Bladder Rupture During ECT

We report a case of intraperitoneal bladder rupture during electroconvulsivee therapy. We consider that the likely cause of this complication was powerful abdominal muscle contraction, during an unmodified seizure, on a bladder distended by failure to void urine before treatment and the anticholinergic effects of medication. The literature is reviewed, a similar case is discussed, and we make recommendations for the prevention of this complication.

Emerging issues in AIDS: variant strains of human immunodeficiency virus and its subtypes

The emergence of variant strains of HIV has triggered the need for active local, national, and global surveillance. Some new strains identified in the US cannot be detected reliably with current test kits--a problem with important implications for blood safety and for diagnosis and prevention of AIDS.

The TMJ-ear connection

This article documents the existence of three structures that traverse through the petrotympanic fissure. These structures are the mandibular malleolar ligament, the chorda tympani nerve and the anterior tympanic artery. The mandibular malleolar ligament or the disk-malleolar ligament originates on the anterior process of the mallous. It traverses through the petro-tympanic fissure and attaches to the posterior portion of the capsule and disk of the temporomandibular joint. The chorda tympani nerve supplies sensory feeling to the posterior two thirds of the tongue. The anterior tympanic artery supplies blood to the area of the tympanic membrane. Clinical experience with implants that impinge or cover ear problems and other symptoms. Removal of these implants and placements with devices that do not cover these structures often relieve these symptoms.

Development of alloplastic materials for temporomandibular joint prosthesis: a historical perspective with clinical illustrations

This paper gives the history of the development of alloplastic materials presently used in the temporomandibular joint (TMJ). It discusses the evaluation of TMJ implants, from those being used primarily for ankylosis to the more varied and sophisticated implant designs used today. There is a discussion on the treatment of osteoarthritis with implants and also a discussion on the use of TMJ implants to repair skeletal and dental malrelationships, primarily anterior open bites. Included is a presentation of the latest research by Schellhas et al., which establishes that previously undiagnosed organic disease in the joint proper is a common cause of skeletal and dental malrelationships and that TMJ disease can cause malocclusion.

Tinnitus of TMJ origin: a preliminary report

Twenty patients whose chief complaint was tinnitus were examined. They were not known to have temporomandibular disorders. They did not have pain or dysfunction. They were examined by physicians for ear disorders and the results were considered negative. Each of these patients had a complete history and clinical temporomandibular joint examination. The clinical examination included muscle and joint palpation and stethoscopic examination of the joint. This examination also included selected computerized mandibular scans and electromyographic studies of selected facial muscles. Each subject had eight views of transcranial lateral oblique x-rays taken. It was determined that 19 of these individuals had one or more clinical, electromyographic, and radiographic indications of a temporomandibular disorder. From this study, it appears that individuals who have tinnitus with no apparent otologic basis for this symptom should have a careful evaluation of the temporomandibular apparatus. A temporomandibular disorder may be one of the primary causes of this symptom.

Limited impact of testicular self-examination promotion

Analysis of data obtained through a survey of 415 men in New Orleans, Louisiana, and Rochester, New York, indicates that the transfer of testicular self-examination (TSE) skills from the medical community to the public has been relatively ineffective. Only two of every 100 respondents reported monthly self-examination performed at the correct time and with the proper method. The findings suggest that, until the transfer of self-detection skills is improved, one cannot assess the efficacy of the technology itself. Problems impeding such improvement are reviewed.

Minority health status in New Jersey

The health status of minorities in New Jersey, like that of the nation, continues to lag far behind that of whites. In an effort to address this problem, UMDNJ has established a Minority Health Institute to focus the resources of the state's academic health science center on the problem.

A comparison of graphical nomogram methods with a computerized Bayesian analysis method in the interpretation of serum phenytoin concentrations

A study was performed to compare the predictability of a reported Bayesian graphical method, the drug nomogram used in the Bayesian Computer Method and the Driessen Nomogram with that of a computerized Bayesian analysis method in the interpretation of serum phenytoin concentrations. It was found that the results generated by the graphical method were similar to those of the computer with a mean prediction error of 3.9 mg/day in the dose to achieve a concentration at steady-state of 20 ml/l. Overall the results of the graphical method were less biased and had more precision with a significant improvement in relative precision (P less than 0.01) than the initial estimate or Driessen methods.

HDL-C Concentrations in Weight-Trained, Endurance-Trained, and Sedentary Females

In brief: Serum high-density lipoprotein cholesterol (HDL-C) levels and percent HDL-C were significantly higher in nine female endurance runners than in equal groups of female weight trainers and sedentary female controls. Weight trainers and controls showed no significant differences in HDL-C and percent HDL-C. Subjects who had higher HDL-C levels were more likely to be non-smokers who consumed little alcohol and did not use oral contraceptives. No significant dose-response relationships were found for either runners or weight trainers when daily training duration, weekly training frequency, and weekly mileage were correlated with HDL-C. It was concluded that HDL-C levels in females are associated with specific training methods.

Temporomandibular joint surgery: results of a 14-year joint implant study

This paper analyzes the surgical techniques that are now used in treating organic temporomandibular joint (TMJ) disease. The authors attempt to evaluate the high condylectomy procedure which has been recommended by one group as the only surgical approach. In particular, the authors describe their experiences in using metallic and/or metal and plastic prosthetic devices for repairing damaged joints. The procedure used most frequently is a form of joint resurfacing, although total TMJ replacement is also described. On January 9, 1978, 205 questionnaires were mailed to patients who had undergone TMJ implant surgery. The population surveyed, representing 314 TMJ procedures, were asked to make a subjective overall assessment of the surgical result, and to rate the improvement, elimination, or worsening of each of 22 surgical indications (whenever such indications were applicable to themselves). The survey was done by the Clinical Research Division of a major company in the orthopedic field. The authors did not see the results of the evaluation until they were computed and analyzed by this independent group.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical evaluation of TMJ arthroplasties with insertion of articular eminence prosthesis on ninety patients (an eight year study)

This paper represents an analysis, accomplished over an eight-year period, of 90 individuals who have been operated on for various arthritic diseases of their temporomandibular joints (TMJ). In arthritic changes of the joint, several changes may occur: perforation of the disc, flattening of the articular eminence, asymmetrical condylar movement, and chronic synovitis. This may result in increased synovial pressure on nerve fibers within the capsule of the joint, and a variety of referred pain symptoms. Prior to operation, a careful differential diagnosis was made by an otolaryngologist and, frequently, by a neurologist/neurosurgeon and a psychologist. The prosthesis inserted during surgery was a metallic device which fits over the articular eminence in the upper portion of the joint. This prosthesis accomplished primarily three functions: elimination of the crepitus; restoration of the contour of the eminence; separation of the articular surface of the joint.

Surgical correction of temporomandibular joint arthritis

Restoration of the contour of the articular eminence with a prosthesis has been successful when chronic sublaxation has resulted from flattening of the eminence. Use of a prosthesis is helpful in the treatment of patients with arthritic disease of the temporomandibular joint. A careful differential diagnosis is necessary to eliminate other possible causes of the patient's symptoms.

Jaundice associated with amitriptyline

Reports of serious complications arising from the administration of amitriptyline have been very few, particularly when account is taken of the widespread prescription of this drug in recent years for depressive illness. This is a report of three cases of jaundice, one mild, one fatal, and the third severe, but leading to a good recovery, occurring following the administration of amitriptyline, though in two cases other drugs were being given concurrendy. The makers of amitriptyline do include in their literature a caution about the very occasional link with jaundice, but only two cases have so far been reported (Cunningham, 1965; Biagi and Bapat, 1967). In a recent article (Sherlock, 1968), no specific mention was made of amitriptyline in particular, or of tricyclic antidepressant drugs in general, as liable to produce hepatic disorder.