Comparative analysis of the clinical effectiveness of reflexotherapy and psychopharmacotherapy in the treatment of neurotic disorders in dermatology patients

Comparative studies on the efficacy of a multiple-modality treatment of patients with chronic dermatoses (atopic dermatitis, eczema, psoriasis), including reflexotherapy (RT) and drug psychotherapy (DPT), have shown high clinical efficacy of RT in cases with hysterical and moderately expressed anxiety-depressive disorders and of DPT in pronounced depressive hypochondriac disturbances. Unlike DPT, RT has not been associated with side effects. Clinical results have been confirmed by the data of comprehensive clinical and psychological examinations of the patients in the course of treatment.     

Forced vergence fixation disparity parameters with and without a central fusion lock

The effect of a central fusion lock on forced vergence fixation disparity curve parameters, that is, magnitudes of fixation disparity and associated phoria, curve type and the central slope of the curve, was studied in 84 subjects because of ambiguity in the previous studies. It was found that the magnitudes of exo fixation disparity and exo associated phoria decreased significantly when they were measured with the central fusion lock. The central lock had no noticeable effect on the type of the curve, although, the central slope of the curve was flatter in the presence of the central lock.     

Transient synovitis of the hip in children: role of US

Transient synovitis of the hip remains a common diagnostic problem for the clinician. The physical signs are not pathognomonic of the condition, and the classic technical examinations are of little help. Therefore, the authors retrospectively studied the value of hip arthrosonography in 46 children with clinical symptoms suggesting pathologic hip conditions. In 20 of the 21 patients with a final diagnosis of transient synovitis, articular effusion was detected on ultrasound (US). Conventional radiography showed an increased medial joint space in only eight of these patients. Increased echogenicity of the articular fluid was found in both transient synovitis and septic arthritis. The high sensitivity of US in detecting intraarticular fluid was demonstrated by cadaver studies.     

Metastases of kidney cancer (based on autopsy data)

The paper deals with the data on 1,248 autopsied cases of renal cancer. Metastases were detected in 87.1% (lung--48.2, lymph nodes--43.6, bones and joints--29.1 and liver--28.7%). 90 out of 139 cases of brain metastases died of the lesion. Metastases into the operative scar (most likely, implantation ones) were registered in 8 out of 224 (3.6%) previously nephrectomized cases. In some patients, nephrectomy produced an inhibitory effect on metastatic spread; 13% of the nephrectomized patients survived 5-20 years after surgery.     

Yersinia-related Arthritis in the United Kingdom. A Report of 12 Cases and review of the Literature

Reactive arthritis following infection with Yersinia is endemicin Scandanavian countries; the prevalence is low in the UK,however. We have reviewed the literature pertaining to Yersinia-relatedreactive arthritis in the UK and describe 12 patients who presentedover a 3-year period with an asymmetrical seronegative polyarthropathyand serological evidence of recent Yersinia infection. Fivepatients recalled having a diarrhoeal illness prior to the onsetof the arthropathy. None had a prior history of psoriasis, inflammatorybowel disease or ankylosing spondylitis. A history of urethraldischarge was elicited from one patient. Extra-articular manifestationswere seen in three patients (iritis in two, erythema nodosumin another). Four patients developed chronic joint disease afterperiods of 4, 6, 8, and 18 months, respectively. The prevalenceof Yersinia-related arthritis in the UK may be higher than previouslythought.     

Change in neoadjuvant chemotherapy could alter the prognosis of patients with pancreatic adenocarcinoma: A case report

BACKGROUNDNeoadjuvant treatment has become a standard of care for borderline or locally advanced pancreatic cancer and is increasingly considered even for up-front resectable disease. The aim of this article is to present the case of a 62-year-old patient with locally advanced pancreatic adenocarcinoma who was successfully treated with gemcitabine plus nab-paclitaxel after the failure of the first line treatment.CASE SUMMARYComputerized tomography scan and magnetic resonance imaging demonstrated a nodular lesion of ill-defined limits in the body of the pancreas, measuring approximately 4.2 cm × 2.7 cm, with an infiltrative aspect. The tumor had contact with the superior mesenteric vein, splenomesenteric junction and the proximal segment of the splenic artery, causing focal reduction of its lumens. Due to vascular involvement, neoadjuvant chemotherapy treatment with eight cycles of “folinic acid, 5-fluorouracil, irinotecan and oxaliplatine” (FOLFIRINOX) were performed. At the end of the cycles, surgery was performed, but the procedure was interrupted due to finding of lesions suspected of metastasis. Gemcitabine plus nab-paclitaxel was then successfully used for neoadjuvant treatment with subsequent R0 surgical resection.CONCLUSIONGemcitabine plus nab-paclitaxel may be effective as an alternative regimen when FOLFIRINOX fails as the first line of treatment, suggesting the need for further studies to identify which patients would benefit from each type of therapeutic approach.     

The clinical importance of the dynamic determination of the serum neopterin level in patients with dilated cardiomyopathy]

Serum neopterin was measured over time (from 3 to 24 months) by RIA in 15 patients with dilated cardiomyopathy. Comparison with the clinical data revealed that the initially normal concentration of neopterin (less than 9 nM/l) was associated with a stable disease course on a long-term observation (group I). The second group with an initially high neopterin concentration showed an objective improvement of the health status together with normalization of the neopterin level. The third group of patients were characterized by an increase of the neopterin level measured over time, coupled with a disease progress. It should be noted that 5 out of 8 patients died. In addition to neopterin measurements, the patients with dilated cardiomyopathy were examined for serum beta-2-microglobulin (beta-2M). Analysis of the data obtained has demonstrated a similar relationship between the level of neopterin and beta-2M and the clinical course of dilated cardiomyopathy. Still, neopterin is a more sensitive marker. Therefore, the data obtained attest to a possibility of the use of serum neopterin as a prognostic marker in patients suffering from dilated cardiomyopathy.     

Detection of antibodies to Trypanosoma cruzi among blood donors in the southwestern and western United States. II. Evaluation of a supplemental enzyme immunoassay and radioimmunoprecipitation assay for confirmation of seroreactivity

BACKGROUND: Chagas' disease, caused by the protozoan parasite Trypanosoma cruzi, is endemic to Latin America and may be transmitted in the United States via blood donated by infected immigrants. Blood- borne pathogens such as T. cruzi require supplemental testing for confirmation of seroreactivity. STUDY DESIGN AND METHODS: A study was undertaken to determine an optimal scheme for confirmation of seroreactivity in repeatedly reactive samples identified by the Chagas antibody enzyme immunoassay (EIA). The procedure for initial confirmation involves three purified antigens coated onto three separate polystyrene beads and uses an EIA format. If the sample is reactive with two of three or three of three antigens, it is confirmed as seroreactive. If none or one of three beads is reactive, the sample is indeterminate and subjected to a radioimmunoprecipitation assay (RIPA). The RIPA must demonstrate characteristic bands at 32, 34, and 90 kDa. RESULTS: When tested with sera from persons with potentially cross-reactive diseases (n = 39) or against a presumed negative population from southeast Wisconsin (n = 289), the confirmatory EIA had a specificity of 100 percent. Sensitivity was 100 percent (28/28) with xenodiagnosis-positive sera and 97.6 percent (80/82) with chagasic sera from Latin America. The RIPA showed a specificity of 100 percent in EIA- nonreactive samples (n = 100) and a sensitivity of 100 percent with both xenodiagnosis-positive (28/28) and chagasic (82/82) sera. CONCLUSION: The confirmatory EIA and the RIPA together provide a highly specific and sensitive means of confirming seroreactivity for antibodies to T. cruzi.     

Tension-free plasty in the surgery of abdominal wall hernias

The article presents an experience with application of tension-free plasty of the anterior abdominal wall using reticular endoprostheses. New endoprostheses of Reperen are developed and applied, a method of sutureless fixation of polypropylene net in the abdominal wall tissues is proposed when performing plasty for great ventral hernias. Advantages of new methods are shown compared with analogs both in selective and in emergency surgery, in different age groups of patients. The direct and long-term postoperative results and parameters of quality of life are investigated.