Asymptomatic pneumoperitoneum or pneumatosis cystoides intestinalis? Easy to make a mistake.

Pneumoperitoneum refers to the presence of intraperitoneal free gas outside the viscera. A perforation of a hollow viscus is the main cause and usually indicates a surgical emergency. However, some case of pneumoperitoneum can be completely asymptomatic and secondary to benign conditions that do not require any surgical intervention.

Onycholemmal carcinoma: a morphologic comparison of 6 reported cases.

Background: We report 6 new cases of onycholemmal carcinoma, a rare, often misdiagnosed, subcategory of squamous cell carcinoma. All reported cases to date have been treated with amputation of the affected digit.

Objective: The purpose of this study was to present the clinical and pathological features of each new case and to discuss treatment options that spare digit functionality.

Bleeding control by radiofrequency in penetrating trauma of the liver.

Termocoagulation by radiofrequency (RF) is widely used for ablation of liver neoplasms. Recently, innovative uses of RF were proposed, as to assist liver resection, to help partial splenectomy, or to treat ruptured hepatocellular carcinoma. A 21 years old man was admitted for massive haemorrhage from a right thoraco-abdominal knife wound.

Treatment persistence with adalimumab, etanercept, or infliximab in combination with methotrexate and the effects on health care costs in patients with rheumatoid arthritis.

Background: Anti-tumor necrosis factor (TNF) biologic agents are effective in treating rheumatoid arthritis (RA). Information on patient persistence with biologic anti-TNF therapies is limited, and the effects of persistence on the costs of therapy are unknown.

Objectives: The aims of this study were to compare treatment persistence with adalimumab, etanercept, or infliximab in combination withmethotrexate (MTX) and evaluate the effects of persistence on overall health care costs.

A multicenter, randomized, open study to evaluate the impact of an electronic data capture system on the care of patients with rheumatoid arthritis.

Objective: To examine the impact of an electronic data capture system on patient satisfaction and patient-physician interactions in a rheumatology clinical setting.

Study Design: In this multicenter study, 1079 patients with rheumatoid arthritis completed questionnaires quarterly about their health and satisfaction with care using a computer. At 6 months, 901 eligible patients were randomized 2:1 to receive or not to receive graphical summarized health information or Health Tracker (HT) reports.

Open-label, pilot protocol of patients with rheumatoid arthritis who switch to infliximab after an incomplete response to etanercept: the opposite study.

Objective: To incorporate a new trial design to examine clinical response, cytokine expression and joint imaging in patients with rheumatoid arthritis (RA) switching from etanercept to infliximab treatment.

Methods: A randomised, open-label, clinical trial of 28 patients with an inadequate response to etanercept was conducted. Eligible patients received background methotrexate and were randomised 1:1 to discontinue etanercept and receive infliximab 3 mg/kg at weeks 0, 2, 6, 14 and 22, or to continue etanercept 25 mg twice weekly.

Solvation parameters Part 1. Mutual improvements of several approaches and determination of two first sets of optimized values.

An improvement in the characterization and the determination of the solvation parameters allows, not only a better knowledge of solutions, but also of some biological phenomena. In this paper, we test several published data and approaches in the field of solubility and solvation parameters in two ways: (i) the mutual independence of the parameters and (ii) their ability to take into account recently published gas-liquid chromatographic data. From this enquiry it arises that the most suitable published values are those of Abraham concerning 314 solutes.

Supra infection of amoebic liver abscess consequent to acute appendicitis. Clinical case.

Amoebic liver abscess is the most common extra-intestinal manifestation of amebiasis with approximately 10% of the world's population infected by this parasite. Actually, incidence of this infection is also increasing in industrialized countries, as a consequence of the more frequent immigration or travelling. Only 3-10% of patients with intestinal amebiasis develop liver abscess.

Complementary studies of the gastrointestinal safety of the cyclo-oxygenase-2-selective inhibitor etoricoxib.

Background: Cyclo-oxygenase-2-selective non-steroidal anti-inflammatory drugs are intended to preserve cyclo-oxygenase-1-mediated gastroprotection and platelet function, whilst inhibiting cyclo-oxygenase-2-mediated inflammation.

Aim: To assess the gastrointestinal safety of the cyclo-oxygenase-2-selective inhibitor etoricoxib vs. non-selective non-steroidal anti-inflammatory drugs.

Selection criteria for non-surgical treatment of liver injury in adult polytraumatized patients.

Conservative treatment of hepatic trauma is currently implemented in 80-90% of cases with a success rate of 92.5% and is mainly based on the haemodynamic status of the patients. We conducted a retrospective study of 71 patients with hepatic trauma from January 1993 to April 2001 and reviewed our experience with surgical and conservative treatment, also considering associated extrahepatic lesions.

Is there cyclosporine-induced bone disease?

Considerable controversy remains concerning the effect of cyclosporine on bone. One effect of this agent is to increase bone turnover, favoring resorption of bone. This effect is best illustrated in animal models.

Olfactory quality: from descriptor profiles to similarities.

The model described here, which links olfactory semantic profiles to canonical similarities, performs significantly better than the current state of the art, mainly due to the use of an optimization procedure. Application of Tversky's model in this study shows that in olfaction, estimation of similarities is based exclusively on the distinctive elements of the profiles, and does not take into account the common elements. Moreover, the optimum number of descriptors to reckon with seems to lie between 25 and 30.

Molecular detection of bacterial DNA in venereal-associated arthritis.

Objective: To evaluate the utility of polymerase chain reaction (PCR) amplification in detecting DNA from venereal-associated microorganisms in the synovial fluid of patients with inflammatory arthritis.

Methods: Oligonucleotide primers were developed for nested PCR based on Chlamydia, Ureaplasma, and Neisseria DNA sequences. PCR products were detected by gel electrophoresis and dot-blot hybridization.

Laboratory tests for rheumatic diseases.

Preview Laboratory testing to aid the diagnosis of rheumatic disease represents an area of considerable controversy in the United States. There is growing recognition that "overtesting" contributes to the rising costs of healthcare and that strategies need to be developed to optimize use of the increasing number of available tests. In this article, the authors discuss some of the commonly ordered tests for rheumatic diseases, focusing on their usefulness, sensitivity, and specificity.

Laboratory tests for rheumatic diseases. When are they useful?

Because negative tests often do not exclude a rheumatic disease and positive tests do not always diagnose it, judicious use of laboratory testing in patients with suspected rheumatic disease is essential. The final diagnosis must be made clinically. However, when the tests are used in conjunction with clinical manifestations, they may help differentiate the numerous rheumatic disorders, and they may also be of value in monitoring activity of the disease.

Streptokinase and rt-PA activate platelets by a different way: implications on the rethrombosis rate after their administration in myocardial infarction.

The natural history of acute myocardial infarction has been dramatically changed by the advent of thrombolytic treatment, with a 30% mortality reduction, a better recovery of ventricular function, and a better quality of life. This treatment notwithstanding, failure or delay in achieving reperfusion, along with reocclusion and bleeding, still worry clinicians and challenge researchers to improve thrombolytic regimens and concomitant antithrombotic treatments. Platelet activation, at least in part because of thrombolytic treatment itself, plays a pivotal role in the pathogenesis of resistance to lysis and rethrombosis.

Detection of T cell receptors in early rheumatoid arthritis synovial tissue.

Synovial tissue is rarely available from patients with early synovitis, with the exception of synovial biopsies. However, T cell populations early in the development of synovitis may be enriched in antigen-specific cells and critical to disease pathogenesis. To investigate the T cell repertoire in early synovitis, we utilized a PCR protocol for detection of T cell receptor (TCR) transcripts present in small amounts of synovial tissue.

High levels of the shed form of L-selectin are present in patients with acute leukemia and inhibit blast cell adhesion to activated endothelium.

L-selectin is expressed by most leukocytes and mediates the initial step of adhesion to vascular endothelium. A feature of this adhesion receptor is to be shed from the cell surface. We report here the presence of high levels of the shed form of L-selectin (sL-selectin) in plasma from patients with acute leukemia.

Osteoporosis and bone morbidity in cardiac transplant recipients.

Purpose: To evaluate the incidence and etiology of osteopenia and pathologic fractures in cardiac transplant recipients.

Patients: Thirty-one adult male cardiac transplant recipients and 14 adult men with congestive heart failure (CHF) awaiting cardiac transplantation.

Methods: Assessment of indices of bone and mineral metabolism and of bone mineral density (BMD) by dual-energy x-ray absorptiometry.