The defendant in a medical malpractice suit: an integral part of the defense team

This article explains the litigation process of a medical malpractice suit and offers suggestions to help pediatric radiologists cope with the stress of being sued. It provides tangible ways in which the pediatric radiologist can become an important part of the defense team. Our goal is to enable the pediatric radiologist to place the lawsuit in a proper perspective and demonstrate the importance of providing medical insight to aid in forming legal strategy.     

Prevalence of male pattern hair loss in 18-49 year old men

BACKGROUND: Previous studies investigating the prevalence of male pattern hair loss (MPHL) typically used biased samples of men recruited from clinical populations which may limit generalizability of findings to broader populations. OBJECTIVE: To obtain an updated and improved estimate of the occurrence of MPHL in healthy men residing in the community. METHODS: Community-based sample of healthy men aged 18-49 years participated in a study investigating the effects of MPHL. Participants completed a brief questionnaire self reporting degree of hair loss, general health-related quality of life (HRQL) and hair-loss-specific measures. A trained observer also rated each participant using standardized classification for MPHL. RESULTS: The proportion of men with moderate to extensive hair loss (type III or greater) was 42%. The proportion of men with moderate to extensive hair loss increased with increasing age, ranging from 16% for men 18-29 years of age to 53% of men 40-49. Twelve percent of the men were classified as having predominantly frontal baldness (type A variants). CONCLUSIONS: MPHL, especially frontal baldness, may be more common than previously reported.     

An isopavine alkaloid from Thalictrum minus

A new alkaloid, isothalisopavine, was isolated from Thalictrum minus and shown to be 2,3,8-trimethoxy-7-hydroxyisopavine from spectral evidence. The known thalisopavine, from T. dasycarpum, is 2,3,8-trimethoxy-9-hydroxyisopavine. Isothalisopavine is the first of its class to be substituted unsymmetrically in the two aromatic rings.     

Wavelength dependence of skin cancer induction by ultraviolet irradiation of albino hairless mice

BACKGROUND: Because of the inverse relation between dietary fish consumption and coronary heart disease and because of the importance of serum homocysteine as an independent risk factor for atherosclerosis, the effect of fish oil on serum homocysteine was studied in hyperlipemic men. METHODS: Fifteen men with either type IIa or IIb lipoproteinemia or hypertriglyceridemia were maintained on a controlled, balanced diet and given either fish oil or olive oil supplements, 12 g/d for 3 weeks, followed by a cross-over period of 3 weeks during which the olive oil or fish oil supplements were given in reverse order. Serum homocysteine was determined by liquid chromatography of acid hydrolyzates of whole serum. RESULTS: Fish oil was found to diminish serum homocysteine levels in 14 of 17 subjects (P < 0.01). Serum homocysteine was 48% +/- 33% less than control values in seven of nine patients and 36% +/- 22% less than values in seven of eight subjects who had first received olive oil. There was no effect of olive oil supplements on serum homocysteine, compared with control values, but olive oil produced an increase in serum homocysteine in those who had first received fish oil. Serum triglycerides and very low-density lipoprotein were decreased by fish oil in patients who were first given olive oil, in agreement with previous studies. There was no effect of either fish oil or olive oil on total cholesterol, apolipoprotein B, low-density lipoprotein, or high-density lipoprotein. CONCLUSIONS: The protection against coronary heart disease afforded by a diet rich in fish may be attributed to the lowering of serum homocysteine levels by the n-3 polyunsaturated fatty acids of fish oils.     

Clinical experience of automated peritoneal dialysis

For uremic patients on continuous ambulatory peritoneal dialysis who are complicated with peritonitis, hernia or burn out of meticulous procedure, automated peritoneal dialysis (APD) is a new alternative therapy. We started our APD program by continuous cyclic peritoneal dialysis (CCPD) method from October, 1991 and this study included 3 CAPD patients. Our studies showed high dose CCPD was better than CAPD in ultrafiltration and urea clearance with similar weekly creatinine clearance and weekly KT/V urea. During the one year treatment course, there was no signs of fluid overload. We performed once to twice day time exchange by low volume dialysate (1500-1600ml) There was no events of abdomen discomfort due to increase intraabdominal pressure or recurrent hernia in susceptible patient. The decrease in day time exchange frequency obviously reduced patients'loading. One patient changed to high dose CCPD due to underdialysis after stand CCPD therapy. Two patients returned to hemodialysis due to severe peritonitis and technique method, but careful assessment of dialysis adequacy with PET test and KT/V evaluation is mandatory.     

The effect of heteropolysaccharide‐producing strains of Streptococcus thermophilus on the texture and organoleptic properties of low‐fat yoghurt

Heteropolysaccharide‐producing Streptococcus thermophilus strains (LY03, ST 111, or 5077) were compared with nonropy S. thermophilus strains (NR or 5137), in respect of texture development of low‐fat yoghurt produced at 42°C. Whether milk solids were added or not, lower syneresis and improved texture and sensory properties were obtained in yoghurts produced with S. thermophilus LY03 or S. thermophilus 5077 compared with nonropy strains. Texture effects, lower syneresis and improved sensory properties because of the use S. thermophilus ST 111 were only noticeable in the presence of milk solids. Milk solids had no significant effect on the textural parameters of nonropy strains.     

Physicochemical characterisation of calcium phosphates prepared from milk ultrafiltrates: Effect of the mineral composition

This study deals with the precipitation of calcium phosphate in permeates removed from milks at different pH (6.7, 5.2 and 4.6). An overall high yield of precipitation of calcium and phosphate (70–80%, respectively) was obtained for all precipitates with Ca/P molar ratios close to 1.5. The suspended milk‐derived calcium phosphate (MDCP) precipitates had 8–14 μm size and ?14 to ?28 mV zeta potential. The dried MDCP precipitates were identified as amorphous calcium phosphate (ACP), stable over 18 months of storage at room temperature.     

Mycobacterium avium subsp. paratuberculosis survival during fermentation of soured milk products detected by culture and quantitative real time PCR methods

Mycobacterium avium paratuberculosis (MAP), etiological agent of paratuberculosis in ruminants, is able to survive extreme conditions like very low pH (stomach), high temperature (pasteurization) or low temperature (refrigerated storage). Cheese, infant powder milk, cream and other milk and dairy products might thus be considered as possible sources of MAP for humans. The aim of this study was to investigate the survival of two MAP field isolates during fermentation of three different types of soured milk products (SMP; yogurt, acidophilus milk and kefir) under laboratory conditions. Pasteurized MAP-free milk was artificially contaminated with 10(6)MAPcells/mL and survival and absolute numbers of MAP were monitored during fermentation (4 or 16 h) and after six weeks of storage at 4°C by culture and quantitative real time PCR (qPCR). Viability of MAP was determined by culture using Herrold's egg yolk medium and Middlebrook 7H10 with antibiotics, supplemented with Mycobactin J and incubated at 37°C for up to 12 weeks. The absolute numbers of MAP were quantified by previously published qPCR assays targeting F57 and IS900 loci in MAP genome. We herein confirm that MAP can survive pH reduction, however, longer exposure to pH below 4 in SMP seems to be critical because it inhibits growth. Therefore, it is suggested that probiotic cultures that can decrease pH below 4 during fermentation could provide better inactivation of MAP in SMP.