Impact of Preliminary Bronchodilator Dose in Chronic Obstructive Pulmonary Disease Patients With Suboptimal Peak Inspiratory Flow.

Purpose: Suboptimal peak inspiratory flow rate (PIFR) is highly prevalent in patients with chronic obstructive pulmonary disease (COPD) owing to the mismatch of their PIFR with the corresponding inhaler-device resistance. This study aimed to investigate the impact of a preliminary dose of pressurized metered dose inhalers (pMDIs) on patients with COPD with suboptimal PIFR using Diskus dry powder inhalers (DPIs).

Methods: A prospective, randomized, case-control study included 24 patients with COPD.

Molecular characterization of full genome sequences of Newcastle disease viruses circulating among vaccinated chickens in Egypt during 2011-2013.

Although intensive vaccination programs have been implemented, Newcastle disease (ND) outbreaks, accompanied by severe economic losses, are still reported in Egypt. The genetic characterization of ND virus (NDV) strains isolated from ND-vaccinated chicken flocks provides essential information for improving ND control strategies. Therefore, here, 38 NDV strains were isolated and identified from outbreaks among vaccinated flocks of broiler chickens located in the provinces of Qena, Luxor, and Aswan of Upper Egypt during 2011-2013.

Molecular and biological characterization of the immunological potency of Newcastle disease virus oil emulsion-inactivated vaccines prepared from field isolate obtained from vaccinated chickens outbreak.

This study was conducted to characterize the immunological parameters of chickens vaccinated with two formulated inactivated vaccines, water in oil (WO) and water in oil in water (WOW), prepared from velogenic Newcastle disease virus (vNDV) genotype VIIj isolated from outbreak among vaccinated chickens. Six groups (G1-G6) of commercial broiler chickens were established (n = 20). The G1-G3 were received homologous (WO and WOW) and heterologous (LaSota) inactivated vaccines, respectively.

A Rare Case of Diffuse Large B Cell Lymphoma Presenting as a Cardiac Mass.

BACKGROUND Primary mediastinal diffuse large B cell lymphoma (DLBCL) presenting as a large intracardiac tumor is extremely rare and has not been significantly reported in the literature. Cardiac lymphoma consists of 2 subtypes: mediastinal DLBCL invading the heart and primary cardiac lymphoma. Both subtypes have a poor prognosis and are treated similarly.

Potential of two nucleic acid amplification assays for quantifying mycobacterial load in respiratory and non-respiratory specimens: a prospective study.

Quantification of bacillary load plays a critical prognostic role in tuberculosis patients. This study evaluated the potential of the Cepheid GeneXpert (GX) MTB/RIF and the BD ProbeTec system as quantitative assays. The time to positivity (TTP) measured by the Mycobacterial Growth Index Tube system was compared to the cycle threshold (Ct) of GX MTB/RIF and the Metric Other than Acceleration (MOTA) scores generated by the ProbeTec system.

A Randomized, Placebo-Controlled Trial of Omega-3 Fatty Acids for Inhibition of Supraventricular Arrhythmias After Cardiac Surgery: The FISH Trial.

Background: Omega-3 polyunsaturated fatty acids (n3-PUFAs) might have antiarrhythmic properties, but data conflict on whether n3-PUFAs reduce rates of atrial fibrillation (AF) after coronary artery bypass graft surgery (CABG). We hypothesized that n3-PUFAs would reduce post-CABG AF, and we tested this hypothesis in a well-powered, randomized, double-blind, placebo-controlled, multicenter clinical trial.

Methods And Results: Patients undergoing CABG were randomized to pharmaceutical-grade n3-PUFAs 2 g orally twice daily (minimum of 6 g) or a matched placebo ≥24 hours before surgery.

A bone to pick about chest pain.

Chest pain is an extremely common presenting symptom that is usually related to a cardiac cause. This case illustrates an unusual presentation of multiple myeloma as a cause of atypical chest pain. This case presentation shows the importance of having a broad differential diagnosis while evaluating patients with atypical chest pain.

Patient experiences with MedlinePlus.gov: a survey of internal medicine patients.

Background: In 2004, the American College of Physicians joined with the National Library of Medicine in an effort to help patients find reliable health information free of commercial bias as the Web site MedlinePlus.gov. The aim of this study was to evaluate the usefulness of the MedlinePlus.

Interaction between warfarin and levofloxacin: case series.

Warfarin is the most widely used oral anticoagulant and is indicated for many clinical conditions. Levofloxacin, a fluoroquinolone, is one of the most commonly prescribed antibiotics in clinical practice and is effective against Gram-positive, Gram-negative, and atypical bacteria. While small prospective studies have not revealed any significant drug-drug interaction between warfarin and levofloxacin, several case reports have indicated that levofloxacin may significantly potentiate the anticoagulation effect of warfarin.

Buerger disease in an elderly man.

Buerger disease is characterized by progressive distal extremity ischemia in persons with recent tobacco consumption. Typically, affected persons are young men. There have been case reports of Buerger disease in older men.

Reversible pulmonary hypertension and isolated right-sided heart failure associated with hyperthyroidism.

Hyperthyroidism may present with signs and symptoms related to dysfunction of a variety of organs. Cardiovascular pathology in hyperthyroidism is common. A few case reports describe isolated right heart failure, tricuspid regurgitation, and pulmonary hypertension as the prominent cardiovascular manifestations of hyperthyroidism.

Diagnosis and treatment of peripheral arterial disease compared with other atherosclerotic vascular diseases in a university primary care clinic.

Background: Despite the fact that peripheral arterial disease (PAD) significantly increases the risk of cardiovascular mortality, it is significantly underdiagnosed and undertreated. The purpose of this study was to evaluate the practice at a northeast Tennessee university primary care clinic regarding the diagnosis and treatment of PAD.

Methods: A retrospective medical record survey was conducted to evaluate practice patterns in diagnosing and treating PAD in a university primary care clinic.

Attitudes toward hormone replacement therapy in the new millennium: university physicians' and patients' perspectives.

Background: Recent studies are changing the way physicians and patients view hormone replacement therapy (HRT). This study was performed at the East Tennessee State University (ETSU) internal medicine clinic to evaluate the current behaviors of university physicians and patients with respect to HRT.

Methods: A retrospective chart review was conducted at the main internal medicine outpatient clinic at ETSU.

Practice patterns in treating high-risk patients with hyperlipidemia at a northeast Tennessee university clinic.

Background: This study was conducted to test the hypothesis that internal medicine residents at a northeast Tennessee university clinic were not compliant with the latest National Cholesterol Educational Program Adult Treatment Panel (NCEP-ATP) guidelines in treating hyperlipidemia in patients with diabetes and coronary artery disease.

Methods: A retrospective medical record survey was conducted to evaluate residents' pattern in lowering low-density lipoprotein (LDL) cholesterol to below 100 mg/dL in patients with diabetes and coronary artery disease. The survey covered a 5-year period, from July 1998 to June 2003, and included 15 randomly chosen residents who were in training for 3 consecutive years.

The role of omega-3 fatty acids in cardiac protection: an overview.

There have been increasing research efforts in recent years to evaluate the role of various dietary supplements, such as antioxidant vitamins, L-arginine, glucan, isoflavones, soy estrogens, omega-3 fatty acids, etc., in cardiovascular health. Although there is not adequate evidence of the beneficial effects of many nutriceuticals on cardiac function, in the case of omega-3 fatty acids, the evidence has been more convincing.

Vertigo. A neurobiological review.

Dizziness is one of the most common presenting symptoms in clinical practice. Yet, the meaning of this symptom is patient-dependent and can span from true vertigo due to vestibular dysfunction to syncope or vertebro-basilar stroke. This review addresses the neurobiological background of vertigo and the most common syndrome of benign paroxysmal positional vertigo, with an outline of the approach towards localization and management of the acute vertiginous patient.

The use of M-latency in the diagnosis of carpal tunnel syndrome.

Objective: To study the use of M-latency (ML) as an electrodiagnostic parameter for diagnosis of carpal tunnel syndrome (CTS).

Methods: One hundred and one consecutive patients (77 females, mean age 42 years and 24 males, mean age 46 years) referred with a clinical diagnosis of CTS to the Neurodiagnostic laboratories at the King Fahd Hospital of the University, Al-Khobar, Kingdom of Saudi Arabia were evaluated between November 1999 and October 2000. Standardized nerve conduction studies on 191 hands, including 191 median and 108 normal ulnar nerves were performed.

Newly diagnosed seizures in adolescents: a comparative study.

Objective: To study the clinical, EEG and CT profile in a hospital population of adolescents with newly diagnosed recurrent seizures.

Methods: The clinical profiles obtained from history including detailed descriptions of the seizures, examination, electroencephalographic (EEG) and computed tomography (CT) findings were recorded prospectively for all 14 to18-year-old patients who were referred to the electrodiagnostic service at King Fahd Hospital of the University, Al- Khobar, Eastern Province, Saudi Arabia from 1(st) January 1996 to 31(st) December 1997. The data were entered into a standard dbase file and analyzed using a personal computer.

Newly diagnosed seizures in adults.

Objective: To study the clinical, electroencephalographic (EEG) and computed tomography (CT) profile in a hospital population of over 18-years adult patients with newly diagnosed recurrent seizures.

Methods: The clinical profiles obtained from history including detailed description of the seizures, examination, EEG and CT findings were recorded prospectively for all over-18 patients who were referred to the electrodiagnostic service at King Fahd Hospital of the University, Al-Khobar, Eastern Province, Kingdom of Saudi Arabia from January 1, 1996 to December 31, 1997. The data was entered into a standard database file and analyzed using a personal computer.

Evaluation of nitric oxide (NO) levels in hepatitis C virus (HCV) infection: relationship to schistosomiasis and liver cirrhosis among Egyptian patients.

Nitric oxide (NO), a recently discovered free radical, is overproduced in liver cirrhosis. Hepatitis C virus (HCV) might increase NO levels via increased inducible NO synthase (iNOS). This work was carried out to study the effect of HCV-induced liver cirrhosis on NO levels among Egyptian patients.

Cerebral palsy in Saudi children.

Objective: To describe the clinical profile, and identify its risk factors, of cerebral palsy (CP) as seen in a cohort of consecutive Saudi children aged between one and 3 years of age prospectively over a one-year period.

Methods: Saudi children aged 1-3 years with CP (diagnosis based on specified criteria) were selected from children presenting to the Neurology service at the King Fahd Hospital of the University, Al-Khobar, Kingdom of Saudi Arabia with delayed milestones, seizures, mental retardation and difficulty with walking and evaluated at 3-monthly intervals for one year from January to December 2000. Information on gestation duration, labor and delivery, birth weight and the medical history of the mothers was obtained.

Are we ready for arabization in medical education?

Objective: To obtain the views of faculty members of the College of Medicine, King Faisal University on Arabization of medical education.

Methods: A cross-sectional study was conducted in the College of Medicine, King Faisal University, Dammam, between January and June 2001 using a standardized 41-item questionnaire to obtain the views of faculty members in both basic science and clinical departments on issues relating mainly to scientific research. The responses were recorded on a 5-point scale: strongly agree, agree, undecided, disagree and strongly disagree.

Acute exacerbations of chronic bronchitis.

Preview Acute bacterial exacerbations of chronic bronchitis cause considerable morbidity and mortality, particularly in the elderly. Effective antimicrobial therapy results in fewer hospitalizations for respiratory failure and better resolution of symptoms. However, there is growing concern regarding treatment failures caused by resistant organisms.