Efficacy of ultrasonography-guided intra-articular steroid injection of the shoulder and excercising in patients with adhesive capsulitis: Glenohumeral versus subacromial approaches

Aim of the work

To evaluate the efficacy of intra-articular steroid injection of the shoulder joint with exercises in the management of patients with adhesive capsulitis and to compare glenohumeral (GH) versus subacromial subdeltoid (SASD) ultrasound-guided approaches.

Health Effects of Residential Exposure to Aluminum Plant Air Pollution

In this study, the authors evaluated the relative risk of residential exposure to air pollution from an aluminum plant. The authors used government-compiled data to compare hospital admissions in 1997 for selected respiratory diseases for 2 communities in Brazil. One community, Ouro Preto, was located near an aluminum plant and the other, Diamantina, was located far from any source of industrial air pollution. The relative risk of hospital admissions for selected respiratory diseases was 4.11 (95% confidence interval = 2.96, 5.70). The risk was highest among individuals between 30 and 39 yr of age (relative risk = 11.70; 95% confidence interval = 1.52, 89.96). Admissions per thousand residents were highest for individuals under 10 yr of age and for individuals older than 70 yr of age. The authors assessed exposure with environmental measurements. Dust deposition was collected in the residences of participants (n = 36 in each location) and the dust was analyzed for aluminum, manganese, magnesium and calcium content. There were significantly different (p < .05) levels of aluminum in the 2 communities; the highest quantities were found near the aluminum plant. Measurements from independent studies indicated that both 24-hr maximum values and annual mean concentrations of suspended particulate matter exceeded the average of international standards in Ouro Preto (i.e., aluminum plant area). These results suggested that exposure to greater air pollution in the aluminum plant area (i.e., Ouro Preto, Brazil) versus the control area resulted in statistically significant health effects in those individuals who resided in Ouro Preto.     

Clinical and immunological results of segmental splenectomy in schistosomiasis

We evaluated segmental splenectomy in 51 patients who required splenectomy to relieve the symptoms of schistosomal splenomegaly, and compared their course with that of 44 patients who underwent total splenectomy in an unrandomized study. We describe a minor modification of our initial technique. Patients having segmental splenectomy had a similar postoperative course to those having total splenectomy. Conversion of a segmental to a total splenectomy was required in two cases due to technical faults. No regrowth of the spleen has occurred in up to 4 years of observation. We noted an increased percentage of T lymphocytes with an increased ratio of T helper to T suppressor cells in patients having segmental splenectomy. Our cumulative experience supports adoption and wider evaluation of segmental splenectomy in schistosomiasis.     

Synthesis of new quinoline derivatives as antimicrobial agents

2-Hydroxyquinoline-4-hydrazide was condensed with some aromatic aldehydes and acetophenones to give the hydrazones 1a-h. It was also reacted with HCOOH, PhCOCl and p-CH3O-PhCOCl to afford 2a-c. Cyclization of 2b was completed by using PPA, POCl3 and/or P2S5, which gave compounds 3, 4, and 6 respectively. Reaction of 4 with some amines gave the corresponding derivatives 5a-f. The thiosemicarbazide 7 was cyclized under acid and basic condition to give the thiadiazolyl-8 and triazolyl-10 derivatives.     

Thalidomide impairs insulin action on glucose uptake and glycogen synthesis in patients with type 2 diabetes

OBJECTIVE: To investigate the effect of thalidomide on glucose turnover (glucose production and uptake), on intracellular pathways of glucose utilization (glycogen synthesis [GS], glycolysis [GLS], carbohydrate oxidation, and nonoxidative GLS), and on free fatty acid (FFA) turnover (lipolysis, FFA oxidation, and FFA reesterification). RESEARCH DESIGN AND METHODS: A total of 6 patients with type 2 diabetes were studied with 4-h isoglycemic-hyperinsulinemic clamps (approximately 8 mmol/l and 500-600 pmol/l, respectively) before treatment (Prestudy), after 3 weeks of thalidomide (150 mg orally at bedtime), and after 3 weeks of placebo. RESULTS: Thalidomide reduced insulin-stimulated glucose uptake by 31% (from 27.7 to 19.2 pmol x kg(-1) x min(-1), P < 0.05) compared with the prestudy and by 21% (from 24.2 to 19.2 pmol x kg(-1) x min(-1), P < 0.05) compared with placebo. Thalidomide also reduced insulin-stimulated GS by 48% (from 14.1 to 8.2 micromol x kg(-1) x min(-1), P < 0.05) compared with the prestudy and by 40% (from 13.6 to 8.2 micromol x kg(-1) x min(-1), P < 0.5) compared with placebo. Thalidomide had no effect on rates of GLS, carbohydrate oxidation, nonoxidative GLS, lipolysis, FFA oxidation, and reesterification. CONCLUSIONS: We conclude that thalidomide increased insulin resistance in obese patients with type 2 diabetes by inhibiting insulin-stimulated GS and that patients taking thalidomide should be monitored for possible deterioration in their glucose tolerance.     

Is Endovascular Repair of Mycotic Aortic Aneurysms a Durable Treatment Option?

ObjectiveEndovascular repair for degenerative aortic aneurysms is well established, but its role in those with infective pathology remains controversial. This study aims to assess the durability of endovascular repair with a review of our midterm results.MethodA retrospective analysis of a prospectively maintained endovascular database (1998–2008) was conducted, which identified 673 consecutive patients with aortic aneurysms.ResultsNineteen patients (2.8%) were identified with infected aortic aneurysms, in which there were a total of 23 separate aneurysms (16 thoracic and seven abdominal). Six patients (32%) presented with rupture. Eleven patients (58%) had received antibiotics preoperatively for a median duration of 11 days (1–54 days). Fifteen of the 19 (79%) had positive blood cultures, with Staphylococcus aureus being the most common organism.All 19 patients underwent endovascular repair. There were three Type I endoleaks (one requiring conversion to open repair) and two Type II endoleaks. One patient developed transient paraplegia, resolved by cerebrovascular fluid (CSF) drainage, and one patient had a stroke.The 30-day mortality was 11%, and survival at median follow-up of 20 months (0–83 months) was 73%. All eight deaths in the series were related to aneurysm.ConclusionEndovascular treatment of infective aortic pathology provides an early survival benefit; however, concerns over on-going graft infection remain.