Lancet
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Absorption of irrigating solution during transcervical resection of endometrium can cause dilutional hyponatraemia, nausea, and cerebral oedema. We studied 6 patients who absorbed more than 1500 mL of 1.5% glycine, and 14 patients who absorbed less. ⋯ None of the 10 patients who absorbed less than 500 mL had nausea; changes on CT scan suggestive of cerebral odema were found in 1. 8 patients who absorbed 1000 mL or more had a decrease in serum sodium of 10 mmol/L or more, nausea, and cerebral oedema on CT scan. Cerebral oedema may contribute to the development of postoperative nausea in patients undergoing transcervical surgery who absorb more than 500 mL of 1.5% glycine irrigating solution.
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When setting standards for protection against ionising radiation it has been usual to extrapolate from experience with high-dose short-term exposure--studies based on atom bomb survivors and patients exposed to radiation therapeutically. Those who work in the nuclear industry are exposed to low-level predominantly gamma radiation for longer periods, and provide an alternative direct source of information. We have combined mortality data from seven cohort studies on nearly 96,000 nuclear industry workers monitored for external radiation in Canada, UK, and USA to assess directly the carcinogenic effects of protracted low-dose exposure to ionising radiation. ⋯ This estimate is consistent with a range of risks varying from negative to nearly twice those estimated from atomic bomb survivors (0.18 per Sv). These are the most precise direct estimates so far made of carcinogenic risk after protracted exposure to low-dose ionising radiation. They provide little evidence that the estimates that form the basis of current radiation protection recommendations are appreciably in error.