Search

Background Angiographic assessment is an alternative to computerised tomography (CT) prior to endovascular aneurysm repair (EVAR). We evaluated angiography in aortic neck morphology assessment as an alternative investigation. Methods Patients admitted for elective or emergency EVAR were assessed by pre-operative CT and intra-operative angiography. The proximal and distal aortic neck diameters, and neck length were measured. Measurements were expressed as median (95% CI). Results 35 patients (20 male) were assessed from August 2003 to January 2005 for elective (26) and emergency (9) EVAR. In the overall group, the proximal neck diameter was 22.0mm (21.0–23.0) on CT, and 20.7mm (19.3–22.3) on angiography. The distal neck diameter was 23.0mm (22.0–24.0) on CT, and 22.3mm (20.3–24.6) on angiography, while the neck length was only slightly greater on angiography [23.0mm (17.5–28.4)] relative to CT [23.0mm (20.0–28.0)]. The stent-grafts deployed were oversized by 26.8% (± 14.8%) relative to the CT measurements, and 33.7% (± 15.6%) relative to angiographic measurements. Good correlation was found for all three measurements between CT and angiography. Conclusions Angiography alone is inadequate for endovascular aneurysm repair. Although it has timesaving potential, the accuracy achieved is not sufficient to use alone.

BACKGROUND: Occupational exposure to irritants is associated with chronic bronchitis. The aim of this study was to elucidate whether repeated peak exposures with respiratory symptoms, gassings, to sulphur dioxide (SO2) and other irritant gases could increase the risk of chronic bronchitis. METHODS: The study population comprised 3,060 Swedish pulp mill workers (84% males) from a cohort study, who completed a comprehensive questionnaire with items on chronic bronchitis symptoms, smoking habit, occupational history, and specific exposures, including gassings. 2,037 have worked in sulphite mills. Incidence rates and hazard ratios (HRs) for the observation period, 1970-2000, in relation to exposure and the frequency of repeated gassings to SO2 and other irritant gases were calculated. RESULTS: The incidence rate for chronic bronchitis among workers with repeated gassings was 3.5/1,000 person-years compared with 1.5/1,000 person-years among unexposed workers (HR 2.1, 95% confidence interval (CI) 1.4-3.1). The risk was even higher in the subgroup with frequent gassings (HR 3.2, 95% CI 2.0-5.2), particularly among never-smokers (HR 8.7, 95% CI 3.5-22). CONCLUSIONS: Repeated gassings to irritant gases increased the incidence of chronic bronchitis in our study population during and after work in pulp mills, supporting the hypothesis that occupational exposures to irritants negatively affect the airways. These results underscore the importance of preventive actions in this work environment.

This study investigates the measurement equivalence of a five-factor measure of personality across two groups applying for jobs, who completed the same questionnaire using either a paper-and-pencil ( n = 429) or a web online answer format ( n = 651). The data were collected using the Big Five Questionnaire–2 (BFQ-2; which is a measure of the Five Factor Model) of personality traits. Multiple-group confirmatory factor analysis was used to test for the equivalence of factor covariance and mean structures of the BFQ-2. Findings suggested that the Five Factor Model scales have the same measurement unit and origin across applicants using different administration modes. However, latent means were slightly higher for applicants who responded in a web and unproctored condition than for applicants who completed a paper-and-pencil version of the same test. Practical implications for personality assessment are discussed.

Background: The apparent differences in risk factors for intra- and extracranial atherosclerosis are unclear and the mechanisms that underlie strokes in patients with intracranial atherosclerosis are not well known. We investigated the conventional vascular risk factors as well as other factors in stroke patients with large artery atherosclerosis. Methods: Using diffusion weighted imaging (DWI) and vascular and cardiologic studies, we selected patients with acute non-cardioembolic cerebral infarcts within the middle cerebral artery (MCA) territory. Patients were divided into two groups: those with atherosclerotic lesions on the carotid sinus (n = 112) and those with isolated lesions on the proximal MCA (n = 160). Clinical features, risk factors, and DWI patterns were compared between groups. Results: There were no differences in conventional risk factors, but markers for inflammation were significantly higher in patients with carotid atherosclerosis than in those with isolated MCA atherosclerosis (p

Objective: To estimate the mortality of progressive supranuclear palsy (PSP) and to assess the quality of death certification in patients with PSP who died in England and Wales. Methods: An analysis was conducted of ICD-9 (International Classification of Diseases, version 9) coded deaths obtained through the Office of National Statistics over an eight year period. Results: The crude annual mortality rate was 1.77 (95% confidence interval, 1.64 to 1.90) cases per million, using the mid-1996 population estimate for England and Wales. Annual mortality increased over time, possibly as a result of increased incidence or increased awareness of the disorder. Forty nine death certificates from deceased patients previously diagnosed clinically showed that the commonest proximate cause of death was pneumonia, occurring in 45% of cases (22/49). The underlying cause of death was cited as pneumonia in 14% of cases (7/49). PSP was mentioned in only 65% of death certificates (32/49). Eight of the 49 cases (16%) underwent necropsy and results were available for five of these cases. PSP was confirmed pathologically in four; the remaining case was diagnosed as Parkinson's disease. Conclusions: Further research is needed to establish the reasons for the observed increase in mortality. Determining the population mortality rate for PSP using the ICD-9 coding system is problematic but is likely to improve following the introduction of ICD-10 updated codes and coding rules.