Cough Frequency in a Group of Males

An epidemiologic study by questionnaire was undertaken in Great Britain and the United States, to provide data on diabetes mellitus in Down’s syndrome. Among 20,362 patients with Down’s syndrome, 88 living diabetics were found.

A high prevalence of diabetes in the population with Down’s syndrome, particularly In the younger age groups, was noted. In these age groups the prevalence of diabetes in the population with Down’s syndrome exceeded that of the general population by factors 6.8, 3.3, and 3.0. Insufficient data exist to determine the exact statistical significance of these ratios. Further investigation is necessary. Nevertheless, a definitive association between Down’s Syndrome and diabetes mellitus is suggested. The role of prediabetes, autoimmunity and genetics in this association is discussed.     

Papaveretum infusions in infants under 6 months of age

The effectiveness of a continuous low dose papaveretum infusion for the relief of postoperative pain was assessed in 29 infants aged 1-6 months nursed on the infant surgical ward following major abdominal surgery. Trained nursing staff were able to adjust the dosage within prescribed guidelines and satisfactory analgesia was obtained with a regimen which delivered up to 0.0375 mg/kg/hour, approximately half the dose recommended in children older than 12 months. There was one case of clinically significant respiratory depression.     

Day case laparoscopy: a survey of postoperative pain and an assessment of the value of diclofenac

A randomised, controlled study was undertaken to assess the postoperative pain and side effects experienced by patients undergoing day case diagnostic laparoscopy and laparoscopic sterilisation, and to evaluate the effectiveness in these patients of peroperative diclofenac. Patients undergoing laparoscopic sterilisation had significantly higher pain scores at one hour postoperatively, and at discharge, than patients undergoing diagnostic laparoscopy (p less than 0.01) but there were no significant differences in pain scores 24 hours after discharge. The incidence of postoperative side effects following discharge from hospital was high, but there were no significant differences between the groups. Diclofenac had no significant effect in either group on the severity of postoperative pain, or the incidence of postoperative side effects.     

Isoflurane for anaesthesia in the dental chair. A comparison of the incidence of cardiac dysrhythmias during anaesthesia with halothane and isoflurane

A randomised single-blind trial was performed to compare the effects on cardiac rhythm of isoflurane and halothane in 100 dental outpatients having extractions under general anaesthesia in the dental chair without tracheal intubation. The incidence of supraventricular dysrhythmias did not differ significantly. No patient in the isoflurane group developed a ventricular dysrhythmia, whilst nine of those who received halothane did so (p = 0.0013). The quality of anaesthesia was acceptable in the isoflurane group, but induction time was longer (p less than 0.05) and the maximum heart rate was faster (p less than 0.01). There was no difference in the maximum end tidal carbon dioxide concentrations measured in a further 20 cases.     

An assessment of tissue harmonic versus fundamental imaging modes for echocardiographic measurements

The study aimed to evaluate whether a significant difference exists between tissue harmonic imaging (THI) and fundamental imaging (FI) in routine quantitative echocardiographic assessment. We also examined the effects of THI on endocardial definition (ED). Fifty-eight unselected patients (29 men, 29 women; mean age 53 years) referred for transthoracic echocardiography were studied with use of both FI and THI modes. Two independent observers made M-mode measurements of the following: left atrium, aortic root, and left ventricular internal dimensions and wall thickness; they also measured left ventricular outflow tract diameter and left atrial area from 2-dimensional images. Endocardial definition was assessed with use of an arbitrary scoring system (0 = endocardium not visualized, 1 = endocardium visualized but suboptimally, 2 = endocardium well defined) and the American Society of Echocardiography 16-segment model. No significant difference existed between cardiac measurements derived from FI and THI. However, a highly significant improvement in ED occurred with THI (ED index 1.83 versus 1.70, P <.0001). This study suggests that no systematic differences exist in standard echocardiographic measurements between THI and FI, even in the setting of improved ED.     

Angelman syndrome: evolution of the phenotype in adolescents and adults

Individuals with Angelman syndrome (AS) have severe learning disability,* ataxia, seizures, dysmorphic facies, a happy, sociable disposition, and inability to speak. Most of the literature concerning the clinical features of AS has concentrated on younger children. This study aimed to look at the natural history of AS by documenting the clinical features in a group of 28 adolescents and adults with AS (12 males, 16 females; age range 16 to 40 years). Specific aspects studied included physical characteristics, general health, mobility, seizure disorder, behaviour and communication, and self-help skills. Problems seen in this older group of individuals differed significantly from those typically observed in younger children. The incidence of scoliosis and joint contractures increased with age. Facial features were more striking in adults. Hyperactivity and concentration improved and the sociable disposition persisted. There were subtle clinical differences between the groups of individuals with different underlying genetic abnormalities. Information obtained from this study is relevant to diagnosis and management of older individuals with AS.     

Do Internet interventions for consumers cause more harm than good? A systematic review

Objective  To systematically review the effect of consumer use of online health information on decision-making, attitudes, knowledge, satisfaction and health outcomes and utilization.
Search strategy  Electronic databases searched included the Cochrane Controlled Trials Register, MEDLINE, PREMEDLINE (to 14 March 2001), CINAHL, Australian Medical Index, Health and Society, National Institutes of Health Clinical Trials Database and CenterWatch.
Inclusion criteria  All post-1995 comparative studies (including controlled studies, before and after studies, and interrupted time series analyses) of Internet users vs. non-Internet users and other communications mediums, and Internet characteristics such as e-mail vs. other communication mediums, were included. Outcomes included consumer decision-making, attitudes, knowledge, satisfaction and measurable changes in health status or health utilization.
Data extraction and synthesis  One reviewer screened all papers then two reviewers independently assessed studies against the selection criteria and any discrepancies were resolved by discussion with a third reviewer. No attempt was made to combine the data for further statistical analysis.
Main results  We identified 10 comparative studies. Studies evaluated the effectiveness of using the Internet to deliver a smoking cessation programme, cardiac and nutrition educational programmes, behavioural interventions for headache and weight loss, and pharmacy and augmentative services. All studies showed some positive effects on health outcomes, although the methodological quality of many studies was poor.
Conclusions  Despite widespread consumer Internet use to obtain health-care information, there is almost a complete lack of evidence of any effects this may have on health outcomes.