The mechanism of genetic predisposition in congenital dislocation of the hip.
(1/27)
The important role of polygenic acetabular configuration and monogenic joint laxity has again been proved in the aetiology of congenital dislocation of the hip. According to the findings reported these two genetic predispositions seem to be unrelated. The time of diagnosis in accetabular dysplasia type and joint laxity type did not differ, thus the neonatal and late-diagnosed cases do not seem to be two clear-cut entities. (+info)
Diagnostic X-rays and ultrasound exposure and risk of childhood acute lymphoblastic leukemia by immunophenotype.
(2/27)
The objective of this study was to evaluate the association between in utero diagnostic X-rays and childhood acute lymphoblastic leukemia (ALL) and the less well-studied relationship of this malignancy to preconception and postnatal diagnostic X-rays or fetal ultrasound exposures. The Children's Cancer Group conducted a case-control study including interviews with parents of 1842 ALL cases diagnosed under the age of 15 years and 1986 individually matched controls. Associations of self-reported parental preconception, in utero, and postnatal X-ray exposure with risk of childhood ALL were examined using odds ratios (ORs) and corresponding 95% confidence intervals (CIs) obtained from logistic regression models among the overall group of ALL cases as well as immunophenotypic and age-specific subgroups. Overall, in utero pelvimetric diagnostic X-rays were not associated with the risk of pediatric ALL (OR, 1.2; 95% CI, 0.8-1.7). Childhood ALL, all types combined (OR, 1.1; 95% CI, 0.9-1.2) and specific types were also not linked with postnatal diagnostic X-ray exposures. Neither maternal (OR, 0.9; 95% CI, 0.8-1.2) nor paternal (OR, 1.1; 95% CI, 0.8-1.4) lower abdominal preconception diagnostic X-rays were associated with risk of childhood ALL. Among the multiple comparisons for age-, sex-, and subtype-specific subgroups, we observed an elevated risk of total ALL among children ages 11-14 at diagnosis (OR, 2.4; 95% CI, 1.1-5.0) in relation to in utero pelvimetric diagnostic X-ray exposures and a small increase in pre-B ALL for all ages combined (OR, 1.7; 95% CI, 1.1-2.7) in relation to postnatal diagnostic X-rays. In utero diagnostic ultrasound tests were not linked with risk of childhood ALL. We found little consistent evidence that in utero diagnostic ultrasound tests or X-rays were linked with an increased risk of childhood ALL. Small increases in total or pre-B ALL risks for children in selected age groups to very low ionizing radiation exposures from postnatal or preconception diagnostic X-ray exposures may represent chance findings or biases. Future studies of diagnostic X-rays and childhood leukemia in the United States will require extensive additional efforts and resources to quantify risk because of declining in utero exposures in the general population (thus necessitating large numbers of subjects, particularly cases) and the difficulty in validating reported exposures. (+info)
Role of pelvimetry in active management of labour.
(3/27)
All cases referred for pelvimetry in 1970-1 and all breech presentations referred for pelvimetry in 1972-4 were reviewed. Indications for pelvimetry fell into four main categories: high head in the antenatal clinic (47-8%); high head in labour (13-9%); breech presentation (20-9%); and previous caesarean section (14-8%). In the first two categories pelvimetry rarely if ever influenced management, and it should not be performed routinely. In breech presentation and cases of caesarean section pelvimetry seemed to be of value, but in the latter group it should be performed puerperally to avoid the known radiation hazard to the fetus. A fairly close correlation between obstetric conjugate and pelvic capacity was shown, which suggested that a 3400-g baby might pass through a pelvis of obstetric conjugate of 10 cm as a cephalic trial of labour, but would need an obstetric conjugate of 11-7 cm for safe vaginal breech delivery. (+info)
X-RAY PELVIMETRY.
(4/27)
The results of x-ray pelvimetry performed on 66 pregnant women, with a view to predicting the outcome of pregnancy, were reviewed. It was concluded that such pelvimetry was most valuable in cases in which it indicated a normal pelvis or gross bony disproportion. It was least effective in those with a "borderline" pelvis, in which the correct management of the patient requires an adequate trial of labour. The authors believe that pelvimetry in the later stages of pregnancy has no ill effects on the unborn baby or the mother.Indications for use of x-ray pelvimetry in obstetrics, the technique employed, the various types of female pelvis and the relation of these to the course of labour are considered. Pelvimetry findings are compared with the eventual outcome of labour in women with suspected cephalopelvic disproportion. It is emphasized that the pelvic assessment should be made jointly by the radiologist and obstetrician. (+info)
Relationships between 3-y longitudinal changes in body mass index, waist-to-hip ratio, and metabolic variables in an active French female population.
(5/27)
Three-year longitudinal changes in body mass index (BMI), waist-to-hip ratio (WHR), and metabolic variables were examined in 209 active French women. For the entire group, a weak but significant positive association was found between change in BMI and change in WHR. However, analysis of covariance according to the degree of abdominal fat distribution showed a heterogeneity of this association that was confined to women with abdominal fat distribution. Changes in BMI were positively associated with changes in total cholesterol (P less than 0.05), triglycerides (P less than 0.10), and blood pressure (P less than 0.001), whereas changes in WHR were associated with changes in triglycerides (P less than 0.05) and diastolic blood pressure (P less than 0.10). These longitudinal results suggest that a more favorable body-fat pattern and metabolic profile might be achieved by reducing weight, or at least by preventing weight gain, particularly in women with high abdominal-fat distribution. (+info)
A retrospective review of performance and utility of routine clinical pelvimetry.
(6/27)
BACKGROUND AND OBJECTIVES: Some authorities have questioned the utility of performing clinical pelvimetry as part of routine prenatal care. This study determined the frequency with which clinical pelvimetry is still performed at two military hospitals and whether the results of pelvimetry influence the management of labor and delivery. METHODS: We conducted a retrospective review of prenatal records at two military hospitals. One was an overseas hospital, and one was a family medicine teaching hospital in the United States. The records of 660 pregnant women were reviewed to identify documentation that pelvimetry was performed during prenatal care and whether there was evidence that the physician managing labor and delivery altered management based on pelvimetry results. RESULTS: Seventy percent (461) of the 660 records reviewed had all pelvimetry measurements documented as normal, or the provider had written "good for TOL (trial of labor)," "proven to XX pounds," or similar annotation that pelvimetry was normal. Nine percent (58 records) had no documentation of pelvimetry (pelvimetry section left blank). The remaining 21% (141 charts) had at least one pelvimetry measurement listed as abnormal on the initial prenatal exam. No admission note, progress note, or operative note recorded during labor and delivery made reference to clinical pelvimetry results. No abnormal pelvimetry result was referenced in follow-up visits or appeared to make any difference in mode of delivery or treatment in labor. Two women (one at each institution) had initial visit notes indicating the need to consider radiographic pelvimetry based on the results of clinical exam, but this test was not done in either case, and both women delivered vaginally. CONCLUSIONS: Our study indicates that clinical pelvimetry does not change management of pregnant patients. Current practice is to allow all women a trial of labor regardless of pelvimetry results. This makes the routine performance and recording of clinical pelvimetry a waste of time, a potential liability, and an unnecessary discomfort for patients. (+info)
Think globally act locally: the case for symphysiotomy.
(7/27)
When expatriate doctors from developed countries working in sub-Saharan Africa suggest to the local doctors and midwives that symphysiotomies should sometimes be done, they are silenced neither with quotations from the medical literature nor with tales of patients seen, but with: "If symphysiotomies are such good operations why don't you perform them at home?" Here is why. (+info)
Contribution to the knowledge of anatomy of species of genus Mobula Rafinesque 1810 (Chondricthyes: Mobulinae).
(8/27)
A comparative anatomical study was conducted among four mobulid species (Mobula japanica, M. munkiana, M. tarapacana, and M. thurstoni), from the coasts of the Gulf of California. Characters of the skeleton (neurocranium, mandibles, scapular girdle, pelvic girdle, and synarcual) were described. Mobula species had a wide structural variation. In the skeleton, M. tarapacana displayed the most plesiomorphic characters, mainly at the cranial level (cranium longer than wide, reduced internasal width, fontanelle longer than wide), while M. japanica had the most derived characters (cranium wider than longer, fontanelle wider than longer). Based on the observations, the dorsal cephalic musculature were similar in all species; however, oppositely to other batoid species, the epiaxilis is strongly developed, as it extends toward the cephalic part of the neurocranium, at level of the postorbital processes. In the ventral musculature, ventral constrictor muscles are quite reduced, whereas complex mandibular muscles are very developed. Muscles showing the highest variation are the coracohioideus and the coracoarcual. (+info)