The surgical treatment of an aortic aneurysm following a prior correction of its coarctation

In a group of 381 patients who were operated on for coarctation of the aorta 34 (8.9%) were found to have an aneurysm of the aorta in the zone of the correction in the late-term postoperative period. The frequency of aneurysm formation was greater in patients with flap plastics. Fifteen patients underwent a second operation for aneurysm of the aorta, 2 (13.3%) of them died. In the group of patients who were not operated on 6 (31.6%) died.     

The fair sex? Foul play among female rugby players

Rugby, a full contact sport, exposes participants to a high risk of injury. While several studies have explored injuries among male rugby players, few have investigated injuries among females. We conducted a cross-sectional study of United States of America (USA) female rugby players to assess the players' perception of foul play and the referee response to foul play and to evaluate the association between players' perception of foul play and injury. An anonymous, self-administered questionnaire reporting injury status, history of player perceived foul play and referee response was administered to 258 players recruited at a women's rugby tournament. The overall rate of injury was 4.4 injuries/100 matches, 0.2 injuries/100 practices and 1.4 injuries/100 total rugby exposures (matches and practices), with 107 (41.5%) players classified as injured. While 16.5% of players admitted to perpetrating foul play without an assessed penalty and 13.8% to being penalised for foul play, a smaller proportion reported being sent to the 'sin bin' (temporarily removed from play) or being ejected from a match (3.3% and 1.3% respectively). Of the 107 injured, 24.3% believed they had been injured as a result of foul play. Among all 258 players, self-perception of having been hurt due to unpenalised foul play was associated with study-defined injury (OR = 2.4, 95% CI = 1.0-5.9, p = 0.046). To make the sport safer, efforts should be made to minimise foul play. Suggested preventive methods include educating referees, coaches and players about the prevalence of foul play in women's rugby and the association between foul play and injury.     

Chemical pleurodesis in the management of iatrogenic chylothorax

Abstrct A case of chylothorax following ligation of persistent ductus arteriosus, successfully treated by drainage and chemical pleurodesis is reported.     

Effect of blood transfusion therapy on the course of suppurative septic diseases in children

The authors have studied the influence of different variants of hemotransfusion therapy on the course of pyo-septic diseases in 189 children aged from 1 month to 14 years. Positive effects of blood transfusions on the parameters of the peripheral blood, homeostasis and coagulating system as well as the stimulating effect on the bone-marrow blood formation and the immune defense system were demonstrated.     

Excess release of ferriheme in G6PD-deficient erythrocytes: possible cause of hemolysis and resistance to malaria

Hemoglobin in glucose-6-phosphate dehydrogenase (G6PD)-deficient erythrocytes is abnormally vulnerable to oxidative denaturation, which may release ferriheme, a known cytolytic agent. We found 13.3 nmol of ferriheme in G6PD-deficient erythrocyte membranes (per gram of total erythrocyte hemoglobin) using a spectrophotometric assay, as compared to 9.8 in normal membranes (P less than .05). After incubation of erythrocytes with 250 mumol/L menadione, an oxidant drug, the values increased by 37.4 nmol in G6PD-deficient membranes and by 26 in normal membranes (P less than .005), indicating increased hemoglobin denaturation. To verify that hemoglobin denaturation in G6PD-deficient erythrocytes releases ferriheme in a form available to interact with other ligands, [14C]-chloroquine binding to intact erythrocytes was measured. With an initial concentration of 5 mumol/L chloroquine in a medium containing no menadione, an excess of 14.8 nmol of chloroquine was bound in G6PD-deficient erythrocytes (per gram of hemoglobin) as compared to normal erythrocytes (P less than .005). In the presence of 250 mumol/L menadione, chloroquine binding increased by 17.9 nmol in G6PD-deficient and by 7.2 in normal erythrocytes (P less than .005). These results indicate that ferriheme becomes available to interact with endogenous ligands and, thus, to mediate menadione-induced hemolysis in patients with G6PD deficiency. Furthermore, the increase in ferriheme may mediate the selective toxicity of menadione for Plasmodium falciparum parasites growing in G6PD-deficient erythrocytes. Ferriheme release in response to the intraerythrocytic oxidant stress introduced by malaria parasites also may account for the resistance to malaria afforded by G6PD deficiency. This is a US government work. There are no restrictions on its use.