Chronic daily headache- one disease or two? Diagnostic role of serum ionized magnesium

The entity of chronic daily headache (CDH) is well documented, but is not included in the current classification. We divided patients with CDH into groups with and without migrainous features. This division resulted in clearly distinguishable syndromes of daily migrainous headaches (DMH) and daily tension-type headaches (DTH). Family history of headaches was more common in patients with DMH. Patients in both groups had a high incidence of caffeine or drug overuse. The clinical division into DMH and DTH was supported by our finding of a higher incidence of disturbed magnesium (Mg) metabolism in patients with DMH. Of 26 patients with DMH, 8 (30.8%) had low serum ionized, but not total, Mg levels, and 16 (61.5%) had high ionized calcium/magnesium ratios. The corresponding numbers for the 22 patients with DTH were 1 (4.5%) and 8 (30.4%). These new laboratory measurements offer possible biological markers for the diagnosis of different headache syndromes.     

Studies on the inhibition of poly(A) polymerase from rat liver and hepatoma 3924A by rifamycin SV derivatives

The inhibition of poly (A) polymerase activity from liver and hepatoma 3924A by several O-n-alky derivatives of rifamycin SV:3-formyloxime was studied. Only the O-n-pentyl (AF/012) and the O-n-octyl (AF/013) analogs were active at the maximum tested concentration of 1 × 10^?4 M. Equivalent concentrations of liver and hepatoma enzymes were inhibited to the same degree by both compounds. The 50 per cent inhibitory concentration (IC₅₀) for AF/013 and AF/012 was 1.2 × 10^?5M and 7.5 × 10^?5M respectively. Poly (A) polymerase activity was more sensitive to AF/013 if the enzyme was preincubated with the drug before the initiation of the reaction with poly (A) than if the reaction was initiated by the addition of the enzyme. Addition of AF/013 after initiation of the assay led to a rapid inhibition of poly (A) synthesis. The mechanism of inhibition by AF/012 and AF/013 of poly(A) polymerase was of the non-competitive type with respect to ATP.     

Sexual fantasy and activity patterns of males with inhibited sexual desire and males with erectile dysfunction versus normal controls

The fantasy patterns of patients with sexual difficulties have only recently received attention. Research has shown that females with inhibited sexual desire fantasize less than normal controls during foreplay and coitus, masturbation, and general daydreaming. This study is a continuation of the investigation of sexual fantasy and activity patterns and specific sexual dysfunctions. A fantasy questionnaire was completed by 37 men reporting a satisfying sex life and 35 males who came to a sexual dysfunction clinic complaining of either erectile dysfunction or inhibited sexual desire. This study indicates the frequency of sexual fantasy during foreplay and/or coitus, during general daydreaming and during masturbation is significantly less in the inhibited sexual desire males than in the control group and/or the erectile dysfunction group. The erectile dysfunction group and the control group were virtually identical in their frequency of fantasy during foreplay and/or coitus. The content of fantasies in all three groups is similar. The frequency of fantasy during masturbation was greatest in the erectile dysfunction group. The frequency of masturbation was greatest in the inhibited sexual desire males.     

Nerve Injuries in Athletes

In brief: Nerve injuries in athletes may be serious and may delay or prevent an athlete's return to his or her sport. Over a two-year period, the authors evaluated the condition of 65 patients who had entrapments of a nerve or nerve root, documented with electromyography. They describe four case histories: Two patients had radial nerve entrapments, one caused by baseball pitching and the other by kayaking; one football player had combined suprascapular neuropathy and upper trunk brachial plexopathy; and one patient had carpal tunnel syndrome of a median nerve secondary to rowing. Sports-related peripheral nerve lesions of the lower extremity were not seen during the study period. Based on a literature review, the nerve injuries discussed represent the spectrum of nerve entrapments likely to be seen in US clinics. The authors conclude that peripheral nerve lesions should be considered in the differential diagnosis of sports injuries, particularly at the shoulder, elbow, and wrist.     

Impact of Hybrid Delivery of Education on Student Academic Performance and the Student Experience

Objectives

To compare student academic performance and the student experience in the first-year doctor of pharmacy (PharmD) program between the main and newly opened satellite campuses of the University of Maryland.

Methods

Student performance indicators including graded assessments, course averages, cumulative first-year grade point average (GPA), and introductory pharmacy practice experience (IPPE) evaluations were analyzed retrospectively. Student experience indicators were obtained via an online survey instrument and included involvement in student organizations; time-budgeting practices; and stress levels and their perceived effect on performance.

Results

Graded assessments, course averages, GPA, and IPPE evaluations were indistinguishable between campuses. Students'' time allocation was not different between campuses, except for time spent attending class and watching lecture videos. There was no difference between students'' stress levels at each campus.

Conclusions

The implementation of a satellite campus to expand pharmacy education yielded academic performance and student engagement comparable to those from traditional delivery methods.     

Permanent paralysis of the atrium in a patient with facioscapulohumeral muscular dystrophy

A 32 year old man with the facioscapulohumeral (Landouzy-Dejerine) type of muscular dystrophy was evaluated because of a slow pulse rate. Hemodynamic studies were performed at rest and during ventricular pacing. The patient's atria were found to be electrically and mechanically silent. This unusual disorder of permanent atrial paralysis (standstill) is reviewed. There seems to be more than a casual relation between permanent atrial paralysis and this form of muscular dystrophy.     

Malfunction of a Cutter-Smeloff mitral ball valve prosthesis: diagnosis by phonocardiography and echocardiography

Mitral ball valve prosthesis malfunction is uncommon but may be associated with serious morbidity and may be fatal. The diagnosis may be suspected clinically and confirmed phonocardiographically and echocardiographically. It would appear reasonable to perform these studies serially at intervals of 3 to 6 months in patients with a mitral ball valve prosthesis, and whenever symptoms suggestive of peripheral embolization or of the onset or worsening of congestive heart failure are present.