Emergencies: What are they and do they influence bystanders to intervene?

Empirical literature does not seem to be available on what factors bystanders use to define an emergency nor the effect of such a decision on the rate of helping. A series of 4 studies, employing 1,232 undergraduates, sought to answer these questions. Results show the following: (a) Emergencies are a subclass of problem situation that usually result from accidents. (b) There is a high degree of agreement concerning what problem situations are definitely emergencies. (c) Emergency situations are differentiated from other problem situations by threat of harm or actual harm worsening with time, unavailability of an easy solution to the problem, and necessity of obtaining outside help to solve the problem. (d) Disagreement on whether a problem situation is an emergency or not results from differing perceptions of the degree to which threat of harm or actual harm worsens with time. (e) Bystanders are more likely to help in emergency than in nonemergency problem situations. Results indicate that the need of the victim is a salient feature used by bystanders in determining whether or not to help. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Increased incidence of alcohol-related deaths from accidents and violence in subjects with ankylosing spondylitis

Subjects with ankylosing spondylitis (AS) have an increased incidence of deaths from accidents and violence, which is due in part, but perhaps not entirely, to the vulnerability of the affected spine to fractures. The present study covered all the 71 subjects (58 men and 13 women) who had died in Finland in 1989 and who were entitled under the nationwide sickness insurance scheme to receive specially reimbursed medication for AS. The death certificates of an earlier cohort study dealing with mortality in AS were also re-examined. Sixteen subjects (14 men and two women) in the 1989 mortality series had died of accidents and violence. Nine of the deaths (three accidents, two suicides and four alcohol poisonings) were alcohol related. The relative risk of such deaths in subjects with AS compared to the Finnish population as a whole was 2.64 (95% confidence interval 1.44-4.84). In the cohort study, 16 deaths had been due to accidents and violence, the expected number being 11.4. Eight of the 16 deaths had been alcohol related. Uncontrolled use of alcohol is an important determinant in the surplus of deaths from accidents and violence in Finnish patients with AS.     

Augmentation techniques: are they out?

Basics of ligament augmentation are reviewed from the literature. As biomechanical in-vitro studies, animal experiments, and clinical studies show different designs and data, the results may be interpreted variably. Theoretically there is a positive effect of augmentation, but no significant improvement of clinical results is evident. The goal of our own prospective study was to check the healing capacity of a repaired and augmented ACL with respect to stability compared to a primary or secondary BTB ligament replacement with and without augmentation. 200 patients were allocated to 4 groups. In group I (G1) acute proximal ruptures were repaired arthroscopically and augmented with PDS II-cord. Patients in G2 received an acute and in G3 a late BTB ligament replacement. Additionally in G4 a late ligament replacement was augmented with a PDS II-cord. The clinical results reveal a comparative stability between G1 and G2, and gradually less stability in G3 and G4. Subjectively, knee function was felt best in G1 and G2 while being worst in G3 and G4. There is no significant difference in the mobility of knees between primary and secondary ligament replacement. An additional augmentation doesn't improve the knee stability. CLINICAL RELEVANCE: There is no positive effect of an augmentation technique of a biologic ligament replacement concerning stability, morbidity, complication rate, and costs. Very marginal freshly ruptured cruciate ligaments may be reinserted successfully by a biodegradable augmentation. Subjective feeling and functional stability may be at least equal to a primary ligament replacement. There are no advantages in knee mobility, when a secondary ligament replacement is performed.     

Annexins: what are they good for?

Annexins comprise a unique family of calcium- and phospholipid-binding proteins. At least one of the twenty members thus far described from this family can be found expressed in nearly every eukaryotic cell type. As common as these proteins may be, no one clear function for all has been established. Historically, individual members of this family have been given various names describing their ability to associate with a host of intra- and extracellular proteins and with cellular lipid membranes. The collection of reviews in this issue of CMLS represents an effort to offer a coordinated view of the research activities in the field and to extract structural and functional commonalities.     

Anxiety sensitivity and depression: How are they related?

Anxiety sensitivity is the fear of anxiety-related bodily sensations, which arises from beliefs that the sensations have harmful somatic, psychological, or social consequences. Elevated anxiety sensitivity, as assessed by the Anxiety Sensitivity Index (ASI), is associated with panic disorder. The present study investigated the relationship between anxiety sensitivity and depression. Participants were people with panic disorder (n?=?52 ), major depression (n?=?46), or both (n?=?37 ). Mean ASI scores of each group were elevated, compared to published norms. Principal components analysis revealed 3 factors of anxiety sensitivity: (a) fear of publicly observable symptoms, (b) fear of loss of cognitive control, and (c) fear of bodily sensations. Factors 1 and 3 were correlated with anxiety-related measures but not with depression-related measures. Conversely, factor 2 was correlated with depression related measures but not with anxiety-related measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Autopsies in children: are they still useful?

BACKGROUND: Juvenile chronic arthritis (JCA) is the commonest autoimmune rheumatic disease in childhood and presents different clinical subtypes. Juvenile chronic arthritis is considered to be of a polygenic nature and its genetic background is still under investigation. The clinical profile of JCA in the Greek population has not been studied completely. This study retrospectively analyzed the clinical and immunological features of JCA in Greek children presented between 1989 and 1994. Human leukocyte antigen (HLA)-positive or -negative associations in the different clinical subtypes were also detected. The findings of this study were correlated with those reported from other populations. METHODS AND RESULTS: Antinuclear antibodies (ANA) anti-ds DNA and anti-extractable nuclear antigen antibodies were estimated by immunofluorescent and ELISA assays. Human leukocyte antigen typing was performed by microlymphocytotoxicity, using immunobeads. The peak ages of JCA onset were between 2 and 5 years and also between 9 and 12 years. There was a high female predominance in pauciarticular and polyarticular groups. The most common disease was pauciarticular (58.7%) followed by systemic (25%) arthritis. The incidence of eye involvement was 12.5% and presented only in the pauciarticular group. Overall, ANA positivity was 53.7%, increasing to 90% in pauciarticular cases associated with chronic uveitis. In the early onset (EOPA) pauciarticular subtype, positive-HLA associations with alleles DR11 and DR8 were shown. In the late onset pauciarticular (LOPA) group only B27 allele was increased. CONCLUSIONS: The results of this retrospective study did not reveal major differences between JCA in Greek children compared with other Caucasian series.     

Handwriting posture and cerebral organization: How are they related?

Since J. Levy and M. Reid (see PA, Vols 57:5149 and 61:12570) first reported an association between handwriting posture and cerebral lateralization, a number of studies related to this issue have appeared in the literature. There is currently a great deal of controversy regarding the nature of the association between handwriting posture and brain organization. It is argued that this controversy loses much of its force when clinical data regarding functional lateralization in left-handers are taken into account. The relevant background on brain organization in left-handers, Levy and Reid's findings and studies related to their findings, and Levy and Reid's speculations with respect to possible interpretations of their data and research bearing on those speculations are reviewed and discussed. (2 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Benign breast surgical biopsies: are they always justified?

The actions of peptidic toxins that work as Ca2+-channel antagonists were investigated on neostriatal glutamatergic transmission. Both intracellularly recorded excitatory postsynaptic potentials (EPSPs) and extracellularly recorded population spikes (PS) evoked by afferent stimulation were evaluated in the presence of 10 microM bicuculline. Percentage of block (mean +/- SEM; n = 4) for these events (EPSP and PS, respectively) was: omega-AgTxIVA (100-200 nM): 35 +/- 2 and 54 +/- 4%; omega-CgTxGVIA (1 microM): 37 +/- 3 and 63 +/- 6%; omega-CgTxMVIIC (500 nM): 40 +/- 4 and 50 +/- 2%; and calciseptine (500 nM): 5 +/- 4 and 9 +/- 6%. When given together, toxins had additive effects. The calciseptine effects were nonsignificant. The toxins were also tested on Ca2+-dependent random synaptic responses induced by 100 microM 4-AP. Each toxin reduced the frequency of spontaneous EPSPs by more than 60% (n = 2). The summed actions of individual toxins yields more than 100% block (superadditivity); suggesting that several terminals may possess more than one channel type. The reduction in frequency was not accompanied by a reduction in amplitude confirming that toxins' actions were presynaptic. It is concluded that at least three different Ca2+-channel subtypes are involved in glutamate release in neostriatal afferents: N-type, P/Q-type, and a type resistant to the toxins used. The L-type Ca2+-channel had little, if any, participation.     

Differential asymmetries for recognizing nouns and verbs: Where are they?

To support categorical representation in the brain for grammatical class, it is necessary to show that noun-verb differences are attributable to parts of speech and not to covarying semantic factors. Prior visual-half field investigations of noun-verb processing have confounded grammatical class with imageability. The current study included numerous tests of differential noun-verb processing across visual fields for stimuli equated for imageability. Task (lexical decision, pronunciation) and list context (blocked vs. mixed lists) variables were examined in 168 right-handed participants. There was no reliable reduction of the right visual field advantage for moderately imageable nouns as compared with verbs. If there are qualitative hemisphere differences in single-word noun and verb recognition, these may be attributable to semantic dimensions that tend to covary with grammatical class. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Infant and child mortality determinants in Bangladesh: are they changing?

From the data of the 1989 Bangladesh Fertility Survey, aggregate deaths reported at ages 0-12 and 13-60 months are used to estimate infant and child mortality. Multivariate analysis shows that preceding birth interval length, followed by survival status of the immediately preceding child, are the most important factors associated with differential infant and child mortality risks; sex of the index child and mother's and father's education are also significant. Demographic factors are influential during infancy as well as childhood, but social factors, particularly mother's and father's education, now emerge as significant predictors of infant mortality risks. This indicates a change in the role of socioeconomic factors, since the earlier Bangladesh Fertility Survey in 1975.     

Tropical vaginal hydroceles: are they all filarial in origin?

Hydrocele of the tunica vaginalis testis has been conventionally used as an absolute indicator of filarial disease in most clinical surveys. The prevalence of filarial etiology in 100 consecutive hydroceles was studied using clinical, parasitological, histopathological and immunological parameters. Filarial etiology could be proved in 57% of hydrocele cases using major criteria: presence of microfilaria in hydrocele fluid, presence of chyle in hydrocele fluid, demonstration of adult worm in tunica, ratio of fluid antibody titer to serum antibody titer more than 2 and presence of filarial antigen in hydrocele fluid. The results of other tests in these 57 cases were used to define the minor criteria. In the other 43 cases, based on the minor criteria, 12 hydroceles could be classified as likely to be due to filariasis and the rest were probably non-filarial. Thus only 69% of hydroceles were definitely or probably filarial.     

Health maintenance organizations: are they for the inner cities?

Health Maintenance Organizations present some major limitations as a means to address the health care needs in our nation's inner cities. The HMO as it has been affected by HMO legislation is discussed and an identification made of those areas that may adversely affect the delivery of health services to inner-city residents where costs may be greatest for those who can least afford it.