Malrotation with mid-gut volvulus and partial small bowel peritoneal membrane encapsulation.

Unlabelled: Urgent investigation is crucial for infants with bilious vomiting, potentially indicating bowel obstruction. Upper gastrointestinal fluoroscopy aids diagnosis, but is not without its challenges. This case report describes a rare case of neonatal intestinal malrotation and mid-gut volvulus with an additional complication of congenital peritoneal encapsulation.

Nepalese origin of cholera epidemic in Haiti.

Cholera appeared in Haiti in October 2010 for the first time in recorded history. The causative agent was quickly identified by the Haitian National Public Health Laboratory and the United States Centers for Disease Control and Prevention as Vibrio cholerae serogroup O1, serotype Ogawa, biotype El Tor. Since then, >500 000 government-acknowledged cholera cases and >7000 deaths have occurred, the largest cholera epidemic in the world, with the real death toll probably much higher.

Effective normative samples for the detection of cognitive impairment in older adults.

The inclusion of individuals with incipient dementia in normative data contaminates the distinction between normal and pathological aging. Conventional and Robust (excluding persons with incipient dementia) norms were created using data from the Canadian Study of Health and Aging (CSHA). Robust norms were not significantly better at distinguishing between normal and pathological aging.

Discriminating inhalational anthrax from community-acquired pneumonia using chest radiograph findings and a clinical algorithm.

Background: Limiting the effects of a large-scale bioterrorist anthrax attack will require rapid and accurate detection of the earliest victims. We undertook this study to improve physicians' ability to rapidly detect inhalational anthrax victims.

Methods: We conducted a case-control study to compare chest radiograph findings from 47 patients from historical inhalational anthrax cases and 188 community-acquired pneumonia control subjects.

Compliance with childhood immunizations in Kern County, California.

A rapid survey was conducted to describe the immunization status of the 0- to 2-year-old population in selected communities of Kern County, California, and identify reasons for noncompliance with immunization recommendations. Households were selected by two-stage cluster sampling. Among 860 children, 38% had received immunizations on schedule, while 44% had not received the recommended doses for their age.

Reliable change scores and their relation to perceived change in memory: implications for the diagnosis of mild cognitive impairment.

The relation between the subjective report of memory problems and objective evidence of the same has been debated with mixed results appearing in the literature. Less is known about the relation between objective change in test performance and the perceptions of cognitive change from family members/friends and trained clinicians. These relations were explored using 5-year longitudinal data from the population-based Canadian Study of Health and Aging.

A comparison of methods for measuring cognitive change in older adults.

Well-researched statistical methods are required to guide clinicians in determining the significance of test score changes in serial neuropsychological assessment of older adults. The following six change score methods were examined using five-year test-retest data from the Canadian Study of Health and Aging: the standard deviation method, three reliable change indices (RCIs), and two standardized regression-based methods. Changes in scores on four memory measures were examined in cognitively healthy older adults, and the RCI with a correction for practice/aging effects most accurately classified this normal variability.

Clinical predictors of bioterrorism-related inhalational anthrax.

Limitation of a bioterrorist anthrax attack will require rapid and accurate recognition of the earliest victims. To identify clinical characteristics of inhalational anthrax, we compared 47 historical cases (including 11 cases of bioterrorism-related anthrax) with 376 controls with community-acquired pneumonia or influenza-like illness. Nausea, vomiting, pallor or cyanosis, diaphoresis, altered mental status, and raised haematocrit were more frequently recorded in the inhalational anthrax cases than in either the community-acquired pneumonia or influenza-like illness controls.

Five-year follow-up of cognitive impairment with no dementia.

Context: The importance of early identification of dementia has prompted numerous investigations of mild cognitive impairment and the preclinical stages of progressive degenerative disorders. To date, there is limited information from large-scale studies regarding outcomes of persons specifically identified with cognitive impairment but no dementia (CIND).

Objectives: To investigate outcomes for persons with no cognitive impairment (NCI) or CIND, focusing on its etiologic subcategories, from the Canadian Study of Health and Aging (CSHA) and to examine the predictive validity of a set of core features thought to be early manifestations of subsequent dementia.

Why single men might abhor foreign cultures.

In contrast to cues to women's mate value (youth and physical attractiveness), many qualities that men display in lekking are socially and culturally specific. We predict that, for this reason, men avoid exposure to foreign cultures, but such xenophobia should cease once they are married (especially since the presence of their wives can function as a cross-culturally meaningful lekking device). Analyses of data from Europe and the United States confirm our predictions.

Acceptance of HIV testing and counseling among unmarried young adults in Northern Thailand.

A cluster randomized trial was used to assess the effect of an active group intervention in promoting utilization of voluntary HIV testing and counseling (HIV-TC). Villagers from 40 clusters were sampled to represent the premarital age population and assigned into two groups, intervention and comparison. The intervention was designed to enhance risk perception and increase knowledge about HIV testing.

Cognitive impairment, no dementia: concepts and issues.

This article reviews the concept of mild cognitive impairment in groups of people whose cognitive impairment does not warrant a diagnosis of dementia (cognitive impairment, no dementia; CIND). Problems with the application of existing sets of criteria to the Canadian Study of Health and Aging (CSHA) data sets are addressed and a procedure for identifying a subgroup presumed "at risk" for developing dementia is presented. Application of an informant's report of changes in cognitive functioning and neuropsychologists' ratings of mild to severe deficits in any of eight cognitive domains results in approximately half of the CIND cases being identified as "at risk.

A street intercept survey to assess HIV-testing attitudes and behaviors.

Nationally, it has been estimated that 44% of adults in the United States have been tested for HIV, with substantial individual and community-level variations in HIV-testing attitudes and behaviors. HIV-testing behaviors and intentions and attitudes toward HIV testing, particularly toward home tests, were assessed among 385 adults recruited in a street intercept survey from a gay-identified agency, a substance-abuse treatment program, and inner-city community venues (a shopping mall and community center). Across these Los Angeles sites, the proportion of persons reported being tested for HIV in their lifetime (77%) was higher than the national estimate.

Small-community-based surveys.

Rapid, small surveys are routinely done in much of the developing world but are less common in the United States. We present as an example a rapid survey of immunization status and other factors in a predominantly Hispanic region in Los Angeles. The survey united county employees, students, and community volunteers, first to enumerate the eligible population and then to conduct in-person interviews.

Cognitive impairment with no dementia (CIND): longitudinal studies, the findings, and the issues.

Identification of persons at risk for developing dementia is of increasing importance as the proportion of persons over the age of 65 years grows globally. This review examines the neuropsychological literature specifically addressing the concept of impaired cognitive functioning of insufficient magnitude to warrant a diagnosis of dementia and its meaning with respect to the development of dementia. Although the most obvious finding in the literature is that persons with impaired cognitive functioning have varied outcomes, it is clear that a significant proportion of persons with mild cognitive impairment progress to dementia over a 1- to 2-year interval and approximately 50% progress to dementia by 5 years.

Nitrogen purging of oxygen pipelines: an unusual cause of intraoperative hypoxia.

Intraoperative hypoxia occurred in two patients during the maintenance of the medical gas system. Engineers were purging oxygen pipelines with nitrogen to remove particulate debris but were unaware of a connection to operating room pipelines. This case illustrates the importance of communication between anesthesia providers and engineers servicing the gas system.

Immunization coverage among predominantly Hispanic children, aged 2-3 years, in central Los Angeles.

Purpose: To assess the immunization status of young children in a predominantly Hispanic region in and around downtown Los Angeles, and factors associated with complete immunization by age 24 months.

Methods: The information was gathered in a two-stage cluster survey with probability proportionate to estimated size (PPS) sampling of 30 clusters at the first stage, and simple random sampling of a constant number of children at the second stage. Vaccination coverage was determined by a review of the home immunization (HI) card, or of clinic records.

Stability of saliva for measuring HIV in the tropics.

If HIV is to be detected among pregnant women in remote regions of the tropics, HIV antibodies need to remain stable until specimens arrive at the laboratory. Our objective was to assess the stability of HIV antibodies in saliva held for up to 1 month at ambient temperature in Yangon, Myanmar. We gathered 10 saliva specimens from each of 102 HIV-infected persons with the Omni-Sal collection device (Saliva Diagnostic Systems, Inc.

Visual localization in dyslexia.

Individuals with specific reading disability (SRD) may exhibit visual psychophysical abnormalities that include prolonged visual persistence, decreased luminance contrast sensitivity, lower flicker fusion thresholds, abnormal metacontrast masking, and lower motion detection sensitivity. These abnormalities could result from impairment of the magnocellular division of the visual afferent pathway to the cortex. The authors predicted that an impairment of this pathway would also cause abnormalities in ability to localize visual stimuli.

Local evaluation of a rapid HIV assay for use in developing countries.

We present a research scheme for evaluating inexpensive HIV rapid tests in a developing country setting and assess the field validity of the Sero Strip HIV 1/2 rapid test. The research design features the random allocation of 100 true HIV-positive and 100 true HIV-negative serum specimens to 4 groups, followed by blind testing for HIV status. After one short training session, laboratory technicians at 4 township hospitals (25-35 beds) located 20-50 km from Yangon, Myanmar were sent 800 sera labelled with only an identification number and divided into four groups of 200 specimens each, half being HIV-positive and half HIV-negative.