An exploration of awareness bias in two environmental epidemiology studies

Awareness bias in environmental health research is the tendency to report more illness because of concerns arising from proximity to a hazard in the absence of a measurable biological effect. Such bias complicates the interpretation of self-reported symptoms in communities exposed to emissions from heavy industry. We used data from two epidemiologic studies in Northeast England where community concerns existed about health risks from industry. An association between proximity to industry and self-reported respiratory and nonrespiratory illnesses and symptoms had been found in one study but not in the other. An indicator of concern about industrial pollution was constructed from responses to a 17-item questionnaire about issues that had caused stress or anxiety. Univariate and multivariate analyses of health outcome variables in both studies showed that individuals with "industry-related worries" reported more illness, irrespective of proximity to industry. We conclude that self-reported illness was influenced by both worry and proximity to industry, but that worry about the hazard had the greatest effect on self-reported illness. We suggest that because absolute certainty about the role and extent of awareness bias in environmental epidemiology studies is unlikely to be achieved, self-reported data should be supplemented with other observations.     

Phase I study of RP 49532A,a new protein-synthesis inhibitor,in patients with advanced refractory solid tumors

Giroline (RP 49532A) is a new protein-synthesis inhibitor with broad antitumor activity in experimental models. In the present phase I study, Giroline was given by 24-h i.v. infusion every 3 weeks at doses ranging from 3 to 15 mg/m² to 12 patients with advanced refractory solid tumors. The dose-limiting toxic effects were delayed hypotension and severe asthenia. The maximum tolerated dose (MTD) was 15 mg/m². Transient nausea and vomiting during infusion were reported at all dose levels. Mild reversible prolongation of prothrombin time and activated partial thromboplastin time was observed in most patients at dose levels above 3 mg/m². No antitumor activity was observed. The toxicity profile of Giroline precludes further evaluation in cancer patients.This work is dedicated to the memory of Prof. Michel Clavel     

Use of bacterial antigen detection in the diagnosis of pediatric lower respiratory tract infections

Two immunochemical methods were used to identify Haemophilus influenzae and Streptococcus pneumoniae capsular antigens in the urine and serum of 162 children with acute lower respiratory tract infection. These methods were compared with standard bacterial blood culture. Viral and mycoplasma cultures of respiratory secretions were obtained simultaneously to determine the frequency of antigenuria at the time of nonbacterial acute lower respiratory tract infection. Urine from groups of well children and children with acute otitis media was tested for capsular antigens to determine the incidence of antigenuria. Antigenuria was found in 24% of children 2 months to 18 years of age with acute lower respiratory tract infection compared with a 2% incidence of bacteremia. Antigenuria was found in 4% of asymptomatic children and 16% of children with acute otitis media. One third of children with symptoms of acute lower respiratory tract infection and viral isolates from the oropharynx had bacterial antigenuria. The sixfold increase in frequency of bacterial antigenuria in children at the time of lower respiratory symptoms suggests that bacterial acute lower respiratory tract infection may be more common than identified by traditional culture techniques. Because bacterial antigen may come from other sites such as the middle ear, further studies are needed to determine the role of antigen detection in the diagnosis of pediatric acute lower respiratory tract infection.     

Intraspinal oxidised cellulose (Surgicel) causing delayed paraplegia after thoracotomy--a report of three cases

Oxidised regenerated cellulose (Surgicel) is a commonly used haemostatic agent in neurosurgery, thoracic surgery, and orthopaedics. We present three cases of paraplegia after thoracic surgery during which oxidised cellulose had been used during thoracotomy for haemorrhage control, and was later found to have passed through the intervertebral foramen causing spinal cord compression. In all intraspinal and perispinal procedures, the over-liberal use of Surgicel should be avoided, and attempts made to remove all excess Surgicel once adequate haemostasis is obtained.     

Post-traumatic stress disorder in child sexual abuse survivors: A literature review

Research to date has failed to identify a unique syndrome describing the sequelae of child sexual abuse (CSA). Recently, however, some researchers have suggested Post-Traumatic Stress Disorder as the diagnosis which best fits the syndrome commonly seen in CSA survivors. Research examining the consequences of CSA in terms of the applicability of a PTSD diagnosis is reviewed. Additionally, based on findings of significant relationships between PTSD and traumatic exposure in other trauma groups, this review also examines studies which have investigated relationships between exposure and symptom development among CSA survivors. Finally, conclusions regarding the applicability of PTSD to CSA survivors and suggestions for future research are offered.This article was accepted for publication under the Editorship of Charles R. Figley.     

The Results of Tuboplasty With Fimbrial Conservation and Intra-Abdominal Hydrotubation

Summary: A technique of tuboplasty associated with intra-abdominal hydrotubation is described. The procedure was performed on 20 patients, 95% of whom had subsequent tubal patency, while 55% became pregnant. It is concluded that, although high patency rates may be obtained by using hydrocortisone and prosthetic adjuncts, further improvement in terms of successful pregnancy are more likely to be gained by improvement in surgical techniques.