Impulse oscillometry measurement of distal airways obstruction in depleted uranium‐exposed Gulf War veterans

Introduction

A cohort of Gulf War I veterans who sustained exposure to depleted uranium undergoes biennial surveillance for potential uranium‐related health effects. We performed impulse oscillometry and hypothesized that veterans with higher uranium body burdens would have more obstructive abnormalities than those with lower burdens.

Methods

We compared pulmonary function of veterans in high versus low urine uranium groups by evaluating spirometry and oscillometry values.

Results

Overall mean spirometry and oscillometry resistance values fell within the normal ranges. There were no significant differences between the high and low uranium groups for any parameters. However, more veterans were classified as having obstruction by oscillometry (42%) than spirometry (8%).

Conclusions

While oscillometry identified more veterans as obstructed, obstruction was not uranium‐related. However, the added sensitivity of this method implies a benefit in wider surveillance of exposed cohorts and holds promise in identifying abnormalities in areas of the lung historically described as silent.

     

Thermal injuries associated with MRI.

Most physicians are aware of the absolute contraindications to magnetic resonance imaging (MRI). However, less familiar is the potential for an MRI-induced thermal or electrical burn associated with electrical monitoring devices. Although detailed studies concerning the burn hazard in MRI have not been reported, it is widely believed that direct electromagnetic induction in looped cables associated with the patient is responsible for the excessive heating and it is on this theory that present guidelines are based. Recent reports have however indicated that other mechanisms may cause the heating of metal, either in or on the patient. This document reviews numerous reported burn injuries sustained during MRI and addresses the underlying heating mechanisms possibly causing these events.     

Nail re-growth in fingertip injuries

One hundred and fifty-five fingertip injuries were treated over a one-year period. Seventy-six patients with 90 fingertip injuries attended for follow-up. Sixty-four of these injuries were suitable for study. In ten cases, the nail was either trimmed and left in-situ, or cleaned and replaced (Group A). In the remaining 54 cases, the nail was either missing, or had been removed at operation (Group B). The two groups were compared in terms of nail re-growth and nail appearance, but no statistically significant difference was found. There was a direct correlation between final outcome and the degree of crush injury. We conclude that it is the severity of the original injury and the accuracy of the primary repair of the nailbed which are the main determinants of the outcome of a nailbed injury. Non-replacement of the nail did not appear to adversely affect nail re-growth and nail appearance.     

双波长一元线性回归分光光度法同时测定复方氨基比林注射液中三组分含量

本文依据一组含有不同比例待测和干扰组分的标准混合液的吸收值,采用一元线性回归方法,在选择最佳测定波长对的同时建立标准工作曲线方程,使其更符合实际作品测定时的情况,提高了结果的精度和可靠性,并使计算量和实验工作量得以降低。应用于复方氨基比林注射液中三组分氨基比林、安替比林和巴比妥的同时测定,其平均回收率分别为99.8%,100.4%和99.8%,变异系数分别为0.59,1.48和1.05,结果优于卡尔曼滤波法、偏最小二乘法和目标因子分析法。     

Medical litigation. The aetiological role of psychological and interpersonal factors.

The present paper focuses upon psychological factors which may cause patients to make formal complaint or embark upon legal proceedings against a doctor despite competent medical management. Although the principles involved arose from experience of liaison psychiatry in neonatal and obstetric settings, they are more broadly applicable to other areas of medical practice. The corner stone of prevention is appropriate psychological management. One of the most common forms of psychological mismanagement is a failure to share information openly with patients when it becomes available. Sometimes, despite exemplary medical and psychological management, grievance proceedings are still initiated. Often in such cases the cause lies in the patient's psychopathology. Finally, formal complaint or litigation may arise as a result of the patient's unrealistic expectations of the doctor.     

The horn flap: a curved V-Y advancement flap with lateral pedicle.

The Horn Flap, a curved V-Y advancement flap with a radially based subcutaneous pedicle, has proven to be a versatile, reliable method of reconstruction following excision of small facial lesions, particularly in the medial canthal area. Entry of the pedicle on the radial, or concave, side makes significant advancement possible.