Spinal dermal sinus and pseudo-dermal sinus tracts: two different entities.

BACKGROUND: Occult spinal dysraphism (OSD) encompasses various conditions. A dermal sinus tract (DST) consists of a duct communicating to the skin with deep structures that carries an important risk of infection. A different lesion consisting of a translucent skin opening and a fibrous tract that lacks a lumen can also be found in OSD. We termed this lesion pseudo-dermal sinus tract. PATIENTS AND METHODS: We reviewed clinical features of 20 patients with spinal skin orifices. The patients were classified into two categories: group 1 comprised children with true DST and group 2 included patients with skin dimples resembling a DST. AIMS: The aim of this study was to analyze differential features of patients in these two groups as they behaved dissimilarly in regard to clinical significance and outcomes, especially those concerning infectious risk. RESULTS: Children of group 1 (n = 8) presented with tiny skin orifices and with superficial or deep infection. In contrast, group 2 (n = 12) mostly manifested with neurological symptoms. No patient in group 2 developed an infection preoperatively. In both groups, magnetic resonance showed tracts that ended in different structures. Histopathology of the lesions were dissimilar, those of group 1 being hollow tubular structures lined by epithelium while those of group 2 being solid tracts of fibrous connective tissue. CONCLUSIONS: DST constitutes a clinicopathological diagnosis. Although sharing some common cutaneous and neuroimaging findings, both groups behaved differently. Patients of group 1 tended to show up with infection requiring urgent surgery. Patients of group 2 often presented with neurological manifestations and skin lesions, but needed no immediate operation.

Effect of SonoVue on the synovial membrane in rabbit knees.

OBJECTIVES: The purpose of this study was to evaluate the effect of intra-articular injection of SonoVue (sulfur hexafluoride with a phospholipid shell; Bracco SpA, Milan, Italy) on the synovial membrane in an animal model. METHODS: Twenty-one New Zealand White rabbits (42 knees) were used in this study. We injected the knees with normal saline (saline group; n = 21) and SonoVue (SonoVue group; n = 21). A histologic examination of the knees was performed out at 3 and 12 hours and 3, 7, 15, 30, and 45 days after injection. Four histologic parameters (synovial hyperplasia, synovial stroma, vascular dilatation, and inflammatory infiltrates) were graded separately. RESULTS: We found no significant differences in this study for synovial hyperplasia, vascular dilatation, or inflammatory infiltrates between the saline and SonoVue groups. A significant difference was only observed for synovial stroma (P < .05), and most of the histologic changes were mild in the saline group and moderate in the SonoVue group. The histologic changes observed in this study are considered transitory and reversible. CONCLUSIONS: The results suggest that intra-articular injection of SonoVue is a safe procedure.

[Child and juvenile delinquency and legal system in the province of Buenos Aires, Argentina]. / Delincuencia infantojuvenil y sistema judicial en la Provincia de Buenos Aires, Argentina.

Taking into account the social relevance of child and juvenile delinquency, the little availability of local scientific evidence concerning the subject and the moment of change in the system, this article is intended to describe the criminal system of responsibility in the Province of Buenos Aires, Argentina. Psychiatric and psychological aspects of youth involved in crimes and of those who are institutionalized in the Legal Department of La Plata shall be explored.

MR arthrography of the shoulder using an anterior approach: optimal injection site.

OBJECTIVE: The purpose of our study was to optimize anterior MR arthrography of the shoulder by comparing three injection sites. MATERIALS AND METHODS: Seventy-eight patients were divided into three groups of 26 each, according to the injection site selected: the upper third of the medial part of the humeral head, the lower third of the medial part of the humeral head, or the area between the middle and lower thirds of the glenohumeral joint. A marker plate with radiopaque coordinates was used in performing the technique. Radiologist time and exposure time were recorded, and the intensity of the patient's pain was measured using a Visual Analogue Scale (VAS). Groups were compared using variance analysis and the least significant difference method. RESULTS: Shoulder arthrography was considered satisfactory for all three injection sites. Mean exposure time was 20.9 +/- 7.8 (SD) milliseconds, and mean radiologist time was 6.4 +/- 0.8 minutes. Mean pain intensity registered by the VAS was 1.7 +/- 0.9, the lowest values tending to be those recorded by patients who received an injection in the upper third. Exposure and radiologist times were lower for these latter patients; differences between the upper third and the other two areas were statistically significant (p < 0.005). CONCLUSION: The optimal injection site for anterior MR arthrography of the shoulder is the upper third of the humeral head, a simple, rapid procedure that is well tolerated by patients and reduces the radiation dose administered.

Delincuencia infantojuvenil y sistema judicial en la Provincia de Buenos Aires, Argentina / Child and juvenile delinquency and legal system in the Province of Buenos Aires, Argentina

Considerando la relevancia social de la delincuencia infanto-juvenil, la escasa disponibilidad de evidencias científicas locales y el momento de cambio en el sistema, este artículo tiene el propósito de comentar el sistema de responsabilidad penal en la Provincia de Buenos Aires, Argentina, y explorar aspectos relacionados con la salud mental de los jóvenes que cometieron delitos y se encuentran institucionalizados en la jurisdicción del Departamento Judicial La Plata.

Taking into account the social relevance of child and juvenile delinquency, the little availability of local scientific evidence concerning the subject and the moment of change in the system, this article is intended to describe the criminal system of responsibility in the Province of Buenos Aires, Argentina. Psychiatric and psychological aspects of youth involved in crimes and of those who are institutionalized in the Legal Department of La Plata shall be explored.

Violencia y escritura de las prácticas / Violence and writing of the practices

Este trabajo no pretende exceder los límites de la conjetura, de la exploración que no reconoce una versión acabada o finita, sino un atisbo digno de mejores consideraciones. Insinúa, en primer término, la configuración de una violencia institucional larvada, de un maltrato que provocan las instituciones, sutil y poco evidente, casi obvio. Propone, entonces, modos de nombrarlo, caracterizarlo y discriminarlo de otras violencias y otros malos tratos. Luego, postula modos de estudiarlo y analizarlo con detalles, a partir de las escrituras que las instituciones provocan con sus modos de actuar y de las cuestiones no escritas, no dichas o existentes solo de modo intersticial.