To close or not to close? Treatment of abdominal compartment syndrome by neuromuscular blockade without laparostomy

Abdominal compartment syndrome (ACS) is a recognised postoperative complication seen frequently in the intensive care unit (ICU). Surgical decompression and laparostomy remain the gold standard treatment for established ACS, combined with supportive non-surgical therapy, such as nasogastric decompression. In the following case report, we describe our successful management of a patient with established postoperative ACS by re-laparotomy to exclude a reversible cause, immediate re-closure of the abdomen and prolonged neuromuscular blockade, avoiding a laparostomy.     

Estimating the cost effectiveness of screening tests

A number of criteria have been postulated that a screening test should fulfill in order for it to be a good or worthwhile screening tool. However, it is a rare test which fulfills all the criteria that have been thought to be important. Therefore, there always exists some form of trade-off between, for example, the detection rate and the false- positive rate and cost. It is the magnitude and form of these trade- offs, which differ for each screening test, that are important, not whether a test fulfills some arbitrary set of criteria. In this paper, we describe some of the trade-offs which occur when appraising a screening test and we argue that listing arbitrary criteria is an unhelpful activity.      

Birth weight and body fat distribution in adolescent girls

OBJECTIVE: To examine the association between birth weight and body fat distribution in a group of adolescent girls. DESIGN: A total of 216 white girls who were born in Southampton had their heights, weights, waist and hip circumferences, and skinfold thicknesses measured when they were aged between 14 and 16 years. RESULTS: The girls who were smallest at birth, but who were fattest at time of measurement were the most centrally obese. In girls whose body mass index was above the median (21 kg/m2), the subscapular to triceps skinfold ratio rose by 9% for every kilogram decrease in birth weight. Among overweight girls, with a body mass index over 25, the ratio rose by 27% for every kilogram decrease in birth weight. CONCLUSION: In adolescent girls, the tendency to store fat on the trunk rather than the limbs, seems to be programmed by growth in fetal life, and is most evident in those who are overweight.     

马兜铃酸的倍半萜的酯类化合物Ⅶ．绵毛马兜铃中马兜铃酸萜酯Ⅰ的结构鉴定

从绵毛马兜铃（ＡｒｉｓｔｏｌｏｃｈａｍａｎｎｉｓｓｉｍａＨａｎｃｅ）中分得一个马兜铃酸倍半萜的酯类化合物，经红外、紫外、高分辨质谱和多种一维和二维核磁共振谱鉴定，确定了其骨架结构及顺反构型，命名为马兜铃酸萜酯Ｉ。