Sex-related risks of trauma in medieval to early modern Denmark, and its relationship to change in interpersonal violence over time.

Skeletons from three Danish cemeteries, Sortebrødre, Tirup, and St. Mikkel, that collectively held 822 adults (>15 years) and spanned the medieval to early modern periods (ca. AD 1100-1610) show that men, in general, experienced more bone fractures than women. Men were three times more likely to have healed cranial vault and ulnar shaft fractures than women, with many of these bones presumably broken in interpersonal violence. More women, however, broke distal radii, presumably often the result of falls. Both sexes suffered more cranial fractures than modern Danes, with the proportional difference for men and women being about the same. The difference in cranial trauma frequencies between historic-period and modern Danes has implications for a decline over the past several centuries in interpersonal violence that scholars in other disciplines have inferred from historical sources.

Neurocognitive symptoms and impairment in an HIV community clinic.

BACKGROUND: Neurocognitive impairment is a frequent complication of HIV infection and heralds a poor survival prognosis. With the availability of highly active antiretroviral therapy (HAART), survival times for HIV-infected patients have markedly increased although the effects of HAART on the prevalence of neurocognitive impairment remain uncertain. OBJECTIVE: To determine the relationship between self-reported neurocognitive symptoms and neuropsychological (NP) performance together with the impact of HAART among HIV-infected patients. METHODS: A cross-sectional study was performed in which patients without previously documented neurocognitive impairment attending an HIV community clinic were questioned about neurocognitive symptoms and a NP test battery was administered. RESULTS: Of the eighty-three patients examined, neurocognitive symptoms were reported by 34% of patients and were associated with a shorter duration of HAART and higher viral loads. Patients reporting neurocognitive symptoms were also more likely to exhibit impaired NP performance (p<0.005) with NP impairment being detected in 46% of all patients examined (12% with HIV-associated dementia). Neuropsychological impairment was directly correlated with age (p<0.001), plasma viral load (p<0.005) and inversely correlated with the number of prescribed antiretroviral drugs (p<0.01). CONCLUSIONS: These results suggest that neurocognitive symptoms are predictive of impaired NP performance and that NP impairment remains a frequent finding among older patients with higher viral loads. An increased number of antiretroviral drugs may be neuroprotective.

Sex determination of ancient human skeletons using DNA.

A method for determining the sex of human skeletons was developed using molecular genetic techniques. The amelogenin gene, found on the X and Y chromosomes, was examined using the polymerase chain reaction (PCR) and a nonradioactive dot blot procedure. DNA was analyzed from 20 modern individuals of known sex and 20 skeletons from an archaeological site in central Illinois dating to A.D. 1300. An independent assessment of the sex of each skeleton was made according to standard osteological methods. The sex of 19 ancient and 20 modern individuals was accurately determined using this molecular genetic technique. Molecular sex determination will be especially useful for juvenile and fragmentary remains when it is difficult, or impossible, to establish an individual's sex from morphological features.

Colour flow mapping in the diagnosis of the calf deep vein thrombosis.

This prospective trial was organized to evaluate further the role of colour flow Doppler ultrasound techniques in the diagnosis of deep vein thrombosis (DVT) with particular reference to the isolated calf lesion. In 100 patients ultrasound was compared against the recognized gold standard of ascending venography. Fifty venograms were positive for DVT compared with 49 on ultrasound, a sensitivity of 98%. The specificity of ultrasound for DVT in the 50 patients without DVT on venography was 100%. Forty-five venograms demonstrated calf thrombus with varying proximal extent. Sixteen proved to be isolated calf lesions and these were all identified by ultrasound (100% sensitivity and specificity respectively for isolated calf DVT). In five of these isolated calf thrombus cases, results suggested that ultrasound better diagnosed the presence of thrombus. Ultrasound diagnosed significant pathology in 13 of the normal venogram patients giving an overall diagnostic yield of 62% as compared to 50% at venography.

Alcohol and attempted suicide.

This study investigates the prevalence of excessive drinking and alcohol-related problems amongst suicide attempts. It also compares the characteristics of attempted suicide by alcohol consumption group. Drinking histories were taken on 250 consecutive attempted suicides admitted to the West Midlands Poisons Unit. Fifty-one per cent of the men and 31% of the women drank more than the weekly limits recommended by the Health Education Council. Of the men, 22.5% drank more than 50 units of alcohol a week and 9.5% of the women drank more than 35 units of alcohol a week. Alcohol-related problems (social problems, alcohol dependence or physical illness) were present in 34% of men and 15.5% of women. These results show a greater incidence of alcohol misuse than previous studies on attempted suicide. This is probably because detailed alcohol histories were taken on all patients. Alcohol misuse is best treated before major alcohol-related problems develop. Those responsible for assessing cases of attempted suicide should be adept at detecting alcohol misuse and instituting appropriate management.

Worcester Development Project: the closure and replacement of a mental hospital.

The Worcester Development Project began in 1968 when the Department of Health and Social Security brought together the Worcester and Kidderminster Hospital Management Committee and the County Council in a co-ordinated joint planning venture. Powick Hospital was chosen as the location for testing the hypothesis that closing a mental hospital and replacing it with general hospital psychiatric units, supported by a variety of community facilities, would provide a more economical and better service. This paper describes the outcome of this unique opportunity to study the problems involved in closing a mental hospital and its replacement with other facilities.

Pattern matching of age-at-death distributions in paleodemographic analysis.

Model age-at-death distributions are generated from fertility and mortality rates derived from two present-day, traditional human societies with widely differing cultural systems: the !Kung hunters-and-gatherers and Yanomamo horticulturalists. Visual examination of these models demonstrates that fertility has more of an effect than mortality on the overall configuration of the age-at-death distributions of stable populations. Comparisons with a late prehistoric Oneota skeletal sample from the American Midwest illustrate how reference age-at-death schedules can be used 1) to identify whether a given skeletal sample approximates an age-at-death distribution expected of an extant human population and 2) to provide a basis for developing further testable hypotheses about the demographic and cultural characteristics of past populations.

Carnivore alteration of human bone from a late prehistoric site in Illinois.

The nature and pattern of destruction of human bone by scavenging animals, probably canids, is described for 30 Oneota skeletons from a west-central Illinois cemetery dated at ca. A.D. 1300. The most frequently damaged parts of the skeleton include bones covered by relatively little soft tissue, such as the major joints of the limbs, and those in the facial, abdominal, and gluteal regions.

Organic reaction in AIDS.

A case of organic brain syndrome in a patient with AIDS is described. The implications for medical and psychiatric services are discussed and problems highlighted.

Anorexia nervosa occurring in pregnancy.

A case of Anorexia nervosa presenting during pregnancy is described. Problems in the management of this condition during pregnancy are outlined.