Living with a child with familial Mediterranean fever: does it affect the quality of life of the parents?

OBJECTIVE: The aim of the present study was to assess the quality of life (QOL) and the psychological status of parents of children with familial Mediterranean fever (FMF). METHODS: The QOL, anxiety and depression of the parents of 35 children with FMF were evaluated and compared to the parents of 23 healthy children. RESULTS: Mothers of FMF children had lower QOL scores than mothers of healthy children: 5.5 +/- 1.1 versus 6.0 +/- 0.6 (p = 0.048). They also expressed higher levels of anxiety and depression. Within each group, mothers were more anxious and depressed than fathers. Parents with several FMF children were not significantly different from parents with only one FMF child. CONCLUSION: The QOL and psychological well being of parents with FMF children were found to be slightly impaired, especially that of the mothers.     

Dynamic Doppler evaluation of the hand arteries of the patients with Raynaud’s disease

The aim of this study was the determination of blood flow characteristics and parameters in the hand arteries of patients with primary Raynaud’s phenomenon (pRP) and comparison with the results of healthy subjects. The diameter, resistive index and flow volume of the digital, ulnar and radial arteries of the patients with pRP and the control group were measured at rest and after cold provocation. The flow starting time (FST) in the digital artery and the flow normalising time (FNT) of all three arteries were also recorded after cold provocation. The diameter and flow volume of the digital and ulnar arteries of the patients were lower at rest, but resistive index was significantly high in all arteries. After cold provocation, the diameters of the radial and ulnar arteries and the flow volume of the digital arteries of the patients were significantly lower than those of the controls. The mean FST was 3.6 ± 3.8 min for the patients and 0.9 ± 1.2 min for the controls. The mean FNT was significantly longer in all the arteries of the patients; FNT cutoff times for the radial, ulnar and digital arteries were 6.5, 5.5 and 6.5 min, respectively. The measurements of the diameter, resistive index and flow volume of all the arteries measured before and after cold provocation as well as FST of the digital artery and FNT of all the arteries may facilitate in providing additional information in pRP patients.     

Mucinous cystadenoma of the appendix associated with adenocarcinoma of the sigmoid colon and hepatocellular carcinoma of the liver： Report of a case

Mucinous cystadenoma of the appendix is a rarecondition and represents one of the three entities withthe common name mucocele of the appendix.It ischaracterized by a cystic dilatation of the lumen withstasis of mucus inside it.Histopathologically mucoceleis divided into three groups:focal or diffuse mucosalhyperplasia,mucinous cystadenoma and mucinouscystadenocarcinoma.This condition is often associatedwith other neoplasia,especially adenocarcinoma ofthe colon and ovaries.We here describe a 57 year oldmale patient who presented with abdominal discomfort,constipation,fresh blood in stool and frequent urination.He had a big cystadenoma of the appendix associatedwith adenocarcinoma of the colon and hepatocellularcarcinoma of the liver.The patient underwent righthaemicolectomy,sigmoid colon resection and segmentalresection of the liver.Now 3 years later he has noevidence of disease relapse.According to this,westress the need of accurate preoperative diagnosis andintraoperative exploration of the whole abdomen in thesepatients.     

Effects of social relationships on mortality of the elderly: how do the influences change with the passage of time?

The purpose of this study was to determine the changes with time lapse in the influences of social relationship factors, in relation to mortality in the elderly. A baseline investigation was conducted in 1992 and survival conditions of 637 subjects aged 68-82 years were followed up for 12 years. The associations of social relationships with mortality were compared between the first and later half periods. The results showed that for men, close friends, group membership and finding life worth living were significantly associated with mortality in the first half period and the association disappeared in the later half; also in men, providing instrumental support was significantly associated in the 12-year period. In the first half, living arrangement was not significantly associated with mortality for men, and marital status and job were not for women, but in the later half, the association of those became apparent. The present study suggests that for men, the association of close friends, group membership and finding life worth living with mortality decreased with the passage of time while providing instrumental support had positive effects throughout the long term. The association of living arrangement increased for men, and marital status and job for women.     

Is the supplementation with antioxidants effective in the treatment of atherosclerosis?

Results from experimental and epidemiologic studies suggest an influence of oxidative stress on development and progression of atherosclerosis in man. Prospective endpoint studies failed to support this hypothesis. The current literature is summarized in this review.     

What is the role of tests of lung function in the management of infants with lung disease?

This review considers whether there is a role for lung function tests in the clinical management of infants with lung disease. The purpose of testing lung function in older subjects, the tests available for infants, and the practical problems of testing lung function in infants are considered. After reviewing all the facts, we suggest that there are four situations in which lung function testing should be recommended for infants, as follows: (1) the infant who presents with unexplained tachypnea, hypoxia, cough, or respiratory distress in whom a definitive diagnosis is not apparent from physical examination and other, less difficult investigations; (2) the infant with severe, continuous, chronic obstructive lung disease who does not respond to an adequate clinical trial of combined corticosteroid and bronchodilator therapy; (3) the infant with known respiratory disease of uncertain severity in whom there is need to justify management decisions; and (4) research and development. A review of 62 recent publications to determine how lung function tests are being used at the present time showed that they are being used overwhelmingly for research. The role of lung function testing in the clinical management of infants has not been established, and research is needed to clarify this situation. We suggest that such studies should explore the role of lung function tests in infants with specific symptoms, signs, or diagnoses, taking into account information from other types of investigation and the cost/benefit/risk ratios.     

Annoyed with Haemorrhoids? Risks of the Emborrhoid Technique

Digestive Diseases and Sciences - Haemorrhoids, a common ailment afflicting mostly Western patients, can produce bothersome symptoms, in particular pain, pruritus, and bleeding. There is a wide...     

Do the Age of Patients with Tetralogy of Fallot at the Time of Surgery and the Applied Surgical Technique Influence the Reoperation Rate?

Abstract Background and Purpose:   Primary repair of tetralogy of Fallot (TOF) has been favored in many centers for years now and results and advantages of this management seem to verify this procedure. The authors wanted to know, if the age at the time of surgery and the surgical techniques had an influence on the long-term results. Patients and Methods:   Between 1992 and 2003, 124 patients underwent complete repair of TOF at the University Hospital Münster, Germany. Patients were subdivided into two groups based on their age (< 1 year and > 1 year of age). Patients in whom a transannular patch (TAP) was used were compared with those without (NTAP), or in whom a conduit was used. Results:   Overall mortality was 8%, with an average age of death of 9.53 years (range 0.06–19.77 years). The patients’ age at the time of surgery affected their survival as only two cases of death were reported among the group of children < 1 year of age (3.2%) whereas eight patients were older (12.9%; p = 0.0483). Six patients died within the first 30 days post surgery. Reoperation had to be performed in 21 cases, 13 (61.9%) of these patients were < 1 year of age at the time of surgery, eight were older (38.1%). A TAP, NTAP or conduit treatment did not show significant differences in long-term survival or freedom from reoperation. Conclusion:   Early repair of TOF within the 1st year of life can be recommended, because mortality is lower than in patients treated at a higher age. There seems no significant difference in the reintervention rate between patients treated within the 1st year of life or later.      

Palliation of patients with malignant gastroduodenal obstruction with self-expanding metallic stents: the treatment of choice?

BACKGROUND: Gastroduodenal obstruction is a common preterminal event for patients with gastric and pancreatic cancer who often undergo palliative surgical bypass. Endoscopic palliation with self-expanding metallic stents has emerged as a safe and an effective alternative to surgery, but experience with the technique remains limited. METHODS: Twenty-eight patients hospitalized with GI obstruction because of incurable gastric or pancreatic cancer were recruited for a prospective study of palliation with self-expanding metallic stents. Complications and clinical outcomes were assessed. OBSERVATIONS: Stent insertion was technically successful in 26 patients. Thereafter, 24 patients resumed an adequate liquid or semisolid diet. Stent insertion facilitated hospital discharge for 20 patients. Occlusion of the stent because of tumor ingrowth occurred in 3 patients, but there was no complication related to stent insertion or the stent itself. CONCLUSIONS: Endoscopic placement of a self-expanding metallic stent is a simple, effective means of palliation for patients with malignant gastroduodenal obstruction.