Effects of continuous positive airway pressure on lung mechanics of babies after operation for congenital heart disease

The effect of continuous positive airway pressure (CPAP) on lung mechanics was investigated in 12 babies after operation for severe congenital heart disease. At the time of study all babies were receiving or being weaned from ventilatory support and had abnormally low lung volume or compliance. During CPAP there was a fall in the pulmonary resistance which, with a slight decrease in minute ventilation, resulted in a significant decrease in the work of breathing. It is suggested that lowering the oxygen cost of breathing may contribute to the improvement in arterial oxygenation seen when CPAP is used.     

Inhaled benzene increases the frequency and length of lacI deletion mutations in lung tissues of mice

This study investigated the frequency and pattern of mutations that arose in lacI transgenes in lung tissues of mice exposed to 300 p.p.m. of benzene for 6 h/day x 5 days/week for 12 weeks. The nucleotide sequence changes in 86 lacI- transgenes from lung tissues of eight benzene-exposed mice (BEM) and 78 spontaneous lacI- transgenes from lung tissues of eight unexposed control mice (UCM) were identified and compared. A total of 31% (27/86) of the lacI mutations in BEM are deletions compared with 9% (7/78) deletions in UCM. In BEM, 44% (12/27) of the deletions were longer than 10 bp, whereas only 14% (1/7) of the deletions in UCM exceeded 10 bp in length. Statistical tests supported the hypothesis that benzene exposure resulted in significant increases in both the frequency and length of deletions. Based on the lacI mutant frequency and fraction of unique mutations, lung tissues of BEM were estimated to have a 1.8-fold increase in lacI mutation frequency compared with lung tissues of UCM. The results presented in this paper demonstrate that inhaled benzene is a gene mutagen in lung tissues of mice.      

Weaning practice in the Glasgow Longitudinal Infant Growth Study

AIMS: To assess compliance with Department of Health guidelines on weaning practice in a representative sample of 127 infants from Glasgow, and to identify factors influencing timing of weaning. METHODS: Questionnaires on feeding and weaning were completed during home visits. Ninety eight mothers completed a further questionnaire on attitudes to weaning. RESULTS: Median age at introduction of solid food was 11 weeks (range 4-35 weeks); only 7% of infants had not been weaned before age 4 months. There was no difference in timing of weaning between boys and girls. Younger mothers (< 20 years old), those of lower socioeconomic status, and those who formula fed their infants tended to introduce solids earlier. Infants who were heaviest before weaning were weaned earlier. Seventy three of 98 mothers reported that they weaned their babies because they felt that they required more food. Sources of information influencing time of weaning were previous experience (53/98), books and leaflets (43/98), advice from the health visitor (31/98), and family and friends (15/98). Sixty five of 98 mothers reported receiving formal information on weaning, in most cases (54) this was from the health visitor. Mothers who received formal information tended to wean their infants later. Two per cent of infants had been given cow's milk as a main drink by age 6 months, 17% by 9 months, and 45% by the end of the first year. CONCLUSION: Compliance with recommendations on timing of weaning (not before 4 months), weaning foods, and cow's milk consumption in Glasgow is poor, although no poorer than in many other areas of the UK as found by Office of Population, Censuses and Surveys. Public health messages in relation to weaning may not be reaching their target audience.     

Effectiveness of a nurse-led case management home care model in Primary Health Care. A quasi-experimental,controlled, multi-centre study

Background  

Demand for home care services has increased considerably, along with the growing complexity of cases and variability among resources and providers. Designing services that guarantee co-ordination and integration for providers and levels of care is of paramount importance. The aim of this study is to determine the effectiveness of a new case-management based, home care delivery model which has been implemented in Andalusia (Spain).     

改变对骨质疏松的看法

根据最近 11个独立研究群体的汇总分析和 2 0 0 0例以上骨折病例的回顾性分析可以断定 :骨密度“不能确定某个个体会不会发生骨折1”。既然这样 ,为什么我们还要测量它呢 ?据英国骨质疏松协会提供的数据 ,用于测量骨密度的双能量Ｘ线吸收仪已超过 130台。以双能量Ｘ线吸收仪作为检索词 ,在Ｍｅｄｌｉｎｅ检索出的文献从1988年的 2 6条上升到 1997年的 4 6 4条。按照ＷＨＯ定义 ,一旦绝经前妇女的骨密度低于平均值 1个标准差 (ＳＤ) ,即为骨质稀疏 ,这一“骨折阈值”的概念引导人们进行预防性治疗。但我们应该根据这些数字来处理骨质疏松吗 ?…     

Randomized clinical study comparing Compeed® cold sore patch to acyclovir cream 5% in the treatment of herpes simplex labialis

Background Hydrocolloid technology has been proven effective in treating dermal wounds. A previous study showed that a newly developed thin hydrocolloid patch [Compeed® cold sore patch (CSP)] provided multiple wound‐healing benefits across all stages of a herpes simplex labialis (HSL) outbreak. Methods An assessment of CSP efficacy and safety was conducted in an international, multicentre, assessor‐blinded study, which enrolled 728 subjects with a history of recurrent HSL. Of these, 351 experienced an HSL outbreak and were randomized to use CSP (n = 179) or acyclovir cream 5% (n = 172) at the onset of symptoms until the lesion healed, for a maximum of 10 days. The primary end point was the subject's global assessment of therapy (SGAT; 0–10 scale; 0 = no response, 10 = excellent response). Multiple secondary end points included clinician‐assessed healing time and subject assessment of lesion protection, noticeability and social embarrassment. Results CSP and acyclovir were highly effective (mean SGAT = 7.89 and 8.00, respectively), with no significant difference observed (P = 0.65). The difference in healing times between products was not significant (median, 7.57 days with CSP vs. 7.03 days with acyclovir, P = 0.37). Both treatments were well tolerated. Conclusion CSP using hydrocolloid technology provides an efficacious and safe alternative to topical antivirals in treating HSL as a wound while affording additional immediate benefits of wound protection, discretion and relief of social embarrassment.     

Occupational predictors of pregnancy outcomes in Irish working women in the Lifeways cohort

Objective  The objective of this study was to explore the association between occupational factors and pregnancy outcomes in a prospective cohort of Irish pregnant women.
Design  This study has a prospective design.
Population  The Lifeways cohort included 1124 pregnant women, 676 of whom delivered a single baby and were working at their first prenatal care visit when they filled in a self-administered questionnaire.
Methods  Occupational factors were measured using this questionnaire and included eight factors describing job and working conditions. Data including pregnancy outcomes were also obtained from clinical hospital records. Logistic regression analysis was used to adjust for well-known risk factors.
Main outcome measures  Birthweight (≤3000 g and ≤2500 g), preterm delivery (<37 gestation weeks) and small-for-gestational-age.
Results  Significant associations were found between physical work demands and low birthweight (≤2500 g) and working with between a temporary contract and preterm delivery. Trends were also observed between working 40 hours or more a week and shift work, and birthweight of 3000 g or less. The study of a cumulative index showed that being exposed to at least two of these occupational factors significantly predicted birthweight of ≤3000 g (OR = 2.44, 95% CI: 1.17–5.08) and of ≤2500 g (OR = 4.65, 95% CI: 1.08–20.07) and preterm delivery (OR = 5.18, 95% CI: 1.00–27.01).
Conclusions  Our findings suggest that occupational factors may predict birthweight through their predictive effects on preterm delivery. This is one of the few prospective studies on pregnancy outcomes that include working conditions. As they may be modifiable, occupational factors deserve more attention in relation to birth outcomes.