A case report: Hypoxic ischemic encephalopathy & pneumonia in a neonate after SARS-CoV-2 intrauterine transmission.

Severe acute respiratory coronavirus 2 (SARS-CoV-2) is primarily transmitted via respiratory droplet or aerosol route. However, there is mounting evidence for intrauterine transmission. We report on a late preterm infant with suspected intrauterine acquisition of SARS-CoV-2 who experienced birth depression, hypoxic ischemic encephalopathy, multisystem organ involvement, and late onset COVID-19 pneumonia [22].

[Gradually increasing apathy and self-neglect in a 29-year-old man]. / Geleidelijk ontstane apathie en zelfverwaarlozing bij een jongvolwassene.

A 29-year-old man presented with progressive behavioural changes, expressed mainly in the form of increasing of apathy and self-neglect. The initial differential diagnosis included a psychotic disorder, a mood disorder or a personality disorder. After a month of medication-free observation and uncertainty regarding the results of various diagnostic approaches, we decided to use MR-imaging; this revealed a frontal meningioma which had invaded the entire frontal lobe. Although patients with some types of somatic disorders frequently present with psychiatric symptoms, there are often indications (e.g. from history or physical examination) that in fact the symptoms are of organic origin. In this case report we discuss the indications that should lead clinicians and psychiatrists to consider the possibility of organic pathology when young adults present with only psychiatric symptoms.

Cycle control and side effects of a new combiphasic oral contraceptive regimen.

In a multicentre study 882 women were treated during a total of 12,850 cycles with a new combiphasic contraceptive: CTR 24. The study period was 18 cycles. The combiphasic preparation CTR 24 contains 25 micrograms desogestrel (CAS 54024-22-5) plus 40 micrograms ethinylestradiol (CAS 57-63-6) daily for the first 7 days followed by the combination of 125 micrograms desogestrel and 30 micrograms ethinyl-estradiol daily for the subsequent 15 days. The bleeding patterns were analysed over pill cycles and a comparison was made between starters and switchers. The cycle control of the combination was very good. The side effect profile was favourable.

PIP: Physicians recruited 882 women into a multicenter trial of a new biphasic oral contraceptive (OC) (25 mcg + 125 mcg desogestrel and 40 mcg + 30 mcg ethinyl estradiol). Trial sites were in Belgium, Denmark, Finland, France, Germany, Norway, Sweden, and the former Yugoslavia. After 3 cycles, women who had switched from using another OC in the 2 months before the study (switchers) were less likely to continue the new OC than were women who had not used any OC in the last 2 months (starters) (6 cycles = 87.2% vs. 90.6%, 12 cycles = 74.7% vs. 79.5%; and 18 cycles = 59.8% vs. 64.9%). Withdrawal bleeding did not occur in 3.2% of all cycles. Absence of withdrawal bleeding became less common over time (cycle 1 = 7.6%, cycle 3 = 5%, cycle 6 = 3.2%, and cycle 18 = 1.8%). Duration of withdrawal bleeding was no more than 5 days in 80% of all women. More and more women had no more than 5 days of withdrawal bleeding as time passed (cycle 1 = 81.7%, cycle 6 = 85.6%, and cycle 18 = 90.6%). Irregular bleeding was more common in the first cycles of the study than in subsequent cycles (e.g., spotting during cycles 1-3 = 8.5-4.8% vs. 3.7-3.1% during cycles 6-18). By cycle 18, 96% of all women had no irregular bleeding. The drop-out rate for irregular bleeding was 2.2% at the end of the study. In 5% of cycles, at least 1 tablet was forgotten. In the first cycles, starters were somewhat more likely to complain of nausea, headache, and breast tenderness than switchers (e.g., nausea, cycle 1 = 5.8% vs. 3.4%). The gap between the 2 groups disappeared after 3 cycles. Starters were more likely to have minor complaints before OC use than after OC use (e.g., 6.5% fewer frequencies of headaches at 18 months). These findings show that the new OC has very good cycle control and a agreeable side effect profile.

Cancer incidence and mortality in the Du Pont Company: an update.

In a previous publication, Pell et al described the cancer epidemiologic surveillance program that was begun in the Du Pont Company in 1956 and presented standardized cancer incidence and mortality data through 1974 for Du Pont employees compared with such data for the US general population. This report provides the analysis of an additional 10 years of cancer incidence and mortality data, and examines time trends for specific cancer sites. Conoco, Inc, acquired in 1981, is not included in the analysis.

Cancer incidence and mortality among workers exposed to acrylonitrile.

A cohort of 1,083 male employees who had potential for exposure to acrylonitrile between 1944 and 1970 at a Du Pont textile fibers plant were followed through 1981 for mortality and through 1983 for cancer incidence. In total, the 21 cancer deaths were fewer than expected based on either Du Pont or U.S. rates. No significant excesses were seen by primary site. In all, 37 cancer cases occurred as compared with 36.5 expected based on company rates. Five lung cancer cases were observed and 6.9 expected. There were 5 prostate cancer cases as compared with 1.9 expected. Of these, 4 occurred among wage employees during the 1975-1983 period, compared to 0.9 expected. This excess was statistically significant.

Epidemiologic study of workers exposed to acrylonitrile: an update.

A previous report presented the cancer morbidity and mortality experience through 1976 of a cohort of 1,345 male employees with potential for exposure to acrylonitrile at a fibers-producing plant. This study has now been updated through 1983 for cancer incidence and through 1981 for mortality. Overall, 43 cancer cases have occurred, with 37.1 expected based on company rates. A previously reported excess number of cases of lung cancer remains, but is not as marked (10 observed, 7.2 expected). Prostate cancer cases were significantly in excess, with six cases observed and 1.8 expected. Mortality analyses revealed 36 cancer deaths, with 31.6 expected. Of these, 14 were from lung cancer, with 11.6 expected based on company rates. Only one death from prostate cancer occurred, with 1.0 expected. To our knowledge, prostate cancer excesses have not been reported in any other acrylonitrile studies, and hence their significance is currently difficult to assess.

Epidemiologic study of workers exposed to acrylonitrile.

This retrospective cohort study of 1,345 male employees with potential for exposure to acrylonitrile analyzes cancer incidence and mortality from 1956 to 1976. Expected numbers based on company and national rates have been computed on person-years. The analyses consider calendar time, payroll classification, occupation, duration of exposure, severity of exposure, and latency. Overall, 25 cases of cancer occurred, with 20.5 expected based on company rates. Of these, eight were respiratory cancer cases, with 4.4 expected. Excesses were found primarily during the 1970-76 time period among wage roll employees who had worked during plant start-up. A trend toward increased risks was seen with increased duration and severity of exposure. Twenty cancer deaths were found, with 17.4 expected according to company rates. Since many cancer cases were recently diagnosed and are living, it may be premature to evaluate mortality statistics. These findings, coupled with results from tests in laboratory animals, raise the serious suspicion that acrylonitrile may be a human carcinogen.

[Surgical treatment of Sipple's syndrome (author's transl].

Sipple's syndrome (bilateral phaeochromocytoma and medullary thyroid carcinoma) is a multiple endocrinopathy with a familial occurrence. The medullary thyroid carcinoma develops from the intrathyroidal C-cells. Radioimmunological analysis of serum calcitonin, basally or after calcium infusion, discloses the tumor also in asymptomatic members of the families. The patients are treated in two sessions. In the first a bilateral adrenalectomy is performed and in the second a total thyroidectomy with modified neck dissection. Major preoperative diagnostic procedures as angiograms and phlebograms as well as the bilateral adrenalectomy must be preceded by pre-treatment with alpha- and beta- receptorblocking substances.