Enteropathy complicating maintenance therapy in acute lymphoblastic leukaemia

Seven patients being treated for acute lymphoblastic leukaemia between March 1976 and March 1981, in accordance with Medical Research Council protocols, developed clinical malabsorption while on maintenance chemotherapy. All of them received weekly methotrexate and 6 of the 7 were given co-trimoxazole. Five patients had folate deficiency. Stopping the anti-leukaemic therapy led to a resolution of gastrointestinal symptoms. A combined effect of methotrexate and co-trimoxazole is postulated.     

Synopsis of non-communicable diseases in children admitted to the paediatric ward of the university of Nigeria teaching hospital (UNTH) Enugu,Nigeria: A ten year review

Background:

Non-communicable diseases are increasing worldwide due to rapidly changing lifestyles and socio-economic status. It is contributing significantly to the global burden of diseases.

Objective:

To determine the pattern of non-communicable diseases in children admitted into the Paediatrics ward in a tertiary health centre in Enugu.

Materials and Methods:

A review of admissions into the Paediatrics ward of the University of Nigeria Teaching Hospital Enugu, between January 1999 and December 2008 was done using the registry of admission and discharge.

Results:

The age range of patients admitted during the period was 2 months to 18 years (mean 5.27 ± 5.42 years). There were 1173 (59.6%) males and 796 (40.4%) females. Disorders of the haematological system accounted for 514 (23.3%) of the non-communicable diseases among the admissions, malignancies accounted for 424 (19.2%) among the admissions, whereas the renal, central nervous, and cardiovascular systems were involved in 282 (12.8%), 274 (12.4%), and 241 (10.9%) patients, respectively. There were 274 (12.4%) deaths and 1667 (75.5%) discharges while 38 (1.7%) were discharged against medical advice. Data on 221(10.2%) of the patients were reported missing. Malignancies contributed to 75 (27.3%) of the deaths, haematological disorders accounted for 44 (16%) whereas renal disorders and nutritional disorders contributed to 43 (15.7%) and 41 (15%) of the deaths, respectively.

Conclusion:

Non-communicable diseases affect children in our environment and contribute to morbidity and mortality in children. Strategies to prevent these diseases should be encouraged in order to avert the challenges of double burden of the diseases in children.     

Parasuicide and suicide in the south-west of Ireland

Background Suicidal behaviour has become recognised as a major public health problem.Aim To examine hospital-treated parasuicide and suicide in the Southern and Mid-Western Health Boards.Methods Parasuicide data were derived from independent data collection in general and psychiatric hospitals and prisons between 1995 and 1997. The corresponding suicide data were obtained electronically from the Central Statistics Office. Results Respectively, the annual person-based male, female and total European age-standardised rates were 128.9, 154.3 and 141.3 per 100,000 for parasuicide compared to 22.7, 5.5 and 14.1 per 100,000 for suicide. The parasuicide/suicide ratio varied markedly by age, gender, area and marital status. The majority of suicides were by hanging or drowning whereas drug overdose made up the vast majority of parasuicide acts. Parasuicide was largely a city phenomenon confined to the young of both genders whereas suicide was a significant problem for city and county men, especially young adult men. Conclusion There are striking differences between the patterns of fatal and non-fatal suicidal behaviour in Ireland, which should be considered in prevention initiatives.     

Experience of Health Complaints and Help Seeking Behavior in Employees Screened for Depressive Complaints and Risk of Future Sickness Absence

Introduction The aim of this study was to examine the associations between on the one hand depressive complaints and risk of future sickness absence and on the other hand experience of health complaints and help seeking behavior in the working population. Methods Cross-sectional data were used from employees working in the banking sector (n = 8,498). The screening instrument included measures to examine the risk of future sickness absence, depressive complaints and help seeking behavior. Results Of employees reporting health complaints, approximately 80% had already sought help for these complaints. Experience of health complaints and subsequent help seeking behavior differed between employees with mild to severe depressive complaints and employees at risk of future sickness absence. Experience of health complaints was highest in employees identified with both concepts (69%) compared with employees identified at risk of future sickness absence only (48%) and with mild to severe depressive complaints only (57%). In those employees identified with one or both concepts and who had not sought help already, intention to seek help was about 50%. Conclusions From a screening perspective, employees who do not experience health complaints or who do not have the intention to seek help may refuse participation in early intervention. This might be a bottleneck in the implementation of preventive interventions in the occupational health setting.     

The design of the Dutch EASYcare study: a randomised controlled trial on the effectiveness of a problem-based community intervention model for frail elderly people [NCT00105378]

Background  

Because of their complex clinical presentations and needs frail elderly people require another approach than people who age without many complications. Several inpatient geriatric health services have proven effectiveness in frail persons. However, the wish to live independently and policies that promote independent living as an answer to population aging call for community intervention models for frail elderly people. Maybe models such as preventive home visits, comprehensive geriatric assessment, and intermediate care qualify, but their efficacy is controversial, especially in frail elderly persons living in the community. With the Dutch EASYcare Study Geriatric Intervention Programme (DGIP) we developed a model to study effectiveness of problem based community intervention models in frail elderly people.     

Subseafloor sedimentary life in the South Pacific Gyre

The low-productivity South Pacific Gyre (SPG) is Earth's largest oceanic province. Its sediment accumulates extraordinarily slowly (0.1–1 m per million years). This sediment contains a living community that is characterized by very low biomass and very low metabolic activity. At every depth in cored SPG sediment, mean cell abundances are 3 to 4 orders of magnitude lower than at the same depths in all previously explored subseafloor communities. The net rate of respiration by the subseafloor sedimentary community at each SPG site is 1 to 3 orders of magnitude lower than the rates at previously explored sites. Because of the low respiration rates and the thinness of the sediment, interstitial waters are oxic throughout the sediment column in most of this region. Consequently, the sedimentary community of the SPG is predominantly aerobic, unlike previously explored subseafloor communities. Generation of H₂ by radiolysis of water is a significant electron-donor source for this community. The per-cell respiration rates of this community are about 2 orders of magnitude higher (in oxidation/reduction equivalents) than in previously explored anaerobic subseafloor communities. Respiration rates and cell concentrations in subseafloor sediment throughout almost half of the world ocean may approach those in SPG sediment.     

Clinical and immunologic effects of sublingual immunotherapy on patients with allergic rhinitis to house-dust mites: 1-year follow-upp results

目前亚洲还没有关于舌下免疫疗法(sublingual immunotherapy,SLIT)治疗粉尘螨引起变应性鼻炎(AR)患者的资料。本研究旨在探讨韩国患者SLIT治疗12个月后的有效性和免疫学变化。对58例患屋尘螨及粉尘螨过敏的AR患者进行12个月SLIT,分别记录SLIT前及治疗12个月后患者的症状评分;此外,也