This study deals with the distribution and extent of hemophilic arthropathy in 52 adult patients suffering from severe hemophilia A. A clinical and radiological score-evaluation of knee, ankle and elbow joints was undertaken, 4.7 of 6 examined joints proved to be affected in the third life-decade in the average, the extent of destruction being most pronounced at the knee joints. A rather close correlation of clinical and radiological signs was found to exist only related to the knee joints.

Adolescent↗

PubMedDate not supplied

[Follow up study of 997 total hip endoprostheses with special reference to late results 9-11 years after operation].

81.1% of a total of 1230 total hip arthroplasties could be reviewed by means of questionaries between 4 and 11 years after the operation. There was clear evidence for wors results in the long term group (between 9 and 11 years postoperatively) as to pain and ability to walk. In the short-term group of 1972-76 8.4% are not satisfied with the results of the operation, but in the long term group of 1970 this refers, as to be expected, to 23.5%. The same trend has been stated what aseptic complications are concerned: 42.7% clinically relevant ectopic ossifications and non-infectious implant loosenings in the long term group as compared with only 5.6% in the short term group. 1131 Müller prostheses were implanted. In this group 61 reoperations because of aseptic complications were necessary. Of all implanted Müller prostheses models the one with the middle neck length revealed the lowest rate of loosenings. Postoperative infections (both early and late) indicated a re-operation in 0.5%.

Adolescent↗

PubMedDate not supplied

A pilot epidemiologic study of possible health effects associated with 2,3,7,8-tetrachlorodibenzo-p-dioxin contaminations in Missouri.

In 1971, 2,3,7,8-tetrachlorodibenzodioxin (TCDD)-containing waste oils were sprayed for dust control on residential, recreational, and work areas in Missouri. In several of these areas, the magnitude and the extent of this environmental contamination were not known until late 1982 or 1983. In the first phase of the investigation, a group of persons considered to be at highest risk of exposure and an appropriate comparison group were selected from reviews of Health Effects Survey screening questionnaires. These persons received complete medical examinations and a series of laboratory tests focused on detecting presymptomatic effects in key target organ systems (i.e., hepatic, dermatologic, immunologic, and neurologic effects). Comparisons of these two groups did not produce any firm indications of increased disease prevalence directly related to the putative exposures; of significance is the fact that no cases of chloracne or porphyria cutanea tarda were seen. Nevertheless, no overall definitive conclusion should be based just on this initial pilot study. Insights were provided that are being examined in more refined epidemiologic studies using different designs and strategies--especially of larger, more homogeneous population groups in which exposure status can be better characterized--focused primarily on discerning any potential effects on the urinary tract, liver, neurological, and immune systems. Concurrently, research into the development of replicable laboratory analytical methods and reference ranges for measuring TCDD body burden are being pursued.

Adolescent↗

PubMedDate not supplied

Drugs of abuse in saliva: a review.

There has been substantial interest in the use of saliva as a diagnostic medium for drugs of abuse because it can be obtained noninvasively. Although drugs of abuse have been investigated in saliva for more than a decade, the role of saliva remains uncertain. A clear picture is difficult to obtain because of variations in (1) the analytical methods used; (2) the dose regimen of subjects, which was either unknown or differed between studies; and (3) the elapsed time between drug intake and sample collection. This communication summarizes the studies on the quantitative determination of different drugs of abuse in saliva to elucidate the current status in this area. Marijuana, cocaine, phencyclidine, opiates, barbiturates, amphetamines, and diazepines (or their metabolites) have all been detected in saliva by various analytical methods, including immunoassay, gas chromatography/mass spectrometry, and thin layer chromatography. Initial studies with cocaine and phencyclidine suggest a correlation between saliva and plasma concentrations of these drugs, indicating a dynamic equilibrium between saliva and blood. Tetrahydrocannabinol, the active component in marijuana, on the other hand, does not appear to be transferred from plasma to saliva. However, tetrahydrocannabinol is sequestered in the buccal cavity during smoking and can be detected in saliva. These findings point to the potential role of saliva in the analysis of many illicit drugs. To clearly identify the role of saliva as a diagnostic medium for drugs of abuse, research efforts should be directed towards (1) performing systematic studies on correlations between saliva, blood, and urine and (2) determining the concentrations of drugs and their metabolites in saliva as a function of dose and time after intake.

Female↗