Neighborhood disorder predicts lower serum vitamin D levels in pregnant African American women: A pilot study.

Pregnant African American women are more likely to live in neighborhoods with more disorder (e.g., vacant housing, littler, crime) and to have vitamin D deficiency due to their darker skin pigmentation and poor production of vitamin D [25(OH)D] from ultraviolet rays. However, no study has examined the potential link between neighborhood disorder and 25(OH)D status in African American pregnant women. Forty-one pregnant African American women completed validated questionnaires about perceived neighborhood disorder (6 items; 3-point scale; range 6-18) and with concurrent serum levels of 25-hydroxyvitamin D [25(OH)D] assessed during pregnancy at 18-24 weeks gestation. Higher levels of perceived neighborhood disorder were associated with lower levels of serum 25(OH)D. Pregnant African American women who report higher disorder in their neighborhood may spend less time outside. Health care providers should include assessment of perceived neighborhood disorder. Future research needs to evaluate the relationships among neighborhood disorder and 25(OH)D levels among pregnant African American women.

Management of periocular basal cell carcinoma: Mohs' micrographic surgery versus radiotherapy.

In treating periocular basal cell carcinoma the goal is to achieve the most complete eradication of affected tissue while preserving as much healthy tissue as possible. In the first of these "Viewpoints" articles, Drs. Leshin and Yeatts discuss the success of Mohs' microsurgical technique (MMS) in both regards. Moreover, they note that MMS offers the additional advantage of placing all surgical and histological phases of tumor excision in the hands of one specialist, thus circumventing problems that may arise with procedures requiring the separate involvement of several specialists. In the second article, Drs. Anscher and Montana point out that modern radiotherapy techniques may offer adequate tumor control with less damage to surrounding tissues than is caused by surgical excision and reconstruction. With small lesions, radiotherapy has a success rate similar to that of surgery. With large lesions, the success rate is lower; however, if surgical excision would cause extensive disfigurement or functional damage, an initial trial of radiotherapy may be warranted, then followed by surgery, if necessary. In an editorial, Dr. Dutton summarizes the indications for and advantages and disadvantages of both techniques.

Dilated intercavernous sinuses: an MR sign of carotid-cavernous and carotid-dural fistulas.

Dilated venous channels traversing the sella and connecting the two cavernous sinuses were seen on contrast-enhanced MR images in four patients with angiographically proved carotid fistulas. The anatomy and variations of these so-called intercavernous sinuses are discussed and are demonstrated in Latex-injected anatomic specimens. Direct visualization of the intercavernous sinuses on contrast-enhanced MR images may serve as an ancillary sign for the diagnosis of carotid-cavernous or carotid-dural fistulas near the sella.

Methylene blue stain guiding layered excision in Mohs' micrographic surgery.

Resection of a continuous layer of tissue by means of Mohs' micrographic surgery is problematic at several periorbital sites. We describe a technique in which methylene blue is used to identify instances of incomplete specimen removal and thus facilitate subsequent complete removal.

Self-concept correlates in academic placement of secondary school students.

In a large school system in the Southeastern United States 26% of the eighth grade students in the lower distribution of scores on a standardized test in reading and mathematics were assigned to vocational education courses and a career education program. One of the school counselors administered a self-concept inventory, the Me Scale (Yeatts & Morrison, 1974), to a randomized group of 43 students who were in the lower 26% of scores. The same inventory was administered to 91 randomly selected students in the upper distribution of scores. Significant differences were noted for one of five factors in the Me Scale. Lower achieving students perceived themselves as more capable in manual dexterity than higher achieving students.