Cardiac tamponade associated with a peripheral vein central venous catheter.

We present a case of cardiac tamponade associated with placement of a central venous catheter (CVC) via a peripheral vein in a 14-year-old girl with idiopathic scoliosis undergoing corrective surgery. A number of complications have been described in association with CVC misplacement. Sporadic cases of cardiac tamponade from this have been reported, but the actual incidence is unknown.

Bone, blood and semen lead in men with environmental and moderate occupational exposure.

Lead (Pb) in blood, bone, and semen was measured in 162 to 186 environmentally exposed men from Mexico City, aged 19- 48. Semen Pb was measured by inductively coupled plasma mass spectrometry, blood Pb by atomic absorption spectrometry and bone Pb by K X-ray fluorescence. Mean Pb levels in blood, semen, tibia (cortical) and patella (trabecular) bone were 12 microg/dl, 2.

Atrazine in municipal drinking water and risk of low birth weight, preterm delivery, and small-for-gestational-age status.

Background: Atrazine is a herbicide used extensively worldwide. Bioassays have shown that it is embryotoxic and embryolethal. Evidence of adverse reproductive outcomes from exposure in the general population is sparse.

Paratesticular desmoplastic small round cell tumor: case report.

Background: The desmoplastic small round cell tumor has recently been separated from other small round cell tumors because of its characteristic pathological and clinical features. They are usually intra-abdominal tumors affecting young people and have classically been associated with a bad prognosis. However, in recent years there have reports on desmoplastic small round cell tumors affecting other body regions, including the paratesticular area.

Hemodynamic effects of terlipressin and high somatostatin dose during acute variceal bleeding in nonresponders to the usual somatostatin dose.

Objectives: High dose of somatostatin infusion achieves a greater reduction of hepatic venous pressure gradient (HVPG) than the usual dose, and terlipressin decreases HVPG through mechanisms other than somatostatin. Our aim was to assess the hemodynamic effects of terlipressin and high somatostatin dose during acute variceal bleeding in nonresponders to the usual somatostatin dose.

Methods: Hemodynamic studies were performed in 80 patients with cirrhosis and variceal bleeding during the first 3 days of admission.

Reliability of retrospective clinical data to evaluate the effectiveness of lumbar fusion in chronic low back pain.

Study Design: Patients in whom a posterior spinal fusion instrumentation had been performed to treat low back pain were asked to recall their preoperative clinical status by retrospectively filling out the same 3 self-evaluation scales they had completed before surgery in a prospective fashion.

Objectives: To evaluate the impact of recollection error and compare outcomes using retrospective versus prospective methodologies among a cohort of patients treated with posterior spinal fusion instrumentation.

Summary Of Background Data: Literature on spine surgery from 1990 to 2000 shows a greater increase in retrospective studies as compared to randomized controlled trials and other prospective studies.

Neurotransmitter amino acid in cerebrospinal fluid of patients with dementia with Lewy bodies.

The purpose of the present study was to compare neurotransmitter amino acid concentrations in the cerebrospinal fluid (CSF) and CSF/plasma ratios in 21 patients with dementia with Lewy bodies (DLB) and 26 matched controls. To this purpose, we used an ion-exchange chromatographic method. DLB patients exhibit higher CSF concentrations of asparagine (+25%) and glycine (+21%) compared to a control group, whereas no differences in CSF/plasma ratios were found between both groups.

Epidermal abnormalities and increased malignancy of skin tumors in human epidermal keratin 8-expressing transgenic mice.

Keratins K8 and K18 are the major components of the intermediate filament cytoskeleton of simple epithelia. Increased levels of these keratins have been associated with invasive growth and progression to malignancy in different types of human and murine epithelial tumors (including skin tumors), and even in tumors from nonepithelial origin. However, it has not yet clarified whether K8/K18 expression in tumors is cause or consequence of malignancy.

Preoperative erythropoietin in spine surgery.

Unlabelled: Spine surgery may be associated with profuse intraoperative bleeding that often requires blood transfusions. In recent years several techniques have been developed to avoid allogenic transfusions and their potential complications to surgical patients. In this study we review and analyse the role of preoperative recombinant human erythropoietin (rHuEPO) administration in spine surgery as a blood conservation strategy.

Ozone exposure induces iNOS expression and tyrosine nitration in rat aorta.

The aim was to study whether ozone affects vascular endothelium by causing inducible nitric oxide synthase (iNOS) expression and tyrosine nitration. We also studied biomarkers of endothelial function. Male Wistar rats were exposed to ozone (0.

Disinfection byproducts and bladder cancer: a pooled analysis.

Background: Exposure to disinfection byproducts in drinking water has been associated with an increased risk of bladder cancer. We pooled the primary data from 6 case-control studies of bladder cancer that used trihalomethanes as a marker of disinfection byproducts.

Methods: Two studies were included from the United States and one each from Canada, France, Italy, and Finland.

Maintenance of hemodynamic response to treatment for portal hypertension and influence on complications of cirrhosis.

Background/aims: Following treatment with beta blockers in patients with cirrhosis and portal hypertension, reduction of hepatic venous pressure gradient (HVPG) to <12 mmHg or by >20% of baseline induces an extremely low risk of variceal bleeding. However, several factors such as compliance to therapy or alcohol abstinence may change the initial response after a long follow-up, and the effect of response on other complications of cirrhosis is less clear. The aim of this study was to assess the long-term maintenance of hemodynamic response and its influence on complications of cirrhosis.

Predictors of cognitive decline following coronary artery bypass graft surgery.

Background: A significant number of patients develop cognitive impairment that persists for months following coronary artery bypass grafting (CABG) surgery. Our objectives were to identify patient-related risk factors, processes of care, and the occurrence of any perioperative complications associated with cognitive decline.

Methods: Nine hundred thirty-nine patients enrolled in the Processes, Structures, and Outcomes of Care in Cardiac Surgery study undergoing CABG-only surgery at 14 Veterans Administration medical centers between 1992 and 1996 completed a short battery of cognitive tests at baseline and 6-months post-CABG.

Relationship between processes of care and coronary bypass operative mortality and morbidity.

Background: Information is limited regarding the effects of processes of care on cardiac surgical outcomes. Correspondingly, many recommended cardiac surgical processes of care are derived from animal experiments or clinical judgment. This report from the VA Cooperative Study in Health Services, "Processes, Structures, and Outcomes of Cardiac Surgery," focuses on the relationships between 3 process groups (preoperative evaluation, intraoperative care, and supervision by senior physicians) and a composite outcome, perioperative mortality and morbidity.

Let's talk about sex: how comfortable discussions about sex impact teen sexual behavior.

A secondary analysis of data from 1,039 Latino adolescents who participated in a study of a sex education program was conducted to examine the impact of comfortable communication about sex on intended and actual sexual behavior. Results indicate that Latino adolescents have a broad communicative network, including friends, dating partners, and extended family members, with whom they talk about sex. Regression analyses suggest comfortable sexual communication is predictive of less likelihood of being sexually active, older at first intercourse, and increased intentions to delay intercourse.

Environmental exposure, chlorinated drinking water, and bladder cancer.

Environmental and/or occupational factors have been proposed to play a critical role in urological malignancies and, in particular, in bladder cancer. Epidemiological studies have demonstrated with sufficient evidence that factors such as smoking and exposure to aromatic amines, paints and solvents, leather dust, inks, some metals, polycyclic aromatic hydrocarbons, combustion products, or diesel exhaust fumes are associated with the development of bladder cancer. Candidates with an uncertain potential for inducing this type of cancer include dietary factors, specifically fats and cholesterol, and the exposure to contaminants in drinking water.

Transcranial Doppler monitoring during laparoscopic anterior lumbar interbody fusion.

Unlabelled: We studied the consequences on cerebral hemodynamics of lengthy laparoscopic procedures requiring pneumoperitoneum and head-down positioning. From October 1995 to April 1999, 17 ASA status I or II patients (16 women and 1 man; mean age, 38 yr) were treated with laparoscopic anterior lumbar fusion. Besides standard perioperative monitoring for laparoscopic surgery, the mean blood-flow velocity of both middle cerebral arteries and the pulsatility index were determined by transcranial Doppler ultrasound.

[Identification of B and F human immunodeficiency virus subtypes in Chilean patients].

Background: Type I human immunodeficiency virus (HIV) is characterized by a great genetic variability. There are three groups of virus throughout the world: O, N and M. Group M is responsible for AIDS pandemic and is subdivided in 9 genetic subtypes.

Survivorship analysis of Cotrel-Dubousset instrumentation in idiopathic scoliosis.

This study presents a survivorship analysis of Cotrel-Dubousset instrumentation in the surgical treatment of idiopathic scoliosis. Between 1987 and 1995, a total of 133 patients with idiopathic scoliosis received posterior spine fusion and instrumentation with the CD system at our center. The patients' mean age at surgery was 16.

Impedance spectroscopy for monitoring ischemic injury in the intestinal mucosa.

This work evaluates the feasibility of monitoring ischemic injury in the gastrointestinal mucosa by impedance spectroscopy, using a minimally invasive intestinal catheter. The disruption of the intestinal mucosa plays a key role in the evolution of shock and is the 'motor of multiple organ failure'. Different technologies have been developed to monitor mucosal perfusion, oxygenation and/or ischemia, but no practical method exists to assess tissue damage, which may be crucial for preventing multiple organ failure.

Propranolol plus placebo versus propranolol plus isosorbide-5-mononitrate in the prevention of a first variceal bleed: a double-blind RCT.

Nonselective beta-blockers are very effective in preventing first variceal bleeding in patients with cirrhosis. Treatment with isosorbide-5-mononitrate (IS-MN) plus propranolol achieves a greater reduction in portal pressure than propranolol alone. The present multicenter, prospective, double-blind, randomized, controlled trial evaluated whether combined drug therapy could be more effective than propranolol alone in preventing variceal bleeding.

Extramedullary hematopoiesis in an adult.

Cutaneous extramedullary hematopoiesis is a rare disease, affecting mainly children with intrauterine viral or hematologic disorders. To our knowledge, only about 30 cases have been reported in adults, mainly associated with myelofibrosis. We report a new case of this entity in a 79-year-old woman and comment on the clinical and histologic differential diagnosis.