Blood PCB, p,p'-DDE, and mirex levels in Great Lakes fish and waterfowl consumers in two Ontario communities.

PCB, p,p'-DDE, and mirex levels were examined in blood plasma samples of 232 anglers from Cornwall and Mississauga, Ontario, in a pilot study to establish the feasibility and suitability of using a cohort of Ontario fish license holders for large-scale health studies. Great Lakes fish, waterfowl, and ocean fish consumption were examined as predictors of contaminant levels using regression analysis, with adjustment for age, gender, and community. Levels of Great Lakes fish and waterfowl consumption and contaminant levels were generally low in comparison with those observed in other Great Lakes studies. However, even within these low levels, Great Lakes fish consumption was associated with increased blood plasma PCB levels in men and mirex levels in both men and women. Waterfowl consumption was associated with higher plasma PCB (men and women), DDE (men only), and mirex levels (men and Cornwall women), and requires further exploration. We conclude that other study designs are required (to identify high consumers) for carrying out studies of health effects associated with high levels of Great Lakes fish and waterfowl consumption.

Fatal outcome in a child with pseudomembranous colitis.

The clinical and histologic changes occurring with antibiotic-associated pseudomembranous colitis are usually reversible with discontinuation of the causative medication. The spectrum of disease patterns ranges from a benign form to a very fulminant and occasionally fatal one. This report describes a child with a severe form of the disease. Despite recognition and sigmoidoscopic confirmation of this syndrome and cessation of antibiotics, his course continued to deteriorate. Sepsis, leukocytosis, refractory diarrhea, and abdominal distension led to exploratory laparotomy. A proctocolectomy was performed for necrosis of the entire colon; however, the patient died of sepsis.