The role of arthrography in the management of dysplasia epiphysealis hemimelica

Dysplasia epiphysealis hemimelica can be diagnesed on plain radiographs of the affected areas. However, double contrast arthrography in three new cases provided additional information. The cartilaginous portions of the lesion at the articular surface of the bone were precisely demonstrated, aiding the orthopedic surgeon in deciding which patients should have surgery and planning the extent of operation necessary.     

Effect of glucocorticoids on extravascular lung water following extra-corporeal circulation

The influence of 3 different, preoperatively given glucocorticoids (30 mg/kg bw methylprednisolone, 3 mg/kg bw dexamethasone, 30 mg/kg hydrocortisone) on extravascular lung water (EVLW) was investigated in a randomised study consisting of 60 patients undergoing elective aortocoronary bypass surgery and compared to a control group having received 0.9% NaCl as placebo. EVLW-measurements were performed by using the double indicator dilution technique with indocyanine green and a microprocessed lung water computer. Besides EVLW-measurements haemodynamics and various laboratory data were studied before as well as after (15 min, 45 min, 5 h) extracorporeal circulation (ECC). ECC was followed by an increase in EVLW, which was less pronounced in the dexamethasone-group without being statistically significant (p = 0.1), however. Pulmonary gas exchange, too, did not differ statistically, in spite of a less pronounced (p = 0.1) deterioration of paO2 in the dexamethasone-group. Haemodynamics and laboratory data in the corticoid-group did not show any significant difference compared to the non-treated control group. It was concluded, that pretreatment with corticoids in pharmacological doses in cardiac surgery had no beneficial effects on extravascular lung water and pulmonary function.     

Isolated modification of the vascular system by vasopressor agents (akrinor, etilefrin, ephedrine, norfenefrine, amezinium) during extracorporeal circulation in man

The influence of different vasopressors (Akrinor, etilefrine, ephedrine, norfenefrine, ameziniummetilsulfate) on arterial perfusion pressure and oxygenator volume during extracorporeal circulation was compared to a control group. All substances led to an increase in perfusion pressure, thus demonstrating a direct influence on arterial vessels. The rise in arterial pressure after injection of ameziniummetilsulfate persisted during the investigation period, whereas norfenefrine led to a short-lasting, but massive increase. No rise in venous tone was noticed during the investigation period.     

Verschlechterung bei Patienten nach Aufnahme an einer Stroke Unit – Ergebnisse aus dem Österreichischen Stroke Unit Register

Wiener Medizinische Wochenschrift - Eine klinische Verschlechterung innerhalb der ersten Stunden bis Tage bei Patienten, die mit einem ischämischen Schlaganfall oder einer TIA stationär...     

Computed tomography of nephrogenic adenoma of the urinary bladder

Nephrogenic adenoma of the urinary bladder is a rare benign tumor. It is generally accepted that the tumor represents metaplasia of the urothelium in response to chronic inflammation or injury. Its CT appearance can be similar to that of carcinoma of the bladder.     

Emergence of Mutations in the K13 Propeller Gene of Plasmodium falciparum Isolates from Dakar,Senegal, in 2013-2014

The kelch 13 (K13) propeller gene is associated with artemisinin resistance. In a previous work, there were no mutations found in 138 Plasmodium falciparum isolates collected in 2012 and 2013 from patients residing in Dakar, Senegal (M. Torrentino-Madamet et al., Malar J 13:472, 2014, http://dx.doi.org/10.1186/1475-2875-13-472). However, the N554H, Q613H, and V637I mutations were identified in the propeller region of K13 in 92 (5.5%) isolates in 2013 and 2014. There were five polymorphisms identified in the Plasmodium/Apicomplexa-specific domain (K123R, N137S, N142NN/NNN, T149S, and K189T/N).     

Menopause Management Knowledge in Postgraduate Family Medicine,Internal Medicine,and Obstetrics and Gynecology Residents: A Cross-Sectional Survey

Objective

To evaluate the knowledge of and nature of training for menopause management in postgraduate residents.

Early virological failure with a combination of tenofovir, didanosine and efavirenz

OBJECTIVE: To describe the occurrence of a high early virological failure (VF) rate and development of resistance mutations in antiretroviral-naive patients receiving tenofovir, didanosine and efavirenz. METHODS: HIV-infected antiretroviral-naive patients with viral load > or =30 000 copies/ml were enrolled in a pilot randomized trial of tenofovir/didanosine (250 mg)/ efavirenz with (arm A) or without (arm B) lopinavir/r for the first 12 weeks. As six cases of early VF (a drop of <2 log at month 3, or a rebound of >1 log from the nadir) were detected (five in arm B and one in arm A who had previously stopped lopinavir/r) an unplanned interim analysis was performed. RESULTS: A total of 29 out of 36 enrolled patients completed at least 3 months of follow-up and were included in the interim analysis. An intent-to-treat analysis showed treatment failure in 7/15 (46.7%) patients in arm B (five VF, one lost, one switched) versus 2/14 (14.3%) in arm A (one lost, one switched) (P=0.109). The patient in arm A who interrupted lopinavir/r at day 3 and continued with tenofovir/didanosine/efavirenz later developed VF. At baseline, 6/6 VF patients had VL >100000 copies/ml and an advanced stage of disease (CD4 <200 plus CDC stage C or B3) versus 0/8 non-VF patients taking the triple drug regimen (P<0.001). At failure, G190S/E alone or associated with K103N and K101R mutations was detected in five patients, and K103N/L1001/V108l in the sixth patient. Additionally, L74V/I and K65R were detected in four and two patients, respectively. CONCLUSIONS: A high early virological failure rate and the occurrence of resistance mutations were detected in a group of antiretroviral-naive patients treated with tenofovir/didanosine/efavirenz.