Bilateral giant hydroureteronephrosis--a case report with a review of the literature

Giant hydronephrosis and hydroureteronephrosis are rare conditions, but must be kept in mind in especially children and in young-to-middle-aged adults with long-standing, often symptomless, enlargement of the abdomen. A case of bilateral giant hydroureteronephrosis due to calculi in the ureters is reported. Despite renal insufficiency the patient denied any treatment, but survived 42 months after the primary diagnosis. For diagnostic purposes intravenous pyelography, ultrasonography and computerized tomography are preferable. Supplementary ante- and retrograde pyelography is valuable in locating stenosis or calculi.     

An alternative sampling approach to the study of diabetes prevalence

Sampling methods hitherto used in epidemiological surveys have generally faced two major sorts of potential bias: a latent period between listing and testing of listed individuals which can cause a misrepresentation of the population under study, compared with the population basis; population migration and death during the study period, which may result in a discrepancy between the population selected for study and the part of the population examined. A Central Population Register, found in all Scandinavian countries, permits an evaluation of the size of these problems of bias and makes it possible to use an alternative sampling method based on test samples successively drawn from the actual dynamic population. The feasibility of this new approach was tested in an epidemiological survey of diabetes mellitus among individuals in the age group 60-74 years living in a Danish municipality (Fredericia). It is concluded that this alternative dynamic method produces a more representative study population with less bias, thanks to the smaller number of deaths and migration among non-responders during the study, than do the methods previously used. Furthermore, the length of the study period, the size of the test samples, as well as the intervals between selecting samples may be adjusted to the capacity available, thus reducing the resources required. By using a correction in the computer program for selecting test sample size, the sex and age profile of the whole study population may be chosen in accordance with the incidence of the disease studied. In the Scandinavian countries a unique possibility exists to carry out prevalence studies on all kinds of diseases by the method described and evaluated here.     

Congenital heart defects in live-born children of epileptic parents

In a study of congenital heart defects (CHD) in 2,461 live-born children of an unselected group of 979 male and 1,093 female epileptics, 18 children with CHD were recorded; eight had epileptic fathers and 10 epileptic mothers. The prevalence of CHD does not differ significantly from that of the background population. Many different CHD types were recorded with no single defect being predominant. Likewise, no association with a specific type of anticonvulsant treatment was noted. The fact that the prevalence of CHD among children of male and female epileptics and of the background population was similar supports the view that antiepileptic treatment is no major factor in the etiology of CHD in the off-spring of epileptics.     

Oesophageal and Gastric Potential Difference and pH in Healthy Volunteers Following Intake of Coca-Cola,Red Wine,and Alcohol

Abstract: Alcohol causes gastroesophageal reflux and mucosal damage in the oesophagus and the stomach. The transmucosal electrical potential difference gives information on gastric mucosal integrity and function, while the validity of oesophageal measurements have been discussed. Baseline oesophageal potential difference measurements were performed three times with an interval of at least one week. We found oesophageal potential difference measurements reliable with an acceptable reproducibility. Oesophageal and gastric potential difference and pH were measured by use of a new microelectrode principle in 10 healthy volunteers following intake of coca-cola, wine and alcohol. Oesophageal and gastric potential difference decreased after intake of 250 ml coca-cola, 250 ml 11 vol% red wine and 60 ml 43 vol% whisky. Gastric potential difference decreased after intake of 250 ml ethanol 11 vol% and 60 ml ethanol 43 vol%. Intake of red wine and whisky resulted in a significant greater gastric potential difference decrease compared to similar concentrations and volumes of ethanol. The time until the potential difference had regained baseline level was longer after intake of red wine compared to coca-cola, whisky and ethanol. Oesophageal pH decreased after intake of coca-cola and red wine, but was unchanged after whisky. Gastric pH was unchanged after intake of all the drinks. In conclusion, the gastric potential difference reduction was not correlated to alcohol concentration. Red wine seems to affect the gastric potential difference more than coca-cola, whisky and ethanol. The observed changes in oesophageal and gastric potential difference might be due to changes in Cl secretion and/or due to a damaging effect of the additives of the beverages.     

The Combination of Structural Parameters and Areal Bone Mineral Density Improves Relation to Proximal Femur Strength: An In Vitro Study with High-Resolution Peripheral Quantitative Computed Tomography

The aim of this study was to assess structural indices from high-resolution peripheral quantitative computed tomography (HR-pQCT) images of the human proximal femur along with areal bone mineral density (aBMD) and compare the relationship of these parameters to bone strength in vitro. Thirty-one human proximal femur specimens (8 men and 23 women, median age 74 years, range 50–89) were examined with HR-pQCT at four regions of interest (femoral head, neck, major and minor trochanter) with 82 μm and in a subgroup (n = 17) with 41 μm resolution. Separate analyses of cortical and trabecular geometry, volumetric BMD (vBMD), and microarchitectural parameters were obtained. In addition, aBMD by dual-energy X-ray absorptiometry (DXA) was performed at conventional hip regions and maximal compressive strength (MCS) was determined in a side-impact biomechanical test. Twelve cervical and 19 trochanteric fractures were confirmed. Geometry, vBMD, microarchitecture, and aBMD correlated significantly with MCS, with Spearman’s correlation coefficients up to 0.77, 0.89, 0.90, and 0.85 (P < 0.001), respectively. No differences in these correlations were found using 41 μm compared to 82 μm resolution. In multiple regression analysis of MCS, a combined model (age- and sex-adjusted) with aBMD and structural parameters significantly increased R ² values (up to 0.90) compared to a model holding aBMD alone (R ² up to 0.78) (P < 0.05). Structural parameters and aBMD are equally related to MCS, and both cortical and trabecular structural parameters obtained from HR-pQCT images hold information on bone strength complementary to that of aBMD.