Feasibility and Preliminary Validation of an Online Version of the Ohio State University Traumatic Brain Injury Identification Method

Objective

To test the feasibility and validity of an online version of an established interview designed to determine a lifetime history of traumatic brain injury (TBI).

Effects of Wrist Weights on Kinematic and Myographic Movement Characteristics During a Reaching Task in Individuals With Parkinson Disease

Objective

To investigate the kinematic and myographic effects of weighted wrist cuffs on individuals with Parkinson disease (PD) during a reaching task.

Prevalence of Trachoma in Jigawa State,Northwestern Nigeria

ABSTRACT

Purpose: To determine the magnitude of trachoma and the prevalent forms of the disease, and to provide baseline data for the establishment of a trachoma control program in Jigawa State, northwestern Nigeria.

Methods: A population-based cross-sectional survey was conducted in Jigawa State in May 2007 using a 2-stage cluster random sampling technique to select 4598 persons from 40 villages based on probability proportional to size. All participants were examined using a penlight and a 2.5?×?binocular loupe for signs of trachoma, and graded using the World Health Organization (WHO) simplified grading system.

Results: A total of 4598 people were seen with 99.96% coverage. Of these, 2460 (53.5%) were female and 2138 (46.5%) were male. Mean age was 21.6 years (?±?19.8 years). The prevalence of follicular trachoma in children aged ≤9 years was 20.5% (95% confidence interval, CI, 18.7–22.4%) with no difference between the sexes. The prevalence of trichiasis in adults aged ≥15 years was 5%, and the prevalence was higher in females than males (odds ratio 2.60, 95% CI 2.06–3.28; p?<?0.001).

Conclusion: Trachoma is a major problem in Jigawa State; there is a need to train trichiasis surgeons and empower them to carry out community-based surgery. District-level prevalence of trachoma needs to be determined to know which aspects of the WHO SAFE strategy (surgery, antibiotics, facial cleanliness and environmental improvements) need to be emphasized in each district.     

Fatal disseminated herpesvirus hominis type 2 infection in an adult with associated thymic dysplasia

Disseminated herpesvirus hominis (HVH) type 2 infection, proved by viral isolation, is described in a previously healthy young woman. The clinical course was characterized by rapidly progressive hepatic failure leading to death 1 week after hospitalization. Postmortem examination showed involvement of many organs by HVH, most severe in the liver. The thymus gland showed dysplasia. It is suggested that this thymic alteration was congenital and was associated with a partial deficiency in cellular immunity, which permitted the patient's relatively long survival but ultimately rendered her susceptible to overwhelming viremia. Six adults with disseminated HVH infection, type unspecified but proved by viral isolation, were found in a review of the literature; predisposing factors (steroids, burns, Hodgkin's disease, malnutrition) existed in five patients. The thymus gland was not described, however, in the autopsy reports on any of the five patients who died.It is concluded that in order to initiate early antiviral therapy, HVH should be a diagnostic consideration in adults with hepatitis, particularly if skin or mucosal lesions are present. Furthermore, the central and peripheral lymphoid system of any patient who dies of a disseminated viral infection should be thoroughly examined.     

Acquired factor X deficiency with associated defects in platelet aggregation: A response to corticosteroid therapy

A 79 year old white woman presented with a severe bleeding disorder. Evaluation revealed a prothrombin time of 27.6 seconds (control, 11 seconds) and an activated partial thromboplastin time of 61 seconds. Specific clotting factor assays showed an isolated deficiency of factor X ranging from 7 to 12 per cent on three determinations. Platelet aggregation and bleeding time were also abnormal in response to epinephrine and collagen. Factor X levels and platelet aggregation returned to normal and bleeding stopped after institution of corticosteroid therapy.     

Cold acclimation of obese (ob/ob) mice: effects of energy balance

Obese (ob/ob) and lean mice at 4 weeks of age were housed at 23 degrees C or 14 degrees C for 4 to 8 weeks to examine effects of acclimation to mild cold on energy balance. Energy intake of young lean mice increased by about 50% when housed at 14 degrees C, but energy intake of cold-acclimated obese mice increased by only 8%. Efficiency of energy retention (ratio of energy gain to energy intake) in obese mice declined from 22% +/- 1.2% at 23 degrees C to 10% +/- 1.8% after 4 weeks at 14 degrees C. Lean mice exhibited a less pronounced response to temperature; their efficiency of energy retention declined from 7% +/- 1.3% at 23 degrees C to 4% +/- 2.2% after 4 weeks at 14 degrees C. After 8 weeks of cold exposure, body weights and efficiency of energy retention became equal in obese and lean mice. Calculated heat production of cold-acclimated obese and lean mice was 40% higher than that of respective controls. Obese mice reacclimated to 23 degrees C after being kept for 4 weeks at 14 degrees C consumed the same amount of energy and were 16% more efficient than obese maintained at 23 degrees C; reacclimated lean mice consumed 12% more energy but were 53% less efficient than lean mice maintained at 23 degrees C. The results indicate that obese mice are able to increase heat production and markedly reduce their efficiency of energy retention when acclimated to mild cold but that they, unlike lean mice, rapidly revert to a high efficiency of energy retention after 4 weeks of reacclimation to 23 degrees C.     

Geometric and functional abnormalities of the left ventricle with a chronic localized noncontractile area

Thirty-one patients with coronary artery disease, 25 of whom had a chronic localized noncontractile area in the anteroapical region of the left ventricle, were studied at rest by means of left heart catheterization, left cineventriculography and selective coronary arteriography. The left ventricular volume, stroke volume, ejection fraction, left ventricular end-diastolic pressure, cardiac output and the surface area of the noncontractile area were measured.

The patients with a noncontractile area were classified in 4 groups according to the size of the noncontractile area relative to the end-diastolic left ventricular surface area. The relative size of the non-contractile area ranged from 5 to 47 percent. Six patients with uncomplicated coronary artery disease comprised the control group.

The critical size of the noncontractile area beyond which significant functional derangement occurred appeared to be 20 to 30 percent of the left ventricular internal surface area. The end-diastolic volume increased significantly and the ejection fraction was reduced to less than half of normal when the regional noncontractile area was larger than the critical size. Neither the cardiac output nor the left ventricular end-diastolic pressure correlated closely with size of the noncontractile area. In contrast, the ejection fraction was a more sensitive indicator and correlated well with the extent of regional contraction abnormality. In this study, double vessel disease was most common, followed by single vessel disease. Obstruction of the left anterior descending coronary artery was significant in the formation of anteroapical noncontractile regions.     

Central and regional hemodynamic effects and neurohumoral consequences of minoxidil in severe congestive heart failure and comparison to hydralazine and nitroprusside

Minoxidil is a potent oral vasodilator of potential value in patients with congestive heart failure (CHF), although preliminary studies show that it causes fluid retention. To test whether minoxidil acts primarily as an arterial vasodilator in CHF, it was compared with hydralazine and nitroprusside. To evaluate its chronic efficacy and mechanism of fluid retention, the effects of minoxidil (7 patients) were compared, in a double-blind manner, with those of hydralazine (8 patients) on central and regional hemodynamics and the renin-angiotensin-aldosterone and sympathetic nervous systems. There was no demonstrable difference in the central hemodynamic effects of minoxidil and hydralazine in the dosages used. After 6 hours both drugs increased cardiac index (minoxidil group, from 1.65 ± 0.29 to 2.26 ± 0.40 liters /min/m², p < 0.0001; hydralazine group, from 1.88 ± 0.61 to 2.34 ± 0.90 liters/min/m², p < 0.0001), decreased systemic vascular resistance and increased heart rate without change in pulmonary arterial, pulmonary capillary wedge or right atrial pressures. Nitroprusside effects differed from those of minoxidil and hydralazine with respect to heart rate (p < 0.005) and mean pulmonary arterial (p < 0.007) and right atrial (p < 0.009) pressures. Nitroprusside also decreased relative hepatomesenteric flow compared with the other 2 agents (p < 0.005). Neither renal blood flow, glomerular filtration rate, filtration fraction, nor urinary sodium excretion were significantly altered acutely by any of the 3 drugs. Minoxidil and hydralazine did not differ in their neurohumoral effects: Both agents produced an increase in plasma norepinephrine concentration (p < 0.003) and plasma renin activity (p < 0.04), but no change in plasma epinephrine or aldosterone concentrations. After 1 week of double-blind therapy, fluid retention was a greater problem with minoxidil than with hydralazine. Thus, minoxidil behaves primarily as an arterial vasodilator in CHF, fluid retention is a severe adverse effect, and the greater degree of fluid retention with minoxidil than hydralazine is not attributable to differing acute effects on total renal blood flow or function, or differing effects on the renin-angiotensin-aldosterone or sympathetic nervous systems.