Pre-clinical atherosclerosis is found at post-mortem,in the brains of men with HIV

Journal of NeuroVirology - The aim of this study is to ascertain the burden of pre-clinical atherosclerotic changes in the brains of young adult males with HIV and explore the impact of...     

Behcet's disease with multiple intracranial arterial aneurysms. Report of a case]

Beh?et disease is a rare condition in central Europe but more common in Morocco. A case of multiple intracranial arterial aneurysms occurring in a 44 year-old Moroccan patient with 2-years history of Beh?et's disease is reported. CT-scan showed an infarction in the right middle cerebral artery territory. Panangiography showed sacciform aneurysms of the bifurcation of the right and left middle cerebral arteries. The draining veins and sinuses were normal. The two aneurysms were successfully clipped by two microsurgical frontotemporal approach in one surgical time. There have been only eight reports of intracranial arterial aneurysms associated to Beh?et disease in the literature.     

Association of Social Support with Outcomes in Incident Dialysis Patients

Background and objectives: The association of social support with outcomes in ESRD, overall and by peritoneal dialysis (PD) versus hemodialysis (HD), remains understudied.Design, setting, participants, & measurements: In an incident cohort of 949 dialysis patients from 77 US clinics, we examined functional social support scores (scaled 0 to 100 and categorized by tertile) both overall and in emotional, tangible, affectionate, and social interaction subdomains. Outcomes included 1-year patient satisfaction and quality of life (QOL), dialysis modality switching, and hospitalizations and mortality (through December 2004). Associations were examined using overall and modality-stratified multivariable logistic, Poisson, and Cox proportional hazards models.Results: We found that mean social support scores in this population were higher in PD versus HD patients (overall 80.5 versus 76.1; P < 0.01). After adjustment, highest versus lowest overall support predicted greater 1-year satisfaction and QOL in all patients (odds ratio 2.47 [95% confidence interval (CI) 1.18 to 5.15] and 2.06 [95% CI 1.31 to 3.22] for recommendation of center and higher mental component summary score, respectively). In addition, patients were less likely to be hospitalized (incidence rate ratio 0.86; 95% CI 0.77 to 0.98). Results were similar with subdomain scores. Modality switching and mortality did not differ by social support in these patients, and associations of social support with outcomes did not generally differ by dialysis modality.Conclusions: Social support is important for both HD and PD patients in terms of greater satisfaction and QOL and fewer hospitalizations. Intervention studies to possibly improve these outcomes are warranted.Social support is widely thought to have the potential to improve patients'' health outcomes. Perceived social support has been shown to be associated with improved health outcomes in a variety of chronic health conditions (1), including heart disease (2,3) and diabetes (4); however, the association of social support with health outcomes remains an understudied problem in chronic kidney disease and ESRD, with little previous evidence of an association of social support with improved outcomes (5–8). Most previous studies of social support have focused on mortality alone, and results have been contradictory (7,8).Better social support could increase dialysis patients'' satisfaction with their care and their overall perceived health-related quality of life (HRQOL). In addition, social support could provide the means for better treatment, medication adherence, and nutrition, leading to better clinical outcomes. Among those receiving dialysis, levels of social support and associations of social support with outcomes may differ between the dialysis modalities, because hemodialysis (HD) and peritoneal dialysis (PD) differ dramatically in the amount of self-care required.In a national cohort of incident HD and PD patients, we assessed the level of social support overall and by dialysis modality. We also examined the associations of social support with patient satisfaction, HRQOL, and clinical outcomes, including modality switching, hospital admissions, and all-cause mortality. Finally, we assessed whether these associations differed by dialysis modality.     

Surgical registrars' perceptions of surgical training and capacity in Zambia: Results from three COSECSA affiliated training hospitals

Background

Surgery is a vital component of a comprehensive health system, but there are often personnel limitations in resource constrained areas. Zambia provides post graduate surgical training through two systems to help address this shortage. However, no studies have analyzed surgical trainees' perceptions of these programs.

Quality of life in schizophrenics with and without the deficit syndrome.

We investigated the relations between deficit as part of schizophrenic symptomatology and the popular but unclear concept of quality of life (QOL). In a 47-patient sample, subjective QOL was compared in schizophrenics with and without the deficit syndrome. Self- and hetero-rated QOL is more impaired in deficit patients. Differences between deficit and non-deficit groups are more significant as the index used for measuring QOL gets less "behavioral" and more "psycho-pathological". These results are consistent with existing literature. The "behavioral" dimensions of Heinrichs' quality of life scale (QLS) are less discriminative between deficit and non-deficit schizophrenics, but they are more independent of the symptoms. They might have a special clinical meaning, which needs to be defined. The concepts of QOL (as used in QLS) and deficit symptomatology are partially redundant. QLS might be an inappropriate, or at least un-specific measure of QOL.     

The effect of low level laser therapy (LLLT) on bone remodelling after median diastema closure: A one year and half follow-up study

Background and objectivesMaintenance of a corrected median diastema after orthodontic treatment often requires permanent retention. This study was performed to evaluate low level laser therapy (LLLT) effect on bone density after diastema closure and to determine whether increased density will prevent diastema relapse.Study designFourteen patients (22 ± 4.78 years) with median diastema (6.79 ± 2.28 mm) were randomly allocated to a lased and a non-lased group (i = 7). The patients in the lased group were exposed to GaAs (904 nm, 30 mW, 5.4 J/session, 3 times/3 min each/every second day). Standardized periapical radiographs of the maxillary central incisors were taken immediately after diastema closure, and at 15 days, 45 days, 3 months, 6 months and 1.5 years. Bone density and linear distances were measured using Digora software.ResultsDiastema reopening showed no statistically significant differences between the two groups. Reduction in linear distances was noticed in the lased group. Mean percentage changes in bone density were statistically significant between the groups at 15 days and 6 months. Only the periapical area distal to the right central incisor retained significantly higher bone density after 1.5 years. There was an insignificant negative correlation between the diastema size and bone density in the lased group at all experimental periods.ConclusionsLLL induced bone remodelling and prevented reduction in bone density in the lased group. Diastema reopening, although minor, did not seem to be significantly affected by the bone density changes. Further studies on a larger sample are necessary to optimize treatment parameters so LLL can be applied on a routine therapeutic basis.     

门静脉栓塞术在肝脏肿瘤二期切除中的应用

目的 探讨门静脉栓塞术在肝脏肿瘤二期切除过程中的作用与安全性。方法 分析总结5例难以一期切除肝脏肿瘤,先行门静脉栓塞术后再行二期肿瘤切除患者的临床资料。所有患者均采用B超及DSA引导下经皮肝门静脉左支穿刺法对门静脉右支进行栓塞。检测门静脉栓塞术后肝功能及肝叶体积变化,总结门静脉栓塞与肿瘤二期切除手术成功率。结果 5例患者均成功实施PVE术,术后出现一过性的肝功能减退,经保肝治疗短期恢复,未栓塞侧肝脏体积代偿性增大明显,达到预期效果;所有病例均顺利完成二期肝叶切除术,术后肝功能良好。结论 门静脉栓塞术成功率高、安全可行,对侧肝脏代偿性增大明显,达到预期目的,使得难以一期切除的肝脏肿瘤可以切除,从而提高肝脏肿瘤的切除率。     

Metastatic and hemorrhagic brain arteriovenous fistulae due to a choriocarcinoma. Case report

Brain metastasis of choriocarinoma is uncommon. These tumors develop in women of childbearing age and commonly produce signs and symptoms of subarachnoid hemorrhage, intracerebral hemorrhage, or brain tumor. Diagnosis can be established by histologic study of operative swabs and bioassay of the patient's blood, urine and cerebrospinal fluid for chorionic gonadotropin. This condition is highly chemo- and radiosensitive. We report the case of a 36-year-old woman with intracranial neoplastic fistulae. Rupture occurred 3 days after spontaneous abortion at 3 months of pregnancy. The patient presented with hemiplegia, aphasia and unclear consciousness. Left fronto-parietal hematoma was diagnosed on the CT scan, and cerebral angiography showed an arteriovenous intracranial fistulae. The hematoma and angioma were surgically removed successfully. The histological examination showed a metastatic choriocarcinoma. Surgery was followed by chemotherapy and radiotherapy. After 6 years of follow-up, complete remission has been obtained.