A case/control study of adult haematological malignancies in relation to overhead powerlines

A population based case control study of adult haematological malignancy and distance from, and magnetic fields associated with, overhead (OH) power lines has been carried out in the North West and Yorkshire regions of England. Three-thousand, one hundred and forty-four cases with histologically proven disease were entered into the study. One control per case, matched for age, sex, year of diagnosis and health district of residence, was selected from hospital discharges. Seven per cent of cases and controls lived near to OH power lines as defined by the study protocol. The measure of exposure used was the calculated magnetic field strength at each of these addresses due to maximum load currents carried by OH power lines in the 5 years preceding diagnosis. The odds ratio (OR) for living within 50 m of an OH line was 1.29 with a 95% Confidence Interval (CI) of 0.99-1.68 but a chi 2 test for trend with distance was not statistically significant. The analysis of calculated magnetic fields, did not produce any statistically odds ratios. The OR for magnetic fields greater than or equal to 0.1 mG was 1.03 (95% CI 0.81 1.32). Analysis of magnetic fields greater than or equal to 3.0 mG gave an OR of 1.87 (95% CI 0.79 4.42), but this result is based on small numbers. No evidence was found for confounding by the type of dwelling which was used as a partial surrogate for socio-economic status.     

Is religion a help around the time of death?

Based on reports from relatives and other associates about a random sample of adults who had recently died, the data suggest that three-fifths of the people who died were perceived as having some sort of religious faith that had been helpful to them in the time before they died. Acceptance of death was seen as more common among those thought to have had a strong religious faith, but was not related to believing or not believing in some sort of life after death. It was less frequent among those thought to be uncertain about this. The majority of relatives who said they had a religious faith felt it had been helpful to them over their bereavement, but religious faith was not related to whether or not they felt they had come to terms with the person's death. Those with a religious faith were more likely than others to describe their relationship with the person who died as having been 'very good'. The data can be interpreted in various ways and it is not possible to say with certainty that a religious faith is helpful around the time of death.     

PCR of peripheral blood for diagnosis of meningococcal disease.

Meningococcal disease is normally suspected on clinical grounds and is confirmed by isolation of Neisseria meningitidis bacteria from blood or cerebrospinal fluid or, more recently, by serology or PCR of cerebrospinal fluid. Achieving confirmation of a clinical diagnosis of meningococcal disease has become more difficult in the last few years. The pre-hospitalization administration of parenteral benzylpenicillin normally renders blood cultures sterile, and lumbar puncture is undertaken less frequently, especially in young children. We evaluated PCR for the detection of meningococcal DNA in 80 blood samples taken from patients with known or suspected meningococcal disease or from patients with other diagnoses (negative controls). Both the sensitivity and the specificity of the test were 100% for patients with confirmed cases of meningococcal disease when the blood buffy coat was used (83 to 100% sensitivity and 87 to 100% specificity with 95% confidence limits). Positive PCR results could be obtained from both blood buffy coat and serum samples. Sensitivity was unaffected by prior antibiotic treatment. PCR is a rapid, sensitive test that may be used to confirm a diagnosis of meningococcal disease by using peripheral blood samples. Introduction of this test into clinical laboratories may in some cases obviate the need for lumbar puncture to be performed on patients with suspected meningococcal disease. Our results demonstrate that a substantial number of cases of meningococcal disease are not confirmed by conventional techniques and remain undiagnosed. If the PCR test described here was widely applied, the number of cases of meningococcal disease ascertained might rise by as much as 60% greater than that recognized at present. It is likely that we are in a prevaccination era for meningococcal disease. Better case ascertainment is urgently required to assess the need for vaccines, to determine their costs and benefits, and to monitor their efficacies.     

Improved enrichment broth for cultivation of fastidious organisms.

An enrichment broth developed in our laboratory, fastidious broth (FB), was compared with two commercially available broth media, supplemented thioglycolate broth and enriched eugonic broth. FB supported the growth of a number of organisms that were not cultivatable in either of the other two media, including Corynebacterium jeikeium, Haemophilus influenzae, Neisseria gonorrhoeae, and Streptococcus pneumoniae. In addition, for several organisms that were able to grow in all three broths, including Neisseria meningitidis, Nocardia asteroides, and Actinomyces spp., both the time of incubation and the starting inoculum necessary to enable detection of growth were decreased significantly by using FB.     

Molecular basis of protein S deficiency in three families also showing independent inheritance of factor V leiden

The molecular basis of type I or III Protein S deficiency has been investigated in three kindred also showing independent inheritance of factor V (FV) Leiden. A T to C transition in codon 570 (Met-->Thr) was identified in the propositi and shown to segregate with protein S deficiency in all but one of the affected members of two kindred. This individual was heterozygous for a second transition (C to T) causing substitution of serine 624 by leucine. A second member of the same family, with markedly reduced free protein S levels when compared with affected relatives, was heterozygous for both mutations. Haplotype analysis of individuals with the mutated ATG570ACG allele in the two kindred suggested they may have been related by a common ancestor. A G to A transition resulting in substitution of cysteine 145 by tyrosine was detected in the third kindred. All mutations are believed to interfere with protein S binding to C4b-binding protein resulting in reduced free protein S levels. Of the five individuals studied who had experienced thrombotic events, three had combined protein S deficiency and FV Leiden reemphasising the importance of FV Leiden as an additional risk factor for thrombosis in protein S deficiency.