Second to fourth digit ratio confirms aggressive tendencies in patients with boxers fractures.

BACKGROUND: Upper limb second to fourth digit ratio (2D:4D) has been shown to be dependent on prenatal androgen exposure. A longer relative fourth digit to second digit is indicative of increased intrauterine testosterone exposure prenatally and the converse is also true for oestrogen exposure. The 2D:4D ratio has implications in the sporting, academic, financial and sexual arenas. The purpose of this study was to examine the association between smaller finger length ratios (2D:4D) and boxers fractures, in both men and women, by comparing the 2D:4D ratios in 150 boxers fractures and comparing them to matched controls. Boxers fractures are an injury classically incurred during acts of aggression and we postulated that this cohort of patients would have a smaller 2D:4D ratio in comparison to the normal population mean ratio. METHODS: One hundred and fifty radiographs from patients with boxers fractures secondary to aggressive actions were analysed and the 2D:4D ratio was calculated. A further 150 X-rays from patients not involved in aggressive activities were used as a control group and the 2D:4D ratio was calculated in the same manner. We then performed statistical analysis to compare the 2D:4D ratios between our two groups. RESULTS: As predicted, the 2D:4D in males was smaller than females in all of the groups. However, our results showed that those presenting with a boxers fracture due to an aggression related injury had a statistically significant smaller 2D:4D ratio when compared to the normal population. CONCLUSION: Boxers fractures are injuries that typically occur from an aggressive act. It is well documented that a low 2D:4D ratio is reflective of an increased prenatal exposure to androgens, particularly testosterone. We have shown that boxers fractures are associated with a smaller 2D:4D ratio than the normal population, thus suggesting that persons exposed to high levels of prenatal androgens are more likely to exhibit aggressive tendencies in adulthood. Our results suggest that smaller digit ratios may predict a predisposition to acts of aggression, and as such result in an increased likelihood of sustaining an injury such as a boxers fracture. This relationship seems to be present independently of gender.

Random urine calcium/osmolality in the assessment of calciuria in children with decreased muscle mass.

BACKGROUND: Random urine Ca/creatinine (UCa/Cr) is used to estimate 24-hour Ca excretion. However, due to decreased urine creatinine excretion in children with decreased muscle mass (DMM), UCa/Cr overestimates their Ca excretion. OBJECTIVE: To evaluate whether in children with DMM random urine Ca/osmolality (UCa/Osm) can accurately predict hypercalciuria (24-hour urine Ca > 4.0 mg/kg) and at which "cutoff" value. METHODS: 19 children with DMM and 29 with normal muscle mass (NMM), ages 6 - 17 years, were studied. DMM was diagnosed based on clinical findings and decreased serum creatinine, and confirmed by low urine creatinine excretion. Over 24 hours, subjects collected each void separately. After each sample was analyzed, samples of each participant were combined to form a 24-hour specimen from which an aliquot (AL) was obtained; 24-hour urine Ca was first correlated with the corresponding AL Ca/Cr and Ca/Osm. As an internal control, a similar assessment ofproteinuria was conducted. In the next step, AL data were compared with individual urine samples to identify the time of day when a random sample best correlates with AL. RESULTS: The correlation coefficient between 24-hour Ca and AL Ca/Cr in all children was 0.61, in NMM 0.96, and in DMM 0.69 (in all p < 0.001). The correlation coefficient between 24-hour urine Ca and AL Ca/Osm in all children was 0.90, in NMM 0.90, and in DMM 0.91 (in all p < 0.001). In children with DMM, the correlation coefficient of 24-hour protein with AL protein/Cr was 0.75, and with protein/Osm 0.98 (both p < 0.001). Receiver operating characteristic curves showed UCa/Cr as a better predictor of 24-hour Ca > 4.0 mg/kg in NMM, whereas UCa/Osm was a better predictor of hypercalciuria in DMM patients. In NMM, UCa/Cr ratio > 0.20 had sensitivity of 88% and specificity of 96% in detecting 24-hour Ca > 4.0 mg/kg, whereas in those with DMM UCa/Osm (x 10) ratio of > 0.25 had sensitivity of 100% and specificity of 93% in detecting hypercalciuria. It was further found that random urine specimens collected between 9:00 a.m. and 2:00 p.m. best represented 24-hour urine data. CONCLUSION: In children with DMM, UCa/Osm can successfully replace UCa/Cr as a screening tool for hypercalciuria.

The problem of seeing hospital staff without G.P. referral--the otolaryngological experience.

Over a three month period, a record was kept of the number of hospital staff who approached the E.N.T. team requesting help for a medical problem. Staff members included doctors, nurses, clerical staff, paramedical staff and porters. The total number of employees in the hospital was recorded. The average General practitioner public patient list (General medical Service cardholders) for South Dublin was recorded (our hospital is in south west Dublin). The total number of hospital staff seen by E.N.T. in 3 months was seventy seven. The total number of hospital staff seen by other surgical specialties was approximately one hundred and sixty seven. Extrapolation of numbers seen by E.N.T. service in three months to numbers seen over a one year period is 308 patients. The numbers seen by the E.N.T. service in three months corresponds to 11.7% of the average South Dublin General Practitioner Medical card list. It has been estimated that approximately 20% of all problems the average General practitioner sees in a week are E.N.T. related. Those practices with a smaller paediatric population would have approximately 15% of the total practice concearned with E.N.T. problems. Therefore as 15% of 2,400 (total hospital staff) = 360, there is potentially a small General Practice which is 'hidden' within the hospital.

The relationship of rural persons' multidimensional health locus of control to knowledge of cancer, cancer myths, and cancer danger signs.

The purpose of the study was to determine if a relationship exists between multidimensional health locus of control and knowledge of breast cancer, prostate cancer, cancer myths, and danger signs. A descriptive correlational design was used. A convenience sample of 78 rural men and 79 rural women participated in the study. Participants completed three questionnaires: (a) the Cancer Danger Signs Questionnaire, (b) the Cancer Myths Questionnaire, (c) the Prostate Cancer Knowledge Test (completed by the men) and the Breast Cancer Knowledge Test (completed by the women). Results indicated that an internal score on the Multidimensional Health Locus of Control (MHLOC) scale did not predict knowledge of breast cancer in women, prostate cancer in men, cancer myths, or danger signs. Women who scored high on the Powerful Others subscale of the MHLOC had statistically significant high scores on knowledge of breast cancer, but not on cancer myths and danger signs. The MHLOC and its subscales did not predict knowledge of prostate cancer, cancer myths, or cancer danger signs for the male participants. The implications of these results for rural nursing practice and their relationship to previous research are discussed.

Studies on growth, development, and infectivity of Philophthalmus hegeneri Penner and Fried 1963 in the chick.

A reinvestigation of the growth curve of Philophthalmus hegeneri in chicks showed rapid growth for the first 17 days after infection. After this, the growth rate declined for multiple infections (two or more worms per eye), and after 20 days, adults in monometacercarial infections ceased appreciable growth and never attained reproductive maturity. These results are similar to those reported by Fried (1962), but here adults were approximately 0.5 mm shorter in all cases and were slower in producing mature eggs. When worms from 28 to 36 days old from monometacercarial infections were transplanted into multiple infections, normal growth occurred. Worms recovered from multiple infections and transplanted singly grew normally for at least 18 days but recovery rates were extremely low. When P. hegeneri adults over 20 days old from monometacercarial infections were transplanted singly with Philophthalmus megalurus adults, growth was not stimulated in either species.