Familiäre Gewalt und Kindesmissbrauch in Kolumbien

"Kolumbiens Präsident Álvaro Uribe hat mit dem Versprechen, die Gewalt einzudämmen, 2002 die Wahlen gewonnen, und Umfragen bescheinigen ihm große Popularität, vor allem, weil die Bürger sich heute sicherer fühlen. Bombenattentate nahmen ebenso ab wie Morde und Körperverletzungen. Am wenigsten gingen allerdings die innerfamiliäre Gewalt sowie die Misshandlung von Kindern zurück, denn Uribes Offensive gegen die Gewalt beschränkt sich auf den militärischen Bereich. Einige Experten vertreten inzwischen die Auffassung, dass die familiäre Gewalt Hauptursache dafür ist, dass Kolumbien trotz aller Bemühungen nicht zum Frieden findet. Wenn auch der über 40-Jährige bewaffnete Konflikt viel dazu beiträgt, dass kolumbianische Kinder weitaus mehr Übergriffen ausgesetzt sind als die Gleichaltrigen anderer Länder, so ist er doch nicht die alleinige Ursache dafür: schwerfällige Bürokraten, Ärzte oder Richter sowie Armut und überkommene Wertvorstellungen tragen ihren Teil der Schuld." (Brennpkt. Lat.am/DÜI

Clinical and morphological findings on mustard gas [bis (2-chloroethyl) sulfide] poisoning

n 1984 and 1985, a total of eleven Iranian patients were transferred to hospitals in Munich, Germany, after a reported gas attack in the Iran-Iraq war. The initial symptoms and pretreatment in Teheran, Iran, as well as the admittance examination data, the clinical courses of the patients, and the clinical laboratory data in Germany, are reported. The main injuries were to the skin, the eyes, and the respiratory tract. One patient stopped breathing suddenly on the third day of treatment (eight days after the exposure). A large piece of mucous membrane blocking a bronchus was removed during an immediate bronchoscopy, but attempts at resuscitation failed. The most important autopsy findings in this case were severe pseudomembranous inflammation of the trachea and the bronchial tubes. The histological findings are reported. Chemical proof of the poison (mustard gas) was established. A review of the history of chemical warfare, the physical and chemical properties of mustard gas, and a literature survey of clinical findings (including, especially, experiences from World Wars I and II) contribute to the understanding of the actual cases

A validation of the Oswestry Spinal Risk Index

Purpose The purpose of this study was to validate the Oswestry Spinal Risk Index (OSRI) in an external population. The OSRI predicts survival in patients with metastatic spinal cord compression (MSCC). Methods We analysed the data of 100 patients undergoing surgical intervention for MSCC at a tertiary spinal unit and recorded the primary tumour pathology and Karnofsky performance status to calculate the OSRI. Logistic regression models and survival plots were applied to the data in accordance with the original paper. Results Lower OSRI scores predicted longer survival. The OSRI score predicted survival accurately in 74% of cases (p = 0.004). Conclusions Our study has found that the OSRI is a significant predictor of survival at levels similar to those of the original authors and is a useful and simple tool in aiding complex decision making in patients presenting with MSC

Leptomeningeal carcinomatosis as the primary presentation of relapse in breast cancer

Leptomeningeal metastasis (LM) is an uncommon presentation of relapse in breast cancer, which is associated with poor clinical outcomes and poor prognosis. Notably, LM most commonly occurs in breast cancer. The aim of the present review was to investigate the occurrence of LM as the primary presentation of relapse following remission in breast cancer patients and to determine whether specific histological subtypes are predisposed to meningeal metastases. In addition, the present review evaluated whether patients presenting with LM as the primary site of relapse exhibit differences in survival when compared with patients exhibiting metastasis to other sites. Cross-sectional studies have demonstrated that LM is commonly associated with other sites of distant metastasis including lung, liver and bone metastases. The histological breast cancer subtype most commonly associated with LM was invasive lobular carcinoma, while triple-negative breast cancer patients appear to be predisposed to the development of LM when considering the overall prevalence of histological breast cancer subtypes. At present, data regarding LM as the primary site of relapse are limited due to its rarity as the first site of metastasis in breast cancer. Case-controlled studies are required to investigate the incidence of LM as the primary site of recurrence in breast cancer patients as this would enable treatment standardization and identification of prognostic factors for improved survival