Psychiatric symptomatology associated with contemporary peacekeeping: an examination of post-mission functioning among peacekeepers in Somalia.

Contemporary peacekeepers frequently confront complex stressors including the need to directly enforce peace between warring factions, to deliver humanitarian aid in the midst of political-social devastation, and to balance shifting rules of engagement. As such, it is proposed that participants may be at increased risk for the development of psychiatric distress. The present study examined the types of stressors encountered by 3,461 peacekeepers in Somalia, their current psychiatric functioning as measured by the Brief Symptom Inventory, and the relationship between exposure to various stressors and adjustment. Over one third of participants met criteria for psychiatric caseness. The most commonly reported symptoms included hostility, psychoticism, depression, and paranoid ideation. The best predictors of current functioning were found to be exposure to traditional war-zone-related stressors and general military pride and cohesion. These findings highlight the mental health consequences that service in a peacekeeping mission may have for United States solidiers. Further research is needed to investigate potential mechanisms that could serve as buffers to the stress associated with peacekeeping service.

Increases in retrospective accounts of war-zone exposure over time: the role of PTSD symptom severity.

Retrospective reports of the frequency of war-zone exposure are commonly used as objective indices in studies investigating the mental health consequences of exposure to such stressors. To explore the temporal stability of these types of reports, we obtained frequency estimates of exposure to war-zone stressors at two time points from 460 U.S. soldiers who had served in the peace-keeping mission in Somalia. On average; soldiers demonstrated a significant increase in their frequency reports from initial (postdeployment) to subsequent (follow-up) assessment. Severity of posttraumatic symptomatology was uniquely associated with this change, indicating a possible systematic bias in which severity of symptoms leads to increased reports of stressor frequency. The implications of these findings for research in the field of traumatic stress are discussed.

Prognostic value of the pattern electroretinogram in cases of tumors affecting the optic pathway.

BACKGROUND: Tumors compressing the optic pathway may lead to irreversible loss of vision which may be detected by the pattern electroretinogram (PERG) because of its relation to ganglion cell function. METHODS: Eyes of 19 patients were tested shortly before and 5-10 days after tumor surgery. Visual acuity, the 30-deg visual field and the transient and steady-state pattern reversal ERG were measured. RESULTS: Using patterns of 1.5 x 1.2 deg there was a good correlation between the change of pre- and post-surgical visual performance and most of the pattern ERG amplitudes. For all variables tested--P50, N95- and steady-state amplitude--there was a critical value beyond which the visual outcome could be bad or favorable, whereas patients showing higher amplitudes always remained stable or improved after surgery. CONCLUSION: The positive correlation between pattern ERG amplitudes and the post-surgical outcome in the case of tumors affecting the optic pathway may be helpful in predicting the outcome for these patients.

Posttraumatic stress disorder associated with peacekeeping duty in Somalia for U.S. military personnel.

OBJECTIVE: The end of the Cold War has marked a period when the U.S. military is asked to secure peace under conditions in which peace is tenuous, yet the need for resolution of the conflict is great. Combat-trained soldiers are highly visible and are exposed to threats to their lives, yet are asked to exhibit restraint and neutrality. The psychiatric consequences of peace-keeping duty under these conflicting and volatile conditions have been underresearched. The authors examined the prevalence of posttraumatic stress disorder (PTSD) associated with exposure to peacekeeping duty in Somalia. METHOD: A large cohort of active duty personnel deployed to Somalia (N = 3,461) were surveyed approximately 5 months after their return to the United States. A variety of military service characteristics and exposure variables and PTSD symptoms were examined. RESULTS: Eight percent of peacekeepers were found to meet diagnostic criteria for PTSD. PTSD symptom severity was best predicted by the rewards of military service, war zone stress, and frustrations with peacekeeping (e.g., restrictive rules of engagement). CONCLUSIONS: It is likely that the mission in Somalia represents a new paradigm of dangerous military operations for the United States. These data suggest that peacekeeping may be difficult to reconcile for some combat-trained soldiers and can create a risk for PTSD.

["Oligocone" trichromasy, a rare form of incomplete achromatopsia]. / Die "Oligocone"-Trichromasie, eine Sonderform der inkompletten Achromatopsie.

PATIENTS AND METHODS: An 11-year-old girl presented because of reduced visual acuity while color vision was almost normal. Besides a general ophthalmological examination, special psychophysical tests, such as perimetry, color vision tests using pseudoisochromatic plates, arrangement tests, the Nagel anomaloscope and spectral sensitivity measurement, and electrophysiological tests (electroretinogram and electrooculogram) were conducted. RESULTS: The tests yielded the following: congenital nystagm, normal results at ophthalmoscopy, best visual acuity of 0.1 monocular and 0.2 binocular. Perimetry revealed a relatively central scotoma. All color vision tests showed only mild dysfunction of the blue-sensitive cones. Findings at photopic electroretinogram were almost completely lacking. There was no sign of progression in the last 6 years. CONCLUSION: Differential diagnosis includes all diseases associated with congenital nystagm, such as aniridia, diseases of the optic nerve, albinism and all forms of hereditary cone dysfunction, cone dystrophies and complete and incomplete congenital stationary monochromatism. In the present case the findings are most congruent with oligocone trichromasy.

[Epidermoid cyst of the testis]. / Epidermoidzyste des Hodens.

A very rare case of epidermoid cyst of the testis is being reported; the tumor was enucleated and the testicle preserved after evaluating the patient's history, clinical and especially ultrasonographic data. The literature is also being reviewed.

[Endemic goiter in Austria's youth?]. / Gibt es noch eine Kropfendemie bei Osterreichs Jugend?

After 17 years the efficiency of iodine prophylaxis of endemic goiter (1 : 100000) in Austria was checked by control field studies in 3 Tyrolean towns n Austria. The data obtained there were compared with those of 123 school age children from the iodine deficient endemic goiter area of the province of Bolzano (Italy). The results show a reduction in goiter incidence from 50 to 35% in the total population in Austria, where goiter incidence in schoolchildren dropped from 45.9% to 12%. Urinary iodine/g creatinine was 65 micrograms in Austria, the 24 hr radioiodine uptake with 41.8% was normal. In comparison the ethnologically and geographically similar endemic goiter zone in the province of Bolzano showed a goiter incidence in schoolchildren of up to 46%, while urinary iodine/g creatinine was 35.9 micrograms and radioiodine uptake after 24 hr about 50%. Extensive studies of peripheral hormone parameters (T4, TBG, T3, TSH, rT3, FT3, FT4) revealed a significantly higher rT3 concentration of 24.7 ng/dl in Austria compared with a value of only 19.8 ng/dl in the province of Bolzano. These facts suggest an increased conversion of T4 to real T3 in iodine deficiency, which might contribute to the adaptation of the organism to this condition. No statement, however, can be presented regarding the regulation of this phenomenon. Even as endemic goiter is decreasing in Austria, an increase of salt iodization to 1 : 50000 according to the swiss procedure might eliminate definitely endemic goiter in Austria.

[The radiological diagnosis of bronchial atresia (author's transl)]. / Die Röntgendiagnostik der Bronchusatresie.

Congenital atresia of the apico-dorsal segmental bronchus of the left upper lobe in a 10-year-old boy is described. The radiological features of bronchial atresia are described in detail and the view is expressed that the diagnosis can be made on plain films of the chest with tomography. According to present day concepts, treatment is not indicated in the absence of symptoms.