Digital tourniquets: a pressure study with clinical relevance

This study measured the pressures under the three most commonly used digital tourniquets--the Penrose drain, the rolled rubber glove, and the rubber band. A miniature pressure transducer and a digital strain indicator were used to measure pressures generated by the various tourniquets. The rolled rubber glove technique was highly consistent, irrespective of the clinical experience of the subject, and uniformly generated pressures of less than 500 mm Hg. Pressures generated by Penrose drains and rubber bands were highly variable and were significantly greater than 500 mm Hg. The so-called calibrated Penrose drain generated the highest pressures in the study. The relationship between tourniquet pressures and neurovascular injury in the human digit is not clearly defined.     

Ultrasonographic demonstration of a gas-containing pancreatic abscess. A case report

A 24-year-old man presented with acute pancreatitis. Serial ultrasonographic examination showed the development of bright echoes within the pancreatic parenchyma compatible with gas formation. This was confirmed on subsequent computed tomography and at laparotomy. The value of serial ultrasonographic examinations in pancreatitis is emphasized.     

Comparative anorexigenic activity and other pharmacological properties of quipazine and its N-acyl derivatives

In experiments on mice and rats quipazine exerts a moderate and short-term anorexigenic activity. N-acyl quipazine derivatives are markedly less toxic, do not exert anorexigenic action and influence weakly the serotoninergic and adrenergic systems.     

Bone turnover in postmenopausal women after withdrawal of estrogen/gestagen replacement therapy

Bone turnover before and after withdrawal of estrogen/gestagen treatment was studied in a randomized trial with 110 healthy female volunteers, who had passed a natural menopause 6 months to 3 years before the start of the study. Urinary excretion of intravenously injected 99m-technetium diphosphonate was measured as an index of bone turnover; plasma bone Gla protein and serum alkaline phosphatase were measured as indices of bone formation; and fasting urinary excretion of hydroxyproline and calcium were measured as estimates of bone resorption. During 2 years of hormone treatment, all variables decreased highly significantly (p less than 0.001) to a constant low level. Three months after withdrawal all variables increased highly significantly (p less than 0.001) towards, but not above, pretreatment and placebo levels. We conclude that withdrawal of estrogen/gestagen replacement therapy in postmenopausal women increases bone turnover, but not in excess of pretreatment values. This indicates that bone loss (after withdrawal) is similar to that seen in the placebo group and that a rebound phenomenon is unlikely.     

Adjuvant radiotherapy in carcinomas of the uterine cervix: the prognostic value of hemoglobin levels

Anemia has been associated with a poorer treatment response and reduced survival in women undergoing primary radiotherapy (RT) or radiochemotherapy for advanced cervical carcinoma. This study aimed to determine the influence of anemia on outcome in patients with cervical carcinoma undergoing adjuvant RT. Medical records were reviewed for 183 cervical cancer patients who had received adjuvant RT because of risk factors after radical surgery (n= 109) or inadequate primary surgery (simple hysterectomy; n= 74). Kaplan-Meier and Cox regression analyses were used to study hemoglobin levels before and during adjuvant RT in relation to recurrence-free and overall survival. Hemoglobin values > or =11 g/dL were considered normal, while those <11 g/dL indicated anemia. Hemoglobin levels before RT influenced significantly overall survival and recurrence-free survival across the whole group (overall survival--log rank(all patients)= 7.5; df = 1; P= 0.006). However, subgroup analysis showed that the observed difference was mainly due to the group of women who had undergone inadequate primary surgery (overall survival--log rank(inadequate surgery)= 10.8; df = 1; P= 0.001). Multifactorial regression analyses comparing hemoglobin before RT with grading and tumor stage confirmed the prognostic value of hemoglobin values. Maintaining normal hemoglobin values before and during adjuvant RT seems to be important, especially in patients who have had inappropriate simple hysterectomy, which may resemble a therapeutic situation.