Congenital lumbar hernias: A case report.

Congenital lumbar hernias are rare and associated with other malformations. There have been 42 cases reported to date. The authors report the first case in the literature of isolated bilateral congenital lumbar hernias.

Altered megakaryocyte-platelet-haemostatic axis in patients with acute stroke.

Platelet function is accentuated in acute ischaemic stroke (IS) and may also be altered in haemorrhagic stroke. Whether these changes are a direct reaction to the stroke or are secondary to changes in megakaryocytes (MKs) is unknown. To determine whether MKs are altered in acute stroke we studied 24 patients (18 with ischaemic stroke, six with haemorrhagic stroke) within 3 days of symptom onset, and 14 matched controls.

Assessing structure, process and outcome in palliative day care: a pilot study for a multicentre trial.

Palliative day care is an expanding service which remains under-researched. Study designs need to be developed to evaluate the costs and outcomes of the service in ways which are meaningful to patients, clinicians and policy-makers. At the same time, these must be open to the same criteria for rigour and reliability as techniques used elsewhere in health and social service evaluation.

Community care for stroke patients in the last year of life: results of a national retrospective survey of surviving family, friends and officials.

The quality of community care received in the last year of life by stroke patients and their informal carers is described. This is secondary analysis of data from the Regional Study of Care for the Dying, in which information was collected on a randomly selected sample of people who died in 1990, in 20 self-selected English health districts that were nationally representative in terms of socio-demographic characteristics and health care provision. The respondents comprised 20 spouses, 48 relatives, three friends or neighbours and 40 officials who had known about the last year of life of 111 people who died of stroke, and had spent some time at home (or in a residential or nursing home) in the last year of life.

Altered megakaryocyte-platelet haemostatic axis in hypercholesterolaemia.

Hypercholesterolaemia is associated with accentuated platelet function. We assessed in a pilot study whether megakaryocytes (MK), the platelet precursor cell, were altered in subjects with primary hypercholesterolaemia and whether these changes were linked with platelet function. MK and platelet function were assessed in eight untreated patients with primary hypercholesterolaemia (total cholesterol, TC > 7 mmol/l), and 14 control subjects (TC < or = 7 mmol/l): MK ploidy (DNA content), size, granularity, and expression of the adhesion molecule GP IIIa, and platelet expression of GP IIIa, P selectin and CD 63, and RNA content, were each measured using flow cytometry; mean platelet volume, platelet count, plasma thrombopoietin, and cutaneous bleeding time were also assessed.

Primary dissecting hepatic artery aneurysm in pregnancy.

A 32-year-old 32 weeks pregnant primigravida presented with acute abdomen and died 13 h later. She was normotensive during her antenatal period and on admission. At postmortem, a primary dissecting aneurysm of the main hepatic artery extending into its intrahepatic right branch was found.

Tobacco use and oral cancer: a global perspective.

For both genders, cancer of the mouth and pharynx ranks sixth overall in the world; it is also the third most common site among males in developing countries. In industrialized countries, men are affected two to three times as often as women, largely due to higher use of alcohol and tobacco. Ethnicity strongly influences prevalence due to social and cultural practices, as well as socioeconomic differences.

Synchronized mechanical ventilation for respiratory support in newborn infants.

Background: During synchronized mechanical ventilation, positive airway pressure and spontaneous inspiration coincide. Thus, if synchronous ventilation is provoked, it is likely that adequate gas exchange should be achieved at lower peak airway pressures, reducing barotrauma and hence airleak and chronic lung disease. Synchronous ventilation can be achieved by manipulation of rate and inspiratory time during conventional ventilation and employment of patient assisted ventilation.

The effect of transdermal glyceryl trinitrate, a nitric oxide donor, on blood pressure and platelet function in acute stroke.

Background And Purpose: Hypertension is a common medical complication in acute stroke and is associated with a poor outcome. However, no large trials have assessed the effect of lowering blood pressure (BP) on outcome, and it remains unclear how BP should be managed in acute stroke. We assessed, in a double-blind randomised controlled trial, whether the nitric oxide (NO) donor glyceryl trinitrate (GTN, a known systemic and cerebral vasodilator), would lower BP and alter platelet function.

A systematic review of estrogens for recurrent urinary tract infections: third report of the hormones and urogenital therapy (HUT) committee.

Our objective was to apply a meta-analysis to the available data to evaluate the effect of estrogen supplementation in the prevention of recurrent urinary tract infections in postmenopausal women. The literature review incorporated articles based on a search of Excerpta Medica, Medline, Science Citation Index and a manual search of commonly read journals in the fields of urology, gynecology, gerontology and primary healthcare, from January 1969 to December 1998. The search was not limited to English-language publications.

Type II nitric oxide synthase (NOS2) expression correlates with lymph node status in oral squamous cell carcinoma.

In tumour biology, nitric oxide (NO) has a complex array of concentration-dependent actions, including both inhibitory and promoting effects. It is thought that the levels of NO found in many human cancers lead to enhanced angiogenesis and tumour dissemination. In the current study, we assessed the immunohistochemical expression of the enzyme type II nitric oxide synthase (NOS2) in 41 cases of oral squamous cell carcinoma and correlated the findings with lymph node status.

Quality of life after liver transplantation for alcoholic liver disease.

There are few data on predictive factors for alcohol relapse or long-term functional outcome after liver transplantation for alcoholic liver disease (ALD). In all 56 surviving UK patients (47 men, 9 women; mean age: 51 years; range: 33 to 69 years) who underwent transplantation for ALD at King's College Hospital over a 10-year period, alcohol relapse and outcome were assessed by outpatient and case-note review and by postal questionnaire containing (1) the Nottingham Health Profile (NHP), (2) the Short-Form-36 (SF-36) Health Survey, and (3) a drug and alcohol questionnaire. At a median of 2.

Involvement of iron (ferric) reduction in the iron absorption mechanism of a trivalent iron-protein complex (iron protein succinylate).

Iron protein succinylate is a non-toxic therapeutic iron compound. We set out to characterise the structure of this compound and investigate the importance of digestion and intestinal reduction in determining absorption of the compound. The structure of the compound was investigated by variable temperature Mössbauer spectroscopy, molecular size determinations and kinetics of iron release by chelators.

Gene expression and serum levels of insulin-like growth factors (IGFs) and IGF-binding proteins in a case of non-islet cell tumour hypoglycaemia.

We describe a case of non-islet cell tumour hypoglycaemia (NICTH) associated with a renal cell carcinoma. Serum insulin-like growth factors (IGFs) (including IGF-II E peptide), IGF-binding proteins (IGFBPs), insulin and C-peptide were measured before and after surgical removal of the tumour. IGFBPs were visualized by Western ligand blotting.

Incorporating data from dissertations in systematic reviews.

Objectives: To determine whether unpublished dissertations are an important source of trials for systematic reviews.

Methods: In a review of infant massage, we identified 17 dissertations. We recorded whether each dissertation was included in the review and, if so, whether it contributed data to any analyses.

Antigen-specific and nonspecific determinants of cytokine production during topical sensitization of mice to chemical allergens.

Background: Topical exposure to chemical allergens such as trimellitic anhydride or 1-chloro-2,4-dinitrochlorobenzene results in the accumulation of dendritic cells (DCs) and subsequent rapid up-regulation of CD4 T-cell proliferation and cytokine secretion within draining lymph nodes.

Objective: We investigated the contribution of antigen-specific and CD40 ligand (CD40L)-mediated signals to chemical allergen-induced CD4 T-cell growth and cytokine production.

Methods: DCs enriched from lymph nodes of allergen-challenged animals by metrizamide centrifugation were used to stimulate cytokine and proliferative responses by magnetic immunobead-sorted CD4 T cells primed in vivo with the same or unrelated allergen.

A novel binding site for the native hepatic acute-phase protein alpha1-antitrypsin expressed on the human hepatoma cell line HepG 2 and intestinal cell line Caco 2.

Aims/background: alpha1-antitrypsin (alpha1-AT) is a hepatic acute phase protein which predominantly inhibits neutrophil elastase. Besides this major function, we have also previously shown that alpha1-AT markedly increased H-ferritin mRNA expression and ferritin synthesis in the human hepatoma cell line HepG 2. These actions suggest that alpha1-AT might interact with HepG 2 cells via a specific cell surface binding site.

Precautions against cross-infection during operations for maxillofacial trauma.

One hundred oral and maxillofacial units in the UK were sent a postal questionnaire. Surgical staff of all grades were asked which infection-control measures were taken during the treatment of maxillofacial fractures. Two hundred and ninety-four questionnaires were completed, a response rate of 49%.

Low-speed centrifugation of retroviral vectors absorbed to a particulate substrate: a highly effective means of enhancing retroviral titre.

For many gene therapy applications the effective titre of retroviral vectors is a limiting factor both in vitro and in vivo. Purification and concentration of retrovirus from packaging cell supernatant can overcome this problem. To this end we have investigated a novel procedure which involves complexing retrovirus to a dense and particulate substrate followed by a short low-speed centrifugation.

Development and validation of a core outcome measure for palliative care: the palliative care outcome scale. Palliative Care Core Audit Project Advisory Group.

Objectives: To develop an outcome measure for patients with advanced cancer and their families which would cover more than either physical symptoms or quality of life related questions. To validate the measure in various specialist and non-specialist palliative care settings throughout the UK.

Design: A systematic literature review of measures appropriate for use in palliative care settings was conducted.

Resistance of pediatric and neonatal endotracheal tubes: influence of flow rate, size, and shape.

Objective: The aim of this study was to determine the resistances of endotracheal tubes (ETTs) commonly used in neonatal and pediatric intensive care units and the relationship of resistance to flow rate, size, and shape of ETT.

Setting: Laboratory-based measurements.

Evaluation: We examined straight tubes with inner diameters between 2.

Sensitivity to linguistic anomalies in spoken sentences: a case study approach to understanding thought disorder in schizophrenia.

Background: As a group, positively thought-disordered (TD) schizophrenic patients are relatively impaired in their ability to use linguistic context to process sentences online (Kuperberg et al. 1998). This study investigates the heterogeneity in the use of linguistic context both between individual TD patients and within the individual patients as severity of thought disorder changes over time.

Army psychiatry in the Korean War: the experience of 1 Commonwealth Division.

This study seeks to investigate the incidence of psychiatric casualties in 1 Commonwealth Division during the Korean War. It had been hypothesized that these casualties were unusually low compared with earlier conflicts. Casualty returns and psychiatric reports were analyzed and showed that the war fell into two phases determined by the intensity of combat, which, in turn, influenced the nature of the psychiatric disorders encountered.

Synchronized mechanical ventilation for respiratory support in newborn infants.

Background: During synchronous ventilation, positive pressure ventilation and spontaneous inspiration coincide. Thus, if synchronous ventilation is provoked, it is likely that adequate gas exchange should be achieved at lower peak pressures, reducing barotrauma and hence airleak and chronic lung disease. Synchronous ventilation can be achieved by manipulation of rate and inspiratory time during conventional ventilation and employment of patient assisted ventilation.