Anxiety in medically III patients

Anxiety disorders and anxiety symptoms are highly prevalent in the general population and more so in the medically ill. They have a number of negative consequences for these patients and may worsen the outcome of the medical illness and increase health care utilization. In the evaluation of these patients, it is of paramount importance to identify the etiology of the anxiety and, in particular, to differentiate primary from secondary anxiety. Management includes medications (especially benzodiazepines and selective serotonin reuptake inhibitors) and psychotherapy (particularly cognitive-behavioral therapy).     

Fractal analysis of the PDL-bone interface and implications for orthodontic tooth movement

BACKGROUND: The periodontal ligament (PDL) is a soft tissue interposed between the tooth and the alveolar bone. It is responsible for transmission of forces in vivo; this promotes bone remodeling. The purpose our study was to use fractal analysis to quantify the complex morphology of the PDL-bone interface. METHODS: We used Scion Image (Scion Corp, Frederick, Md) and Benoit fractal analysis (Tru Soft International, St. Petersburg, Fla) programs to calculate the fractal dimension of the PDL-bone interface in rats via the box-counting method. Rats in the experimental groups received an initial force of 0.1N or 0.5N with customized springs for 6 hours. RESULTS: Our studies showed an increase in normal fractal dimension at the root apices of the rats' maxillary molars. We also found evidence that the fractal dimension varies along the entire root length from the apex to the cementoenamel junction. CONCLUSIONS: Mechanical loading might lead to an increase in fractal dimension at the PDL-bone interface apart from mechanisms of bone cell directed remodeling. These changes in fractal dimension are proportional to loading and could provide a new parameter for force determination in orthodontic tooth movement.     

Interstitial cystitis treated with intravesical doxorubicin

Three patients with interstitial cystitis diagnosed on the basis of clinical symptoms, classic endoscopic findings, and a typical histologic picture were treated with intravesical doxorubicin. All 3 patients showed remarkable improvement, as manifested by complete clearance of irritative bladder symptoms and healing of ulceration. Doxorubicin therefore may be the breakthrough drug for interstitial cystitis.     

Physiological analysis to quantify training load in badminton.

OBJECTIVE: To estimate the training load of specific on court training regimens based on the magnitude of variation of heart rate-lactate response during specific training and to determine the magnitude of variation of biochemical parameters (urea, uric acid, and creatine phosphokinase (CPK)) 12 hours after the specific training programme so as to assess training stress. METHODS: The study was conducted on six national male badminton players. Maximum oxygen consumption (VO2), ventilation (VE), heart rate, and respiratory quotient were measured by a protocol of graded treadmill exercise. Twelve training sessions and 35 singles matches were analysed. Heart rate and blood lactate were monitored during technical training routines and match play. Fasting blood samples collected on two occasions--that is, during off season and 12 hours after specific training--were analysed for serum urea, uric acid, and CPK. RESULTS: Analysis of the on court training regimens showed lactate values of 8-10.5 mmol/l in different phases. The percentage of maximum heart rate ranged from 82% to 100%. Urea, uric acid, and CPK activity showed significant changes from (mean (SD)) 4.93 (0.75) mmol/l to 5.49 (0.84) mmol/l, 0.23 (0.04) to 0.33 (0.06) mmol/l, and 312 (211.8) to 363 (216.4) IU/l respectively. CONCLUSION: Maximum lactate reported in the literature ranges from 3-6 mmol/l. Comparatively high lactate values and high percentage of maximum heart rate found in on court training show a considerable stress on muscular and cardiovascular system. The training load needs appropriate monitoring to avoid over-training. Workouts that are too intensive may interfere with coordination, a factor that is important in sports requiring highly technical skill such as badminton.     

Intraabdominal pressures during natural activities in patients treated with continuous ambulatory peritoneal dialysis

Intraabdominal pressures were measured during natural activities in 6 men, age 24-62 years, treated with continuous ambulatory peritoneal dialysis. The pressures were measured with a pressure transducer secured at the level of the umbilicus in the supine, sitting, and upright positions with 0-3 liters intraperitoneal fluid during talking, coughing, straining, changing position, walking, jogging, exercycling, jumping and weight lifting. Coughing and straining generated the highest intraabdominal pressures in every position. The pressures with weight lifting were proportional to the magnitude of the weight lifted up to 50 lbs, but were lower than those during coughing and straining. The pressures were generally higher with greater intraabdominal fluid volumes, especially with jumping and coughing. Exercycling was associated with lower intraabdominal pressure than was jogging, and the pressures were only minimally influenced by intraperitoneal fluid volumes. The results of this study can be used as a guide in establishing preventive measures in patients with intraperitoneal fluid to decrease complication rates related to raised intraabdominal pressures such as dialysate leaks, hernias and hemorrhoids.     

Fine needle aspiration cytology, imprint cytology and tru-cut needle biopsy in breast lumps: a comparative evaluation

Fine needle aspiration cytology, imprint cytology and tru-cut needle biopsy were performed in 86 patients with breast lump and the results of these techniques were finally compared with the incisional or excisional biopsy in all the patients. Fine needle aspiration cytology had the sensitivity of 96.8% and specificity of 100%, the imprint cytology had the sensitivity of 98.4% and specificity of 100%. While the tru-cut needle biopsy had the sensitivity and specificity of 100% though in this technique 15 of 86 (17.4%) specimens were rejected as insufficient for any diagnosis.