No abstract

A severe earthquake occurred in Kashmir in 2005. The epicentre was close to Muzzafarabad. We collected data on over 1,100 children 18 months after the earthquake to look at symptoms of PTSD and behavioural and emotional problems using well established questionnaires. We found that 64.8% of children had significant symptoms of PTSD. Girls were more likely to suffer from these symptoms. The proportion of children suffering from emotional and behaviour difficulties was 34.6%. This percentage was not different from other studies of children from Pakistan within areas which were not affected by the earthquake. The rate of emotional symptoms was higher in girls while hyperactivity was more frequent in boys. This pattern is similar to other studies from across the world.

The blood supply of the growth plate has been described in the late 50s and early 60s, and there was controversial discussion about the existence of transphyseal vessels. The vascular supply of growth plate and epiphysis of the proximal tibia was reinvestigated using a modern technique, the Mercox-perfusion method, in six sheep aged 6-24 weeks. A comparison was made among pure perfusion specimens, the corrosion casts, and histological sections. The metaphyseal, epiphyseal, and perichondral blood supply systems were confirmed. However, there was evidence of regular transphyseal anastomoses between the metaphyseal and epiphyseal system. Based on the histological arrangement of the blood vessels, the arterial blood flow would appear to be from the metaphysis to the epiphysis. The existence of transphyseal arterial vessels originating metaphyseally and seen both in cast preparations and histological sections was added to the present description of the blood supply of the growth plate. Age-related differences in the vascularization of the growth plate were not found in this study.

The results show a reduction in fall occurrence from previously reported rates in this at-risk population. We find the falls clinic a convenient and effective method of managing elderly people who are at increased risk of falling.

Background:The vascular anatomy of the growth plate is not yet fully understood with some reports on transphyseal vessels the role of which remains unclear. Further, the development of bone bridges and axial and longitudinal deformities cannot be completely explained with present knowledge. Material and Methods: Under general anesthesia, a Salter-Harris-II-fracture was created at the medial aspect of the proximal tibia in 16 immature sheep and stabilized by an external fixateur. The perfusion study in ten sheep used Mercox® and corrosion casts were obtained. The histological analysis of the remaining six sheep was made by conventional stains and immunohistochemistry against bromodeoxyuridine (BrdU) to evaluate the cell proliferation rate. The observation time was 0, 1, 2, 4, 6, and 12 weeks. Results: The healing process of growth plate fractures followed a regular pattern. After posttraumatic depression of any proliferation up to 1 week, a rich neovascularization took place seen in the vascular casts and the histological sections. This phenomenon was dominant until the 6th week after injury. Then, the hypervascularity and the proliferation rate returned to normal. The temporary hypervascularity was closely associated with the increased proliferation rate demonstrated by immunohistochemistry. Conclusions: Healing of growth plate fractures is dominated by the vascular response to the injury. The temporary hypervascularity 1-6 weeks after the fracture leads to a higher proliferation rate of the chondrocytes in the proliferative zone. These results may be one explanation for the development of posttraumatic longitudinal and angular deformities as a result of temporary hypervascularity.