Prevalence and likelihood ratio of symptoms in patients with good therapeutic response to Lycopodium clavatum. A retrospective study.

BACKGROUND: Assessment of the likelihood ratio (LR) of symptoms has been proposed as a rational means for detecting indicators to homeopathic medicines. AIMS: To investigate the prevalence and LR of symptoms commonly attributed to the homeopathic medicine Lycopodium clavatum (Lyc). Secondarily, to answer the question if experienced homeopaths could intuitively infer which the main symptoms of this medicine are. METHODS: The presence of 35 selected symptoms, prescribed medicines and therapeutic response were assessed retrospectively. The symptoms' prevalence in the Lyc responding population and the LR of the symptoms compared to their prevalence in the remainder of the population were calculated. RESULTS: Two hundred and two Lyc and 550 non Lyc cases (total 752) were included for analysis. Twenty-two symptoms were confirmed as pertaining to Lyc's semiology (prevalence %; LR): contemptuous (3.3; 6.7), urinary stones history (2.7; 5.4), egotism (5.6; 3.6), dictatorial (33.3; 3.4), haughty (8.7; 3.3), sleeps on abdomen (3.3; 3.3), intolerance to clothing in abdomen (12.0; 3.1), reproaches (4.0; 3.0), helplessness (24.0; 2.7), fear of failure (10.7; 2.6), irritability on waking in the morning (16.7; 2.5), constipation alternating with diarrhea (8.7; 2.5), intolerant to contradiction (59.3; 2.3), want of self confidence (30.0; 2.4), abdominal distension after eating (23.3; 2.1); ailments from anticipation (32.0; 1.9), irritability before menses (23.3; 1.8), conscientious (26.0; 1.6), desire of sweets (52.0; 1.6), desire of chocolate (16.7; 1.6), lack of vital heat (41.3; 1.3), and flatterer (1.3; ∞). Surveyed homeopaths' intuitive inferences correlated well with symptoms' prevalence but not with their LR. CONCLUSIONS: Lycopodium's main symptoms are well known by homeopaths, but their knowledge correlates well with the symptoms' prevalence and not with their LR. Retrospective assessment of prevalence and LR of symptoms in good responders might be a means for better selection of symptoms for prospective studies.

Densitometric study of the clavicle: bone mineral density explains the laterality of the fractures

Introduction: Epidemiological studies have shown laterality in clavicle fractures, such that the left side is more frequently fractured. The present study had the aim of evaluating whether the clavicle on the dominant side is denser and thus explaining the greater incidence of fractures on the non-dominant side. Materials and methods: This was a descriptive study on 52 healthy patients, who were classified according to age, sex and whether the dominant or non-dominant side was affected. Results: The participants comprised 28 women (53.8%) and 24 men (46.2%). Regarding the dominant side, 30 were right-handed (57.7%) and 22 were left-handed (42.3%). The mean age was 25 years. In this study, it could be seen that the non-dominant side had greater bone mass than the dominant side. It was also observed that the bone density was greater in the middle and distal thirds on the non-dominant side, with a statistically significant difference. In the women, the density was also greater on the non-dominant side; this difference was not significant in relation to the dominant side, but there were significant differences between the middle thirds (p<0.001) and the distal thirds (p <0.006). Conclusion: Variations in bone density, toward higher and lower bone mass, may have been responsible for the fractures. According to the findings from this study, fractures occur more in the middle third of the non-dominant clavicle, as a result of greater bone mineral mass, which gives rise to lower flexibility and fractures in the region...

Introdução: Estudos epidemiológicos mostram uma lateralidade nas fraturas da clavícula, com o lado esquerdo mais frequentemente fraturado. O presente estudo tem como finalidade avaliar se a clavícula do lado dominante é mais densa e explicar, dessa forma, a maior incidência de fraturas no lado não dominante. Material e métodos: Estudo descritivo de 52 pacientes hígidos, classificados quanto a idade, sexo e lado dominante ou não. Resultados: Fizeram parte deste estudo 28 mulheres (53,8%) e 24 homens (46,2%); em relação ao lado dominante, 30 eram destros (57,7%) e 22, canhotos (42,3%); a idade média foi de 25 anos. Neste estudo, foi possível constatar que o lado não dominante teve maior massa óssea quando comparado ao lado dominante. Também observamos que a densidade óssea foi maior nos terços médios e distais no lado não dominante, com diferença estatisticamente significativa. Nas mulheres, a densidade também foi maior no lado não dominante; essa diferença não foi significativa quando comparado com o lado dominante, porém foi significativamente diferente entre os terços médio (p< 0,001) e distal (p< 0,006). Conclusão: As variacões da densidade óssea, tanto com maior como com menor massa óssea, podem ser responsáveis pelas fraturas. De acordo com os achados deste estudo, as fraturas ocorrem mais no terço médio da clavícula não dominante, em decorrência de uma maior massa mineral óssea, o que acarretaria uma menor flexibilidade da região e as fraturas...

Fraturas de fêmur na criança / Femoral fractures in child

Os autores fazem uma revisäo da literatura nos últimos 10 anos, relacionando os vários aspectos ligados a estas fraturas. Comparam com a epidemiologia e os tipos de tratamento que vêm sendo empregados no Serviço de Ortopedia e Traumatologia da PUCRS, em pacientes de 0 a 14 anos de idade