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Selected AbstractsTowards an understanding of the high death rate among young people with diabetes in UkraineDIABETIC MEDICINE, Issue 1 2001M. Telishevka SUMMARY Aims Published rates of deaths attributed to diabetes mellitus among those aged under 50 have risen substantially in several former Soviet republics since the late 1980s. The reasons for this increase, and the situation facing patients with diabetes in these countries are poorly understood. The aim of this study was to describe the circumstances leading up to the death of individuals dying under the age of 50 years with mention of diabetes on their death certificate. Methods Interviews with surviving relatives or neighbours, combining elements of verbal autopsy and confidential enquiry. For those who had lived in the city of Lviv a random sample was taken. For those in rural areas a purposive sample was used to ensure coverage of more and less remote areas. Results Key informants were identified and agreed to be interviewed for 64 individuals out of a possible 79 with insulin-treated diabetes identified from their death certificates. The main immediate causes of death were renal failure (69%), ischaemic heart disease (9%), ketoacidosis (6%) and hypoglycaemia (3%). Over a third of men, but no women, were reported to have been heavy drinkers. Informants described many difficulties in obtaining regular supplies of insulin and related supplies since 1990. Although insulin is officially available free of charge, most had retained supplies for use in an emergency. More than half had, at some time, purchased supplies. The large number of deaths from renal failure reflects the effective absence of renal replacement therapy for patients with diabetes. Conclusions Individuals with diabetes in Ukraine face profound challenges involving access to necessary care. Their needs require significantly more attention from policy makers. [source] Managing varicoceles in children: results with microsurgical varicocelectomyBJU INTERNATIONAL, Issue 3 2005Jonathan Schiff Authors from New York present their experience of elective varicocelectomy, using microsurgical techniques, in a large series of children. They found the procedure to be safe and effective, and gave a much lower complication rate than the published rate in open varicocelectomy. The results of urethroplasty in post-traumatic paediatric urethral strictures are presented by authors from Mansoura. They found the overall success of one-stage perineal anastomotic repair of such strictures to be excellent, with very little morbidity. OBJECTIVE To report our experience of microsurgical subinguinal varicocelectomy in boys aged ,,18 years. PATIENTS AND METHODS Boys aged ,,18 years treated with microsurgical varicocelectomy between 1996 and 2000 at one institution were retrospectively reviewed. Indications for surgery included ipsilateral testicular atrophy, large varicocele or pain. Microsurgery was assisted by an operating microscope (×10,25) allowing preservation of the lymphatics, and the testicular and cremasteric arteries. Patient age, varicocele grade, complications and follow-up interval were recorded. RESULTS In all there were 97 microsurgical subinguinal varicocelectomies (23 bilateral) in 74 boys (mean age 14.7 years). Left-sided varicoceles were significantly larger (mean grade 2.9) than right-sided (mean grade 1.4) varicoceles. The mean follow-up was 9.6 months. There were four complications: two hydroceles, of which one resolved spontaneously after 4 months; one patient had persistent orchialgia that resolved after 8 months; and one developed hypertrophic scarring at the inguinal incision site. There were no infections, haematomas or intraoperative injuries to the vas deferens or testicular arteries. All boys were discharged home on the day of surgery. CONCLUSIONS Microsurgical subinguinal varicocelectomy in boys is a safe, minimally invasive and effective means of treating varicoceles. Compared with published results of the retroperitoneal mass ligation technique, which has a 15% overall complication rate and a 7,9% hydrocele occurrence rate, the microsurgical subinguinal approach appears to offer less morbidity, with a 1% hydrocele rate. We consider that microsurgical subinguinal varicocelectomy offers the best results with lower morbidity than other techniques. [source] Contribution of deep-seated bedrock landslides to erosion of a glaciated basin in southern AlaskaEARTH SURFACE PROCESSES AND LANDFORMS, Issue 9 2005Ann M. Arsenault Abstract Landslides represent a key component of catchment-scale denudation, though their relative contribution to the erosion of glaciated basins is not well known. Bedrock landslide contribution was investigated on the surface of one of eleven glaciers on a glaciated ridge in the Chugach-St Elias Range of southern Alaska, where the debris from four major landslides is easily distinguished from moraines and other supraglacial material. A series of aerial and satellite photos from 1972 to 2000 and field observations in 2001 and 2002 indicate that three of four landslides have fallen onto the surface of the glacier since about 1978. The landslides, which originated from the steeply dipping (60,70°) bedrock walls, were deposited onto the glacier in the ablation zone and are currently being transported downstream supraglacially. Individual glacial valleys with topographic relief of ,400 m are cut into high-grade metamorphic rock characterized by a steep north-dipping foliation and fractured by numerous large joints. Measurements of landslide area and average thickness obtained from high-resolution survey data indicate a total landslide volume of ,2·3 × 105 m3. This volume suggests a basin-averaged erosion rate from landslides of 0·48 mm a,1. An overall basin-scale erosion rate of 0·7 to 1·7 mm a,1 can be inferred, but depends on the percentage of the total-basin sediment yield contributed by supraglacial sources. A mean rockwall retreat rate of 6·7 mm a,1 is calculated and is considerably higher than published rates, which range from 0·04 to 4·0 mm a,1. Controls on landslide generation include seismicity, freeze,thaw processes, topography, rock strength, and debuttressing. It is likely all of these factors contribute to failure, although the primary controls for the landslides in this study are thought to be rock strength and topography. The absence of landslides on ten of the eleven glaciers on this ridge is attributed to landslide magnitude,frequency relationships and short temporal scale of this study. Large-volume bedrock landslides (>100 000 m3) may have low frequency, occurring less than once in a 55-year time frame. Copyright © 2005 John Wiley & Sons, Ltd. [source] Percentage of Body Recovered and Its Effect on Identification Rates and Cause and Manner of Death Determination,JOURNAL OF FORENSIC SCIENCES, Issue 3 2007Debra A. Komar Ph.D. ABSTRACT: Anthropologists frequently encounter cases in which only partial human remains are recovered. This study reports how the percentage of the body recovered affects identification (ID) rates and cause and manner of death determination. A total of 773 cases involving anthropology consults were drawn from the New Mexico medical examiner's office (1974,2006). Results indicate a significant correlation between body percent recovered and ID rates, which ranged from 89% for complete bodies to 56% when less than half the body was present. Similar patterns were evident in cause/manner determination, which were the highest (83% and 79%, respectively) in complete bodies but declined to 40% when less than half the body was found. The absence of a skull also negatively impacted ID and ruling rates. Findings are compared with general autopsy ID rates (94,96%) and cause/manner determination rates (96,99%) as well as prior published rates for individual casework and mass death events. [source] Prevalence of Dementia Among the Elderly in a Japanese Community Population,Comparative Study on the 1983 and 1996 Survey: The Aichi StudyPSYCHOGERIATRICS, Issue 4 2001Hiroto Shibayama Background:An epidemiological survey of dementia among community residents over 65 years of age in Aichi Prefecture (Japan) was conducted in 1983 and 1996. We compared the prevalence rates of dementia in 1996, with the previously published rates of 1983. Methods:The study employed a two-stage design. First stage: A test based on the DSM-III-R criteria for dementia was administered to all participating residents, who were randomly drawn from the resident register (856,879) of Aichi Prefecture in 1995 (495,923 in 1983). Second stage: A detailed clinical and cognitive evaluation (including MMSE and neurological examination) of the subjects identified in the first stage was carried out by trained psychiatrists. Results:The prevalence rate for dementia in 1996 was 4.8% (moderate and severe 2.1%) compared with 5.8% (2.2%) in 1983; for senile dementia of Alzheimer type (SDAT) it was 2.8% in 1996 and 2.4% in 1983; for cerebrovascular dementia (CVD), 1.8% in 1996 and 2.8% in 1983. Conclusion:Up to this time, the cases of CVD have been more frequent than those of SDAT in Japan, especially in the urban areas. However, the relationship between CVD and SDAT has now reversed. These data suggest that SDAT is a common condition and that its public health impact will continue to increase with the increasing longevity of the population in Japan. [source] Toward Quantifying the Relative Importance of Invertebrate Consumption and Bioturbation in Puerto Rican StreamsBIOTROPICA, Issue 4 2008Wyatt. ABSTRACT Although many tropical stream consumers have large effects on resource quantity and quality, little is known about the relative importance of consumption versus bioturbation. We quantified egestion rates of freshwater shrimps (Atya spp. and Xiphocaris elongata) and mayflies (Leptophlebiidae) in two forest streams within the Luquillo Experimental Forest, Puerto Rico. Consumer body size was a strong predictor of egestion rates, with mass-specific egestion rates declining with body size and per-individual egestion rates increasing with body size. We used these egestion rates, together with published rates of epilithon removal by consumers and epilithon accrual by particle deposition and periphytic growth (i.e., with and without consumer access), to estimate the importance of consumption and bioturbation after storm events and during base-flow conditions. Our estimates suggest that direct consumption of epilithon can only account for a minor proportion (< 5%) of material removed following storm events, with most removal likely resulting from bioturbation. During base-flow conditions, we found that consumers (largely shrimps) may be capable of consuming a significant proportion of the material that would otherwise accrue on benthic substrata, but this result was limited to one high-elevation site. Our study suggests that bioturbation is the dominant process that redistributes and entrains fine particles after storm events, and that a variable fraction of deposited and accrued benthic material may be consumed during base-flow conditions. Our results underscore the importance of tropical stream animals in altering the benthic environment through both consumption and bioturbation, and suggest that consumer-mediated material cycling is likely to be context dependent. RESUMEN A pesar de que muchos de los consumidores en ríos tropicales tienen grandes efectos en la cantidad y calidad de los recursos, se sabe poco sobre la importancia relativa del consumo y los biodisturbios. Por ello, cuantificamos las tasas de egestión de los camarones (Atya spp. y Xiphocaris elongata) y los efemerópteros (Leptophlebiidae) en dos quebradas dentro del Bosque Experimental de Luquillo, Puerto Rico. El tamaño corporal de los consumidores fue un buen indicador de las tasas de egestión, y las tasas de egestión por masa disminuyeron con el tamaño corporal y las por individuo aumentaron con el tamaño corporal. Usamos estas tasas de egestión, junto con tasa publicadas de remoción de perifiton por los consumidores y acumulación de epiliton por la deposición y el crecimiento de perifiton (ej. con y sin consumidores), para estimar la importancia del consumo y los biodisturbios luego de tormentas y durante condiciones de flujo basal. Nuestros resultados sugieren que el consumo directo de epiliton representa una proporción menor (< 5%) del material removido luego de las tormentas, la mayor parte de la remoción es probablemente el resultado de los biodisturbios. Durante condiciones de flujo basal, encontramos que los consumidores (mayormente camarones) pueden ser capaces de consumir una proporción importante del material que de otra forma se acumularía sobre el substrato béntico, pero este resultado se limita a uno solo de los sitios. Nuestro estudio sugiere que los biodisturbios son el proceso que predomina en la redistribución y mueve partículas luego de las tormentas, y que una fracción variable del material béntico depositado y acumulado puede ser consumida durante condiciones de flujo basal. Nuestros resultados enfatizan la importancia de los animales en alterar el ambiente béntico de los ríos tropicales a través del consumo y los biodisturbios, y sugiere que el reciclaje de los materiales por los consumidores es un proceso que probablemente depende del contexto. [source] | ||||||||||