An Unusual fracture dislocation pattern in a patient with an os lunatotriquetrum.

Lunatotriquentral fusions are fairly uncommon. An unusual fracture dislocation pattern from a severe wrist injury in the presence of a congenital os lunatotriquetrum is presented. The authors suggest anomolous carpal mechanics secondary to the carpal coalition as the reason for the unusual fracture pattern. Restoration of the pre-injury carpal orientation and internal fixation yielded a satisfactory result.

The radial sensory nerve. An anatomic study.

The superficial branch of the radial nerve was dissected using loupe magnification in 20 cadaver forearms. The nerve was found to arise between the tendons of the branchioradialis and extensor carpi radialis longus 8.6 cm proximal to the radial styloid, piercing the forearm fascia 6.0 cm from the radial styloid. An average of 5.8 branches crossed the wrist joint. Innervation to the dorsum of the digits was variable, with 45% of specimens innervating the radial 2 1/2 digits and 30% innervating the radial 3 1/2 digits. Sixteen specimens had branches directly overlying the typical transverse incision for De Quervain's release and 12 specimens had branches directly overlying the 3-4 wrist arthroscopy portal. An appreciation for the location of the superficial radial nerve in the forearm, the variation of its digital innervation, and the proximity of branches to commonly used surgical incisions is important when performing surgical procedures over the dorsum of the hand and wrist.

Sex of interviewer, place of interview, and responses of homosexual men to sensitive questions.

Effects of sex of interviewer and place of interview on the responses of 57 AIDS patients and 145 other homosexual men were studied. Data on sensitive topics were collected by five male and three female medical officers at places convenient to respondents. Male physicians recorded fellatio more frequently, but female physicians recorded younger ages of initiating homosexual activities and more frequent use of certain recreational drugs. These differences apparently were due to different patterns of sexual contact and drug use in four cities. Patients with AIDS tended to be interviewed in hospitals and doctors' offices, other men tended to be interviewed in hotel rooms, and patients tended to be different from other men. After adjustments were made for confounding, sex of interviewer and place of interview seemed to have little influence on the answers obtained.

Cluster of cases of the acquired immune deficiency syndrome. Patients linked by sexual contact.

The possibility that homosexual men with the acquired immune deficiency syndrome (AIDS) had been sexual partners of each other was studied. Of the first 19 homosexual male AIDS patients reported from southern California, names of sexual partners were obtained for 13. Nine of the 13 patients had sexual contact with one or more AIDS patients within five years of the onset of symptoms. Four of the patients from southern California had contact with a non-Californian AIDS patient, who was also the sexual partner of four AIDS patients from New York City. Ultimately, 40 patients in 10 cities were linked by sexual contact. On the basis of six pairs of patients, a mean latency period of 10.5 months (range seven to 14 months) is estimated between sexual contact and symptom onset. The finding of a cluster of AIDS patients linked by sexual contact is consistent with the hypothesis that AIDS is caused by an infectious agent.

Lack of significant person-to-person spread of swine influenza-like virus following fatal infection in an immunocompromised child.

In February 1982, a four-year-old Nevada girl with acute lymphoblastic leukemia in remission was hospitalized with fulminant pneumonia and died eight days later at a hospital in California. An influenza virus was the only pathogen detected, and was present in both antemortem and postmortem specimens. The virus was closely related antigenically to A/New Jersey/8/76 (H1N1) and had a genome very similar to a contemporary enzootic swine influenza virus. The patient had had no known contact with swine, and the source of infection could not be determined. Only five possible secondary cases could be detected by retrospective investigation of 62 contacts, and there was no evidence of spread to the general community. Swine influenza viruses circulate among pigs in the United States annually, and it is likely that sporadic transmissions to humans will continue to be detected. Nevertheless, person-to-person spread under these circumstances appears to be limited.

National case-control study of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men: Part 1. Epidemiologic results.

To identify risk factors for the occurrence of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men, we conducted a case-control study in New York City, San Francisco, Los Angeles, and Atlanta. Fifty patients (cases) (39 with Kaposi's sarcoma, 8 with pneumocystis pneumonia, and 3 with both) and 120 matched homosexual male controls (from sexually transmitted disease clinics and private medical practices) participated in the study. The variable most strongly associated with illness was a larger number of male sex partners per year (median, 61 for patients; 27 and 25 for clinic and private practice controls, respectively). Compared with controls, cases were also more likely to have been exposed to feces during sex, have had syphilis and non-B hepatitis, have been treated for enteric parasites, and have used various illicit substances. Certain aspects of a lifestyle shared by a subgroup of the male homosexual population are associated with an increased risk of Kaposi's sarcoma and pneumocystis pneumonia.