Zweipunktediskrimination bei Phantomschmerzen

There is evidence that phantom pain is associated with a disrupted organization of the sensory cortex and that this organization can be normalized by training with two-point discrimination (TPD). In this case study a reduction in all three phantom modalities (i.e. phantom pain, phantom feeling and painful phantom sensation) and a reduction in pain level from m=?4.13/10 visual analogue scale (VAS) to m=?0.67/10 (VAS) could be observed in a patient with an upper limb amputation during a test period of 28 days with TPD. The quality of life and performance increased significantly. This can be a promising indication for a better social and work reintegration.     

中青年糖尿病患者胰岛素治疗存在的问题及护理干预

糖尿病易导致严重的急慢性并发症,已成为影响人们生活质量的一种常见疾病。胰岛素作为降糖激素,在控制糖尿病的发生、发展中有不可取代的作用。本文对中青年糖尿病患者在接受胰岛素治疗方面存在的问题及护理干预进行归纳。     

Analysis of queries sent to PubMed at the point of care: Observation of search behaviour in a medical teaching hospital

Background

A dengue fever outbreak occured in French Guiana in 2006. The objectives were to study the value of a syndromic surveillance system set up within the armed forces, compared to the traditional clinical surveillance system during this outbreak, to highlight issues involved in comparing military and civilian surveillance systems and to discuss the interest of syndromic surveillance for public health response.

Methods

Military syndromic surveillance allows the surveillance of suspected dengue fever cases among the 3,000 armed forces personnel. Within the same population, clinical surveillance uses several definition criteria for dengue fever cases, depending on the epidemiological situation. Civilian laboratory surveillance allows the surveillance of biologically confirmed cases, within the 200,000 inhabitants.

Results

It was shown that syndromic surveillance detected the dengue fever outbreak several weeks before clinical surveillance, allowing quick and effective enhancement of vector control within the armed forces. Syndromic surveillance was also found to have detected the outbreak before civilian laboratory surveillance.

Conclusion

Military syndromic surveillance allowed an early warning for this outbreak to be issued, enabling a quicker public health response by the armed forces. Civilian surveillance system has since introduced syndromic surveillance as part of its surveillance strategy. This should enable quicker public health responses in the future.     

黑色素性室管膜瘤1例

黑色素性室管膜瘤(Melanotic ependymoma)属室管膜瘤的一种．临床十分罕见，我科发现1例，现报道如下。     

Spinal cord central echo complex: histoanatomic correlation

Real-time sonography consistently demonstrates an echo complex centrally located in the spinal cord. This echogenic focus is currently attributed to the central canal. The authors sought the source of this central echo with ultrasound (US) and histoanatomic study of both fresh and fixed cadaver spinal cords. Correlative transverse sections of the spinal cord were stained with hematoxylin-eosin and Luxol fast blue for cells and myelin and with Holzer stain for glial fibrils. The central echo complex is produced by the interface between the myelinated ventral white commissure and the central end of the anterior median fissure. Variations in the shape of the central complex seem to reflect varying degrees of flaring of the central end of the anterior median fissure. The inconstant residual central canal and islands of residual ependymal cells are clearly not the source of the central echo complex.     

Temporal lobe necrosis in nasopharyngeal carcinoma: Pictorial essay

Nasopharyngeal carcinoma (NPC) shows a high frequency of skull base erosion and intracranial spread. This tumour is usually treated with radiation therapy. The medial and inferior portions of both temporal lobes are included within the radiation portals. These areas are therefore potential sites of radiation-induced necrosis. It is important to recognize this complication and separate it from intracranial tumour recurrence because the treatments of these entities are different.     

Consistency of microvascular and autonomic abnormalities in diabetes

The progression of early measures of microvascular disease and autonomic neuropathy were studied in a group of 81 children with insulin dependent diabetes mellitus over a mean interval of 4.2 years. Repeated measurements were made of blood pressure, albumin excretion, joint mobility, and pupillary dilatation in darkness. Over the years between the first and the second study, systolic and diastolic blood pressure showed positive tracking correlations (r = 0.38 and r = 0.32) with a small but significant deviation from normality; albumin/creatinine ratio was significantly increased (0.79 v 0.55); a greater number of children were identified in the second study as having limitation of mobility of the fifth metacarpophalangeal joint; and pupillary dilatation in darkness significantly decreased (61.5% v 62.9%); 62% of the children with one or more abnormal measurements in the first study were found to have measurements outside the normal ranges in the second study, indicating a consistency in observations over time. It remains to be seen with what accuracy these measurements predict adult onset clinical disease.     

The influence of thin-section tomography on the treatment of cervical spine injuries

A study was performed to determine the influence of routine thin-section tomography on subsequent treatment of the patient with acute trauma to the cervical spine. Of 79 such patients who underwent tomography over a 14-month period, 55 had suspicious indirect findings on the radiograph and 25% of these were shown to have fractures, while 67% of the patients without radiographic abnormalities who presented with a neurological deficit also demonstrated fractures on tomography. Of the patients who were shown to have fractures prior to tomography, 54% had more extensive injury than originally suspected. In nearly 18% of patients, the mode of therapy was changed significantly after tomographic evaluation. Indications for tomography are discussed and specific recommendations for systematic radiographic evaluation of cervical spine injuries are presented.