Treatment of patients with asymmetries using asymmetric mechanics

Since 1990, unusually high rates of false-positive serological reactions (FPSR) in bovine brucellosis screening have been observed in some countries of the European Union. The aim of this survey was to describe this phenomenon in a highly affected French Department, and to evaluate the links between some individual or herd factors and the occurrence of these FPSR. Before 1990, low backgrounds of FPSR were recorded (individual prevalence rate: less than 0.5 per 10,000). The phenomenon burst during the 1990-91 screening campaign, reached a peak in 1992-93 (50.5 per 10,000), and then decreased until the last studied campaign, 1995-96 (9.1 per 10,000). The phenomenon was transient and sporadic within a herd. At the herd-screening level, four assumed risk factors were isolated: (i) the probability of a herd-screening to be positive was closely and positively linked with the herd screening size; (ii) during a given screening campaign, the prevalence of FPSR decreased from December to November; (iii) the presence of at least one goat on the premises increased the risk for the 1992-93 and 1993-94 screening campaigns; and (iv) a previous FPSR in a given herd appeared to be a weak but significant risk factor. At the individual-animal level, herd size, sex and breed did not seem to be linked with FPSR appearance, while young animals were significantly more affected than older ones. However, global variations in herd or individual prevalences remained unexplained. The lack of link between FPSR and brucellosis is strengthened. The hypothesis of a widely spread causal agent with a low individual host susceptibility and/or a low probability of detecting FPSR animals can be supported by these results.     

Why quality of life measures should be used in the treatment of patients with respiratory illness

Treatment of airways disease is directed towards improving patients' health and well-being. Measurements of airways function do not reflect all the disease activity present in the airways that may affect the patient. Spirometry correlates poorly with health. Physicians appear to estimate their patients' health using criteria different from the patients themselves. Quality of life questionnaires provide a method of quantifying the effect of disease on patients' lives. They can summarize a number of aspects of the disease and provide an overall estimate of the effect of disease and benefits due to therapy. They have the potential to identify a threshold response to treatment that may be considered "worthwhile", and allow comparison between therapies with respect to the health gain that each provides.     

The value of diagnostic methods used to assess the response to treatment in patients with limited small cell lung carcinoma

Tumor response is used as a main criterion whether or not the treatment yields an anticancer activity. The tumor response criteria are defined by WHO recommendation but little is known about the tests must be used. The aim of this paper was to compare the degree of response to the treatment of 268 patients with limited small cell lung cancer, using independently 3 methods: radiological, bronchoscopic and cytological of bronchial material. Particular categories of response (CR, PR NR and presence or absence of carcinomatous cells) were related to survival time of patients independently to method of assessment. Multivarinte Cox analysis selected 3 parameters related to 3 different methods as independent survival risk factors. We conclude that each of diagnostic method (chest x-ray, bronchoscopy, cytological examination of bronchial material yield independent information correlated with survival risk of particular patient.     

Crossed immunoelectrophoresis used for bacteriological diagnosis in patients with endocarditis

Sera from 151 patients suspected of having endocarditis were obtained during a period of 3 1/2 years at Rigshospitalet, Copenhagen. The sera were examined by crossed immunoelectrophoresis for antibodies to bacteria causing endocarditis. The patients were divided into four groups: 1. Patients with definite endocarditis, 2. Patients with culture-negative endocarditis, 3. Patients with uncertain endocarditis, and 4. Patients without endocarditis. In sera from patients suffering from endocarditis caused by viridans streptococci, precipitating antibodies were demonstrated by crossed immunoelectrophoresis (diagnostic specificity = 86%; diagnostic sensitivity = 100%) while other bacterial etiologies of endocarditis were less reliably demonstrated by this method.     

Problems in the treatment of patients with pulmonary tuberculosis

The paper presents the current approaches to chemotherapy in patients with pulmonary tuberculosis and shows the main reasons that do not allow one to achieve high outcomes of treatment. These involve the drug resistance of Mycobacterium tuberculosis, the morphological features of a specific process in the lung, the higher incidence of acutely progressive types of pulmonary tuberculosis in particular; tuberculosis-contaminant diseases (diabetes mellitus, gastrointestinal, hepatic, renal diseases, and non-specific respiratory diseases, etc.). Recommendations how to eliminate the reasons for ineffective treatment of pulmonary tuberculosis are given.     

Considerations in the treatment of patients with renal disease

Renal function includes maintenance of fluid pH, electrolyte and fluid balance, influence on blood pressure, excretion of fluid and metabolic soluble wastes after filtration or reabsorption, and production of erythrocyte stimulating factor and the active form of vitamin D. These processes involve sensory mechanisms in the kidney, as well as the ability to respond to sensed changes, to maintain body homeostasis. Decrease in or failure of renal function induces abnormalities in many other systems, requiring a modified approach that is individual to each patient, and includes alteration of medications used and a re-evaluation of their doses. Some patients may require a regimen of dialysis or eventual renal transplantation, each with attendant advantages and risks. Careful evaluation and consultation with a nephrologist is required when local or systemic treatment is contemplated.     

Dental extractions in patients on an oral anticoagulant: a survey of practices in North America

PURPOSE: The World Health Organization (WHO) recommends the use of the International Normalized Ratio (INR) for reporting prothrombin time (PT) values. However, there are no scientifically based guidelines for performing dental extractions when using the INR. Oral and maxillofacial surgeons were surveyed to determine whether the INR is the method they use to monitor the level of anticoagulation and to determine what protocols are followed when anticoagulated patients require dental extractions. MATERIALS AND METHODS: A mail survey of academic oral and maxillofacial surgeons in North America was conducted to determine their choice of laboratory tests for assessing patients on oral anticoagulants and their protocol before proceeding to dental extractions. RESULTS: Fifty-three of 73 respondents (73%) routinely use the INR, but only 21% rely on this method alone. Twelve percent and 11% of respondents, respectively, also use the PT value and PT ratio. The level of anticoagulation at which surgeons would proceed with dental extractions was variable. For those using the INR, it was from 1.3 to 4.0, for those using PT ratios the perceived safe range was from 1.0 to 2.0, and for those using the PT value, the range was from 13 to 21 sec. CONCLUSIONS: Despite the support in the medical literature for use of the INR, many oral and maxillofacial surgeons still use the PT for monitoring oral anticoagulant therapy. There is no consensus on the INR interval at which dental extractions can be safely performed. Prospective studies are needed in this area.     

Role of the input in visual hemispheric asymmetries.

Because the nature of the input is one of the most important variables in determining how the brain will process information, findings from tachistoscopic studies aimed at assessing hemispheric lateralization of functions are examined in terms of the characteristics of the incoming information either available or required for processing. The basic features of tachistoscopic experiments are analyzed with a special emphasis on methodology. Variables determining the quality of the input are investigated as a function of the properties of the human visual system. Exposure duration, luminance, retinal eccentricity, and stimulus size all contribute to the efficiency of the hemispheres and interact in complex ways in the emergence of visual-field superiorities. Task demands are also examined in terms of the information necessary for efficient processing. The present review suggests that in tachistoscopic experiments, the factors determining the quality of the input must be controlled if this technique is to prove a reliable source of information for assessing hemispheric asymmetries. (5 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Search asymmetries with real faces: Testing the anger-superiority effect.

The anger-superiority hypothesis states that angry faces are detected more efficiently than friendly faces. Previously research used schematized stimuli, which minimizes perceptual confounds, but violates ecological validity. The authors argue that a confounding of appearance and meaning is unavoidable and even unproblematic if real faces are presented. Four experiments tested carefully controlled photos in a search-asymmetry design. Experiments 1 and 2 revealed more efficient detection of an angry face among happy faces than vice versa. Experiment 3 indicated that the advantage was due to the mouth, but not to the eyes, and Experiment 4, using upright and inverted thatcherized faces, suggests a perceptual basis. The results are in line with a sensory-bias hypothesis that facial expressions evolved to exploit extant capabilities of the visual system. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The enhanced bioavailability of mebendazole in echinococcosis patients when used with Essentiale

We report a case of extremely severe hyponatraemia which led to the discovery of anterior hypophysis insufficiency associated with empty sella turcica in a dysimmune context. This type of hyponatraemia is consecutive to corticotropic and thyreo-tropic hormones deficiency and to inappropriate secretion of arginine vasopressin. These endocrine abnormalities are of suprapituitary origin. They can be explained by a hypothalamo-hypophyseal dysregulation of little known mechanism, or by a lesion of the hypothalamus.     

Electrocardiographic changes in cardiac patients having dental extractions under a local anesthetic containing a vasopressor

PURPOSE: This study attempted to identify which group of cardiac patients is most at risk when dental extractions are performed under a local anesthetic with a vasopressor. PATIENTS AND METHODS: Forty cardiac patients who had dental extractions under local anesthesia were connected to a Holter monitor for 24 hours, starting an hour before the procedure. The electrocardiogram was analyzed for the number of premature beats, ST depression, and cardiac rhythm. A mean rate was calculated for the first 2 hours after injection of the local anesthetic and for the subsequent 22 hours. The preoperative electrocardiogram was compared with the electrocardiogram performed 1 week before treatment. RESULTS: Electrocardiographic changes were observed in 15 patients (37.5%), and all occurred during the first 2 hours after injection of the local anesthetic. Of the 15 patients, eight were being treated with digoxin. CONCLUSIONS: Cardiac patients being treated with digoxin had more electrocardiographic changes after administration of a local anesthetic than other cardiac patients. When the local anesthetic contained a vasopressor, there was a greater incidence of tachycardia but less arrhythmia or ST depression.     

Endoscopic treatment methods in patients with the postcholecystectomy syndrome

458 patients with postcholecystectomy syndrome have been examined. In 289 (63.1%) of them the reason of complication and location of the lesion in biliopancreatic-duodenal zone have been specified. In 212 (73.4%) patients the endoscopic treatment was used, including papillosphincterotomy with removal of concrements; suprapapillary choledochoduodenostomy; nasobiliary draining, endoprosthesis. In 181 (85.4%) of cases these methods appeared to be efficient and final; in 31 (14.6%) they promoted stabilization of clinical status of patients and performing surgery in more favorable conditions. Complications have been registered in 4 (1.9%) patients, 1 patient (0,47%) died. The authors advocate endoscopic methods as methods of choice in postcholecystectomy syndrome.     

Developments in the treatment of patients with chronic myeloid leukemia

In the treatment of chronic myelocytic leukaemia (CML) allogeneic bone marrow transplantation (BMT) from a sibling donor is the treatment of choice in patients younger than 50 years; the overall 5-year survival is about 60%. Donor lymphocyte infusion without chemotherapy may serve as an efficacious therapy for recurrence of CML after allogeneic BMT. Application of allogeneic BMT from a matched unrelated donor is increasing, but the outcome is still inferior to that of sibling BMT, largely due to more severe and more frequent complications. Treatment with interferon-alpha has been shown to prolong the overall median survival, but especially in a subgroup of patients (about 15%) who achieve a major cytogenic response. Combination of interferon-alpha and low-dose cytarabine leads to increased survival and a better cytogenic response than interferon-alpha alone. Current investigations are aimed at further improving survival and cytogenic response by using more intensive chemotherapy, such as high-dose cytarabine, followed by interferon-alpha maintenance therapy.     

Changes in perceptual asymmetries with clinical improvement of depression and schizophrenia.

16 depressed patients, 16 schizophrenic patients, and 16 normal controls (20–50 yrs old) were given 2 dichotic listening tests and 2 cognitive tests at intervals ranging from patients' initial hospitalization to recovery. Repeated-measures ANOVA revealed that severely depressed Ss failed to obtain normal ear-superiority in either dichotic test; however, normal superiorities emerged with recovery from depression. Schizophrenic Ss initially failed to show normal right-ear superiority on a dichotic-words test but did obtain the expected left-ear advantage on a dichotic-chords test. Following treatment, schizophrenics shifted from a left-ear to a right-ear advantage in dichotic chords and also increased (although not significantly) their right-ear advantage in dichotic words. Both patient groups showed normal word-fluency but impaired spatial ability, which did not improve with recovery. Results suggest that both depression and schizophrenia are associated with a breakdown in the process of interhemispheric inhibition that mediates perceptual asymmetry. In depression, treatment returned Ss' normal patterns of asymmetry, whereas in schizophrenia, treatment created an abnormal pattern of asymmetry that may have reflected the allocation of both verbal and nonverbal material to the left hemisphere. (42 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The characteristics of the effect of obzidan on the cardiac hemodynamics in patients with an artificial pacemaker when used one time and over a course of treatment

ECG investigations of cardiodynamics were performed in 47 patients subjected to isolated ventricular electrocardiostimulation on obsidan treatment. The drug was given in a single dose or in a course. Cardiodynamic effects were evaluated in 3 groups of patients: with hyperkinetic, eukinetic and hypokinetic circulation (17, 19 and 11 patients, respectively). Cardiohemodynamic effects of obsidan are shown to depend on type of circulation and features of intracardiac hemodynamics (fixed cardiac rhythm, atrioventricular dissociation, pathological ventricular asynchronism, valvular blood regurgitation). This potentiates cardiodepressive effects of obsidan in patients with hypokinetic circulation who experience deterioration of cardiac insufficiency.     

Functional asymmetries in the stepping reflex of human neonates.

Determined the leading leg in the stepping reflex of 24 infants at average ages of 17, 51, 82, and 105 days. Ss, offspring of right-handed parents, showed a clear tendency to lead with the right leg on all 4 test sessions. It is concluded that the functional asymmetry between the "support leg" and the "leading leg" in adults may have its roots very early in development. (French summary) (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)