A comparative review of extracorporeal shock wave generation

Shock waves are specific sound waves produced by shock-wave generators; the generators currently available have different physical properties and represent different technical solutions. The measurement of shock-wave pressure is necessary in laboratory settings to define the physical characteristics of a given shock-wave source. Under clinical conditions other variables, e.g. the stone-free rate or the percentage of complications, are used to describe the efficacy and safety of a lithotripter.     

Peroxide als Pflanzeninhaltsstoffe, 12. Mitt.: Peroxide vom Davanon-Typ aus der Eberraute (Artemisia abrotanum) und ihre Darstellung

Peroxides as Plant Constituents, XII: Davanone Type Peroxides from Artemisia abrotanum and Their Preparation From the aerial parts of Artemisia abrotanum L. (Asteraceae), besides (+)-Davanone ( 1 ) and Arteincultone ( 2 ), the known peroxy-semiketals 2 , 5 , and 7 were isolated. In addition, the previously unknown davanone type peroxides epi-arteincultone ( 4 ) and spiro-arteincultone ( 6 ) were identified in A. abrotanum by TLC. By means of singlet oxygen oxidation of 1 , compounds 2, 3, 4, 5 , and 7 are formed, by triplet oxygen oxydation compounds 2, 3, 5, 6, 7 as well as hydroxy-davanone.     

Serum ribonuclease in urologic cancer Relation to host immunocompetence

Increased circulating levels of S-RNase (serum ribonuclease), an enzyme with immunosuppressive properties, were demonstrated in 14 of 19 patients with prostatic carcinoma, 6 of 6 patients with renal cell carcinoma, 5 of 6 patients with bladder carcinoma, but only 1 of 8 patients with testis tumors. A significant correlation between S-RNase levels and the extent of tumor was demonstrated in patients with prostatic carcinoma, but not in patients with other urologic malignant conditions. Moreover, a significant correlation was demonstrated between S-RNase and host cell-mediated immunocompetence as measured by delayed cutaneous hypersensitivity to DNCB (dinitrochlorobenzene). The results suggest that the S-RNase assay may be of clinical use in experimental treatment programs to reflect fluctuations of tumor status when subtle effects on tumor growth may be obscured by the advanced tumor state.     

Randomized comparison of a multidisciplinary job-retention vocational rehabilitation program with usual outpatient care in patients with chronic arthritis at risk for job loss

OBJECTIVE: Work disability is a major consequence of inflammatory rheumatic conditions. Evidence regarding the effectiveness of interventions aimed at the prevention or reduction of work disability in rheumatic diseases is limited. We conducted a randomized controlled trial to investigate the effectiveness of a multidisciplinary job-retention vocational rehabilitation (VR) program in patients with a rheumatic condition who were at risk for job loss. METHODS: A total of 140 patients with a chronic rheumatic condition were randomly assigned to either a multidisciplinary job-retention VR program (n = 74) or usual outpatient care (UC) (n = 66). Patients in the VR group were assessed and guided by a multidisciplinary team, whereas patients in the UC group received care as initiated by their rheumatologist, supplemented with written information. The main outcome measure was the occurrence of job loss (complete work disability or unemployment); additional outcome measures included job satisfaction, pain, functional status, emotional status, and quality of life. RESULTS: There was no difference between the 2 groups regarding the proportion of patients having lost their job at any time point, with 24% and 23% of the patients in the VR and UC groups, respectively, having lost their job after 24 months. Over the total period of 24 months, patients in the VR group had a significantly greater improvement of the fatigue visual analog scale and of emotional status (all P values < 0.05). CONCLUSION: A job-retention VR program did not reduce the risk of job loss but improved fatigue and mental health in patients with chronic rheumatic diseases at risk for job loss.     

Microbiological and clinical effects of chlorhexidine enclosed in fixtures of 3I-Titamed implants

This double-blind study used a split-mouth design to investigate the microbiological and clinical effects of 0.2% chlorhexidine enclosed in fixtures. Twelve patients had 46 fixtures implanted. At second-stage surgery, a microbiological sample (baseline sample) of the inner parts of the fixtures was taken. Then, a 0.2% chlorhexidine solution was applied into the inner space of 23 fixtures (test group), and in 23 fixtures saline was applied (control group). Abutments were installed and gingival index, plaque index and crevicular fluid flow were monitored weekly. After 6 weeks, a second microbiological sample of the inner part of the fixtures was taken. At baseline, viable bacteria were detected within 46% of the fixtures. After weeks, bacteria were found in 87% of the fixtures. The numbers of bacteria in the control group were significantly higher than those in the test group. The results indicate that, after first-stage surgery, contamination of the inner spaces of the fixtures is commonplace. Application of a 0.2% chlorhexidine solution at second-stage surgery inhibits growth or acquisition of bacteria in the fixtures. In both test and control groups, the crevicular fluid flow as well as the gingival index decreased during the experimental period. At 4, 5, and 6 weeks after chlorhexidine application, these values in the test group appeared lower, but did not attain statistical significance.     

Comparison of frequency of left ventricular thrombi in patients with anterior wall versus non-anterior wall acute myocardial infarction treated with antithrombotic and antiplatelet therapy with or without coronary revascularization

Of 200 patients with ST-segment elevation acute myocardial infarction (AMI), all received antiplatelet and antithrombotic therapy, and 186 patients (93%) underwent coronary revascularization. Left ventricular thrombi were diagnosed by 2-dimensional echocardiography ≤1 week after AMI in 19 of 114 patients (17%) with anterior wall AMI and in 3 of 86 patients (3%) with non–anterior wall AMI (p <0.001).     

Sensitivity, specificity, positive predictive value, and negative predictive value of the dipyridamole sestamibi stress test in predicting graft occlusion or > or = 50% new native coronary artery disease in men versus women and in patients aged > or = 65 years versus < 65 years who had prior coronary artery bypass grafting

The sensitivity, specificity, positive predictive value, and negative predictive value of the dipyridamole sestamibi stress test (DSST) in predicting graft obstruction or > or = 50% new native coronary artery disease (CAD) in 88 men compared with 56 women with prior coronary artery bypass surgery were 96% and 94% (p = NS), 30% and 67% (p = NS), 91% and 96 % (p = NS), 50% and 57% (p = NS), respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of the DSST in predicting graft obstruction or > or = 50% new native CAD in 92 patients aged < 65 years were 95% and 95% (p = NS), 50% and 40% (p = NS), 96% and 87% (p = NS), and 43% and 67% (p = NS), respectively.