Assessment of health risks from fallout radiocesium in a hunting and food-gathering society.

Hunting and food-gathering societies are particularly vulnerable to the effects of fallout, since these people are often at the head of natural food chains which can bioaccumulate toxic substances. This paper describes a study on the effects of fallout radiocesium in caribou consumers of northern Canada. Portable whole body counting equipment was transported into five Arctic communities in 1989-90 and used to measure radiocesium body burdens in over 1100 people. The results were compared with a similar survey carried out in 1967-68. The mean body burden for adults in each community had decreased by a factor of 20 to 30 since the earlier survey. It was possible to derive an effective half time of about 4.5 years for the decrease of Cs-137 body burdens in the Arctic. The mean lifetime dose from the ingestion of radiocesium since 1967 amounted to not more than 12 mSv, with possibly an equal contribution from the period before 1967. The current radiation doses are much less than natural background and it is possible to reassure northern residents that caribou meat remains a safe and nutritious food source.     

Effect of erythropoietin on ischemia tolerance in anemic hemodialysis patients with confirmed coronary artery disease.

From a total of 81 patients on maintenance hemodialysis who underwent coronary angiography, 8 patients fulfilled the criteria: significant coronary artery disease, hematocrit less than 27%, reproducible (ECG) positive treadmill test, no disturbance of repolarization in ECG at rest. Exercise stress testing was performed at a hematocrit of 25 +/- 2% and following erythropoietin therapy at a hematocrit of 34 +/- 0.5%. Symptom-limited exercise performance increased in all patients (1.10 +/- 0.3 W/kg b.w. vs. 1.44 +/- 0.31 W/kg b.w., p less than 0.01) as well as exercise duration (489 vs. 362 s, p +/- 0.01). ST segment depression during maximal exercise was reduced from a mean of 2.1 to 0.4 mm (p less than 0.01). It is concluded that amelioration of renal anemia by erythropoietin in dialysis patients with significant coronary artery disease reduces exercise-induced myocardial ischemia.     

SELECTIVE ENDOSCOPY IN MANAGEMENT OF INGESTED FOREIGN BODIES OF THE UPPER GASTROINTESTINAL TRACT: IS IT SAFE?

During a four-year period, 308 patients presented following ingestion of foreign bodies. Ingestion was accidental in 272 cases (88.3%) and deliberate in the remainder. Symptoms at presentation included dysphagia, odynophagia, nausea and vomiting, chest pain and pharyngeal discomfort. Sixty-eight patients were asymptomatic. A policy of expectant management and selective endoscopy was employed. Following initial assessment 202 patients (65.6%) were discharged without treatment, 30 (9.7%) of whom were later reviewed as outpatients and did not require admission. Forty-nine patients (16%) were admitted for treatment; 27 had oesophagoscopy, five bronchoscopy and two had foreign body extraction with direct laryngoscopy. In nine patients who were endoscoped, no foreign body was identified. Twenty-seven others were referred to the otorhinolaryngology service in another hospital. There were no deaths in the group and morbidity was 1.2%. We conclude that a policy of selective endoscopy is safe and effective in the management of patients following ingestion of foreign bodies.     

Variation in femoral anteversion

Variation in femoral anteversion in an adult African skeletal population is examined in this study. Variation is measured in reference to population, gender, and side of the extremity (right vs. left). This study demonstrates greater average anteversion (19°) and a significant right-left variation (21 vs. 17) when compared to previously reported Caucasian and Oriental populations. The increased anteversion complements previous reports documenting morphologic differences between populations in length and width of the femur. This study documents a variation in femoral anteversion not appreciated in earlier studies that may be clinically useful in the assessment and correction of “abnormal” anteversion. © 1994 Wiley-Liss, Inc.     

Microinvasive resectional sympathectomy using the harmonic scalpel

Clinical Autonomic Research - Compensatory sweating remains one of the most unpredictable and debilitating complications of sympathectomy for hyperhidrosis. There appears to be a significant...     

足部反射区推拿对白细胞介素-1β水平的影响

目的:观察足部反射区推拿疗法对不同年龄人群血清白细胞介素-1β(IL-1β)水平的变化及其可能的作用机制.方法:分别挑选24名健康年轻人、24名健康中年人和32名健康老年人.随机分为青、中、老年对照组和观察组.治疗组给予足部反射区推拿法治疗.分别于推拿前、后测定血清IL-1β水平.结果:中、老年组血清IL-1β水平较青年组明显为高,且两者之间有明显的秩和相关(P<0.05). 推拿前、后,中、老年观察组IL-1β水平明显降低(P<0.05);青年对照组和观察组无显著变化(P>0.05).结论:中老年人群血清IL-1β水平升高可能是老年人衰老神经内分泌和免疫机制改变的原因之一.足部反射区推拿法能一定程度降低IL-1β水平,推测足部反射区推拿法可能具有一定的抗衰老作用.     

Determinants of intrapartum fetal death in a remote and indigent population in China.

OBJECTIVE: To explore the reasons for the high rate of intrapartum fetal death observed in a remote and indigent population in China. STUDY DESIGN: We conducted an epidemiologic analysis of determinants of intrapartum fetal death in a sample of 20,891 births in 18 hospitals participating in the Qingyuan Perinatal Surveillance System from January 1, 1997 to June 30, 1998. The main determinant examined was cesarean delivery; other determinants included mother's insurance status, residence, maternal age, infant's gender, parity, gestational age, birth weight, and obstetric complications. Rates of intrapartum fetal death within categories of various maternal and infant factors were first calculated and compared; adjusted odds ratios for intrapartum fetal death were then estimated by multiple logistic regression analysis. RESULTS: The intrapartum fetal death rate in this population was 5 per 1000 total births, which accounted for about one-third of all fetal deaths. Compared with vaginal delivery, elective cesarean delivery was associated with a 100% (i.e., no intrapartum fetal death among 1572 elective cesarean deliveries) and emergency cesarean delivery with a 88% reduction, in intrapartum fetal death. Other significant determinants were related to access to obstetric care (i.e., insurance status and residence). CONCLUSION: Lack of access to quality obstetric care is the major determinant of intrapartum fetal death in this population.     

Seizure following brief exposure to the insect repellent N,N-diethyl-m-toluamide.

A 5-year-old boy with a history of mild developmental delay experienced a major motor seizure at day camp after topical application that morning of the insect repellent Muskol and a later application of OFF [both contain N,N-Diethyl-m-toluamide (DEET)]. The patient continued convulsing in the emergency department and was treated with diazepam. Laboratory tests were unremarkable, as were lumbar puncture, computed tomography scan, and blood cultures. Skin decontamination was performed. DEET levels in the urine were 0.003 micrograms/mL. Although seizures and encephalopathic syndrome have been described with DEET in previous case reports involving topical exposure of pediatric patients, atypical aspects with regard to this case include that this patient was a male (most other case reports involve females), exposure was relatively brief compared with other reports, and the patient developed seizures without a prodrome described in previous reports. Avoidance of high-concentration DEET formulations in pediatric patients should be considered.     

Glutathione mobilization during cerebral ischemia and reperfusion in the rat.

1. Cerebral ischemia applied for 15 min and followed by a 30 min reperfusion did not change the glutathione (GSH) levels and beta-adrenoceptor density (Bmax) in brain cortex. 2. A significant increase in erythrocyte-lysate GSH concentration (vs control) and a significant decrease of Bmax values in erythrocyte membranes (vs control) was found at the same time. 3. Pretreatment with the alpha-adrenoceptor antagonist phentolamine (5 mg/kg i.p.) prevented the erythrocyte GSH increase but not the decrease of Bmax value. Pretreatment with the beta-antagonist propranolol (2 mg/kg i.p.) did not influence the increase in erythrocyte GSH but circumvented the decrease of Bmax.