A case of fatal multidrug intoxication involving flualprazolam: distribution in body fluids and solid tissues

Forensic Toxicology - Designer benzodiazepines (DBZDs) increasingly emerged on the novel psychoactive substance (NPS) market in the last few years. They are usually sold as readily available...     

Characterization of polymorphic microsatellite markers for the bearded goby Sufflogobius bibarbatus

Fourteen polymorphic microsatellite markers with tetranucleotide repeats were developed for the bearded goby (Sufflogobius bibarbatus) from partial genomic DNA libraries using a repeat enrichment protocol, and characterized using two putative populations from the northern Benguela. The average number of alleles per locus ranged from 4 to 34, and the observed heterozygosities across loci were between 0.237 and 0.983. We also tested the utility of these markers in two other marine gobies; sand goby Pomatoschistus minutus and two-spotted goby Gobiusculus flavescens. These polymorphic markers can be employed to investigate population structure and related questions of the bearded goby.     

Negative perceptions of illness and health are associated with frequent use of physiotherapy in primary healthcare

Background

There is growing concern that an ageing population and increasing number of patients with chronic illnesses in the future will foster a need for health services beyond the resources available in society. Patients with chronic illnesses are reported to be frequent users of physicians' services in the primary health sector. Therapies for patients with chronic musculoskeletal illnesses are delivered by physiotherapists in this sector. However, we know little about the use of physiotherapy services and the factors that may explain their use.

Purpose

The aim of the present study was to examine the association between the regular/non‐regular use of physiotherapy services, impacts of illness, and perceptions of illness and health.

Methods

A cross‐sectional survey included patients between 18 and 70 years of age who visited a physiotherapy outpatient clinic in Oslo during one randomly chosen week. Patient characteristics and use of physiotherapy were mapped. The Brief Illness Perception Questionnaire (BIPQ), a single item of the Short Form Health Survey (SF‐12) and the Ørebro Musculoskeletal Pain Questionnaire (ØMPQ) were used to assess perceptions of illness and health, and impacts of illness. Data were analysed using independent sample t‐tests and logistic regression analysis.

Results

A total of 507 patients with a mean age of 46 (standard deviation 12) years participated, of whom 54% were regular users of physiotherapy. BIPQ (p = 0.02; β = 0.03) and the single‐item on general health perception (p = 0.001; β = 0.44,) were the only significant variables in the final equation associated with regular use of physiotherapy.

Conclusion

About half of the participants were regular, high consumers of physiotherapy, and negative perceptions of illness and health were associated with this regular use.     

Atrial fibrillation burden during the post-implant period after crt using device-based diagnostics

AF Burden After CRT Implantation. AIMS: Cardiac resynchronization therapy (CRT) is increasingly used in congestive heart failure (CHF) patients (with cardiac dyssynchrony). In addition to delivering therapy, CRT devices offer a variety of diagnostic tools for continuous long-term monitoring of clinically relevant information (i.e., occurrence and duration of arrhythmia episodes). METHODS AND RESULTS: Eighty-four patients with drug-refractory CHF in NYHA-class II-IV received a CRT device. The response to CRT was assessed by determining NYHA class at baseline and at 3 months follow-up. Atrial fibrillation (AF) burden (defined as time of AF per day) was continuously measured by the device. A significant gradual reduction of AF burden (from 9.88 +/- 12.61 to 4.20 +/- 9.24 [hours/day]) and number of patients experiencing AF episodes (from 26 to 13) were observed during CRT. CONCLUSIONS: (1) Diagnostic features for long-term monitoring of physiological variables provide useful information on the state and course of AF and may improve disease management. (2) AF burden reduces over time during the first 3 months after CRT implantation.     

Neurological and manual medicine findings after whiplash injury to the cervical spine

Summary In this article we summarize the current knowledge on “whiplash injury” by means of selected papers and our own results. The newest hypotheses and the results of research in pathophysiology, symptomatology, predictors and therapy are also discussed.      

Assessing the methodological quality of nonrandomized intervention studies

In many areas of health care, randomized controlled trials (the best evidence regarding the effectiveness of health care interventions) are lacking and decision-makers have to rely on evidence from nonrandomized studies (NRS). We conducted a Medline search to identify English-language articles describing instruments for assessing the quality of NRS of health care interventions. These instruments varied greatly in scope, in the number and types of items and in developmental rigor. Items commonly included were those related to specification of study questions, allocation method, comparability of groups, and blinding of outcome assessment. We do not support the development of a generic scale to evaluate the methodological quality of nonrandomized intervention studies. Instead, further study should be directed to investigate the degree to which, and the circumstances under which, different methodological characteristics are associated with bias. This information will assist researchers in identifying a priori which methodological characteristics need careful evaluation in particular studies.     

Radiographic diagnosis of the occult hip fracture: Experience in 16 patients

We have benefited from using a simple, time-saving radiographic procedure for more than 5 years which may establish a correct diagnosis in most patients with clinically suspected, but initially occult, hip fractures.     

Biology of Alaria spp. and human exposition risk to Alaria mesocercariae—a review

Recent incidental background findings of Alaria alata mesocercariae [“Distomum muscularis suis,” Duncker, 1896] in meat of wild boars during official Trichinella inspection initiated a re-assessment of the potential human health risk as posed by this parasite. The present review of the literature on Alaria biology shows that the human exposition risk should no longer be accepted to be negligible, as it demonstrates a general lack of knowledge in relevant areas of Alaria biology confounding any risk analysis. Sound risk assessment needs future studies which should concentrate on the most pressing questions of (1) the optimization and/or development of methods for reliable Alaria mesocercariae detection, (2) the distribution of the mesocercariae within their paratenic hosts, i.e., identification of potential predilection sites, particularly in wild boars, and (3) their prevalence in sylvatic populations of animals with respect to their introduction into the human food chain. Further, the degree and possibly also the species specificity of Alaria mesocercariae tenacity within the paratenic hosts and respective meat as pertaining to food technological treatments need to be elucidated. While these questions remain unanswered, it is an incontrovertible fact that Alaria mesocercariae have a potentially high human pathogenicity by both occupational and alimentary exposition.     

Möglichkeiten und Grenzen des telemedizinischen Homemonitorings in der Augenheilkunde

For medical professionals, home monitoring represents an innovative health service for remote patient care: The patient may remain in his or her domestic environment and continue normal activities. The physician can also, through technical and organizational integration, provide medical attendance from his or her usual working environment. All in all, in the near future home monitoring can help provide sufficient health services while also enabling medical resources to be used more effectively. The patient may benefit from individually optimized treatment and active integration into medical care. The better we manage the technical, organizational, medical, legal, and economic challenges of telemedicine, the better we can minimize the limitations of telemedical home monitoring. Other existing subjective concerns will be eliminated only if telemedical concepts are adapted to the specific needs of affected patients and physicians.     

Time from the Admission as the Predictor of Aggressive Behavior of Inpatients with Schizophrenia Spectrum Disorder

Psychiatric Quarterly - The aim was to assess the incidence of aggressive events (AE) committed by patients diagnosed with schizophrenia spectrum disorethder (SSD) after the first 7 days...