Rising incidence of oesophageal adenocarcinoma in men in Australia

Adenocarcinomas of the oesophagus and of the gastric cardia have been reported to be increasing in incidence in many countries, while the incidence of squamous cell carcinoma of the oesophagus is stable and non-cardia gastric cancers are decreasing in incidence. Age-standardized incidence rates for the years 1982–93 for oesophageal adenocarcinoma and non-adenocarcinoma, and gastric cardia and non-cardia cancers were calculated based on state cancer registry incidence data. Time trends in the age-standardized rates were assessed using linear regression. A consistent increasing trend in the incidence of oesophageal adenocarcinoma in men was seen in all states of Australia and was statistically significant in all states except South Australia. There were no consistent nationwide trends in the incidence of oesophageal adenocarcinoma in women, although a trend towards an increase in the incidence of this cancer reached statistical significance ( P < 0.05) in three states (New South Wales, Victoria, Queensland). There were no important trends in the incidence of oesophageal non-adenocarcinoma in either men or women. There were no consistent nationwide changes in the incidence of gastric cardia cancer in either men or women, although this cancer was significantly increasing in Tasmania in both men and women. The incidence of cancer of the stomach not arising at the gastric cardia was significantly decreasing in men in all states and was also decreasing in women in all states, although in women this decrease was statistically significant only in New South Wales, Victoria and Western Australia. There has been a dramatic increase in the incidence of oesophageal adenocarcinoma in men in Australia. The incidence of this cancer in men is now approximately equal with that of non-adenocarcinoma of the oesophagus. The incidence of non-cardia stomach cancer continues to fall.     

Role for postoperative cortisol response to desmopressin in predicting the risk for recurrent Cushing's disease

In the early postoperative period of Cushing's disease patients, desmopressin may stimulate ACTH secretion in the remnant corticotrophic tumour, but not in nontumour suppressed cells. Objective The aim of this study is to evaluate the serum cortisol responses to desmopressin after pituitary surgery, establishing an optimal cut‐off for absolute increment (Δ) of serum cortisol (F) suitable to predict recurrence risk. Design Retrospective case record study. Patients Fifty‐seven Cushing's disease patients submitted to pituitary surgery and desmopressin stimulation in the early postoperative with a long‐term follow‐up (20–161 months) were studied. Methods and measurements Serum cortisol levels after desmopressin test (10 µg IV) 15–30 days after adenomectomy were used to determine ΔF (absolute increment of F: F peak ? F baseline). Sensitivity and specificity of ΔF were calculated and a ROC curve was performed to establish an optimal cut‐off for ΔF to predict recurrence risk. Results Fifteen patients had immediate postoperative failure (basal F > 165 nmol/l; 6 µg/dl) and one patient was lost during the follow‐up. Forty‐one patients achieved initial remission and were followed‐up. Five of 11 patients who recurred had ΔF > 193 nmol/l (7 µg/dl), but none of 30 patients who remained in prolonged remission showed ΔF > 193 nmol/l after postoperative desmopressin stimulation. Conclusions Persistence of cortisol response (ΔF > 193 nmol/l) to desmopressin in the early postoperative period can help to identify Cushing's disease patients with initial remission who present risk for later recurrence.     

Dietary nutrient intake comparisons for rural and urban Russian boys,ages 6, 9, and 15 years,living in St. Petersburg and surrounding areas

Dietary intake data were gathered on 123 rural and 111 urban males, ages 6, 9, and 15 years, living in and near St. Petersburg, Russia. Data were analyzed to estimate intakes of kilocalories, protein, calcium, iron, vitamin A, thiamin, riboflavin, niacin, vitamin C, and percentage of kilocalories from protein, carbohydrate, and fat. Comparisons were made between nutrient intakes of urban and rural subjects; intakes were also compared with the Recommended Dietary Intakes (RDI) of the USSR Research Institute of Nutrition. There were no significant differences between rural and urban boys in energy intake at any age. Urban boys consumed more vitamin C at ages 6 and 9, had higher intakes of protein, calcium, and niacin at age 9, and consumed more protein at age 15. Rural boys had higher intakes of riboflavin and calcium than urban boys at age 6. Urban boys consumed larger proportions of energy as carbohydrate at age 6, protein at age 9, and both protein and fat at age 15 than rural subjects. Rural boys had higher proportions of kilocalories from fat at age 6 and carbohydrate at age 15 than urban boys. Mean nutrient intakes below the RDI were: energy for rural boys at 9 and 15 years; iron for rural subjects at ages 6 and 9 and urban boys at age 6; calcium for rural and urban boys at all ages; vitamin C for rural subjects at ages 6 and 9; vitamin A for rural and urban boys at age 15; and protein for rural boys at age 15. At age 6, rural boys had nutrient intakes superior to those of urban boys; urban nutrient intakes were better than rural at ages 9 and 15. © 1994 Wiley-Liss, Inc.     

Neurenteric cyst of the posterior mediastinum

We report a case of a large posterior mediastinal neurenteric cyst in a neonate demonstrated by chest radiographs, barium swallow examination, ultrasonography and CT of the thorax. All the investigations revealed a large posterior mediastinal cystic mass with vertebral anomalies in the form of scoliosis and hemivertebra. The cyst was completely excised by a right posterolateral thoracotomy and biopsy showed the features of a neurenteric cyst. The rarity of the lesion prompted us to report this case.     

TOLERANCE TIME OF EXPERIMENTAL THERMAL PAIN (COLD INDUCED) IN VOLUNTEERS

Perception of thermal pain (cold induced) was studied in 106 volunteers from troops and civilians deployed in J & K. Thermal stimulus devised was “holding ice”. Tolerance time of holding ice was taken to be a measure of thermal sensitivity, volunteers were classified based on their native areas, addiction habits and socio-economic status, out of 106 volunteers, 81 could & 25 could not hold ice over 10 min. Sixteen out of 40 from coastline States and 9 out of 66 from non-coast line States failed to hold ice over 10 min. In “below average” “average” and “high average” socio-economic groups, three out of 27, 19 out of 73 and 03 out of 6 failed to hold ice over 10 min respectively. Fifteen out of 64 from “addiction habit group” and 10 out of 42 from “no addiction habit group” failed to hold ice over 10 min. Statistically no classification used in the study revealed significant difference in “tolerance times” of volunteers except the one based on coastline and non-coastline States.KEY WORDS: Pain, Nociception, Thermal sensations     

Neurovascular compression associated with trigeminal neuralgia and systemic arterial hypertension: surgical treatment

OBJECTIVE AND IMPORTANCE: To highlight arterial hypertension as an additional factor favoring surgical indication in neurovascular compression syndromes such as trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia. CLINICAL PRESENTATION: A 52-year-old woman with trigeminal neuralgia concomitant with systemic arterial hypertension, submitted initially to unsatisfactory conservative treatment, presents tortuousness and enlargement of the vertebral artery (VA) topography on magnetic resonance imaging (MRI). A microsurgical neurovascular decompression of the trigeminal nerve and the medulla was performed, revealing that the compression was due to the superior cerebellar artery instead of the VA. Both the neuralgia and the hypertension were controlled with no need of medication during a 1-year follow-up. CONCLUSION: Surgical indication in neurovascular compression disorders should be reinforced in the presence of concomitant arterial hypertension and a compatible MRI examination.     

Field Trial of Relative Efficacy of Abate and Bacillus thuringiensis Against Simulium himalayense Larvae (Diptera simulidae)

Simulium himalayense (Diptera simulidae) are known pests which cause severe biting nuisance in North-East region and breed in its fast flowing rivers and rivulets. A field trial was undertaken to control this nuisance with the help of larvicides and to help ascertain relative efficacy of Abate and B thuringiensis against Simulidae. Abate proved to be an effective larvicide for river treatment wherein 0.1 PPM resulted in 100% larval reduction while in small streams, the treatment with Teknar (Bacillus thuringiensis) with 10 PPM for 10 minutes resulted in 80% larval reduction. The results of the present study showed that Abate was more effective in rivers while B thuringiensis proved to be useful in controlling the breeding in the rivulets. An integrated approach using chemical and biological agents is recommended and considered ecologically sound as it does not affect the fish and potability of water.Key Words: Larvicidal control, Simulidae