Ultrasound-guided chemical parathyroidectomy in patients with primary hyperparathyroidism: a prospective study

Twenty of 31 consecutive ultrasound examined patients with primary hyperparathyroidism were selected for treatment with ultrasound-guided percutaneous injection of ethanol (96%) into biopsy-verified solitary parathyroid tumours following a strict protocol with regard to dose, number of treatments and a minimum of 6 months follow-up. Of 18 patients completing the above protocol, a biochemical improvement was observed in 12, of whom eight became normocalcaemic during the follow-up period of 6 months after the last treatment. An obvious clinical improvement was seen in eight of the patients. In four patients, a unilateral vocal cord paralysis was observed, but was permanent in only one patient. Progressive fibrosis of the parathyroid tumours following injections impeded the intraglandular dissemination of ethanol. Another problem noted was the inability of ultrasound to detect multiglandular involvement. We find ultrasound-guided chemical parathyroidectomy an attractive alternative to surgery in patients who are not well suited for surgical intervention. However, the technique has not been fully developed, and in the present study, possible improvements are indicated.     

Cancer risks after diagnostic doses of 131I with special reference to thyroid cancer

Between 1951 and 1969 a total of 35,074 patients less than 75 years of age (mean = 44 years) were examined with diagnostic doses of 131I. The mean administered activity of 131I was 52 microCi and the radiation dose to the thyroid gland was on the average of 0.5 Gy. The cohort was matched with the Swedish Cancer Register for the years 1958-1984. During this period, 3746 cancers occurred more than 5 years after the 131I examination, and the resulting standardized incidence ratio (SIR) was 1.01 (95% confidence interval [CI] = 0.98 to 1.04). SIR for thyroid cancer was 1.18 (95% CI = 0.88 to 1.56). The risks for both cancer of all sites and for thyroid cancer were highest 5 to 9 years after examination (SIR = 1.07 and 2.06, respectively) and did not differ from unity thereafter. With greater than or equal to 10 years of follow-up, risk was not statistically associated with the dose of 131I.     

Dental health and dental health behaviour in 8-year-old Finnish immigrant children in the north of Sweden

The aim was to investigate whether the observed difference in dental health between Finnish immigrant children and Swedish children at ages 4-6 persisted at the age of eight. The study also included knowledge of dental health and dental health behaviour. Dmft, dmfs, DMFT, DMFS and GBI were recorded in 70 Finnish and 97 Swedish children included in an earlier study. The children were interviewed about toothbrushing frequency, use of fluoride and dietary habits. Questions about knowledge of dental health were included. Dmfs and DFS averaged 13.1 and 3.8 for the Finnish children and 8.9 and 2.6 for the Swedish. Only 19% of the Finnish and 28% of the Swedish children had cariesfree permanent teeth. The mean GBI was 7.9% in the Finnish and 5.9% in the Swedish group. More Finnish children had bad or poor dietary habits, with more frequent between-meal eating of sucrose containing products than the Swedish children. There were no statistically significant differences in the use of fluorides or in individual prophylaxis within the last 36 months.     

In vitro method for measuring synthesis rates in the intervertebral disc

A method for culturing intervertebral disc tissue in vitro under conditions that control changes in hydration and minimize loss of proteoglycans has been developed. Disc slices were enclosed in small-pore dialysis tubing and incubated in medium containing polyethylene glycol (PEG). By varying the PEG concentration, different external swelling pressures could be applied to the tissue. The rate of glycosaminoglycan synthesis in rabbit and dog disc was then measured using [35S]sulphate as a precursor. Synthesis rates varied with final hydration of the tissue, and the highest rates were found at hydrations close to those found in vivo. Under conditions of controlled hydration, rabbit nucleus has a higher rate of glycosaminoglycan synthesis than annulus. However, the rates measured in sagittal slices of dog disc decreased from the outer to the inner regions of the anterior annulus, reaching a minimum value in the nucleus and then increasing again in the posterior part of the annulus. The results show that in the intervertebral disc, measured rates depend on culture conditions.     

Grimelius' silver method for all types of malignant melanomas

Various cytologic appearances of malignant melanomas represent a great diagnostic problem in the pathologist's everyday work. The new Pearse concept that the melanoblast/cyte is the APUD cell led the authors to the idea of using Grimelius' silver method, characteristic of APUD cells, in the diagnostic pathologic work of both melanotic and amelanotic malignant melanomas. The results are based on the examination of 20 tumours. All types of malignant melanomas were Grimelius reactive. The blanching by hydrogen peroxidase of Grimelius reactive cells makes this silver reaction specific in the study of melanomas.     

Dental caries in preschoolchildren in Gizan, Saudi Arabia

Abstract 296 preschoolchildren attending the pediatric clinic at Gizan Hospital were examined over a period of 3 months. Caries was recorded using the criteria described by WHO. One third of the children had untreated caries and none of the children had received any restorative dental care. A strategy for development of preventive dental services for this age group is discussed.     

Health technology identities and self. Patients’ appropriation of an assistive device for self-management of chronic illness

In recent years, assistive technologies have gained acceptance as tools for supporting chronically ill patients in achieving improvements in physical activity. However, various healthcare and sociological studies show contradicting results regarding the physical and social impact of using such devices. This paper explores real-time user appropriation of an assistive monitoring/tracking device, the pedometer, in a healthcare intervention, with a particular focus on the technology identities users attribute to the pedometer. The study site was a rehabilitation programme at a local Danish health centre supporting patients with chronic obstructive pulmonary disease. As part of this empirical study, six focus-group interviews were conducted with patients before and after they used pedometers. The analysis of respondents’ accounts shows that monitoring devices become part of users’ complex socio-technical ensembles in which the use of the device and its tracking of activity is constantly negotiated through experimentation with type and frequency of use; interpretation of knowledge and experience gained via the device; and negotiation of expectations, wellbeing, and the value of quantified knowledge for the management of chronic illness. On the basis of these findings the paper brings together and advances sociological scholarship on chronic illness, embodiment, the quantified self and technology adoption.     

Back to WHAT? The role of research ethics in pandemic times

Medicine, Health Care and Philosophy - The Covid-19 pandemic creates an unprecedented threatening situation worldwide with an urgent need for critical reflection and new knowledge production, but...     

The Effect of a Combined Gluten- and Casein-Free Diet on Children and Adolescents with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis

There has been a growing interest in the gastrointestinal system and its significance for autism spectrum disorder (ASD), including the significance of adopting a gluten-free and casein-free (GFCF) diet. The objective was to investigate beneficial and safety of a GFCF diet among children with a diagnosis of ASD. We performed a systematic literature search in Medline, Embase, Cinahl, and the Cochrane Library up to January 2020 for existing systematic reviews and individual randomized controlled trials (RCTs). Studies were included if they investigated a GFCF diet compared to a regular diet in children aged 3 to 17 years diagnosed with ASD, with or without comorbidities. The quality of the identified existing reviews was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR). The risk of bias in RCTs was assessed using the Cochrane Risk of Bias Tool, and overall quality of evidence was evaluated using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). We identified six relevant RCTs, which included 143 participants. The results from a random effect model showed no effect of a GFCF diet on clinician-reported autism core symptoms (standardized mean difference (SMD) −0.31 (95% Cl. −0.89, 0.27)), parent-reported functional level (mean difference (MD) 0.61 (95% Cl −5.92, 7.14)) or behavioral difficulties (MD 0.80 (95% Cl −6.56, 10.16)). On the contrary, a GFCF diet might trigger gastrointestinal adverse effects (relative risk (RR) 2.33 (95% Cl 0.69, 7.90)). The quality of evidence ranged from low to very low due to serious risk of bias, serious risk of inconsistency, and serious risk of imprecision. Clinical implications of the present findings may be careful consideration of introducing a GFCF diet to children with ASD. However, the limitations of the current literature hinder the possibility of drawing any solid conclusion, and more high-quality RCTs are needed. The protocol is registered at the Danish Health Authority website.