Seasonal impact on the outcome of multidisciplinary pain therapy.

Multidisciplinary pain treatment programs (MPTP) have been considered to be the most effective treatment of chronic pain. In this study, we analyzed the influence of seasons on the outcome of chronic pain patients undergoing MPTP. Therefore, a prospective, observational trial was conducted in patients with chronic pain undergoing a 5-week interdisciplinary treatment program.

Personality disorders and outcome after multidisciplinary pain therapy.

Objectives: Interdisciplinary treatment programmes are the gold standard for patients suffering from chronic pain. However, several patient-related factors seem to influence the patients' outcome. The aim of our study was to inquire whether patients with personality disorders (PD) might benefit less from an interdisciplinary treatment programme compared to patients without PD.

[Diffuse fasciitis after Borrelia infection--a case report].

Diffuse fasciitis (DF) [diffuse fasciitis with eosinophilia-Shulman's syndrome] has occasionally been linked to a precedent infection with Borrelia burgdorferi. Here, we report on another case of DF in a 25 year old male, in whom Borrelia burgdorferi infection as possible inciting agent could be identified based on the patient's history and laboratory data. Efforts to microscopically demonstrate spirochetes or to amplify Borrelia-DNA by nested PCR in lesional tissue failed after antibiotic treatment had already been initiated.

Pediatric equestrian injuries: assessing the impact of helmet use.

Objective: To assess the impact of helmet use on the pattern, and severity of pediatric equestrian injuries.

Design: A prospective observational study of all children less than 15 years of age who were brought to the University of Virginia children's Emergency Department with horse-related injuries.

Results: During the two-year period of the study, 32 children were evaluated.

Stairway-related injuries in children.

Objective: To identify the pattern and severity of injury associated with stairway-related falls in children.

Methods: During a 2-year period, all children less than 5 years of age presenting to the University of Virginia Pediatric Emergency Department with a stairway-related injury were prospectively studied. At the time of the emergency department visit, demographic and epidemiologic information was obtained.

Infant walker-related injuries: a prospective study of severity and incidence.

Objective: To determine the incidence and significance of walker-related injuries in infants.

Methods: During a 3-year, 8-month period, all infants who were brought to the University of Virginia Pediatric Emergency Department with a walker-related injury were prospectively studied. During the emergency department visit, demographic and epidemiologic information were recorded.

Skin disorders encountered in a pediatric emergency department.

A total of 1381 visits to a pediatric emergency department (ED) during a six-week period were surveyed to determine the types and frequency of skin disorders encountered. A primary skin complaint accounted for 431 (31%) visits. There was a skin complaint of secondary importance in another 35 (3%) visits, and a skin disorder not mentioned by the patient or parent was detected on examination in a further 88 (6%) visits.

Childhood sexual abuse reported by facilitated communication.

Facilitated communication remains an unproven and controversial strategy for nonspeaking children with developmental disabilities. It is possible that the process may be influenced by the facilitator. The evaluation of alleged sexual abuse reported by FC must include a full psychosocial history, complete physical examination for evidence of abuse, and the assessment of the child's communicative competence.

Rheumatoid arthritis of the knee: value of gadopentetate dimeglumine-enhanced MR imaging.

In an attempt to differentiate among joint effusion, synovitis, pannus, and subchondral sclerosis in patients with clinically proved chronic rheumatoid arthritis, we used gadopentetate dimeglumine-enhanced MR imaging to examine 23 patients with acute knee symptoms. All patients had had rheumatoid arthritis for more than 6 months and satisfied four or more of the criteria of the American Rheumatism Association for rheumatoid arthritis. MR imaging was performed on a 1.

[Results obtained by intravesical instillation of BCG in superficial bladder tumors].

The authors carried out immunotherapy in bladder cancer patients in stage pTa-1 G1-2 NoMo. The strain Connaught BCG (120 mg) was instilled weekly for 6 consecutive weeks in 26 patients. Another 13 patients were treated with 150 mg BCG strain Pasteur.

Pain reduction in local anesthetic administration through pH buffering.

The effects of pH buffering on the pain of administration and efficacy of three local anesthetics (1% lidocaine, 1% lidocaine with 1:100,000 epinephrine, and 1% mepivacaine) were investigated in a randomized, prospective, double-blind study of 25 adult volunteers. Plain and buffered solutions of the three local anesthetics were prepared, and a 0.5 intradermal injection of each was administered.

[Amniotic fluid embolism caused by uterine rupture with severe coagulopathy].

There is reported on a 35 years old woman, who was delivered of her third child. Six days after the expected day of delivery labour was introduced. On the end of the second stage an amniotic fluid infusion happened.

Use of influenza A virus vaccines in seronegative children: live cold-adapted versus inactivated whole virus.

We report the safety and antigenicity of influenza A vaccines in seronegative children one to seven years of age. A natural H1N1 challenge that occurred shortly after completion of the vaccination program permitted an evaluation of efficacy. Twenty-eight subjects were inoculated with live cold-adapted (ca) influenza A/Washington/897/80 (H3N2), 29 with ca influenza A/California/10/78 (H1N1), 24 with inactivated whole-virus influenza A/Bangkok/79 (H3N2), and 30 with a placebo.

A pharmacokinetic evaluation of peritoneal dialysis for phenytoin intoxication.

Despite the indications of previous case reports and standard references, peritoneal dialysis did not appreciably enhance the elimination of phenytoin in our patient. In view of our observations, the effectiveness of peritoneal dialysis for phenytoin poisoning should be seriously questioned. A careful reassessment of the efficiency of peritoneal dialysis for phenytoin should be performed and should consider the possible role of phenytoin metabolites contributing to toxicity.