Flame retardants in indoor air at an electronics recycling plant and at other work environments.

Air samples from a plant engaged in recycling electronics goods, a factory assembling printed circuit boards, a computer repair facility, offices equipped with computers, and outdoor air have been analyzed with respect to their content of brominated hydrocarbon and phosphate ester flame retardants. Polybrominated diphenyl ethers, polybrominated biphenyls, 1,2-bis(2,4,6-tribromophenoxy)-ethane, tetrabromobisphenol A, and organophosphate esters were all detected in the indoor air samples, with the highest concentrations being detected in air from the recycling plant. In air from the dismantling hall at the recycling plant the average concentrations of decabromodiphenyl ether, tetrabromobisphenol A, and triphenyl phosphate were 38, 55, and 58 pmol/m3, respectively. Significantly higher levels of all of these additives were present in air in the vicinity of the shredder at the dismantling plant. This is the first time that 1,2-bis(2,4,6-tribromophenoxy)-ethane and several arylated phosphate esters are reported to be contaminants of air in occupational settings. At all of the other sites investigated, low levels of flame retardants were detected in the indoor air. Flame retardants associated with airborne particles, present at elevated levels, pose a potential health hazard to the exposed workers.

Greek immigrant children in southern Sweden in comparison with Greek and Swedish children. III. Energy and nutrient intake.

Greek immigrant children (GI) belonging to the second generation of immigrants in Sweden have been compared with Swedish children (S) and Greek children in Greece (G) regarding energy and nutrient intake. Twenty-four-hour recalls were obtained in the homes of the families. The mean energy intake was the same in all three groups and met the Swedish Nutrition Recommendations. The energy distribution for protein, carbohydrates and fat was also similar. The fat intake was far above the recommended level in all groups. The GI and the G group had a significantly higher mean daily intake of monounsaturated fatty acids than the S group (p less than 0.05 and p less than 0.001, respectively). Children aged four to eight years in the GI group had a significantly higher nutrient density of retinol, vitamin D, riboflavin, vitamin B6, calcium, iron, magnesium and sucrose compared to the G group, but compared to the S group they had a lower nutrient density of retinol, vitamin D, ascorbic acid, niacin, vitamin B12 and selen. The GI children consumed more milk than the G children but as much as the S children and they had started to use enriched low-fat milk in Sweden. In conclusion, the food quality in the GI group was better than in the G group and much the same as in the S group, and, with few exceptions, it met the Swedish Nutrition Recommendations.

Reinforced anatomical reconstruction of the anterior talofibular ligament in chronic anterolateral instability using a periosteal flap.

Twenty-eight consecutive ankles with chronic severe lateral instability were treated by reinforced anatomic reconstruction using a periosteal flap from the lateral aspect of the fibula. At the followup after a median of 24 months, 86% had excellent or good functional results. This result compares favorably with other techniques. As the results after tenodesis appear to deteriorate with time, anatomic reconstruction is recommended. No complications were encountered. No statistical correlation was found between clinical and radiological versus functional instability at followup.

Studies on perceived breast milk insufficiency. III. Consequences for breast milk consumption and growth.

Fifty-one mother-infant pairs were followed prospectively during the period 3 days to 18 months after delivery. In total 54.9% of the mothers experienced transient lactation crises, emanating mostly from a perception of breast milk insufficiency. Within the crisis group no significant difference in the infants' intake of breast milk during the crises compared with control measurements 1 week later was found. Nor had the crises any immediate impact on growth of the infants. A comparison between the crisis and the non-crisis group, revealed that the breast milk consumption in the crisis group was throughout lower with significant differences at 3 and 5 months. The infants in the crisis group also had a significantly lower weight at 2, 3, 4 and 9 months and were significantly thinner for their height at 1-6 months and at 9 months, although both groups were above the NCHS mean. We conclude that even if the infants in the crisis group had a lower consumption and a slower growth development, the differences were comparatively small. Furthermore, evidence was provided that the breast milk insufficiency occasionally perceived as acute by the mothers was in most cases not real.

Nutrition and health in Swedish children 1930-1980. Three nutrition surveys in a northern Swedish county.

In 1930 a nutrition survey was made of 1675 school children in the county of Västerbotten in northern Sweden. In 1967 a second survey was carried out in the same area, covering 1411 children aged 4, 8 and 13 years. A third survey was carried out in 1980 of 572 children in the same age groups. In the first survey questionnaires concerning food consumption were used, in the two later surveys 24-hour recall of food intake was recorded. Underweight and iron deficiency anaemia were prevalent in 1930. Since then socio-economic conditions have improved dramatically and dietary habits have become more diversified. In the last study the average energy intake had decreased from 100 to 87% of the RDA. A slight increase in the prevalence of overweight among 13-year-old children was also noted. The fat intake was lower in 1980 than in 1967, but the P/S-ratio was still low (0.23). The iron intake reached a satisfactory level in the two later studies and no case of iron-deficiency anaemia was found in 1980. In spite of a relatively frequent sucrose intake dental health had improved as a consequence of other prophylactic activities. The malnutrition problems of 1930 have been eradicated but new nutritional problems, linked to the risk of developing obesity and health problems in adulthood such as coronary heart disease, call for new preventive strategies.

[Foot injuries caused by a chain saws]. / Fodlaesion ved anvendelse af motorkaedesav.

Two cases of chain saw injuries of the foot are reported. The protective footwear did not provide sufficient protection. Suggestions are made for improving the footwear and for compulsory approval of the safety equipment.

Clinical fracture of the carpal scaphoid--supportive bandage or plaster cast immobilization?

In a prospective study of 108 patients with a clinical diagnosis of fracture of the carpal scaphoid, but without radiological evidence of fracture, the patients were randomised to treatment with either a supportive bandage or a dorsal plaster cast. Four patients proved to have incomplete fractures and three to have avulsions from the scaphoid tuberosity. Two of the fractures had been suspected radiologically at the primary investigation. No complete fractures of the scaphoid were seen. The average time in plaster was 15 days and in a bandage 12.2 days. The average sick leave for manual workers was 14 days in plaster and 4 days in a bandage, a difference that represents a significant loss of productivity. Since these fractures almost always heal irrespective of treatment, they may as well be treated as a soft tissue injury with a supportive bandage.

Diets of healthy Swedish children 4-24 months old. II. Energy intake.

In a semi-longitudinal investigation comprising a total of 81 infants studied at one or more of the ages 4, 9, 15 and 24 months, the food intake was recorded on three consecutive days at 4 months and on seven consecutive days at 9, 15 and 24 months (40, 40, 38 and 40 infants, respectively in the four age groups). The median energy intake was lower than the Recommend Dietary Allowances in all age groups. The energy intake derived from fat was low among some of the 9-month-old infants. The contribution of sucrose to energy was as high as 10% at 24 months.

Diets of healthy Swedish children 4-24 months old. III. Nutrient intake.

In a semi-longitudinal investigation comprising a total of 81 infants studied at one or more of the ages 4, 9, 15 and 24 months, the food intake was recorded on three consecutive days at 4 months and on seven consecutive days at 9, 15 and 24 months (40, 40, 38 and 40 infants, respectively in the four age groups). The formula-fed 4-month-old infants had a markedly higher intake of all nutrients, except fat and retinol, than the breast-fed ones. In the three oldest age groups the nutrient intake was high as compared with RDA. The protein intake was exceptionally high. Median intakes that were definitely lower than RDA were noted only for vitamin D, iron and zinc. The nutrient density changed from the age of 9 to 24 months, indicating a transition during that period from infant to adult food habits.

Physical activity in relation to energy intake and body fat in 8- and 13-year-old children in Sweden.

A random sample of 682 8- and 13-year-old children resident in Sweden was studied with regard to physical activity, energy intake, height, weight and skinfold thickness. A reduction of physical activity over the years was indicated by a tendency towards a higher body fat content in spite of a lower mean energy intake as compared with such values obtained 10-15 years ago in Swedish children of equal ages. Children characterized by high habitual physical activity tended to have a lower body fat content, despite a higher energy intake, than less active children. Children, especially girls, of parents with a low educational level showed a tendency towards higher body fat content as compared with those of parents with higher education.

Adenocarcinoma of the colon presenting as lower extremity gas gangrene (metastatic myonecrosis). Case report.

Nontraumatic metastatic gas gangrene is often associated with occult gastrointestinal malignancies. Usually an ulcerative lesion of the intestinal mucosa serves as portal of entry for the clostridia. Unless treatment is promptly instituted the patients die from overwhelming sepsis within days. Patients surviving should be assumed to harbor an underlying malignancy until proved otherwise.

Ligation of the renal vein during resection of abdominal aortic aneurysm.

In resection of abdominal aortic aneurysm, ligation and division of the left renal vein may be necessary in order to expose the perirenal aorta. This manoeuvre is possible, with conservation of the left kidney function, because of the extensive venous collateral circulation of the left kidney. It is of crucial importance however, that ligation of the vein is performed close to the inferior vena cava. A case is presented where ligation of the left renal vein was performed in relation to an operation for a ruptured abdominal aortic aneurysm. After the operation there was initially dysfunction of the left kidney, and later on sepsis-induced uraemia. The renal function stabilized at a moderately reduced level. No permanent kidney damage related to the venous ligation could be demonstrated. In the literature serious renal damage has been reported in 10 cases out of 89 reported ligations of the left renal vein. Ligation of the left renal vein is thus a reasonably safe and acceptable procedure for surgical exposure in difficult aortic procedures.