Serum and parotid salivary IgA in chronic bronchitis and asthma

Siegler, D. I. M. and Citron, K. M. (1974).Thorax, 29, 313-316. Serum and parotid salivary IgA in chronic bronchitis and asthma. It has been suggested that immunoglobulin A (IgA) deficiency may be an important predisposing factor to infection in chronic bronchitis and that this occurs more often in extrinsic asthmatics than in normal subjects. These claims have been investigated by measurement of IgA in stimulated parotid saliva and serum in chronic bronchitics and asthmatics. Salivary and serum IgA levels in 84 chronic bronchitics could not be correlated with sputum purulence, the degree of ventilatory impairment, radiographic evidence of emphysema or the smoking history. Serum IgA was low in 6% and salivary IgA was normal in all cases. IgA levels measured in both serum and saliva in 50 asthmatics showed no correlation with the number of positive skin tests or other evidence of atopy. Serum IgA was low in 8% and salivary IgA was normal in all cases.     

Stress and adaptation in later life

The effects of five major life events, and of three types of resources, on the physical and social-psychological adaptation of 375 participants in a longitudinal study were examined. As expected, medical events had the most impact on physical adaptation, but they had surprisingly little impact on social-psychological adaptation. Retirement had the most negative social-psychological effects, but had little effect on physical adaptation. The other three events had even less effects, although multiple events tended to cumulate in impact. Better physical resources helped only physical adaptation, and better psychological and social resources mainly helped satisfaction. It appears that most of these potential stressors have less serious long-term outcomes than the crisis orientation would suggest.     

Octylcyanoacrylate (Dermabond) for skin closure at the time of head and neck surgery: a longitudinal prospective study

OBJECTIVES: A prospective non-randomised evaluation of the octyl-2-cyanoacrylate (Dermabond) for skin closure in head and neck surgery. MATERIALS AND METHODS: An inception cohort of 52 patients managed by six otorhinolaryngologists head and neck surgeons at a single institution (university teaching and tertiary referral center) during the months of May-July 2004. The length of the skin incision varied from 3 to 30 cm (mean: 7 cm). Morbidity evaluation, longitudinal analysis of the evolution of the scar, and analysis of the degree of satisfaction. RESULTS: Postoperative death was not encountered. The overall morbidity rate was 3.8% (2/52). There was no instances of wound dehiscence's. A subcutaneous abscess was noted in one patient. From an aesthetic point of view, the scar appearance was considered to be slightly retracted during the first postoperative month and to be very good 2 to 4 months from initial surgery. Only one patient developed a minimal cheloid scar. Among the 47 patients who expressed an opinion postoperatively regarding the use of the octyl-2-cyanoacrylate (Dermabond) for skin closure, the degree of satisfaction was very high due to the ability to take an early shower (40 patients) followed by the lack of skin sutures (5 patients) and the lack of any allergic skin reaction (2 patients). CONCLUSION: At our department, the octyl-2-cyanoacrylate (Dermabond) for skin closure at the time of head and neck surgery is becoming more and more utilized due to the completion of a solid and aesthetic suture, the ability to take an early shower and the high degree of satisfaction expressed by the patients.     

Hemolytic uremic syndrome; pathogenesis, treatment, and outcome

PURPOSE OF REVIEW: The hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure in infants and young children, and is a substantial cause of acute mortality and chronic morbidity. It is therefore relevant and appropriate that pediatricians remain familiar with the various subsets of the disease including its classification, management, and outcome. RECENT FINDINGS: This review will focus on recent information relative to epidemiology, pathogenesis, treatment, and outcome. It will include some of the newer associations between HUS and a variety of infections, including, but not limited to E. coli 0157:H7 (Shiga toxin-mediated) HUS, as well as the ever-increasing number of associations between HUS and a variety of drugs. It will review some of the newer therapies for the more common subsets, but will acknowledge that choosing evidence-based therapies is often limited by our incomplete understanding of the various pathogenic cascades, and that with the possible exception of Shiga toxin-mediated HUS(D+HUS), long-term outcome information is often limited by small numbers and limited follow-up. SUMMARY: This review should provide a framework for making the proper diagnosis, implementing appropriate treatment, and advising the family about anticipated outcome.     

Vesicovaginal fistula resulting from loop electrosurgical excision in a woman with intraepithelial neoplasia of the cervix and vagina: a case report

A 52-year-old woman had concomitant cervical intraepithelial neoplasia (CIN) grade 3 and vaginal intraepithelial neoplasia grade 3. On performing a loop electrosurgical excision procedure, a vesicovaginal fistula accidentally occurred. The vaginal intraepithelial neoplasia covering the anterior fornix could have been a contributing factor in the occurrence of the fistula.