Outcome of transanal irrigation for bowel dysfunction in patients with spinal cord injury.

Background/objective: To compare symptoms of neurogenic bowel dysfunction in patients with spinal cord injury (SCI) at baseline and after 10 weeks of treatment with transanal irrigation and to identify possible factors that could predict outcome of the treatment.

Methods: Sixty-two patients with SCI (45 men and 17 women; mean age, 47.5 +/- 15.

Outcome of antenatally diagnosed fetal anterior abdominal wall defects from a single tertiary centre.

Objective: The aim of this study was to review the outcome of all cases of antenatally diagnosed anterior abdominal wall defects at a single tertiary centre.

Method: 41 cases from the database of the Centre of Fetal Care at Queen Charlotte's and Chelsea Hospital in London from 2000 to 2005 were reviewed and both obstetric and neonatal data were collected.

Results: 25 cases were exomphalos (61%), 9 were gastroschisis (22%), 6 were body stalk anomaly (15%) and 1 case was cloacal exstrophy (2%).

A modified Mediterranean diet is associated with the greatest reduction in alanine aminotransferase levels in obese type 2 diabetes patients: results of a quasi-randomised controlled trial.

Aim: The aim of the study was to compare the effect of different dietary interventions on alanine aminotransferase (ALT) in obese patients with diabetes.

Methods: A post hoc analysis of an open label, parallel design, quasi-randomised (allocation by alternation), controlled trial, conducted in Israel. Obese patients with diabetes (n = 259), treated in the community, were centrally allocated to one of three diets: (1) the 2003 recommended American Diabetes Association diet (ADA): 50-55% carbohydrate, 30% fat and 20% protein, n = 85; (2) a low glycaemic index (LGI) diet: 50-55% LGI carbohydrate, 30% fat, 15-20% protein, n = 89; or (3) a modified Mediterranean diet (MMD): 35% LGI carbohydrate, 45% fat that was high in monounsaturated fat, 15-20% protein, n = 85.

Gait analysis does not correlate with clinical and MR imaging parameters in patients with symptomatic lumbar spinal stenosis.

Background: Parameters of MR imaging play a pivotal role in diagnosing lumbar spinal stenosis (LSS), and serve as an important tool in clinical decision-making. Despite the importance of MR imaging, little is known about the correlation between MRI parameters, objective gait analysis, and clinical presentation of patients with lumbar spinal stenosis.

Methods: Sixty-three patients from our clinic with symptomatic lumbar spinal stenosis leading to neurogenic claudication were included in this study in accordance with clearly defined inclusion and exclusion criteria.

Posterior decompression and stabilization for metastatic compression of the thoracic spinal cord: is this procedure still state of the art?

Study Design: Retrospective study utilizing the standard patient data documentation of a spinal cord injury (SCI) unit.

Objective: To examine the efficacy and outcome of posterior decompression and stabilization for metastatic cord compression.

Setting: Orthopedic university hospital with large SCI unit.

Role of the active-site solvent in the thermodynamics of factor Xa ligand binding.

Understanding the underlying physics of the binding of small-molecule ligands to protein active sites is a key objective of computational chemistry and biology. It is widely believed that displacement of water molecules from the active site by the ligand is a principal (if not the dominant) source of binding free energy. Although continuum theories of hydration are routinely used to describe the contributions of the solvent to the binding affinity of the complex, it is still an unsettled question as to whether or not these continuum solvation theories describe the underlying molecular physics with sufficient accuracy to reliably rank the binding affinities of a set of ligands for a given protein.

Maternal anesthesia via isoflurane or ether differentially affects pre-and postnatal behavior in rat offspring.

Our understanding of prenatal behavior has been significantly advanced by techniques for direct observation and manipulation of unanesthetized, behaving rodent fetuses with intact umbilical connections to the mother. These techniques involve brief administration of an inhalant anesthesic, enabling spinal transection of the rat or mouse dam, after which procedures can continue with unanesthetized dams and fetuses. Because anesthetics administered to the mother can cross the placental barrier, it is possible that fetuses are anesthetized to varying degrees.

Is an intercostal chest drain necessary after video-assisted thoracoscopic (VATS) lung biopsy?

Background: Video-assisted thoracoscopic surgical lung biopsy is a frequently performed procedure as an integral part of the diagnostic armamentarium for parenchymal lung disease. However, there is no evidence in the literature concerning the need for an intercostal chest drain after the procedure.

Methods: A prospective randomized control trial was set up to assess the need for intercostal chest drainage after video-assisted thoracoscopic surgical lung biopsy.

Repeated botulinum-A toxin injections in the treatment of myelodysplastic children and patients with spinal cord injuries with neurogenic bladder dysfunction.

Objectives: To examine the effects of repeated detrusor injections of botulinum-A toxin (BTX) for possible changes in bladder function, muscular structure of the detrusor, increase in BTX tolerance (tachyphylaxis) and side-effects, as BTX is a new treatment alternative for patients with a neurogenic bladder condition that is difficult to treat and refractory to anticholinergic medication.

Patients And Methods: Between 2000 and 2005, 19 patients with myelodysplasia (MDP) and 25 spinal cord-injured (SCI) patients were treated with repeated suburothelial BTX injections (Dysport, Ipsen-Pharma, Ettlingen, Germany) or injections into the intramural detrusor. The follow-up was > or = 3 years (range 3-5, median 4.

Validation of the walking index for spinal cord injury in a US and European clinical population.

Objective: To demonstrate the prospective construct validity of the walking index for spinal cord injury (WISCI) in US/European clinical population.

Design: Prospective Cohort in Denmark, Germany, Italy and the USA. PARTICIPANTS/METHOD: Participants with acute complete/incomplete (ASIA Impairment Scale (AIS) A, B, C and D) traumatic spinal cord injuries were enrolled from four centers.

Does dairy calcium intake enhance weight loss among overweight diabetic patients?

Objective: To examine the effect of dairy calcium consumption on weight loss and improvement in cardiovascular disease (CVD) and diabetes indicators among overweight diabetic patients.

Research Design And Methods: This was an ancillary study of a 6-month randomized clinical trial assessing the effect of three isocaloric diets in type 2 diabetic patients: 1) mixed glycemic index carbohydrate diet, 2) low-glycemic index diet, and 3) modified Mediterranean diet. Low-fat dairy product consumption varied within and across the groups by personal choice.

Motifs for molecular recognition exploiting hydrophobic enclosure in protein-ligand binding.

The thermodynamic properties and phase behavior of water in confined regions can vary significantly from that observed in the bulk. This is particularly true for systems in which the confinement is on the molecular-length scale. In this study, we use molecular dynamics simulations and a powerful solvent analysis technique based on inhomogenous solvation theory to investigate the properties of water molecules that solvate the confined regions of protein active sites.

Effects of labor contractions on catecholamine release and breathing frequency in newborn rats.

Plasma catecholamines in newborn rats (0-2 hr old) were analyzed following vaginal birth, cesarean section with simulated labor contractions, or cesarean section without labor contractions. Upon delivery, pups were exposed to key elements of the rat's natural birth process, that is, umbilical cord occlusion, tactile stimulation, and cooling. Only pups exposed to actual or simulated labor showed an immediate rise in norepinephrine and epinephrine.

Down in the mumps.

A 10-week-old female infant presented with a right-sided facial swelling without any constitutional symptoms. The swelling was nontender, nonfluctuant, with no erythema or induration. On the basis of the clinical picture, magnetic resonance imaging findings and serology, a diagnosis of unilateral mumps parotitis was made.

Comparison of multiple Amber force fields and development of improved protein backbone parameters.

The ff94 force field that is commonly associated with the Amber simulation package is one of the most widely used parameter sets for biomolecular simulation. After a decade of extensive use and testing, limitations in this force field, such as over-stabilization of alpha-helices, were reported by us and other researchers. This led to a number of attempts to improve these parameters, resulting in a variety of "Amber" force fields and significant difficulty in determining which should be used for a particular application.

A randomized, controlled trial of transanal irrigation versus conservative bowel management in spinal cord-injured patients.

Background & Aims: Bowel dysfunction in patients with spinal cord injury often causes constipation, fecal incontinence, or a combination of both with a significant impact on quality of life. Transanal irrigation improves bowel function in selected patients. However, controlled trials of different bowel management regimens are lacking.

Colorectal mucosal histamine release by mucosa oxygenation in comparison with other established clinical tests in patients with gastrointestinally mediated allergy.

Aim: This study evaluated colorectal mucosal histamine release in response to blinded food challenge-positive and -negative food antigens as a new diagnostic procedure.

Methods: 19 patients suffering from gastrointestinally mediated allergy confirmed by blinded oral provocation were investigated on grounds of their case history, skin prick tests, serum IgE detection and colorectal mucosal histamine release by ex vivo mucosa oxygenation. Intact tissue particles were incubated/stimulated in an oxygenated culture with different food antigens for 30 min.

Automated method to measure trabecular thickness from microcomputed tomographic scans and its application.

Trabeculae form the internal bony mesh work and provide strength to the bone; interconnectivity, overall density, and trabecular thickness are important measures of the integrity of the internal architecture. Such strength is achieved only gradually during ontogeny, whereby an increase in trabecular thickness precedes an increase in mineralization. Loss of bone mass later in life may be compensated for by thickening of the remaining trabeculae.

Kyphectomy in children with myelodysplasia: results 1994-2004.

Study Design: We retrospectively studied 24 consecutive pediatric patients with lumbar kyphosis due to myelodysplasia who had received corrective surgical treatment with the Warner and Fackler technique from 1994 to 2004.

Objectives: The purpose of the study was to evaluate the technical problems and outcome and to identify complications of this treatment modality, especially regarding the biomechanics.

Summary Of Background Data: The management of lumbar kyphosis (8%-20%) in conjunction with myelodysplasia is difficult.

Juvenile xanthogranuloma: a case report of a preterm baby.

This case report describes a preterm baby with juvenile extracutaneous xanthogranuloma that rapidly expanded. The tumor was excised because of rapid enlargement and extension into the thoracic inlet. To our knowledge, this is the first case of a preterm baby with extracutaneous juvenile xanthogranuloma.

Imaging in scoliosis from the orthopaedic surgeon's point of view.

For treating patients with scoliosis orthopaedic surgeons need diagnostic imaging procedures in order to provide answers about a possible underlying disease, choice of treatment, and prognosis. Once treatment is instituted, imaging is also critical for monitoring changes of the deformity so as to optimize therapy. The combined effort of orthopaedic surgeons and radiologists helps detect treatable causes of scoliosis at an early stage, define the need and timing for surgery, and ensure that every precaution is taken to minimize the risks of surgery.

Pediatric spinal cord injury in a subset of European countries.

Study Design: Postal survey.

Setting: A total of 19 countries in Europe.

Objectives: Firstly, to collect information about incidence and systems of care for pediatric spinal cord injury (pedSCI); including prevention, initial care and follow-up in a subset of European countries.