Biofeedback-assisted relaxation training with brain injured patients in acute stages of recovery

There are few published accounts or empirical studies of biofeedback assisted relaxation training with brain injured patients still in acute stages of recovery. Given the efficacy of biofeedback assisted relaxation training with other medical populations, brain injured patients in acute stages of recovery with anxiety based symptoms may also stand to gain some benefits form this form of treatment. It has yet to be determined, however, if severe cognitive impairment or disorientation contraindicate biofeedback treatment. The cases profiled here tentatively suggest that consideration of biofeed back assisted relaxation training, even for severely cognitively impaired brain injured patients in acute stages of recovery, may be appropriate. Empirical investigations will be needed to determine selection criteria and contraindications for biofeedback treatment in the acute brain injury population.     

A myeloproliferative disease in two infants associated with eosinophilia and chromosome t(1;5) translocation

Two children are described who presented at the age of 5 and 7 months with anaemia, a high white cell count with eosinophilia and thrombocytopenia. Both children had an identical balanced translocation t(1;5)(q23;q33) and no evidence of a constitutional abnormality. The response to treatment of one child was poor, the other remains well on therapy. This translocation has not been previously reported and is likely to represent a subclass of myeloproliferative disorder analogous to the monosomy 7 syndrome, although less common. The previous literature of acquired chromosome abnormalities involving chromosomes 1 and 5 is reviewed.     

A comparison of changes seen on radiographs of rheumatoid arthritis patients in Australia and in China

To test the hypothesis that rheumatoid arthritis in patients in China is milder in severity than that in patients in a western country, a comparison was made of 2 series of consecutive outpatients with definite or classic rheumatoid arthritis who were attending referral centers in Melbourne, Australia and Shanghai, China. This paper reports the findings on radiographs of the wrists and hands. Making allowances for age and duration of disease, changes were more frequent and severe in the Australian patient series, particularly at the metacarpophalangeal joints.     

Effects of glucose or fructose feeding on glycogen repletion in muscle and liver after exercise or fasting

In athletics, muscle and liver glycogen content is critical to endurance. This study compared the effectiveness of glucose and fructose feeding on restoring glycogen content after glycogen was decreased by exercise (90-min swim) or fasting (24 h). After 2 h of recovery from either exercise or fasting there was no measurable glycogen repletion in red vastus lateralis muscle in response to fructose. In contrast, glucose feeding induced a similar and significant carbohydrate storage after both depletion treatments (8.44 mumol X g-1 X 2 h-1). In the liver, following 2 h of recovery, the rates of glycogen storage were similar after either glucose or fructose ingestion, but fasting caused a greater rate of repletion (83 mumol X g-1 X 2 h-1) than exercise (50 mumol X g-1 X 2 h-1). After 4 h of recovery fructose-fed exercised animals had the highest glycogen concentration (165 mumol X g-1) followed by the glucose-fed exercised group (119 mumol X g-1). These values were 50 and 36%, respectively, of that measured in the normal-fed liver (327 mumol X g-1). In contrast, liver glycogen values in the fasted group decreased between the 2nd and 4th hour of recovery in response to both feeding regimens. From these results we conclude that fructose is a poor nutritional precursor for rapid glycogen restoration in muscle after exercise, but that both glucose and fructose promote rapid accumulation of glycogen in the liver.     

Changes in body temperature and urinary cortisol after routine immunization in babies with intrauterine growth retardation

Aim : To investigate whether infants with intrauterine growth retardation (IUGR) experience different changes in temperature and cortisol excretion after routine immunization compared with normal healthy infants. Methods : Overnight deep body temperature and urinary cortisol to creatinine ratios were measured on the night after immunization and a control night in normal and IUGR infants. Results : In 60 normal infants, first vaccination at about 10 wk of age led to a significant increase in minumum overnight temperature compared to the control night, mean rise 0.25°C (95% CI, 0.12 to 0.38). In 35 IUGR infants the mean rise in temperature between immunization night and control night was 0.35°C (95% CI, 0.15 to 0.55). The increases in minimum temperature did not differ significantly between the normal and IUGR infants ( p = 0.11). Cortisol to creatinine ratios measured from overnight urine samples showed that 23 IUGR infants had consistently higher levels than 39 normal infants; control night medians 34 and 15 ( p = 0.01) and immunization night medians 56 and 26 ( p= 0.02), respectively. However, the percentage increase did not differ significantly between the IUGR infants and the normal infants. A smaller number of second immunizations were studied, but no significant differences were found.

Conclusion : These results suggest that although the impact of immunization is the same for IUGR and normal infants, because IUGR infants are less mature and at greater stress before immunization, the absolute levels that they experience after immunization are higher than those for normal infants.     

Pulmonary embolism after hip or knee replacement: postoperative changes on pulmonary scintigrams in asymptomatic patients

Serial pulmonary imaging has proved to be effective in the evaluation of patients undergoing total joint arthroplasty. A clinical dilemma arises in asymptomatic patients whose postoperative pulmonary images differ from the preoperative images. The authors prospectively evaluated 403 patients with serial imaging to determine the significance of changed postoperative images in asymptomatic patients undergoing total hip or knee arthroplasty. Twenty-two (5.5%) patients had significant changes on postoperative images. Seventeen were asymptomatic; all but one underwent pulmonary angiography. Documented pulmonary emboli were demonstrated in 100% of patients whose postoperative images changed to indicate a high probability of pulmonary embolism, 71% whose images changed to a moderate probability, and 0% whose images changed to indeterminate probability. Overall, pulmonary emboli occurred in 76% of all asymptomatic patients with significantly change postoperative images. Asymptomatic pulmonary embolism is a significant occurrence after total hip or knee repair, and a changed lung scan with appropriate clinical evaluation is an accurate indicator of pulmonary emboli in asymptomatic postarthroplasty patients.     

Nutritional status of middle-aged and elderly females in Kentucky in two seasons: Part 1. Body weight and related factors

Middle-aged and elderly females aged between 51 and 86 years volunteered for this study. In June and July, 147 females were studied; data collected through interview included general socioeconomic information, health history, use of medication, and a 7-day food intake. During the same 7-day period, physical activity level was measured for each person by use of a pedometer. On the 8th day, anthropometric measurements were conducted and fasting blood was analyzed for certain hormones and related metabolites. In the following January and February, the same group was surveyed again and the same measurements were repeated. Of the initial 147 subjects, 130 persons completed the winter survey. A comparison of the summer and winter data indicated some significant differences: mean body weight increased in winter from 70.4 +/- 12.7 to 71.1 +/- 13.5 kg (p less than or equal to 0.05); energy intake was raised from 1450 +/- 384 to 1549 +/- 372 kcal (p less than or equal to 0.01); physical activity decreased from 10.9 +/- 8.2 to 8.5 +/- 5.4 miles/week (p less than or equal to 0.01); and serum free thyroxine (T4) fell from 1.72 +/- 0.27 to 1.64 +/- 0.27 ng/dl. These results together with other data suggest that more attention should be addressed to seasonal fluctuations involved in body weight maintenance.