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PubMed1992

Cystectomy and substitution enterocystoplasty: alternative primary treatment for T2/3 bladder cancer.

The optimal treatment for invasive bladder cancer remains controversial. Although external beam radiotherapy is able to eradicate the disease in a number of patients, the difficulty is selecting those who will respond. Those who do develop a local recurrence will require a salvage cystectomy combined with urinary diversion. The results of performing cystectomy and bladder reconstruction as a primary procedure are presented and the concept of combining this with chemotherapy as an alternative strategy for the management of bladder cancer is discussed.

Adenocarcinoma↗
PubMed2003

Weekly antibiotic prescribing and influenza activity in Sweden: a study throughout five influenza seasons.

Influenza often leads to bacterial complications that require treatment. It may also be confused with bacterial respiratory infections, leading to unnecessary prescription of antibiotics. In this first study on the relationship between influenza and antibiotic utilization for a whole country, weekly data on verified influenza cases in Sweden were compared to weekly sales of antibiotics for 5 influenza seasons 1997-2002. The peak of influenza activity occurred during the winter. In 4 out of the 5 monitored influenza seasons it occurred in February-March. The fluctuation of antibiotic utilization was relatively constant over the years with peaks before Christmas and in February-March. There were no obvious differences in the total amount of antibiotics dispensed over the years that could be related to influenza activity, but a coincidental relationship between the peaks of diagnosed influenza cases and the peaks of antibiotic utilization was indicated, especially for older age groups.

Adolescent↗
PubMed1999

Seasonal variations in sexual activity and their implications for sexual health promotion.

Although seasonal variations in births are observed in all human populations, the links between calendar events and sexual activity have received little attention in relation to health promotion and service provision. We have plotted various relevant data--routinely collected data for births within and outside of marriage, abortions, sexually transmitted infections, human immunodeficiency virus tests and condom sales figures--by calendar period. The trends point consistently to an increase in sexual activity and unsafe sex occurring at or around the Christmas period, and a longer but less pronounced subsidiary period of increased sexual activity and unsafe sex coinciding with the summer vacation. We conclude that seasonal patterns of sexual activity have implications for provision of sexual health services and for the timing and targeting of sexual health promotional interventions.

Abortion, Induced↗
PubMed1999

Correlation of the osteoblastic phenotype with prostate-specific antigen expression in metastatic prostate cancer: implications for paracrine growth.

The characteristic sclerotic appearance of bone metastases from prostate cancer is unexplained but could involve excess peritumoural activity of osteoblast mitogens such as the insulin-like growth factors (IGFs). Since prostatic metastases are distinguished by androgen-dependent secretion of prostate-specific antigen (PSA), a serine protease which cleaves extracellular IGF-binding proteins and thereby enhances the bioavailability of IGFs, the relationship was examined between tumour PSA expression and the osteoblastic phenotype. To this end, a cohort of 27 prostate cancer patients was evaluated to determine the relationship between serum PSA and radiographic bone lesion density at first presentation with metastatic disease. No linear correlation between absolute PSA levels and metastatic osteosclerosis was apparent. However, non-parametric statistical analysis revealed a highly significant link between low-PSA (<20 ng/ml) metastatic prostate cancer and osteolytic bone lesions (p<0.0001, chi(2)=21.5). This finding raises the possibility that the osteoblastic phenotype of prostate cancer derives in part from PSA-dependent proteolysis of IGF-binding proteins within bone matrix.

Bone Neoplasms↗
PubMed1986

Outbreak of pulmonary tuberculosis in children.

A case of miliary tuberculosis in a 4-year-old child led to contact tracing, revealing 32 children with evidence of tuberculous infection. 3 adult cases were also identified. The source case was a mother who passed on the infection at two Christmas parties. Limited exposure to the organism caused infection, suggesting a virulent strain and a susceptible subgroup. A range of complications of primary tuberculosis in children was seen. Minor side-effects of the chemotherapeutic agents occurred in most children but only 3 suffered substantial toxic effects. The limited range of agents marketed in a presentation suitable for young children was a serious difficulty.

Adolescent↗
PubMed2005

Monte Carlo simulation of animal-product violations incurred by air passengers at an international airport in Taiwan.

Our aim was to evaluate the inspection of arriving passengers for the illegal transport of animal products through the international airport into Taiwan. Passenger-violation data were retrieved from the Bureau of Animal and Plant Health Inspection and Quarantine (BAPHIQ) in Taiwan. Monte Carlo simulations with 5000 iterations were applied to estimate the predicted violation numbers considering factors such as passenger's nationality/ethnicity, sex, and monthly statistics of violations. The results showed that Chinese-related passengers and passengers from South East Asian countries have a relatively higher potential risk for incurring violations during the period from Christmas to Chinese Lunar New Year. Most monthly estimated violation risks are significantly higher than observed violation risks in 2001 and 2002, except April, July, and August. Due to the low sensitivity of the current detection system (reflected by the higher estimated violation risks and a two-fold detection increase after the implementation of an inspection service using detector dogs), we recommend additional preventive measures be taken.

Animal Diseases↗
PubMed2003

[Beta-blocking drugs indicated in patients with heart failure].

Until recently, beta-blocking drugs were considered to be contraindicated in patients with chronic heart failure. However, several well-conducted randomised clinical trials have now proven otherwise. Yet, it was still not clear whether nonselective alpha-, beta 1- and beta 2-receptor blockade with carvedilol would be superior to selective beta 1-receptor blockade with metoprolol. One of the studies ('Carvedilol or metoprolol European trial' (COMET)) demonstrated a statistically significant 17% reduction of all-cause mortality with carvedilol. Although striking, the results may have been influenced by differences in blood pressure and heart rate, as well as the short-acting formula of metoprolol that was used. Furthermore, the 'Carvedilol hibernation reversible ischaemia trial; marker of success' (CHRISTMAS) study demonstrated myocardial hibernation in the majority of ischaemic heart-failure patients, and showed beneficial effects on left-ventricle function with carvedilol in both hibernated and non-hibernated patients. Despite this and the rest of the overwhelming evidence, at present only a minority of eligible chronic heart-failure patients are treated with beta-blockers.

Adrenergic beta-Antagonists↗
PubMed1988

Morphologic considerations in the interpretation of gastrointestinal disorders.

Misinterpretations of gastrointestinal alterations can be reduced or eliminated by avoiding sampling/labeling errors, reducing artifact, and gaining familiarity with normal variations for the species under study. The errant thrust of the gastroscopic biopsy forceps can yield mucosa resembling atrophic gastritis; ileal villi taken for jejunal erroneously lead to consideration of sprue-like disorder. Reduction of the postmortem delay prior to fixation is critical for avoiding artifact. Villous epithelial cells separate from basement membrane within 5 to 10 minutes. Flushing saline, water, or fixative through unopened intestine causes intolerable damage to epithelium and villi. The thin-walled intestines of small laboratory species may be fixed unopened, but without dissection gross lesions are overlooked. Osmolarity of the fixative is important for preserving normal shapes of villi. Smooth muscle of the muscularis and villi of the dog contracts vigorously after euthanasia and immediate fixation. Optimum preservation may be had by applying iso-osmolar neutral buffered fixatives to intestinal segments which have been opened, stretched slightly, and pinned to cardboard or styrofoam. The villous height:crypt depth ratios vary among species and among intestinal segments. Shapes vary as well, ileal villi of many species appearing short and Christmas-tree- or thumb-shaped. Dilated lacteals occur occasionally in normal villi. The goblet cell population increases aborally, while the lymphocytic-plasmacytic population of the core increases with age. Eosinophils are a normal component in several species; globule leukocytes are common in others. Mast cells of the villi will be overlooked unless tissues are fixed in Carnoy's solution and stained with Astra or Alcian blue.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1979

Duodenal and jejunal atresia with agenesis of the dorsal mesentery: "apple peel" small bowel.

Two newborn infants with duodenal and jejunal atresia and agenesis of the dorsal mesentery represent our surgical experience with "apple peel" small bowel or "christmas tree" demormity. The first patient had the typical appearance of this condition. The postoperative course was complicated by hyperbilirubinemia, septicemia, and disseminated intravascular coagulation. The infant is in satisfactory condition 1.5 years after operation. The second patient had agenesis of the dorsal mesentery without spiraling of the bowel around its vascular stalk. The child died after 1 month, with complete absence of extrahepatic bile ducts as seen at a second laparotomy. Neither child had been subjected to gastrostomy.

Duodenal Diseases↗
PubMed2003

Guttate morphoea in human T-cell lymphoma/lymphotrophic virus type-1 (HTLV-1) infection.

A 62-year-old Japanese man presented with multiple small atrophic macules on the trunk and extremities. The lesions were discrete, oval in shape and enclosed by lilac ring. They were distributed in a Christmas tree distribution, reminiscent of pityriasis rosea. Skin biopsy showed increased collagen fibres in the dermis and invading subcutaneous tissue. The clinico-pathological features were consistent with guttate morphoea, a rare variant of localized scleroderma. Serological tests revealed a positive reaction to human T-cell lymphoma/lymphotropic virus type-1 infection.

Biopsy↗
PubMed1986

Intestinal atresia and stenosis: a review comparing its morphology.

A review of the literature on intestinal atresia of domestic animal species and humans was done. The 5 types of intestinal occlusions described in human infants are atresia type 1, atresia type 2, atresia type 3, stenosis, and the "apple peel" or "Christmas tree" deformity. The intestinal defects described in domestic animal species such as the bovine, equine and porcine are similar to those of human infants. The "T-formation", an intestinal defect of the bovine resembling atresia type 3, and rectal stricture, an acquired intestinal defect of the porcine resembling stenosis, were described recently. Intestinal atresia is similar in several species and these similarities raise the questions as to whether the pathogenic mechanism and possibly etiologies of intestinal atresia are similar in these species.

Animals↗
PubMed2003

Phenology and density of balsam twig aphid, Mindarus abietinus Koch (Homoptera: Aphididae) in relation to bud break, shoot damage, and value of fir Christmas trees.

The balsam twig aphid, Mindarus abietinus Koch (Homoptera: Aphididae), is a major insect pest of balsam and Fraser fir grown for Christmas trees. Our objectives in this study were to 1) monitor the phenology of A. abietinus in fir plantations; 2) assess relationships among M. abietinus density, tree phenology, and damage to tree foliage; and 3) develop an esthetic injury level for M. abietinus on Christmas trees. We monitored phenology of M. abietinus and fir trees on three commercial Christmas tree plantations in central and northern Lower Michigan for 3 yr (1999-2001). Phenology of M. abietinus fundatrices and sexuparae was strongly correlated with accumulated degree-days (DD) base 10 degrees C. Fundatrices matured by approximately 83 DD(10 degrees C) and sexuparae were first observed at approximately 83-111 DD(10 degrees C). Trees that broke bud approximately 1 wk later than other trees in the same field escaped M. abietinus damage and shoot expansion rate in spring was generally positively correlated with M. abietinus damage. Retail customers surveyed at a choose-and-cut Christmas plantation in 2 yr did not consistently differentiate between similarly sized trees with no, light, and moderate M. abietinus damage, but heavy damage (>50% damaged shoots) did affect customer perception. Similarly, when wholesale grades were assigned, the high quality Grade 1 trees had up to 40% shoot damage, whereas Grade 2 trees had 32-62% shoot damage. Two trees ranked as unsaleable had sparse canopies and distorted needles on 42% to almost 100% of the shoots.

Abies↗
PubMed1982

[Double refraction of crystals in the lens (spheroliths, "Christmas tree ornaments") and in the vitreous body (scintillatio nivea)].

1. The round, oval, or kidney-shaped, radially built spheroliths of the brown or morgagnian cataract show a double refraction in polarized light of about 0.160 optically positive. This is in accordance with Whewellite (calcium oxalate monohydrate). 2. In crystalline cataracts, there are crystals in polarized light with a mean double refraction of 0.046, which is in accordance with cholesterol (C27H48O). 3. In asteroid hyalinosis of the vitreous, the small bodies consisting of needle-shaped crystals arranged in a radial fashion show a small double refraction of 0.012. Therefore the crystal may be brushite (Ca HPO4 X 2 H2O).

Cataract↗
PubMed2001

Peritoneal fluid concentrations of interleukin-4 in relation to the presence of endometriosis, its stage and the phase of the menstrual cycle.

BACKGROUND: Interleukin-4 (IL-4) is a cytokine with both stimulatory and inhibitory effects on the inflammatory system such as macrophage inhibition and T-cell activation. It is known to regulate several monocyte functions, including inhibition of the synthesis of cytokines such as IL-1, IL-6 and TNF-alpha as well as potentiating IL-8. METHOD: In an attempt to clarify the association between IL-4 and endometriosis, we measured the concentration of IL-4 in the peritoneal fluid of 52 women; 24 with endometriosis and 28 with no endometriosis, controlling for the phase of the cycle and the stage of disease. RESULTS: There was no difference in the concentrations of IL-4 between women with (n=28) and without endometriosis (n=24). No difference was found between the IL-4 concentrations in women with different stages of endometriosis. Levels of IL-4 did not show a difference according to the phase of the cycle in either group. CONCLUSION: Our results indicate no association between peritoneal fluid levels of IL-4 and endometriosis and hence suggest that IL-4 is not involved in the pathogenesis of endometriosis.

Ascitic Fluid↗
PubMed1999

Influenza activity in England and Wales: October 1998 to June 1999.

Influenza activity in England and Wales in the winter of 1998/1999 reached the highest weekly levels seen since the epidemic of 1989/1990. Activity peaked at Christmas and the New Year, adding to the winter pressures on general practitioner and hospital services. Adults aged 65 years and over consulted with general practitioners at the highest rates. Outbreaks of influenza or flu-like illness occurred in several schools and nursing homes and, in June 1999, on a British cruise ship in the Mediterranean. Deaths from all causes reached a higher peak in week 1 of 1999 than occurred in the peak week of the influenza epidemic of 1989/90.

Adolescent↗
PubMed1975

International outbreak of Salmonella Eastbourne infection traced to contaminated chocolate.

Between Dec. 4, 1973, and Feb. 15, 1974, 80 cases of infection due to Salmonella eastbourne, previously a rare isolated serotype in the United States, were reported from twenty-three States. An additional 39 cases were reported from seven Provinces in Canada during a similar period. A telephone case-control study implicated Christmas-wrapped chocolate balls manufactured by a Canadian company as the vehicle of transmission. S. eastbourne was subsequently isolated from several samples of leftover chocolate balls obtained from homes where cases occurred. Investigation of the factory revealed that the contaminated Christmas and Easter chocolates, and a few chocolate items for year-round sale, had been produced between May and October, 1973. Bacteriological testing of samples taken at the plant implicated cocoa beans as the probable source of the salmonella organisms which, in the low-moisture chocolate, were able to survive heating during production. This outbreak and the finding of salmonella of other serotypes in chocolates produced by another manufacturer suggest that chocolate-related salmonellosis may be a significant public-health problem.

Cacao↗
PubMedDate not supplied

The ghost of Christmas past: health effects of poverty in London in 1896 and 1991.

OBJECTIVES: To compare the extent to which late 20th century patterns of mortality in London are predicted by contemporary patterns of poverty and by late 19th century patterns of poverty. To test the hypothesis that the pattern of mortality from causes known to be related to deprivation in early life can be better predicted by the distribution of poverty in the late 19th century than by that in the late 20th century. DESIGN: Data from Charles Booth's survey of inner London in 1896 were digitised and matched to contemporary local government wards. Ward level indices of relative poverty were derived from Booth's survey and the 1991 UK census of population. All deaths which took place within the surveyed area between 1991 and 1995 were identified and assigned to contemporary local government wards. Standardised mortality ratios for various causes of death were calculated for each ward for all ages, under age 65, and over age 65. Simple correlation and partial correlation analysis were used to estimate the contribution of the indices of poverty from 1896 and 1991 in predicting ward level mortality ratios in the early 1990s. SETTING: Inner London. RESULTS: For many causes of death in London, measures of deprivation made around 1896 and 1991 both contributed strongly to predicting the current spatial distribution. Contemporary mortality from diseases which are known to be related to deprivation in early life (stomach cancer, stroke, lung cancer) is predicted more strongly by the distribution of poverty in 1896 than that in 1991. In addition, all cause mortality among people aged over 65 was slightly more strongly related to the geography of poverty in the late 19th century than to its contemporary distribution. CONCLUSIONS: Contemporary patterns of some diseases have their roots in the past. The fundamental relation between spatial patterns of social deprivation and spatial patterns of mortality is so robust that a century of change in inner London has failed to disrupt it.

Cause of Death↗
PubMed1992

Christmas candy maker's asthma. IgG4-mediated pectin allergy.

We evaluated a 29-year-old candy maker with no history of asthma who developed asthma after exposure to pectin, a compound manufactured from fruits and fruit rinds. Following eight years of employment during which he added pectin to a recipe for Christmas candies, the candymaker developed acute respiratory symptoms. Challenge testing with the pectin mixture caused a 40 percent decrease in FEV1. Skin prick testing was positive to the pectin extract. Total IgE was normal and pectin-specific IgE antibodies were not detected. A strongly positive pectin-specific IgG4 antibody response was present that was not detected in a control serum and could be inhibited by the addition of pectin. Antigen-specific IgG4 should be sought in IgE negative cases of occupational asthma.

Adult↗