A systematic review of the therapeutic interventions for heterotopic ossification after spinal cord injury.

STUDY DESIGN: Systematic review. OBJECTIVE: To conduct a systematic review of the effectiveness of interventions used to prevent and treat heterotopic ossification (HO) after spinal cord injury (SCI). SETTING: St Joseph's Parkwood Hospital, London, Ontario, Canada. METHODS: MEDLINE, CINAHL, EMBASE and PsycINFO databases were searched for articles addressing the treatment of HO after SCI. Studies were selected by two reviewers and were only included for analysis if at least 50% of the subjects had an SCI, there were at least three SCI subjects and if the study subjects participated in a treatment or intervention. Study quality was assessed by two independent reviewers using the Downs and Black evaluation tool for all studies, as well as the PEDro assessment scale for randomized control trials only. Levels of evidence were assigned using a modified Sackett scale. RESULTS: A total of 13 studies met the inclusion criteria. The selected articles were divided into prevention or treatment of post-SCI HO. Nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin, and pulse low-intensity electrogmagnetic field (PLIMF) therapy were reviewed as prophylactic measures. Bisphosphonates, radiotherapy and excision were reviewed as treatments of post-SCI HO. CONCLUSIONS: Pharmacological treatments of HO after SCI had the highest level of research evidence supporting their use. Of these, NSAIDs showed greatest efficacy in the prevention of HO when administered early after an SCI, whereas bisphosphonates were the intervention with strongest supportive evidence once HO had developed. Of the non-pharmacological interventions, PLIMF was supported by the highest level of evidence; however, more research is needed to fully understand its role.

Longitudinal tracking and retention in a school-based study on adolescent smoking: costs, variables, and smoking status.

Methods used to track a cohort of Grade 6 students through Grades 8 and 11, and costs involved for survey completion in school and by mail for ever and never smokers from the original group are detailed. At baseline, 1,598 students in Scarborough, Canada, completed a questionnaire on smoking, drinking, and health, and again in Grade 8 (N = 1,543/1,598) and Grade 11 (N = 1,454/1,598). In Grades 8 and 11, tracking and administering the questionnaire was more costly per participant when the survey was administered by mail than in school. Average completion costs were highest for Grade 11 students who used tobacco at baseline ($52.44). Students categorized as ever smokers in Grade 6 were harder to locate at each phase of testing, which suggests that this group should be identified at baseline so that closer tracking procedures may be employed between data collection points.

Penile responses of rapists and nonrapists to rape stimuli involving physical violence or humiliation.

The sexual arousal profile of a subgroup of rapists with a history of low-level physical violence during their offenses was assessed. Twenty subjects participated: 10 rapists and 10 nonrapists. Stimuli consisted of audiotapes with the following five thematic contents: mutually consenting sexual activities; rape involving physical violence; rape involving humiliation; physical aggression without sexual activities; neutral. Penile responses were recorded during stimuli presentation using a mercury-in-rubber strain gauge. Data showed no differences between both groups for the rape stimuli involving physical violence. For the rape stimuli involving humiliation, however, the penile responses of the two groups differed. With those stimuli the average penile response of the rapists was higher than that of the nonrapists. Therefore, for this subgroup of rapists the association between sexual activities and humiliation presents a higher erotic value than the association between sexual activities and physical violence. Implication of these results as to the discriminant validity and classificatory accuracy of phallometry in rapists is discussed.

Sexual preference assessment of sexual aggressors: predictors of penile response magnitude.

A current method used to assess the sexual preference of sexual aggressors is the recording of their penile responses during the presentation of erotic stimuli. This method is ineffective in subjects who do not obtain sufficient penile responses. Whether variables related either to the subjects or their crimes would correlate with the magnitude of penile responses during sexual preference assessment was studied. The penile responses of 92 subjects were recorded. Older and pre-sentencing subjects showed a lower maximum penile response magnitude than younger and sentenced subjects. Results are discussed as they relate to the validity of physiological assessment of sexual preference.

[An inventory for the evaluation of dangerousness in mental patients]. / Un inventaire pour l'évaluation de la dangerosité des patients psychiatriques.

The authors of the article propose an inventory for the systematic assessment of the dangerousness of psychiatric patients. This clinical tool is qualitative and is helpful in a case-by-case approach. The prediction of violent behaviour is discussed; quantitative and qualitative research perspectives are also mentioned.

Genetic regulation of lipopolysaccharide-induced interleukin 1 production by murine peritoneal macrophages.

The production of IL 1 by LPS-stimulated peritoneal macrophages from inbred mouse strains was studied. Macrophages from A/J (A) mice were deficient in IL 1 production, when compared with high IL 1-producing strains, including C57BL/6J (B). The difference between A and B macrophages was maintained over a wide LPS concentration range and throughout a 72-hr incubation period. Because of these differences, it was possible to investigate the mechanisms regulating IL 1 production by applying techniques of genetic analysis by using recombinant inbred (RI) strains derived from the A and B progenitors. A strain distribution pattern (SDP) of IL 1 production (low/high response) was obtained with the use of 15 AXB/BXA RI strains. This suggested the presence of a major gene locus controlling the production of IL 1 in response to LPS stimulation, with allelic differences presumably resulting in deficient or efficient IL 1 production. In addition, there appeared to be one or more other loci involved in determining the magnitude of the IL 1 response to LPS in the responder mice. The IL 1 response did not appear to be linked to the major histocompatibility complex, since B10.A mice (which share the same H-2a haplotype as A/J) were efficient IL 1 producers. There did not appear to be any correlation between the degree of IL 1 production and the magnitude of the peritoneal macrophage inflammatory response, or between IL 1 production and LPS responsiveness (as determined by splenocyte proliferation). SDP analysis also indicated that the IL 1 response was not linked to macrophage tumoricidal activity. A comparison of the SDP for IL 1 production with a library of SDP for other known genetic waits suggested linkage with at least four loci on chromosome 1.