Association between changes in characteristics of local cerebral blood flow and slow brain electrical activity in patients with dyscirculatory encephalopathy

Associated changes in the characteristics of local cerebral blood flow (CBF) and slow brain electrical activity were studied in 40 patients with dyscirculatory encephalopathy. CBF and CBV (cerebral blood volume) values for the frontal and temporal cortex and basal ganglia positively correlated with the constant potential values in the central lead influenced by the blood flow rate in the upper sagittal sinus.     

Intraoperative and early postoperative complications of puncture-dilation tracheostomy in neurosurgical patients

The paper provides a detailed analysis of the most common and clinically significant complications due to percutaneous dilation tracheostomy performed in 479 patients with neurosurgical diseases in 2002-2007. It also considers such complication of the technique, which is specific to neurosurgical patients, as elevated intracranial pressure (ICP), and describes a procedure of tracheostomy in patients with elevated ICP. Percutaneous dilation tracheostomy made by a skilled surgeon is shown to be effective and safe.     

Chronic hepatitis C in Latinos: natural history, treatment eligibility, acceptance, and outcomes

OBJECTIVES: The natural history of chronic hepatitis C and treatment response are different between blacks and Caucasians, but little comparable data is available about Latinos. METHODS: A cross-sectional secondary analysis to investigate differences between 421 anti-HCV-positive, treatment-na?ve, HCV-viremic Latinos and 2,510 Caucasians in 24 VA medical centers enrolled in a prospective study. RESULTS: Latinos were infected at a younger age and were less likely to have blood contact during combat, surgery, and needle stick injury, but were more frequently HIV coinfected (20.4%vs 3.9%, p < 0.0001) and prior HAV infection (39.9%vs 26.4%, p= 0.0001). Latinos were more likely to be treatment candidates, but less likely to actually initiate treatment. Liver histology (123 Latinos, 743 Caucasians) showed no difference in fibrosis or fibrosis rate, but steatosis (54.7%vs 43.2%, p= 0.038) was more common in Latinos. Eighty-eight Latinos and 481 Caucasians were subsequently treated with interferon-ribavirin: body mass index (BMI), duration of infection, baseline tests, liver histology and genotype distribution were similar. Compared with Caucasians, Latinos discontinued treatment prematurely more often (39.8%vs 28.9%, p= 0.043) and tended to have lower sustained virological response (SVR) rates (14.8%vs 22.5%, p= 0.10). Multivariate analysis found Latino race and history of recent alcohol use to be associated with early treatment discontinuation, whereas genotype and viral load but not ethnicity to be associated with SVR. CONCLUSIONS: Latinos were infected younger, more frequently HIV coinfected, more likely to meet criteria for antiviral therapy yet less likely to initiate treatment and had a trend toward lower SVR rates than Caucasians, but not in severity of liver disease. Latino ethnicity was associated with early discontinuation but not as an independent predictor of SVR.     

Transferring AAC intervention to the home

Purpose: To evaluate the acquisition of AAC skills during an initial clinical trial and assess subsequent transfer of the training to the home setting. Method: A 12-year-old male with autism was first seen in a clinical setting to establish the use of a voice-output communication device. After learning to use the device to request access to preferred objects in the clinical trial, the intervention was transferred to the home. Follow-up with the parent was conducted via e-mail and telephone. Videotapes were made of initial home-based sessions to enable evaluation of the participant's progress. Results: The programme was successful in teaching the participant to use a portable AAC device to make requests during the clinical trial and then in two home-based activities. Conclusion: An initial clinical trial with follow-up support for parents may be an efficient method for beginning AAC intervention and transferring the training procedures to the home setting.     

Revascularization of avascular spongy bone]

There have been studied the state of blood circulation in proximal parts of femur of 24 dogs (48 hip joints with simulated aseptic necrosis). In the first group of joints there have been carried out revascularization of the head by caudal epigastric artery with commitant veins. The second group have been subjected to tunneling. The third group of joints served as a control. Microcirculation disturbances, ascertained by intraosseous contrast phlebography arteriography and microscopic examination of osseous tissue, indicated that aseptic necrosis of the head of femur in an experiment is accompanied by increased intraosseous pressure, revascularization of an avascular spongy bone causes stable normalization of intraosseous hemodynamics.     

Immune hemolytic anemia associated with tolmetin and suprofen

This article reports the first case of immune hemolytic anemia possibly associated with the ingestion of suprofen. The patient suffered from massive hemoglobinuria and acute renal failure. Serologic studies of the patient's serum revealed suprofen-dependent red cell antibodies. However, tolmetin-dependent antibodies were also found in the serum, showing the same properties as the suprofen antibodies and an even higher titer. The patient not only had drug-dependent antibodies in the serum, but also had developed autoantibodies, a phenomenon that has been described for several other drugs. The working mechanism by which suprofen and tolmetin caused immune hemolysis had properties of both the immune complex model and the induction of autoimmunity. Although it was unclear whether the immune hemolytic anemia was the result of suprofen, tolmetin, or cross-reacting antibodies, we feel that suprofen should be added to the list of nonsteroidal anti-inflammatory drugs associated with a positive direct antiglobulin test.