Refractory Angina

The regimen for treating refractory angina is similar to that for impending infarction. Specific approaches to treatment include drugs and other medical methods. Operative intervention is reserved for those patients who do not respond to medical measures.     

Pediatric Power Wheelchairs: Evaluation of Function in the Home and School Environments

The purpose of this study was to compare the performance of four power wheelchairs when used by children to perform a variety of indoor activities. Eight boys and eight girls performed a series of 11 functional tasks when positioned in each of four different power wheelchairs reflecting different design classes. There were no significant differences for many of the dependent variables. However, the Everaid Turbo was significantly better for functional positioning at a standard kitchen table and at school desks and for accessing objects at different heights. By contrast the Invacare Jaguar was better for straight-line driving speed. Other findings include children's subjective impressions of the four power wheelchairs.     

Cutaneous involvement in a rare case of adult visceral leishmaniasis acquired in Israel

Skin lesions are rare in visceral leishmaniasis, especially in Mediterranean countries. We describe an unusual case of visceral leishmaniasis in a 41-year-old man that began with a skin lesion. The parasites isolated from both the skin lesion and the bone marrow were typed as Leishmania donovani sensu stricto. This pathogen is not endemic in Israel or neighboring countries; its contribution to adult visceral leishmaniasis in Israel is summarized.     

Immunoblastic sarcoma with features of Sj?gren's syndrome and systemic lupus erythematosus in a patient with immunoblastic lymphadenopathy.

A patient with immunoblastic lymphadenopathy and features of Sj?gren's syndrome and systemic lupus erythematosus is presented. Clinical features included generalized lymphadenopathy, rash, alopecia, and synovitis, with associated laboratory abnormalities of a positive antinuclear factor and double-stranded DNA antibodies, positive lupus band test, and hemolytic anemia. Symptoms of Sj?gren's syndrome included dry eyes and mouth and swollen parotid gland; biopsy results of the accessory salivary glands were positive. At autopsy immunoblastic sarcoma was found that involved the myocardium, which stained for both kappa and lambda light chains by immunoperoxidase techniques.     

A Low Pulse Food Intake May Contribute to the Poor Nutritional Status and Low Dietary Intakes of Adolescent Girls in Rural Southern Ethiopia

Poor nutrition in adolescent girls poses critical health risks on future pregnancy and birth outcomes especially in developing countries. Our purpose was to assess nutritional status and dietary intake of rural adolescent girls and determine pulse and food intake patterns associated with poor nutritional status. A cross-sectional community-based study was conducted in a traditional pulse growing region of southern Ethiopia on 188 girls between 15 to 19 years of age, with 70% being from food insecure families. Prevalence of stunting (30.9%) and underweight (13.3%) were associated with low food and nutrient intake. Diets were cereal-based, with both animal source foods and pulses rarely consumed. Improving dietary intakes of female adolescents with nutrient dense foods would ensure better health for themselves and for the next generation.     

Venous pressure and exercise tolerance.

Compared to the number of contractions obtained when a blood pressure cuff on the upper arm was at zero pressure, inflation of the cuff to pressures ranging between 5 and 40 mm Hg resulted in an augmentation of the number of hand contractions that could be performed prior to the development of ipsilateral severe fatigue or intolerable pain. Cuff pressures of 60 mm Hg reduced the number of contractions below the control level. These results are consistent with the concept that exercise during venous congestion facilitates the washout of the toxic catabolite presumed to be produced during muscular contraction.