Mannequin-assessed dry-heat exchanges in the incubator-nursed newborn

For manufacturers of warming devices for newborn infants, knowledge of the partition of the various channels of heat transfer between the neonate and the environment is necessary to regulate them adequately. The goal of this study was to determine the contributions of the different components of dry heat exchange using a thermal mannequin that replicated a full-term neonate. Each mannequin segment could be controlled separately at a selected surface temperature. The mannequin was placed in a reclining position on a mattress in a single-walled incubator (BioMS C2750). Conductive (K), convective (C), and radiative (R) heat exchanges were measured at incubator temperatures (T alpha) of 29 degrees, 32 degrees, and 34 degrees C and at air velocities (Va of 0 to 0.7 m/sec. Conductive heat exchanges varied from 4.5% to 7.9% of total dry heat loss (H). The conductive heat transfer coefficient was 0.21 W/degree C, and the mannequin surface area in contact with the mattress was 10.4% of the total surface area (A). Under natural convection, the convective and radiative heat transfer coefficients were 4.94 and 4.77 W/m2/degree C, respectively. The radiating surface area was 78% of total surface area. Convective heat exchange decreased from 36% to 17%, and radiative heat exchange increased from 60% to 79% of total dry heat loss as incubator temperature increased from 29 degrees to 34 degrees C. When air velocity was raised, convective heat exchange increased, whereas radiative heat exchange decreased. Whatever the incubator temperature, a fivefold increase in convective heat exchange was observed when air velocity increased, whereas radiative heat exchange was unchanged. At an incubator temperature of 34 degrees C and for air velocities between 0.1 and 0.4 m/sec radiative heat exchange is the dominant mode of heat loss. The results suggest that this thermal mannequin is a good tool for assessing dry heat exchange in incubators.

Autosomal dominant painful plantar callosities

We describe large kindred with an autosomal dominant condition characterized by painful callosities that develop over the pressure points of the soles. These callosities are not congenital; they arise with upright ambulation.

[Myelopathy induced by anticoagulant medication. Report of a case with spinal epidural hematoma]

A 51 year-old female patient, under anticoagulant therapy due to thrombophlebitis and pulmonary embolism, developed sudden paraplegia. Emergency myelogram showed a total block at L2 level and an epidural hematoma was removed at surgery, but the motor deficit remained unchanged post-operatively. The pertinent literature is reviewed, etiological considerations are made and emphasis is placed on early diagnosis and prompt treatment.

[Myopathy caused by propoxyphene: report of 2 cases with muscle histochemistry]

The cases of a 43 years old-man with gout and a 24 years-old woman with severe back pain who developed dextro-propoxyphene addiction during pain treatment are reported. They had severe edema and fibrosis of skin, subcutaneous tissue and muscle involving the upper and lower limbs. ESR was elevated, CPK and LDH were normal. EMG in proximal muscles showed decreased duration and voltage of potentials, excess of short polyphasics and increased recruitment (BSAP), with positive waves and fibrillations; distal muscles had fasciculations, fibrillations, positive waves, normal voluntary potentials, decreased recruitment. Lymphography indicate delayed progression of contrast media and obstruction in the thighs. Muscle biopsy on fresh-frozen section and histochemistry showed extensive connective tissue proliferation with intense acid and alkaline phosphatase activity in the perimysial and endomysial area, infiltration of lymphocytes near and around small vessels and capillaries. There were perifascicular and type II fiber atrophy. After discharge the patients returned to propoxyphene addiction and the symptoms who subsided during drug withdrawal come back again. New admission, new drug withdrawal and they were discharged free of symptoms and pathologic changes.

Open multicentre clinical trial of diftalone in osteoarthrosis

An open, multicentre trial was carried out in 140 patients with coxarthroxis and/or gonarthrosis to assess the effectiveness of treatment with diftalone. The trial lasted 4 weeks with a drug dosage decreasing from 1000 mg (Week 1) to 750 mg (Week 2), and to 500 mg (Weeks 3 and 4). In almost all of the objective and subjective assessments used for the measurement of effectiveness there was a statistically significant improvement with treatment, which was dose related, the greatest improvement being seen during the first week. Tolerance of treatment was assessed as good in the majority of patients and again, side-effects appeared to be dose related.