In-111-labeled leukocyte scintigraphy in suspected orthopedic prosthesis infection: comparison with other imaging modalities

When infection of prosthetic orthopedic implants is suspected, optimal management requires accurate confirmation or exclusion of infection. The authors retrospectively studied 98 patients with possible infection who underwent scanning with indium-111-labeled white blood cells (WBCs) and subsequently underwent surgery within 14 days. At surgery, 50 patients had infections, as determined by means of culture or histologic results. The diagnostic accuracy of In-111 scanning was compared with that of plain radiography, arthrography, three-phase bone scanning, and various clinical and laboratory findings classically associated with infection. Positive findings on In-111 WBC scans and elevated erythrocyte sedimentation rates were found to be the most predictive variables in the diagnosis of septic prostheses (P less than or equal to .001 and P less than or equal to .002, respectively). Likelihood ratio analysis more clearly demonstrated the superiority of In-111 WBC scanning, with positive and negative scans yielding likelihood ratios of 5.0 and 0.16, respectively.     

The Effect of Alternate Style Keyboards on Severity of Symptoms and Functional Status of Individuals with Work Related Upper Extremity Disorders

There is evidence that performing job tasks involving repetition, vibration, sustained posture or forceful movement may contribute to symptoms of work related upper extremity disorders. Typing is one such activity; symptoms that develop as a result of this activity can affect performance of work, self-care and leisure occupations. Studies investigating the impact of ergonomic keyboards on symptom reduction are limited, and little research exists regarding the reduction of key activation force as an intervention. Methods: This randomized, prospective study used a sample of 68 symptomatic workers employed by a single company. One group received a commercially available ergonomic keyboard, a second group used a modified version of the same keyboard designed to reduce activation force, vibration and key travel. We measured symptoms and clinical signs, functional status, and device satisfaction in both groups over a six-month study period. Results: Between-groups analyses indicated that the groups performed similarly on the outcomes of interest. Repeated-measure analysis identified a reduction of symptoms, an improvement in functional status, preference for and increased satisfaction with the intervention keyboards, and maintenance of typing speed and accuracy for both groups. Conclusions:     

Über Veränderungen der Feinstrukturen von Bakterien unter der Einwirkung von Chloramphenicol

Zusammenfassung Durch Einwirkung von Chloramphenicol (Paraxin) auf die grampositiven Staphylokokken lassen sich starke Zellwandverdickungen induzieren, die auf eine Hemmung des Wachstums der Bakterienzelle bei gleichzeitig fast ungehemmt weiterlaufender Synthese von Zellwandmaterial zurückzuführen sind.Die Masse der Wandsubstanz kann daher als Maß für den Grad der induzierten Wachstumshemmung herangezogen werden.Durch Chloramphenicol können bei Staphylokokken auch die Membrankörper und die Chromosomenareale verändert und die Ausbildung myelinartiger Strukturen induziert werden. Eine aktive Beteiligung der Membrankörper an der Zellwandsynthese wurde wahrscheinlich gemacht.Im Gegensatz zu den grampositiven Staphylokokken reagierten gramnegative Bakterien wie E. coli auf Chloramphenicol mit andersartigen Zellveränderungen.

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Summary By the influence of Chloramphenicol (Paraxin) on grampositive staphylococci, large cellwall thickenings can be induced, that are to be referred to a growth-restriction of the germ cell cytoplasme with an at the same time almost unrestrictedly continuing synthesis of cell wall material.The mass of the cell wall substance can therefore be referred to as a measure for the degree of induced growth restriction.Plasmalemmasomes and chromosom areas of staphylococci may become altered by Chloramphenicol, and the formation of myelin figures may be induced. An active participation of the plasmalemmasomes on the synthesis of the cell wall substance has been made likely.In contrast to the grampositive staphylococci gramnegative germs like E. coli react on Chloramphenicol with other cell alterations.

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Durchgeführt mit Unterstützung der C. F. Boehringer & Söhne GmbH Mannheim-Waldhof.     

Dissociative symptoms and sleep

There is a widespread view among psychiatrists that dissociative experiences such as depersonalisation, derealisation, absorption, and psychogenic amnesia have a traumatic etiology. This view is subjected to a critical evaluation. We also discuss an alternative interpretation namely that dissociative experiences are caused by a labile sleep-wake rhythm. We evaluated this alternative view in two exploratory studies. In study 1 we looked at the relationship between the Dissociative Experience Scale (DES) and the Iowa Sleep Experiences Survey (ISES) and in study 2, we checked this relationship when the response bias was controlled for. Dissociative experiences (measured with the DES) correlated with the ISES. The correlation between DES and ISES remained completely intact even when we controlledfor response bias. Our findings show that dissociative symptoms are associated with typical sleep experiences such as nightmares and strange dreams. The association is not the by-product of the positive response bias which generally characterises persons with dissociative symptoms.     

Psychological distress and salivary cortisol covary within persons during pregnancy

The mechanisms whereby maternal stress during pregnancy exerts organizational effects on fetal development require elaboration. The aim of this study was to assess the plausibility of cortisol as a biological link between maternal psychological distress during pregnancy and fetal development. Previous research has resulted in equivocal findings for between-persons differences in stress and cortisol. Ecological momentary assessment was used to simultaneously assess mood and cortisol 5 times daily for 3 days in 83 women (gestational ages 6-37 weeks). Results from multilevel analysis indicated a robust within-person association between negative mood and cortisol. For each 1.0% increase in negative mood there was a corresponding 1.9% increase in cortisol. This association was unaffected by advancing gestational age. The results suggest that cortisol is a plausible biological mechanism for transducing the effects of maternal psychological distress during pregnancy to fetal development.