Ultrasound-assisted lipoplasty

BACKGROUND

Ultrasound-assisted lipoplasty (UAL) has been associated with particular types of complications and uncertain long-term effects arising from interactions between ultrasonic energy and living tissue. The present review seeks to address these issues.

METHODS

Search strategy Three search strategies were devised to retrieve literature from Medline, Current Contents, Embase and Cochrane Library databases up until April 2000. Study selection Inclusion of papers was largely determined using a predetermined protocol. English language papers were selected. Acceptable study designs included randomized controlled trials, controlled clinical trials, case series or case reports. Data collection and analysis Thirty-six papers met the inclusion criteria. They were tabulated and critically appraised in terms of methodology and design, outcomes, and the possible influence of bias, confounding and chance. Other papers were also included to provide background material.

RESULTS

There was little high-level evidence available comparing UAL and suction-assisted lipoplasty (SAL), with no conclusive evidence that UAL has a safety benefit, although low-quality evidence suggests that UAL is associated with reduced surgeon fatigue as well as increased operating times, slower aspiration rates and an increased learning curve. There is inadequate evidence to determine whether the theoretical potential for DNA damage from ultrasound is realized in the clinical setting.

CONCLUSIONS

The evidence base for UAL is inadequate to determine the procedure's safety and efficacy. The potential for DNA damage must be investigated with appropriate in vivo animal models. Recommendations for the safe use of UAL are discussed.

Idiocy and the law in colonial New England

A review of the laws and records of the courts of colonial New England indicate some ways the early settlers thought about and responded to idiocy. Early Massachusetts laws extended certain rights to idiots: They authorized the transfer of property, exonerated idiots who committed capital crimes, and extended relief to idiots who were impoverished. There is no documentation of the implementation of these laws nor is there direct reference to idiocy in court proceedings. Nevertheless, the court records identify certain individuals with incompetence and atypical behavior suggestive of idiocy. Most of the colonial laws as well as the colonists' ways of thinking about idiocy originated in English common law and custom. The New England colonial laws and records of the courts offer insights into contemporary issues regarding mental retardation.

Comparative effects of mine wastes on the benthos of an acid and an alkaline pond

Benthic invertebrates collected from an acid (pH 3.2) and an alkaline (pH 7.9) tailing pond in the Rouyn-Noranda mining region were compared with those of a control pond in order to assess the effects of the pH on the benthic community structure and on metal accumulation by invertebrates. The acid pond showed high mean soluble concentrations of aluminium (2600 ppb), copper (230 ppb), iron (6500 ppb) and zinc (4900 ppb) in the water and high mean concentrations of copper (340 ppm), iron (15,238 ppm) and zinc (445 ppm) in the sediments. The benthic fauna was dominated by Chironomus spp and the water beetle Ilybius sp. The Shannon-Weaver diversity index was 0.04. The alkaline pond had high mean sediment concentrations of cadmium (21 ppm), iron (15,823 ppm), manganese (658 ppm) and nickel (146 ppm). A total of 37 insect genera and a diversity index of 3.4 were recorded for this pond. Of the seven metals studied only copper and aluminium showed greater accumulations in the biota of the contaminated ponds than in that of the control. Insects dominated the benthic fauna in both contaminated ponds and crustacea in the control.