Procedure for the systematic orientation of digitised cranial models. Design and validation.

Comparison of bony pieces requires that they are oriented systematically to ensure that homologous regions are compared. Few orientation methods are highly accurate; this is particularly true for methods applied to three-dimensional models obtained by surface scanning, a technique whose special features make it a powerful tool in forensic contexts. The aim of this study was to develop and evaluate a systematic, assisted orientation method for aligning three-dimensional cranial models relative to the Frankfurt Plane, which would be produce accurate orientations independent of operator and anthropological expertise. The study sample comprised four crania of known age and sex. All the crania were scanned and reconstructed using an Eva Artec™ portable 3D surface scanner and subsequently, the position of certain characteristic landmarks were determined by three different operators using the Rhinoceros 3D surface modelling software. Intra-observer analysis showed a tendency for orientation to be more accurate when using the assisted method than when using conventional manual orientation. Inter-observer analysis showed that experienced evaluators achieve results at least as accurate if not more accurate using the assisted method than those obtained using manual orientation; while inexperienced evaluators achieved more accurate orientation using the assisted method. The method tested is a an innovative system capable of providing very precise, systematic and automatised spatial orientations of virtual cranial models relative to standardised anatomical planes independent of the operator and operator experience.

Vascular dementia. A clinicopathological study.

We have reviewed the clinical and pathological records of 40 aged patients who showed only vascular lesions on histological examination. They were followed up for 3.5 +/- 6.3 years before death, and in 28 cases the diagnosis of dementia was done during life. Demographic data, vascular and systemic illnesses, psychiatric neurological and neuropsychological disturbances, and pathological findings were compared between demented and non-demented patients. The number of strokes, several neurological and almost all neuropsychological disturbances, the volume of macroscopic cerebral infarct, especially in frontal, occipital and basal regions, the lacunar state and the white matter lesions, were significantly greater in demented patients. However most of them had less than 100 ml3 of brain infarct. The relative influence of each type of cerebral vascular lesion upon the dementia syndrome was determined by means of multivariate analysis. The volume of macroscopic cerebral infarct, the white matter lesion and the lacunar state showed quite similar contributions to mental deterioration.

[Assessment of the promotion component in the postpartum/postabortion program]. / Evaluación del componente de promoción en el programa postparto/postaborto.

PIP: To study the low acceptance rate of contraception, the authors investigated the postpartum postabortum program of family planning in 8 hospitals run by the Mexican Ministry of Health. During 1 week all patients, 502 women who were leaving the hospital were interviewed; the personnel in charge of family planning were also interviewed. The number of acceptors leaving the hospital went from 1% of patients in Hermosillo to 47% in the General Hospital, a rate of acceptance much lower than that observed with other programs. Sociocultural characteristics of patients were very similar in all hospitals, and acceptance of IUDs was much greater than acceptance of the pill. In all hospitals, promotion of contraception consisted of a talk given to groups of patients and never to individuals; in most hospitals there were no other possibilities to receive contraceptive information. Most patients, either before or after the talk, still equated family planning with better education for children and better social conditions for the family; very few mentioned the health of mothers and children. 4% of patients did not know what contraceptives were available at the hospital even after the talk; many patients stated that the type of presentation and the vocabulary used were too difficult. Only 4% left the hospital with an adequate knowledge of both oral contraception and the IUD. Duration of the talk went from 7-39 minutes, depending on the hospital. The personnel delivering the talk were not specifically prepared for that purpose, and many times failed to answer questions or to expound on important aspects of contraception, such as side effects or contraindications. No teaching materials were available and even the meeting rooms were inadequate. It is obvious that postabortum postpartum programs of family planning should be restructured and reorganized, personnel should be trained, patients should receive individual attention, husbands should be encouraged to participate, and simple, inexpensive teaching materials, such as slides and prints, should be made available.^ieng