[Small intestinal transit with radio-opaque markers to localize intermittent small bowel obstruction] . / Magendarmpassage mit röntgendichten Tracerkugeln zur Lokalisation von Dünndarmstenosen bei intermittierenden Obstruktionen.

AIM: In difficult diagnostic cases of partial small bowel obstruction, radiopaque, non-digestible markers were used to challenge and localize the site of obstruction. MATERIAL AND METHOD: 32 patients (19 female, 13 male, 3-80 years) were examined. Each patient received 20 4-mm radiopaque markers orally. Abdominal radiographs were obtained at 4-8 h intervals. Mechanical obstruction was defined as the clustering of at least 3 markers for 4 hours or longer. The transit of radiopaque markers was compared to plain radiography, ultrasound, barium meal, computed tomography, enteroclysis and operative findings. RESULTS: 18 of 32 patients showed small bowel clustering suggestive of obstruction. Diagnostic agreement was found in 12 of 14 cases with ultrasound, in 7 of 13 cases with plain radiography and in 3 of 6 cases with enteroclysis. 13 of the 18 patients with clustering had surgery. All of them (13/13) had adhesions with the need of resection. CONCLUSION: This investigation is an alternative diagnostic method for the decision between conservative and surgical treatment in cases of intermittent partial small bowel obstruction.

Calcium intakes and femoral and lumbar bone density of elderly U.S. men and women: National Health and Nutrition Examination Survey 2005-2006 analysis.

OBJECTIVES: This analysis was aimed at assessing the benefits of total calcium intake from diet and supplements on both femoral neck and lumbar vertebral bone mineral density (BMD) in a representative sample of older U.S. women and men. DESIGN: For 1384 women and men aged 50-70 and 71+ yr, quintiles of total calcium intake were tested for their association with hip and spine BMD after adjusting for body mass index. All data in this observational study were cross-sectional. DATA SOURCE: Subjects included elderly residents statistically representative of the United States, women and men aged 50 yr and older in the National Health and Nutrition Examination Survey 2005-2006 cohort. MAIN OUTCOME MEASURES: Calcium intakes and femoral and lumbar BMD were evaluated. RESULTS: Total calcium intakes ranged from means of 400+ mg/d in quintile 1 to 2100+ in quintile 5. Little difference in hip or lumbar BMD was found in relation to total calcium consumption in women and men across five quintiles, especially for those aged 50-70, in models adjusted for body mass index only. Femoral hip BMD in men 71 and older increased slightly with high calcium intake (3.6% higher density, P = 0.0391), whereas femoral BMD in women 71 and older decreased slightly with high calcium intake (-3.2%, P = 0.0132). Lumbar BMD remained fairly consistent across all quintiles, but greater variation within each quintile was found compared with the hip. CONCLUSIONS: A usual high calcium intake beyond the recommended dietary allowance of elderly women and men, most commonly achieved by calcium supplements, did not provide any benefit for hip or lumbar BMD. A dietary intake of calcium approaching or meeting the current recommendations was not related to higher BMD of the hip or lumbar spine in late life compared with lower intakes of calcium in older adults.

Micronutrient intakes in two US populations of older adults: lipid research clinics program prevalence study findings.

Dietary intakes of several minerals and vitamins were assessed in two US sub-populations of older men and women between 60 and 80 years as part of the Lipid Research Clinics Program Prevalence Study conducted in the mid-1980s prior to widespread fortification. Dietary intakes were analyzed from 24-hour recalls using the Minnesota Nutrition Coding Center. Descriptive statistics on the two diverse sub-populations were generated for the elderly subjects at the two clinic sites, southern California and Oklahoma. Regression analyses of specific micronutrients were performed while controlling for several variables, namely, age, sex, clinic (region), education, Body Mass Index (BMI), alcohol consumption, and smoking status. Compared to current (1999-2004) Estimated Average Requirements (EARs) and Adequate Intakes (AIs) for three micronutrients without EARs for the US and Canada, several micronutrients were consumed at or close to their EAR values. Exceptions include intakes of vitamin A, vitamin E, folic acid, potassium and calcium which were very low; intakes of thiamin, riboflavin, niacin, and vitamin C were low but closer to the published EAR or AI values. High intakes approaching cut-offs for practically all subjects were found for both groups of elders at the two clinic sites for iron, phosphorus, and sodium. In general, California elderly had somewhat better consumption patterns for the vitamins, but the Oklahomans, males at least, had higher overall mineral intakes. The micronutrient deficits found in this small study suggest that most elderly US citizens were likely to be deficient in five micronutrients and marginally insufficient in four others in the mid-1980s and, despite even greater fortification currently, elderly intakes seem not to have improved substantially since the 1980s, except for subjects who are regular multi-supplement users.

[Comparison of Blount's sling and Kirschner wire fixation in the treatment of a dislocated supracondylar humeral fracture in childhood]. / Vergleich von Blountscher Schlinge und Kirschner-Drahtfixation zur Behandlung der dislozierten suprakondylären Humerusfraktur im Kindesalter.

From 1979 to 1982 we were treating 63 cases of displaced supracondylar fractures of the humerus. Patients underwent either closed reduction and fixation by collar and cuff immobilization (32 cases), or fixation by means of Kirschner wires following closed or (more often) open reduction (31 cases). Follow-up controls after an average time of three years clearly showed the more favourable results of the conservative method.

The boneless neonate: a severe form of achondrogenesis type I.

We report a case of a severe form of achondrogenesis type I. Prenatal ultrasonography showed a micromelic fetus; bony structures could not be identified. Postnatal radiographs revealed some foci of ossification in the ossa ilia, the clavicles, the upper and the lower jaw and the base of the skull. The long bones, the vertebral column and the ribs were not visible. The diagnosis was established by histologic examination of the growth plates.

Robinow syndrome with parental consanguinity.

We describe the clinical features of Robinow syndrome in the first child of a consanguineous Turkish couple. This observation supports the view that severe vertebral anomalies are a feature of the autosomal-recessive form of Robinow syndrome.

[Total laryngo-tracheo-esophageal cleft with situs inversus totalis, aplasia of the right diaphragm and hypoplasia of the lung on the right side]. / Totale laryngo-tracheo-oesophageale Spalte in Kombination mit Situs inversus totalis, Zwerchfellaplasie rechts und Hypoplasie der rechtsseitigen Lunge.

A report is presented on a newborn with congenital malformations of the respiratory and gastrointestinal tract associated with total laryngo-tracheo-oesophageal cleft (type III). The history, the clinical course with respiratory distress after birth, the intra vitam diagnostic procedures with x-ray and laryngoscopy and the autopsy are reported. Additionally a situs inversus totalis, an aplasia of the right diaphragm and a hypoplasia of the lung on the right side were found. To the best of our knowledge this type of association has not been previously reported.

[Invasion of the growth plate by bone tumors and osteomyelitis in childhood]. / Das Uberschreiten der Wachstumsfuge durch Knochentumoren und Osteomyelitiden im Kindesalter.

Crossing of the physis by primarily metaphyseal, localized bone tumors and osteomyelitis in childhood was rarely observed. Therefore, the physis in childhood is considered to be a barrier against the spread of tumors and infection. We report five children, in whom MR imaging demonstrated early crossing of the physis and spread of the disease from the metaphysis to the epiphysis. Follow-up in three children with osteomyelitis showed that antibiotic therapy resulted in almost complete resolution of the changes in the physis, epiphysis and metaphysis. These observations challenge the concept of the physis as a barrier against the spread of tumors and infection.

Dietary determinants of plasma cholesterol change in the recruitment phase of the Lipid Research Clinics Coronary Primary Prevention Trial.

We have investigated the relationship of diet to plasma lipid and lipoprotein levels in 6494 hypercholesterolemic (Type IIA) men who were instructed in an isocaloric, 400 mg cholesterol, 0.8 polyunsaturated-to-saturated fat ratio diet in the course of recruitment for the Lipid Research Clinics Coronary Primary Prevention Trial. Single 24-hour dietary recalls, plasma total and high density lipoprotein cholesterol, and total triglyceride determinations were obtained approximately 1 month before and 1 month after dietary instruction. Cross-sectional correlation analysis disclosed no significant association between diet and plasma cholesterol at entry. However, when diet-associated changes were similarly analyzed, weight loss, decreased intakes of saturated fat and cholesterol, and increased intake of polyunsaturated fat were all significantly and independently predictive of falls in plasma cholesterol, mainly in its low density lipoprotein fraction. The multiple correlation coefficient for the resultant four-variable regression model was 0.29. Diet-associated changes in plasma very low density lipoprotein cholesterol were less marked but in the same direction. These dietary changes were also weakly associated with a lowering of plasma high density lipoprotein cholesterol, while weight loss had an opposite effect of similar strength. When one takes into account the variability of dietary recall data, the observed diet-associated changes in plasma cholesterol were compatible with the findings of metabolic ward studies.

The constancy of parent-offspring similarity of total cholesterol throughout childhood and early adult life. The Lipid Research Clinics Program Prevalence Study.

In a cross-sectional study of 11,409 white parent-offspring pairs in five North American populations we examined the effect of age of the offspring on parent-offspring total cholesterol correlations. In general there were no differences in correlations by age of the offspring for the four types (by gender) of parent-offspring pairs. This was true within each of the five populations and for the average of all populations combined. For offspring from less than 2-29 years of age, these average age-specific correlations ranged from 0.17 to 0.42. Despite the considerable physiologic and environmental changes which influence cholesterol levels from birth to early adulthood, the strength of parent-offspring similarity shows no consistent pattern of change.