Parental confusion may result when primary health care professionals show heterogeneity in their knowledge, attitudes, and perceptions regarding infant nutrition, food allergy, and atopic dermatitis.

INTRODUCTION AND OBJECTIVES: Whether the guidelines on infant nutrition, food allergy and atopic dermatitis confer real health benefits in practice at the population level has not been deeply studied. We aimed here to characterize the knowledge, attitudes, and perceptions regarding these issues among primary health care professionals. In addition, we surveyed available parent-reported information sources and the incidence of food-related symptoms, dietary restrictions, food allergy, and atopic dermatitis among one-year-old children in the general population. MATERIALS AND METHODS: An online questionnaire was designed for public health nurses and general practitioners. In addition, parents of one-year-old children were recruited to a separate survey at the time of their regular check-up visit. RESULTS: Altogether, 80 professionals took part. The median overall knowledge score was 77% and significantly higher among the general practitioners than among the nurses (p=0.004). However, only 35% of all the professionals recognized either severe airway or cardiovascular symptoms as potential food allergy-related symptoms. Moisturizers and emollients were thought to be adequate treatment for atopic dermatitis by 56%. Among 248 one-year-old children, the incidence of food allergy was 4% and atopic dermatitis 13%. During this period, parents intentionally avoided giving at least one food to 23% of the children, yet more than 80% of these restrictions can be regarded as unnecessary. CONCLUSION: The knowledge, attitudes and beliefs regarding infant feeding, food allergy, and atopic dermatitis varied significantly among the primary care professionals. This will likely result in heterogeneous guidance practices and confusion among the families at the population level.

Compression sonography in the diagnosis of deep venous thrombosis of the leg.

The value of compression sonography was assessed to reduce the number of phlebographies otherwise necessary when deep venous thrombosis (DVT) is suspected among hospital patients. Compression sonography was used to study 119 prospective hospital patients who were suspected of having DVT of the lower extremity. The results were compared to those by phlebography. There were 44 DVTs detected by phlebography; ten of these were located only in the calf, below the knee. Of the remaining 34 femoropopliteal DVTs 33 were detected by the compression sonography technique. It is concluded that the use of compression sonography for primary investigation of suspected DVT reduces the number of patients who require phlebography to those whose results by compression sonography are negative. In our study, this would have represented a decrease of 28%, corresponding to a reduction of the total diagnostic costs by 10%.

What happens to the Valtrac anastomosis of the colon? A follow-up study.

Late results after colonic anastomoses performed with the biofragmentable anastomosis ring (BAR; Valtrac; Davis & Geck, Wayne, NJ) were evaluated in 30 patients who had undergone a left-sided colonic or rectosigmoid anastomosis a mean of 24.5 (range, 12-38) months earlier. Patients were asked about their late postoperative recovery and their bowel habits. A barium enema was performed, and then a flexible endoscopy was done, during which the anastomotic area was evaluated both in macroscopic terms and histologically. One of the patients had died, and three refused to participate in the investigation. Of the remaining 26 patients, one had been reoperated on 22 months after the primary sigmoid resection. The reason for reoperation was an anastomotic stricture. One of the patients was admitted to the hospital during the study and was operated on for reasons not related to the anastomosis. Twenty-four patients underwent the study scheme. All had recovered uneventfully. Sixteen anastomoses could not be identified radiologically and seven not even during endoscopy. Histologically, there was mild-to-moderate fibrosis and scarring in 17 anastomoses, and, in the seven that could not be identified, only normal colonic mucosa was found. The late results of BAR anastomoses are satisfying, and the rate of complications is acceptable.

Radiologic patterns of carcinoma of the oesophagus.

A retrospective analysis of the radiologic findings of 270 malignant tumours of the oesophagus is presented. The tumours were located in the upper and lower third of the oesophagus in 10%, 52.6% and 37.4% of the cases respectively. In only 28.5% of cases was the length of the tumor less than 5 cm, since all patients were symptomatic at the time of the diagnosis. The radiographic appearance of the tumours was scirrhous in 64.4%, medullary in 18.9% and polypoid in 16.7% of the cases. Radiographic findings observed after resection or radiotherapy are presented.

Radiology of uncommon esophageal neoplasms.

The radiographic appearance of 16 uncommon primary esophageal tumors (4 adenoid cystic carcinomas, 3 adenoacanthomas, 4 small cell carcinomas, 2 adenopapillary carcinomas, adenocarcinoma, mucoepidermoid carcinoma and malignant melanoma), is presented. These tumors were found in a retrospective study of 270 esophageal neoplasms. Sufficient radiographic, histologic and clinical data was available to substantiate primary esophageal origin of the tumors. Cylindromas tender to have a smooth surface and either funneled or polypoid appearance. None of the tumors, however, had radiographic appearance readily distinguishable from variable patterns of the common esophageal carcinomas. The age and sex distribution, location as well as prognosis of the rate adenocarcinomas appear to be similar to squamous cell carcinomas. The small cell carcinomas of the esophagus only had an average prognosis of 4 months. The x-ray examination was of little value in predicting local tumor spread, mediastinal metastases or prognosis.

The posterior tracheal band and recurrent esophageal carcinoma.

The posterior tracheal band (PTB) was studied on upright chest radiographs in 43 patients and its appearance and diagnostic usefulness correlated with recurrence of esophageal carcinoma after surgery of radiation therapy. It was seen well enough to be useful in 36 treated patients (83.7%). In 10 of 17 recurrent carcinomas (60%), all or part of the PTB showed progressive thickening up to greater than or equal to 5 mm compared with radiographs taken one month after therapy or later, suggesting recurrence in 6 of 8 cases after resection and in all 4 cases after radiotherapy. Such thickening never occurred in patients without recurrent carcinoma. In 6 of 10 cases, thickening of the PTB preceded the diagnosis of recurrence by two to six months.

The posterior tracheal band: correlation between computed tomography and chest radiography.

As seen on the lateral chest radiograph, the posterior tracheal band (PTB) is useful in evaluating the retrotracheal area. The anatomical basis of its variations on the lateral chest radiograph were analyzed by comparison with computed tomography (CT). Lack of visualization or occasional thickening of the PTB is explained on an anatomical basis. Such variations are distinguishable from retrotracheal abnormalities on CT.

Posterior tracheal band in esophageal carcinoma.

The appearance and diagnostic usefulness of the posterior tracheal band (PTB) was studied from upright chest radiographs taken from 178 individuals with diagnosed esophageal squamous cell carcinoma. PTB was visualized well enough to be diagnostically useful in about 80-90% of individuals depending on the location of the carcinoma. PTB or a portion of it measured 6 mm or more in 57.1, 72.4 and 37.3% of cases of carcinoma of the upper, middle and lower third of the esophagus, respectively. While a width of 4-5 mm is frequently observed in normal patients, especially in the upper third of the PTB, a width of 6 mm or more and/or progressive widening of more than 2 mm between consecutive films is highly suggestive of pathology. Correlation between changes in PTB and operability or prognosis is poor.

The posterior tracheal band in the lateral chest radiograph.

The appearance and variations of the posterior tracheal band (PTB) was studied from 406 upright chest radiographs, taken from 293 individuals of varying age. PTB is visualized in about 80% of individuals well enough to be diagnostically useful. Its average width is 3 mm, and patient positioning can cause variations not exceeding 2 mm. Progressive widening by 2 mm or more, blurring of previously sharp margins or an overall width exceeding 5 mm should be considered suggestive of mediastinal or related abnormality.