Attenuation of low-frequency sound in freshwater.

Lake Superior was chosen as an experimental site to compare sound absorption of freshwater with the results of absorption measurements in seawater. The relaxation-like absorption at 1 kilohertz occurring in seawater is also present in freshwater. A relaxation related to the structural characteristics rather than to the salt content of water may be responsible for the anomalous absorption.

Endoscopic paranasal sinus surgery: radiographic evaluation of severe complications.

PURPOSE: To report our experience with the radiographic evaluation of severe complications resulting from the functional endoscopic sinus surgery (FESS) procedure. PATIENTS: Ten major complications were reviewed retrospectively. FINDINGS: Ten major complications occurred. Eight of 10 had injury to the floor of the anterior cranial fossa, fovea ethmoidalis (roof of the ethmoid sinus), or roof of the sphenoid sinus. Six patients presented with meningitis or rhinorrhea, two presented with headache and massive pneumocephalus; one patient who presented with meningitis had a large nasal frontal encephalocele. Noncontrast brain CT that included the paranasal sinuses adequately evaluated the source of pneumocephalus. Thin-section coronal CT accurately predicted the site of leak in five patients. Both coronal sinus CT and MR imaging were useful to confirm the nasal encephalocele. Two of 10 had vascular injury secondary to FESS. One patient presented with subarachnoid hemorrhage seen on noncontrast CT and cerebral angiography demonstrated an aneurysm of the anterior cerebral artery. The second patient suffered severe intraoperative hemorrhage. Emergency angiography revealed a pseudoaneurysm of the cavernous carotid artery, and balloon occlusion of the artery was performed. No deaths occurred in this series. CONCLUSION: Radiologists should be familiar with the rare, but potential complications of this commonly performed procedure in order to help direct the work-up in an efficacious manner.

Head trauma in young athletes.

Despite the most meticulous preparation for the most noncontact of sports, head injuries are a fact of daily life. Physicians should continue to strive to decrease the occurrence of these injuries by monitoring events for adherence to guidelines designed to reach this end. Contributing to policymaking, unannounced spot checks at practices and games, and appropriate on-site and follow-up care may help minimize the complications and sequelae of this injury.

Nutrition in women. Assessment and counseling.

Nutritional aspects of health care for women are receiving special attention in the lay and research press. Primary care physicians must have accurate knowledge of general nutrition to counsel patients accordingly. This article addresses a practical approach to nutritional assessment and counseling. Current data on specific nutrients and disease are evaluated. Attention is given to antioxidant vitamins and disease as well as calcium, vitamin D, and osteoporosis.

Bracing and taping in an office sports medicine practice.

Braces can be divided according to their use: rehabilitative, functional, or prophylactic. Rehabilitative braces are used following injury or surgery to allow protection of the injured part while rehabilitation is taking place. Functional braces are used following injury or surgery to allow an individual player to return to athletic activities while protecting the injured part from further damage. Prophylactic braces are used in an attempt to prevent injury to a normal area while engaged in athletic endeavors. Braces are available for the neck, back, and both the upper and lower extremities. There are many commercially available braces that are quite useful and effective. It is still controversial whether or not prophylactic braces prevent knee injuries in contact sports. However, prophylactic braces and/or taping have proved to be quite effective in preventing ankle injuries. It should always be kept in mind, however, whether one is using rehabilitative, functional, or prophylactic braces, that a good rehabilitation program and conditioning should be instituted along with their use to strengthen the involved area and prevent further injuries.

Diphenhydramine toxicity in a child with varicella. A case report.

Varicella may be associated with serious complications including encephalitis, Reye's syndrome, and drug toxicity. In this case, a 19-month-old child with varicella was brought to the family practice clinic by her parents when she began behaving abnormally. At the time of presentation the child exhibited dilated pupils, ataxia, urinary retention, and facial grimacing. The child's parents had treated her with acetaminophen, diphenhydramine syrup, colloidal oatmeal baths, and frequent applications of Caladryl lotion. The results of her immediate laboratory tests were within normal limits, and she was admitted to the hospital for observation. She recovered without therapeutic intervention. Although not available at the time of admission to the hospital, her diphenhydramine serum level was 1948 ng/mL. Diphenhydramine levels above 100 ng/mL have been associated with toxicity.

Cryptococcosis of the larynx in a patient with AIDS: an unusual cause of fungal laryngitis.

We have presented a case of unsuspected cryptococcal laryngitis, clinically masquerading as Kaposi's sarcoma in a patient with AIDS. The spectrum of laryngeal disease in AIDS patients includes a variety of infections and neoplasms, which can be treated satisfactorily when accurate and timely diagnosis is made.