PREVENTION OF POST-OPERATIVE WOUND INFECTION IN ABDOMINAL OPERATIONS

One hundred patients undergoing abdominal surgery were included in this prospective study. The role of local application of Betadine, use of synthetic sutures, and use of low pressure subcutaneous suction drainage were evaluated in preventing post-operative wound infection. The infection rate was 15 per cent with Betadine, 15.4 per cent with prolene, 20 per cent with subcutaneous suction drainage and 30.8 per cent in the control group.KEY WORDS: Surgical wound infection, Betadine, Sutures, Infection control     

Editor's note for debate Sporadic dementia of Alzheimer type: Role of amyloid in etiology is challenged

Summary Alzheimer's disease is a heterogenous neurodegenerative disorder. Whereas only a minority is due to genetic abnormalities and mostly with early onset, the majority of all Alzheimer cases is sporadic and with late onset. Therefore, in the latter, age-related disturbances in cellular metabolism may come into focus with respect to the etiopathogenesis rather than the primary formation of amyloid. In this Editor's note for debate, the role of amyloid as a causative factor of sporadic Alzheimer's disease is challenged. Instead, as a possible primary abnormal event in sporadic Alzheimer's disease, the perturbations in neuronal glucose metabolism and the subsequent ATP deficit with its impacts on the secondary amyloid formation are discussed to open a new field of research and another aspect for debate.     

Konstitutionsaufklärung der Reaktionsprodukte aus Benzonitriloxid und 1,4-disubstituierten Urazolen

Structural Elucidation of the Reaction Products from Benzonitrile Oxide and 1,4-Disubstituted Urazoles The reaction of benzonitrile oxide with 1,4-disubstituted urazoles 1 does not yield 1,4-disubstituted 3-(phenylcarbamyoloxy)--1,2,4-triazolin-5-ones 2 , as reported in the literature, but leads to N¹′,N³′-disubstituted 3-phenyl-4-ureido--1,2,4-oxadiazolin-5-ones 4 .     

Antipsychotic drugs and dopamine-mediated responses in Aplysia neurons

Summary The effect of antipsychotic drugs was tested on responses to micro-electrophoretically applied dopamine, acetylcholine and 5-hydroxy-tryptamine in identified neurons of the marine gastropod Aplysia californica. Fluphenazine was able to depress the response to DA in concentration of 10M, with 100M DA-responses of many neurons were blocked completely. Thioridazine (10 and 100M) and haloperidol (50M) were also effective in depressing DA-responses, while the non-antipsychotic phenothiazines mepazine (10 and 100M) and promethazine (100M) had only a slight action on DA-receptors. ACh-and 5-HT-responses were slightly affected only by high concentrations after long lasting perfusion. The investigated drugs had no persistent or only an insignificant effect on resting membrane potential and amplitude of action potentials of the neurons. With haloperidol depolarizing afterpotentials leading to double discharges were observed in some neurons. In a few instances spontaneous EPSPs disappeared with the DA-response under the influence of anti-psychotic drugs.The results render a direct neurophysiological evidence for the blockade of DA-receptors by antipsychotic drugs in correspondence to their clinical efficacy and agree with data from clinical observations and obtained in neurochemical, behavioral and indirect neurophysiological experiments.Supported by the österreichischen Fonds zur Förderung der wissenschaftlichen Forschung. —A preliminary report of a part of the results was published in Experientia30, 1318–1320 (1974).     

Letal verlaufende Varizellen nach Nierentransplantation

Zusammenfassung Wir berichten über ein 7 Jahre altes M?dchen, das 14 Tage nach einer Nierentransplantation an Varizellen erkrankte. Erste Symptome waren krampfartige Bauchschmerzen mit radiologischen Hinweisen auf einen Obturationssubileus bei Obstipation. Als nach abführenden Ma?nahmen keine Besserung auftrat, wurde eine Probelaparotomie mit Entfernung des Tenckhoff-Dialysekatheters durchgeführt. Dabei zeigte sich kein pathologischer Befund, insbesondere fanden sich keine Briden. Zwei Tage nach Beginn der abdominalen Symptomatik trat ein zun?chst uncharakteristisches Exanthem auf. Aus den sich in den n?chsten 12 h entwickelnden Bl?schen konnte Varicella-Zoster-Virus isoliert werden. Trotz hochdosierter Gabe von Aciclovir und Varicella-Zoster-Immunglobulin entwickelte sich ein fulminantes Leberversagen mit Verbrauchskoagulopathie. Die Patientin verstarb am 18. postoperativen Tag trotz intensiver supportiver Therapie im Multiorganversagen. Diskussion: Vor dem Hintergrund dieser letalen Varizelleninfektion wird auf die Komplikationen und die teilweise untypischen Verl?ufe von Windpocken bei immunsupprimierten Kindern hingewiesen. Eine aktive Impfung ist daher bei seronegativen Patienten vor einer geplanten Organtransplantation zu fordern.      

HIV AND TUBERCULOSIS CO-INFECTION IN A REFERRAL CHEST HOSPITAL

Serving personnel of Armed Forces admitted with tuberculosis between Apr 1996–1999 were evaluated for co-infection of tuberculosis and HIV. Sixty (1.06%) of tuberculosis patients were found to be HIV positive. Initial test was done by spot kits and subsequently confirmed by ELISA on two different samples. Majority of the cases were in sexually active age group 48 (80%). Alcohol and smoking was associated in 80% cases. Thirty six (60%) were sputum smear positive for AFB. Twenty eight (46.7%) gave history of exposure to sex workers. Family members were not available for study. Sero prevalence of HIV in association with tuberculosis is less in Armed Forces compared to civil population.KEY WORDS: HIV, Seroprevalence, Tuberculosis     

广州队列研究生物库中条形码技术应用与评价

目的建立大规模人群的分子流行病学队列研究生物库，确保快速、准确地识别每一份生物样本，并保持其活性，以便长时间跟踪研究。方法采用条形码识别技术对血液样品的采集、处理及存储、查询过程进行全程管理。结果创建成功以条形码自动识别技术为核心的新型运作管理模式，建立起10000人份的生物样品库。大型生物样本库实施条形码管理系统可缩短每份样品的处理时间，提高工作效率1．5倍。结论条形码技术的应用可有效地避免样品间的相互混淆，使实验室每一项工作准确、可靠、高效，实现医学研究工作全面信息化，提高基因队列研究的质量。     

Effect of a structured asthma education program on hospitalized asthmatic children: A randomized controlled study

BACKGROUND: The aim of this study was to compare the effectiveness of an intensive asthma education program (group B) with that of a standard asthma education program (group A). METHODS: A prospective randomized single blinded study was conducted in the pediatric department of a public hospital in Hong Kong. Children aged 2-15 years admitted to the pediatric department with an acute attack of asthma were recruited. A standard asthma education program (group A) or an intensive asthma education program (group B) for children were offered. The main outcome measures include the number of visits to the emergency department and the number of hospitalization for asthma during the 3 month follow-up period. RESULTS: A total of 45 children were in group A and 55 in group B. Group B had statistically significant reductions in the number of visits to the emergency department and the number of hospitalizations. Drug compliance was also significantly improved in group B. Parents' satisfaction rate was also higher in group B. CONCLUSION: The intensive asthma education program might be more cost effective than the standard asthma education program in the management of asthmatic children admitted to hospital in Hong Kong.     

Hb Manukau [β67(E11)Val → Gly; HBB: c.203T>G]: The Role of Genetic Testing in the Diagnosis of Idiopathic Hemolytic Anemia

The increasing availability of DNA sequencing of globin genes has improved our ability to detect conditions that were presumed to be extremely rare. These conditions may remain undiagnosed due to unfamiliarity with clinical presentation, relative unavailability of advanced diagnostic alternatives, or may defy detection by being electrophoretically silent or extreme instability rendering their presence to be below detection level. Genetic studies were pursued in a mother and daughter with severe hemolytic anemia as initial testing failed to be diagnostic. DNA sequence analysis of the β-globin gene identified Hb Manukau [β67(E11)Val?→?Gly; HBB: c.203T?>?G], an extremely unstable hemoglobin (Hb) variant. This is the second family described with this condition (first in the western hemisphere). An astute clinician may benefit from being persistent and pursuing additional testing including molecular genetic characterization where clinical suspicion remains high.     

Screening for Depression in Emergency Department Patients

Background: Depression is a common disease, yet it is not commonly studied in the Emergency Medicine literature. Study Objectives: To evaluate the prevalence of emergency department (ED) patients who have the symptoms of depression. Design: This was a prospective observational study performed at two EDs over a 9-month period. Adult patients were screened for depression symptoms by Diagnostic and Statistical Manual of Mental Disorders, 4^th edition criteria. Results: There were 505 patients screened from April through December, 2004. Of the 505 patients, 109 (21.6%) screened positive for the symptoms of depression. The prevalence of positive screens was similar at each ED. Conclusion: About 1 in 5 ED patients may be suffering with depression.