Human temperature regulation during cycling with moderate leg ischaemia

The effect of graded ischaemia in the legs on the regulation of body temperature during steady-state exercise was investigated in seven healthy males. It was hypothesised that graded ischaemia in the working muscles increases heat storage within the muscles, which in turn potentiates sweat secretion during exercise. Blood perfusion in the working muscles was reduced by applying a supra-atmospheric pressure (+6.6 kPa) around the legs, which reduced maximal working capacity by 29%. Each subject conducted three separate test trials comprising 30 min of steady-state cycling in a supine position. Exercise with unrestricted blood flow (Control trial) was compared to ischaemic exercise conducted at an identical relative work rate (Relative trial), as well as at an identical absolute work rate (Absolute trial); the latter corresponding to a 20% increase in relative workload. The average (SD) increases in both the rectal and oesophageal temperatures during steady-state cycling was 0.3 (0.2)°C and did not significantly differ between the three trials. The increase in muscle temperature was similar in the Control (2.7 (0.3)°C) and Absolute (2.4 (0.7)°C) trials, but was substantially lower (P<0.01) in the Relative trial (1.4 (0.8)°C). Ischaemia potentiated (P<0.01) sweating on the forehead in the Absolute trial (24.2 (7.3) g m^–2 min^–1) compared to the Control trial (13.4 (6.2) g m^–2 min^–1), concomitant with an attenuated (P<0.05) vasodilatation in the skin during exercise. It is concluded that graded ischaemia in working muscles potentiates the exercise sweating response and attenuates vasodilatation in the skin initiated by increased core temperature, effects which may be attributed to an augmented muscle metaboreflex.     

A trace element preparation increases antitumor activity in mice

A trace element preparation (Béres Drops Plus, BDP) produced immunomodulatory effects in previous in vitro and in vivo experiments. Here, C57B1/6 inbred mice were transplanted with either Lewis lung tumor or with B16 melanoma. BDP was given intraperitoneally a. before transplantation; b. after transplantation or c. after the removal of the primary tumor. As a result, BDP pretreatment could slow down the tumor progression by decreasing the number and the volume of metastases as well as the proportion of mice with metastases without influencing the growth of the primary tumors. Furthermore, BDP treatment improved the immunological activity of the tumor-bearing host, too. These preliminary data suggest that the parenteral administration of the practically non-toxic BDP could help to control tumor progression in experimental models.     

Increased Risk of Infections with Anti-TNF Agents in Patients with Crohn’s Disease After Elective Surgery: Meta-Analysis

Digestive Diseases and Sciences - Postoperative complication rates in patients with inflammatory bowel disease (IBD) receiving preoperative biologics have been analyzed without considering the...     

A 44-year-old man with bilateral eyelid swelling

Swollen eyelids are commonly ascribed to allergic conjunctivitis, contact dermatitis, eczema, angioedema, or acute sinusitis. The differential diagnosis extends to thyroid eye disease; blepharitis; Sj?gren's syndrome; Churg-Strauss vasculitis; Wegener's granulomatosis; Gleich syndrome; orbital and ocular lymphoid hyperplasia or adnexal lymphoma; idiopathic orbital inflammatory disease/idiopathic sclerosing orbital inflammation; rarely, orbital parasitosis; and IgG4-related diseases. The likely diagnosis proceeds from the more to the less common in patients without a history of allergy or infection. Both ocular lymphoid hyperplasia and ocular adnexal lymphoma must be considered in the differential diagnosis of persistent disease, and neither of these entities can be recognized or differentiated from one another clinically or radiologically. Early diagnosis is essential because therapy may consist of frequent follow-up and/or active intervention. Outcomes in patients treated early and appropriately are often favorable.     

Lag screw fixation in midface fractures

Through analysis of case series from medical record review, this article demonstrates how lag screw fixation may be used to effectively treat obliquely oriented maxillary, zygomatic, and orbital rim fractures. Lag screw fixation of midface fractures has been overshadowed by other readily available plate fixation techniques. Nonetheless, lag screw fixation provides quick, stable, and effective reduction of obliquely oriented maxillary, zygomatic, and orbital fractures without risk of plate exposure and with potentially superior primary osteosynthesis. Lag screw fixation remains an excellent alternative to plate fixation techniques in the repair of appropriate midface fractures.     

Comprehensive strategy to prevent nosocomial spread of methicillin-resistant Staphylococcus aureus in a highly endemic setting

BACKGROUND: The effectiveness and feasibility of a comprehensive strategy to reduce nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in a highly endemic setting have not yet been proved. Limited benefits and the high cost of such programs are the main concerns. METHODS: We prospectively evaluated the effect of an aggressive infection control program on transmission of MRSA in the University Clinic of Respiratory and Allergic Diseases. All patients with MRSA carriage during 5 years (January 1, 1998, through December 31, 2002) were included and categorized into imported or hospital-acquired cases. RESULTS: Methicillin-resistant S aureus was recovered from 223 hospitalized patients; 142 cases were imported and 81 were acquired at our institution. After introduction of the comprehensive infection control program in 1999, the annual incidence of MRSA carriage per 1000 admissions increased from 4.5 in 1998 to 8.0 in 1999 (P = .02), and remained stable thereafter. In this period, the proportion of MRSA cases acquired in our institution decreased from 50.0% in 1999 to 6.1% in 2002 (P<.001), whereas the proportion of MRSA cases transferred from other hospitals (P<.001) and nursing homes (P = .03) increased. All 19 MRSA carriers with 3 sets of follow-up cultures were successfully decolonized. CONCLUSIONS: With a comprehensive infection control program, it was possible to reduce nosocomial transmission of MRSA in a highly endemic setting. With good hand hygiene using alcohol handrub, early detection, isolation, and a decolonization strategy, containment of MRSA was achievable, despite a high rate of transferred patients with MRSA.     

Effects of cerebral hemispheric laterality on the span of apprehension of schizophrenic and healthy subjects

The effects of hemispheric laterality on a forced-choice Span of Apprehension (SoA) task were investigated. Forty-eight adult schizophrenic inpatients were recruited. A control group of healthy subjects was put together using the matched-pairs method with age, gender, and eduction as control variables. SoA performance was determined separately for the left and right visual field (VF), respectively. No SoA group differences were found, in both groups, the hit percentage was higher in the right VF. However, in the schizophrenic group, the left VF performance showed significant negative correlations with psychopathologic symptoms (especially auditory verbal hallucinations). In a subsample of patients receiving atypical neuroleptic drugs, the daily dosage correlated negatively with left VF performance. In general, young subjects performed better than old subjects (both VFs), males performed better than females, and subjects with high education performed better than subjects with low education (right VF). Received: 31 May 2000 / Accepted: 17 October 2000     

Evaluation of the ventricular system in children using transcranial ultrasound: reference values for routine diagnostics

In children, evaluation of the size of the ventricular system is important. Transcranial Doppler sonography (TCD), a broadly available and easily applicable method that is not hampered by side effects, such as radiation, is a valuable tool for routine examinations. However, standard TCD values of the ventricular system are lacking. In this study, we performed TCD through the temporal acoustic bone window in a large cohort of 1693 healthy children. Of these, 157 had to be excluded because of insufficient bone windows. In the remaining children, a mean width of 1.4 +/- 0.8 mm for the third ventricle, 14.4 +/- 0.8 mm for the right and 14.6 +/- 0.7 mm for the left cella media, and 1.6 +/- 0.7 mm for the right and 1.9 +/- 0.8 mm for the left temporal horn were measured. Side differences are indicated and values are given in relation to age and gender. Inter-rater reproducibility obtained in 25 children was adequate, with no significant difference between the two measurements in any of the parts of the ventricular system measured, rendering these values suitable for reference.