Scotch tape as an adjunct to relaxation training in a case of Huntington's Chorea

Involuntary movements and emotional outbursts characteristic of Huntington's Chorea were controlled in a 60-yr-old male. Behavior therapy included relaxation training and clear adhesive tape to the face for tactile feedback as a cue to relaxation. Follow-up during a four-year period shows the treatment effects to be maintained.     

A case of Lassa fever: clinical and virological findings

Five days after arriving in London from Jos a young Nigerian women developed a severe and prolonged illness that proved to be Lassa fever. Virus was not detected in urine during the first three weeks but then appeared and reached a peak during the sixth week, with continuing excretion for 67 days after the onset of illness. Laboratory investigations showed evidence of extensive tissue damage and disturbance of clotting, but there was no serious bleeding and she eventually made a complete recovery despite a high sustained viraemia and severe liver damage. Convalescent serum was used in treatment but it was difficult to assess its contribution to the favourable outcome.     

Variability in fMRI: a re-examination of inter-session differences

We revisit a previous study on inter-session variability (McGonigle et al. [2000]: Neuroimage 11:708-734), showing that contrary to one popular interpretation of the original article, inter-session variability is not necessarily high. We also highlight how evaluating variability based on thresholded single-session images alone can be misleading. Finally, we show that the use of different first-level preprocessing, time-series statistics, and registration analysis methodologies can give significantly different inter-session analysis results.     

Paradoxical reactions during tuberculosis treatment in patients with and without HIV co-infection

BACKGROUND: It has been suggested that deterioration of tuberculosis (TB) during appropriate treatment, termed a paradoxical reaction (PR), is more common and severe in HIV positive individuals on highly active antiretroviral therapy (HAART). METHOD: A study was undertaken to determine the frequency of PR and its associated features in a population of HIV+TB+ patients and a similar sized group of HIV-TB+ individuals. RESULTS: PR occurred in 28% of 50 HIV+TB+ patients and 10% of 50 HIV-TB+ patients. Disseminated TB was present in eight of 13 HIV+TB+ patients and four of five HIV-TB+ patients with PR. In 28 HIV+TB+ patients starting HAART, PR was significantly associated with commencing HAART within 6 weeks of starting antituberculosis treatment (p = 0.03) and was more common in those with disseminated TB (p = 0.09). No association was found between development of PR and baseline CD4 count or CD4 response to HAART. CONCLUSIONS: PR is common in HIV infected and uninfected individuals with TB. Early introduction of HAART and the presence of disseminated TB appear to be important in co-infected patients.     

The classification of outcome following whiplash injury—a comparison of methods

There are many definitions and classifications of chronic neck pain and of neck pain following whiplash injury, many of them developed for a single study. This study compares three different outcome measures (neck disability index, Gargan and Bannister grade, general health questionnaire) in 277 patients who were examined for medicolegal reporting following isolated whiplash injury. There is significant correlation between the physical outcome scales and also between the physical and psychological outcome scales examined (both p <0.01). Definitions of chronic neck pain (with or without whiplash injury) and measures to assess and classify patients with chronic symptoms are reviewed. We recommend the use of a simple self-administered questionnaire that does not require physical measurement as the most useful tool in the evaluation of these patients and the most accurate method of classifying outcome.No financial assistance was required to complete this study     

Treatment of Allergic Bronchopulmonary Aspergillosis with Fluconazole and Itraconazole

Treatment of allergic bronchopulmonary aspergillosis (ABPA) has remained both problematic as well as controversial. Although the sheet anchor in treatment of ABPA still remains steroids, various workers have tried oral antifungals (fluconazole and itraconazole) with encouraging results. This study evaluates the effect of fluconazole or itraconazole in the treatment of ABPA patients and compares them with the patients who had received palliative therapy other than antifungals. Case records of 44 proven cases of ABPA treated at our referral service hospital during February 1998 to April 2001 were analyzed. In addition to oral and inhaled bronchodilators, 16 patients received fluconazole 150 mg OD and 13 patients itraconazole 200 mg OD for six months. Response to therapy was assessed clinically, radiologically and by spirometry every 3 months. Patients who did not receive antifungals had chronic course characterized by airway obstruction, recurrent pulmonary consolidation and obstructive defect on pulmonary function test (PFT). Patients treated with itraconazole had better control of asthma symptoms, less requirement of reliever inhalers, steroids and lesser exacerbations of asthma during follow-up even after stopping antifungal. Fluconazole group had better control of symptoms but improvement in other parameters was not statistically significant. From this study it was evident that itraconazole improved the symptoms of airway obstruction, pulmonary functions, pulmonary opacities and decreased exacerbations during follow up.Key Words: Allergic bronchopulmonary aspergillosis, Fluconazole, Itraconazole     

The role of standby emergency medication for falciparum malaria: current opinion

Travellers to malaria-endemic destinations are at risk of significant disease and, sometimes, death. Current malaria protection strategies, including chemoprophylaxis, can never be completely effective. In some cases, protective measures are discontinued or misapplied while the risk of infection still exists. In others, suboptimal measures are used, or even no measures at all, because of poor information or inappropriate risk-benefit assessment. In very rare cases, inexplicable failure of prophylaxis occurs. If malaria is contracted whilst abroad the danger to the individual is often further compounded by a lack of high-quality medical facilities and an uncertain supply of effective drugs for treatment. The advent of newer, well tolerated, drugs for treating malaria provides an opportunity to review the role of standby emergency self-medication in travellers visiting or staying (for work or other reasons) in areas where there is a risk of contracting malaria. This article was prepared following a meeting convened in London on Africa Malaria Day in 2002, in which the current opinions of experts in travel medicine and specifically malaria were discussed. It reviews opinion on the current effectiveness and acceptance of prevention strategies, as well as the role of standby emergency medication for falciparum malaria.     

Dynamic expression patterns of Robo (Robo1 and Robo2) in the developing murine central nervous system

The Robo family of molecules is important for axon guidance across the midline during central nervous system (CNS) development in invertebrates and vertebrates. Here we describe the patterns of Robo protein expression in the developing mouse CNS from embryonic day (E) 9.5 to postnatal day (P) 4, as determined by immunohistochemical labeling with an antibody (S3) raised against a common epitope present in the Robo ectodomain of Robos 1 and 2. In the spinal cord, midline-crossing axons are initially (at E11) S3-positive. At later times, midline Robo expression disappears, but is strongly upregulated in longitudinally running postcrossing axons. It is also strongly expressed in noncrossing longitudinal axons. Differential expression of Robo along axons was also found in axons cultured from E14 spinal cord. These findings resemble those from the Drosophila ventral nerve cord and indicate that in vertebrates a low level of Robo expression occurs in the initial crossing of the midline, while a high level of expression in the postcrossing fibers prevents recrossing. Likewise, Robo-positive ipsilateral axons are prevented from crossing at all. However, in the brain different rules appear to apply. Most commissural axons including those of the corpus callosum are strongly S3-positive along their whole length from their time of formation to postnatal life, but some have more complex age-dependent expression patterns. S3 labeling of the optic pathway is also complex, being initially strong in the retinal ganglion cells, optic tract, and chiasma but thereafter being lost except in a proportion of postchiasmal axons. The corticospinal tract is strongly positive throughout its course at all stages examined, including its decussation, formed at about P2 in the central part of the medulla oblongata.     

An analysis associating the presence of Claviceps purpurea in grassland with the incidence of type 1 diabetes

We introduce our paper by briefly outlining how we came to the conclusion that neurons in the brain and cells in other tissues can be killed by high intracellular concentrations of calcium ions (Ca(2+)). The life cycle of Claviceps purpurea is then described before theoretical information is drawn upon which indicates that ergot alkaloids can inactivate alpha adrenergic receptors for noradrenaline released from sympathetic nerve terminals. We deduce that inhibition of these receptors by ergot alkaloids leads to an increase in intracellular Ca(2+) concentration which can cause the death of the insulin producing cells of the pancreas.