Percutaneous coronary intervention in two occluded arms of a saphenous 'Y'-graft: the importance of protecting both of your arms.

Percutaneous intervention in saphenous vein grafts (SVG) carries a higher risk of distal embolization than intervention in a native vessel, and use of a distal protection device has been shown to improve the outcomes in SVG interventions. We describe an intervention done in an unexpected 'Y' SVG which required dual distal protection with Filterwires placed in both limbs of the diseased graft and which was performed via a 6 Fr guide catheter.     

Catheter-directed middle hemorrhoidal artery embolization for life-threatening rectal bleeding.

Over the past 10 years, arteriography has become a well-established technique for the diagnosis of acute lower gastrointestinal bleeding, but not particularly for rectal bleeding. However, to the authors' knowledge, the technique of middle hemorrhoidal artery embolization has rarely been reported in the literature. In the present report, three patients with life-threatening rectal bleeding are presented, which was controlled by superselective embolization of the middle hemorrhoidal artery or selective embolization of the internal iliac artery as a last resort.     

Prostatitis: Updates on diagnostic evaluation

Prostatitis accounts for almost 2 million office visits to urologists and primary care physicians. The label “prostatitis” refers to a diverse constellation of symptoms and disease processes. The diagnosis and treatment of this disorder present numerous challenges for the physician, including a lack of abnormal findings on physical examination, laboratory tests, and radiographic images. In this article, we offer a review of the current literature and recommendations for the evaluation and diagnosis of the patient presenting with prostatitis.     

Alemtuzumab (CAMPATH 1H) Induction Therapy in Cadaveric Kidney Transplantation—Efficacy and Safety at Five Years

Alemtuzumab is a powerful lymphocyte depleting antibody currently being evaluated in solid organ transplantation. This paper describes 5-year results of a single center study of alemtuzumab as induction in renal transplantation. Thirty-three renal transplant recipients received 20 mg alemtuzumab on day 0 and 1, followed by half-dose cyclosporin monotherapy (trough concentration 75-125 ng/mL) from day 3. They were compared in a retrospective contemporaneous-controlled manner with 66 kidney transplant recipients transplanted in the same period and center who received conventional immunosuppression with cyclosporin, azathioprine and prednisolone. In the alemtuzumab group 12% of recipients died compared to 17% in the control group (p = 0.48); likewise graft loss was similar in both groups (21% vs. 26%, respectively, p = 0.58). Incidence of acute rejection was also comparable at 5 years (31.5% vs. 33.6%), although the pattern of rejection was different with 14% patients in the alemtuzumab group experiencing rejection over 1 year post-transplant compared to none in the control group. There was no significant difference between groups in terms of infection or serious adverse events. While acknowledging the limitations of a relatively small single-center study, results suggest that alemtuzumab induction allowed satisfactory long-term patient and graft survival equivalent to that seen with standard triple immunosuppression, while avoiding steroid therapy.     

Iron-containing proteins in the plasma and serum of the blood in patients during hyperbaric oxygenation therapy

Extra-erythrocyte hemoglobin (EEH) level and total peroxidase activity (TPA) have been analysed in the blood serum and plasma of 44 patients following hyperbaric oxygenation (HBO). The levels of the parameters tested decreased after 3 HBO procedures and remained low to the end of the treatment period in the first group of patients. In the second group of patients, on the contrary, EEH and TPA levels increased after 3 HBO procedures and remained high to the end of the treatment period. In both groups of patients EEH changes correlated with TPA alterations. Possible EEH and TPA determination for the estimation and enhancement of HBO treatment efficacy is discussed.     

Limitations of efficacy of chemotherapies in schizophrenia]

The concept of treatment-resistant schizophrenia cannot be defined as this of resistant depression: schizophrenia is a long-term illness; its evolution is almost always influenced by neuroleptics--but complete recovery is rare. French psychiatry tends to use clinical-empirical criteria, while english speaking studies prefer quantitative criteria, by extended use of clinical and psycho-social scales. The definition of resistant schizophrenia by Kane et al. is a typical example of this method of work. We propose to overview the limits of neuroleptics efficiency in schizophrenia from three groups of studies: a) The effects of maintenance therapy: 24 studies of the last twenty years show that 2/3 of schizophrenics under neuroleptics maintain their remission over one or two years, opposed to less than 1/3 of those who discontinue their treatment. These data seem to be independant from the method of the study, the choice of the neuroleptic drug, the dose and the way of administration (per os or depot treatment). b) A second group of studies tries to define the clinical characteristics of treatment-resistant schizophrenia. French psychiatry uses an empirical graduation of neuroleptics clinical efficiency: these drugs are more effective on hallucinations than on delusional ideas--they are more effective on recent and acute hallucinations and delusions than on those of which course is chronic. Other studies specify predictive factors of poor response to neuroleptics, as few affective symptoms and presence of negative symptoms--a controversed factor. c) Not clinical factors of poor neuroleptics efficiency in schizophrenia begin to be studied.(ABSTRACT TRUNCATED AT 250 WORDS)     

Efficiency of preventive use of bemethyl during long-term voyages

A positive effect of bemityl in the 24-hour dose of 0.25-0.5 g on the cellular and humoral factors of nonspecific defence, blood neutrophils intracellular exchange, barrier properties of the skin, working ability of operators and on morbidity has been established. An important property of the drug is long duration of preservation of the pharmacological effect, which prevents the development of disadaptation states following the cessation of its use. The data obtained gives the basis to recommend the actoprotective drug bemityl to increase nonspecific resistance during long-term voyages.