No abstract

Blood lead concentration was measured in 398 male and 133 female London civil servants not subject to industrial exposure to heavy metals. The relation between blood lead and serum creatinine concentrations and blood pressure were examined. Blood lead concentration ranged from 0-20 to 1-70 pmol/l with a geometric mean concentration of 0-58 umolIl in men and 0-46 pmol/l in women (p < 0-001). In women blood lead concentration increased with age (r = + 0-27; p = 0 002). In the two sexes blood lead concentration was positively correlated with the number of cigarettes smoked a day (men r = + 0-17 and women r = + 0-22; p < 0-01), with the reported number of alcoholic beverages consumed a day (men r = + 0 34 and women r = 0-23; p < 0-01), and with serum gamma-glutamyltranspeptidase (men r = + 023 and women r = +0414; for men p < 0-01). Blood lead concentration was not correlated with body weight, body mass index, and employment grade. In men 14% ofthe variance ofblood lead concentration was explained by the significant and independent contributions of smoking and alcohol intake and in women 16% by age,

29 tamicin and kanamycin. Blood culture also grew E. coli and Staph. aureus. Treatment with gentamicin and cloxacillin was started and within a few days the swelling of the knee abated and the baby started to move the leg. The tip of the big toe demarcated into dry gangrene, which separated on 9 May. The antibiotics were stopped after four weeks when the leg appeared normal and x-ray examination showed that the infection had settled. The baby was discharged home on 18 May when 11 weeks old and weighing 3,410 g. Comment Prolonged umbilical vein catheterization may cause local thrombosis, umbilical vein phlebitis and pyaemia, liver necrosis, and pulmonary embolism (Scott, 1965). Portal hypertension (Thompson and Sherlock, 1964), bowel perforation (Corkery et al., 1968; Orme and Eades, 1968), and myocardial infarction have also been documented (Van Der Hauwaert et al., 1967). Umbilical artery catheterization has also been associated with a few complications. Gupta et al. (1968) reported complications in 10''', of 335 babies, which included bleeding, clinical signs of arterial obstruction, and arterial thrombosis detected at necropsy. Cnly one baby lost the tip of the big toe. Cochran et al. (1968) reported complications in 8 ' , " of 387 babies. Gluteal muscle necrosis has been described (Ulan and Swyer, 1968). The clinical picture in our two cases can be explained only by thrombosis induced by the catheter in the arterial tree with superimposed infection. When the catheters were removed multiple embolization must have occurred, affecting the skin, the big toe, and lower end of the femur. In the second case the infection was not controlled so suppuration became widespread. These are the only two cases with permanent sequalae in the 406 babies we have exchange transfused in the past four years.

No abstract

No abstract