Massive hemoptysis: control by embolization of the thyrocervical trunk

A case of recurrent hemoptysis following bronchial artery embolization is presented. The bleeding was successfully controlled by embolization of the thyrocervical trunk.     

Hepatic parenchymal gas after blunt trauma

Hepatic parenchymal gas was demonstrated by computed tomography in a boy who had sustained severe blunt trauma to the abdomen 12 hours earlier. There was no clinical evidence of infection. Although previous reports have suggested that hepatic parenchymal gas indicates the presence of infection, such gas may also be a manifestation of severe blunt trauma without infection.     

Smoking habits in relapsed subjects from a smoking cessation trial after one year

Reports of smoking cessation studies often claim that many relapsed subjects reduce their smoking. We investigated the smoking habits of relapsers 1 year after quitting in a smoking cessation trial using nicotine or placebo patches. All 289 participants in that study were summoned to a 1-year follow-up visit–148 (57%) of 259 relapsers attended, as did all 30 sustained abstainers. Fewer than 1% of the subjects had quit spontaneously after the primary relapse. Daily cigarette consumption, standard nicotine yield per cigarette, saliva cotinine concentration, expired carbon monoxide level and two nicotine dependency scales were assessed at entry and at the 1-year follow-up. In five of these six smoking-related characteristics, there was a small but significant mean reduction of 7%-27%. A significant weight gain of 0.5 ± 2.9 kg (mean ± SD) was recorded in the relapsers compared with 4.8 ± 4.2 kg for abstainers (p < 0.001). It is concluded that smoking habits in relapsers are relatively unchanged, and thus the most important outcome measure in smoking cessation trials is abstinent subjects.     

Acute meningo-encephalitis in pregnancy—a problem of differential diagnosis

Two cases of Coxsackie B viral meningo-encephalitis in pregnant women are described. Both patients recovered well and delivered healthy babies, but because of delay in establishing the aetiology of their infections both mothers, and one child, received acyclovir therapy. The differential diagnosis of non-pyogenic meningo-encephalitis in late pregnancy can present particular problems: clinicians caring for such women should remain aware of the potential for enteroviral infection in their patients, and take appropriate action to prevent cross-infection in neonatal units.