Heart failure and echocardiographic changes during long-term follow-up of patients with sick sinus syndrome randomized to single-chamber atrial or ventricular pacing

OBJECTIVE: In the present study, physical and sexual abuse among incarcerated youth were examined with respect to sexual activity, contraceptive use, and pregnancy. METHOD: The self-report survey data were collected from 62 females and 334 males who were incarcerated in Nevada youth correctional facilities in the summer of 1994. Of the males, 46.8% (n = 156) reported a history of physical abuse and 9.9% (n = 33) reported sexual abuse. A surprisingly high 73% (n = 46) of the females reported a history of physical abuse and 68.3% (n = 43) reported sexual abuse. RESULTS: The analyses indicated that females who reported a history of sexual abuse had an earlier mean age of first intercourse than those who reported no sexual abuse. In addition, male and female respondents with a history of physical and/or sexual abuse reported using no method of contraception as compared to youth with no history of abuse. CONCLUSIONS: Implications of these results for detention-based counseling and prevention programming are discussed.     

Cost-effectiveness of transaxillary muscle-sparing same-day operative closure of patent ductus arteriosus

Transaxillary muscle-sparing patent ductus arteriosus closure performed as same-day surgery is described in 10 patients. This approach provides a superb cosmetic result while obviating the need for thoracostomy tube placement.     

Cholecysto-duodenal fistula. A cause of severe gastrointestinal hemorrhage

A unique case of haematemesis due to a pyloroduodenal ulcer caused by an erosion by a 3 cm gallstone impacted in the duodenal bulb is presented. This is the first case where the localisation of a severe haemorrhage due to a complication of a duodenal biliary fistula is identified.     

Transdural spinal cord herniation: imaging and clinical spectra

OBJECTIVE: Many diseases induce asymmetric delays in the visual pathway, resulting in a spontaneous Pulfrich phenomenon (PP). The PP is a visual stereoillusion that may cause difficulties in persons when traveling in cars, crossing the road, or playing ball games. The authors developed and tested a simple new bedside procedure to detect PP. DESIGN: A case series. PARTICIPANTS: Disease simulation in 2 normal subjects and 18 patients with optic neuritis (ON) was examined. Ninety normal subjects were studied to determine normal range of PP. INTERVENTION: The new test, called swinging pen test (SPT), is performed by oscillating a pen by hand. The SPT was compared to a gold standard, a mechanical pendulum (MP). MAIN OUTCOME MEASURES: The authors measured simulated PP in two normal subjects and PP in 18 patients with ON and 90 normal control subjects. The Pearson product-moment correlation (r) and the Spearman rank correlation (rs) between SPT and MP were calculated. RESULTS: The magnitudes of simulated PP determined with the SPT and the MP correlated well (r = 0.92, P < 0.005, and r = 0.96, P < 0.001). Correlation also was good in patients with ON (rs = 0.90, P < 0.05). The positive predictive value of the SPT was 100%, and the negative predictive value was 92%. The PP was absent in all control subjects testing with either pendulum. The normal range for PP varied from -1.40 to 1.52 msec. For the SPT, the intraobserver variability coefficient was 8.2%, and the interobserver variability coefficient was 10.5%. CONCLUSIONS: The authors believe that SPT will be of value to clinicians on bedside evaluation of motion stereopsis dysfunctions. The normal range of PP was approximately +/- -1.5 msec (approximately +/- -1.5 cm), corresponding to a 0.3-log unit neutral density filter).