Testicular torsion is overrepresented among malpractice cases for gonadal torsion.

INTRODUCTION & OBJECTIVE: Ovarian and testicular torsion are comparable surgical emergencies that may result in organ loss and, as such, have high litigious potential. We sought to describe the relative frequency and outcome of malpractice litigation between cases of ovarian and testicular torsion. METHODS: Searches were completed in the Westlaw Jury Verdicts & Settlements and Lexis Cases databases using the following search terms: "(ovarian or ovary)/5 torsion" and "(testicular or testicle)/5 torsion". Cases were excluded if they were not directly related to torsion or were not malpractice claims. Cases were reviewed for year, jurisdiction, age of plaintiff, verdict, appeal status, contention, damages, and alleged time delay to appropriate care. RESULTS: The legal databases contained 155 malpractice cases related to testicular torsion and 4 cases related to ovarian torsion. Two of three ovarian torsion cases and 52% of testicular torsion cases with available rulings were in favor of the defense. The median age of plaintiffs in testicular torsion cases was 14, and 75% were minors. Median delay in care for testicular cases was 3 days, and median damages awarded to plaintiffs was $250,000 ($12,000-8.5 million). No data regarding age, delay in care, or damages were available for ovarian torsion cases. CONCLUSIONS: Among malpractice cases related to gonadal torsion, testicular torsion is vastly overrepresented despite literature demonstrating longer delays in care and greater likelihood of gonadal loss in ovarian torsion during the study period. LEVEL OF EVIDENCE: IV.

Discovery of a widespread infestation of Aedes albopictus in the Torres Strait, Australia.

Aedes albopictus is a container-breeding Stegomyia mosquito that has dispersed widely from its origins in Southeast Asia. Because Ae. albopictus is a known dengue vector and a potential vector of a variety of arboviruses and it can tolerate cooler climates than Aedes aegypti, Australian quarantine and health authorities have strategies to detect and eliminate it from international ports. Following the detection of 42 adult Ae. albopictus in BG-Sentinel traps set on Yorke island in the Torres Strait of Australia in April 2005, extensive surveys were conducted to determine the distribution of Ae. albopictus in the Torres Strait and adjoining Cape York Peninsula. A total of 17 islands and the northern peninsula area of Cape York Peninsula were surveyed by collection of larvae and pupae from flooded containers and human bait collections of adult mosquitoes with aspirators and sweep nets. Aedes albopictus was detected on 10 islands and comprised 100% of the day-biting container-breeding mosquitoes on Yorke and Stephens Islands. No Ae. albopictus were detected in the mainland sites on Cape York. Retrospective genetic analysis of larvae collected in April 2004 and April 2005 on Yorke Island indicated that Ae. albopictus was present in low densities in 2004 and that there were 3 genetically distinct mitochondrial haplotypes on Yorke Island in April 2005. Additionally, on Yorke Island there is evidence that Ae. albopictus is displacing Aedes scutellaris.