Screening for a raised rectal temperature in Africa

The main purpose of this study was to compare rectal and axillary temperature measurements in African children. Altogether 573 sick children were seen in an outpatient setting in rural West Africa. Rectal and axillary temperatures were measured and the parent or guardian was asked if they thought that the child had a raised body temperature. Normal ranges were defined from an age matched population of 203 healthy children. A raised axillary temperature predicted a raised rectal temperature with a sensitivity of 98% and a specificity of 88%. The parents' impression that their child had a fever was a less sensitive (89%) and less specific (59%) indicator of raised rectal temperature. A raised axillary temperature is a good screening test for a raised rectal temperature in African children.     

Fibromatosis of bone in children

Radiographs, computed tomograms, and radionuclide bone scans were obtained preoperatively in three children with fibromatosis involving the bones and soft tissues of the extremities. Two of the children had identical scar-like bone lesions of the proximal tibia, which, to the authors' knowledge, have not been reported before in this disease. The lesions recurred in two children.     

Emphysema in the renal allograft

Two diabetic patients in whom emphysematous pyelonephritis developed after renal transplantation are described. Clinical recognition of this unusual and serious infection is masked by the effects of immunosuppression. Abdominal radiographic, ultrasound, and computed tomography findings are discussed. The clinical presentation includes urinary tract infection, sepsis, and acute tubular malfunction of the allograft in insulin-dependent diabetics.     

A population-based study of anxiety as a precursor for depression in childhood and adolescence

Background  

Anxiety and depression co-occur in children and adolescents with anxiety commonly preceding depression. Although there is some evidence to suggest that the association between early anxiety and later depression is explained by a shared genetic aetiology, the contribution of environmental factors is less well examined and it is unknown whether anxiety itself is a phenotypic risk factor for later depression. These explanations of the association between early anxiety and later depression were evaluated.     

Perioperative complications in revision hip surgery

Revision hip surgery now constitutes 10-30% of all joint procedures. The morbidity and associated with this demanding operation are not well established. The goal of this paper is to determine these rates and to identify some predictive factors.
The complication rate ranges from 31,5 to more than 77% in the literature. Life threatening complications represent 1,8 to 8% of these, leading to death in about 1,6%. ASA score and age above 75 appear to be correlated with medical complications. The injection rate varies from 1 to 5,8%, and may be as high as 14% in cases with a past history of infection. Heterotopic ossification occurred in 13 to 65%, reaching severity in 3,3 to 8,3%.
Surgical complications include dislocation and femoral injuries. Dislocations occur in almost 10%, leading to revision in1-4,2%. Age and the number of previous surgical operations appear to be significant risk factors. Femoral injuries (perforations or femoral fractures) occur in 6-37%, especially in impaction grafting technique and when uncemented implants are used. Age over 75 years and femoral defects appear to be significant risk factors for femoral fractures.
The rate of complications in revision hip surgery continues to be high, but successful clinical outcome can be attained even in elderly patients. Attentive preoperative exams, good prevention of technical pitfalls, the experience of the surgeon and the use of specific tools may decrease these complications and make this demanding procedure safer.
     

盐酸放线瑞香宁的紫外二阶导数光谱法测定及在兔体内的药代动力学

盐酸放线瑞香宁(actinodaphine-HCl)系从莲叶桐科青藤属植物黑吹风(Illigera khasiana C.B Clarke)中分离提取而得的有效成分,结构式如图1。药理试验证明有解热、镇痛、解痉等作用。本文报告用紫外二阶导数光谱法研究盐酸放线瑞香宁在兔体内的药代动力学结果。家兔4只,体重2.8±0.6kg。盐酸放线瑞香宁由本所植化室提供。氯仿、乙醇均为A.R。Perkin-Elmer型紫外—可见光分光光度计系美国产品。     

Eicosanoid synthesis by cultured human urothelial cells: potential role in bladder cancer

Prostaglandin (PG) H synthase and eicosanoid products of arachidonic acid metabolism have been implicated in several steps in the carcinogenic process. This study assessed these parameters using primary cultures of human urothelial cells. To determine the possible presence of permeability barriers to agonist stimulation, incubations were performed with adherent cells in the presence or absence of thioglycolate pretreatment or with cell suspensions. No evidence for permeability barriers was observed. With adherent cells in the absence of thioglycolate, radioimmunoassayable PGE2 was stimulated by epinephrine less than 12-O-tetradecanoylphorbol-13-acetate = thrombin less than bradykinin = A23187 much less than arachidonic acid. Tumor promoters but not non-tumor promoters stimulated PGE2 synthesis. 1-Oleoyl-2-acetylglycerol which like 12-O-tetradecanoylphorbol-13-acetate activates protein kinase C also increased PGE2 synthesis. Cells prelabeled with [14C]arachidonic acid were exposed to agonists and the profile of eicosanoids synthesized was assessed by high performance liquid chromatography. With bradykinin, the pattern of eicosanoids synthesized was 6-keto-PGE1 alpha (12% of total 14C label), thromboxane B2 (0.4%), PGF2 alpha (1.7%), PGE2 (18%), PGD2 (1%), leukotrienes (0.4 to 1%), 12-hydroxy-5,8,10-heptadecatrienoic acid (3%), 15-hydroxy-5,8,11,13-eicosatetraenoic acid (4%), 12-hydroxy-5,8,10,14-eicosatetraenoic acid (0%) and 5-hydroxy-5,8,12,14-eicosatetraenoic acid (2%). Thus, human urothelial cells contain both prostaglandin H synthase and lipoxygenase pathways with the former being more prominent. These pathways may participate in urinary bladder carcinogenesis.