Perioperative haemodynamic effects of an intravenous infusion of calcium chloride in children following cardiac surgery

Murdoch IA, Qureshi SA, Huggon IC. Perioperative haemodynamic effects of an intravenous infusion of calcium chloride in children following cardiac surgery. Acta Pzdiatr 1994;83:658–61. Stockholm. ISSN 0803–5253
Twelve children received an infusion of 10% calcium chloride 0.1 ml/kg to a maximum dose of 5 ml, infused over 5 min, following open heart surgery. Blood ionized calcium, systemic arterial pH, cardiac index, mean systemic arterial blood pressure and systemic vascular resistance index were measured at baseline and repeated 20 and 40 min following completion of the infusion. There was considerable overlap, with no significant differences in the response to the calcium chloride infusion between children with ionized hypocalcaemia (< 1.1 mmol/l) and those with ionized normocalcaemia when its effect on percentage change in either the haemodynamic or biochemical measurements was assessed ( p>0.2 for all measurements; Mann-Whitney). For this reason they were treated as a single group. Significant changes from baseline were noted in mean systemic arterial pressure (p 10.02), cardiac index (p<0.01) and systemic vascular resistance index (p<0.01) after completion of the calcium chloride infusion when analysed using Friedman's two-way analysis of variance. A significant increase in mean systemic arterial blood pressure occurs after an infusion of 10% calcium chloride as a direct result of an increase in the systemic vascular resistance index with a concomitant decrease in cardiac index.     

The educational background and qualifications of UK medical students from ethnic minorities

Background

UK medical students and doctors from ethnic minorities underperform in undergraduate and postgraduate examinations. Although it is assumed that white (W) and non-white (NW) students enter medical school with similar qualifications, neither the qualifications of NW students, nor their educational background have been looked at in detail. This study uses two large-scale databases to examine the educational attainment of W and NW students.

Methods

Attainment at GCSE and A level, and selection for medical school in relation to ethnicity, were analysed in two separate databases. The 10^th cohort of the Youth Cohort Study provided data on 13,698 students taking GCSEs in 1999 in England and Wales, and their subsequent progression to A level. UCAS provided data for 1,484,650 applicants applying for admission to UK universities and colleges in 2003, 2004 and 2005, of whom 52,557 applied to medical school, and 23,443 were accepted.

Results

NW students achieve lower grades at GCSE overall, although achievement at the highest grades was similar to that of W students. NW students have higher educational aspirations, being more likely to go on to take A levels, especially in science and particularly chemistry, despite relatively lower achievement at GCSE. As a result, NW students perform less well at A level than W students, and hence NW students applying to university also have lower A-level grades than W students, both generally, and for medical school applicants. NW medical school entrants have lower A level grades than W entrants, with an effect size of about -0.10.

Conclusion

The effect size for the difference between white and non-white medical school entrants is about B0.10, which would mean that for a typical medical school examination there might be about 5 NW failures for each 4 W failures. However, this effect can only explain a portion of the overall effect size found in undergraduate and postgraduate examinations of about -0.32.     

Identification Of Two New Pmp22 Mouse Mutants Using Large-Scale Mutagenesis And A Novel Rapid Mapping Strategy

In some alcohol-related pathologies of chronic alcoholism women are more vulnerable than men. A consecutive sample of 62 chronic alcoholics was studied, 18 females and 44 males, aged between 28 and 69 years to assess the incidence and distribution of peripheral neuropathy with regard to gender. All patients underwent clinical and neurological observations, laboratory tests, and electroneurography. Total lifetime dose of ethanol (TLDE) and other risk factors for neuropathy (disease duration, age, nutritional status) were calculated and correlated to sural nerve sensory-evoked potential (SEP) amplitude. In 42 patients (67.7%), we observed the presence of clinical and/or infraclinical neuropathy, mostly axonal, in 29 males (65.9%) and 13 females (72.2%). In women, compared to men, TLDE and disease duration were significantly inversely correlated to sural nerve SEP amplitude, i.e in women, SEP amplitude is significantly reduced in relation to TLDE and disease duration increase. These data indicate a higher sensitivity of females towards the toxic effects of ethanol, other than malnutrition, on peripheral nerve fibres.     

Neurogenesis, neuroplasticity and severe affective disorder

Reid IC. Neurogenesis, neuroplasticity and severe affective disorder. Bipolar Disord 2002: 4(Suppl. 1): 58. © Blackwell Munksgaard, 2002