Respiratory effects of household exposures to tobacco smoke and gas cooking on nonsmokers

The records of 708 nonsmoking white adult residents of Washington County, MD, who had participated in two of respiratory symptoms were analyzed to evaluate the effects of exposure at home to two potential sources of indoor air pollution: cigarette smoking by other household members, and use of gas as a cooking fuel. After adjustment for the effects of age, sex, socioeconomic level, occupational exposure to dust, and years of residence in household, the presence of one or more smokers in the household was only suggestively associated with a higher frequency of chronic phlegm and impaired ventilatory function defined as FEV₁ < 80% predicted. The use for cooking was associated with a significantly increased frequency of chronic cough and a significantly greater percentage with impaired ventilatory function as measured both by FEV₁ < 80% predicted and by FEV₁/FVC < 70%.     

Metaphyseal chondrodysplasia McKusick type in a Chinese fetus,caused by novel compound heterozygosity 64T> A and 79G >T in RMRPgene

We present the first confirmed case by molecular analysis of a metaphyseal chondrodysplasia, McKusick type, in a 22-week fetus. Two novel compound heterozygous mutations, 64T> A and 79G > T, were found in the highly conserved regions of the RMRP gene. Twenty-two heterozygous g.1018 T> C mutations, two homozygous g.1018 T> C mutations, two heterozygous insertion mutations g.799_g.800insC and one heterozygous insertion mutation g.849_g.850insT were found among 100 normal controls. Careful radiological examination of the fetus for skeletal dysplasia allowed definitive diagnosis, proper genetic counselling and future prenatal diagnosis. Copyright © 2006 John Wiley & Sons, Ltd.     

ISO 14001: A systems approach to managing environmental risk

The field of environmental risk management is relatively new and has developed rapidly over the past several years. There has been, however, a significant lack of integration of seemingly dissimilar disciplines into a meaningful context for top management risk decisions—until now. A new holistic approach, centered on the ISO 14001 standard for environmental management systems, addresses many of the issues that have kept environmental risk management focused on technical rather than strategic issues. This article describes the risk management process, illustrates how the ISO 14001 standard can be used by organizations to integrate and assess technical environmental information, and shows how to place this information in a strategic risk management context. It also explains how key ISO 14001 concepts such as policy implementation, operational control, and continuous improvement form the basis of a systems approach, and why the systems approach is the preferred, cost-effective structure for controlling environmental risk.     

Sonographic features of ileal duplication cyst at 12 weeks

Enteric duplication cyst is a congenital abnormality that is believed to arise from abnormal recanalization of the bowel during embryogenesis. Previous reports suggest that the condition may be suspected prenatally by sonographic demonstration of an intra-abdominal cystic mass in the second and third trimesters. We present the sonographic features of a fetus with ileal duplication cyst at 12 weeks of gestation, which show that the condition may present in the first trimester of pregnancy. Copyright © 2002 John Wiley & Sons, Ltd.     

The effect of fetal gender on second-trimester maternal serum inhibin-A concentration

Second-trimester serum inhibin-A is increasingly used as a fourth marker in addition to the triple test to screen for Down syndrome. We investigated whether fetal gender had an effect on serum inhibin-A concentration. A retrospective analysis was done on 316 normal pregnancies and 48 Down syndrome pregnancies in which maternal serum inhibin-A assays were performed between 15 and 20 weeks of gestation and in which the fetal sex was known. The median inhibin-A MoM (95% CI) for normal pregnancies in the presence of a male fetus was 0.93 (range 0.88–1.03). This was significantly lower than that in the presence of a female fetus (median MoM=1.04). The gender difference was not observed in the Down syndrome pregnancies. The increased inhibin-A concentration would lead to a 2.3-fold higher false-positive rate in the presence of a female fetus (10.6% vs 4.6%; p<0.05, Chi-square test). Because of the small number of cases studied, the results need to be substantiated by a larger series. If the gender effect is confirmed, adjustment for fetal sex may be necessary when inhibin-A is used as a screening marker. Copyright © 2001 John Wiley & Sons, Ltd.