Efficacy of a patient-training videotape on motor fluctuations for on-off diaries in parkinson's disease

Patient on-off diaries are used in clinical trials, but a method to assure agreement between patient and examiner has never been developed. We tested whether a patient-teaching tape increased the rate of agreement between patient diary ratings and simultaneous neurologic assessment by a trained professional. A total of 32 consecutive patients who had Parkinson's disease with motor fluctuations independently completed a 4-h on-off diary (nine ratings) at the same time as an examiner. Those with <80% agreement with the examiner (n = 20) were randomized to view either a training tape that showed motor fluctuations (experimental group) or another videotape of general patient educational material (control group). All patients then underwent the same 4-h assessment of motor fluctuations. To test for long-term retention, they returned 1 month later and, without reviewing the videotape, underwent a final 4-h correlation assessment. After the training tape, the experimental group showed significant improvement, whereas the control group showed no improvement. Furthermore, another month later, the improvement in the experimental group was retained. Based on these findings, we suggest that future clinical trials assessing motor fluctuations incorporate this tape into their basic methodology.     

Human brucellosis in a nonendemic country: a report from Germany, 2002 and 2003

Human brucellosis has become a rare disease in Germany since the eradication of bovine and ovine/caprine brucellosis in this country. Therefore, most physicians are unfamiliar with the illnesses clinical presentation, diagnostic tools, and therapeutic strategies. This retrospective study was carried out to evaluate the epidemiological, clinical, and laboratory features of human brucellosis in Germany in the years 2002 and 2003. Thirty-one bacterial isolates from 30 patients sent to the German national reference laboratory were characterized using the genus-specific bcsp31 real-time PCR, the species-specific AMOS-PCR, and standard microbiological methods for the detection and identification of Brucella spp. The medical records of all patients with bacteriologically confirmed brucellosis were evaluated. All 31 isolates proved to be Brucella (30 Brucella melitensis and 1 Brucella suis). Most of the brucellosis patients were infected in endemic countries while visiting friends and relatives during their summer holidays. One case of laboratory-acquired infection was identified. Brucellosis was transmitted mainly by the consumption of contaminated unpasteurized milk or cheese from goats and sheep. The patients presented primarily with flu-like symptoms, i.e. fever, chills, sweating, headaches, arthralgia, and myalgia. In most cases, however, symptoms and signs of focal complications, e.g. spondylitis, endocarditis, and meningoencephalitis, predominated. The rate of complications was much higher than that in endemic countries, presumably as a result of diagnostic delay due to a low index of suspicion. In summary, physicians in nonendemic countries such as Germany must be aware of brucellosis being a possible cause of fever of unknown origin in immigrants and tourists travelling from endemic countries.     

Die Wirkung von Erythromycin in Kombination mit anderen Antibiotica auf Escherichia Coli

Journal of Molecular Medicine - An vier verschiedenen Escherichia Colistämmen, die alle mehr oder weniger starke Erythromycin-Resistenz aufwiesen, wurde der Einfluß von Erythromycin in...     

Thermal receptors in the scrotum of the rat.

1. The technique of single fibre dissection has been used to study the warm and cold thermoreceptors in the rat scrotum. 2. The warm receptors showed dynamic activity during increases of scrotal temperature and static activity when temperature was constant. The static activity/temperature curve was bell-shaped, with minima at 31 and 45 degrees C and a peak at 42 degrees C. 3. The cold receptors also showed dynamic and static responses to reductions of temperature. At steady temperatures the impulses from some receptors were grouped in bursts. The number of impulses in each burst increased from zero at 30 degrees C to four at 20 degrees C.     

Effect of temporal and spatial temperature gradients on the ampullae of Lorenzini

Summary Afferent single fiber impulses were recorded from isolated ampullae of Lorenzini of dogfishes (Scyliorhinus canicula). The ampullae were placed between two thermodes, each of which could be circulated separately with water at 12°, 18° and 24° C, thus allowing cooling and warming with various combinations of spatial temperature gradients. At constant temperature, there was a static discharge in the ampullary fibers. Cooling elicited a dynamic overshoot in frequency, followed by adaptation to a new steady state, whereas warming led to a transient inhibition. Within the limits of error the direction and slope of the spatial temperature gradient had no influence whatsoever on the static and dynamic responses of the ampullae, the only effective parameters being the temperature at the site of the receptor and the rate of temperature change with time.About 13% of the single fibers responded with bursts of impulses, interrupted by silent intervals, and 10% showed an inversed dynamic response, i.e. dynamic overshoot on warming and transient inhibition on cooling. It is possible that these patterns of activity are anomalous responses.This work was supported by the Deutsche Forschungsgemeinschaft.     

Acute hypervolemia does not improve arterial oxygenation in maximally exercising thoroughbred horses

Recently, it was reported that acute hypervolemia improves arterial oxygen tension in human athletes known to experience exercise-induced arterial hypoxemia. Since exercise-induced arterial hypoxemia is routinely observed in racehorses and is known to limit performance, we examined whether pre-exercise induction of acute hypervolemia would similarly benefit arterial oxygenation in maximally exercising thoroughbred horses. Two sets of experiments, namely, placebo [intravenous (IV) physiological saline] and acute hypervolemia (IV 7.2% NaCl, causing an 18.2% expansion of plasma volume) studies were carried out in random order on 13 healthy, exercise-trained thoroughbred horses, 7 days apart. An incremental exercise protocol leading to 120 s of galloping at 14 m s^–1 on a 3.5% uphill incline was used. Galloping at this workload elicited maximal heart rate and induced pulmonary hemorrhage in all horses in both treatments. In the placebo study, arterial oxygen tension decreased to 76.1 (2) mmHg (P<0.0001) at 30 s of maximal exertion, but further significant changes did not occur as exercise duration increased to 120 s [arterial oxygen tension 72.4 (2) mmHg]. A significant arterial hypoxemia also developed in galloping horses in the acute hypervolemia study [arterial oxygen tension at 30 and 120 s was 76.7 (1.7) and 71.9 (1.6) mmHg, respectively], but significant differences between treatments could not be demonstrated. In both treatments, a similar desaturation of arterial hemoglobin was also observed at 30 s of maximal exercise, which intensified with increasing exercise duration as hyperthermia, acidosis and hypercapnia intensified. Thus, acute expansion of plasma volume did not benefit arterial oxygenation in maximally exercising thoroughbred horses.