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Selected AbstractsAssessment of tracheal temperature and humidity in laryngectomized individuals and the influence of a heat and moisture exchanger on tracheal climateHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2008J. Karel Zuur MD Abstract Background The beneficial function of heat and moisture exchangers (HMEs) is undisputed, but knowledge of their effects on intra-airway temperature and humidity is scarce. The aim of this study was to evaluate the clinical applicability of a new airway climate explorer (ACE) and to assess the HME's influence on tracheal climate. Methods Intratracheal temperature and humidity were measured with and without HME in 10 laryngectomized patients. Results An HME causes the intratracheal mean humidity minima to increase with 3.2 mg H2O/L (95% CI: 1.5,4.8 mg H2O/L; p <.001), from 21.4 to 24.6 mg H2O/L, and the mean temperature minima to decrease with 1.6°C (95% CI: 0.9,2.4°C; p <.001) from 28.5°C to 26.9°C. Relative humidity values suggest that the tested HME keeps inspired air (nearly) fully saturated during the full course of inspiration. Conclusion Assessment of intratracheal temperature and humidity, and evaluation of HME effectiveness is feasible with the ACE. The tested HME significantly increases the intratracheal humidity, but decreases the intratracheal temperature. Relative humidity calculations suggest that increasing the thermal capacity of this rehabilitation device can further increase the heat and moisture exchange efficiency. © 2008 Wiley Periodicals, Inc. Head Neck, 2008 [source] Intestinal tuberculosis mimicking fistulizing Crohn's diseaseJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 1 2007Wai-Man Wong Abstract A patient is reported with intestinal tuberculosis that mimicked fistulizing Crohn's disease endoscopically. He had complete resolution of symptoms after a full course of antituberculosis therapy. Gastroenterologists and general physicians should aware of the possibility of intestinal tuberculosis in areas with a high prevalence of tuberculosis infection. [source] A heterogeneous kinetic model of the oxidative polymerization of 2,6-dimethylphenol with a copper-EDTA complex in waterAICHE JOURNAL, Issue 10 2009Qun Liu Abstract The heterogeneous oxidative polymerization kinetics of 2,6-dimethylphenol (DMP) catalyzed by a copper(II)-EDTA complex in water was studied. During the oxidative polymerization of DMP in water the oxygen uptake rate increases with an increase in DMP concentration and an increase in temperature. The Michaelis,Menten kinetic model as applied to the polymerization of DMP in organic solvents is not appropriate for the description of the full course of DMP polymerization in water. A new heterogeneous kinetic model is proposed to describe the catalyst deactivation during the oxidative polymerization as well as the difference in reactivity between the monomer, water-soluble oligomer and water-insoluble oligomer. The polymerization rate estimated by the new model is consistent with the measured data. © 2009 American Institute of Chemical Engineers AIChE J, 2009 [source] Sustained virological responses following standard anti-viral therapy in decompensated HCV-infected cirrhotic patientsALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2009A. IACOBELLIS Summary Background, Little data is available about predictors of sustained virological response (SVR) during anti-viral therapy of patients with decompensated HCV cirrhosis. Aims, To determine whether rapid and early virological responses (RVR and EVR) could predict SVR and help optimize treatment in these patients. Methods, A total of 94 cirrhotics underwent treatment with peg-interferon alfa-2b (1.5 ,g/kg weekly) and ribavirin (800/1200 mg daily) for 48 or 24 weeks for genotypes 1/4 or genotypes 2/3, respectively. Results, Overall, SVR was achieved in 33 patients (35.1%), 16% with genotype 1/4 and 56.8% with genotype 2/3 (P < 0.01). At treatment week 4, 34 patients had undetectable HCV-RNA, 10 with genotype 1/4 and 24 with genotype 2/3. Of RVR patients, 24 achieved SVR (70.5%), 6 and 18 with genotypes 1 and non-1. At the multivariate analysis, only EVR, genotypes 2 and 3, and adherence to full course and dosage of therapy retained their independent predictive power, with corresponding ORs of 25.5 (95% CI 3.0,217.3), 4.2 (95% CI 1.2,15.3) and 9.1 (95% CI 2.2,38.0), respectively. Conclusion, In decompensated cirrhotic patients, anti-viral therapy with current regimens is feasible and associated with an overall SVR rate of 35.1%. Treatment ought to be pursued among patients who attain an EVR, and maintain a full course and dosage of therapy. [source] Performance measures in Friedreich ataxia: Potential utility as clinical outcome toolsMOVEMENT DISORDERS, Issue 7 2005David R. Lynch MD Abstract Although several neuroprotective agents have been proposed as potential therapies in Friedreich ataxia (FA), clinical trials of their efficacy are limited by a lack of sensitive outcome measures. We assessed whether performance measures (nine-hole peg test, the timed 25-foot walk, and low-contrast letter acuity) provide valid measures of disease status in FA. Scores for each measure correlated significantly with neurologic disability and disease duration. Rank correlations between scores for performance measures were moderate in magnitude, suggesting that the each test captures separate yet related dimensions of neurological function in FA. Linear regression models demonstrated that scores from the nine-hole peg test and the timed 25-foot walk (after reciprocal transformation) were predicted by age and triplet repeat length in patients with FA. In addition, comparison of the temporal courses of change for each performance measure demonstrated that scores from the timed 25-foot walk change early in the course of FA, nine-hole peg test scores change slowly over the full course of the disorder, and low-contrast letter acuity scores change in the later stages of the disease. Thus, a composite scale derived from these performance measures may provide the best overall measure for assessing disease progression throughout the illness. © 2005 Movement Disorder Society [source] Brain-sparing radiotherapy for neuroblastoma skull metastasesPEDIATRIC BLOOD & CANCER, Issue 6 2008Suzanne L. Wolden MD Abstract Background Neuroblastoma (NB) frequently metastasizes to the skull, often diffusely involving the calvarium and skull base. Radiotherapy may enhance local control; however, irradiating the brain is undesirable in young patients. The purpose of this study was to describe the technique, outcome and toxicities in patients with high risk NB metastatic to the skull treated with brain-sparing skull radiotherapy (BSRT). Procedure Between 1999 and 2007, 31 patients with INSS stage four high risk NB, aged 2,32 years (median 6 years), underwent multimodality therapy, including radiotherapy to the whole skull using a brain-sparing technique never previously described in this population. Dosimetric analyses were performed to compare the BSRT technique to a whole brain radiotherapy (WBRT) technique. Patients were either treated to consolidate upfront induction therapy (n,=,22) or to palliate relapsed disease (n,=,9). Results Thirty of 31 patients (97%) completed the full course of BSRT. Median follow-up was 19 months (range 1,83 months). Radiographic response to therapy was noted in 89% of patients. The actuarial rate of disease control in the skull was 89% and 60% 1 year after starting BSRT in patients treated in consolidation and for palliation, respectively. BSRT delivered half of the mean radiation dose to the brain when dosimetrically compared to whole brain radiotherapy. Few patients experienced significant toxicity. Conclusions BSRT in NB patients with diffuse skull metastases offers dosimetric advantages over WBRT and results in good local control when used in the consolidative setting. The technique is well tolerated and while toxicity appears acceptable, longer follow-up is necessary. Pediatr Blood Cancer 2008;50:1163,1168. © 2007 Wiley-Liss, Inc. [source] An accelerated hepatitis B vaccination schedule for young drug usersAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2005Nich Rogers Objective: Jo determine completion rates for an accelerated hepatitis B vaccine (HBV) program among a population of young drug users. Design: Between January 2001 and May 2002, a three-dose course of HBV vaccine (0, 7 and 21 days) was offered free to all drug users (aged 22 years or younger) accessing two outreach sites of a youth-focused support and drug treatment service in metropolitan Melbourne, Australia. Clients were offered vaccination in any safe environment of their choice. An audit was conducted on the health records of participating clients. Main outcome measures: Number of completed vaccinations; settings in which vaccinations were completed. Results: Ninety young people accepted vaccination, with 71% completing the full course. The majority preferred to receive vaccination at drug treatment outreach sites (53%). Conclusions: An accelerated vaccination schedule appears acceptable to young drug users, suggesting that vaccination programs can be successful when barriers to immunisation are appropriately identified and addressed. [source] Palmaris profundus: One name, several subtypes, and a shared potential for nerve compressionCLINICAL ANATOMY, Issue 6 2009Elena Pirola Abstract The palmaris profundus is a rare, but known anatomic variation which may lead to compression of the median nerve and/or its branches. Two patients with carpal tunnel syndrome are presented in whom a palmaris profundus was discovered at operation. In these cases, median nerve compression at the wrist was attributed to the course of the extra tendon and its local mass effect on the nerve (i.e., the palmaris profundus and median nerve shared a common sheath); more commonly, the resultant decreased available space for the median nerve within the carpal tunnel due to the presence of an accessory (10th) flexor tendon is thought to be responsible. Postoperative 3 Tesla magnetic resonance imaging (MRI) was performed to demonstrate the full course of the variant muscle; despite variations in the size and longitudinal extent of the accessory musculotendinous unit, an important similarity was noted: the intimate relationship of the median nerve and the palmaris profundus. These two cases and our review of the literature highlight the fact that one name (i.e. palmaris profundus) reflects several anatomic subtypes. However, the close relationship of the palmaris profundus with the median nerve in the forearm and the palm is a common theme which emphasizes the potential pathoanatomic consequences of this relationship: nerve compression. Clin. Anat. 22:643,648, 2009. © 2009 Wiley-Liss, Inc. [source] | ||||||||||