Adenocarcinoma of the gallbladder--a 5 year review of outcome in Newcastle upon Tyne.

Patients presenting with adenocarcinoma of the gallbladder within Newcastle upon Tyne over a 5 year period (1980-1985) were reviewed retrospectively. The mean age of patients on diagnosis was 74 years. Of the 29 patients diagnosed, two were detected after routine cholecystectomy. Laparotomy was performed in 21 patients (72%) of which only 14 patients had a cholecystectomy performed. Mean survival after surgery was 6.6 months with only one patient alive after 5 years. Metastatic disease was present in 72% of patients. The poor prognosis of carcinoma of the gallbladder reflects its late diagnosis and early metastasis to distant sites. Improvement in survival will depend upon early detection of in situ lesions and identification of at risk patients.     

The influence of changing age and referral for end-stage renal failure in Newcastle upon Tyne

This paper reports a retrospective analysis of renal replacement therapy in patients over 60 years-of-age admitted to regional unit in Newcastle upon Tyne during a 7-year period. The changing age patterns of referral for management of end-stage renal failure have been reviewed, including the morbidity and mortality of this age-group managed for end-stage renal failure by haemodialysis, peritoneal dialysis and transplantation. The results show an alarming increase in the number of referrals aged over 60 years (> 36% in 4 years). Associated medical problems, methods of treatment and management (including special needs), and the effects of the rapidly increasing proportion of elderly patients on renal services are described.     

Report from the techa river dosimetry review workshop held on 8-10 December 2003 at The State Research Centre Institute of Biophysics, Moscow, Russia

Large releases of fission products into the Techa River, in the Southern Urals, occurred in 1950 and 1951, during the early years of operation of the Mayak Production Association (Mayak PA), which produced plutonium for nuclear weapons. Increases of leukemia and of solid cancers with radiation dose have been noted in the population of about 30,000 people who lived in the settlements downstream of the site of the radioactive releases; that population has been studied for several decades by Russian scientists, notably in the framework of cooperation with American and European scientists. The radiation doses are currently estimated by means of the Techa River Dosimetry System-2000 (TRDS-2000). Recently, a scientist from Mayak PA has suggested in several publications that the doses calculated using TRDS-2000 might be underestimated substantially. A special international Workshop, held in Moscow on 8-10 December 2003, aimed to resolve some of the pressing issues related to the determination of the external and internal doses received by the Techa River population and to give recommendations on the further development of methodologies used for dose reconstruction. The authors of this article were selected by the organizers of the Workshop to draw the conclusions of the meeting. They express the view that, while the dose reconstruction system TRDS-2000 is basically sound, additional work is needed and the results of any epidemiological studies making use of TRDS-2000 should be qualified as preliminary, pending resolution of several issues. The most important of these issues is the re-evaluation of the activities released, using additional information that could be obtained with the help of Mayak experts. Other specific suggestions aiming to improve the dose reconstruction methodology for the Techa River cohort, i.e., continued measurements of accumulated dose in environmental samples and human tissues, validation of external dose estimates with thermoluminescence measurements of bricks and with electron paramagnetic resonance measurements of teeth, estimation of individual doses instead of group doses, detailed account of the contributions to dose of medical examinations and of other releases from the Mayak complex, and careful assessment of the uncertainties, were made by the meeting participants.     

Agreement between the Takeda UA-731 automatic blood pressure measuring device and the manual mercury sphygmomanometer: an assessment under field conditions in Newcastle upon Tyne, UK.

STUDY OBJECTIVE: To assess agreement between two Takeda UA-731 automatic blood pressure measuring devices (referred to as machines A and B) and two manual mercury sphygmomanometers. DESIGN: A 'Y' connector attached each Takeda UA-731 to a manual mercury sphygmomanometer. Simultaneous measurements were made on adult subjects. SETTING: A population based cardiovascular disease survey in Newcastle upon Tyne, UK. PARTICIPANTS: Measurements on machine A were compared in 71 individuals (all women), and on machine B in 75 individuals (9 men, 66 women). The age range of subjects was 28 to 76 years and median ages were 59 years for machine A and 50 years for machine B. MAIN RESULTS: Blood pressure (mmHg) ranged from 72 to 212 systolic and 44 to 102 diastolic. Both Takedas gave significantly lower readings than the manual devices for systolic and diastolic pressures: differences were mean (SD: 95% CI) 3.7 mmHg (6.5: 2.2, 5.2) for machine A systolic, 2.3 mmHg (4.5: 1.3, 3.4) machine A diastolic; 1.8 mmHg (6.2: 0.4, 3.3) machine B systolic, and 1.8 (4.4: 0.8, 2.8) machine B diastolic. On the British Hypertension Society criteria, machine A was graded C on systolic measurements and B on diastolic; machine B was graded B on both systolic and diastolic measurements. CONCLUSIONS: The performance of these machines compares favourably with the Dinamap 8100, recently adopted for survey work by the Department of Health. The Takeda UA-731 looks promising for epidemiological survey work but before it can be fully recommended further evaluations are needed.     

Pancreatic pseudocysts. Report of 13 cases at the Central University Hospital at Lome-Tokoin]

A prospective study done over a period of ten years in which a 13 dossiers of patients with pseudopancreatic cysts due to complication of acute pancreatitis, chronic pancreatitis and one pancreatic traumatism were collected. They were 12 male, one female with age incidence between 14 years and 60 years with an average age of 37 years. Twelve cases were confirmed by abdominal echography one case was diagnosed by indirect signs of oesophago-gastroduodenal transit. There were 4 cases of pseudocysts, 8 cases of retention cysts and one case post traumatic pseudocyst. Eleven patients were operated, 7 cases by cystojejunostomies on Y shape technique, one case with external drainage, and one case by pancreatectomy of the tail.     

Alcohol and prisons: report of a workshop held by WHO HIPP at the Eurocare Bridging the Gap Conference, Helsinki, November 2006

A major European Alcohol Policy Conference, Bridging the Gap,was held in Helsinki, Finland from 20th to 22nd of November2006. The World Health Organisation Health in Prison Project(WHO HIPP)¹ convened a workshop on the subject of Alcohol inPrisons. The workshop was led by Dr Alex Gatherer, WHO HIPP;Dr Andrew Fraser, Director of Health and Care, Scottish PrisonService; Dr Lesley Graham, Public Health Specialist, ScottishPrison Service and Dr Heikki Vartiainen, Medical Director, PrisonHealth Services, Helsinki, Finland. Major strategic objectives of WHO HIPP were outlined, namely,to harmonize and integrate public health with prison healthand to promote international awareness and best practice. Arecent development in global public health thinking is the underpinningof human rights, and therefore the right to health, as a driverfor health development and health for all.