Contrast sensitivity in 10 year old preterm and full term children: a population based study

AIMS: To determine the contrast sensitivity (CS) in 10 year old prematurely born children, previously included in a population based study on the incidence of retinopathy of prematurity (ROP), and in full term controls. METHODS: This study included 205 prematurely born children and 215 children born at term, from the same geographical area and study period. CS was assessed monocularly with the Vistech 6500 test at five spatial frequencies (1.5-18 cycles/deg). RESULTS: Prematurely born children had statistically significant lower CS at all frequencies, compared to full term ones. The mean differences in logarithmic CS were 0.03 (1.5 cycles/deg), 0.09 (3 cycles/deg), 0.10 (6 cycles/deg), 0.12 (12 cycles/deg), and 0.19 (18 cycles/deg). Even when the children with ROP and neurological disorders were excluded there was a difference between the two groups. Children who had been treated with cryotherapy had the lowest CS. CONCLUSION: CS was lower in 10 year old prematurely born children than in full term ones of the same age. Whether this finding affects their visual function in daily life is uncertain.     

Successful ABO-incompatible liver transplantation using A2 donors

INTRODUCTION: The longer waiting time for a liver graft among patients with blood group O makes it necessary to expand the donor pool for these patients. We herein have reported our experience with ABO-incompatible liver transplantation using A(2) donors to blood group O recipients. PATIENTS AND METHODS: Between 1996 to 2005, 10 adult blood group O recipients received 10 A(2) cadaveric grafts. Mean recipient age was 52 +/- 7.7 years (mean +/- SD). The initial immunosuppression was induction with antithymocyte globulin (n = 2), interleukin-2-receptor antagonists (n = 3), or anti-CD20 antibody (rituximab, n = 1), followed by a tacrolimus-based protocol. No preoperative plasmapheresis, immunoadsorption, or splenectomies were performed. RESULTS: Patient and graft survival was 10/10 and 8/10, respectively, at 8.5 months median follow-up (range 10 days to 109 months). Two patients were retransplanted because of bacterial arteritis (n = 1) and portal vein thrombosis (n = 1). The six acute rejections, which occurred in four patients, were all reversed by steroids or increased tacrolimus dosages. The pretransplant anti-A titers against A(1) red blood cells were 1:128 (NaCl technique) and 1:8 to 1024 (IAT technique). The maximum postoperative titers were 1:64 to 4000 (NaCl) and 1:256 to 32000 (IAT). CONCLUSION: The favorable outcome of A(2) to O grafting, with a patient survival of 10/10 and graft survival of 8/10, makes it possible to consider this blood group combination also in nonurgent situations. There was no hyperacute rejection or increased rate of rejections. Anti-A/B titer changes seem to not play a significant role in the monitoring of A(2) to O liver transplantation.     

Influence of pyrazole on ethanol determination with the automated ADH method

Summary It has been demonstrated that the contamination of blood samples with pyrazole will disturb automated enzymatic determinations of ethanol by methods involving the use of YADH, if the sample is not distilled. Determination of ethanol by gas liquid chromatography, the Widmark method or by the ultramicro destination enzymatic method for ethanol analysis (AA-UMDE) according to Buijten were not disturbed by the presence of pyrazole. Contamination of samples with 4-iodo-pyrazole has not been found to disturb ethanol determinations by any method.

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Zusammenfassung Es wurde die Kontamination der Blutprobe mit Pyrazol in wäßrigen Lösung als Salbe verarbeitet sowie als 4-Iodo-Pyrazol-Lösung appliziert überprüft. Bei der Anwendung der Hefe-ADH zur automatisierten enzymatischen Blutalkoholbestimmung ohne Destillationsverfahren treten Störungen ein. Die Anwendung der Gas-chromatographischen Methode, des Widmark-Verfahrens sowie der enzymatischen Ultramikromethode nach Buijten verursacht keine Beeinflussung durch Pyrazol-Beimischung. Die Bestimmungen des Blutalkohols mittels dieser Methoden wurden nach Kontamination mit 4-Iodo-Pyrazol nicht beeinflußt. Auf die mögliche forensische Bedeutung wird hingewiesen.

     

Clinical results and recurrences 1-4 years after parietal cell vagotomy in duodenal ulcer patients

168 patients with duodenal or prepyloric ulcer, treated with parietal cell vagotomy (PCV), were followed up one to four years after operation. 67% of the patients had more than 5 years' history of ulcer disease and in 44% preoperative bleeding or perforation could be confirmed. According to the modified Visick classification the clinical results were considered excellent or very good in 71%, with a marked tendency to better results for those surgeons with the greatest experience in performing parietal cell vagotomy. The result was considered unsatisfactory in 25 patients (15%) and this was in all cases due to reoperation and/or recurrent ulcer. There was no postoperative mortality and a low frequency of postoperative complications. Dumping was found in only one patient and mild diarrhoea in two. At follow-up, 16 patients (9.5%) had had a proven and 8 (4.5%) a suspected recurrent ulcer and 3 had gastric retention without recurrence. The recurrence rate was very high for those patients operated during the first year after the introduction of PCV, but then decreased significantly. 18 patients required reoperation. Antrectomy or truncal vagotomy with drainage is considered the method of choice for patients with an incomplete PCV and recurrent ulcer.     

Asthenopia in Schoolchildren,Orthoptic and Ophthalmological Findings and Treatment

The aim of this study was to describe the orthoptic and ophthalmological findings in schoolchildren with asthenopia, to correlate them with asthenopic symptoms and to evaluate the effect of treatment. One hundred and twenty schoolchildren, aged 6–16 years, were included in the study. They were all referred by school nurses, for asthenopic symptoms. An orthoptic and ophthalmological assessment was performed. The main diagnoses were accommodative insufficiency, convergence insufficiency, refractive errors, and latent strabismus. Reading glasses could help 98% of the schoolchildren with reduced accommodation, and 94% of the children with refractive errors and heterophorias were helped with appropriate spherical, cylindrical and prism correction. Convergence exercise reduced the symptoms in all patients with convergence insufficiency. Ninety-three percent of all 120 schoolchildren were symptom free 3–6 month after treatment had started. By an orthoptic and ophthalmological examination abnormalities in schoolchildren with asthenopia related to visual problems can be identified. Most of the children were relieved from their symptoms by giving adequate glasses, convergence exercises and surgery.     

Does the Covid-19 pandemic affect ankle fracture incidence? Moderate decrease in Sweden

Background and purpose — While many other countries implemented strict regulations and restrictions for their citizens during the 1st wave of the Covid-19 pandemic, Sweden maintained a more restrained approach. The Swedish Public Health Agency emphasized individual responsibility and pushed for behavioral changes. With strict lockdown a 77% decrease in ankle fracture incidence has been reported. We investigated whether there was a change in the incidence of ankle fractures seen at 7 selected hospitals during the Covid-19 pandemic 2020.Patients and methods — Data on all ankle fractures treated at 7 selected departments during March 15 through June 15, 2020, and for the same period in the preceding 3 years (2017–2019), was retrieved from the Swedish Fracture Register. The number of fractures during the whole period and subsequent 30-day periods were compared between 2020 and 2017–2019, including subgroup analyses of age and sex.Results — The monthly rate of ankle fractures was reduced by 14% in 2020 (139 fractures) compared with 2017–2019 (161 fractures). Women had a 16% decrease and patients aged > 70 years had a 29% decrease. During the 1st 30-day period, a 26% decrease in fractures was seen.Interpretation — During the 1st wave of the Covid-19 pandemic, a moderate decline in the number of ankle fractures was seen. Women and patients aged > 70 years displayed the greatest reduction. The greatest reduction in incidence of fractures was seen during the 1st 30-day period. This indicates greater adherence to government recommendations regarding social distancing in these subgroups and during the 1st month of the pandemic. Changes in ankle fracture incidence may be a measure of lockdown extent.

While many other countries implemented strict regulations and restrictions for their citizens during the 1st wave of the Covid-19 pandemic, imposing quarantine and entry bans and closing restaurants, schools, and preschools to prevent the spread, Sweden maintained a more restrained approach. The Public Health Agency of Sweden (SPHA) emphasized individual responsibility and pushed for behavioral changes instead of imposing regulations, with the aim of reducing the pace of viral transmission (Public Health Agency of Sweden 2020). From mid-March, 2020, Swedes were advised to stay at home if they had symptoms, to keep their distance and take personal responsibility (Government Offices of Sweden 2020). The only ban imposed in Sweden during the 1st months of the pandemic during the spring of 2020 was a ban on public gatherings of 50 or more people on March 27.Ankle fractures are common in all age groups and both sexes and most often sustained after a simple same-level fall (Bergh et al. 2020, Rydberg et al. 2020). Following the recommendations imposed by the SPHA, people worked more from home, thereby eliminating travelling to work. Sports activities and competitions were cancelled on a widespread scale. A reduction in the number of ankle fractures could be expected.Haskel et al. (2020) reported a 77% reduction in ankle fractures in New York and Lubbe et al. (2020) reported a reduction in the number of orthopedic trauma and foot injuries in Las Vegas during a 45-day period in March–April. Kuitunen et al. (2020) described a substantial decrease in Finland in the number of visits to A&E due to orthopedic conditions during the 1st wave of the pandemic.The Swedish Fracture Register (SFR) is a national quality register that has been collecting information on fractures of all types for almost 10 years (Wennergren et al. 2015). The SFR collects data on patient characteristics, injury mechanism, fracture type, and subsequent treatment methods for fractures of all types, treated surgically as well as non-surgically. As data are entered in the register by the treating physician at the time of the injury, they can be extracted from the register without delay.We investigated whether there was a change in the incidence of ankle fractures seen in some selected hospitals during the Covid-19 pandemic compared with the same time period during the previous 3 years. We also investigated whether a reduction in the incidence of ankle fractures was seen in sub-groups defined by age and sex, or during certain 30-day periods.