Influence of preoperative testing on cancellation of ambulatory cataract surgery in adults

A case-control study was performed to determine whether an association exists between cancellation of ambulatory cataract surgery in adults, preoperative test results, and systemic diseases present at clinical examination. Among 500 adults who were to undergo ambulatory cataract surgery, cancellation of surgery due to medical events was not associated with results of preoperative testing (hemoglobin, serum glucose, and electrocardiogram). The rate of surgery cancellation was higher only in patients having a history of arterial hypertension. Presented at the 1999 Joint Meeting of the American Academy of Ophthalmology and the Pan-American Association of Ophthalmology, Orlando, Fla, 1999. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article.     

Thoracic outlet syndrome: evaluation with CT

Diagnosis of the thoracic outlet syndrome is often difficult, particularly in patients without osseous abnormalities on plain radiographs. The radiographic and computed tomographic (CT) findings were reviewed from 27 patients with thoracic outlet syndrome and 21 normal subjects. The plain radiographs and CT scans were assessed by two independent observers without awareness of the clinical history. Fifteen patients with thoracic outlet syndrome had osseous abnormalities (anomalous cervical ribs; abnormally long, drooping C-7 transverse processes) identifiable on plain radiographs. CT did not provide further diagnostic information in the patients with abnormal radiographs. Eight of 12 patients (66%) with normal plain radiographs had abnormal findings on CT scans, consisting of impingement of the C-7 transverse process on the scalene triangle or anteromedial aspect of the middle scalene muscle. Only two of 21 control patients (9.5%) displayed this CT abnormality (P less than .01). CT may be useful in patients with symptoms suggestive of thoracic outlet syndrome and no osseous abnormalities on plain radiographs.     

Yersinia-related Arthritis in the United Kingdom. A Report of 12 Cases and review of the Literature

Reactive arthritis following infection with Yersinia is endemicin Scandanavian countries; the prevalence is low in the UK,however. We have reviewed the literature pertaining to Yersinia-relatedreactive arthritis in the UK and describe 12 patients who presentedover a 3-year period with an asymmetrical seronegative polyarthropathyand serological evidence of recent Yersinia infection. Fivepatients recalled having a diarrhoeal illness prior to the onsetof the arthropathy. None had a prior history of psoriasis, inflammatorybowel disease or ankylosing spondylitis. A history of urethraldischarge was elicited from one patient. Extra-articular manifestationswere seen in three patients (iritis in two, erythema nodosumin another). Four patients developed chronic joint disease afterperiods of 4, 6, 8, and 18 months, respectively. The prevalenceof Yersinia-related arthritis in the UK may be higher than previouslythought.     

Change in neoadjuvant chemotherapy could alter the prognosis of patients with pancreatic adenocarcinoma: A case report

BACKGROUNDNeoadjuvant treatment has become a standard of care for borderline or locally advanced pancreatic cancer and is increasingly considered even for up-front resectable disease. The aim of this article is to present the case of a 62-year-old patient with locally advanced pancreatic adenocarcinoma who was successfully treated with gemcitabine plus nab-paclitaxel after the failure of the first line treatment.CASE SUMMARYComputerized tomography scan and magnetic resonance imaging demonstrated a nodular lesion of ill-defined limits in the body of the pancreas, measuring approximately 4.2 cm × 2.7 cm, with an infiltrative aspect. The tumor had contact with the superior mesenteric vein, splenomesenteric junction and the proximal segment of the splenic artery, causing focal reduction of its lumens. Due to vascular involvement, neoadjuvant chemotherapy treatment with eight cycles of “folinic acid, 5-fluorouracil, irinotecan and oxaliplatine” (FOLFIRINOX) were performed. At the end of the cycles, surgery was performed, but the procedure was interrupted due to finding of lesions suspected of metastasis. Gemcitabine plus nab-paclitaxel was then successfully used for neoadjuvant treatment with subsequent R0 surgical resection.CONCLUSIONGemcitabine plus nab-paclitaxel may be effective as an alternative regimen when FOLFIRINOX fails as the first line of treatment, suggesting the need for further studies to identify which patients would benefit from each type of therapeutic approach.     

Context Matters: Examining Perceived Health and Fitness Outcomes of Physical Activity Participation Among South Korean Adults and Youth

Purpose

To examine associations between physical activity contexts and health and fitness perceptions among Korean adults and youth.

Method

Data were from the Korean Survey on Citizens’ Sports Participation in 2015. Korean youth (N?=?832; M_age?=?14.7) and adults (N?=?6719; M_age?=?41.3) were included in the hierarchical logistic and linear regressions. Youth physical activity was examined in school-based (i.e., school-based and after-school/Saturday school sports) and out of school (i.e., organized sports) settings. Adults who met the World Health Organization (WHO) physical activity guidelines or not, and participated in structured (e.g., sport) and unstructured (e.g., walking) physical activity were compared. The outcome variables were self-reported health and fitness. Gender interactions between physical activity and all outcomes were examined for the adult sample only.

Results

No associations existed between physical activity and perceived health or fitness among youth. Adults who met the WHO guidelines, or participated in structured physical activity showed higher odds of reporting good health. Unstructured physical activity was associated with lower odds of reporting good health. Positive perceptions of fitness were more likely to be reported by males who met physical activity guidelines compared to females.

Conclusions

For youth, the potential benefit of physical activity, regardless of contexts, may be more apparent for psychological health than perceived physical health, and school should be used as a venue to promote physical activity. For adults, structured physical activity and achieving the WHO physical activity guidelines may be suggested for perceptions of overall health.

     

Detection of antibodies to Trypanosoma cruzi among blood donors in the southwestern and western United States. II. Evaluation of a supplemental enzyme immunoassay and radioimmunoprecipitation assay for confirmation of seroreactivity

BACKGROUND: Chagas' disease, caused by the protozoan parasite Trypanosoma cruzi, is endemic to Latin America and may be transmitted in the United States via blood donated by infected immigrants. Blood- borne pathogens such as T. cruzi require supplemental testing for confirmation of seroreactivity. STUDY DESIGN AND METHODS: A study was undertaken to determine an optimal scheme for confirmation of seroreactivity in repeatedly reactive samples identified by the Chagas antibody enzyme immunoassay (EIA). The procedure for initial confirmation involves three purified antigens coated onto three separate polystyrene beads and uses an EIA format. If the sample is reactive with two of three or three of three antigens, it is confirmed as seroreactive. If none or one of three beads is reactive, the sample is indeterminate and subjected to a radioimmunoprecipitation assay (RIPA). The RIPA must demonstrate characteristic bands at 32, 34, and 90 kDa. RESULTS: When tested with sera from persons with potentially cross-reactive diseases (n = 39) or against a presumed negative population from southeast Wisconsin (n = 289), the confirmatory EIA had a specificity of 100 percent. Sensitivity was 100 percent (28/28) with xenodiagnosis-positive sera and 97.6 percent (80/82) with chagasic sera from Latin America. The RIPA showed a specificity of 100 percent in EIA- nonreactive samples (n = 100) and a sensitivity of 100 percent with both xenodiagnosis-positive (28/28) and chagasic (82/82) sera. CONCLUSION: The confirmatory EIA and the RIPA together provide a highly specific and sensitive means of confirming seroreactivity for antibodies to T. cruzi.     

Low carbohydrate diet affects the oxygen uptake on‐kinetics and rating of perceived exertion in high intensity exercise

The aim of this study was to determine if the carbohydrate (CHO) availability alters the rate of increase in the rating of perceived exertion (RPE) during high intensity exercise and whether this would be associated with physiological changes. Six males performed high intensity exercise after 48 h of controlled, high CHO (80%) and low CHO (10%) diets. Time to exhaustion was lower in the low compared to high CHO diet. The rate of increase in RPE was greater and the VO₂ slow component was lower in the low CHO diet than in the control. There was no significant condition effect for cortisol, insulin, pH, plasma glucose, potassium, or lactate concentrations. Multiple linear regression indicated that the total amplitude of VO₂ and perceived muscle strain accounted for the greatest variance in the rate of increase in RPE. These results suggest that cardiorespiratory variables and muscle strain are important afferent signals from the periphery for the RPE calculations.     

Mechanical properties of achilles tendon in rats induced to experimental diabetes

The aim of this study was to quantify the effect of chemically induced diabetes mellitus (DM) on the mechanical properties of the Achilles tendon of rats and correlate it with metabolic and biomechanical findings. Adult rats were selected randomly and assigned to two groups, the diabetic group consisted of animals receiving a dose of streptozotocin to induce type I diabetes and the control group. The animals were placed in metabolic cages for analysis of metabolism. Ten weeks after diabetes induction, the Achilles tendon of both groups were collected and submitted to a traction test in a conventional testing machine. The measurements of mechanical properties indicated that the elastic modulus (MPa) was significantly higher in the control group (p < 0.01). In Maximum tension (MPa), the groups did not have differences (p > 0.01). Energy/tendon area (N mm/mm²), specific strain (%) and maximum specific strain (mm) were higher in tendon tests of the diabetic group (p < 0.01). We observed that the mechanical properties of tendons have correlations with metabolic properties of the diabetic animals. These results showed that induced DM in rats have an important negative effect on the mechanical properties of the Achilles tendon.