From October 1985 to September 1988 3000 neonatal hips were controlled clinically and by ultrasound. 3% of those needed an immediate treatment. In 45 of these 90 hips there were no directing clinical signs or suspicious hints in the family history or during the course of pregnancy. This means, that these inconspicuous cases would not have got their necessary therapy without the ultrasound-screening. Thus the results of this investigation supports the call for the general ultrasound-screening of the neonatal hip.

Female↗

PubMedDate not supplied

Evaluating home environments of persons with dementia: interrater reliability and validity of the Home Environmental Assessment Protocol (HEAP).

PURPOSE: This article reports on an interrater reliability and preliminary validity study of an investigator-developed tool, the Home Environmental Assessment Protocol (HEAP) for use in homes of persons with dementia. METHOD: The HEAP consists of 192 items that are summed into separate indices representing the number of hazards, adaptations, and level of clutter and comfort in eight areas of the home. Interrater reliability was examined among four raters, two environmental experts and two non-experts, who observed 22 dementia households. RESULTS: The Kappa statistic was used to evaluate agreement level for each measured item and found that agreement ranged from slight to almost perfect. Intraclass correlations (ICCs), were used to evaluate agreement level for indices. The hazard index in each room ranged from fair (0.36) to moderate (0.66) for all raters. For the adaptation, clutter and comfort indices in each room, ICCs ranged from 0.51 to 0.90 for all raters. Agreement level between expert and non-expert raters differed minimally for all indices. Adaptations to dining rooms (r= -0.080, p = 0.001), kitchens (r = -0.52, p = 0.02) and bedrooms (r = -0.76, p = 0.001) were associated with patient deficits such that more adaptations were made in homes of dependent persons. Low Mini-Mental Status Examination scores were associated with fewer hazards, more adaptations, and less clutter. CONCLUSION: Findings show that both experts and non-expert raters use the HEAP consistently. Also, measured attributes are related to cognitive and functional status in the expected direction.

Activities of Daily Living↗

PubMedDate not supplied

External catheter immobilization improves wound healing in micropigs.

Recurrent traumatic damage by mechanical action is a major cause of catheter exit site problems in CAPD patients. The purpose of this study was to determine the efficacy of a new external immobilization device (Immobilizer) on wound healing characteristics at the catheter exit site. Sixteen Tenckhoff catheters were surgically implanted in four Yucatan micropigs (two catheters per flank). Immobilization devices were placed on one catheter on each side of each animal; the other catheter was allowed free movement. The devices were changed daily, and exit sites were examined for wound healing progress and infection. Fourteen days following implantation the animals were sacrificed, and the catheter exit sites explanted for histologic examination. The results of this study suggest that immobilization of catheters with this device improves wound healing at the exit site, as evidenced by decreased (p less than 0.05) marsupialization/epidermal down-growth (nonimmobilized 2.9 mm vs. immobilized 1.6 mm), and an increased (p less than 0.05) macrophage/epithelioid cell/giant cell response within the exit tract or in the Dacron cuff (granulomatous response histology score of 2.3 for immobilized vs. a histology score of 1.6 for nonimmobilized). Thus, use of this device may help reduce catheter exit site problems in CAPD patients.

Animals↗