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Abstract The object of the study was the assessment of the mortality risk for persons in a representative two-wave community sample assessed longitudinally. In the first cross-section a total of 358 (89.1%) subjects of Munich, Germany, aged 85 years and above were interviewed by research physicians. One year later 263 (73.5%) persons were reexamined. Death certificate diagnoses were obtained after an interval of 4 years 8 months. 58% of the total sample were deceased. Sociodemographic factors, mental disorders, subjective health status and need for care were analysed in relation to mortality by Cox regression. The probability of death was increased in those diagnosed as having a dementia or depressive disorder, in those of increasing age, living in institutions, being in need of care and of bad health status. In the multi-variate Cox regression model the influence of these different factors was examined and evaluated. Need for care was the most powerful predictor of mortality. [ABSTRACT FROM AUTHOR]

In a two-wave community study a representative sample of 402 very old people (older than 85 years) was restudied 1 year later. Four instruments in the clinical examination were used for case identification: (a) the Geriatric Mental State Interview (GMS-A); (b) the Structured Interview for the Diagnosis of Dementia (SIDAM); (c) the Global Deterioration Scale (GDS); and (d) the Mini Mental State Examination (MMSE). The clinical examination was performed by the interviewing physician who made a diagnosis according to DMS-III-R. The focus of the present study is on the (true) incidence of dementia in a representative community sample. The establishment of incidence rates is particularly important for dementia because the prevalence of dementia is affected by the length of survival, which is reducd in dementia and with increasing age. The annual incidence rates per 1000 person years on the basis of the SIDAM DSM-III-R were 116.6 for all cases at risk, 113.6 for those aged 85-89 years, 112.5 for those aged 90-94 years and 235.7 for those aged 95 years and older at first assessment (t). Incidence rates based on the other methods of assessment are reported. In order to obtain the most meaningful estimate of incidence rates a compound dementia diagnosis was defined. According to this the annual incidence rate per 1000 person years was 144.1 for all persons at risk. The incidence rate tended to be higher in the older-age cohorts: It was 126.2 for those aged 85-89 years, 193.1 for those aged 90-94 years and 295.5 for those aged 95 years and older. In comparison with the literature the incidence rates were high. The results are plausible when the very old age of the sample is taken into account. [ABSTRACT FROM AUTHOR]

A random sample of 1298 non-medical mental health workers in West Berlin was asked to fill out a questionnaire concerning professional training, description of their working place, clients treated, financing, special professional qualifications and continuing education. An analysis was made of the distribution of therapists within the city. About half were engaged in intensive counselling only and the rest also practised psychotherapy. Results indicate that there are large differences in the rates per 100,000 inhabitants between the districts for all professional groups (e. g. medical doctors generally, psychiatrists, non-medical psychotherapists (total), medical psychotherapists in private practice, psychologists and social workers). In addition clear differences in the proportions of university and postuniversity training qualifications were found between districts. The same pattern of maldistribution was found for all therapists regardless of their theoretical background, and for major areas of work, for most service institutions and for the major diagnostic groups of clients treated. Highly significant correlations between socio-demographic variables of the twelve districts and therapist variables were found indicating that significantly more therapists and therapist with a higher degree of training are practising in the more affluent districts. [ABSTRACT FROM AUTHOR]

We present three cases of eosinophilic granuloma of the ilium in children. Imaging investigations (computed tomography and magnetic resonance imaging) did not elucidate the disease but rather revealed patterns more like malignant tumours than a benign condition. However, these investigations were of value in directing the surgeon to the correct site for biopsy. [ABSTRACT FROM AUTHOR]

Two cases are presented in which a large abdomino-inguinal defect, created during an extended hemipelvectomy, was closed using artificial patch, a pedicled omental flap and skin grafts. In the first case, early postoperative mortality arrested the wound healing process and prevented follow-up. In the second case, the wound was completely covered and there was no evidence of infection at three moths following the initial operation. We propose that pedicled omental flap with skin grafting is a viable means of covering artifical mesh repairs of giant abdominal wall and inguinal region defects. [ABSTRACT FROM AUTHOR]