Performance changes for patients with chronic obstructive pulmonary disease on long-term oxygen therapy after physiotherapy.

OBJECTIVE: To investigate whether patients with chronic obstructive pulmonary disease on long-term oxygen therapy would benefit from an early 8-week rehabilitation programme in terms of exercise performance, health-related quality of life and activities of daily living. METHODS: Two weeks after onset of oxygen therapy, 20 patients were randomized to rehabilitation (group A) or not (group B). Exercise performance was measured using a 6-minute walking test. Health-related quality of life was measured with the Chronic Respiratory Disease Questionnaire. Activity of daily living ability was measured with the Stanford Health Assessment Questionnaire. RESULTS: The mean 6-minute walking distance increased by 35% (p < 0.01) in group A after rehabilitation. The mean increase in group B was only 8% (n.s.). Patients in group A reported less overall dyspnoea after rehabilitation (p < 0.05) and, compared with group B, reported better activity of daily living ability (p < 0.01). CONCLUSION: Patients with chronic obstructive pulmonary disease on long-term oxygen treatment may improve their walking distance, experience less dyspnoea and improve activity of daily living ability with an early rehabilitation programme.     

Adolescents' experiences of being food-hypersensitive: a qualitative study

Background  

Experiencing or being at risk of adverse reactions to certain food items is a common health issue, especially among children and adolescents. Research has shown that living with the risk of food reactions and always having to take measures to avoid certain food in one's diet has a negative impact on quality of life. The aim of this study was to illuminate adolescents' experiences of being food hypersensitive.     

Atenolol in Migraine Prophylaxis a Double-blind Cross-over Multicentre Study

SYNOPSIS
The prophylactic anti-migraine effect of atenolol was compared to placebo in a multicentre study on 63 patients with classical and/or common migraine. The study design was double-blind cross-over and patients were given atenolol 100 mg o.d. or matching placebo during a study treatment period of 24 weeks. The effect of atenolol was significantly better than that of placebo: integrated headache values were reduced in 70% of the patients (p = 0.004) and the proportion of days with headache was reduced in 59% of the patients (p = 0.010). Few side effects were reported with both atenolol and placebo. This study shows atenolol to be safe and effective in the prophylactic treatment of migraine.     

Consensus Meeting on Microdialysis in Neurointensive Care

Background Microdialysis is used in many European neurointensive care units to monitor brain chemistry in patients suffering subarachnoid hemorrhage (SAH) or traumatic brain injury (TBI).Discussion We present a consensus agreement achieved at a meeting in Stockholm by a group of experienced users of microdialysis in neurointensive care, defining the use of microdialysis, placement of catheters, unreliable values, chemical markers, and clinical use in SAH and in TBI.Conclusions As microdialysis is maturing into a clinically useful technique for early detection of cerebral ischemia and secondary brain damage, there is a need to following such definition regarding when and how to use microdialysis after SAH and TBI.     

Long-term outcomes of six patients after partial internal biliary diversion for progressive familial intrahepatic cholestasis

Background

Partial internal biliary diversion (PIBD) is an alternative approach for the treatment of devastating pruritus in patients with progressive familial intrahepatic cholestasis (PFIC). In these patients quality of life can be improved and progression of liver disease can be delayed while waiting for liver transplantation. The aim of our study was to evaluate six patients with PFIC who have undergone PIBD in long-term follow-up.

Split‐hand phenomenon in amyotrophic lateral sclerosis: A motor unit number index study

Introduction: The split‐hand phenomenon refers to preferential wasting of the thenar muscles with relative sparing of the hypothenar muscles in amyotrophic lateral sclerosis (ALS). Methods: We compared the split‐hand index (SI) calculated from the compound muscle action potential (CMAP; SI_CMAP) with that calculated from the motor unit number index (MUNIX; SI_MUNIX). We performed MUNIX on the abductor policis brevis (APB), first dorsal interosseous (FDI), and abductor digiti minimi (ADM) muscles of 39 ALS patients and 40 age‐matched, healthy controls. SI is derived by multiplying the CMAP (or MUNIX) recorded over the APB and FDI and dividing by the CMAP (or MUNIX) recorded over the ADM. Results: Receiver‐operating characteristic curve analysis revealed good diagnostic accuracy for both indices, but better performance of SI_MUNIX than SI_CMAP. Conclusion: SI_MUNIX and SI_CMAP were useful in differentiating ALS patients from healthy controls. SI_MUNIX appears to be a better electrophysiological marker than SI_CMAP for the split‐hand sign of ALS. Muscle Nerve 53 : 885–888, 2016     

Palliation of bone pain in prostate cancer using chemotherapy and strontium-89. A randomized phase II study

Strontium-89 is an established alternative for the alleviation of bone pain in prostate cancer. There are few data evaluating the effect on pain of palliative chemotherapy. The aim of this randomized phase II study was to assess and compare the analgesic efficacy of strontium-89 and chemotherapy (FEM=5-FU, epirubicin, and mitomycin C) in 35 patients with disseminated, hormone-refractory prostate cancer suffering from persisting bone pain despite analgesic treatment. In order to minimize the risk for imbalances regarding the two patient groups, a double-blind randomization was performed. A significant reduction in pain intensity and pain frequency was registered in both patient groups (P < 0.01 in both groups after 3 weeks). Side effects were generally mild in the strontium-89 group and significantly more severe in the FEM group. The effect of FEM on pain is surprising as chemotherapy has generally only limited effect on tumor growth in bone metastases due to prostate cancer. A possible explanation is that FEM has an inhibitory activity on the inflammatory component of metastases.     

Isolated Accessory Tricuspid Valve Causing Right Ventricular Outflow Tract Obstruction

Abstract Accessory tricuspid valve (TV) tissue is a rare congenital cardiac anomaly with varying clinical and hemodynamic features. We report a rare case of accessory TV tissue causing severe right ventricular outflow tract obstruction (RVOT) in a patient without associated cardiac anomaly. Surgical resection of the isolated accessory TV tissue resulted in complete relief of the RVOT without compromising TV function . (J Card Surg 2010;25:410‐411)     

The efficacy of rhBMP-2 versus autograft for posterolateral lumbar spine fusion in elderly patients

Few studies have specifically examined the outcomes following rhBMP-2 usage in patients 65 years and older. The purpose of this retrospective study is to evaluate the efficacy of rhBMP-2 with allograft versus autograft for posterolateral lumbar fusion in patients 65 years and older. One hundred twenty-seven patients were divided into three groups based on fusion material and age. Subjects in group A (n = 34) consisted of patients 65 years and older who received rhBMP-2 and allograft. Group B (n = 52) was composed of patients under 65 years of age with rhBMP-2 and allograft. Subjects in group C (n = 41) were 65 years and older with autograft use. A comparison was made of fusion rate, fusion time (noticed, solid), clinical outcome, VAS, perioperative complications and revision rate between each group. The fusion rate and fusion time were similar in groups A and C; however, these were lower than that observed in group B. Clinical outcomes were similar amongst the groups. There were no significant differences in VAS and perioperative complication rate between groups A and C. In patients 65 years and older, rhBMP-2 with allograft may lead to acceptable fusion rates and fusion times, good clinical outcomes and reduced perioperative complications. The combination of rhBMP-2 with allograft yields equivalent outcomes as autograft in elderly patients undergoing instrumented posterolateral lumbar fusion. Additionally, when compared to patients under 65 years of age undergoing posterolateral lumbar fusion, the use of rhBMP-2 was not sufficient to overcome all aspects of the age-related weakened osteoinductive capacity encountered in elderly patients.     

Early onset multiple myeloma in a patient with systemic lupus erythematosus: a case report and literature review

Patients with systemic lupus erythematosus (SLE) are at increased risk for various plasma cell dyscrasias, but the coexistence of SLE and multiple myeloma (MM) are rarely reported to date. Due to the rarity, the clinical features of MM associated with SLE have not been elucidated, and the pathogenesis under this association remains unclear. In this report, we investigate a 31-year-old woman with 5-year history of SLE, who is diagnosed as IgA λ-type MM with multiple lymph node involvement. We discuss the clinical features of MM in SLE by reviewing previous cases and possible mechanisms connecting the two conditions.