Brief communication: changes in thermogenesis and caloric efficiency with high and normal protein-reducing diets in women.

A pilot study with four women (40-60% above ideal weight, 32-42 years old) was conducted for 6 weeks of weight maintenance, 12 weeks at 50% calories (1000 and 1200 kcal/day) and 6 weeks of weight maintenance after weight loss. Two women consumed 17% and two 32% of their calories from protein during restriction; their energy metabolism and body composition changes were examined. The use of doubly labeled water for measuring energy expenditure during weight loss was evaluated. Although the 32% protein diet did not reduce lean body tissue loss, the apparent increased efficiency of calorie utilization compared to the 17% protein diet is worthy of further investigation. Thermic effect of a meal was greatly reduced in these women compared to previously reported responses. Further refinements of the doubly labeled water method are needed prior to application in weight loss studies.     

The acute effects of intravenous xamoterol ('Corwin', I.C.I. 118, 587) on resting and exercise haemodynamics in patients with mild to moderate heart failure

The known properties of xamoterol, a partial beta 1-agonist, provide a basis to pharmacologically modulate cardiac responses to variations in sympathetic tone. Haemodynamic variables were assessed at rest and on exercise before and after intravenous xamoterol (0.2 mg kg-1), in 30 patients with mild to moderate cardiac failure. Xamoterol produced significant improvements in resting cardiac index (2.51 +/- 0.15 to 2.80 +/- 0.14 l min-1 m-2; P less than 0.001), stroke volume (62 +/- 4 to 75 +/- 5 mljbeat-1; P less than 0.001) and stroke work index (42.4 +/- 3.6 to 47.7 +/- 3.9 gm beat-1 m-2; P less than 0.01). This occurred despite a significant reduction in heart rate (78 +/- 3 to 74 +/- 2 beats min-1; P less than 0.05). There were also significant reductions in systemic vascular resistance (1990 +/- 141 to 1669 +/- 112 dynes s-1 cm-5; P less than 0.01) and double product (1146 +/- 46 to 1051 +/- 41 mmHg min-1 x 10(-1); P less than 0.05), with no significant changes in systolic blood pressure, pulmonary wedge pressure or ejection fraction. Xamoterol significantly attenuated the heart rate response to exercise (112 +/- 4 to 97 +/- 3 beats min-1; P less than 0.001), with no impairment in the expected exercise induced increase in cardiac index. This was due to the significant increase in stroke volume from 81 +/- 6 to 95 +/- 7 ml beat-1 (P less than 0.001). There were no significant changes in resting or exercise noradrenaline levels.(ABSTRACT TRUNCATED AT 250 WORDS)     

Safety and tolerability of extended-release venlafaxine in severe medical and surgical illness

OBJECTIVE: This study attempted to determine if extended-release venlafaxine is safe for use in severely medically and surgically ill depressed patients. METHOD: The charts of 16 patients who were admitted to medical and surgical inpatient services and given extended-release venlafaxine were retrospectively evaluated for dose and duration of drug treatment, blood pressure changes, medication changes, and side effects. RESULTS: There was 50%-75% improvement in depressive symptoms, with a statistically insignificant mean elevation in blood pressure. CONCLUSIONS: Extended-release venlafaxine appears to be a safe and tolerable agent for the medical-surgical depressed inpatient.     

Clinical aspects of antimicrobial resistance

Soon after penicillin was introduced into clinical use, an enzyme (penicillinase) that inactivated it was discovered. Since then, the variety of antimicrobial agents has increased substantially, along with a parallel increase in resistant pathogenic microorganisms. Resistance is now recognized against all available antimicrobial agents. Factors influencing the emergence of resistance include indiscriminate use of antibiotics, prolonged hospitalizations, increasing numbers of immunocompromised patients, and medical progress resulting in increased use of invasive procedures and devices. This article provides an update on clinical aspects of a few commonly found resistant microorganisms relevant to day-to-day clinical practice. A discussion of all resistant organisms is beyond the scope of this report. Both viral and mycobacterial resistance have been addressed in previous articles in this symposium.     

Orbital pneumatocele

Air in the orbit is usually a result of trauma to the orbit but here we report a case of spontaneously occurring orbital Pneumatocele which followed about of sneezing and clearing of nose. The rare site communication at frontoethmoid junction is highlighted with relevant review of literature.     

Prevalences of oligozoospermia and azoospermia in male partners of infertile couples from different parts of India

Aim:To determine whether there was any regional variation in the prevalence of azoospermia,oligozoospermia andmean sperm counts in male partners of infertile couples from different parts of India.Methods:Data on 16 714semen samples analyzed over the past five years from six different laboratories located in five cities of India werecollated and evaluated.Results:There was a regional variation in the prevalence of azoospermia.The prevalence ofazoospermia was extremely high in Kurnool and Jodhpur(38.3% and 37.4%,respectively).There was also aregional variation in the prevalence of oligozoospermia(51%)in Kurnool.There was no significant difference in themean sperm counts in normospermic men.Conclusion:There is a regional variation in the prevalence of azoosper-mia and oligozoospermia in the male partners of infertile couples from different regions of India.The prevalence ofazoospermia in Kurnool and Jodhpur is higher than any other worldwide reported literature.Further studies need tobe carried out to determine the cause of this.(Asian J Androl 2006 Jan;8:89-93)     

Cone beam computed tomographic evaluation of pharyngeal airway in North Indian children with different skeletal patterns

BACKGROUNDIn growing patients with skeletal discrepancies, early assessment of functional factors can be vital for the restoration of normal craniofacial growth.AIMTo compare airway volumes in patients with mandibular retrognathism with the normal anteroposterior skeletal relationship, thereby assessing the association between cephalometric variables and airway morphology.METHODSCone-beam computed tomography volume scans, and lateral cephalograms, 3-dimensional airway volume and cross-sectional areas of 120 healthy children (54 boys and 66 girls mean age 15.19 ± 1.28) which were done for orthodontic assessment were evaluated. The subjects were divided into 2 groups based on the angle formed between point A, Nasion and point B (ANB) values and cephalometric variables (such as anterior and posterior facial height, gonial angle etc.) airway volumes, and cross-sectional measurements were compared using independent t tests. Pearson’s correlation coefficient test was used to detect any relationship of different parts of the airway and between airway volume and 2-dimensional cephalometric variables.RESULTSMeans and standard deviations for cephalometric, cross-sectional, and volumetric variables were compared. ANB, mandibular body length and facial convexity were statistically highly significant (P < 0.01) whereas condylion to point A, nasal airway and total airway volume (P < 0.05) were statistically significant. The nasal airway volume and the superior pharyngeal airway volume had a positive correlation (P < 0.01), nasal airway was correlated to middle (P < 0.05) and total airway superior had a relation with middle (P < 0.05), inferior and total airway (P < 0.05), middle was related to all other airways; inferior was also related to all the airways except nasal. Lateral cephalometric values were positively correlated with the airway volume with Frankfurt Mandibular Plane Angle and facial convexity showed significant correlations with total airway volume (P < 0.05). Additionally, ANB angle was significantly correlated with total airway volume and superior airway (P < 0.05).CONCLUSIONThe mean total airway volume in patients with retrognathic mandible was significantly smaller than that of patients with a normal mandible.     

Streptococcus suis-Related Prosthetic Joint Infection and Streptococcal Toxic Shock-Like Syndrome in a Pig Farmer in the United States

Streptococcus suis is an emerging swine-associated zoonotic agent that can cause meningitis and septicemia in humans. We present, to our knowledge, the first case of S. suis arthroplasty infection and streptococcal toxic shock-like syndrome due to an nonencapsulated serotype 5 strain in North America.