Lancet
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Comparative Study
Comparison of intrathoracic and intra-abdominal measurements of central venous pressure.
Complications can arise from standard intrathoracic central venous pressure (CVP) measurements in critically ill, mechanically ventilated patients. We have assessed the feasibility of catheterisation by the femoral route to measure CVP in the abdomen (ACVP). We compared measurements by the standard jugular or subclavian route (TCVP) with simultaneous ACVP measurements by the femoral route. ⋯ Our study showed that for clinical purposes CVP can be measured by a femoral catheter placed in the abdominal inferior vena cava near the right atrium. This approach can replace standard TCVP measurements in critically ill, mechanically ventilated patients.
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A winter excess of ischaemic stroke has been found in mortality and hospital-based studies. It is often assumed that this is due to seasonal variation in stroke incidence and several pathophysiological explanations have been proposed. We studied the incidence of stroke in relation to season and outside temperature. ⋯ The widely reported winter excess of ischaemic strokes may be an artifact due to referral bias in hospital-based studies and increased case fatality during the winter in mortality studies.
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Epidemiological surveillance of Creutzfeldt-Jakob disease (CJD) was reinstituted in the UK in 1990 to identify any changes in the occurrence of this disease after the epidemic of bovine spongiform encephalopathy (BSE) in cattle. ⋯ These cases appear to represent a new variant of CJD, which may be unique to the UK. This raises the possibility that they are causally linked to BSE. Although this may be the most plausible explanation for this cluster of cases, a link with BSE cannot be confirmed on the basis of this evidence alone. It is essential to obtain further information on the current and past clinical and neuropathological profiles of CJD in the UK and elsewhere.