Fetal movements registered by the pregnant woman correlated to retrospective estimations of fetal movements from cardiotocographic tracings

After reviewing 30 cardiotocographic tracings from 15 pregnant women who directly registered fetal movements (FM) on the cardiotocographic (CT) tracings, we have found no correlation between the actual number of FM and the FM found by retrospective estimation from CT tracings. Ours is the first study to show this lack of correlation. On the contrary, we have found that by using the “retrospective” or “indirect” method, almost 90% of the FM are overlooked. This is a very important loss of information since registration of FM seems to be a good method for surveillance of the fetus at risk. We also discuss our own methods for overcoming these problems.     

Fansidar resistant falciparum malaria acquired in South East Asia

A case of Plasmodium falciparum malaria resistant to Fansidar (sulphadoxine plus pyrimethamine) at a level corresponding to R III and resistant to chloroquine is reported. The infection was most certainly acquired in Malaysia, but diagnosed and treated in a non-malarious area.Normal resorption and elimination rates of the Fansidar components excludes cure failure due to abnormal drug fate in the host.P. falciparum parasites from the patient have been maintained in in vitro cultures.The patient was permanently cured with mefloquine.     

Nasal methacholine challenge. A test for the measurement of nasal reactivity.

The aim of this study was to develop a test for the measurement of nasal reactivity. Different concentrations of methacholine were sprayed intranasally, and the nasal secretion and blockage were measured in normal subjects. The simple collection and measurement of secretion was found to be a valuable parameter of mucosal reactivity, while measurement of nasal airway resistance was unreliable, due in part to the presence of secretion in the nasal cavity. The methacholine test had a fairly good reproducibility when the amount of secretion was used as the only parameter. It caused a significantly stronger reaction in women than in men. Patients with perennial rhinitis had a more vigorous response than the controls. It is concluded that the methacholine test may prove useful as a sign of perennial rhinitis and also for the objective evaluation of medication, but further studies are warranted.     

Determining factors for the mortality following hip fractures

In this study 518 patients with hip fractures were followed up prospectively for an average of 3 years (range 2.5–3.5 years).

On admission to hospital the patients were allocated to one of 4 social function groups according to their dependence on the social welfare system.

The life expectancy was analysed at follow-up and found to be determined primarily by the patient's social dependence prior to fracture, and secondarily by the age of the patient. Other generally accepted determining factors were not found to have any significant influence on the survival rates.     

Active Surveillance Versus Radical Prostatectomy in Favorable-risk Localized Prostate Cancer

BackgroundActive surveillance (AS) and radical prostatectomy (RP) are both accepted treatments for men with favorable-risk localized prostate cancer (PCa) (ie, clinical tumor category 1-2b, Gleason Grade Group 1-2, and prostate-specific antigen < 20 ng/mL). However, head-to-head studies comparing oncologic outcomes and survival between these 2 treatment strategies are warranted. The objective of this study was to compare the use of prostate cancer treatments and PCa death in men managed on AS and men who underwent immediate RP.Patients and MethodsThis was an observational study including 647 men on AS and 647 men treated with RP propensity score matched. We examined the 10-year cumulative incidence of salvage radiotherapy, hormonal therapy, castration-resistant PCa, and PCa death.ResultsThe 10-year curative treatment-free survival for men on AS was 61% (95% confidence interval [CI], 57%-65%). No differences in use of salvage radiotherapy (AS, 2.7%; 95% CI, 1.4%-4.1% vs. RP 5.4%; 95% CI, 3.4%-7.3%), hormonal therapy (AS, 6.9%; 95% CI, 4.4%-9.4% vs. RP, 4.1%; 95% CI, 2.5%-5.6%), developing castration-resistant PCa (AS, 1.7%; 95% CI, 0.5%-2.9% vs. RP, 2.0%; 95% CI, 0.7%-3.4%), or cumulative PCa mortality (AS, 0.4%; 95% CI, 0%-1.0% vs. RP, 0.5%; 95% CI, 0%-1.5%) were observed between the treatment strategies. The main limitation was the non-random allocation to treatment strategy.ConclusionIn this observational study on men with favorable-risk localized PCa, we found similar PCa mortality at 10 years between men on AS and men who underwent immediate RP. Moreover, there were no differences in the use of PCa therapies between the groups. Our study supports active surveillance as a treatment strategy for men with favorable-risk localized PCa.