Union of the medial clavicular epiphysis in a South African Black skeletal sample.

Current research points to an increase in the interest in and focus on the age at which the medial end of the clavicle begins and completes union in various populations worldwide. As it currently stands, no information exists for the South African population detailing the age at which this skeletal developmental marker commences or completes union. The aim of this study was to establish the age at which partial and complete unions occur and to find if there is any correlation between the age and the assigned stage score in a South African Black skeletal sample. Paired clavicles of 211 males and females (M = 101, F = 110) with ages ranging between 12 and 45 years from the Raymond A. Dart Collection of Human Skeletons were included. A strong correlation between age and the assigned stage score was observed for both males and females (rs = 0.73). No statistically significant differences between the stage of union at the left and right clavicles were observed (p = 0.9). In this sample, partial union was commonly observed in individuals in their third decade of life; while complete union occurred more often in individuals older than 30 years of age. Assessing and recording the degree of union at the medial end of the clavicle can be a helpful additional age-at-death indicator to use when establishing an age-at-death range. However, overlap and variability between the ages of individuals categorized as either displaying signs of partial or complete union were evident.

A discussion of current issues and concepts in the practice of skull-photo/craniofacial superimposition.

A recent review paper on cranio-facial superimposition (CFS) stated that "there have been specific conceptual variances" from the original methods used in the practice of skull-photo superimposition, leading to poor results as far as accuracy is concerned. It was argued that the deviations in the practice of the technique have resulted in the reduced accuracies (for both failure to include and failure to exclude) that are noted in several recent studies. This paper aims to present the results from recent research to highlight the advancement of skull-photo/cranio-facial superimposition, and to discuss some of the issues raised regarding deviations from original techniques. The evolving methodology of CFS is clarified in context with the advancement of technology, forensic science and specifically within the field of forensic anthropology. Developments in the skull-photo/cranio-facial superimposition techniques have largely focused on testing reliability and accuracy objectively. Techniques now being employed by forensic anthropologists must conform to rigorous scientific testing and methodologies. Skull-photo/cranio-facial superimposition is constantly undergoing accuracy and repeatability testing which is in line with the principles of the scientific method and additionally allows for advancement in the field. Much of the research has indicated that CFS is useful in exclusion which is consistent with the concept of Popperian falsifiability - a hypothesis and experimental design which is falsifiable. As the hypothesis is disproved or falsified, another evolves to replace it and explain the new observations. Current and future studies employing different methods to test the accuracy and reliability of skull-photo/cranio-facial superimposition will enable researchers to establish the contribution the technique can have for identification purposes.

A novel eye drop application monitor to assess patient compliance with a prescribed regimen: a pilot study.

PURPOSE: To assess the ability of a novel imaging device to allow physicians to personalize therapeutic regimens based on objective patient drop administration data. METHODS: A novel imaging system was used to record video of the drop technique of subjects in clinic (n=25) or at home (n=17) for 1 week. Video assessment by a reading center was compared with patient reporting and their prescribed regimen with respect to how many drops were applied and how many landed in the eye. RESULTS: Reading center assessment of both drops dispensed and drops landing in the eye was significantly different from the prescribed regimen in the clinic (Pd=0.005, Pi<0.001, respectively) and at-home arms (Pd=0.003, Pi<0.001, respectively). CONCLUSIONS: This imaging system is a powerful tool to help physicians tailor patient therapy more accurately, to help researchers evaluate new drop therapies with objective rather than subjective data, and to potentially facilitate better patient training for improved drug delivery.

An investigation into the accuracy and reliability of skull-photo superimposition in a South African sample.

One of the aims of forensic science is to determine the identities of victims of crime. In some cases the investigators may have ideas as to the identities of the victims and in these situations, ante mortem photographs of the victims could be used in order to try and establish identity through skull-photo superimposition. The aim of this study was to evaluate the accuracy of a newly developed digital photographic superimposition technique on a South African sample of cadaver photographs and skulls. Forty facial photographs were selected and for each photo, 10 skulls (including the skull corresponding to the photo) were used for superimposition. The investigator did not know which of the 10 skulls corresponded to the photograph in question. The skulls were scanned 3-dimensionally, using a Cyberware™ Model 3030 Colour-3D Scanhead scanner. The photos were also scanned. Superimposition was done in 3D Studio Max and involved a morphological superimposition, whereby a skull is superimposed over the photo and assessed for a morphological match. Superimposition using selected anatomical landmarks was also performed to assess the match. A total of 400 skull-photo superimpositions were carried out using the morphological assessment and another 400 using the anatomical landmarks. In 85% of cases the correct skull was included in the possible matches for a particular photo using morphological assessment. However, in all of these cases, between zero and three other skulls out of 10 possibilities could also match a specific photo. In the landmark based assessment, the correct skull was included in 80% of cases. Once again, however, between one and seven other skulls out of 10 possibilities also matched the photo. This indicates that skull-photo superimposition has limited use in the identification of human skeletal remains, but may be useful as an initial screening tool. Corroborative techniques should also be used in the identification process.

Lactobacillus endocarditis: a case report of outpatient management.

A case of infective endocarditis due to Lactobacillus is presented. The diagnosis was established by positive blood cultures and transesophageal (but not transthoracic) echocardiography. The patient was cured with outpatient ceftriaxone therapy.

Exercise and the aging foot.

Overall physical fitness has become increasingly popular in the 1990s, especially in the geriatric community. More runners, bikers, swimmers, and aerobic advocates over the age of 55 are requiring medical attention for foot complaints, as the feet are a necessary tool for almost any athletic activity. This paper discusses the most common foot disorders in active geriatric patients and outlines a variety of conservative and surgical approaches to management. The goal is early return to pain-free activity.

Anaerobic mediastinitis complicating median sternotomy.

Two cases of mediastinitis and bacteremia caused by Bacteroides species following median sternotomy are described. In both patients, purulent sternal drainage and signs of systemic toxicity led to the diagnosis. Surgical reexploration and administration of appropriate antibiotics effected clinical cure. Although there is only a single previous case of anaerobic mediastinitis following median sternotomy incision reported, these two cases suggest that this unusual infection may not be so rare as previously thought.

Podiatric sports medicine. Evaluation and prevention of injuries.

It has been estimated that 70 per cent of all athletic injuries affect the lower extremity. These injuries are more often caused by overuse than by acute trauma. The treatment for overuse injuries is rest, which relieves the symptoms, but prevention is the better answer.