Interactions between foot placement, trunk frontal position, weight-bearing and knee moment asymmetry at seat-off during rising from a chair in healthy controls and persons with hemiparesis

OBJECTIVE: To assess the interaction of foot placement, trunk frontal position, weight-bearing and knee moment asymmetry at seat-off when rising from a chair. DESIGN: Cross-sectional study. SUBJECTS: Seventeen subjects with hemiparesis and 15 healthy controls. METHODS: Trunk position, weight-bearing and knee moment asymmetry were quantified by kinetic and kinematic analysis when the subjects rose from a chair using 3 different foot placements: spontaneous, symmetrical and asymmetrical. Asymmetry was defined by the ratio between sides. RESULTS: In the healthy controls, the spontaneous and symmetrical foot placements were associated with an almost vertical trunk position and a symmetrical weight-bearing and knee moment. The asymmetrical foot placement resulted in a trunk displacement towards the foot placed behind, with more weight-bearing and higher moment on this side. The opposite was observed in the hemiparetic participants where the spontaneous and symmetrical foot conditions determined a trunk position and an asymmetry bias towards the unaffected side. Placing the affected foot behind the other reduced the asymmetrical behaviour. CONCLUSION: Changes in weight-bearing are partly associated with the frontal trunk position, and foot placement manipulations can be used to modify weight-bearing distribution. Inference on weight-bearing is possible by observing the trunk position during the sit-to-stand task in persons with hemiparesis.     

[I]-TYR3-octreotide: clinical dosimetry and use for internal radiotherapy of metastatic paraganglioma and carcinoid tumors

Dosimetry and therapeutic application of [¹³¹I]-Tyr3-octreotide were evaluated in three patients with metastatic paraganglioma and carcinoid tumor. The in vitro stability of [¹³¹I]-Tyr3-octreotide was verified. Tumor uptake and residence time were between 0.02 and 0.1% and 0.5 to 9.8 h, respectively. The calculated tumor radiation doses were between 0.105 and 0.696 mGy·MBq⁻¹. No intolerance or adverse effects were observed after the therapeutic doses (3.3–6.6 GBq). A partial tumor response was obtained in one patient and no response occurred in two patients.     

C-Reactive Protein and Prealbumin in Suspected Sudden Infant Death Syndrome

This study investigated the levels of C-reactive protein (CRP) and prealbumin in 87 infants suspected of dying from sudden infant death syndrome (SIDS). These proteins change rapidly, within 24 hr, in patients who have an acute phase response, especially a response resulting from bacterial infection. In addition, prealbumin is sensitive to a recent reduction of protein or calorie intake. Eighty patients were determined to have typical SIDS. Only four of these had a minimal increase in CRP (0.8-2 mg/dl), and in none could an explanation be found. Seven patients were uncovered who had a significant infection, four of whom had prominent CRP elevations. Prealbumin was not decreased in the SIDS population. We conclude that there is no evidence that the acute inflammatory response is activated in infants dying of SIDS. An elevation of CRP above 2 mg/dl should prompt additional studies to find the cause. There is also no evidence of a recent, significant decrease in nutrition in these patients.     

Comparative study of two whole-body imaging techniques in the case of melanoma metastases: Advantages of multi-contrast MRI examination including a diffusion-weighted sequence in comparison with PET-CT

The aim of our study was to compare whole-body MRI (Magnetic Resonance Imaging) with a multi-contrast protocol including a DW (Diffusion Weighted) sequence to PET-CT (Positron Emission Tomography) using ¹⁸FDG (18F-fluoroDeoxyGlucose) for staging advanced melanoma. In a first part, we compared the respective overall accuracy of each modality. We analyzed in a second part the benefits of a DW sequence added to the standard whole-body MRI protocol. Among the population of the 35 patients who experienced the two examinations of our prospective blinded study, we were able to detect 120 lesions and 70 of them were found malignant. The sensitivity and specificity for whole-body MRI were respectively 82% and 97%, while PET-CT reached 72.8% and 92.7%. DW sequence allowed the detection of 14 supplementary malignant lesions (20%) in comparison with standard MRI protocol. Moreover, this technique has been shown to be the most accurate for detecting metastases in the liver, bone, subcutaneous and intra-peritoneal sites. Consequently, a DW sequence should be added systematically to the standard whole-body MRI oncologic protocol because of its high added-value for metastasis detection.     

Rectal stenosis due to Veganine suppositories

A new case of rectal stenosis due to the chronic use of suppositories of associated analgesic drugs is reported. Surgical treatment was conservative. This observation outlines the dramatic consequences of chronic self-treatment and the difficulties of ensuring long-term withdrawal.     

Can diminished bladder compliance favor spontaneous bladder rupture?

A case of spontaneous rupture of the bladder was observed in a 53-year-old woman. Physical evaluation and diagnostic investigations showed the following findings: initial urinary retention presumed to be psychogenic as the patient had a confusional state and was free of anatomic or neurologic complications; low bladder compliance observed upon urodynamic investigation on the 21st postoperative day and one year later; repeated coughing fits due to chronic bronchitis at the time of the accident. Rupture of the bladder requires the coexistence of an obstacle to urinary outflow and decreased parietal resistance to distension upon filling. According to the Laplace rule, the tension of the bladder wall (T) needed to resist distension is T = KPR, where P is the endovesical pressure and R the bladder sphere radius. Low bladder compliance therefore induces a disproportionate increase in intravesical pressure during filling and may be a significant etiologic parietal factor in the occurrence of spontaneous rupture of the bladder.