Health service experiences among adults with hereditary spastic paraparesis or neurofibromatosis type 1.

Background: Persons with rare disorders may experience poorer health services due to limited knowledge about rare disorders among health professionals. Knowledge about how persons with rare disorders perceive health services can help inform service providers to enhance their practices.

Methods: We conducted a self-report survey among adults with the rare disorders hereditary spastic paraparesis (HSP; n = 108; mean age 57.

Health Survey of Adults with Neurofibromatosis 1 Compared to Population Study Controls.

Neurofibromatosis type 1 (NF1) is a genetic, autosomal dominant multi-organ disease characterized by susceptibility to tumor formation, changes in skin pigmentation, skeletal abnormalities, and neuropsychological deficits. Clinical studies have shown impaired health-related quality of life (HQoL) in adults with NF1. However, little is known about HQoL in non-clinical NF1 samples.

High-intensity aerobic interval training improves aerobic fitness and HbA1c among persons diagnosed with type 2 diabetes.

Purpose: It remains to be established how high-intensity aerobic interval training (HAIT) affects risk factors associated with type 2 diabetes (TD2). This study investigated effects of HAIT on maximal oxygen uptake (VO), glycated Hemoglobin type A1C (HbA1c), insulin resistance (IR), fat oxidation (FatOx), body weight (BW), percent body fat (%BF), lactate threshold (LT), blood pressure (BP), and blood lipid profile (BLP) among persons with T2D. Results were compared to the effects after a moderate-intensity training (MIT) program.

Day to day variability in fat oxidation and the effect after only 1 day of change in diet composition.

Indirect calorimetry is a common and noninvasive method to estimate rate of fat oxidation (FatOx) during exercise, and test-retest reliability should be considered when interpreting results. Diet also has an impact on FatOx. The aim of the present study was to investigate day to day variations in FatOx during moderate exercise given the same diet and 2 different isoenergetic diets.

"She came out of mum's tummy the wrong way". (Mis)conceptions among siblings of children with rare disorders.

Misconceptions or uncertainty about the rare disorder of a sibling may cause adjustment problems among children. New knowledge about their misconceptions may enable genetic counselors to provide targeted information and increase siblings' knowledge. This study aims to describe misconceptions and uncertainties of siblings of children with rare disorders.

1990-2001 US general surgery chief resident gastric surgery operative experience: analysis of paradigm shift.

The almost complete disappearance of benign gastric ulcer disease has led to the perception that there may be an insufficient gastric surgery experience for surgery residents. This study analyzed resident-reported gastric procedure experience by chief residents from U.S.

Classification of groin hernia: milestones.

Do we have true "milestones" along the hernia-classification route? I am not certain; modifications have been presented along the way, and each presentation (partially discussed herein) should be studied by every student of herniology and personal decisions made. In developing classifications, we should beware of too many hernia types. We must focus our attention and decisions upon each abdominal wall defect.

Evolution of hernia repair: a salute to Professor Piero Pietri.

This subject has been well covered in recent years. Yet it seems appropriate to search for major advances in hernia methodology during the last 100 years. Eduardo Bassini is credited with pioneering the modern era.

Force reduction by an external hip protector on the human hip after falls.

This is the first quantitative study of the impact force over the hips of volunteers who fell laterally from standing to a hard surface while wearing a hip protector. Protector pads were first tested with a drop weigh machine. Piezoelectric sensors were placed on the impact surface to record force-time curves with and without a pad covering the surface.

Creation, evaluation, and continuing assurance of excellence of the certified surgical specialist.

A position paper on the subject of certified surgical specialists was published in 1966 under the direction of Professor Charles Wells of Liverpool, England. President John Terblanche of the International Federation of Surgical Colleges brought together leaders in surgical education from four nations (Australia, Japan, South Africa, United States) to update current "state-of-the art" views. Presentations were made at the 38th Congress of the International Society of Surgery, August 18, 1999 in Vienna, Austria.

Marked asymmetry of LES: important element of LES barrier in subsets of patients with reflux symptoms.

Computerized axial manometry (CAM) of the lower esophagus measures squeeze pressure at multiple points in each segment of the lower esophageal sphincter (LES), calculates several unique parameters of LES function, and constructs a 3-D display of the LES. Whether parameters derived from CAM, such as the radial mean pressure (LESrmp), Asymmetry (Asym), and Vector Volume (VV), have relevance to function of the LES remains undefined. This study compares the results of CAM in patients with gastroesophageal reflux disease (GERD) and controls.

Antioxidant therapy using high dose vitamin C: reduction of postburn resuscitation fluid volume requirements.

Twenty-four guinea pigs with third degree burns over 70% of the body surface area were divided equally into four groups. At 0.5 hours postburn, all groups received Ringer's lactate solution (R/L) according to the Parkland formula.

Esophagocardiomyotomy--floppy Nissen fundoplication effectively treats achalasia without causing esophageal obstruction.

Background: Effective surgical treatments for achalasia of the esophagus facilitate swallowing by division of muscles that fail to relax normally during swallowing. If esophagocardiomyotomy is performed, a complementary antireflux procedure is mandatory to prevent postoperative gastroesophageal reflux. We evaluated patients who had undergone a circumferential antireflux procedure after esophagocardiomyotomy to determine the effects of this procedure in patients with an aperistaltic esophagus.

[Extended superselective vagotomy. Experimental bases and application in the surgical treatment of duodenal ulcer].

There is a sound basis for performing EHSV with reference to the "areas of vagotomy" as described and for wider application of EHSV. Most patients with complications of duodenal ulcer disease can be treated successfully by EHSV, with a small incidence of recurrent ulcers. The liberal use of pyloroplasty or drainage procedures is justified, since the potential problems of perioperative infection and postoperative alkaline reflux are not clinically significant.

Endoscopic ultrasonography verifies effect on endoscopic treatment of reflux in dogs and man.

We have previously reported that endoscopic sclerosis of the gastric cardia is an effective treatment for experimental gastroesophageal reflux in dogs. The histologic effect of endoscopic sclerosis is limited to the proximal stomach; mucosal deformity provides endoscopic evidence of sclerosis, and the intramural effects are shown by ultrasonographic technique. This report describes histologic and ultrasonographic results in the dogs at the completion of endoscopic sclerosis.

Effects of afferent and efferent celiac nerves on acute gastric lesions: due to changes in blood flow?

Since ablation of afferent nerves prior to stress results in increased severity of acute gastric mucosal lesions, afferent nerves are thought to mediate protective mechanisms in the stomach. These mechanisms are known to include vasodilation of gastric mucosal vessels; vasodilation is thought to allow the gastric mucosa to respond to injurious substances. However, it is not known whether other aspects of mucosal health, independent of those caused by increased blood blow, are affected by afferent blockade.

Iliopubic tract repair of inguinal and femoral hernia. The posterior (preperitoneal) approach.

There are two arms of inguinal hernia treatment herein presented--the approach and the repair. Whereas the posterior approach is not new, the repairs are unique, and details given are precise and must be followed carefully to obtain proven excellent long-term results. A classification of hernia types is outlined.