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The diagnosis of intermittent explosive disorder in violent men.

In a study of violent men, 443 symptomatic adult male volunteers were evaluated for presence of intermittent explosive disorder (IED). Investigators first established presence of severe and frequent violent outbursts not readily explainable by another disorder. Seventy-nine violent men were so selected. Of these, 26 had excessive impulsivity, an exclusionary criterion for IED. Twenty-one were excluded because of other, exclusionary mental disorders. Violent behavior of five subjects was deemed proportionate to the provocation. Insufficient data were obtained for an accurate diagnoses of IED in 12 subjects. Fifteen subjects satisfied all criteria for IED, i.e., 18.9 percent of sufficiently violent men without other major psychopathology or 1.49 percent of all 443 men who complained of violence. Epidemiologic and validity aspects of IED are discussed.

Adult↗

Comparison of the electrophysiological pattern of fatigue between athletes required to perform explosive and endurance sports.

The electrophysiological behavior of an isometric contraction sustained to fatigue, was examined in 6 long distance runners and 9 athletes involved in explosive (burst) sports, by on line computer analysis of the electrical activity of vastus medialis, rectus femoris and vastus lateralis. The experiments were carried out with a counterload of 50% of the maximal strength of the muscle. The duration of spike increased and the frequency decreased in the 3 examined muscles, in both types of sport. In the burst sports the changes of value of both parameters were statistically significant in the 3 muscles. In endurance sports the variations of duration were not significant and the changes of frequency were statistically significant only in the vastus lateralis. These results could be explained by the gradual activation of motor units of more strikingly different sizes in burst sports. Thus it may be speculated that prolonged training in burst sports may result in the automatic mobilization of higher number of small motor units, for the initiation of contraction while in endurance sports the onset of contraction is more gradual and carried out by large motor units.

Adolescent↗

[Gunshot and explosion injuries of the hand].

The problem of hand injuries from bullets and explosives is covered in this paper by the example of three cases. The recommendation is made to remove only easily accessible projectiles. The damage caused by the intervention must not be larger than that caused by the bullet injury. Essential measures should include immediate wound toilet with removal of devitalised tissue, primary osteosynthesis, preferentially with minifixateur externe, coverage of exposed tendons, nerves, bones, and joints, splitting of the ligamentum carpi volare, perioperative administration of antibiotics, and secondary skin suture. Definite treatment should be left to a centre of hand surgery.

Adult↗

[Lighter accidents. Burns caused by lighter explosions].

Attention is drawn to the danger of gas lighters. Four cases of burns caused by lighters are reported, two of these were due to lighter explosions. In Denmark, safety regulations concerning gas lighters are only recommended. The manufacturers and importers can decide whether or not requirements are adhered to.

Adult↗

[The hydrodynamic effect of gunshots in cranial explosive shots].

Case report on five fatal gunshot injuries in which discharge of the cranial contents had occurred owing to a skull blast. Despite an appreciable explosive action with destruction of the bony cranium, the brains were not completely destroyed. In analogy to the "Krönlein shot", comparative reflections were made concerning wound ballistics. The case reports show that injury patterns resembling "Krönlein shot" may arise in cranial blast shots in rare cases despite destroyed projectile parts and even in a mouth shot.

Adult↗

Ocular trauma resulting from the explosive rupture of a liquid center golf ball.

The likelihood of a patient seeking consultation with an ocular injury due to puncturing and subsequent explosive rupture of a golf ball seems remote. This very set of circumstances occurred at our V.A. Medical Center Optometry clinic. Golf ball manufacturers receive inquiries each year concerning the makeup of these liquid centers. Lack of current available information from ophthalmic journals or poison control centers prompted an inquiry into the exact nature of these golf balls. Further concern was for the measured alkalinity and extreme pressure exhibited by the liquid center golf ball brought in by the patient just after injury occurred. A case report is presented. Retrospective evaluation of previous literature is reviewed as well as information from golf ball manufacturers.

Adult↗

Some sociomedical aspects of the population explosion.

Dr Robert Smith surveys the history of birth control and sounds a warning for the future of mankind, if the population explosion is allowed to continue unchecked.He stresses the importance of the role of the general practitioner in the limitation of births.Sir Theodore Fox describes the work of the Family Planning Association and stresses that, increasingly, this is a specialist service covering all aspects of fertility.He also feels that the general practitioner has a role in family planning.

Economics↗

Epidemiological studies on radiation carcinogenesis in human populations following acute exposure: nuclear explosions and medical radiation.

The present review provides an understanding of our current knowledge of the carcinogenic effect of low-dose radiation in man, and surveys the epidemiological studies of human populations exposed to nuclear explosions and medical radiation. Discussion centers on the contributions of quantitative epidemiology to present knowledge, the reliability of the dose-incidence data, and those relevant epidemiological studies that provide the most useful information for risk estimation of cancer induction in man. Reference is made to dose-incidence relationships from laboratory animal experiments where they may obtain, for problems and difficulties in extrapolation from data obtained at high doses to low doses, and from animal data to the human situation. The paper describes the methods of application of such epidemiological data for estimation of excess risk of radiation-induced cancer in exposed human populations and discusses the strengths and limitations of epidemiology in guiding radiation protection philosophy and public health policy.

Adolescent↗

Thyroid hypofunction after exposure to fallout from a hydrogen bomb explosion.

Thyroid function was evaluated in the Marshallese who were accidentally exposed to fallout-containing radioiodine isotopes in 1954. Measurements of thyrotrophin (TSH, thyroid-stimulating hormone) levels and free thyroxine (T4) index (FT4I) have revealed that, among 86 persons exposed on Rongelap and Ailingnae atolls, 14 have shown evidence of thyroid hypofunction. This was first noted in some individuals about ten years after exposure. Only two of these showed clinical evidence of hypothyroidism. The most marked TSH elevations were noted in nine persons exposed when younger than 6 years, with estimated doses to the thyroid from 390 to 2,100 rad. Most of this group subsequently had surgery for removal of thyroid nodules. The remaining five cases have been noted more recently among 36 surviving adults exposed at an older age who showed no other detectable thyroid abnormalities. This group had received estimated thyroid doses ranging from 135 to 335 rad and showed modest elevation of serum TSH levels (6 to 9 microU/mL) and a slightly subnormal FT4I. No abnormalities were found in persons on Utirik who received substantially less radiation, and hypothyroidism was present in less than 1% of the control, unexposed Marshallese. The high prevalence of a thyroid hypofunction in these persons indicates that this condition, as well as thyroid nodularity, can be a delayed complication of exposure to early fallout from a nuclear explosion. The fact that a significant fraction of the radiation to the thyroid was from short-lived radioiodine isotopes (132I, 133I, 135I), as opposed to 131I, may account for the severity of the thyroid damage.

Adolescent↗

Acute management of laser-ignited intratracheal explosion.

The laser-ignited airway explosion is a shocking emergency. Techniques available for prevention of an airway fire minimize the risk, but they are not applicable in all circumstances. The severity of the patient's injury depends on the duration and intensity of the burn. Prompt, appropriate management is facilitated if the operating team has previously discussed and "rehearsed" this potential disaster. The distal airway burn produced by an ignited endotracheal tube differs from an inhalation burn in character and severity. The anatomic and respiratory effects occurring subsequent to the laser-induced burn are examined. Emergency care requires immediate elimination of the fire, removal of the tube and any foreign body or debris, and usually a tracheostomy. A program of medical and endoscopic management is suggested.

Bronchoscopy↗

[The cytogenetic effects in the population of the Altai Territory subjected to ionizing radiation exposure as a result of the nuclear explosions at the Semipalatinsk proving grounds].

The cytogenetic examination of 178 persons living in seven settlements of the Altai region exposed to ionizing radiation during Semipalatinsk nuclear tests in 1949-1962 was carried out. It was shown that more than 80% of absorbed dose was due to the first nuclear explosion in 1949. The frequency of chromosome aberrations (dicentrics and rings) significantly exceeded the control level. The linear correlation between the dicentrics and rings frequency and absorbed dose was found. The cells with more than one aberrations were revealed in irradiated persons. This is supposed to be the result of 239Pu alpha-radiation.

Adult↗

[Therapy of middle ear injuries caused by explosive devices].

Forty nine wounded with the explosive injury of the middle ear were treated. The largest number of injuries were ruptures of the ear drum (79.35%), followed by the break of the ossicular chain (15.87%) and the fractures of the mastoid, along with the paralysis of the facial nerve (4.77%). In therapeutic procedure the reposition and connection of the eardrum parts and 'patch' technique were performed, and in case of perforation persistence longer than four months myringoplasty was done. Injuries of the auditory bones were solved by ossiculoplasty, and injuries of facial nerve by decompression and neuro suture. In 66% spontaneous healing of rupture occurred and the ossicular chain was successfully fixed in 80% of injuries while the reparation of the facial nerve was partially achieved. The acute secondary infection developed in 18% and the chronic otitis in 10% of cases. The early reposition of the eardrum rupture is recommended due to infection prevention of the middle ear and in order to stimulate the spontaneous improvement, while the surgical treatment is recommended in cases with persistent rupture or conductive loss of hearing lasting longer than four months.

Adolescent↗

[Pharmacological treatment of the intermittent explosive disorder. Report of three cases and literature review].

The treatment of intermittent explosive disorder is still empirical, although it tries to use drugs according to present knowledge on neurobiology of aggression. We report three patients in which a good control of aggressive behavior was achieved using inhibitors of serotonin reuptake and carbamazepine. We review the literature on pharmacologic treatment of aggressive behavior.

Adult↗

[Cellular immune reactions in the victims of explosive injuries to the skull and brain].

Specific features in the immunological status of 49 wounded with explosion injuries of neurosurgical profile are as follows: in light injuries--it is hyperergic character of the immune system and its inadequacy to the injuries of a middle degree it is a distinct parallelism between the dynamics of the immune status indices and the functional state of the CNS depending on the severity of the injury-an extremely flabby with the inhibiting of main immunological indices at a low but permanent level.

Adolescent↗

[The use of laser ignited mini-explosive technique in treating 100 cases of gastric bezoars].

The experience of breaking gastric bezoars endoscopically with a laser ignited mini-explosive head was reported. After successful application of this technique in vitro and in experimental animals, we began to use it clinically in January 1988. In a period of more than four years, we treated 100 cases of gastric bezoars, 80 cases being male and 20 female, aged from 5 to 65 years. 70 cases were cured after one treatment, 24 after two and the remaining 6 cases after three times of treatment. The cure rate was 100%. Except one case complicated with gastric perforation, no other complications were observed. The etiology and prevention of gastric bezoars, as well as the new method and experience in treating this disease were discussed.

Adolescent↗

[Reconstruction of grip function in bilateral complex explosion injury].

Evaluation, therapeutical possibilities, and surgical planning for the restoration of bilateral grip function are described, based upon the case of a blind patient presenting after severe bilateral explosion injuries of the hand with grade 3-4 loss of thumbs and fingers. Finally, the given level of amputation and remaining components of the hand together with toe transplantation permitted restoring of power grip on one side and fine grip on the other side in combination with bone and soft-tissue procedures.

Adult↗