Acute encephalopathy syndrome in Bangalore

Sixty four cases of acute encephalopathy syndrome admitted to the Vani Vilas Children's Hospital, Bangalore, during the period April 1973 through January 1974 were studied. The median age was 4.84 years. There was no difference in the sex ratio. Maximum number of cases were admitted during the winter months. Cases tended to cluster in certain congested localities of the city among the lower socio-economic strata. 53 (89.8%) of the 59 patients, who could be followed up to the end, expired. The clinical and biochemical findings in many patients were suggestive of Reye's syndrome. Though 6 strains of coxsackie viruses were isolated from 160 specimens processed for virus isolation, they could not be incriminated as etiological agents in majority of patients.     

Analysis of censored and incomplete survival data using flowgraph models

Multi-state stochastic models are widely used to model stages of disease progression in survival analysis. This paper develops flowgraph models for data analysis in survival analysis. We illustrate these methods using data from a study of diabetic retinopathy consisting of 277 subjects with insulin-dependent (type I) diabetes mellitus (IDDM). These data were collected at the Eye-Kidney Clinic of the Barbara Davis Center for Childhood Diabetes at the University of Colorado Health Sciences Center.     

Breast cancer mortality among female radiologic technologists in the United States

We evaluated breast cancer mortality through 1997 among 69 525 female radiologic technologists who were certified in the United States from 1926 through 1982 and who responded to our questionnaire. Risk of breast cancer mortality was examined according to work history and practices and was adjusted for known risk factors. Breast cancer mortality risk was highest among women who were first employed as radiologic technologists prior to 1940 (relative risk [RR] = 2.92, 95% confidence interval [CI] = 1.22 to 7.00) compared with risk of those first employed in 1960 or later and declined with more recent calendar year of first employment (P for trend =.002). Breast cancer mortality risk increased with increasing number of years of employment as a technologist prior to 1950 (P for trend =.018). However, risk was not associated with the total number of years a woman worked as a technologist. Technologists who first performed fluoroscopy (RR = 1.69, 95% CI = 1.02 to 3.11) and multifilm procedures (RR = 1.87, 95% CI = 1.04 to 3.34) before 1950 had statistically significantly elevated risks compared with technologists who first performed these procedures in 1960 or later. The high risks of breast cancer mortality for women exposed to occupational radiation prior to 1950 and the subsequent decline in risk are consistent with the dramatic reduction in recommended radiation exposure limits over time.     

Changes in the corrected QT interval and corrected QT dispersion during haemodialysis

The link between increased QT dispersion and cardiac death in subjects with diabetes and arterial disease is well recognised. Corrected QT dispersion was studied in subjects with end stage renal failure on haemodialysis. Thirty one stable, chronic subjects on haemodialysis had 12-lead electrocardiograms (ECGs) taken before and after a single haemodialysis session. The QT interval was measured manually in each and the corrected QT and corrected QT dispersion calculated. Serum concentrations of potassium, calcium, and magnesium were measured at the same time as ECG acquisition. Corrected QT dispersion increased from a mean (SEM) 90.6 (5.8) to 117.7 (10.2) ms (p=0.002). Serum potassium and magnesium decreased from 5.0 (0.14) to 3.5 (0.09) mmol/l and 0.95 (0.04) to 0.89 (0.09) mmol/l respectively, while serum calcium increased from 2.56 (0.04) to 2.77 (0.04) mmol/l. Intradialytic weight fell by a mean of 2.1 kg. There was no significant correlation between the change in QTc dispersion and the changes in measured serum anions or the subjects' weight during dialysis. Corrected QT dispersion was higher in subjects on haemodialysis than previously suggested normal values, and was significantly increased by haemodialysis. This reflects increased inhomogeneous ventricular repolarisation, which may lead to an increased risk of arrhythmias and sudden death. Studies looking at QT dispersion in subjects on dialysis should standardise the timing of ECG recordings taken with respect to dialysis.     

Cephalic vein cutdown for inserting indwelling subclavian vein catheters in gynecologic oncology patients

To decide on an alternate procedure for placement of central vein catheters other than percutaneous access of the subclavian vein, we conducted a study of 46 women who underwent placement of a central venous catheter utilizing the cephalic vein procedure at Ruby Memorial Hospital at West Virginia University in Morgantown. Of these patients, 96% had a successful placement of a catheter into the subclavian vein following dissection of the cephalic vein within the deltopectoral groove. There were no cases of pneumothorax or injury to the great vessels during the surgical procedure, which is a significant advantage for women who often have significant pleural effusions.     

Childhood Stressors and Coping Actions: A Comparison of Children and Parents’ Perspectives

At a time when many children and families are faced with enormous daily life hassles and major stressful events, it is crucial to understand issues pertaining to childhood stress and coping. The present study examined children and parents’ perceptions of childhood stressors and children’s coping actions. Findings reveal that children report higher stress levels than parents. The stressors identified by children range from peer related stressful situations such as being laughed at to internal factors such as lack of control, and major life events such as death of a loved one. Children and parents report a large range of coping actions with three predominant themes—cognitive, social, and emotional coping strategies. Implications for practice are discussed. This research was supported by a General University Research Program Grant from the University of Delaware.     

Recent technological advances in oral drug delivery - a review

Despite disadvantages, oral drug delivery remains the preferred route of drug delivery. Novel technologies with improved performance, patient compliance, and enhanced quality have emerged in the recent past. Oral fast-dispersing dosage forms, three-dimensional Printing (3DP) and electrostatic coating are a few examples of a few existing technologies with the potential to accommodate various physico-chemical, pharmacokinetic and pharmacodynamic characteristics of drugs. This article provides a comprehensive review of these three technologies.     

Adenosine 5'-triphosphate-citrate lyase activity in mammalian spermatozoa: A new radiometric method and characterization of the enzyme in spermatozoa

A simple radiochemical method was developed for determining the ATP-citrate lyase activity in mammalian spermatozoa. The determination of enzyme activity was followed by the measurement of the incorporation of the [1-¹⁴C]acetyl group from [1,5-¹⁴C]citrate into [1-¹⁴C]acetylcoenzyme A (ACoA). Separation of ¹⁴C-labeled ACoA from the reactants and their products was achieved by rapid anion exchange chromatography. The optimum pH was 6.4 for rat spermatozoal ATP-citrate lyase. The activity was not altered by dithiothreitol. MgCl₂ (l0mM) caused a 50 per cent inhibition in the enzyme activity. ATP-citrate lyase activities in rat and human spermatozoa were 154 ± 14 and 90 ± 12 nmoles of ACoA formed/mg of protein/5 min. Citrate may serve as an acetyl source for acetylcholine formation by spermatozoa.     

Day-to-day variation in body weights of children.

Day-to-day fluctuations in the body weights on five consecutive days of 54 boys and 50 girls aged between 2 and 6 years were measured. The standard deviation of the body weights over this period were of the order of +/- 0-2 kg in boys and girls. On the basis of these findings, it is suggested that only loss or gain in body weights of more than twice this amount should be taken as indicative of real change.