Asthma Programme in Finland: the quality of primary care spirometry is good

AIMS: To assess the quality of primary care spirometry by visual inspection of the flow-volume expiratory curve and to study the quantity of clinical information provided on the spirometry report sheets. METHODS: Retrospective audit of 868 expiratory flow-volume curves referred to three pulmonary clinics assessed against five predefined quality criteria. Clinical information included on the spirometry report sheets was also collected. RESULTS: Quality was good in 78% of pre-bronchodilation curves and in 80% of post-bronchodilation curves. Obtaining a sharp PEF value and full vital capacity exhalation seemed to be the critical points of measurement. Inter-rater reliability of the curve assessment was mainly good. Data on where the spirometry took place, and comments on the use of respiratory medication and patient co-operation were often lacking. CONCLUSIONS: The quality of primary care spirometry was good. Adequate clinical information on the report sheets would further improve the quality of this diagnostic process.     

Impaired absorption of cholesterol and bile acids in patients with an ileoanal anastomosis

Background—No data exist on cholesterolabsorption in patients with an ileoanal anastomosis (IAA).
Aims—To study cholesterol absorption and itseffects on cholesterol and bile acid metabolism in patients with an IAA.
Patients and methods—Cholesterol absorption, andserum, biliary, and faecal lipids were studied in 24 patients with anIAA and 20controls.
Results—Fractional cholesterol absorption wassignificantly lower in the patients (36% versus 47% in controls).Surprisingly, the calculated intestinal influx of endogenouscholesterol was reduced so that the absolute absorption of cholesterolwas decreased; elimination of cholesterol as faecal neutral steroidsremained normal. Thus, the slightly increased cholesterol synthesis was mainly due to increased faecal bile acid excretion, which, in turn, wasassociated with reduced absorption and biliary secretion of bile acids.Serum total and low density lipoprotein (LDL) cholesterol and LDLtriglycerides were lower in the patients. Molar percentage andsaturation index of biliary cholesterol were slightly higher inpatients with an IAA. Proportions of secondary bile acids in bile andfaeces were diminished, and faecal unidentified bile acids were higherin patients.
Conclusions—Cholesterol absorption issignificantly impaired in patients with an IAA, and is closely relatedto changes in serum and biliary lipids observed in these patients.

Keywords:cholesterol absorption; cholesterol synthesis; faecal bile acids; inflammatory bowel disease

     

薄层扫描法测定熊胆引流物中胆汁酸含量

熊胆向以贵重药材闻名,被称之为稀有药品,为开发熊胆资源,解决熊胆奇缺问题,我校解剖教研室已成功地完成了人工引流熊胆汁技术,可随时进行人工引流获取熊胆汁。为了确定胆汁的质量指标,了解其主要成分,我们进行了引流胆汁与天然熊胆的分析。文献报道,熊胆中主要含熊去氧胆酸(ursodesoxycholic acid,UDCA)、鹅去氧胆酸(cheno desoxycholic acid,CDCA)、胆酸(cholic acid,CA)、去氧胆酸(deoxycholic,acid DCA)等。     

Epidemiologic characteristics of dentai caries: reiation of DIVIFT and DMFS to proportion of children with DMF teeth

The relation of the age-specific mean DMFT and mean DMFS to the age-specific proportion of children with DMF teeth has been studied using the original data of Knutson and data of a recent Finnish material. When studying the relationship between the mean DMFT (x) and the proportion of children with DMF teeth (y), three models of regression were compared. For low caries populations, a specific correction exponential curve y = 1-abx seemed to fit caries data somewhat better than the other models. The relationship between the mean DMFS (x) and the proportion of children with DMF teeth (y) could be expressed by a curvilinear model y = e[b(lnx) + a]; this applied to low caries populations (y approximately less than 0.7) as well, but the unexplained residual variation was about 6%.     

Allysine peptides and derivatives

Allysine, which is synthesized enzymatically in vivo starting from lysine, is a very important crosslink precursor in proteins. We describe the chemical synthesis of allysine derivatives starting from 3,4-dihydro-2H-pyran. Two independent synthetic routes to prepare allysine peptides and derivatives are presented. The synthesized compounds are characterized by spectroscopic methods including ¹³C-n.m.r. The reactivity of the aldehyde function is shown to be extremely high. An unexpected nucleophilic attack of the allysine amide nitrogen upon the aldehyde group is described. This ring-closure reaction is not expected to take place in native collagen; however, denatured peptides containing allysine may react similarly as the model peptides presented in this paper.     

Patient safety in external beam radiotherapy – Guidelines on risk assessment and analysis of adverse error-events and near misses: Introducing the ACCIRAD project

In 2011 the European Commission launched a tender to develop guidelines for risk analysis of accidental and unintended exposures in external beam radiotherapy. This tender was awarded to a consortium of 6 institutions, including the ESTRO, in late 2011. The project, denominated “ACCIRAD”, recently finished the data collection phase. Data were collected by surveys administered in 38 European countries. Results indicate non-uniform implementation of event registration and classification, as well as incomplete or zero implementation of risk assessment and events analysis. Based on the survey results and analysis thereof, project leaders are currently drafting proposed guidelines entitled “Guidelines for patient safety in external beam radiotherapy – Guidelines on risk assessment and analysis of adverse-error events and near misses”. The present article describes the aims and current status of the project, including results of the surveys.