Risk factors associated with retinopathy of prematurity (ROP) in northern Jutland, Denmark 1990-1993.

This population-based, historical, follow-up study analysed possible risk factors for retinopathy of prematurity (ROP) and resulting visual impairment in newborns over a period of 3 1/2 years in the County of Northern Jutland, Denmark. The study subjects were 141 infants with birth weight < or = 1500 grams and gestational age < 35 completed weeks who survived to a first eye examination at 5 weeks. The incidence of ROP (all stages) was 18%, and the frequency of severe visual impairment from ROP was 14/100,000 live births. A logistic regression analysis identified low gestational age, multiple births, continuous oxygen treatment, and male sex as risk factors for ROP. The main factor in the prevention of ROP is to prevent preterm births.

The superiority of rectal thermometry to oral thermometry with regard to accuracy.

Electronic oral thermometry is performed routinely in most medical centres. From the studies available on this subject it seems difficult to find any documentation for this practice. We have conducted clinically controlled studies in which the accuracy of electronic oral thermometry (CRAFTEMP and TERUMO WCT) and that of electronic rectal thermometry (TERUMO WCT) were tested. Rectal glass mercury thermometry was used as a reference method. Two studies were designed. In study 1, 184 patients (72 women, 112 men), median age 70 (18-95) years were investigated. In study 2, 91 patients (41 women, 50 men), median age 59 (18-96) years were investigated. Electronic oral thermometry was found unacceptably inaccurate under daily routine conditions. Electronic rectal thermometry was found to be accurate. Calculations of mean temperature difference between reference measurements and test measurements (mean +/- SD) were found to be: routine oral CRAFTEMP at 0.70 +/- 0.50 degrees C, optimum oral TERUMO WCT at 0.75 +/- 0.74 degrees C, routine rectal TERUMO WCT at 0.08 +/- 0.26 degrees C and optimum rectal TERUMO WCT at 0.02 +/- 0.17. In the screening procedure for fever oral thermometry showed low sensitivity (routine CTAFTEMP 0.47 and optimum TERUMO WCT 0.59) whereas rectal thermometry showed high sensitivity (routine TERUMO WCT 0.74 and optimum TERUMO WCT 0.91). It was concluded that rectal thermometry must be preferred to oral thermometry for daily routine measurements.

Size- and charge selectivity of glomerular filtration in Type 1 (insulin-dependent) diabetic patients with and without albuminuria.

Albuminuria is the first clinical event in the development of diabetic nephropathy. We assessed glomerular charge- and size selectivity in 51 patients with Type 1 (insulin-dependent) diabetes mellitus of juvenile onset and 11 healthy individuals. Patients were allocated to five groups. The urinary albumin excretion rate was normal in group D1; 30-100 mg/24 h in group D2; 101-300 mg/24 h in group D3 and greater than 300 mg/24 h in groups D4 and D5. Group D5 had elevated serum creatinine (above 110 mumol/l). Glomerular filtration rate and renal plasma flow were determined by constant infusion techniques and tubular protein reabsorption by excretion of beta 2-microglobulin. Charge selectivity was estimated from the IgG/IgG4 selectivity index. Size selectivity was measured by dextran clearance. Dextran was measured by refractive index detection after fractionation (2 A fractions in the range 26-64 A) by size exclusion chromatography. IgG/IgG4 selectivity index was significantly decreased in patients with albuminuria (p < 0.001). The drop in IgG/IgG4 selectivity index was found in patients with minimal albuminuria (D2) and was not accompanied by any changes in tubular function or glomerular haemodynamics. Size selectivity was significantly altered only in patients with the most advanced nephropathy (D5) as reflected by an increase in the clearance of 62 A dextran (p < 0.04). We conclude that loss of glomerular charge selectivity precedes or accompanies the formation of new glomerular macromolecular pathways in the development of diabetic nephropathy.

[Should electronic mouth thermometers be used in routine everyday hospital practice? Usefulness of mouth thermometers]. / Bør elektroniske mundhuletermometre anvendes i dagligt rutinemaessigt afdelingsarbejde?

An oral electronic thermometer was compared with Hg-thermometer used rectally in the daily clinical routine. The rectal temperatures were, on an average, 0.7 degrees C higher than the oral temperatures. In 27% of the cases, the difference between rectal and oral measurement was more than 1 degree C. The variations between the differences of oral and rectal temperature measurement were unacceptable. It is concluded that the precision of oral electronic thermometers was not found to be satisfactory, and employment of this apparatus can not be recommended in daily clinical work.

Late appearance of arterial injury caused by fracture of the neck of the humerus.

A 65-year-old man sustained a fracture of the humeral neck. Four days later he suddenly developed symptoms of occlusion of the axillary artery. The fracture was reduced and fixated and the torn intima occluding this artery was fixated. Clots were removed with a Fogarty balloon catheter. Late appearance of arterial injury is rare and we found no reports of this complication after fracture of the humeral neck.