Recreational injuries in children: incidence and prevention.

Participation in eight common types of recreational activities leads annually to more than 2 million medically treated musculoskeletal injuries in children aged 5 to 14 years. Many of these injuries could have been prevented if current safety guidelines and protective equipment had been used. Studies have demonstrated the value of safety education programs in preventing injuries. Parents consider their child's physician an important source of safety education, and orthopaedic surgeons have a unique opportunity to provide injury prevention counseling. The American Academy of Orthopaedic Surgeons recognizes the importance of injury prevention and has developed advocacy programs that are readily available to physicians and the public. Individual orthopaedists should be involved in injury prevention through patient education, research, community programs, and regulatory efforts that promote safe play for children.

Esophageal and hypopharyngeal injuries in patients with cervical spine trauma.

The authors review their recent experience with four patients referred to the Shepherd Spinal Center, Atlanta, with cervical spine fracture dislocation and quadriplegia. The patients were subsequently found to have tears of the hypopharynx or the esophagus as a complication of their injury. Unexplained fever, swelling of the neck, dysphagia or leukocytosis in the patient with acute cervical spine injury suggest, the authors urge, the possibility of esophageal or hypopharyngeal perforation. The authors review the kinematics and pathophysiology of cervical fractures and provide clues to early detection and management of perforation of the hypopharynx or esophagus, including the use of radiographic study and endoscopy.

Smoking among medical students.

A survey of smoking habits of medical students was done using basic medical science graduate students at the same institution as a comparison group. Smoking status was not significantly related to sex, race, or academic classification. Knowledge of adverse health consequences of smoking was related to time spent in medical school and to whether or not the respondent smoked (ie. probable denial of knowledge of the adverse consequences among smokers). The respondent's smoking status was significantly related to familial and peer group smoking status and to peer group attitude. The most common reason given by quitters was "the media influence." The nonsmoker most frequently never began the habit because of fear of health consequences. Because of the finding that a small percentage of medical students still are not convinced of the dangers of smoking, it was suggested that increased educational emphasis on these dangers be included in the medical curriculum.

Acute calcareous deposits of the hand and wrist.

Acute calcareous deposits of the hand and wrist have been infrequently reported. A review of the literature and five recent cases indicate that these painful lesions will respond rapidly to immobilization and medication. Differentiation from infection is important.

Fatty acid accretion during perinatal brain growth in the pig. A model for fatty acid accretion in human brain.

1. Brain fatty acid composition in the fetal, full term and postnatal piglet was analyzed. 2. Changes in fatty acid content of developing pig brain parallel those found in the human. 3. Total fatty acids per gram of brain increase with post conceptional age. 4. Brain concentration of long chain derivatives of essential fatty acids, c18:2omega6 and c18:3omega3 increase during gestation while levels of shorter chain precursors (c18:2omega6 and c18:3omega3) remain low. 5. The results indicate that the developing piglet is an appropriate model, analogous to the human, for studies of changes in brain fatty acid content during neural development throughout the perinatal period.

Chain elongation-desaturation of linoleic acid during the development of the pig. Implications for the supply of polyenoic fatty acids to the developing brain.

Rates of chain elongation-desaturation of C18:2 omega 6 were compared for liver and brain microsomes in fetal, neonatal and postnatal piglets. Rates of chain elongation-desaturation of C18:2 omega 6 were greatest in liver and increased during perinatal development on a per organ basis. These results suggest that fetal liver and brain has the capability to chain elongate and desaturate essential fatty acids to longer chain homologues. For brain rates of synthesis of chain elongation-desaturation products was greatest during the newborn period whereas this metabolic function was greatest in liver in the postnatal stages of life examined.

Preliminary experience with the Scottish Rite Hospital abduction orthosis for Legg-Perthes disease.

Containment of the femoral head within the acetabulum is now an accepted method of treatment for LCPD. Several types of ambulatory abduction orthoses have been utilized to obtain such containment. A group of 41 patients has completed treatment of LCPD by wearing an efficient and ambulatory abduction brace designated as the SRH orthosis. By following a specific treatment protocol the results have been comparable to other accepted methods of treatment. The orthosis, when utilized as described, is recommended as a method of containment. It has proven to be durable and readily fabricated with few restrictions on patient activity, few complications and good acceptance by patients and families.