Blood pressure support in extremely premature infants is affected by different courses of antenatal steroids

Objective:  To examine the effects of partial, single and multiple courses of antenatal corticosteroids (ANS) on the need for blood pressure support in extremely premature infants.
Methods:  Extremely premature infants with gestational age of 24 to 28 weeks were included in this study during a 5-year period. The main outcome measure of the study was the amount of blood pressure support during the first 3 days of life.
Results:  The study infants (n = 163) were divided into: infants not exposed (ANS; n = 27) and exposed to ANS (ANS; n = 136). Blood pressure support was significantly lower in ANS compared with No ANS (65% vs 96%; p = 0.003) and in single course (SANS; n = 73) and ≥2 courses (MANS; n = 34) compared with partial course of ANS (PANS; n = 29) (62%, 56% vs 86%; p = 0.03). The number of infants who received volume support and the amount of volume support were significantly lower in ANS compared with that in No ANS (p < 0.001) and in SANS and MANS compared with that in PANS (p < 0.02).
Conclusion:  Exposure to multiple courses of ANS was as beneficial as single course of ANS in decreasing the need for blood pressure support in extremely premature infants.     

Leukocyte-technetium-99m uptake in Crohn''s disease:Does it show subclinical disease?

AIM:To evaluate inflammatory activity in patients with Crohn‘s disease (CD) using technetium-99m-hexamethylpropyleneamine oxime (99mTc-HMPAO) granulocyte scintigraphy.METHODS: Twenty patients (7 male and 13 female) with CD and five healthy volunteers were selected for 99mTc-HMPAO granulocyte scintigraphy. The Crohn‘s Disease Activity Index (CDAI), blood tests and C-reactive protein (CRP) of each patient were performed 7 d before the scintigraphic images. The leukocytes were labeled according to the Internat...     

Laser-induced thermal occlusion of berry aneurysms: initial experimental results

An intravascular laser-catheter technique was used to occlude 12 experimental berry aneurysms, ranging in size from 4 X 3 mm to 8 X 6 mm (length X width), while the patency of adjacent arteries was preserved. A small steel cap on the end of an optical fiber was fluoroscopically positioned within the aneurysm. The cap was rapidly heated by the optical transmission of laser energy. This produced a thermal tissue reaction within the aneurysm, resulting in its occlusion. After treatment, the steel cap was detached atraumatically from the fiber and left as a permanent implant within the occluded aneurysm. This method has an advantage over the use of a bare-ended intravascular optical fiber because the steel cap provides a uniform distribution of thermal energy, thereby reducing the risk of unexpected perforation during treatment. The radiologic and histologic results of using this laser-catheter system were evaluated 1-21 weeks after treatment.     

铀矿接尘人员矽肺发生的特点

目的 了解铀矿接尘人员矽肺发生的规律与特点。方法 利用单因素分析法对核工业矿山与地质系统间、纯铀矿与混铀矿接尘人员间,矽肺患者的发病工龄、发病年龄、病程及死亡年龄进行分析。结果 随着时间的推移,铀矿接尘人员的发病工龄、发病年龄、病程及死亡年龄均延长。地质系统的矽肺Ⅰ期患者的发病工龄、发病年龄分别为(10.15±5.95)年、(40.60±9.86)岁,短于矿山系统的患者[(14.23±8.12)年、(41.38±10.98)岁];地质系统的矽肺Ⅰ期患者的病程(P50)及死亡年龄分别为14.29年及(53.69±10.04)岁,长于矿山系统的患者[12.52年及(51.45±10.85)岁]。纯铀矿的矽肺Ⅰ期患者的发病工龄为(11.78±8.06)年,发病年龄为(38.04±9.89)岁,短于混铀矿的患者[(12.74±6.29)年、(41.40±10.67)岁];纯铀矿的矽肺Ⅰ期患者的病程(P50)为14.59年,死亡年龄为(53.93±10.60)岁,均长于混铀矿的患者[13.20年、(51.82±10.20)岁]。结论地质系统与矿山系统、纯铀矿及混铀矿接尘者矽肺发生情况的差别可能与所接触粉尘的理化性质及各自的工作环境有关。     

Factors and outcomes associated with the induction of labour in Latin America

Objective  To describe the prevalence of labour induction, together with its risk factors and outcomes in Latin America.
Design  Analysis of the 2005 WHO global survey database.
Setting  Eight selected Latin American countries.
Population  All women who gave birth during the study period in 120 participating institutions.
Methods  Bivariate and multivariate analyses.
Main outcome measures  Indications for labour induction per country, success rate per method, risk factors for induction, and maternal and perinatal outcomes.
Results  Of the 97 095 deliveries included in the survey, 11 077 (11.4%) were induced, with 74.2% occurring in public institutions, 20.9% in social security hospitals and 4.9% in private institutions. Induction rates ranged from 5.1% in Peru to 20.1% in Cuba. The main indications were premature rupture of membranes (25.3%) and elective induction (28.9%). The success rate of vaginal delivery was very similar for oxytocin (69.9%) and misoprostol (74.8%), with an overall success rate of 70.4%. Induced labour was more common in women over 35 years of age. Maternal complications included higher rates of perineal laceration, need for uterotonic agents, hysterectomy, ICU admission, hospital stay >7 days and increased need for anaesthetic/analgesic procedures. Some adverse perinatal outcomes were also higher: low 5-minute Apgar score, very low birthweight, admission to neonatal ICU and delayed initiation of breastfeeding.
Conclusions  In Latin America, labour was induced in slightly more than 10% of deliveries; success rates were high irrespective of the method used. Induced labour is, however, associated with poorer maternal and perinatal outcomes than spontaneous labour.