Dan Med Bull
-
Retrospective studies have indicated that operating room personnel may have increased risks of spontaneous abortion, congenital malformations in offspring, and cancer (Cohen et al 1980, Buring et al 1985). Occupational exposure to waste anaesthetic gases may be responsible for these possible adverse health effects, but a cause-effect relationship has never been proved. Induction of changes in the DNA in the chromosomes leading to mutations may play a role in teratogenicity and carcinogenicity. ⋯ The author and his associates used the SCE test to investigate the possible mutagenicity of anaesthetic gases after exposure in vivo. From extensive methodologic studies of possible confounding factors it was concluded that each of the factors sex, age, and smoking habits contributed significantly to the interpersonal variation of SCE frequencies, whereas use of oral contraceptives did not influence the SCE rates. The potential mutagenicity of inhalation anaesthetics was studied after exposure in vivo in two settings: (1) Acute exposure to anaesthetic concentrations, and (2) Chronic occupational exposure to trace concentrations.(ABSTRACT TRUNCATED AT 400 WORDS)
-
Although falls among the elderly carry high costs to individuals and society, the prevention of falls in later life has not received adequate attention from health care professionals. The prevalence of falls appears to involve roughly one-third of persons aged 65 and over, and the risk of falling and suffering serious injury increases substantially up to the eighth decade of life. The proportion of falls which result in fracture is low, but the absolute number of older people who suffer fractures is high and places heavy demands on health care systems. ⋯ The report underscores that the causes of falls are very different for persons of varying ages, health status, and levels of mobility. While the many risk factors for falls are not yet known, poor health status, especially chronic illness, impaired mobility and postural instability, and a history of prior falls have been associated with the risk of falling. Balance, the ability to prevent falls upon displacement, can be impaired by disease or age-related changes in a number of anatomical structures, by medications which reduce their efficient functioning, and by environmental hazards.(ABSTRACT TRUNCATED AT 400 WORDS)
-
Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative pain relief and respiratory performance after thoracotomy: a controlled trial comparing the effect of epidural morphine and subcutaneous nicomorphine.
Twenty patients scheduled for lateral thoracotomy were randomly allocated to receive either epidural morphine at regular intervals or subcutaneous nicomorphine on demand for postoperative pain relief. The daily dose of opiate administered was greater in the group receiving subcutaneous nicomorphine than in the epidural group although four patients in the latter needed additional subcutaneous injections of opiate. ⋯ No significant difference could be demonstrated between the group;s. The conclusion is that epidural morphine may produce sufficient pain relief after thoracotomy, but compared with conventional pain treatment the benefits are limited.