Biomedical subjects
Publications and source records attributed to M Nobile.
The Authors supply documentary evidence for the aeroembolism of auricular lobe vessels photographed in transillumination of living albino rabbits exposed to high grade barometric depression (850 g/cm2) limited on the top of the head.
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We studied 60 women with postmenopausal bone loss randomly allocated to the following treatments: Group 1 (20 patients), no treatment; Group 2 (20 patients), clodronate 400 mg daily by mouth for 30 consecutive days, followed by 60 days of no treatment; Group 3 (20 patients) oral calcitriol 2 mcg by mouth for 5 days and oral clodronate 400 mg daily for additional 25 days, followed by 60 days of no treatment. The therapeutic cycles were repeated four times in the 12-month study period. In the 36 treated patients of Groups 2 and 3 who completed the study period we observed a progressive and significant increase in lumbar bone density both at 6 and 12 months of therapy, without significant differences between the two treatment protocols (+3.88 +/- 0.65%, P < 0.001 and +3.21 +/- 0.89%, P < 0.005 in Groups 2 and 3, respectively, at the end of the study). In contrast, there was a progressive and significant decline of bone mineral density in untreated patients (-2.34 +/- 0.49%, P < 0.001). After 12 months serum calcium values in treated subjects were higher than in untreated patients (P < 0.05). Serum phosphate was raised only in Group 2, mean values being higher after 12 months than before treatment (P < 0.05); parathyroid hormone (PTH) declined in all treated patients, the fall being significant in Group 2 (P < 0.02). No important side effects were observed with treatment and no patient withdrew because of these. We conclude that cyclical low dose clodronate therapy induced a gain in lumbar spine bone mass in patients with postmenopausal osteoporosis.
OBJECTIVE: The purpose of a curfew is to decrease the amount of crime inflicted on minors during the late hours of the night. On June 1, 1994, a city curfew was instituted in New Orleans, requiring all persons 17 years of age or younger to be off the streets from 9 PM to 6 AM Sunday through Thursday, and from 11 PM to 6 AM on Friday and Saturday. This study evaluated the effect of the curfew on emergency medical services (EMS) transports for patients who were 17 years old or younger (pediatric). METHODS: Data from all pediatric transports were included from the months before (5/94) and after (6/94) the institution of the curfew, and from the same two months one year earlier (5/93 and 6/93). A chi-square test was used to evaluate comparisons. RESULTS: The city EMS transports 48,000 patients per year in a one-tiered system (paramedic only) that acts as the sole provider of emergency EMS transport in the city. Approximately 10% of all transports are pediatric, and 40% of the pediatric transports are for trauma. A total of 1,642 transports were found that fit the inclusion criteria. In May 1993, there were 415 total pediatric transports; 234 were pediatric trauma. In June 1993, there were 406 total pediatric transports; 250 were pediatric trauma. In May 1994, there were 447 total pediatric runs; 243 were pediatric trauma. During the postcurfew month, June 1994, there were a significant decrease in pediatric transports to 370 (p < 0.01) and a significant decrease in pediatric trauma transport to 189 (p < 0.01). CONCLUSION: The institution of a curfew may lead to a drop in pediatric EMS runs during curfew hours. Another value of the curfew may be in the secondary effects of the curfew in preventing childhood injury during noncurfew hours.
The authors describe a clinical case of occupational asthma due to dioctyl-phthalate in a worker using a conveyor belt for bottle stoppers. The dioctyl-phthalate is used for the production of PVC and as a compound of many other substances. The literature describes many cases of occupational asthma do to phthalate anhydride but few cases do to dioctyl phthalate. The clinical history, the environmental monitoring data, the pulmonary function tests such as bronchodilatation test by salbutamol, peak flow meter daily monitoring for three weeks, and stop and start work test showed a good correlation with the work and the worker's asthma. The authors emphasize that a detailed clinical history and a careful analysis of the production cycle are very useful and, as simple and non invasive tests, can play an important role in the diagnosis of occupational asthma.
In two previous papers we reported allergic diseases in workers employed in breeding insects for biological pest control. It was found that Ephestia kuehniella, Orius laevigatus and other insects caused allergic rhinoconjunctivitis and asthma. The aim of this new study was to assess the relationship between the implementation of the recommended preventive measures and the decrease in sensitization in exposed workers. We performed a four-year follow-up of exposed workers, using the prick test and RAST with specific allergens and pulmonary function test at the end of the work shift. The results showed a decrease in skin test sensitization for Orius and Ephestia, a decrease in allergic diseases in the previously studied workers, and no symptoms in recently employed workers. These results confirm the validity of the recommended preventive measures: semi-closed cycles, gloves, protective masks, overalls and sunglasses.
BACKGROUND: Acquired hemophilia is a rare disorder due to spontaneous development of antibodies directed against the factor VIII molecule in patients with previously normal levels of factor VIII. In this paper we report an unusual case of acquired hemophilia admitted to our department of nephrology due to persisting gross hematuria. CASE REPORT: A 38-year-old primigravida woman, previously fit and well, had an uncomplicated pregnancy, labor and a caesarean delivery at 38 weeks of gestation. Two weeks after delivery she developed gross hematuria with anemia. She was therefore admitted to a department of urology where urinary system and hematological investigation did not reveal important anomalies. Due to persisting gross hematuria and suspected kidney disease, the patient was admitted to our department of nephrology where serious anemia and prolongation of aPTT were noted; factor VIII procoagulant activity was low with a Bethesda assay confirming the presence of anti human f VIII antibody. Diagnosis of acquired hemophilia was confirmed and treated with corticosteroid therapy, intravenous immunoglobulins and recombinant factor VIII. After 10 days, gross hematuria stopped with improvement of aPTT and level of factor VIII. DISCUSSIONS: It is postulated that pregnancy leads to an altered immune status whereby the F VIII from the embryo, through transplacental leakage, may be considered as a foreign antigen by the mother, leading to the formation of antibodies. Bleeding symptoms usually became apparent within 3 months of delivery but could be as late as 12 months post-delivery and sometimes coagulation investigation results are normal at the beginning. It is therefore very important to estimate many times the activated partial thromboplastin time in macrohematuria post-partum. Mortality due to hemorrhage varies between 14 and 22 % in previous series. In the vast majority complete remission is achieved spontaneously within a few months. The diagnosis of acquired hemophilia is of fundamental importance for an adequate treatment preventing serious complications and high mortality.
The authors review some aspects of radiological analysis in forensic medicine not only to formulate a correct diagnosis and prognosis or a correct evaluation of a personal damage, but also to appreciate the casualty-relationship in many traumatic lesions.
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On the basis of the results of a previous study and immuno-allergological tests, a group of workers employed in breeding insects for biological pest control were studied to ascertain whether any new sensitizations to arthropods recently included in the work cycle occurred and whether any new allergic diseases were observed. The results confirmed a high sensitization to Ephestia kuehniella and to Orius, the latter probably due to contamination; sensitization to Tetranicus urticae and to Planococcus citri were observed, although to a lesser degree. It is concluded that the insects used in biological pest control are highly allergogenic and that the protective devices used up to the present were ineffective; the authors therefore recommend the use of closed or semi-closed cycles along with local ventilation equipment.