Pulmonary function in healthy young adult Indians in Madras.

Forced vital capacity, forced expiratory volume in one second, functional residual capacity, residual volume, total lung capacity, and single breath diffusing capacity measurements (effective alveolar volume, carbon monoxide transfer factor, and transfer coefficient) were measured in 247 young healthy adults (130 male, 117 female) aged 15-40 years living in Madras. Subjects were of Dravidian stock, living at sea level with rice as their staple diet. Regression equations were derived for men and women for predicting normal pulmonary function for young adults in South India. The values were similar to those reported for subjects from Western India and lower than those reported for North Indians and caucasians.     

Post lumbar puncture headache: is bed rest essential?

Headache following lumbar puncture is a well known and well described complication. Various manoeuvres have been tried to prevent post lumbar puncture headache--the commonest being bed rest for 4 to 24 hours following lumbar puncture, though its value is questionable. Randomised controlled clinical trial was done to evaluate the effect of 24 hours bed rest on the incidence and severity of post lumbar puncture headaches. Two hundred and eight patients were randomly allocated to either the ambulant or the bed rest group. Patients were interviewed by a single investigator on days 0, 1, 2 and 7 about the presence and nature of headache. Other relevant clinical and laboratory data pertaining to the lumbar puncture was collected. The overall incidence of post lumbar puncture headache was 17%; 15% in the ambulant and 18% in the bed rest group. Of the patients who had headaches, severe headache was observed in 57% in the ambulant and 12% in the bed rest group (p = 0.02). Other variables did not alter the outcome of headaches. Bed rest does not appear to alter the incidence of post lumbar puncture headaches, but reduces the severity in those who get headaches, after a lumbar puncture.     

Effect of glass composition on the degradation properties and ion release characteristics of phosphate glass--polycaprolactone composites

A series of polycaprolactone and ternary-based (Na(2)O)(0.55-x)(CaO)(x)(P(2)O(5))(0.45) glass composites were created, each containing 20% volume percentage of glass with various calcium compositions. A short-term degradation study was carried out to investigate the physical and ion release behaviour of these composites, utilising analytical techniques such as dynamical mechanical analysis, and ion chromatography. All the composites experienced significant loss of weight and stiffness throughout the study, with the 24 mol% calcium composites losing the greatest amount of weight and stiffness. The pH profile of the aqueous solutions in which the composites were placed were initially acidic, but began to neutralise mid-way through the study, with the 36 mol% solution achieving the most acidic conditions. The ion release behaviour mirrored the mass loss behaviour of the glass component of the composites. The cations (sodium and calcium ions) release was comparable with the initial stages of composite mass degradation, both of which exhibited almost immediate release when placed into solution. The 24 mol% composites underwent rapid rates of cation release, while the 36 mol% experienced the slowest rates of release. By contrast, anion (phosphates and polyphosphates) release showed a dissimilar trend, with rapid release of the P(2)O(7) and P(3)O(10) occurring during the first few hours in solution, whilst the P(3)O(9) structure released steadily during the first 48 h in solution. Finally, PO(4) release was at a constant rate over the duration of the study, releasing up to 300 ppm from the 32 and 36 mol% samples by the end of 200 h. To summarise, these results show that by combining phosphate glasses with biodegradable polymer, it is possible to create composites whose rate of degradation can be controlled to meet the needs of their end application.     

Acute coronary syndromes

The first 150 words of the full text of this article appear below. Key points Coronary artery disease accounts for >30% ofdeaths in Western society. The diagnosis of myocardial infarctionshould be qualified by size, causation and time from occurrence. Mortalityis reduced by immediate or ‘primary’ percutaneouscoronary intervention or thrombolysis within the first 24 hof onset of ST-segment elevation myocardial infarction. Strategiesto reduce platelet activation (glycoprotein IIb/IIIa receptorantagonists, or clopidogrel) are now recommended in the treatmentof high-risk non-ST-segment myocardial infarction/unstable angina. Elevatedserum troponins may be the result of non-ischaemic myocardialdamage, especially in critical illness.