Lancet
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Fluorescein angiography was used to study retinal microvascular perfusion in 20 patients undergoing coronary artery surgery. Colour retinal photographs and fluorescein angiograms were obtained preoperatively and at 5-14 days postoperatively. ⋯ No new pathological features appeared in the retina after surgery. Intraoperative fluorescein angiography of the retina may prove valuable for investigation of cerebrovascular microembolism in the territory of the internal carotid artery during cardiopulmonary bypass in man.
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Casualties from a nuclear attack on the United Kingdom would overwhelm the health services, and health workers would be faced with many more people seeking help than could be offered treatment. Discussion is needed to determine which methods of medical and non-medical triage would be acceptable and feasible.
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500 consecutive Danish women who had full-term babies were interviewed on the third or fourth day post partum and asked about smoking in all household members. Exposure to smoking by the mother was found to reduce birth-weight, and indirect or passive exposure to smoking by the father had nearly as large (66%) an effect. ⋯ This relation remained statistically significant after controlling for mother's age, parity, alcohol and tobacco consumption during pregnancy, illness during pregnancy, and social class and sex of the baby. The effect of passive smoking was greatest in the lower social classes.
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Between January, 1977, and March, 1986, 200 patients were registered as receiving home parenteral nutrition (HPN) in the UK and the Republic of Ireland. Although 28 centres contributed case-reports, 75% of the cases were registered by 7 centres. Most patients started treatment between the ages of 10 and 40 years, a reflection of the high incidence of Crohn's disease during these decades. ⋯ Patients whose indication for HPN was a primary intestinal disease had a better quality of life than did those in whom the intestinal failure was secondary to a systemic disorder. Of the 108 patients who have completed treatment 56 have been able to resume enteral nutrition through adaptation of the remaining bowel, or closure of a fistula. 34 have died, 19 as a consequence of the underlying disease and 10 of complications of treatment. The incidence of catheter-related sepsis varied between 0.2 and 0.9 episodes per year of treatment (overall 0.35) depending on the length of experience of the supervising centre.