Parity as a risk factor for cancer cervix

PURPOSE: To analyze the likelihood of perioperative transfusion using the data of the abstracted patient discharge records. MATERIAL AND METHODS: It was studied the data of the records of the pediatric patients in whom were done surgical procedures for 1996. The abstracted patient discharge records are codified according the ICD-9-CM codes. RESULTS: 1,166 pediatric patients were operated, of whom were transfused 25 (2.1%). The transfusion rate was higher in patients less than 3 years old, who were operated with three o more surgical procedures simultaneously, who were admitted newly after the admittance here studied, and patients operated of spine, dorsolumbar spine, pharynx, thorax and mediastinum, central nervous system, colon, vessels and hip. CONCLUSIONS: Given the variability of the transfusion rate, to know it will allow a better planning of the surgical transfusions, the policy of the hospital blood bank and to increase the information to patient about the risk of the elective surgery.     

Pyrazoline bisphosphonate esters as novel antiinflammatory and antiarthritic agents

Vinylidenebisphosphonic acid tetraethyl ester (1) and diazo ketones 7a-1 in ether at 22 degrees C yield pyrazoline bisphosphonate tetraethyl esters 8a-1 in moderate to good yield. These compounds were evaluated in animal models of arthritis: rat adjuvant-induced polyarthritis (AIP) and murine antigen-induced arthritis (AIA) and a murine model of chronic inflammation, the delayed type hypersensitivity granuloma reaction (DTH-GRA). (5-Benzoyl-2,4-dihydro-3H-pyrazol-3-ylidene)-bisphosphonic acid tetraethyl ester (8a), and [5-(3-fluorobenzoyl)-2,4-dihydro-3H-pyraxol-3-ylidene]- bisphosphonic acid tetraethyl ester (8d) significantly inhibited the arthritis models, AIP (15 mg/kg) and AIA (25 mg/kg), as well as the DTH-GRA (25 mg/kg). Conversion of 8a to the corresponding bisphosphonic acid, 10a, resulted in loss of activity. Compounds with alkyl substituents on the pyrazoline nitrogen, 9a-d, were inactive in the DTH-GRA. These results show that 8a and 8d have novel antiinflammatory activity and are capable of inhibiting chronic arthritis and inflammation in animals. Such compounds might be useful in man for treating chronic tissue injury associated with arthropathies such as inflammatory joint disease as well as other chronic inflammatory diseases.     

Present status of positive scintigraphic imaging of myocardial infarction

Community hospital graduate medical education programs have been judged deficient in several areas when compared with university programs. Generally community programs are smaller, they have a greater percentage of foreign house officers and unfilled house staff positions, and their graduates do less well on specialty board examinations. Difficulties may exist in offering a balanced and broad-based educational exposure. Four separate pediatric residencies in Phoenix became affiliated in 1972. The traditional deficiencies have been overcome, and a very popular and well-balanced program has ensued. Additionally, wasteful duplication has been avoided. Disadvantages have included complex scheduling and loss of continual close contact with house officers. Assigning patients to residents for continuity of care has been difficult. Experiences gained in this amalgamation may well apply to other hospitals facing similar problems. Local consortiums, such as this, fit well into university affiliated programs or statewide organizations.     

Reversible binding of chlorpromazine to brain tubulin

Isolated lamb hearts perfused at 13degrees C. with acellular perfusates developed progressive intersitital edema and a rise in vascular resistance. They did not exhbit any electrical or mechanical activity. In contrast, hearts perfused with whole fresh blood remained well preserved, had no edema or change in vascular resistance, and contracted vigorously while being perfused at 10degrees and 13degrees C. This study was designed to determine which particular component(s) of whole blood contributed to improved cardiac preservation. Isolated lamb hearts were perfused for 18 hours at 13degrees C. with plasma containing platelets and some or no red blood cells. Continuously fresh plasma was obtained from a donor animal by means of a flow-through centrifuge. Hearts perfused at 13degrees C. with fresh plasma of either low or high platelet count contracted during the initial 2 to 4 hours of the perfusion only and were as poorly preserved as hearts perfused with acellular microfiltered plasma. A hematocrit value of 2 to 5 per cent in the plasma perfusate resulted in the hearts being preserved almost as well as with fresh whole blood; they showed a forceful cardiac activity at 13degrees C., there was no edema, the vascular resistance was stable, and after rewarming they had good ventricular function. The improvement in cardiac preservation brought about by addition of a minimal amount of red blood cells suggests a specific effect of erythrocytes on the cardiac microcirculation.     

Risk assessment of accidents involving environmental high-toxicity substances

The introduction of new safety legislation in Russia has been accompanied by R&D into risk assessment, especially needed when dealing with high-toxicity substances. In the present article, two models for evaluation of the dose absorbed by recipients as a result of instantaneous releases and short-term continuous emissions of toxicant to the atmosphere are developed. The models have the form of definite integrals with Green's function. The numerical problem of evaluation of the absorbed dose with obtained models is reduced to the calculation of single definite integrals. It is shown that under similar initial conditions, the dose absorbed as a result of instantaneous discharge is greater than the dose resulting in a short-term continuous emission of toxicant. An interval approach is developed to estimate the sensitivity of the numerical results to the errors in empirical parameters and variables included in the models. On the base of introduced definitions of interval variables, interval vectors and interval functions, interval estimates for absorbed dose are developed. It is shown that there exists an optimal number of terms in empirical equations with inexact parameters. Numerical examples of interval analysis are given.     

Endoscopic CO2 laser excision of large or recurrent laryngeal saccular cysts in adults

BACKGROUND: Most paediatric cardiac arrest studies have been conducted in the USA, where paramedics provide prehospital emergency care. We wanted to study the outcome of paediatric cardiac arrest patients in an emergency medical system which is based on physician staffed emergency care units. METHODS: We analysed retrospectively the files of 100 prehospital cardiac arrest patients from Southern Finland during a 10-year study period. The patients were less than 16 years of age. RESULTS: Fifty patients were declared dead on the scene (DOS) without attempted resuscitation, and cardiopulmonary resuscitation (CPR) was initiated in 50 patients. The sudden infant death syndrome was the most common cause of arrest in the DOS patients (68%) as well as in those receiving CPR (36%). Asystole was the initial cardiac rhythm in 70% of the patients in whom CPR was attempted. Resuscitation was successful in 13 patients, 8 of whom were ultimately discharged. Six of the patients survived with mild or no disability and 4 of them had near-drowning aetiology. In multivariate analysis, the short duration of CPR (< or = 15 min) was the only factor significantly associated with better survival. CONCLUSIONS: Although prehospital care was provided by physicians, the overall rate of survival was found to be equally poor as reported from systems with paramedics. The only major difference between physician- and paramedic-staffed emergency care units is the ability of physicians to refrain from resuscitation already on the scene when prognosis is poor.