Poisoning by Common Household Products

The danger of poisoning, especially of children, is widespread. In Greater Cleveland, Ohio alone, during 1957 (excluding deaths from automobile accidents) 43 children were accidentally killed. Eleven of those deaths were due to poisoning; all of the children being in the age group from one year to six years. In a recent six-month period the Poison Information Center of The Academy of Medicine of Cleveland received 1,535 calls concerning treatment for accidental poisoning of children. This figure by no means indicates the total number of cases of poisoning that actually occurred. These terrible statistics can be sharply reduced by proper labeling of products, and by common sense handling and storage of dangerous products. Advertising of such products also should contain warnings of danger where such warnings are desirable for the public protection

Radiographic Prevalence of Osteoarthritis of the Scaphotrapeziotrapezoid Joint in Patients With Carpometacarpal Osteoarthritis of the Thumb: A Retrospective Case Series

Background: In planning operative treatment of thumb carpometacarpal (CMC) joint osteoarthritis, surgeons should consider the presence of an arthritic scaphotrapeziotrapezoid (STT) joint. We aimed to determine the radiographic prevalence of concomitant (STT) osteoarthritis with thumb CMC osteoarthritis in patients who underwent surgical treatment at our institution. We hypothesized that the prevalence of concomitant arthritis at these 2 joints (STT and CMC) would be lower than previously reported. Methods: Between September 2005 and July 2012, a total of 417 patients were identified from our institution using the Current Procedural Terminology code for thumb CMC joint arthroplasty (25447). After applying exclusion criteria and identifying patients who underwent treatment, a total of 194 patients were included and 218 preoperative radiographs were available for review. Each radiograph was categorized according to the Eaton classification of thumb CMC osteoarthritis, with stage 4 involving the (STT) joint. Evaluation was performed by four reviewers independently. Results: A total of 47 (21.6%) patients had varying degrees of concomitant (STT) joint osteoarthritis with the thumb CMC joint osteoarthritis. Stage 4 was reported in 6.4% (14) of the radiographs. Conclusions: The radiographic prevalence of concomitant (STT) osteoarthritis with thumb CMC osteoarthritis may be lower than previously reported. Further studies that include a similarly large sample size and additional radiographic views can help evaluate the likelihood of these conditions in patients who elect to undergo surgical treatment of thumb CMC osteoarthritis

Prescription and Other Medication Use in Pregnancy

OBJECTIVE: To characterize prescription and other medication use in a geographically and ethnically diverse cohort of women in their first pregnancy. METHODS: In a prospective, longitudinal cohort study of nulliparous women followed through pregnancy from the first trimester, medication use was chronicled longitudinally throughout pregnancy. Structured questions and aids were used to capture all medications taken as well as reasons they were taken. Total counts of all medications taken including number in each category and class were captured. Additionally, reasons the medications were taken were recorded. Trends in medications taken across pregnancy and in the first trimester were determined. RESULTS: Of the 9,546 study participants, 9,272 (97.1%) women took at least one medication during pregnancy with 9,139 (95.7%) taking a medication in the first trimester. Polypharmacy, defined as taking at least five medications, occurred in 2,915 (30.5%) women. Excluding vitamins, supplements, and vaccines, 73.4% of women took a medication during pregnancy with 55.1% taking one in the first trimester. The categories of drugs taken in pregnancy and in the first trimester include the following: gastrointestinal or antiemetic agents (34.3%, 19.5%), antibiotics (25.5%, 12.6%), and analgesics (23.7%, 15.6%, which includes 3.6%; 1.4% taking an opioid pain medication). CONCLUSION: In this geographically and ethnically diverse cohort of nulliparous pregnant women, medication use was nearly universal and polypharmacy was common

A test of basin-scale acoustic thermometry using a large-aperture vertical array at 3250-km range in the eastern North Pacific Ocean

Author Posting. © Acoustical Society of America, 1999. This article is posted here by permission of Acoustical Society of America for personal use, not for redistribution. The definitive version was published in Journal of the Acoustical Society of America 105 (1999): 3185, doi:10.1121/1.424649.Broadband acoustic signals were transmitted during November 1994 from a 75-Hz source suspended near the depth of the sound-channel axis to a 700-m long vertical receiving array approximately 3250 km distant in the eastern North Pacific Ocean. The early part of the arrival pattern consists of raylike wave fronts that are resolvable, identifiable, and stable. The later part of the arrival pattern does not contain identifiable raylike arrivals, due to scattering from internal-wave-induced sound-speed fluctuations. The observed ray travel times differ from ray predictions based on the sound-speed field constructed using nearly concurrent temperature and salinity measurements by more than a priori variability estimates, suggesting that the equation used to compute sound speed requires refinement. The range-averaged oceansound speed can be determined with an uncertainty of about 0.05 m/s from the observed ray travel times together with the time at which the near-axial acoustic reception ends, used as a surrogate for the group delay of adiabatic mode 1. The change in temperature over six days can be estimated with an uncertainty of about 0.006 °C. The sensitivity of the travel times to ocean variability is concentrated near the ocean surface and at the corresponding conjugate depths, because all of the resolved ray arrivals have upper turning depths within a few hundred meters of the surface.This work was supported largely by the Strategic Environmental Research and Development Program through Defense Advanced Research Projects Agency ~DARPA! Grant No. MDA972-93- 1-0003. Additional support was provided at SIO by the Office of Naval Research ~ONR! through Grant No. N00014- 97-1-0258. J. Colosi wishes to acknowledge support from an ONR Young Investigator Award, from the J. Lamar Worzel Assistant Scientist Fund, and from the Penzance Endowed Fund in support of scientific staff at WHOI

Res Medica, Spring 1962, Volume III, Number 2

TABLE OF CONTENTSABDOMINAL CRISES II: I. S. R. Sinclair. F.R.C.S.NERVE CELLS AND NEUROGLIA: Professor D. Whitteridge, F.R.S. RESPIRATORY INADEQUACY:Charles E. Hope RES MEDICATHE TREATMENT OF RENAL DISEASES: J. A. Calvert. B.Sc. THE EDINBURGH INFLUENCE ON EARLY AMERICAN MEDICINE: Professor Sir Walter MercerSIR CHARLES BELL: Robert A. ButlerOFFICE-BEARERS 1961-1962RETROSPECT—225th SESSIONBOOK REVIE

Physical and mental health comorbidity is common in people with multiple sclerosis: nationally representative cross-sectional population database analysis

<b>Background</b> Comorbidity in Multiple Sclerosis (MS) is associated with worse health and higher mortality. This study aims to describe clinician recorded comorbidities in people with MS. <p></p> <b>Methods</b> 39 comorbidities in 3826 people with MS aged ≥25 years were compared against 1,268,859 controls. Results were analysed by age, gender, and socioeconomic status, with unadjusted and adjusted Odds Ratios (ORs) calculated using logistic regression. <p></p> <b>Results</b> People with MS were more likely to have one (OR 2.44; 95% CI 2.26-2.64), two (OR 1.49; 95% CI 1.38-1.62), three (OR 1.86; 95% CI 1.69-2.04), four or more (OR 1.61; 95% CI 1.47-1.77) non-MS chronic conditions than controls, and greater mental health comorbidity (OR 2.94; 95% CI 2.75-3.14), which increased as the number of physical comorbidities rose. Cardiovascular conditions, including atrial fibrillation (OR 0.49; 95% CI 0.36-0.67), chronic kidney disease (OR 0.51; 95% CI 0.40-0.65), heart failure (OR 0.62; 95% CI 0.45-0.85), coronary heart disease (OR 0.64; 95% CI 0.52-0.71), and hypertension (OR 0.65; 95% CI 0.59-0.72) were significantly less common in people with MS. <p></p> <b>Conclusion</b> People with MS have excess multiple chronic conditions, with associated increased mental health comorbidity. The low recorded cardiovascular comorbidity warrants further investigation

Mindfulness based interventions in multiple sclerosis: a systematic review

<b>Background</b> Multiple sclerosis (MS) is a stressful condition; depression, anxiety, pain and fatigue are all common problems. Mindfulness based interventions (MBIs) mitigate stress and prevent relapse in depression and are increasingly being used in healthcare. However, there are currently no systematic reviews of MBIs in people with MS. This review aims to evaluate the effectiveness of MBIs in people with MS.<p></p> <b>Methods</b> Systematic searches were carried out in seven major databases, using both subject headings and key words. Papers were screened, data extracted, quality appraised, and analysed by two reviewers independently, using predefined criteria. Study quality was assessed using the Cochrane Collaboration risk of bias tool. Perceived stress was the primary outcome. Secondary outcomes include mental health, physical health, quality of life, and health service utilisation. Statistical meta-analysis was not possible. Disagreements were adjudicated by a third party reviewer.<p></p> <b>Results</b> Three studies (n = 183 participants) were included in the final analysis. The studies were undertaken in Wales (n = 16, randomised controlled trial - (RCT)), Switzerland (n = 150, RCT), and the United States (n = 17, controlled trial). 146 (80%) participants were female; mean age (SD) was 48.6 (9.4) years. Relapsing remitting MS was the main diagnostic category (n = 123, 67%); 43 (26%) had secondary progressive disease; and the remainder were unspecified. MBIs lasted 6–8 weeks; attrition rates were variable (5-43%); all employed pre- post- measures; two had longer follow up; one at 3, and one at 6 months. Socio-economic status of participants was not made explicit; health service utilisation and costs were not reported. No study reported on perceived stress. All studies reported quality of life (QOL), mental health (anxiety and depression), physical (fatigue, standing balance, pain), and psychosocial measures. Statistically significant beneficial effects relating to QOL, mental health, and selected physical health measures were sustained at 3- and 6- month follow up.<p></p> <b>Conclusion</b> From the limited data available, MBIs may benefit some MS patients in terms of QOL, mental health, and some physical health measures. Further studies are needed to clarify how MBIs might best serve the MS population.<p></p&gt

Outcomes from a 12-Week, Open-Label, Multicenter Clinical Trial of Teduglutide in Pediatric Short Bowel Syndrome

Objective To determine safety and pharmacodynamics/efficacy of teduglutide in children with intestinal failure associated with short bowel syndrome (SBS-IF). Study design This 12-week, open-label study enrolled patients aged 1-17 years with SBS-IF who required parenteral nutrition (PN) and showed minimal or no advance in enteral nutrition (EN) feeds. Patients enrolled sequentially into 3 teduglutide cohorts (0.0125 mg/kg/d [n = 8], 0.025 mg/kg/d [n = 14], 0.05 mg/kg/d [n = 15]) or received standard of care (SOC, n = 5). Descriptive summary statistics were used. Results All patients experienced ≥1 treatment-emergent adverse event; most were mild or moderate. No serious teduglutide-related treatment-emergent adverse events occurred. Between baseline and week 12, prescribed PN volume and calories (kcal/kg/d) changed by a median of −41% and −45%, respectively, with 0.025 mg/kg/d teduglutide and by −25% and −52% with 0.05 mg/kg/d teduglutide. In contrast, PN volume and calories changed by 0% and −6%, respectively, with 0.0125 mg/kg/d teduglutide and by 0% and −1% with SOC. Per patient diary data, EN volume increased by a median of 22%, 32%, and 40% in the 0.0125, 0.025, and 0.05 mg/kg/d cohorts, respectively, and by 11% with SOC. Four patients achieved independence from PN, 3 in the 0.05 mg/kg/d cohort and 1 in the 0.025 mg/kg/d cohort. Study limitations included its short-term, open-label design, and small sample size. Conclusions Teduglutide was well tolerated in pediatric patients with SBS-IF. Teduglutide 0.025 or 0.05 mg/kg/d was associated with trends toward reductions in PN requirements and advancements in EN feeding in children with SBS-IF