. The trachea and epidermis were excised en bloc for histopathological evaluation. RESULTS: Insertion and correct placement of the disc was unproblematic in all animals. CT at day 14 confirmed a clear airway, appropriate placement of the disc, and full closure of the tracheostoma. Extraction was successful in one animal but complicated in the remaining animals. There was histological evidence of healing after the foreign body placement. CONCLUSIONS: The study demonstrated that the tracheostoma closure device is feasible and biosafe in a porcine animal model, but the design and quality of the materials need to be improved before clinical trials.