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Acute tonsillitis is a common condition and usually runs a benign course. However life-threatening complications do still occur, even in this postantibiotic era. Infection can spread downwards into the mediastinum through the anatomic cervical spaces, causing widespread cellulitis, necrosis, abscess formation and sepsis. We present a case of descending mediastinitis in an 18-year-old woman, arising from her first episode of tonsillitis and treated successfully by surgical drainage. We believe that an awareness of this complication, early diagnosis using computed tomography scanning, and prompt, adequate surgical drainage will reduce morbidity and mortality.
Between April and September 2000, 60 injecting drug users in Scotland died or were hospitalized with severe illness. Laboratory investigations suggested that Clostridium novyi and other bacteria were important aetiological agents. To determine associated environmental/behavioural factors a case-control study was undertaken with 19 ‘definite’ and 32 ‘probable’ cases in Glasgow, Scotland. For every deceased case (n=19), up to three proxy individuals were interviewed. Three controls were identified for each case. Multivariate logistic regression analyses compared (i) all cases and controls; (ii) definite cases and matched controls; (iii) probable cases and matched controls. In all three analyses injecting into muscle or skin and injecting most of the time with a filter used by someone else were the variables most strongly associated with illness. Comparing only muscle-injecting cases and controls, cases were significantly more likely to have injected larger amounts of heroin per average injection than were controls. The findings make an important epidemiological contribution to the understanding of the public health and clinical implications of the contamination of illicit drugs by histotoxic clostridia.
A new photoluminescence system is reported for copper-doped silicon. The luminescence system consists of two doublet zero phonon lines at 1033.51±.05 meV, 1033.62±.05 meV, 1040.05±.05 meV and 1040.17±.05 meV. We establish from Zeeman studies that the lower energy lines are isotropic magnetic triplets, and the upper energy lines are singlets. From temperature dependence measurements the energy separation between triplet and singlet states is determined to be approximately 6 meV, in agreement with the spectroscopic separation. Also from temperature dependence PL we show that the transition probability ratio for the higher and lower states is 210. We conclude that the main features of the luminescence agree with radiative recombination of excitons bound to an axial isoelectronic defect. The chemical identity of the constituent(s) involved is uncertain although the participation of copper is likely.
The photoluminescence from silicon lightly doped with copper and rapidly quenched from ~ 1100° C is dominated by a vibronic band with zero--phonon lines (ZPL) in the region of 943 meV. We have studied the effect of external fields on the electronic properties of this band and the results are consistent with the luminescence occurring at a defect with Td symmetry. The Zeeman measurements indicate that the luminescence is due to the recombination of excitons in J = 1, J = 2 states with the normal ordering of these levels reversed. This reversal is explained by the different response of these states to hydrostatic strains, and it is also argued that strain at the defect provides the binding potential for the exciton.
In a comparison of assessment methods of severity of depressive illness, the Montgomery-åsberg Scale had, broadly, a performance equal to the Hamilton Scale. The Beck Depression Inventory, its subscale, and the Wakefield Inventory all had overall poor performances and should now be abandoned in research. The two-patient-rated scales were, overall, similar and fairly satisfactory measures. The comparisons were at points in severity of illness and not on change of severity.