The effect of cigarette smoking on ceruloplasmin and C3 complement: risk of cardiovascular disease (atherosclerosis)

Serum ceruloplasmin, C3 complement and albumin in 119 male smokers and 65 male non-smoker; from a military unit in Bangkok were investigated in this study. The serum ceruloplasmin concentration was found to be significantly higher in smokers than in non-smokers. However, the serum albumin concentration in smokers was statistically significantly lower than in non-smokers. Significant associations were also found between ages, albumin levels and the quantity of cigarettes smoked. There was a significant positive correlation between serum ceruloplasmin and C3 complement concentrations. An association between the quantity of cigarettes smoked and albumin was also found, as well as a significant relationship between smoking and the quantities of cigarettes smoked to serum ceruloplasmin levels when smoking and the quantity of cigarettes smoked were taken as independent variables, and the serum ceruloplasmin levels as a dependent variable. This might suggest that high concentrations of the acute-phase protein, i.e. ceruloplasmin, might constitute a risk of developing atherosclerosis or cardiovascular disease in smokers.     

Contraceptive methods and epilepsy. Consideration on its physiopathogenesis

The authors present six cases of patients with catamenial epilepsy, that use contraceptive methods (hormonal and intrauterine device). A critical report of the physiopathogenic aspects of hormones and epilepsy is also made. The authors conclude that: 1 - It seems there is no doubt about the influence of sexual hormones in epilepsy. 2 - There is no previsibility about the consequence of the use of contraceptives (hormonal and IUD) in patients with catamenial epilepsy. 3 - Further studies are still necessary to demonstrate the risk factors of contraceptive methods in epileptic patients.     

One-year incidence of home accidents in a rural Swedish municipality

Since 1978 a continuous registration of acute in-patient and out-patient visits, has been conducted in a municipality in Skaraborg County in western Sweden as a part of the evaluation of an intervention programme. Such a comprehensive community oriented intervention programme has never been reported before. A special focus has been directed at accident cases divided up by environment: home, work, traffic, and other. A total of 20 440 inhabitants in the municipality were registered in health and medical care centres over a six-year period because of injuries. Since 23.5% of all accidents happen in the home, cases of home accidents have been mapped out in more detail with the help of standardized and structured surveys via telephone interviews. All of these were completed with a review of hospital records and death certificates. Because of the comprehensive registration we were able for the first time in Sweden to calculate the distribution of home accidents down to very small geographical areas. The thinly populated areas show significantly higher levels of home accidents when compared to the densely populated areas. In addition to geographical differences, there were incidence differences regarding sex, age group, and type of housing. The majority of home accidents (76.5%) occurred in connection with moving, play, and hobbies. Injuries from blows, cuts, and collisions are the most common type of accidents for men, while injuries from falls are the most dominant types for women. The dominating types of injuries are: contusions, fractures, and wounds. A significantly higher incidence of accident cases among the elderly exists in all of the old age homes/service houses in the study area.(ABSTRACT TRUNCATED AT 250 WORDS)     

Calcifying odontogenic cysts: A 20-year retrospective clinical and radiological review

Objective:Calcifying odontogenic cysts (COCs) exhibit diverse clinical behaviours and may be associated with other benign odontogenic tumours. In this study, the clinical and radiological features of COCs were analysed according to subtypes based on the classification by Praetorius et al. Emphasis was placed on cases exhibiting atypical or aggressive radiological appearances. This information may assist the clinician to better understand the radiological spectrum of COCs.Methods:Histologically confirmed cases of COCs were retrospectively reviewed in a 20-year period from three tertiary institutions. The following clinical information was reviewed: patient demographics, main complaint, clinical duration, anatomical site and detailed radiological features.Results:Twenty-seven cases of COCs were included in the study. Asymptomatic swelling was the main clinical presentation with infrequent reports of associated pain. COCs had an anterior mandibular predilection. Well-demarcated borders were seen in all cases with isolated cases showing focal areas with loss of demarcation. Unilocular lesions were more common than multilocular variants. Internal calcifications were frequent and six cases presented with associated odontomas. Maxillary COCs resulted in the displacement of the maxillary sinus and/or nasal cavity walls. Radiological signs of aggression, including cortical destruction, were noted in a few cases.Conclusion:Given the fact that COCs can present with a spectrum of clinical behaviours and radiological presentations, the academic debate regarding the cystic versus neoplastic nature of the entity is justifiable. The cases in the current sample presented with diverse presentations, ranging from indolent to lesions with significant growth and aggression.     

Mutational scanning of large genes by extensive PCR multiplexing and two-dimensional electrophoresis: application to the RB1 gene

With the rapid increase in the number of identified human disease genes, the development of accurate and cost-efficient mutation tests has become opportune. Here we present a combination of extensive PCR multiplexing and two-dimensional (2-D) DNA electrophoresis to screen for mutations in 26 exons of the retinoblastoma (RB1) tumor suppressor gene. In 2-D electrophoresis, fragments are separated according to size and base pair sequence in non-denaturing and denaturing gradient gels, respectively. All target fragments, designed to have optimal melting characteristics, were prepared in a two-step PCR (a 6-plex long-PCR pre- amplification and a subsequent 25-plex short-PCR) followed by heteroduplexing. The mixture of PCR amplicons was then subjected to 2-D electrophoresis under a single set of experimental conditions. With this design, 35 previously identified mutations in 18 different exons were detected in 33 bilateral retinoblastoma patients. These results suggest that 2-D electrophoresis in this format provides a generally applicable, practical and fast way to diagnose with high accuracy large genes for a broad spectrum of possible disease-causing mutations.      

Acquired immunodeficiency syndrome: Ga-67 citrate imaging

All gallium-67 citrate scans obtained in patients with acquired immunodeficiency syndrome (AIDS) at the Clinical Center, National Institutes of Health (Bethesda, Md.) were retrospectively analyzed and correlated with the results of bronchoscopy, chest radiography, and endoscopy. There were 164 scans of 95 patients. Twenty scans were from patients with Pneumocystis carinii pneumonia; 19 were abnormal, for a sensitivity of 95%. Ga-67 uptake tended to be less in patients receiving therapy for P. carinii pneumonia. Chest radiographs were normal at least initially in three patients with abnormal scans and P. carinii pneumonia. Unusually prominent colonic activity was associated with infection in some patients. No lesions of Kaposi sarcoma showed tracer uptake. Gallium scanning is useful for detecting P. carinii pneumonia and other opportunistic infections in patients with AIDS, but it is not useful for localizing Kaposi sarcoma.     

UK childbirth delivery options in 2001–2002: alternatives to consultant unit booking and delivery

BACKGROUND: Government policy advocates maternal choice in pregnancy care. Two key issues are place of birth and type of lead professional. Anecdotal evidence suggests there is variation in both these issues across the UK, but there has been no recent national assessment of whether maternal options are in line with government policy. AIM: To establish the range of women's childbirth delivery options, degree of midwife autonomy, and supporting training and governance mechanisms. DESIGN: Two postal questionnaires. SETTING: UK maternity units. METHOD: Questionnaires were sent to maternity services managers. MAIN OUTCOME MEASURES: number and type of units and births, transfers and care types; midwifery procedures; clinical governance and training activities. RESULTS: Completed questionnaires were received from 301 out of 308 (97.7%) units in 2002 and from 258 out of 309 (83.5%) units in 2001. Midwife-led care is available in 186 English (76.9%), 15 Welsh (78.9%), 18 Scottish (48.6%) and three Northern Ireland (30.0%) units. There are 73 (24.3%) stand-alone, 22 (7.3%) alongside, 127 (42.2%) integrated and 79 (26.2%) consultant units (for definitions of unit types, see main text), with a median 2215 hospital, 25 home and 210 midwife-led births. The median antenatal and labour transfers from midwife-led units are 25.5% (interquartile range [IQR] = 18.5-36.5%) and 18.0% (IQR = 13.4-24.8%) respectively; transfers are independent of distance to nearest consultant unit, country and unit type. CONCLUSIONS: Despite government policy promoting greater parental choice, this is not in evidence in many parts of the UK. The wide variations in home birth, midwife-led care and maternity-unit types merit further exploration. If more midwife-led units are to be established as a way of promoting parental choice and dealing with junior doctor rota problems, then such units must have adequate governance and training activities in place.