Profile of culture positive enteric fever from bangalore

Background: Enteric fever is endemic in India. The aim of this study was to analyse the clinical, laboratory, antibiotic sensitivity profile and response to antibiotics of culture positive enteric fever patients from Bangalore.     

Fruit and vegetable consumption among older adults by tooth loss and socio‐economic status

Background: The aim of this study was to examine consumption of fruit and vegetables in relation to tooth loss and income. Methods: Data were collected in 2004–06, using a three‐stage, stratified clustered sample, involving a computer‐assisted telephone interview (CATI), oral examination and mailed questionnaire followed by a food frequency questionnaire. Results: A total of 14 123 adults responded to the CATI (49% response) of whom 5505 (44% of those interviewed) agreed to undergo an oral epidemiological examination. In the nutrition sub‐study, a total of n = 1218 persons were approached in New South Wales and Queensland, with n = 1129 responding (92.7% response rate). Among respondents aged 55 years or more 34.5% had <21 teeth. Adjusting for income the prevalence of infrequent consumption (‘never or less than once a month’) was associated with [PR = prevalence ratio (95% CI)] fewer teeth for the fruits, ‘peach, nectarine, plum, apricot’ PR = 1.91 (1.12, 3.25) and ‘grapes or berries’ PR = 1.69 (1.03, 2.76), and for the vegetables ‘stir‐fried or mixed’ PR = 2.34 (1.14, 4.78), ‘sweetcorn’ PR = 1.45 (1.001, 2.10), ‘mushrooms’ PR = 1.62 (1.05, 2.50), ‘lettuce’ PR = 3.99 (1.31, 12.17) and ‘soy beans’ PR = 1.11 (1.01, 1.21). Conclusions: An inadequate dentition was associated with lower consumption of a range of fruits and vegetables indicating that dentition‐related impairment of chewing ability could have adverse consequences on nutritional intake among Australian adults.     

The effect of postoperative immobilization on short-segment fixation without bone grafting for unstable fractures of thoracolumbar spine

Background:

Controversy regarding the fixation level for the management of unstable thoracolumbar spine fractures exists. Often poor results are reported with short-segment fixation. The present study is undertaken to compare the effect of fixation level and variable duration of postoperative immobilization on the outcome of unstable thoracolumbar burst fractures treated by posterior stabilization without bone grafting.

Patients and Methods:

A randomized, prospective, and consecutive series was conducted at a tertiary level medical center. Thirty-six neurologically intact (Frankel type E) thoracolumbar burst fracture patients admitted at our institute between February 2003 and December 2005 were randomly divided into three groups. Group I (n = 15) and II (n = 11) patients were treated by short-segment fixation, while Group III (n = 10) patients were treated by long-segment fixation. In Group I ambulation was delayed to 10th-14th postoperative day, while group II and III patients were mobilized on third postoperative day. Anterior body height loss (ABHL) percentage and increase in kyphosis as measured by Cobb''s angle were calculated preoperatively, postoperatively, and at follow-up. Denis Pain Scale and Work Scales were obtained during follow-up.

Results:

Mean follow-up was 13.7 months (range 3-27 months). At the final follow-up the mean ABHL was 4.73% in group I compared with 16.2% in group II and 6.20% in group III. The mean Cobb''s angle loss was 1.8° in group I compared with 5.91° in group II and 2.3° in group III. The ABHL difference between groups I and II was significant (P = 0.0002), while between groups I and III was not significant (P = 0.49).

Conclusion:

The short-segment fixation with amenable delayed ambulation is a valid option for the management of thoracolumbar burst fractures, as radiological results are comparable to that of long-segment fixation with the advantage of preserving maximum number of motion segments.     

The effect of wet-wrap dressing on epidermal barrier in patients with atopic dermatitis

BACKGROUND: Wet-wrap dressing has been shown to be effective for atopic dermatitis; however, the therapeutic mechanism of wet-wrap dressing is only the hypothesis based on the recovery of decreased epidermal barrier function. OBJECTIVES: To examine the therapeutic efficacy as well as the mechanism of wet-wrap dressing in atopic dermatitis patients. METHODS: To examine the difference of non-lesional and lesional atopic skin and to evaluate the change between epidermal barrier function before and after the treatment, SCORAD, epidermal water content, transepidermal water loss, the lipid amount of skin surface, immunohistochemical staining of filaggrin and loricrin, transmission electron microscopic examination, and calcium ion capture cytochemistry method were done in 10 severe form atopic dermatitis patients. RESULTS: In atopic dermatitis patients, SCORAD was clearly decreased, epidermal water content was increased, and transepidermal water loss was decreased after wet-wrap dressing. After wet-wrap dressing, increased release of lamellar body and the recovery of the damaged lamellar structure of intercellular lipid were observed; nevertheless, neither the change in keratinocyte differentiation nor the change of calcium ion gradient was detected. A week after the termination of wet-wrap dressing, increased water content and decreased transepidermal water loss were still maintained. CONCLUSION: We confirmed the abnormality of the epidermal barrier in atopic dermatitis, and the effects of wet-wrap were associated with the recovery of epidermal barrier. In atopic lesions, wet-wrap dressing induced clinical improvement by the release of lamellar body and the restoration of intercellular lipid lamellar structure.     

Concurrent chemoradiation for oesophageal cancer: Factors influencing myelotoxicity

Concurrent chemotherapy and radiation (CT/RT) for localized oesophageal cancer can cause life-threatening myelo-suppression. This non-randomized study examines 95 patients from three Australasian centres treated on the Trans-Tasman Radiation Oncology ‘definitivechemoradiation ‘ study. Duration of fluorouracil infusion and patient age were independently predictive of myelotoxicity after the first cycle of CT/RT. Overall rates of grade III and IV neutropaenia were 23% and of thrombocytopaenia 8% following the first cycle of chemotherapy. Five neutropaenic septic episodes followed the first cycle and six the second. All five patients recovered after the first cycle but there were four treatment-related deaths occurring after the second cycle of CT/RT. Recommendations are made concerning initial dosing, dose reductions and delays to minimize adverse patient outcomes from myelosuppression.