Should the Lungs Be Ventilated during Cardiopulmonary Bypass? Clinical,Hemodynamic, and Metabolic Changes in Patients Undergoing Elective Coronary Artery Surgery

No beneficial effects were achieved by ventilating the lungs of a group of 10 patients during total extracorporeal circulation for coronary artery bypass operation. Ventilation of nonperfused lungs, which was suggested to prevent postoperative atelectasis, may even have negative effects. Intrapulmonary shunting increased significantly (p < 0.05), while the shunt fraction in the non-ventilated lungs of another group of 10 patients remained unchanged. There were only minor differences between the two groups with respect to systemic and pulmonary hemodynamic changes.     

Exposure to welding fumes and chronic renal diseases,a negative case-referent study

Summary It was observed that some patients with glomerulonephritis or interstitial nephritis were welders. A hypothesis that welding fumes were an occupational hazard was put forward and initiated the following case-referent study. 143 cases were defined as living males, age 25 to 65 years, with renal disease which caused renal biopsy from 1976–1982. Three population-based referents for each case were selected from the national register of the total population matched by sex, age and community. Exposure was assessd by means of a questionnaire. Only 7% of the cases and 12% of the referents did not answer the questionnaire. There were no differences in exposure rates between cases and referents, even if exposure restrictions were applied. The power of the case-referent study was high.     

A sociological study of awareness of symptoms among persons with pulmonary tuberculosis

In 39 randomly selected villages and towns in Tumkur District, South India, approximately 2000 persons, tuberculosis cases and matched controls, were interviewed in order to determine how many had symptoms suggestive of tuberculosis. Approximately 70% of the bacteriologically confirmed cases and over half the radiologically active or probably active cases had at least one major symptom. The authors discuss these findings in the light of the results of certain other studies they have carried out—for example, on present action-taking among tuberculosis sufferers. They conclude that under present circumstances in India, it is epidemiologically and economically justified to base tuberculosis control programmes on the persons who seek assistance because of worry over symptoms. Only when services satisfying the needs of the already worried tuberculosis sufferers are well developed, may mass case-finding be considered as an additional measure.     

Microdosimetry of astatine-211 single-cell irradiation: role of daughter polonium-211 diffusion

A microdosimetric analysis of previously published data on 211At-albumin, free 211At, and 211At-C215 irradiation of Colo-205 cells in a slowly rotating single-cell suspension is presented. A custom-built computer program based on the Monte Carlo method was used to simulate the irradiation and the energy deposition in individual cell nuclei. Separate simulations were made for the assumption that the 211Po atom stays in the position where it is created, and that it diffuses away. The mean event number at which 37% of all cells survived, n37, and the frequency mean specific energy per event, zF, were estimated. The Poisson distribution of events and simulated single and multievent distributions of specific energy were used to find the single-cell specific energy at which the probability of survival is reduced to 37%, z37. The calculated single-cell radiosensitivity values show that 211Po atoms, created on a cell surface by the decay of 211At atoms, will diffuse from the cell during its life-span. The increasing distance to the cell nucleus will drastically decrease the probability of the emitted alpha particle to hit the nucleus. This will result in fewer alpha-particle events in the cell nucleus. For dispersed cells, the diffusion of 211Po atoms will reduce the total dose from cell-bound 211At by a factor of 2.     

Symptoms and signs have changed in Swedish children with coeliac disease

OBJECTIVE: To examine symptoms and signs in children with coeliac disease and determine whether the clinical picture at disease onset has changed as incidence of the disease has decreased in the last 10 years. This project was part of the ABIS study (All Babies in Southeast Sweden, born from October 1997 to October 1999). METHODS: Eight paediatric departments in Southeast Sweden recorded all children with coeliac disease and registered symptoms according to a standard form. Data were obtained from 79 children with biopsy-confirmed coeliac disease, 43 contemporary controls, and 65 historic controls. RESULTS: When compared with children with normal intestinal biopsies, children with coeliac disease more often had abdominal distension (odds ratio [OR] = 22.17; 95% confidence interval [CI] OR = 5.00-98.25), thin extremities (OR = 5.89; 95% CI OR = 2.09-16.55), irritability (OR = 6.50; 95% CI OR = 1.83-23.03), and tiredness (OR = 15.43; 95% CI OR = 2.00-119.16). When compared with coeliac children diagnosed at < or =2 years of age in Gothenburg between 1985 and 1989, when the incidence of coeliac disease was three times higher, ABIS patients aged < or =2 years at diagnosis had less often experienced diarrhoea (OR = 0.23; 95% CI OR = 0.12-0.65), suboptimal weight gain (OR = 0.02; 95% CI OR = 0.01-0.10), or suboptimal linear growth (OR = 0.14; 95% CI OR = 0.05-0.39). CONCLUSION: This study indicates that, in parallel to changes in incidence, clinical features of coeliac disease in young children have changed during the last 10 years.