Combining isotope ratios for provenancing Viking Age iron artefacts in the British Isles: a pilot study.

Stable and radiogenic isotope analysis - particularly using lead isotope analysis (LIA) - has previously been shown to be a useful tool for the provenancing of ancient metal artefacts of silver and copper and its alloys, but less progress has been made in the provenancing of iron artefacts, despite their importance and frequency in the archaeological record. In this pilot study we investigate for the first time the possibilities of iron isotope analysis in combination with trace strontium isotope analysis and LIA for the provenancing of iron objects believed to be from the Viking Age in the British Isles. Previous studies have shown that analysis of each of these isotopes can contribute to provenancing iron artefacts, but they are not individually resolutory. In this proof-of-concept study, we examine the Fe, Sr and Pb isotopes of 7 artefacts believed to derive from the Viking Age: 3 from Meols - a former Viking seaport on Wirral and 4 samples from the probable location of the AD 1066 Battle of Fulford in North Yorkshire. We also examine an additional artefact of unknown antiquity from Bebington Heath - a possible location of the AD 937 Battle of Brunanburh. Although the pilot data set is too small to make definitive conclusions, it has paved the way for a fuller study involving 100 samples (including 30 from the former Viking camp of Torksey, Lincolnshire) funded by the NEIF fund of the UK National Environmental Research Council. The high range of 87Sr/86Sr values in the present data set of 8 is beyond what would be expected for bog iron (with a cut-off ∼ 0.709) and suggests that mined ore was being used, a preliminary conclusion supported by the narrow range of Fe isotope data.

Unreliability of home blood pressure measurement and the effect of a patient-oriented intervention.

BACKGROUND: Home blood pressure (BP) measurement (HBPM) is recommended for the diagnosis and follow-up of high BP. It is unclear how this aspect of BP monitoring has evolved over the years and whether interventions could influence patient adherence to HBPM guidelines. METHODS: After a questionnaire-based cross-sectional study performed in 2010, a passive, multimodal intervention, focused on improving adherence to HBPM guidelines, was implemented. A second study was conducted in 2014 to measure its effect. RESULTS: In 2010 and 2014, 1010 and 1005 patients, respectively, completed the questionnaire. In 2010 and 2014, 82% and 84% of patients, respectively, self-measured their BP. Reporting of HBPM and adherence to recommended procedures was suboptimal. Only 34.0% of patients in 2010 and 31.7% in 2014 brought > 80% of their measurements to their doctor. Only 49.6% in 2010 and 52.9% in 2014 prepared > 80% of the time for HBPM. Only 48.1% in 2010 and 52.1% in 2014 rested for 5 minutes > 80% of the time before HBPM. Only 15% of patients in 2010 and 18% in 2014 were defined as sufficiently compliant with all HBPM procedures. Paired analysis of a subset of 535 patients who participated in the 2010 and 2014 studies showed no clinically significant differences in reliability between the 2 surveys. CONCLUSIONS: Adherence to HBPM guidelines was suboptimal in 2010 and still is in 2014 despite a passive, multimodal intervention. Active training in HBPM procedures should be studied. Greater automation could improve HBPM reliability.

[History of trachoma in canada]. / Histoire du trachome au Canada.

The author retraces the history of trachoma in Canada. The numerous articles in Canadian medical journals from the middle of the 18th to the middle of the 19th century show the remarkable contribution of Canadian ophthalmologists. The clinical symptoms and signs followed by the etiology and the different modes of treatment are reviewed. The presence and prevention of trachoma in Canada, ranging from Montreal to Toronto, also in Halifax with the arrival of the transatlantic immigrants, as well as those reaching the western provinces of Canada are described. How the Canadian Department of Health belatedly introduced a prevention campaign only after a widespread dissemination of trachoma across the country is also examined.

[Sympathetic ophthalmia, enigmatic malady]. / Ophtalmie sympathique, maladie énigmatique.

Sympathetic ophthalmia was a well-known but greatly feared entity in the 19th and most of the 20th century. This article reviews the Canadian medical literature, tracing the prophylactic and therapeutic modalities offered to treat this blinding affliction.

[Ophthalmia neonatorum of the newborn and its treatments in Canadian medical publications: 1872-1985]. / L'ophtalmie du nouveau-né et ses traitements á la lecture des publications médicales canadiennes: 1872-1985.

In the 19th century the occurrence of ophthalmia neonatorum had reached alarming rates in the maternity wards not only of Europe but also across Canada. The impact of this blinding ocular infection on Canadian medicine from 1872 to 1985 is examined through a review of 80 medical journals, books, and lay press articles of that period. The prophylactic and therapeutic use of 2% silver nitrate introduced by Credé in 1880 to prevent neonatal blindness is reviewed. The signs, symptoms, and corneal complications of this disease as well as the multiple ocular drugs used during this era will be presented. The judicial consequences on midwives and obstetricians will be discussed. The subsequent use of colloidal silver based agents such as collargol, protargol and argyrol followed by the introduction of sulfonamides and finally the routine use of prophylactic topical antibiotics will be reviewed.

[Not Available]. / Regard sur les lazarets en terre canadienne.

Puisant dans les nombreuses références qu'offrent les publications médicales canadiennes du milieu du XIX(e) siècle à nos jours, l'auteur fait découvrir l'existence de lazarets en terre canadienne, décrit l'impact de la maladie sur les conditions vie des lépreux qui y étaient confinés et en souligne les contrecoups tant sur le plan physique et psychologique que social. Il présente un bref aperçu de la maladie, ses symptômes, ses signes ainsi que ses complications oculaires et rappelle les premiers moyens thérapeutiques à base d'huile de chaulmoogra introduits dans la colonie de Tracadie vers 1901. Il illustre son propos en évoquant la vie dans les lazarets de l'île de Sheldrake (1844-1848) et de Tracadie (1848-1965) au Nouveau-Brunswick, puis dans ceux des îles D'Arcy (1891-1924) et de Bentinck (1924-1957) en Colombie-Britannique.

[View of the canadian history of corneal transplantation]. / Regard sur l'histoire canadienne de la greffe de la cornée

The author presents a brief chronological summary of early attempted corneal grafts over the last century culminating in the first successful Canadian keratoplasty by Dr. Jean Audet-Lapointe in Montreal on April 20, 1945. Medical journals of the day retrace the early experiences at various Canadian medical centres with this new innovative surgical procedure. Testimonials from newspaper clippings highlight the professional career of Dr. Jean Audet-Lapointe. The role and support of the CNIB in Montreal and Toronto in establishing the Canadian Eye Bank Service are also presented.

Orbit and eyelid hemangiomas: is there a relationship between location and ocular problems?

PURPOSE: Infantile hemangiomas of the orbit and eyelid can cause serious ocular problems, such as astigmatism and amblyopia. Magnetic resonance imaging and ultrasonography are the best ways to establish the diagnosis and to evaluate the extent of the lesion. Our goal was to correlate the lesion location with the visual impairment. MATERIAL AND METHODS: This was a retrospective study (1992-2004) of 63 cases of orbit and eyelid hemangiomas (13 male, 50 female patients; ages: 1 day old to 3 years old). Imaging methods were magnetic resonance imaging or computed tomographic-scanning and color Doppler ultrasonography. The anatomic definition was palpebral, extraconal, and extraconal with intraconal involvement. All patients had ophthalmologic evaluations. RESULTS: The hemangiomas were palpebral (n = 32) (normal vision: 19; amblyopia and/or astigmatism: 13), extraconal, and extraconal with intraconal involvement (n = 31) (normal vision: 4; amblyopia and/or astigmatism: 27). LIMITATIONS: This study was small; a prospective study is needed. CONCLUSION: Orbit and eyelid hemangiomas need to be carefully evaluated by an ophthalmologist. Extraconal and intraconal hemangiomas are more frequently associated with ocular involvement. However, ocular complications can occur in palpebral lesions.

Morning glory syndrome: clinical, computerized tomographic, and ultrasonographic findings.

OBJECTIVE: To evaluate the ophthalmic, radiologic, and ultrasonographic findings in morning glory syndrome. PATIENTS AND METHODS: Retrospective review of patients' charts. RESULTS: Twenty-one patients were included. Visual acuity was 20/200 or better in 50% of the eyes. Three eyes developed a retinal detachment. When computerized tomography of the orbit demonstrated peripapillary scleral staphyloma and intraocular calcifications, this correlated with poor visual acuity. Computerized tomography of the brain revealed abnormalities in three asymptomatic patients. B-scan ultrasonography demonstrated retinal tissue overhanging the peripapillary scleral staphyloma. CONCLUSIONS: Morning glory syndrome has a spectrum of severity, with most patients retaining useful vision. Orbital and cerebral computerized tomography scan as well as B-scan ultrasonography may help with diagnosis and management.

Ondansetron for the prevention and treatment of nausea and vomiting following pediatric strabismus surgery.

BACKGROUND: Neither droperidol nor ondansetron has been proven completely effective, and there are conflicting data comparing the efficacy of the two agents. The purpose of this study was to compare the efficacy, safety and cost of a combination of ondansetron administered intravenously in the operating room followed by oral ondansetron treatment at home with the more commonly used treatment of intravenous droperidol therapy and oral dimenhydrinate therapy, for the prevention and treatment of postoperative nausea and vomiting in children undergoing strabismus surgery. METHODS: Double-blind randomized clinical trial with parallel comparison groups. All patients aged 6 months to 18 years who underwent strabismus surgery at a pediatric hospital in Montreal between Nov. 13, 2000, and June 12, 2001, were included. The exclusion criteria were nausea or vomiting, or use of antiemetics or narcotics in the 24 hours preceding surgery, and past history of hepatic, gastric or renal disease. The outcome measures were frequency of nausea and vomiting, severity of nausea and adverse effects in hospital, during transportation home and during the first 24 hours at home. Data were obtained through nursing notes and through a telephone interview conducted 24 to 48 hours after discharge. RESULTS: Of the 208 eligible patients, 172 were randomly assigned to the study groups (88 to the ondansetron group and 84 to the droperidol/dimenhydrinate group). We found no statistically significant difference in the incidence of nausea and vomiting in hospital or at home between the two groups (25.3% vs. 31.6%, p = 0.371). There was a significant difference between the two groups in the rate of vomiting during transportation home (3.6% vs. 12.6%, p = 0.044). The incidence of severe nausea was 14.4% with ondansetron and 15.4% with droperidol, a nonsignificant difference (p = 1.00). No significant difference was observed between the two groups in the incidence of any nausea (p = 0.434) or adverse effects (p = 0.220). We calculated that the combination of droperidol and dimenhydrinate was seven times less costly than the ondansetron regimen. INTERPRETATION: In this study, the efficacy and safety of intravenous administration of droperidol followed by oral use of dimenhydrinate did not differ from that of intravenous followed by oral use of ondansetron in children undergoing strabismus surgery. Since treatment with ondansetron is much more costly than the combination of droperidol and dimenhydrinate, at this time the use of ondansetron in the prevention and treatment of vomiting and nausea in this population may not be beneficial on a cost basis if all other variables are considered.