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1.
Focus (Am Psychiatr Publ) ; 20(2): 252-262, 2022 Apr.
Article in English | MEDLINE | ID: mdl-37153135

ABSTRACT

Objective: Youth suicide rates in the United States have been increasing in recent years, especially in Black Americans, the reasons for which are unclear. Environmental adversity is key in youth suicidality; hence there is a need to study stressors that have a disproportionate impact on Black youths. We aimed to disentangle the unique contribution of racial/ethnic discrimination from other adversities associated with childhood suicidal ideation and attempts (suicidality). Method: We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, which included a large, diverse sample of US children (N = 11,235, mean age 10.9 years, 20.2% Black), assessed for multiple environmental adversities including discrimination. Multivariate regression models tested the association of self-reported racial/ethnic discrimination with suicidality, covarying for multiple confounders including other discrimination types (toward non-US-born individuals, sexual orientation-based, and weight-based). Matched analyses contrasted effects of racial/ethnic discrimination and racial identity on suicidality. Results: Black youths reported more discrimination and higher suicidality rates than non-Black youths. High racial/ethnic discrimination was positively and significantly associated with suicidality, adjusting for other discrimination types (odds ratio = 2.6, 95% CI = 2.1-3.2). Findings remained significant after adjusting for multiple suicidality risk factors. Once experienced, racial/ethnic discrimination was similarly associated with suicidality in White, Black, and Hispanic youths. Matched analyses revealed that racial/ethnic discrimination was associated with suicidality (relative risk = 2.7, 95% CI = 2-3.5), whereas Black race was not (relative risk = 0.9, 95% CI = 0.7-1.2). Conclusion: Racial/ethnic discrimination is disproportionately experienced by Black children, and is associated with preadolescent suicidality, over and above other adversities. Findings highlight the need to address discrimination as part of suicide prevention strategies. Cross-sectional design hampers causal inferences.Reprinted from J Am Acad Child Adolesc Psychiatry, Argabright et al., Association Between Discrimination Stress and Suicidality in Preadolescent Children, S0890-8567(21)01355-1, copyright 2021, with permission from Elsevier.

2.
J Am Acad Child Adolesc Psychiatry ; 61(5): 686-697, 2022 05.
Article in English | MEDLINE | ID: mdl-34425231

ABSTRACT

OBJECTIVE: Youth suicide rates in the United States have been increasing in recent years, especially in Black Americans, the reasons for which are unclear. Environmental adversity is key in youth suicidality; hence there is a need to study stressors that have a disproportionate impact on Black youths. We aimed to disentangle the unique contribution of racial/ethnic discrimination from other adversities associated with childhood suicidal ideation and attempts (suicidality). METHOD: We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, which included a large, diverse sample of US children (N = 11,235, mean age 10.9 years, 20.2% Black), assessed for multiple environmental adversities including discrimination. Multivariate regression models tested the association of self-reported racial/ethnic discrimination with suicidality, covarying for multiple confounders including other discrimination types (toward non-US-born individuals, sexual orientation-based, and weight-based). Matched analyses contrasted effects of racial/ethnic discrimination and racial identity on suicidality. RESULTS: Black youths reported more discrimination and higher suicidality rates than non-Black youths. High racial/ethnic discrimination was positively and significantly associated with suicidality, adjusting for other discrimination types (odds ratio = 2.6, 95% CI = 2.1-3.2). Findings remained significant after adjusting for multiple suicidality risk factors. Once experienced, racial/ethnic discrimination was similarly associated with suicidality in White, Black, and Hispanic youths. Matched analyses revealed that racial/ethnic discrimination was associated with suicidality (relative risk = 2.7, 95% CI = 2-3.5), whereas Black race was not (relative risk = 0.9, 95% CI = 0.7-1.2). CONCLUSION: Racial/ethnic discrimination is disproportionately experienced by Black children, and is associated with preadolescent suicidality, over and above other adversities. Findings highlight the need to address discrimination as part of suicide prevention strategies. Cross-sectional design hampers causal inferences.


Subject(s)
Suicidal Ideation , Suicide , Adolescent , Child , Cross-Sectional Studies , Female , Hispanic or Latino , Humans , Male , Suicide, Attempted/psychology , United States/epidemiology
3.
Braz. j. biol ; 82: 1-9, 2022. ilus, tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1468536

ABSTRACT

Since the classic studies of Alexander Flemming, Penicillium strains have been known as a rich source of antimicrobial substances. Recent studies have identified novel metabolites produced by Penicillium sclerotiorum that have antibacterial, antifouling and pharmaceutical activities. Here, we report the isolation of a P. sclerotiorum (LM 5679) from Amazonian soil and carry out a culture-based study to determine whether it can produce any novel secondary metabolite(s) that are not thus-far reported for this genus. Using a submerged culture system, secondary metabolites were recovered by solvent extract followed by thin-layer chromatography, nuclear magnetic resonance, and mass spectroscopy. One novel secondary metabolite was isolated from P. sclerotiorum (LM 5679); the phenolic compound 5-pentadecyl resorcinol widely known as an antifungal, that is produced by diverse plant species. This metabolite was not reported previously in any Penicillium species and was only found once before in fungi (that time, in a Fusarium). Here, we discuss the known activities of 5-pentadecyl resorcinol in the context of its mode-of-action as a hydrophobic (chaotropicity-mediated) stressor.


Desde os estudos clássicos de Alexander Flemming, as cepas de Penicillium são conhecidas como uma fonte rica em substâncias antimicrobianas. Estudos recentes identificaram novos metabólitos produzidos pela espécie Penicillium sclerotiorum com atividades antibacteriana, anti-incrustante e farmacêutica. Aqui, relatamos o isolamento de uma colônia de P. sclerotiorum (LM 5679) do solo amazônico e relatamos também o estudo baseado em cultura para determinar se ele pode produzir qualquer novo metabólito (s) secundário (s) que não foram relatados até agora para este gênero. Usando um sistema de cultura submerso, os metabólitos secundários foram recuperados por extrato de solvente seguido por cromatografia em camada delgada, ressonância magnética nuclear e espectroscopia de massa. Um novo metabólito secundário foi isolado de P. sclerotiorum (LM 5679); o composto fenólico 5-pentadecil resorcinol que é amplamente conhecido como um antifúngico que é produzido por diversas espécies de plantas. Este metabólito não foi relatado anteriormente em nenhuma espécie de Penicillium, e foi encontrado apenas uma vez em fungos (Fusarium). Aqui, discutimos as atividades conhecidas do 5-pentadecil resorcinol no contexto de seu modo de ação como um estressor hidrofóbico (mediado pela caotropicidade).


Subject(s)
Antifungal Agents/isolation & purification , Phenolic Compounds/analysis , Penicillium/chemistry , Fusarium
4.
Braz. j. biol ; 822022.
Article in English | LILACS-Express | LILACS, VETINDEX | ID: biblio-1468723

ABSTRACT

Abstract Since the classic studies of Alexander Flemming, Penicillium strains have been known as a rich source of antimicrobial substances. Recent studies have identified novel metabolites produced by Penicillium sclerotiorum that have antibacterial, antifouling and pharmaceutical activities. Here, we report the isolation of a P. sclerotiorum (LM 5679) from Amazonian soil and carry out a culture-based study to determine whether it can produce any novel secondary metabolite(s) that are not thus-far reported for this genus. Using a submerged culture system, secondary metabolites were recovered by solvent extract followed by thin-layer chromatography, nuclear magnetic resonance, and mass spectroscopy. One novel secondary metabolite was isolated from P. sclerotiorum (LM 5679); the phenolic compound 5-pentadecyl resorcinol widely known as an antifungal, that is produced by diverse plant species. This metabolite was not reported previously in any Penicillium species and was only found once before in fungi (that time, in a Fusarium). Here, we discuss the known activities of 5-pentadecyl resorcinol in the context of its mode-of-action as a hydrophobic (chaotropicity-mediated) stressor.


Resumo Desde os estudos clássicos de Alexander Flemming, as cepas de Penicillium são conhecidas como uma fonte rica em substâncias antimicrobianas. Estudos recentes identificaram novos metabólitos produzidos pela espécie Penicillium sclerotiorum com atividades antibacteriana, anti-incrustante e farmacêutica. Aqui, relatamos o isolamento de uma colônia de P. sclerotiorum (LM 5679) do solo amazônico e relatamos também o estudo baseado em cultura para determinar se ele pode produzir qualquer novo metabólito (s) secundário (s) que não foram relatados até agora para este gênero. Usando um sistema de cultura submerso, os metabólitos secundários foram recuperados por extrato de solvente seguido por cromatografia em camada delgada, ressonância magnética nuclear e espectroscopia de massa. Um novo metabólito secundário foi isolado de P. sclerotiorum (LM 5679); o composto fenólico 5-pentadecil resorcinol que é amplamente conhecido como um antifúngico que é produzido por diversas espécies de plantas. Este metabólito não foi relatado anteriormente em nenhuma espécie de Penicillium, e foi encontrado apenas uma vez em fungos (Fusarium). Aqui, discutimos as atividades conhecidas do 5-pentadecil resorcinol no contexto de seu modo de ação como um estressor hidrofóbico (mediado pela caotropicidade).

5.
Braz. j. biol ; 82: e241863, 2022. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1278488

ABSTRACT

Since the classic studies of Alexander Flemming, Penicillium strains have been known as a rich source of antimicrobial substances. Recent studies have identified novel metabolites produced by Penicillium sclerotiorum that have antibacterial, antifouling and pharmaceutical activities. Here, we report the isolation of a P. sclerotiorum (LM 5679) from Amazonian soil and carry out a culture-based study to determine whether it can produce any novel secondary metabolite(s) that are not thus-far reported for this genus. Using a submerged culture system, secondary metabolites were recovered by solvent extract followed by thin-layer chromatography, nuclear magnetic resonance, and mass spectroscopy. One novel secondary metabolite was isolated from P. sclerotiorum (LM 5679); the phenolic compound 5-pentadecyl resorcinol widely known as an antifungal, that is produced by diverse plant species. This metabolite was not reported previously in any Penicillium species and was only found once before in fungi (that time, in a Fusarium). Here, we discuss the known activities of 5-pentadecyl resorcinol in the context of its mode-of-action as a hydrophobic (chaotropicity-mediated) stressor.


Desde os estudos clássicos de Alexander Flemming, as cepas de Penicillium são conhecidas como uma fonte rica em substâncias antimicrobianas. Estudos recentes identificaram novos metabólitos produzidos pela espécie Penicillium sclerotiorum com atividades antibacteriana, anti-incrustante e farmacêutica. Aqui, relatamos o isolamento de uma colônia de P. sclerotiorum (LM 5679) do solo amazônico e relatamos também o estudo baseado em cultura para determinar se ele pode produzir qualquer novo metabólito (s) secundário (s) que não foram relatados até agora para este gênero. Usando um sistema de cultura submerso, os metabólitos secundários foram recuperados por extrato de solvente seguido por cromatografia em camada delgada, ressonância magnética nuclear e espectroscopia de massa. Um novo metabólito secundário foi isolado de P. sclerotiorum (LM 5679); o composto fenólico 5-pentadecil resorcinol que é amplamente conhecido como um antifúngico que é produzido por diversas espécies de plantas. Este metabólito não foi relatado anteriormente em nenhuma espécie de Penicillium, e foi encontrado apenas uma vez em fungos (Fusarium). Aqui, discutimos as atividades conhecidas do 5-pentadecil resorcinol no contexto de seu modo de ação como um estressor hidrofóbico (mediado pela caotropicidade).


Subject(s)
Penicillium , Resorcinols , Anti-Bacterial Agents , Antifungal Agents
6.
Braz J Biol ; 82: e241863, 2021.
Article in English | MEDLINE | ID: mdl-34133562

ABSTRACT

Since the classic studies of Alexander Flemming, Penicillium strains have been known as a rich source of antimicrobial substances. Recent studies have identified novel metabolites produced by Penicillium sclerotiorum that have antibacterial, antifouling and pharmaceutical activities. Here, we report the isolation of a P. sclerotiorum (LM 5679) from Amazonian soil and carry out a culture-based study to determine whether it can produce any novel secondary metabolite(s) that are not thus-far reported for this genus. Using a submerged culture system, secondary metabolites were recovered by solvent extract followed by thin-layer chromatography, nuclear magnetic resonance, and mass spectroscopy. One novel secondary metabolite was isolated from P. sclerotiorum (LM 5679); the phenolic compound 5-pentadecyl resorcinol widely known as an antifungal, that is produced by diverse plant species. This metabolite was not reported previously in any Penicillium species and was only found once before in fungi (that time, in a Fusarium). Here, we discuss the known activities of 5-pentadecyl resorcinol in the context of its mode-of-action as a hydrophobic (chaotropicity-mediated) stressor.


Subject(s)
Penicillium , Anti-Bacterial Agents , Antifungal Agents , Resorcinols
8.
JMIR Res Protoc ; 8(1): e10681, 2019 01 31.
Article in English | MEDLINE | ID: mdl-30702434

ABSTRACT

BACKGROUND: In the United States, disparities in the rates of HIV care among youth and young adults result from the intersections of factors that include stigma, substance use, homelessness or marginal housing, institutional neglect, and mental health issues. Novel interventions are needed that are geared to youth and young adults. OBJECTIVE: In this paper, we aim to describe the interventions used by participating sites for Using Social Media initiative, the process for classifying the intervention components, and the methods for conducting a comprehensive evaluation of the interventions. METHODS: In 2015, the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau, Special Projects of National Significance (SPNS) funded the Evaluation and Technical Assistance Center (ETAC) at the University of California, Los Angeles and 10 demonstration projects at sites across the United States that incorporated innovative approaches using a variety of social media and mobile technology strategies designed specifically for youth and young adults living with HIV. The ETAC developed a typology, or a classification system, that systematically summarizes the principal components of the interventions into broader groups and developed a multisite, mixed-methods approach to evaluate them based on the Department of Health and Human Services HIV health outcomes along the HIV care continuum. The mixed-methods approach is key to remove potential biases in assessing the effectiveness of demonstration projects. RESULTS: This SPNS project was funded in September 2015, and enrollment was completed on May 31, 2018. A total of 984 participants have been enrolled in the multisite evaluation. Data collection will continue until August 2019. However, data analysis is currently underway, and the first results are expected to be submitted for publication in 2019. CONCLUSIONS: This HRSA-funded initiative seeks to increase engagement in HIV medical care, improve health outcomes for people living with HIV, and reduce HIV-related health disparities and health inequities that affect HIV-positive youth and young adults. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/10681.

9.
Proc Biol Sci ; 285(1874)2018 03 14.
Article in English | MEDLINE | ID: mdl-29514973

ABSTRACT

The distribution of parasites across mammalian hosts is complex and represents a differential ability or opportunity to infect different host species. Here, we take a macroecological approach to investigate factors influencing why some parasites show a tendency to infect species widely distributed in the host phylogeny (phylogenetic generalism) while others infect only closely related hosts. Using a database on over 1400 parasite species that have been documented to infect up to 69 terrestrial mammal host species, we characterize the phylogenetic generalism of parasites using standard effect sizes for three metrics: mean pairwise phylogenetic distance (PD), maximum PD and phylogenetic aggregation. We identify a trend towards phylogenetic specialism, though statistically host relatedness is most often equivalent to that expected from a random sample of host species. Bacteria and arthropod parasites are typically the most generalist, viruses and helminths exhibit intermediate generalism, and protozoa are on average the most specialist. While viruses and helminths have similar mean pairwise PD on average, the viruses exhibit higher variation as a group. Close-contact transmission is the transmission mode most associated with specialism. Most parasites exhibiting phylogenetic aggregation (associating with discrete groups of species dispersed across the host phylogeny) are helminths and viruses.


Subject(s)
Host Specificity , Host-Parasite Interactions , Mammals/parasitology , Animals , Phylogeny , Species Specificity
10.
Qual Health Res ; 21(5): 587-600, 2011 May.
Article in English | MEDLINE | ID: mdl-21266706

ABSTRACT

High rates of empowerment, HIV-related knowledge, and condom use among sex workers in Sonagachi, India have been attributed to a community-led intervention called the Sonagachi HIV/AIDS Intervention Program (SHIP). In this research we examined the crucial role of brothels in the success of the intervention. In-depth, semistructured interviews were conducted with 55 participants of SHIP. The results indicate that brothels help sex workers reduce HIV risk by (a) serving as targeted sites for SHIP's HIV intervention efforts, (b) being operated by madams (women managers of brothels) who participate in SHIP's intervention efforts and promote healthy regimes, (c) structuring the economic transactions and sexual performances related to sex work, thus standardizing sex-related behavior, and (d) promoting community empowerment among brothel residents. Implications of these results are discussed for future efforts to replicate SHIP's success in other sex work communities.


Subject(s)
Condoms/statistics & numerical data , HIV Infections/prevention & control , Risk-Taking , Sex Work/statistics & numerical data , Female , HIV Infections/epidemiology , HIV Infections/transmission , Health Knowledge, Attitudes, Practice , Health Surveys , Humans , India/epidemiology , Motivation , Power, Psychological , Residence Characteristics , Risk Assessment , Risk Reduction Behavior , Sex Work/psychology , Sexuality/psychology , Sexuality/statistics & numerical data , Women's Health
11.
AIDS Behav ; 13(3): 573-81, 2009 Jun.
Article in English | MEDLINE | ID: mdl-19184394

ABSTRACT

This study examines organizational, provider, client, and test-event level predictors of HIV partner notification (PN) discussion and agreements based on providers' most recent HIV-positive post-test counseling session. Staff (n = 621) were sampled from for-profit, nonprofit, and county government HIV testing organizations (N = 159) in Los Angeles County from 2003 to 2007. Among providers who conducted an HIV-positive post-test counseling session (n = 204), 65% discussed PN but only 10% had confirmed agreement to provider-involved PN (PIPN). In multi-level regression analyses PN discussion was predicted by provider HIV-test training and knowledge, and patients requesting a test while presenting HIV/AIDS symptoms. The strongest predictor of PIPN agreement was public health HIV testing settings followed by counseling by program managers or infectious disease specialists across settings. None of the injecting drug users or patients presenting with AIDS, but not requesting a test, agreed to PIPN. Organizational and provider-level interventions on PN will be needed to realize cost-effective benefits of expanded HIV testing and counseling.


Subject(s)
Contact Tracing/methods , Counseling/methods , HIV Infections/prevention & control , Health Knowledge, Attitudes, Practice , Adult , Attitude of Health Personnel , Female , Forecasting , HIV Infections/psychology , HIV Infections/transmission , Humans , Male , Middle Aged , Regression Analysis , Serologic Tests/psychology , Sexual Partners/psychology
12.
Behav Brain Res ; 173(1): 1-10, 2006 Oct 02.
Article in English | MEDLINE | ID: mdl-16828177

ABSTRACT

Dichlorodiphenyltrichloroethane (DDT) is a persistent organochlorine compound found worldwide that causes significant anatomical, physiological and behavioural abnormalities in humans and wildlife. However, little is known about whether environmental exposure to DDT affects the brain. Here, we show that environmental exposure to DDT alters the brains of American Robins (Turdus migratorius) in several ways. Increasing levels of DDT resulted in: (i) smaller brain and relative forebrain volumes; (ii) a reduction in the size of two song nuclei, nucleus robustus arcopallialis (RA) and HVC; and (iii) a drastic reduction in neuronal size and overall volume of nucleus intercollicularis (ICo), a structure that is critical for normal sexual behaviour. These changes likely result from stress, direct neurotoxicity and androgen receptor antagonism by the primary metabolite of DDT, p,p'-DDE and this is corroborated by analyses of brain region volumes and p,p'-DDE levels. Our results therefore demonstrate that environmental exposure to DDT is correlated with significant changes in the brain and specifically those structures related to mating and song. Given the magnitude of these changes in the brain and the fact that environmental DDT exposure was restricted to early development, we conclude that both humans and wildlife that live in DDT contaminated environments may be at risk of neurological damage.


Subject(s)
DDT/toxicity , Environmental Exposure , Environmental Pollutants/toxicity , Prosencephalon/drug effects , Sexual Behavior, Animal/drug effects , Vocalization, Animal/drug effects , Animals , DDT/analysis , Environmental Pollutants/analysis , Female , Insecticides/analysis , Insecticides/pharmacology , Male , Organ Size , Ovum/chemistry , Ovum/drug effects , Prosencephalon/anatomy & histology , Sex Factors , Songbirds , Telencephalon/anatomy & histology , Telencephalon/drug effects
13.
Am J Health Behav ; 27(4): 389-400, 2003.
Article in English | MEDLINE | ID: mdl-12882433

ABSTRACT

OBJECTIVE: To examine HAART use. METHODS: HIV+ youth, aged 14-29 (n=253; 71% male; 74% ethnic minority), were recruited in Los Angeles, San Francisco, and New York. RESULTS: Almost all youth had been offered HAART (84%); 77% had ever used it, 54% were currently using, and 63% of users adhered to 90% of their medications. Compared to non-users, users were more likely to be female, Latino or African American. Users were also more likely to have the following: AIDS, positive coping styles, social support, and a high quality of life. Users were less likely to: do jail time, perform sexual-risk acts, and use substances. CONCLUSIONS: HIV+ youth self-select to use HAART.


Subject(s)
Antiretroviral Therapy, Highly Active/statistics & numerical data , HIV Infections/drug therapy , Patient Acceptance of Health Care/statistics & numerical data , Adolescent , Adult , Female , HIV Infections/ethnology , Health Status Indicators , Humans , Los Angeles , Male , Minority Groups , New York City , Patient Acceptance of Health Care/ethnology , Quality of Life , San Francisco , Sexual Behavior/ethnology , Sexual Behavior/statistics & numerical data , Social Support , Stress, Psychological , Substance-Related Disorders/ethnology
15.
Anal Chem ; 68(13): 2031-7, 1996 Jul 01.
Article in English | MEDLINE | ID: mdl-21619292

ABSTRACT

Large signal-to-background (S/B) ratios for the Fe(CN)(6)(3)(-)(/4)(-) and IrCl(6)(2)(-)(/3)(-) redox couples in KCl have been observed in cyclic voltammetric measurements made at a conductive diamond thin-film electrode without any conventional surface pretreatment. The S/B ratios were a factor of ∼16 and 8 larger at diamond than at freshly polished glassy carbon (GC) for Fe(CN)(6)(3)(-)(/4)(-) and IrCl(6)(2)(-)(/3)(-), respectively. The polycrystalline diamond film, grown on a p-Si(100) substrate, possessed significant cubic {100} faceting, as evidenced by AFM images, and was of high quality, as indicated by Raman spectroscopy. The high degree of electrochemical activity without surface pretreatment, the enhanced S/B ratios, and the excellent response stability demonstrate that diamond might be an attractive new electrode material for electroanalysis.

16.
17.
Phys Rev B Condens Matter ; 49(2): 796-801, 1994 Jan 01.
Article in English | MEDLINE | ID: mdl-10010380
19.
J Natl Med Assoc ; 78(3): 193-9, 1986 Mar.
Article in English | MEDLINE | ID: mdl-3712458

ABSTRACT

Intraoperative radiotherapy (IOR) is a relatively new modality for the treatment of carcinoma. This modality necessitates a multidisciplinary approach among the surgeon, anesthesiologist, radiotherapist, pathologist, and other members of the surgical support team. In addition to appropriate IOR and surgical techniques, the role of the anesthesiologist is crucial in determining patient outcome. Specifically, the degree of preoperative preparation has a direct correlation with a successful postoperative course. Patients considered for surgery are grouped in terms of: (1) primary tumor with no metastasis and/or unresectable loco-regional disease; (2) clinical and investigational evidence of tumor with no proven malignancy; and (3) those with known metastasis but in otherwise good general condition.The primary surgical goal is to localize the tumor, obtain a frozen-section biopsy, and evaluate for resectability at the same time as the radiotherapist evaluates whether IOR is indicated. Thus many facets come together to make the IOR procedures feasible and safe. The 148 patients treated at Howard University Hospital, uneventfully, should serve to justify intraoperative radiotherapy as both a practical and safe tool in the treatment of malignancy.


Subject(s)
Anesthesia/methods , Intraoperative Care/methods , Neoplasms/therapy , Radiotherapy/methods , Humans , Life Support Systems , Monitoring, Physiologic/methods
20.
Isr J Med Sci ; 16(4): 318-22, 1980 Apr.
Article in English | MEDLINE | ID: mdl-7390784

ABSTRACT

A review of skeletal traction compared with femoral shortening in treatment of older patients with congenital dislocation of the hip clearly favors femoral shortening. During the period 1952-74, 30 hips in 22 patients (average age, 6 6/12 years) were treated with skeletal traction, and during 1971-77, 17 hips in 12 patients (average age, 6 8/12 years) were treated with femoral shortening. In those treated with skeletal traction, avascular necrosis developed in 57%; redislocation or subluxation in 30%; an X-ray rating (Severin) of poor in 43%; and the incidence of pin and skin complications was 27%. The average follow-up was 11 1/2 years. In the group treated with femoral shortening, there were no cases of avascular necrosis and none with a poor rating on X-ray. The average follow-up was three years and seven months and it was never less than one year. Complications included one refracture at the osteotomy site six weeks after surgery, one late resubluxation, and two redislocations (early in the series prior to routine use of Steinmann pin fixation). The redislocations were easily reduced. Acceptable leg length inequality was present in all unilateral cases except in one 12-year-old patient who required a contralateral epiphysiodesis. One patient with late subluxation had open reduction and acetabuloplasty.


Subject(s)
Femur/surgery , Hip Dislocation, Congenital/surgery , Traction , Bone Nails , Child , Child, Preschool , Female , Femur/diagnostic imaging , Follow-Up Studies , Hip Dislocation, Congenital/diagnostic imaging , Humans , Leg Length Inequality/etiology , Methods , Postoperative Complications , Radiography
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