Electric and magnetic fields of 50 Hz are not associated with sudden infant death syndrome

Sudden infant death syndrome (SIDS) is a multifactorial condition. Power frequency magnetic fields have been implicated in SIDS. Through the use of a case-control study measuring 50 Hz electric and magnetic fields at the SIDS baby's last head position, no association could be found between SIDS and either electric (p = 0.327) or magnetic (p = 0.827) 50 Hz fields.     

CT of unusual nasal masses.

This pictorial review illustrates the CT appearances of unusual nasal masses and the possibility of offering a correct diagnosis in some cases but a reliance on histology in others where radiology can only offer a differential diagnosis.     

Design, synthesis, and preliminary pharmacological evaluation of N-acyl-3-aminoglutarimides as broad-spectrum chemokine inhibitors in vitro and anti-inflammatory agents in vivo.

A series of N-substituted 3-aminoglutarimides have been synthesized and tested for inhibitory activity against a range of chemokines in vitro and for suppression of lipopolysaccharide-induced inflammation in vivo. The results show that they represent the first class of small molecules with broad-spectrum chemokine inhibitory effects. Among the compounds studied, 10 (NR58,4) was the most potent, being active at doses between 5 and 15 nM in vitro and at 0.3 mg kg(-1) in vivo.     

Refractory hyperhaemolysis in a patient with beta-thalassaemia major

We report the case of a 1-year-old girl with newly diagnosed beta-thalassaemia major. Following an initial blood transfusion with phenotypically matched blood, she developed a haemolytic anaemia which progressed with subsequent transfusions. The Direct Antiglobulin test (DAT) was strongly positive with C3d and weakly with IgG. The only free antibodies detected were a weak anti-H and a weak cold auto-antibody, which did not exhibit a wide thermal range. The indirect Donath-Landsteiner and Ham's tests were negative. There was no sustained clinical response to steroids, immunoglobulin infusions or splenectomy. An HLA identical sibling donor was available for allogeneic bone marrow transplantation (BMT) and the haemolysis resolved during the immunosuppressive transplant conditioning. Such hyperhaemolysis without significant red cell alloantibodies has previously been reported in patients with sickle cell anaemia, but only rarely in patients with beta-thalassaemia major.     

Postpartum hemorrhage after cesarean delivery: an analysis of risk factors

OBJECTIVE: To determine the incidence and risk factors for postpartum hemorrhage (PPH) associated with cesarean delivery. METHODS: Blood loss at cesarean delivery was measured and defined as 1,000 to 1,499 mL or greater than 1,500 mL and/or the need for a blood transfusion. Variables were identified and evaluated to determine the factors associated with PPH. RESULTS: There were 1,844 elective and 2,993 nonelective cesarean deliveries over 4 years. The PPH rate in nonelective cesarean (6.75%) was greater than after elective cesarean (4.84%, P = 0.007). Risk factors for PPH after an elective operation included leiomyomata, blood disorders, placenta previa, antepartum bleeding, preterm birth, and general anesthesia. Nonelective cesarean PPH risk factors included blood disorders, retained placenta, antepartum transfusion, antepartum/intrapartum hemorrhage, placenta previa, general anesthesia, and macrosomia (odds ratio > 1.5, confidence interval > 1.5). CONCLUSIONS: Nonelective cesarean deliveries have a higher risk of PPH than women delivered electively. Risk factor identification and prevention should be a priority.     

Indications for Tonsillectomy: Are We Documenting Them?

INTRODUCTION

Tonsillectomy is one of the most frequently performed operations in the UK. Documentation of the indications for tonsillectomy is vital, and should fulfil evidence-based guidelines where possible. We present a completed audit, evaluating the documentation of our department''s practice in meeting the recommendations made by the Scottish Intercollegiate Guideline Network (SIGN) on indications for tonsillectomy.

PATIENTS AND METHODS

A prospective audit of 100 children undergoing tonsillectomy for recurrent tonsillitis at a university hospital during two time periods: October 2007 to January 2008 and March to September 2008. Interventions including the production of posters and rubber stamps were agreed and implemented between the two audit periods.

RESULTS

Following the implementation of simple changes, significant improvements were seen in documentation relating to the SIGN guidelines for tonsillectomy. Overall, the number of children meeting all four SIGN criteria for tonsillectomy rose from 12% to 44% (χ² = 57.8; P < 0.001). Furthermore, a significant reduction was seen in the number of children below the age of 5 years undergoing tonsillectomy for recurrent tonsillitis (χ² = 14.66; P < 0.001).

CONCLUSIONS

With increasing scrutiny on tonsillectomy, it is important to ensure that the reasons for performing tonsillectomy are documented clearly and adhere to evidence-based guidance where possible. We have demonstrated that, with only simple and low-cost interventions, significant improvements in the documentation of tonsillectomy indications can be achieved.