TREATMENT OF PALMOPLANTER HYPERHIDROSIS BY IONTOPHORESIS

Twenty-seven patients with idiopathic palmoplanter hyperhidrosis were treated with Iontotherapy over a one year period. In twenty-four cases there was a good response but maintenance therapy was required every 3-4 weeks.KEY WORDS: Iontophoresis, Palmoplanter hyperhidrosis     

Regulator of G-protein Signaling (RGS)1 and RGS10 Proteins as Potential Drug Targets for Neuroinflammatory and Neurodegenerative Diseases

Regulator of G-protein signaling (RGS) proteins were originally identified as negative regulators of G-protein-coupled receptor (GPCR) signaling via their GTPase-accelerating protein (GAP) activity. All RGS proteins contain evolutionarily conserved RGS domain; however, they differ in their size and regulatory domains. RGS1 and RGS10 are smaller than other RGS proteins, and their functions involve various inflammatory responses including autoimmune responses in both the periphery and the central nervous system (CNS). Neuroinflammation is the chronic inflammatory response in the CNS. Acute inflammatory response in the CNS is believed to be beneficial by involving the neuroprotective actions of immune cells in the brain, particularly microglia, to limit tissue damage and to aid in neuronal repair. However, chronically elevated levels of cytokines serve to maintain activation of abundant numbers of immune cells potentiating prolonged inflammatory responses and creating an environment of oxidative stress, which further hastens oxidative damage of neurons. In this review, we describe the implications and features of RGS proteins (specifically RGS1 and RGS10) in neuroinflammation and neurodegenerative diseases. We will discuss the experimental and epidemiological evidence on the benefits of anti-inflammatory interventions by targeting RGS1 and/or RGS10 protein function or expression in order to delay or attenuate the progression of neurodegeneration, particularly in multiple sclerosis (MS) and Parkinson’s disease (PD).     

Mothers' health and work-related factors at 11 weeks postpartum

PURPOSE Many new mothers return to work soon after childbirth. This study examines personal and work-related factors associated with the postpartum health of employed women 11 weeks after childbirth.METHODS Using a prospective cohort design, we recruited 817 Minnesota mothers into the study while they were hospitalized for childbirth in 2001. Telephone interviews were conducted at 5 and 11 weeks postpartum. Eligible women were 18 years or older, employed, and spoke English and gave birth to a singleton infant. Multivariate models using instrumental variables (2-stage least squares) were used to estimate personal and employment characteristics associated with women’s physical and mental health and postpartum symptoms.RESULTS At 11 weeks postpartum, 661 participants (81% of enrollees) completed a full interview, and 50% of participants had returned to work. On average, women reported 4.1 (SD 3.2) childbirth-related symptoms, most frequently fatigue (43%). Factors significantly associated with better health outcomes included better preconception health, the absence of prenatal mood problems, more control over work and home activities, more social support at work and home, and less job stress.CONCLUSIONS The findings suggest postpartum women need to be evaluated regarding their fatigue levels and mental and physical symptoms. Women whose fatigue or postpartum symptoms limit daily role function may find it helpful to have health care clinicians counsel them on strategies to decrease job stress, increase social support at work and home, and certify their use of intermittent family and medical leave to help them manage their symptoms.     

Postpartum depressive symptoms and the combined load of paid and unpaid work: a longitudinal analysis

Purpose  

To investigate the effects of total workload and other work-related factors on postpartum depression in the first 6 months after childbirth, utilizing a hybrid model of health and workforce participation.     

Effect of vascular activity in the determination of rate constants for the uptake of 18F-labeled 2-fluoro-2-deoxy-D-glucose: error analysis and normal values in older subjects

Regional cerebral blood volume (CBV) can be calculated using data obtained during the kinetic analysis of 18F-labeled 2-fluoro-2-deoxy-D-glucose (FDG) uptake measured by positron emission tomography (PET). As a result the influence of vascular activity upon the determination of FDG rate constants can be minimized. The method is investigated by simulation experiments and by analysis of PET studies on seven older, healthy human volunteers aged 52-70 years. The accuracy of measured FDG rate constants k1, k2, and k3, obtained either by omitting the early portion of the uptake curve or by explicit inclusion of CBV as a fit parameter, is compared. The root mean square error in measured rate constant for the latter method is equivalent to that obtained by omitting the first 2.5-3 min of tissue data and neglecting the CBV term. Hence, added information about the physiological state of the tissue is obtained without compromising the accuracy of the (FDG) rate constant measurement. In hyperemic tissue the explicit determination of the vascular fraction results in more accurate estimates of the FDG rate constants. The ratio of CBV determined by this method to CBV obtained using C15O in six subjects with CBV in the normal range was 0.92 +/- 0.32. A comparison of the CBV image obtained by this method with that obtained using C15O in an arteriovenous malformation case demonstrates the accuracy of the approach over a wide range of CBV values. The mean value for CBV fraction in gray matter obtained by this method in the older control group was 0.040 +/- 0.014. Average gray matter rate constants obtained were k1 = 0.084 +/- 0.012, k2 = 0.150 +/- 0.071, and k3 = 0.099 +/- 0.045 min-1.     

Fibrodysplasia ossificans progressiva: orthopedic pitfalls and controversies]

Fibrodysplasia ossificans progressiva (FOP) is a rare disorder of the connective tissue associating malformation of the great toes and progressive heterotopic ossifications. Diagnosis is mostly clinical and currently no treatment is available. We report on the case of an 8 year old boy having an unusual form of FOP. We discuss clinical aspects of the disease and insist on the importance of early diagnosis, avoiding harmful events and therapeutic pitfalls.     

The Effect of Preoperative Pneumonia on Postsurgical Mortality and Morbidity: A NSQIP Analysis

Background

Currently, only indirect evidence suggests that preoperative pneumonia is a significant risk factor for poor postsurgical outcomes. Although this relationship is clinically intuitive, this is the first study that aims to quantify the extent to which pneumonia impacts morbidity and mortality. The objective of this study was to determine the impact of preoperative pneumonia on 30-day mortality and morbidity among both elective and emergency surgical patients.

Methods

We conducted a retrospective cohort study using 2008–2012 data from the American College of Surgeons National Surgical Quality Improvement Program database. Patients with preoperative pneumonia were matched to controls without preoperative pneumonia. Patient demographics and postoperative outcomes were extracted from the database, including 30-day mortality, specific morbidities (wound, cardiac, respiratory, urinary, central nervous system, thromboembolism and sepsis), composite morbidity, number of blood transfusions and number of patients that returned to the OR. Mortality and composite morbidity were further stratified.

Results

We obtained data for 137,174 patients, of whom 6933 (0.50%) had preoperative pneumonia. Overall, 6111 were successfully matched to 24,444 patients with no pneumonia. Postoperative mortality and composite morbidity were both higher in patients with pneumonia than in those without pneumonia, with an odds ratio of 1.37 (95% CI 1.26–1.48) and 1.68 (95% CI 1.58–1.79), respectively.

Conclusion

Preoperative pneumonia significantly increased the rate of postoperative morbidity and mortality across several surgical settings and patient groups. It is our recommendation that elective surgery be delayed until after the pneumonia resolves.

     

Functional and Anatomical Magnetic Resonance Imaging in Parkinson’s Disease

For the past 15 years, measurements of cerebral blood flow as an indicator of neuronal activity have been used to gain a better understanding of the neural basis of motor and cognitive deficits in Parkinson’s disease. The initial studies, using positron emission tomography, yielded results in keeping with the hypothesis that symptoms result from excessive cortical inhibition from cortico-striatal loops. However, subsequent studies with functional magnetic resonance imaging (fMRI) have shown that specific aspects of the paradigms used, such as the need to pay attention to one’s movements, have a significant impact on activation patterns, which may complicate the interpretation of results. Functional neuroimaging has also been used to investigate the causes of cognitive impairment in Parkinson’s disease. While some studies implicate dopamine loss in striatum, more recent investigations using anatomical MRI to measure cortical atrophy suggest that some cognitive deficits are attributable to direct cortical involvement by the disease.