Computed tomography enteroclysis: a review

Computed tomography (CT) enteroclysis is being performed routinely for evaluation of suspected small bowel diseases. The availability of multidetector CT scanners has further increased the diagnostic yield of enteroclysis. There is excellent depiction of small bowel wall pathology on CT enteroclysis especially with use of negative enteric contrast. We discuss the CT enteroclysis technique and procedure along with the imaging spectrum of some common small bowel pathologies.     

Periodontal diseases in HIV-infected patients

Abstract Periodontal diseases may be the first clinical sign of human immunodeficiency virus (HIV)-infection. Since the immunosuppression and subsequent susceptibility may alter the responses of the oral tissues as well as the microflora, both periodontal treatment and result of therapy may be modified. The periodontal diseases in HIV-seropositive patients include common as well as less conventional forms of gingivitis and periodontitis, and bacteria, mycotic and viral infections are seen. Neoplasias may also involve the periodontium; most common are Kaposi's sarcoma and non-Hodgkin's lymphoma. Recent studies of unselected groups of patients indicate that periodontal health in at least some groups of HIV-seropositive patients is better than previously reported.     

Oral candidiasis and human immunodeficiency virus infection

The association of oral candidiasis with the human immunodeficiency virus (HIV) infection has been known since the advent of the acquired immunodeficiency syndrome (AIDS) pandemic. Oral candidiasis is one of the earliest premonitory signs of HIV infection and its diagnosis may have grave prognostic implications for the eventual development of full blown AIDS. There is now an expanding body of data on novel clinical variants of this 'old' disease, its epidemiology in HIV seropositive individuals and, advances in its management, particularly with respect to the recently introduced bis-triazole antifungals. Current concepts pertaining to the epidemiology, clinical features, pathogenesis, laboratory diagnosis and management of oral candidiasis in HIV infection are reviewed.     

EEG IN UNILATERAL AND BILATERAL ELECTROCONVULSIVE THERAPY

The investigation concerned 100 patients with endogenous depression treated with ECT, 52 unilaterally on the non-dominant hemisphere, and 48 bilaterally. A double-blind investigation of the therapeutic effect and the effect on memory and on EEG was carried out. With unilateral treatment, mainly diffuse and same-sided EEG changes appeared, while with bilateral treatment mainly diffuse and left-sided changes occurred. Bilateral treatment led to significantly more EEG changes than did unilateral treatment. For both groups there was a tendency to greater changes after the last than after the sixth treatment. At termination of treatment, a significantly better therapeutic effect was found in cases where EEG changes appeared, especially severe EEG changes. This applied to the total material but not to the groups of unilaterals and bilaterals taken separately. In the entire material after the first six treatments, the greatest representation of patients with unchanged and imparied memory was found in cases with deteriorated EEG compared to cases with no EEG deterioration. After the entire series of ECT, this correlation no longer was present. After separation of the patients into unilaterals and bilaterals it was not present at any of the stages. In the bilateral group, ECT treatment gave more frequent and stronger EEG changes among the older than among the younger patients. For the unilateral group, there was no comparable difference. The number of weak seizures was significantly greater among the unilaterals than among the bilaterals. The therapeutic effect was not correlated to the number of weak seizures, but the number of weak seizures was positively correlated to the number of treatments applied. It was concluded that the therapeutic effect of ECT is positively correlated to the incidence and degree of EEG changes, while the positive correlation between therapeutic effect and age observed in previous investigations did not appear to have a consistent relationship to the appearance of EEG changes. The EEG findings support the contention that unilateral treatment may be considered to have a gentler action on the brain. The importance of obtaining sufficiently strong universal seizures is emphasised, since the treatment otherwise can be less effective unless a greater number of treatments are applied.     

Somatostatin in the treatment of patients with extrapyramidal disorders and patients with EEG abnormalities

The growth hormone release inhibiting hormone acts probably both as a true hypophysiotropic hormone and as a neuroregulatory substance. Neurophysiological studies have shown that somatostatin is a CNS depressant. Somatostatin might therefore be of therapeutic significance in neurological diseases. Sixteen patients with different extrapyramidal disorders and seven patients with various EEG abnormalities were tested with 2-hour somatostatin infusions and control infusions with saline. Somatostatin did not induce any improvement or deterioration of symptoms, signs, or EEG abnormalities in any patient.     

Effects of a one-year administration of phosphate and intermittent calcitonin on bone-forming and bone-resorbing cells in involutional osteoporosis: A histomorphometric study

Summary The bone histomorphometric effects of intermittent phosphate and calcitonin therapy during 1 year were analyzed in 15 involutional osteoporotic patients. Phosphate was administered continuously (1.5 g/day) and calcitonin was injected during 5 days every third week (50 IU/day). The bone cell response was analyzed in two separate groups, according to the amount of trabecular bone present in the iliac bone biopsy: patients with trabecular bone volume (TBV) beyond the histomorphometric spontaneous fracture threshold (0.16 mm3/mm3) (group 1; 11 patients) and patients with TBV above this threshold (group 2; 4 patients). In group 1, the treatment significantly increased TBV from 0.113±0.025 to 0.156±0.046 mm3/mm3 by thickening the existing trabeculae rather than by creating new trabeculae; stimulation of bone formation rate (+50%) and significant reduction in active trabecular resorption surfaces (from 0.021±0.013 to 0.010±0.006 mm2/mm2;P<.05) may have led to positive bone balance. In group 2, TBV was not changed because of the treatment's relative inefficiency for reducing the bone-resorbing cell activity, leading to likely persistent negative bone balance. Cortical thickness did not change in either group. This study confirms the positive effectiveness of continuous treatment with phosphate and intermittent calcitonin during 1 year on bone balance in involutional osteoporosis with low amount of bone. The lack of response in patients with normal amount of bone must be verified before raising the hypothesis of different bone cell activity and before anticipating the therapeutic response according to local bone mass besides bone remodeling status in osteoporosis.     

Heart rate variability changes in physicians working on night call

Purpose  

Adverse effects by night-call duty have become an important occupational health issue. The aim of this study was to investigate whether the heart rate variability (HRV) differed during recovery from day work and night-call duty between distinct physician specialities.