Inline Balloon Occlusion–Assisted Delivery of Ethylene Vinyl Alcohol Copolymer for Peripheral Arterial Applications: A Multicenter Case Series

PurposeTo assess the feasibility, safety, and efficacy of balloon-assisted delivery of ethylene vinyl alcohol copolymer (EVOH) for a range of peripheral arterial applications.Materials and MethodsSix academic medical centers entered retrospective data on 46 consecutive patients (27 men, 19 women; ages, 11–94 y; mean age, 50.3 y) who underwent 60 balloon-assisted EVOH procedures. The cohort was restricted to procedures involving peripheral, nonneural arteries 1–5.5 mm in diameter. Clinical indications included a wide range of vascular pathologic conditions (most commonly arteriovenous malformations [n = 20], renal angiomyolipomas [n = 8], and acute hemorrhage [n = 9]) and targeted visceral and musculoskeletal peripheral arteries. Data collected included sex, age, clinical indication, arterial pathology, arteries embolized, type of occlusion balloon microcatheter, type and concentration of EVOH agent, effectiveness as an embolic backstop, vessels protected, adequacy of EVOH cast penetration, catheter extraction, nontarget embolization, and complications.ResultsBalloon occlusion prevented EVOH reflux in 59 of 60 procedures (98.3%). Nontarget EVOH embolization occurred in 2 procedures (3.3%). Adequate EVOH cast penetration and complete filling of the target pathologic structure were seen in 57 of 60 procedures (95%). Balloon deflation and uneventful extraction occurred in all procedures; small EVOH fragments detached into target arteries in 2 cases. One major (1.7%) and 2 minor (3.3%) complications occurred.ConclusionsBalloon-assisted EVOH embolization of peripheral arteries is feasible, safe, effective, and versatile. The primary advantage of balloon-assisted EVOH embolization is the ability to apply more injection pressure to advance the EVOH cast assertively into the pathologic structure(s).     

Bronchial Artery Embolization in Pediatric Pulmonary Hemorrhage: A Single-Center Experience

PurposeTo explore the safety and effectiveness of bronchial artery (BA) embolization (BAE) in children with pulmonary hemorrhage.Materials and MethodsBetween February 2016 and February 2019, 41 patients (median age, 4 y; interquartile range, 2.3-8 y; median weight, 17.6 kg; interquartile range, 12.3–23.6 kg) underwent BAE. The indication of BAE included massive hemoptysis in 10 patients (24.4%), recurrent hemoptysis in 18 patients (43.9%), and refractory anemia in 13 patients (31.7%). The main etiology of pulmonary hemorrhage included pulmonary hemosiderosis (58.5%), congenital heart disease (17.1%), and infection (14.6%). A retrospective review was conducted of clinical outcomes of BAE.ResultsThere were 44 embolization sessions, with a total of 137 embolized vessels. Pulmonary hemorrhage was caused by BAs in 30 cases, nonbronchial systemic arteries plus BAs in 10, and nonbronchial systemic arteries in 1. Embolic particles were used in 30 cases (24 polyvinyl alcohol [PVA] and 6 microsphere), coils in 9 cases, and particles plus coils in 5 cases (4 PVA and 1 microsphere). Technical success (ability to embolize abnormal vessel) was achieved in 97.6% of patients (40 of 41), and clinical success (complete or partial resolution of hemoptysis within 30 days of embolization) was achieved in 90.2% (37 of 41). There was 1 procedure-related complication (2.4%) of cerebral infarction and 1 death from multiple-organ dysfunction (2.4%). Bleeding-free survival rates at 6, 12, 24, and 36 months were 92.5%, 83.9%, 83.9%, and 70.8%, respectively.ConclusionsBAE is a safe and effective procedure in children with pulmonary hemorrhage.     

Alcohol controls and Aboriginal society: The effects of the Northern Territory restricted areas legislation

The “restricted areas” provisions of the Northern Territory Liquor Act constitute a preventative policy aimed at reducing the effects of alcohol abuse, particularly on Aboriginal communities. Under the provisions, communities can apply to be declared “dry” or semi-restricted with respect to liquor. Since their inception in 1979, the provisions have given rise to continuing controversy. This paper addresses some of the issues associated with the controversy. Patterns of alcohol consumption on “dry”, semi-restricted and unrestricted communities are compared, and the incidence of apprehension for public drunkenness before and after restricted area declarations is examined. The paper also discusses the provisions under which vehicles implicated in acts of illicit “grog-running” are forfeited to the NT Government. It is concluded that the restricted area provisions are associated with reduced levels of alcohol consumption and apprehensions for drunkenness, and are therefore beneficial in outcome. However, it is also argued that at present the provisions are flawed in that, while some aspects serve to promote community control over alcohol consumption, other elements have the effect of undermining community control and responsibility.     

血清低密度脂蛋白胆固醇直接测定与Friedewald公式计算结果比较

采用聚乙烯硫酸（ＰＶＳ）沉淀法测定血清低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）值，同时应用Ｆｒｉｅｄｅｗａｌｄ公式计算ＬＤＬ－Ｃ含量，并对两法结果进行比较分析，提出当甘油三脂（ＴＧ）＜４．５２ｍｍｏｌ／Ｌ时，Ｆ公式计算法可代替ＰＶＳ法，当ＴＧ＞４．５２ｍｍｏｌ／Ｌ时，不宜用Ｆ公式计算ＬＤＬ－Ｃ的值。     

Identifying target segments of male drinkers for health promotion

Data from a 1988 national drinking survey was cluster analysedto identify different types of male drinkers, to assist in thetargeting of health promotion strategies. Of the five segmentsgenerated by the clustering, one labelled Young Heavy DrinkingMales was identified as the most appropriate target segment,because although they were the segment reporting the highestlevel of alcohol-related problems they were also the segmentmost likely to feel they were drinking too much They were thereforethe segment most likely to be responsive to advertising thatsought to support people who wanted to change their drinkinghabits. They were also the most appropriate target for the longer-termgoal of changing the climate of opinion regarding the acceptabilityof more moderate drinking. Comparisons with two previous clusteranalyses showed a high degree of similarity, suggesting thatclustering is a reliable vehicle for identifying drinker types.     

Changing the College AOD Environment for Primary Prevention

Identifying environmental factors reflected to alcohol use is important for program planning and evaluation in college alcohol and drug prevention programs. Little has been written concerning uses of data in environmental prevention efforts. This paper presents four brief interrelated case studies of how environmental modifications were used by a college alcohol prevention project to 1) change the marketing practices and service policies of a student-oriented bar, 2) alter the sales practices of a campus bookstore concerning alcohol paraphernalia, 3) to develop a campaign with the goal of reducing risk factors related to heavy drinking at private student parties, and 4) stop an unsafe bus from transporting students to bars in Mexico. Creative use of such environmental prevention approaches has potential benefit to colleges and universities concerned with the primary prevention of alcohol-related problems experienced by students.     

补体对免疫沉淀的抑制作用与小儿肾脏疾病的关系

以辣根过氧化物酶（PO）和抗-PO作为免疫沉淀中的抗原和抗体，用光电比色法，对78例小儿肾脏疾病血清补体对免疫沉淀的抑制作用（IIPC）进行了研究，并同时检测补体成分C3、C4。结果，正常对照IIPCOD值为0．505±0．085，急性肾小球肾炎（0．137±0．108）显著降低（P＜0．001）；慢性肾小球肾炎（0．470±0．053）改变不明显（P＞0．05）；肾病综合征（0．401±0．038）明显低下（P＜0．05）。IIPC低下的发生率依次为急性肾小球肾炎（83％）、肾病综合征（43％）、慢性肾小球肾炎（32％）。表明小儿肾小球疾病时IIPC大多降低并与疾病的活动性有关。因此认为IIPC低下在肾脏病的发生和发展中起一定作用。     

The effects of alcohol and benzodiazepines on the severity of ski accidents.

Urine samples from 402 victims of ski accidents were analyzed for the presence of benzodiazepines (BZD) and alcohol. Eighty-one (20%) samples were positive for alcohol; BZD were detected in 34 (8.5%) cases. Ten of the samples (2.5%) were found to be positive for both alcohol and BZD. Subjects who were positive for either alcohol or BZD or both were older than the other persons examined. The prevalence of alcohol was significantly higher among male accident victims. BZD intake could be demonstrated to have a significant influence on the severity of injuries. Besides an increased awareness of the need for skier education regarding drug use, heightened attention of medical caregivers is warranted to inform their patients about potential accident hazards in sport activities when BZD are prescribed.     

The effects of age,sex, and genotype on self-report drunkenness following a challenge dose of alcohol

Age is a potential source of variation that contributes to differences between, but not within, twin pairs. In most genetic analyses of twin data, linear and other functions of age are usually removed prior to model fitting. This correction is typically applied only within twin groups of the same sex and zygosity, and no heterogeneity test of age regressions is performed. Here we include age as a variable in the model-fitting procedure and allow for tests of heterogeneity of age regressions across sex and zygosity groups. The LISREL formulation of the approach is illustrated with data collected from Australian twins on subjective impressions of drunkenness following alcohol consumption. The results indicate significant negative covariation of impressions of drunkenness with age. The data support a simple model of additive genetic and unique environmental variation. No evidence was found for sex differences in genetic or environmental components of variation.The theoretical work and data analysis described in this paper were made possible by NATO Grant 86/0823 and grants from the Belgian National Research Fund, the State University of Gent, and the Catholic University of Leuven. We are also grateful to Drs. R. Vlietinck and R. Derom for excellent organization of the successful workshop. Data collection was made possible by a grant from the Australian Associated Brewers to N.G.M. and Drs. J. G. Oakeshott, J. B. Gibson, and G. A. Starmer and by grants from the Australian National Health and Medical Research Council. The authors were supported by NIH Grants MH-40828 and AA-06781.