Septoplasty: long-term evaluation of results

OBJECTIVE: The goal of this study was to ascertain how accurately the surgeons' selection criteria for septoplasty, which largely relies on clinical judgement alone, is able to anticipate patients' long-term satisfaction. Study Design and Setting: A 10-year retrospective study was undertaken in a tertiary care otorhinolaryngology center. METHODS: All patients who underwent septoplasty at the same otorhinolaryngology department in the past 2 to 10 years were mailed a questionnaire to evaluate their perception of the procedure's results. Clinical files were reviewed to establish the initial type of septal deformity. Because some surgeons used rhinomanometry to support their decision to recommend surgery, its capability of predicting patients' satisfaction was simultaneously assessed. RESULTS: Subjects with anterior septal deformities were shown to benefit the most from septoplasty. Selection of patients on clinical grounds alone does carry, however, a considerable risk of patient dissatisfaction with end results. Nevertheless, despite a very strong correlation between anterior septal deviations and increased nasal resistance, preoperative rhinomanometry data failed to prove useful in predicting the long-term surgical outcome. CONCLUSIONS: Surgeons' appreciation of the types of septal deviation that do benefit from surgical correction falls short of desirable. Patients' satisfaction, however, did not improve if rhinomanometry was included in the preoperative evaluation.     

Pneumonitis after intravenous self-administration of solvent

Intravenous self-administration of petroleum distillates is a rare condition. Most experience with petroleum distillates poisoning is with ingestion by children, and the most common and serious manifestation is chemical pneumonitis. We report a case of chemical pneumonitis after intravenous self-administration of ink solvent.     

Role of smooth muscle cell membrane potential in neointima formation in arteries of spontaneously hypertensive rats

Based on observations that vascular smooth muscle cells (VSMC) from spontaneously hypertensive rats (SHR) have altered resting potentials as well as abnormal cell proliferation rates, neointima formation after controlled balloon injury was compared in arteries from SHR and Wistar Kyoto rats (WKY). SHR aortic VSMC showed hyperpolarized resting membrane potentials (−93±8 mV) when compared to those from WKY (−61±6 mV). Histomorphometric analysis of cross sections from aortic segments submitted to balloon injury showed reduced neointima formation in SHR (neointima/media ratio: 0.04±0.03) as compared to WKY (0.2±0.1). On the other hand, in injured carotid arteries, neointima formation was more extensive in SHR (neointima/media ratio 5.0±0.9) than in WKY (0.8±0.7), leading in most cases to luminal occlusion. Measurements of VSMC resting potential showed that carotid artery cells from SHR were depolarized with respect to those from WKY (−46±4 vs. −69±5 mV, respectively). The results demonstrate an inverse relationship between VSMC membrane polarization and neointima formation in SHR arteries, suggesting that genetic modifications in SHR determine a dysfunctional cellular physiology that may influence cell proliferation subsequent to injury.     

Neutralization of proteases from Bothrops snake venoms by the aqueous extract from Casearia sylvestris (Flacourtiaceae).

Aqueous extract from Casearia sylvestris leaves, a typical plant from Brazilian open pastures, was able to neutralize the hemorrhagic activity caused by Bothrops asper, Bothrops jararacussu, Bothrops moojeni, Bothrops neuwiedi and Bothrops pirajai venoms. It also neutralized two hemorrhagic metalloproteinases from Bothrops asper venom. Proteolytic activity on casein induced by bothropic venoms and by isolated proteases, including Bn2 metalloproteinase from B. neuwiedi venom, was also inhibited by the C. sylvestris extract in different levels. The -fibrinogen chain was partially protected against degradation caused by B. jararacussu venom, when this venom was incubated with C. sylvestris extract. We also observed that this extract partially increased the time of plasma coagulation caused by B. jararacussu, B. moojeni and B. neuwiedi venoms. C. sylvestris extract did not induce proteolysis in any substrate assayed.     

Personality assessments as a workforce diversity tool

* Employee recruitment, retention, and workforce diversity are essential ingredients in a successful radiology department. Since potential new hires and existing employees do not come with labels which accurately describe their innate characteristics, radiology managers need to use objective tools such as personality assessments in order to properly evaluate prospective employment candidates. * These tools have traditionally been under utilized in the healthcare industry, but when used as part of a complete employee selection program they have the potential of ensuring a cohesive radiology department filled with diverse and skilled professionals. * Legal concerns and time constraints withstanding, use of personality assessments as a workforce diversity tool will aid in building an integrated department culture which values the varying skills and attributes of every employee. The result is a radiology department with high levels of employee retention and satisfaction.     

Immunomodulatory therapy in multiple sclerosis and breast cancer risk: a case report and literature review

Multiple sclerosis (MS) is an autoimmune inflammatory disease of the central nervous system frequently complicated by devastating neurologic symptoms and progressive disability. Much progress has been made in the development of immunomodulating drugs to help fight the progression of MS. These drugs are believed to work by interacting with various immune system components to reduce the amount of autoimmune destruction to the nervous system. We report 2 cases of women with MS on immunomodulatory therapy who presented with locally advanced breast cancer with aggressive biologic phenotypes and exceptionally poor outcomes. We consider the potential for an increased risk of developing a poorer-prognosis breast cancer as a result of concomitant immunomodulatory effects of the previous MS treatment, particularly the effects the drugs are reported to have on regulatory T cells, and therefore present these cases and a review of the current literature. Current data in the literature reflect the need for further study in ascertaining the risk of biologically poor-prognosis breast cancer development in patients with MS treated with immunomodulatory therapy.