Dysequilibrium of ageing (presbyastasis)

We reviewed clinical findings in 740 patients over age 65 who consulted the Otological Medical Group, Inc., during a one-year period for dizziness. A thorough neurotologic evaluation is indicated in every such case to determine the specific cause of dizziness. In 21 per cent of these patients, a specific cause of dizziness was found. In the remaining 79 per cent, the diagnosis of primary dysequilibrium of ageing (presbyastasis) was made. We classified dysequilibrium of ageing (presbyastasis) according to the character, time course, and precipitating factors of dizziness. Two clinical types were described: constant and episodic; episodic dizziness was subdivided into orthostatic, positional, and unclassified. The histological findings in the temporal bones of four cases with dysequilibrium of ageing were reviewed. Pathological changes other than those in the peripheral vestibular system seem to be responsible for dysequilibrium of ageing. In the present series, about three-fourths of the patients had a daily dose of nicotinic acid to produce flushing of the skin. In 16 per cent, the dizziness was minor, requiring no special treatment. In the remaining 9 per cent with incapacitating vertigo, a vasodilator regimen, antivertiginous drugs, and Cawthorne's vestibular exercises were prescribed.     

A computerized data acquisition system for infusion devices--a clinical support tool, or a risk management tool?

A prototype computerized system for automatic data collection from multi-vendor infusion devices was constructed. The system was specifically designed around the needs of the critical care environment, and a survey of clinical staff was conducted to determine the functional requirements. Hardware, software and system configuration was based on the Medical Information Bus IEEE 1073 standard for medical device data communications. The infusion devices were configured into device communication controllers (DCC), which were polled at 0.25 Hz by a PC configured as a bedside communication controller (BCC). The system stores data samples after intervals of 1 ml of drug delivery and following any changes in the infusion rate. The system demonstrated significant opportunities for supporting clinical care and for the management of health care technology.     

Factor structure and internal consistency of the 12-item General Health Questionnaire (GHQ-12) and the Subjective Vitality Scale (VS), and the relationship between them: a study from France

Background  

The objectives of this study were to test the factor structure and internal consistency of the 12-item General Health Questionnaire (GHQ-12) and the Subjective Vitality Scale (VS) in elderly French people, and to test the relationship between these two questionnaires.     

Protective effect of red grape seeds proanthocyanidins against induction of diabetes by alloxan in rats.

It has been documented that impaired homeostasis in diabetes mellitus is associated with increased production of reactive oxygen species and depletion of the antioxidant defense systems. Natural grape seed proanthocyanidins (GSP) are potent free radical scavengers and hence provide significant protection against oxidative stress. Accordingly, the present study focused on investigating the possible protective role of GSP against free radical-mediated damage in pancreatic tissues of alloxan-induced diabetes in rats. The results revealed that oral administration of 50 and 100 mg kg(-1) (body weight) of GSP for 72 h significantly increased pancreatic glutathione (GSH) levels and inhibited the increase in lipid peroxidation caused by alloxan (p < 0.001). On the other hand, a significant reduction in pancreatic total nitrate/nitrite content (p < 0.001) was observed. Furthermore, GSP caused significant decline in the hyperglycemia induced by alloxan (p < 0.001). Such antihyperglycemic effect of GSP was accompanied by a significant increase in serum insulin levels in diabetic rats following 72 h of administration (p < 0.001). In conclusion, the study suggests that GSP are effective in ameliorating the damage to pancreatic tissue in experimental diabetes mellitus. Such effect may be related to their potent antioxidant properties as evidenced by the increase in pancreatic GSH and reduction of lipid peroxidation as well as total nitrate/nitrite levels.     

Sulfur amino acids in methionine-restricted rats: Hyperhomocysteinemia

ObjectiveDietary methionine restriction in Fischer-344 rats favorably influences visceral fat mass, insulin sensitivity, metabolic parameters, and longevity. However, little is known about the effects of methionine restriction on serum methionine and its downstream sulfur amino acids. We investigated the serum sulfur amino acid profile of male Fischer-344 rats fed a methionine-restricted diet for 3 mo.Methods and resultsUsing tandem mass spectrometry, we observed marked reduction in serum concentrations of methionine, cystathionine, cysteine, and taurine in methionine-restricted rats compared with control (P < 0.001) and a 2.5-fold elevation of homocysteine (P < 0.001).ConclusionThis suggests that homocysteine trans-sulfuration may be inhibited by methionine restriction, and that some of the effects of methionine restriction may be mediated by changes in sulfur amino acids downstream of methionine.     

Identification of Malassezia species isolated from some Malassezia associated skin diseases

BackgroundThe genus Malassezia represents the dominant eukaryotic component of the skin microbial flora. There are complex interactions between this commensal and the skin, leading to various Malassezia-caused or Malassezia exacerbated skin conditions.ObjectivesTo identify Malassezia species in lesions of patients with pityriasis versicolor (PV), atopic dermatitis (AD), and seborrheic dermatitis (SD), as well as corresponding sites in healthy subjects according to the culture methods used for Malassezia species isolation.MethodsScrapings were collected from 80 patients (40 PV, 20 AD, and 20 SD) and 30 healthy subjects. For 10-14 days, specimens were cultured on Dixon's medium and Malt extract agar. Direct microscopic examination with Gram's stain, subculture on Hi chrome agar, Dixon's medium at various temperatures, Tweens assimilation, and hydrolysis of tryptophan were used for the identification of yeast isolates.ResultsThe isolation frequency of Malassezia species in healthy subjects was 13.3% for M. furfur, 10.0% for M. globosa, and 3.3% for M.sympodialis. In patients with SD, M. furfur was isolated more frequently from scalp lesions (25.0%) and then M. sympodialis (15%) and M. globosa (10%). Malassezia sympodialis was the most prevalent isolated species in AD lesions (20%), followed by M. furfur (10%). Malassezia species isolation was found to be most prevalent in PV lesions, with M. furfur being the most prevalent identified species (52.5 %), followed by unidentified species (20%).ConclusionsMalassezia species composition was similar in PV, SD, and healthy subjects, with M. furfur being the commonest isolate, while Malassezia sympodialis was the prevalent species isolated in AD lesions. Chrome agar media can be promising for the identification of Malassezia species phenotypically. However, species differentiation has to be complemented by molecular methods.     

Philtrum length and intercommissural distance measurements at mixed dentition period

Anthropometric measurements of the lip and mouth are of great importance in clinical dysmorphology as well as reconstructive plastic surgery. In this study, the philtrum length (PhL) and intercommissural distance (ICmD) nomograms for Egyptian children in the mixed dentition period were established. A group of 1,338 Egyptian students in primary schools (735 boys and 603 girls) were included in the study. The students were at mixed dentition period and their ages ranged from 7 to 12 years. Anthropometric norms of PhL and ICmD were developed with significant sex difference in certain groups. A ratio between PhL and ICmD was developed. These data will help facilitate both objective and subjective evaluation of the lip and mouth for proper diagnosis of orofacial anomalies and variations as well as for ideal treatment plans.     

Ultrasound-guided spinal anesthesia for cesarean section in a parturient with spinal metastases

Preprocedural spinal ultrasound appears to decrease the failure rate and complications of neuraxial anesthesia compared to the conventional landmark technique. It is especially beneficial in difficult cases where conventional palpation technique may fail. We recently encountered a parturient with multiple lumbar and cervical spinal metastatic lesions presenting for cesarean section in the third trimester. We used spinal ultrasound to define the appropriate intervertebral space and measure the distance to the ligamentum flavum-dura mater complex. This greatly helped in administering a safe spinal anesthetic and avoiding general anesthesia which might have been hazardous in this patient.     

Circadian Body Temperature Variability is an Indicator of Poor Prognosis in Cardiomyopathic Hamsters

BackgroundLow body temperature is an independent predictor of poor prognosis in patients with congestive heart failure. The cardiomyopathic hamster develops progressive biventricular dysfunction, resulting in heart failure death at 9 months to 1 year of life. Our goal was to use cardiomyopathic hamsters to examine the relationship between body temperature and heart failure decompensation and death.Methods and ResultsTo this end, we implanted temperature and activity transducers with telemetry into the peritoneal space of 46 male Bio-TO-2 Syrian cardiomyopathic hamsters. Multiple techniques, including computing mean temperature, frequency domain analysis, and nonlinear analysis, were used to determine the most useful method for predicting poor prognosis. Data from 44 hamsters were included in our final analysis. We detected a decline in core body temperature in 98% of the hamsters 8 ± 4 days before death (P < .001). We examined the dominant frequency of temperature variation (ie, the circadian rhythm) by using cosinor analysis, which revealed a significant decrease in the amplitude of the body temperature circadian rhythm 8 weeks before death (0.28°C; 95% CI, 0.26-0.31) compared to baseline (0.36°C; 95% CI, 0.34-0.39; P = .005). The decline in the circadian temperature variation preceded all other evidence of decompensation.ConclusionsWe conclude that a decrease in the amplitude of the body temperature circadian rhythm precedes fatal decompensation in cardiomyopathic hamsters. Continuous temperature monitoring may be useful in predicting preclinical decompensation in patients with heart failure and in identifying opportunities for therapeutic intervention.