Tachycardia''s toll: tachycardia induced cardiomyopathy — a case study

Cardiac arrhythmias are a well known cause of mortality for patients with heart disease. However, sinus tachycardia is a more unusual arrhythmia which can lead to serious heart damage or death. Even young patients with structurally normal hearts may become gravely ill.

This case study outlines the condition of sinus tachycardia, and associated changes in heart function, altered cellular structure of the myocardium and compensatory mechanisms in the body. Treatment modalities, including electro-physiological studies and drug therapies to moderate the tachycardia and myocardial oxygen demand of the heart, are discussed. Fourteen year old ‘Ben’ was previously a well, active and outgoing youth who suddenly became critically ill. He endured weeks of hospitalisation, numerous serious complications including Torsade de pointes arrhythmia, Cheyne-Stokes respirations, nausea and dizziness during this acute phase. Despite challenges, Ben's severely compromised heart muscle recovered at a remarkable rate.     

AIDS education in Switzerland: implementing strategies to reach groups with high risk behaviours, particularly youth

In Switzerland the Federal Office of Public Health has developeda comprehensive set of AIDS care and prevention policies andactivities in recent years. For their actual implementation,the main responsibility lies with the health departments ofthe 26 Cantons. This paper originates from one of the largeCantons, Vaud. Major efforts have been made from the Federallevel to transmit relevant AIDS-related information to the generalpublic. Much remains to be done to assist people, especiallyhigh risk groups, to translate the vital prevention messagesinto behaviour changes. For youth in general, new attitudestowards sexual relations are called for, different from thoseof young people 10 or 15 years ago. In Vaud, a number of entrypoints are used to pass on this education: physicians and nursesinvolved in school health, teachers and, among the latter, twogroups with specific in-service training and part-time functions—mediators(who make themselves available to children in various risk situations)and health animators (promoting the inclusion of health educationtopics in the teaching). There is a special health programmefor 16–19 year olds. Also a substantial tradition of sexualeducation sessions in the school system offers valuable opportunitiesfor AIDS education. Further, innovative strategies are developedto reach and work with the male homosexuals and, to the extentpossible, intravenous drug addicts. In conclusion it is emphasizedthat, in many ways, AIDS education issues demand courage fromhealth and public leaders.     

Bone Density in Survivors of Childhood Cancer

Advances in combination chemotherapy, radiation therapy, surgery, and bone marrow transplantation have resulted in markedly improved survival rates for many children with cancer. Advancements in therapy, however, have led to new concerns, namely long-term consequences of effective treatments. Young adult and adult survivors of childhood cancer are at risk for a number of disorders related to therapy. Specifically, the young adult who has survived cancer, attendant treatments, and their complications is at risk for factors that can lead to suboptimal acquisition of peak bone mass. These factors include chronic illness, nutritional deficiencies, limited physical activity, and treatment with glucocorticoids, multiagent chemotherapy, and radiation. The long-term adverse effects of these therapies on endocrine systems, especially sex steroid and growth hormone deficiencies, are additional risk factors for some patients. After a brief review of the processes associated with acquisition of peak bone mass in the young adult, this article examines the impact of cancer and cancer therapy on bone mineral density in survivors of childhood cancer.     

Glutamic acid decarboxylase-like immunoreactivity in brainstem auditory nuclei of the rat

The distribution of GABA-producing neurons in the brainstem auditory nuclei of the rat was investigated immunohistochemically by using an antibody to glutamic acid decarboxylase (GAD). In the cochlear nuclei, GAD immunoreactive neurons are present only in the superficial granular and molecular layers, whereas terminals are found in all subdivisions of the nuclei and are particularly dense surrounding large spherical cells and one type of stellate cell. In the superior olivary complex, GAD immunoreactive neurons are located in the lateral olivary nucleus and throughout the periolivary region. Immunoreactive terminals are distributed along dendrites of principal cells of the medial and lateral olivary nuclei and are clustered around somata of globular neurons of the nucleus of the trapezoid body. An extremely dense band of immunoreactive somata and terminals is present along the ventral edge of the olivary complex. The ventral, intermediate, and dorsal nuclei of the lateral lemniscus contain small fusiform GAD-immunoreactive neurons and a moderately dense plexus of immunoreactive terminals. The inferior colliculus contains a large population of GAD-immunoreactive perikarya and an extremely dense accumulation of immunoreactive terminals in the central, dorsomedial, and external nuclei. These observations indicate that GABA systems are involved in function at all levels of the brainstem auditory pathway.     

Lack of correlation between ex vivo apical dye penetration and presence of apical radiolucencies.

OBJECTIVE: The aim of this study was to determine if there is a significant correlation between the in vivo presence of periapical radiolucency and ex vivo apical dye penetration on the same human teeth. STUDY DESIGN: Eighty-four endodontically filled teeth that were scheduled for extraction were classified into 2 groups according to the presence or absence of a periapical radiolucency and further divided into 2 subgroups according to the quality of the root canal filling. After extraction, the apical filling was evaluated by a dye penetration method. RESULTS: The dye extraction evaluation showed no correlation between apical dye penetration and the presence of a periapical radiolucency (not significant), but a statistically significant correlation with the quality of the root canal filling (P = .03). CONCLUSION: The results of the dye penetration study were correlated to the quality of the root canal filling but had no predictive value for the development of periapical radiolucency.     

Mechanobiology and force transduction in scars developed in darker skin types

BACKGROUND: Scarring is a complex process involving many cell types, cytokines and biological pathways including mechanobiology. Some subtle mechanical properties of skin can be assessed by measuring the speed of ultrasound shear wave propagation. The orientation of abnormal skin tension forces can be visualized, particularly in darker skin types, using dermoscopy showing distinct patterns of rete ridges' conformation. AIM: To assess some mechanobiological features of scars in darker skin types. PATIENTS AND METHODS: Large atrophic and hypertrophic surgical scars were examined on the trunk of 35 darker skin subjects. The surrounding skin was used as a comparator. Dermoscopic aspects were recorded. Resonance running time measurements (RRTM) were performed using a shear wave propagation device (Reviscometer). They were performed in four specific directions at given angles with regard to the long axis of the scar. The minimum, maximum and mean RRTM values were recorded at each site. RESULTS: Dermoscopy revealed patterns of melanin deposits in scars distinct from the normal honeycomb network seen in the surrounding skin. Hypertrophic scars showed a patchy pattern of large macular melanoderma dispersed in a lighter background. In these cases, low RRTM values were obtained with little variations according to the orientation of the measurements. By contrast, atrophic scars showed a streaky laddering melanotic pattern under dermoscopy. Higher RRTM values were often obtained, particularly in the transversal direction of the scars. Mechanical anisotropy was greater in the atrophic scars compared with the normal skin. DISCUSSION: Darker skin types represent a model for visualizing the main orientation of the epidermal rete ridges. A correlation was found between the pattern of melanized rete ridges of scars and the main orientation of the intrinsic forces in the skin.     

Facilitating written work using computer word processing and word prediction.

OBJECTIVE: The purpose of this study was to investigate whether occupational therapy intervention that focused on teaching children to use word processing, either alone or with word prediction, was effective in improving the written communication skills of children with learning disabilities and handwriting problems. METHOD: A single-subject alternating treatments design was replicated across three children in grades 4 and 5. During the baseline phase the children wrote stories by hand; during the intervention phase, the children wrote stories, alternating among handwriting, word processing, and word processing with word prediction. Dependent variables focused on percentages of legible words, percentages of correctly spelled words, total amount written, and rate of writing. Data were analyzed by visual inspection. RESULTS: Results were variable. Two children had clear improvements in legibility when using either word processing alone or with word prediction. These same children demonstrated clear improvements in spelling when using word prediction. Though rate of writing was best for two children when using handwriting, relative to total amount produced, one method was not clearly preferable to another. CONCLUSION: Occupational therapy intervention involving word processing with word prediction improves the legibility and spelling of written assignments completed by some children with learning disabilities and handwriting difficulties. It is important to evaluate each child individually and provide training and ongoing support for technology use.