The concordance and discordance of cardiovascular risk factors in a group of twin children

The cross-sectional study of epidemiological screening type has permitted to evaluate some cardiovascular risk factors in two groups of monozygotic (MZ) and dizygotic (DZ) twins born between 1975-1990, in the town of Ia?i. In the 89 MZ pairs and 112 DZ pairs, certain constitutional and behavioural cardiovascular risk factors have presented values of prevalence with statistical signification (p < 0.05) in terms of their age, sex, the urbanisation time and the educational level of their parents. In risk factors existence or absence to both of the twins have put into evidence, to the MZ, most enhanced values of concordance as regards: overweight (66.6%), excessive consumption of salt (56.9%), food with atherogenic risk (50.9%). The concordance values have been less in DZ compared to MZ concerning all the risk factors excepting compartmental type A (77.7%). By analysing the concordance variants, an preponderant influence of the environment has been noted in the studied MZ and heredity and environment influence in DZ. By measuring the arterial blood pressure values at the twins and the twins parents, a prevalence of the essential arterial hypertension is noticed to both of the twins, 6.2% in MZ pairs and 6.9% in DZ ones.     

A randomized phase II trial of interferon-α2b versus 5-fluorouracil after trabeculectomy*

Purpose: The aim of the present study was to investigate the safety and potential efficacy of subconjunctival interferon-α2b (IFN-α), either alone or in combination with 5-fluorouracil (5-FU), in reducing the risk of failure of glaucoma surgery. Methods: A prospective, masked randomized phase II study was undertaken in which patients received three subconjunctival injections per week for 3–4 weeks postoperatively. Three treatments were compared: (i) IFN-α (1 × 10 ⁶ IU per dose); (ii) 5-FU (5 mg per dose); and (iii) alternating IFN-α and 5-FU (BOTH). The primary outcome measures were: (i) rate of successful control of intra-ocular pressure without further surgery; and (ii) the incidence of side effects. Results: Fifty-seven patients undergoing glaucoma surgery with an increased risk of failure were evaluated, including 23 patients (40%) undergoing trabeculectomy combined with extracapsular cataract extraction as well as other conventional high-risk groups. With 53 patients (93%) completing 2 years follow up, there was no significant difference in success rates among the three groups. Intra-ocular pressure was controlled without further surgery in 79% of patients (95% confidence interval (CI): 61, 97%) receiving IFN-α, in 89% of patients (76, 100%) receiving 5-FU and in 89% of patients (76, 100%) receiving BOTH. Side effects were similar among the three groups. Conclusions: These results are consistent with a beneficial effect of IFN-α2b given either alone or in combination with 5-FU after glaucoma filtering surgery. However, the lack of a clear and substantial benefit over conventional anti-fibrotic therapy does not support the further clinical evaluation of these treatments.     

The vascular ‘sunburst’ appearance of osteosarcoma: A new angiographic finding

The angiographic analogue of the sunburst, (right angle) periosteal new bone formation in osteogenic sarcoma is described. The angiographic findings in this tumor and their relationship to the pathologic appearance are discussed.     

Eye Coordination and Vestibular Testing in Electroconvulsive Therapy

Nine depressive patients were examined before bilateral electroconvulsive therapy (ECT), immediately after ECT, and 2 days later with saccadic, pursuit tracking, and Hallpike caloric vestibular tests. Before ECT, all tests showed normal results. Immediately after ECT, the saccadic test displayed dysmetria of the fast eye movements in six of nine patients. The pursuit tracking test showed decreased gain of the slow eye movements with compensatory saccades in seven of nine patients. These findings were for both directions in the horizontal plane. In the caloric vestibular test, the changes were not significant. Two days after ECT, the eye coordination and vestibular testing showed normal function. We conclude that the eye coordination and vestibular function disturbances induced by ECT are transient.     

Radial antibrachial islet flap based on distal perforating arteries. A clinical case

The frequency of the hand trauma involving tissue losses generated the research for developing new technical solutions more simple and economic. The regional flaps, such as the distal pedicle Chinese flap, are usually surgeon's first choice whenever the local resources are over passed. Still, this type of Chinese flap would claim a major disadvantage as they involve the sacrifice of a vascular axis of the hand, sometimes even the dominant one. The operating team, would be able to avoid this inconvenience when using distal perforators based-on antibrachial radial flap; moreover, this technique would allow the covering of the substance losses, as far as the metacarpophalangeal joints. The authors report a clinical case.     

Creation, Evaluation, and Continuing Assurance of Excellence of the Certified Surgical Specialist

A position paper on the subject of certified surgical specialists was published in 1966 under the direction of Professor Charles Wells of Liverpool, England. President John Terblanche of the International Federation of Surgical Colleges brought together leaders in surgical education from four nations (Australia, Japan, South Africa, United States) to update current “state-of-the art” views. Presentations were made at the 38th Congress of the International Society of Surgery, August 18, 1999 in Vienna, Austria. After careful review of the four presentations, it was clear that surgeons all over the world have made great improvements in the many facets of surgical education. Yet the advances remain spotty, with gaps noted when viewed from an international perspective.