[Instability after operative and conservative treatment of isolated Mason type II fractures]. / Instabilität nach operativer und konservativer Versorgung von isolierten Mason-II-Frakturen.

BACKGROUND: Radial head fractures are the most frequent fractures of the elbow joint in adults. For Mason type II fractures without concomitant injuries favorable results have been shown with operative and conservative management. There is insufficient evidence concerning elbow joint stability after conservative treatment compared to open reduction and internal fixation (ORIF). MATERIALS AND METHODS: All patients with isolated Mason type II (two part fracture displaced >2 mm and <5 mm) radial head fractures between 1 January 2003 and 1 April 2013 were retrospectively reviewed. Exclusion criteria were age <18 years, associated fractures of the ipsilateral extremity or elbow luxation. A total of 50 patients (mean age 44.2 years, range 19-71 years) who received either ORIF (n = 31) or conservative treatment (n = 19) were included. The mean follow-up was 43.2 months (range 9-61 months). Patients were evaluated using the Disability of the Arm, Shoulder and Hand (DASH) score, Mayo Elbow Performance score (MEPS), and Oxford Elbow score (OES). Joint stability (varus and valgus stress) was assessed under fluoroscopy and a distinction was made between slight instability (angulation <10°), moderate instability (angulation ≥10°) and gross instability (elbow dislocation). RESULTS: Residual fracture displacement (conservative: 2.7 mm, ORIF: 1.4 mm, p < 0.042) and varus/valgus joint stability (3% ORIF vs. 26% conservative, p = 0.031) showed significant differences. The stability as tested by a radiological dynamic procedure showed an instability after ORIF in 3% of the joints compared to 26% after conservative treatment; however, this did not influence the short to mid-term clinical outcome: No significant differences were found in the DASH score (conservative 33 points, ORIF 36 points), MEPS (conservative 76 points, ORIF 78 points) and OES (conservative 41 points, ORIF 43 points). DISCUSSION: Both conservative management and operative treatment had a good functional outcome. Operative treatment showed a positive tendency concerning radiological and functional outcome without statistical significance.

Bioaccumulation and related effects of PCBs and organochlorinated pesticides in freshwater fish Hypostomus commersoni.

Few studies have investigated the bioaccumulation of persistent organic pollutants (POPs) in Brazilian native freshwater fish. In order to evaluate the bioavailability, potential risk to human exposure and the effects of POPs in the fish Hypostomus commersoni, muscle and liver samples of thirteen specimens were collected in a lake located in the city of Ponta Grossa (Parana State, Southern Brazil). Also, the liver and gills were considered for histopathological studies, and oxidative stress was investigated in the liver. Expressive concentrations of POPs were observed in the liver and muscle, with a total of 427 ± 78.7 and 69.2 ± 18.1 ng g(-1) dry weights of polychlorinated biphenyls (PCBs), respectively. Negative correlations between the concentration of several POPs and glutathione S-transferase and glucose-6-phosphate dehydrogenase were found. Otherwise, the cholinesterase activity in the muscle and brain presented positive correlations with the concentration of POPs. The hepatic bioaccumulation of some banned pesticides like aldrin, dieldrin and DDT was associated with various histopathological findings in the liver and gills. Necrotic areas, fibrosis, leukocyte infiltration, and the absence of macrophage centers were observed in the liver, indicating both chronic exposure and immunological suppression. Neoplasic changes were observed in the gills, confirming the carcinogenic potential reported for some of the investigated pollutants. The current work was the first to study the bioaccumulation of POPs in H. commersoni, an important species in ecological aspects and as a vehicle to human exposure to PCBs and organochlorine pesticides (OCPs).

What voices can do with words: pragmatics of verbal hallucinations.

BACKGROUND: In this paper we consider verbal hallucinations as inner speech with pragmatics. The specific pragmatic properties of verbal hallucinations investigated included the number of voices, the characteristics that individuate the voices, the sequential characteristics of the dialogues between voice hearers and their voices, the dialogical positioning of voices hearers, voices and other individuals, and how the voices influence voice hearers' activities. METHODS: These properties were examined in structured interviews with 28 individuals, 14 of whom had a diagnosis of schizophrenia, while 14 were students who did not use psychiatric services. RESULTS: The analysis showed that voices were most frequently individuated with reference to individuals significant to voice hearers. The talk with voices was typically mundane and related to voice hearers' on-going activities, as is the case for ordinary inner speech. The voices were typically orientated towards the voice hearer, without direct access to each other or to other people. Contrary to received wisdom, the voices typically did not impel actions of voice hearers, rather they influenced voice hearers' decisions on how to act. This was so irrespective of the diagnostic status of informants. Finally, we have found some differences between the voices of informants with, and without, schizophrenia. These concerned the alignment of voices, the type of action required by a voice and the degree of dialogical engagement between voices and voice hearers. CONCLUSIONS: We conclude that verbal hallucinations can be fruitfully considered to be a genus of inner speech. Pragmatics can be used as a framework to distinguish verbal hallucinations in different populations.