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Contrast-induced nephropathy (CIN) is a serious complication of angiographic procedures resulting from the administration of contrast media (CM). It is the third most common cause of hospital acquired acute renal injury and represents about 12% of the cases. CIN is defined as an elevation of serum creatinine (Scr) of more than 25% or ≥0.5 mg/dl (44 µmol/l) from baseline within 48 h. More sensitive markers of renal injury are desired, therefore, several biomarkers of tubular injury are under evaluation. Multiple risk factors may contribute to the development of CIN; these factors are divided into patient- and procedure-related factors. Treatment of CIN is mainly supportive, consisting mainly of careful fluid and electrolyte management, although dialysis may be required in some cases. The available treatment option makes prevention the corner stone of management. This article will review the recent evidence concerning CIN incidence, diagnosis, and prevention strategies as well as its treatment and prognostic implications.

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This unique postal survey was setup to assess the agreement on treatment options in displaced distal radius fractures and whether or not there existed a consensus amongst the surgeons contacted. With this in view we contacted 244 surgeons and 166 completed answers were received.We chose two common examples of displaced distal radius fractures. Case one was a 38 year old teacher with a closed, displaced extra-articular fracture (Frykman type II) of her left non-dominant hand and case two was a 42 year old carer, with a closed, displaced intra-articular fracture (Frykman type VII) of her right dominant wrist. There was a questionnaire included with these radiographs.In the first case, 82 (49%) surgeons favoured MUA + K-wiring, 47 (28%) favoured volar plating and 14 (8%) an external fixator. In the second case, 28 (17%) surgeons favoured MUA + K-wiring, 53 (32%) advocated volar plating and 33 (20%) an external fixator. Furthermore surgeons with specialist Upper limb interest were more likely to apply a volar plate (63% in either case) whilst the surgeons with general or other areas of expertise (18% in first case and 23% for second case).In conclusion there is no consensus among the Orthopaedic surgeons in treating displaced distal radial fractures. A multicentered randomized clinical trial would help elucidate the best treatment options.

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We report an unusual presentation of acute pancreatitis as a tender, irreducible, inguinoscrotal swelling mimicking a strangulated hernia. Lack of abdominal symptoms or signs can lead to misdiagnosis and unnecessary surgery.

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A simple, sensitive, and specific method for measuring the concentration of platinum in urine is reported. Urine specimens for this study were collected from laboratory staff and from patients who received treatment with cisplatin as a chemotherapeutic agent for cancer. The concentration of platinum was determined by inductively coupled plasma atomic emission spectrometry. The entrance slit of the simultaneous spectrometer, normally used for correction of optical alignment, was moved by the micrometer to shift the emission line of platinum onto the detector originally assigned to tellurium. Background correction was applied to compensate for spectral interference and thus enhance accuracy. The analytical detection limit was 0.05 mg Pt/L. At 10.0 mg Pt/L in spiked urines the recovery was 93.3% with a relative standard deviation of 6.6%. Storage for 10 days at 4 degrees C did not affect the recovery.

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Respiratory variables in 95 isocyanate workers and 37 control workers were compared. The exposed workers had a slightly higher frequency of cough and shortness of breath than the controls and a significantly lower frequency of family history of asthma, hay fever, and bronchitis. The isocyanate workers had slightly lower baseline lung function than the control workers but demonstrated significantly larger declines in their pulmonary function over the work shift. Both groups showed some intraday and intraweek variation in lung function. The changes in lung function over the work shift varied with different job categories, the largest changes occurring in finishing-area workers. A gradation of response was observed when exposure was categorized as nil, low, or high, but no exposure-effect relationships could be demonstrated by regression analysis of either area or personal results.

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Transmission electron microscopy (TEM) of asbestos on polycarbonate membrane filters prepared using the direct transfer (DT) method is used as a reference for determining the precision and accuracy of phase contrast microscopy (PCM) of the same filters and for determining the correlation between DT-PCM and the NIOSH method of asbestos analysis. Replicate aliquots of an aqueous suspension of chrysotile were filtered through either polycarbonate or cellulosic membrane filters. The polycarbonate filters were prepared using the DT method and analyzed using TEM and PCM; the cellulosic filters were treated and analyzed using the NIOSH method. Compared to the results of the TEM examination of the polycarbonate filters, about 50% of the fibers longer than 5 micron were detected using DT-PCM, which was more than 3 times the result obtained using the NIOSH method. The improvement in accuracy using DT-PCM is attributed to the increased visibility of thin fibers (diameters less than 0.1 micron). The largest variation in results was found to be due to the fiber distribution on the filters. This factor may be eliminated from interlaboratory comparisons, etc. by the use of pre-designated and well-defined fields-of-view.

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Aqueous chlorination of many organic substances has been found to produce substantial mutagenicity in Salmonella typhimurium TA100. An effective way to decrease such mutagenicity is to raise the pH of the solutions to neutrality or higher. The effect of pH on the mutagenicity of the filtrate from the chlorination of unbleached kraft wood pulp and of certain mutagens found in such filtrates has been investigated. The decay of mutagenicity of the known mutagens has been shown to proceed by cleavage of organically bound chlorine by hydroxide ion. Caution is recommended with respect to the practice of raising the pH of solutions for mutagenesis assays.

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Aqueous chlorination of catechol (4 and 8 mM) at varying reagent ratio has been shown to produce high mutagenicity with the Ames Salmonella strain TA100. The mutagenicity peaks at 3 equivalents of chlorine per mole of catechol. But the mutagens are unstable in neutral and alkaline solutions. Substituted catechols produce less mutagenic solutions than catechol on aqueous chlorination. If the chlorine is replaced with equivalent chlorine dioxide very little mutagenicity is produced. Among the reaction products are chlorinated catechols; all of these were synthesized, none was mutagenic but some were toxic. The sample oxidation products, o-benzoquinone and chloro-o-benzoquinone, have been identified and through synthesis were proven to be mutagenic. Some possible ring fracture products also become mutagenic after reaction with aqueous chlorine. Catechol and other simple phenolic substrates are model compounds for the aqueous reaction of chlorine with wood pulp, sewage water and potable water.

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