Managing fish, flood plains and food security in the Lower Mekong Basin.

The "Lower Mekong Basin" in this paper refers to the part of the Mekong River Basin which is shared by Cambodia, Laos, Thailand and Viet Nam, all members of the Mekong River Commission, consisting of approx. 2,400 km of mainstream river, numerous tributaries and huge flood plains. Few river basins produce as much fish as the Mekong River Basin, and the fishery in the Lower Mekong Basin is among the biggest and most productive inland fisheries in the world. The flood plains of the Lower Mekong produce some four times as much fish per square kilometre as the North Sea, which is among the most productive marine areas in the world. It is quite clear that the fisheries in the Mekong Basin are very important for the population in respect to their food security and income. Its importance in nutrition is highest in the rural areas, where there are few other low cost sources of protein, and even in highland areas fish is of crucial importance in the diet. Most fish species in the Mekong Basin are migratory, and the economically most important ones are certainly so. However, with economic development gaining speed, the impact on migratory patterns and the competition for the water resources are becoming stronger. The water resources offer a large number of opportunities, and a lot of economic activities need access to the water resources for their development. However, what is seen in one sector as an opportunity may be considered as a threat in another, and a careful balance is necessary in order not to lose opportunities in important sectors. The fate of a large number of river basins in the world is frightening. Most have been left biologically near dead, with some of the big rivers reduced for a time, or forever, to be used as waste water canals for the new industries, and others almost dried out from excessive water extraction before they reach the sea.

Capillary plasma neutrophil elastase alpha-1-proteinase inhibitor as infection parameter in neonates.

Raised plasma neutrophil elastase has been reported to be an early and effective marker of infection in neonates. In order to assess the feasibility of implementing a rapid assay on capillary plasma, repeated heel prick samples were taken in a series of 79 neonates with clinically suspected bacterial infection, comparing the elastase response with C-reactive protein (CRP) and with the band:mature neutrophil ratio. Rises in elastase were in agreement with rises in CRP, but were more frequently manifest at onset of symptoms, showing elastase to be a more rapid marker of infection as previously described. However, 23% of elastase measurements either failed due to haemolysis or coagulation or yielded inexplicably high values. Comparison of simultaneous bilateral heel prick values confirmed unacceptable variation, unlike comparison of paired venous samples or venous and capillary samples from adults, indicating that capillary blood sampling in neonates produces an unpredictable release of neutrophil elastase. Thus, in newborn infants samples for determination of elastase should be taken by venous punctures or from indwelling catheters.

[Complications of epidural bupivacaine analgesia in vaginal labor]. / Komplikationer til epiduralanalgesi med bupivakain ved vaginal fødsel.

Epidural analgesia is accepted as a good and effective method of analgesia in labor. The method is, however subject to a variety of complications, the worst being life long sequelae and death. The article presents a survey of the complications of bupivacaine epidural analgesia in labour and state prophylactic measures and treatments. The existing literature on the field is commented and criticized.

Uterine torsion in pregnancy.

Torsion of the pregnant uterus is defined as rotation more than 45 degrees around the long axis of the uterus. Uterine torsion is observed in all age groups of the reproductive period, in all parity groups, and at all stages of pregnancy. Torsion from 60 degrees to 720 degrees has been described. It is not possible to clarify why uterine torsion occurs, but numerous abnormalities have appeared with uterine torsion; most often, abnormal fetal presentation, myoma uteri and uterine malformations. The most usual symptoms of uterine torsion are birth obstruction, abdominal pain, vaginal bleeding, shock, and urinary and intestinal symptoms. Eleven percent are asymptomatic. The treatment in the earlier months of pregnancy is immediate laparotomy and detorsion of the uterus and, if practicable, adjunct surgery to eliminate the possible etiologic factors. Near term or during labor cesarean section is carried out, and elimination of the possible etiologic factors. The fetal and maternal mortality rates since 1976 are 12% and 0% respectively.

Pathologic torsion of the pregnant uterus.

A case of 90 degrees C dextro-torsion of the uterus in the 36th gestational week is reported. The case was asymptomatic and was discovered at cesarean section carried out because of transverse lie following rupture of the membranes. Mother and child were discharged in perfect health.

[Carcinoid syndrome misinterpreted as an allergic reaction]. / Karcinoidt syndrom forvekslet med allergisk reaktion.

A case of the carcinoid syndrome in a woman aged 65 years is reviewed. The condition was initially interpreted and treated as allergy. The carcinoid syndrome should be borne in mind in cases of recently-developed allergy in elderly patients.

[Outpatient legal abortion. 500 operations with paracervical anesthesia]. / Ambulant abortus provocatus legalis. Femhundrede indgreb udfort i paracervikal anaestesi

PIP: A study is presented of 500 outpatient abortions performed with paracervical anesthesia before the 12th week of pregnancy. After tests and consultation, 20 mg diazepam was given im 1 hour before the operation. A paracervical blockade was established with 5 ml Carbocainnoradrenalin 1% applied to each of the 4 quadrants. After 10 minutes the cervical canal was dilated a.m. Hegar to 1 number larger than the aspiration curette to be used. The uteral cavity was evacuated by aspiration, at 500 mm Hg vaccuum followed by a stump curette. Patients were given 1 ml Methergin iv during the evacuation, observed for up to 2 hours afterwards, and then sent home. Frequency of perforations with this procedure was .4%, reevacuation 2.0%, adnexitis 1.6%, pyrexia 1.8%, and vasovagal reaction .4%. There was no significant increase in hemoglobin level in patients. 82% of the patients found the method acceptable. The low rate of complications make the method very suitable for outpatient abortions.^ieng