OBJECTIVE: This paper reports on birth weight, body length, body mass index, and cranial circumference at birth of infants with cleft lip and/or palate born between 1973 and 1992. METHODS: Data were obtained from two nationwide Swedish health registries. Infants with syndromes, twins, and infants with immigrant parentage were excluded from the study. Comparisons were made with all singleton births with the same exclusion criteria (n = 2,031,140). RESULTS: The body dimensions of infants with isolated cleft lip (n = 865) were found not to differ from those of control subjects, but infants with isolated cleft palate (n = 811) or cleft lip and palate (n = 1139) were found to be lighter and shorter than control subjects. Also, infants with the Pierre Robin sequence (n = 121) had a tendency to be lighter and shorter than control subjects, but these differences did not reach statistical significance despite the large study population.
The pathways of 131I, 134Cs and 137Cs from the Chernobyl fallout to man were followed in the county of VÃ¤sterbotten, Sweden. Reported airplane measurements had shown that the ground deposition of 137Cs was 3-40 kBq/m2 with hot spots with more than 80 kBq/m2. Multiplying with a factor of 0.6 gave the 134Cs deposition and an approximate factor of 20 the 131I ground deposition. The effective dose equivalent from 131I became low, less than 0.1 mSv, as the cows were stabled. The 137Cs activity concentration in different types of food was measured in approximately 8,000 samples. The most important sources of Cs intake in man were lake fish, elk (European moose) and reindeer. Variations with time was studied in detail for four types of lake fish. Whole-body measurements on more than 250 persons showed that no group of people on average received more than 1 mSv from food during the first year after the Chernobyl accident. However, single persons eating large amounts of reindeer meat received up to 2.5 mSv. People buying all their food in ordinary provision-shops got less than 0.1 mSv from the food during the first year. The present level of 90Sr activity concentration in man will only give an effective dose equivalent of 0.004 mSv/year, most of it being a result of the atmospheric nuclear bomb tests.
Based on the findings in an early detection study for prostate cancer [Gustafsson et al.: J Urol 148:1827-1831, 1992] using digital rectal examination (DRE), transrectal ultrasound (TRUS), and prostate-specific antigen (PSA), a cost-effectiveness analysis was performed based on 6 screening strategies, namely: 1) DRE of all individuals; 2) TRUS of all individuals; 3) DRE, TRUS, and PSA analysis followed by reexamination of individuals with PSAs > or = 7 ng/ml; 4) DRE of individuals with PSAs of > or = 4 ng/ml; 5) TRUS of individuals with PSAs of > or = 4 ng/ml; 6) DRE and PSA analysis followed by TRUS on individuals with PSAs > or = 4 ng/ml. The detection rates of prostate cancer using these 6 strategies were 2.4%, 3.3%, 3.6%, 2.0%, 2.6%, and 3.2%, respectively. Except for costs per detected cancer, costs were also calculated per detected small cancer ( or = 4 ng/ml (strategy 5) was the most cost-effective strategy and detected 80% of the cancers actually treated for cure. Screening with DRE and PSA analysis followed by TRUS of individuals with PSAs > or = 4 ng/ml (strategy 6) had a somewhat lower cost-effectiveness, but detected 90% of the cancers treated for cure.
Laboratory studies of methane formation in peat samples from an acid subarctic mire in Sweden indicated the presence of a low-temperature-adapted methanogenic flora. Enrichment culture studies with ethanol, acetate, hydrogen, or a combination of these as substrate for methane formation provided evidence for the existence of two different methanogenic populations in the peat: one, unaffected by hydrogen and using acetate, with a temperature optimum at 20 degrees C; the other, oxidizing hydrogen, with a temperature optimum at ca. 28 degrees C.
ABSTRACT OBJECTIVES: To compare a forced air warming system with passive measures to avoid perioperative hypothermia. DESIGN: Prospective open study. SETTING: University hospital, Sweden. SUBJECTS: 28 Patients scheduled for extensive thoracoabdominal operations under standard combined general and regional anaesthesia. MAIN OUTCOME MEASURES: Temperature measured before, repeatedly under anaesthesia and during the operation for up to three hours, and then up to eight hours postoperatively. RESULTS: Three patients were excluded. In the 12 patients who had forced air warming, temperature was preserved, and ranged from a mean (SD) of 36.8 (0.7) degrees C, (95% confidence interval (CI) 36.4 to 37.2) at the start to 36.9 (0.8) degrees C, (95% CI 36.5 to 37.3) after 3 hours. In patients who had conservative passive heat preservation techniques the mean temperature fell significantly perioperatively, from 36.8 (0.6) degrees C (95% CI 36.5 to 37.1) at the start to 35.1 (0.5) degrees C, (95% CI 34.9 to 35.3), after three hours of anaesthesia and surgery. This was a significant fall compared with the temperature in the study group (p
Geochemical parameters and major ion concentrations from sediments of a freshwater lake in the town of Åtvidaberg, southeastern, Sweden, were used to identify the geochemical processes that control the water chemistry. The lake sediments are anoxic, characterized by reduced sulfur and sulfidic minerals. The hypothesis tested is that in sulfidic-anaerobic contaminated sediments, the presence of redox potential changes creates a favorable condition for sulfide oxidation, resulting in the release of potentially toxic metals. The acid volatile sulfide (AVS) contents ranged from 5.5?µmol/g to 16?µmol/g of dry sediment. Comparison of total mine tailing metals (?mine tailing metals) with simultaneously extracted metals (SEM) in sediments indicates that up to 20% of the ?mine tailing metals are bound to the solid phase as AVS. Consequently, the AVS and SEM analysis classified all sediment samples as potentially toxic in terms of heavy metal concentrations (i.e., SEM to AVS ratio distribution?>?1). Evaluation of hydrogeochemical data suggests that calcite dissolution, iron (III) oxyhydroxysulfate mineral jarosite (H-jarosite) precipitation, hematite precipitation, and siderite precipitation are the most prevailing geochemical processes that control the geochemical interactions between the water column and sediment in a mine-impacted lake. The geochemical processes were verified and quantified using a chemical equilibrium modeling program, Visual MINTEQ, Ver 3.1, beta. The identified geochemical processes create an environment in which the characteristics of sulfate-rich waters and acidic-iron produce the geochemical conditions for acid mine drainage and mobilization of toxic metals.
To analyse the outcome of minor amputations (through, or distal to, the ankle joint) in patients with diabetes.
All diabetic patients in a defined population undergoing one or more minor amputation between 1982 and 2006 were investigated according to a standardised protocol and were followed until final outcome (healing or death). A total of 410 consecutive amputations in 309 patients with a median age of 73 (32-93) years were identified.
In 94% of amputations, deep infection (39%) and/or gangrene (55%) was present. Severe peripheral vascular disease or critical limb ischaemia was present in 61% of amputations. 261/410 (64%) of the amputations healed at a level below the ankle joint; 69/410 (17%) healed after a re-amputation above the ankle joint; in 76/410 of amputations (19%), the patient died before healing could occur. In surviving patients, 79% of the amputations healed below the ankle. Median healing time for amputations that healed below the ankle was 26 (2-250) weeks; 21% of amputations required a re-amputation above the ankle. None of the analysed parameters excluded the possibility of healing below the ankle.
In this population-based survey, the goal of avoiding major amputation was achieved in almost two thirds of minor amputations, but at the price of long healing times. In almost all amputations, the patient had deep infection and/or gangrene. In spite of this, 64% of all amputations, and 79% of amputations in surviving patients, healed at a level below the ankle. This indicates that minor amputations in these patients are worthwhile.
Neutron therapy was first introduced by Stone et al. in 1938, i.e. more than 10 years earlier than electron beam therapy and only 6 years after the discovery of neutrons. In spite of the impressive accomplishment in generating an adequate therapy beam, time was also found for careful radiobiological studies of neutron beams. However, it was not considered that for a certain early reaction the late effects were much greater with neutrons than with x-rays. The severe late sequelae in proportion to the few good results motivated the closure of this therapy. Neutron therapy was again introduced in Hammersmith hospital at the end of the 1960's. The major reason seems to have been to overcome the oxygen effect. Encouraging results were reported. It was argued that the very favourable statistics on local tumour control were obtained at the expense of more frequent and more severe complications. A clinical trial in Edinburgh seemed to indicate this, but it was not proved in the end as the two trials differed regarding fractionation. Today about 16,000 patients have been treated with neutrons. The neutron beams now used differ significantly, both regarding dose distributions and microdosimetrical properties, from those utilized earlier. The advantage of neutrons is still, however, controversial. There are indications that neutron treatment may be favourable for some tumours. A careful cost-benefit study ought to be performed before the creation of a neutron therapy centre in Sweden as the group of patients suitable for neutrons is limited, and there may be new possibilities for improvement of photon and electron treatment with much smaller resources.