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Temporal variations in mortality: a comparison of U.S. suicides and motor vehicle fatalities, 1972-1976.

Among the various types of mortality, motor vehicle fatalities (MVF) and suicides are two that are very responsive to social, economic, and psychological factors. The analysis of the temporal patterns of suicides and MVF points to important but neglected forces affecting them. This paper examines the daily patterns of MVF and suicides for the United States from 1972 to 1976. The effects of the day of the week, month, year, and holidays on these types of mortality are estimated. Total MVF and suicides, as well as daily differentials by sex, age, and race, are analyzed with regression techniques. The results show that temporal variations are stronger in MVF than in suicides but are present in both. MVF tend to peak on Saturday, in the summer months, in 1972 and 1973, and on holidays. Suicides are generally highest on Monday, in the spring months, in 1975 and 1976, and on nonholidays. Differentials in the temporal patterns are evident. For instance, whites generally have a sharper decline in suicides on holidays than do nonwhites. The holiday peak in MVF for the 60 and over population is Christmas, while it is New Year's for the younger age groups. Males exhibit a greater increase in suicides from March to May than do females. Finally, the results of a comparison of the daily patterns of MVF and suicides revealed a negative correlation. This contrasted with the strong positive relationship between MVF and suicides generally found in cross-sectional studies. The implications of these findings are briefly discussed.

Accidents, Traffic↗

Urinary and fecal elimination of nickel in relation to air-borne nickel in a battery factory.

Nickel in urine and in air from the breathing zone of 18 male workers in a battery factory was determined weekly during 11 consecutive weeks. The study started immediately following three weeks of Christmas vacation. The nickel levels in air varied but did not increase with time. The average urinary excretion of nickel showed an increase during the first weeks, after which a steady state seemed to have been reached. There was a considerable individual variation in both exposure levels and urine nickel levels. However, a correlation between the averages of nickel in air and urine could be demonstrated on a group basis. In a second study, during one week, measurements of nickel in air and feces were made on 15 of the workers. A significant correlation was found between nickel in air and fecal nickel. Smoking habits did not seem to influence neither urinary nor fecal nickel concentrations.

Adult↗

Preparation of factor IX deficient human plasma by immunoaffinity chromatography using a monoclonal antibody.

A murine hybridoma clone is described that grows continuously in culture and produces a monoclonal antibody we have called Royal Free Monoclonal Antibody to factor IX No. 1 (RFF-IX/1). This has high affinity for a coagulation site on factor IX. RFF-IX/1 immobilised on sepharose can be used to deplete factor IX from normal human plasma. This immunoaffinity depleted plasma is indistinguishable from severe Christmas disease plasma and can be used as the substrate in a one stage coagulation assay for factor IX. The affinity column has high capacity and can be regenerated so that large scale production from normal plasma of factor IX deficient plasma as a diagnostic reagent is now feasible.

Animals↗

The dental impact of eating disorders.

Our self-perceptions are all influenced to some extent by the media. The increase in sales of diet plans immediately after Christmas only serves to highlight the fact that many people (consciously or subconsciously) are aware of the effect that advertisements have on our lives. The weight of most people is controlled by a combination of diet and homoeostatic control and remains relatively constant, but weight loss has a more profound and sinister effect for others. Unexplained dental erosion can occasionally be found during dental examinations and, despite careful questioning, a definitive diagnosis may prove elusive. In these patients, once the more common causes of dental erosion have been eliminated, the eating disorders should be considered. In this paper, the effects of psychological conditions affecting the diet on the dentition will be discussed.

Anorexia Nervosa↗

An epidemic of tuberculosis in an elementary school, Sanremo, Italy, 1993.

In late 1992, three cases of tuberculosis were identified in school children attending a small elementary school in Sanremo, Italy. In order to identify further cases and determine the source, an epidemiologic investigation was undertaken. Tine test and X rays were performed on all students and school personnel. A total of 80% of the 59 students in the school had positive tine test reactions, as did 100% of the 12 teachers. All but one of the positive students had converted since last tested, as had the nine teachers who had been previously negative. The source of the outbreak was a teacher who had been in direct classroom contact with two of the five classes and had worked closely with the rest in building of a Christmas creche for the school. This outbreak suggests that increasing attention should be paid to school as potential foci for the spread of tuberculosis and that greater attention be paid to teacher screening, particularly in areas of higher tuberculosis prevalence.

Adult↗

Jejunal atresia with absent mesentery and a helical ileum.

Of 59 infants with jejunoileal atresia, seven presented with absence of mesentery, the main superior mesenteric artery ceasing to exist beyond the origin of the right colic or ileocolic artery, and a helical ileum. This distinctive form of jejunal atresia has been recognized with increasing frequency in recent years. Distal to the atresia, the small bowel receives its blood supply retrograde from an artery derived from the ileocolic or right colic arcades, and the ileum coils around its nutrient artery in an "apple peel" or "Christmas tree" deformity. The first three patients in this report died. The lastion, but they recovered as their malabsorption gradually disappeared. The treatment includes resection of the dilated bowel, as in other atresias. Resection of part of the distal bowel may be required for additional atresias or for poor vascularity with questionable viability. Postoperative malabsorption generally requires intravenous hyperalimentation.

Female↗

Operation: happy holidays.

The Christmas holiday season is supposed to be a time of togetherness--a time with friends and family. But in most hospitals this is a time of disruption, loneliness and distress for both staff and patients. There are ways, however, to make the holiday season a more positive experience.

Holidays↗

A comparative study of antigens of Aspergillus fumigatus isolates from patients and soil of ornamental plants in the immunodiffusion test.

The strikingly frequent and constant presence of Aspergillus fimigatus in the soil of potted ornamental plants kept in private houses and hospitals has been the reason for studying the antigens of the strains found from the diagnostic and epidemiological angles. Culture-filtrate antigens of A. fumigatus strains isolated from the soil of 4 different ornamental plants, epiphyllum (Epiphyllum truncatum), orange tree (Citrus sinensis), Alpine rose (Azalea indica) and Christmas flower (Euphorbia pulcherrima), were compared, in the immunodiffusion test, with antigens of A. fumigatus strains from aspergillosis patients prepared in an identical way. When tested against 8 different sera from different aspergillosis patients there was a good coincidence of results. Control sera from patients suffering from diseases other than aspergillosis, no false-positive reactions could be observed. The findings are discussed in respect of diagnosis and epidemiology.

Antigens, Fungal↗

[Daily number of births in Norway 1989-93. Variations across months, day of week, phase of the moon and changes in leave entitlements].

The variation in the daily numbers of births across month, day of week, phase of the moon and maternity leave entitlements have been studied for all births in Norway between 1989 and 1993, a total of 302,209 newborn children. The number of births was highest in the spring and lowest in November and December. A secondary birth maximum was observed in September, possibly related to activities during Christmas and New Year celebrations nine months before. Furthermore, births were least numerous at weekends and were concentrated in the middle of the week. This pattern probably reflects less active obstetric intervention at weekends. The number of births does not seem to vary with phase of the moon. At the time of the latest, and largest increase in national birth maternity leave entitlements, fewer births occurred in the days before and correspondingly more births in the days immediately after the date when the change came into force.

Adult↗

Evidence that functional subunits of antihemophilic factor (Factor VIII) are linked by noncovalent bonds.

Partially purified human antihemophilic factor (AHF, factor VIII), when treated with high concentrations of salt, has been shown to dissociate into two components: one, of relatively low molecular weight, possesses procoagulant activity, and the other, of higher molecular weight, forms precipitates with heterologous antiserum against AHF and supports ristocetin-induced platelet aggregation. The ease of separation suggests that the two components in the native state might be held together by noncovalent bonds. Earlier observations do not exclude the possibility that the subunits may be covalently bonded in nature but might be severed by plasma proteolytic enzymes during laboratory manipulation. The issue was examined by preparing partially purified AHF from fresh human plasma in the presence of protease inhibitors, including benzamidine, soybean trypsin inhibitor, epsilon-aminocaproic acid, heparin, and hirudin. Under these conditons, gel filtration in the presence of 0.25 M calcium chloride and 0.001 M benzamidine resulted in its separation into two components, having properties identical to those separated in the absence of these protease inhibitors. The inhibitor mixture blocked generation and action of streptokinase- and kaolin-activated plasmin from plasma, and protected both plasma AHF and partially purified AHF from the action of thrombin. Surface-induced activation of PTA (factor XI) was partially inhibited, and that of Christmas factor (factor IX) was completely inhibited. This observation provides further evidence that in the native state the high- and low-molecular-weight components of preparations of antihemophilic factor are held together by noncovalent bonds.

Benzamidines↗

[Prophylactic replacement therapy in hemophilia. A case report (author's transl)].

In a six year old boy with severe hemophilia prophylactic substitution of factor VIII was started in 1973 in order to prevent early invalidity due to series of bleeding in the right anklejoint. A substitution of factor VIII over 8 months with 21 resp. 30 U/kg body-weight did not lead to a significant improvement. But since the factor VIII in a dosage of 18 U/kg body-weight is given three times a week no bleeding occurred during the treatment time of 14 months and also the ability to walk improved to an excellent degree.--So far no signs of hepatitis or an factor-VIII-antibody could be detected.--Some results from the prophylactic treatment of severe hemophilia and Christmas disease are cited from the literature.

Child↗

Intraorbital implants after enucleation and their complications: a 10-year review.

BACKGROUND: Many different types of orbital implants have been used after enucleation. Associated complications such as infection, exposure, extrusion, and ptosis have been reported. OBJECTIVE: To describe 342 consecutive patients who underwent enucleation with intraorbital implant placement at the Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Fla, during the past 10.5 years and their complications. METHODS: Medical records of orbital implantation after enucleation performed by 3 surgeons (T.G.M., D.T., and T.J.) were reviewed retrospectively. Demographic data, ocular diagnosis, previous ophthalmic surgery, implant characteristics, and postoperative complications were described in all patients, with a minimum of 2 months' follow-up, using a standardized format. RESULTS: Eleven complications were observed in 7 patients. Four patients had exposure of the implant, and 1 of these patients developed associated infection. Three patients developed pyogenic granulomas, 1 patient developed ptosis requiring surgical intervention, 1 patient had long-term orbital discomfort, and 1 patient developed an inclusion cyst. CONCLUSION: Complications after enucleation with orbital implant placement are minimal and are observed with both porous and acrylic orbital implants.

Acrylic Resins↗

Evaluation of efficacy and complications: primary pediatric orbital implants after enucleation.

BACKGROUND: Orbital implants are used routinely in pediatric patients at the time of enucleation. Complications, such as exposure, ptosis, and infection, may occur after implantation. Controversy continues regarding the rate of complications with newer implants in the pediatric population. OBJECTIVE: To examine the effects of orbital implants on children whose eyes have been enucleated. METHODS: Records of orbital implantation after enucleation performed by 5 surgeons on 120 pediatric patients (123 eyes) over a 10.5-year period were reviewed retrospectively. Demographic data, ocular diagnosis, prior ophthalmic surgery, implant characteristics, and postoperative complications were described using a standardized format for all patients, with a minimum of 6 months of follow-up (mean, 3 years). RESULTS: Complications were observed in 7 eyes (5.7%). Implant exposure (1 [0.8%]), implant extrusion (0 [0%), and implant migration (3 [2.4%) were rare. One hundred eighteen eyes (96%) had good cosmesis and 120 (98%) had good motility. CONCLUSIONS: Orbital implantation after enucleation is successful in the pediatric population. Complications are minimal. Hydroxyapatite implants were not associated with unacceptable complications in this pediatric population.

Adolescent↗