An interactive videogame for arm and hand exercise in people with Parkinson's disease: A randomized controlled trial.

Introduction: People with Parkinson's disease (PD) have difficulty performing upper extremity (UE) activities. The aim of this study was to investigate if exergames targeting the UE improve arm and hand activities and impairments and to establish the acceptability and feasibility of these games in people with PD.

Methods: Two tablet-based exergames were developed which were controlled with finger movements or unimanual whole arm movements.

Nonvasculitic autoimmune inflammatory meningoencephalitis (NAIM): a reversible form of encephalopathy.

Five patients, age 54 to 80 years, presented between 3 weeks and 18 months after symptomatic onset of progressive cognitive decline, psychosis, and unsteady gait that proved to be due to a steroid-responsive nonvasculitic autoimmune inflammatory meningoencephalitic syndrome. CSF examination showed elevated immunoglobulin (Ig)G index and IgG synthesis rate in all three patients in whom it was checked, and brain biopsy revealed perivascular lymphocytic infiltrates without vessel wall invasion.

A study of the cutaneous manifestations of Behçet's disease in patients from the United States.

Background: The type and frequency of different manifestations of Behçet's disease (BD) vary in different geographic areas. This variability could affect the ability to diagnose the disease in certain areas by using standardized criteria. The frequency of cutaneous lesions in patients from the United States, where the disease is less prevalent, is not known.

Whipple's arthritis: direct detection of Tropheryma whippelii in synovial fluid and tissue.

We describe 2 patients presenting with polyarthritis in whom the synovial fluid (1 patient) or synovial tissue (1 patient) was positive for Tropheryma whippelii, the Whipple's disease-associated bacillus, when examined by polymerase chain reaction (PCR) and DNA sequencing. Histopathologic findings were consistent with articular Whipple's disease in the synovial fluid of 1 patient and the synovial tissue of the other. In both patients, bowel mucosal specimens were negative for Whipple's disease features by histologic and PCR methods.

Improvement of myelopathy in Sjögren's syndrome with chlorambucil and prednisone therapy.

The authors present a patient with Sjögren's syndrome with a fluctuating and then progressive myelopathic syndrome, and optic nerve involvement. Treatment with chlorambucil and prednisone improved the patient's function from being wheelchair bound to walking unaided. Spinal MRI showed multiple, extensive intraparenchymal areas of abnormal T2-weighted signal intensity, gadolinium enhancement, and cord swelling, which also improved during the period of treatment.

Interferon-alpha treatment of Behçet's disease.

Objective: To determine if interferon-alpha (IFN-alpha) is effective in Behçet's disease (BD).

Methods: Ten patients having active BD were entered into a 6 month open label trial of IFN-alpha therapy given by self-administered dose of 3 million units subcutaneously daily. Provision was made for downward or upward dosing depending on predetermined responses.

Polyarticular blastomycotic arthritis.

Blastomycotic arthritis usually presents as acute monoarticular septic arthritis resembling a bacterial process. Only 2 cases in the literature have subsequently developed arthritis in a second joint. We describe the case of an elderly woman with polyarticular blastomycotic arthritis associated with lung, skin, and bone involvement.

A prospective study of the safety of joint and soft tissue aspirations and injections in patients taking warfarin sodium.

Objective: To determine the safety of joint or soft tissue aspirations and injections in patients taking warfarin sodium.

Methods: The outcome of 32 joint or soft tissue aspirations or injections in patients receiving stable doses of warfarin sodium was assessed through a standardized interview 4 weeks after the procedure. The primary outcome measure was significant joint or soft tissue hemorrhage, ascertained by patient-reported increases in swelling or warmth at the procedure site.

Evaluation of glucocorticosteroid injection for the treatment of trochanteric bursitis.

Objective: We conducted an open observational study to assess the short and longterm effect of single local glucocorticosteroid injection for trochanteric bursitis.

Methods: 75 patient diagnosed with trochanteric bursitis based on clinical criteria were injected; 20, 32, and 22 patients each received 6, 12, and 24 mg betamethasone, respectively, mixed with 4 cm3 of 1% lidocaine. A standardized baseline questionnaire was administered to assess the severity and functional limitation due to trochanteric pain, including the visual analog scale for pain.

Common rheumatologic diseases in elderly patients.

Objective: To review common rheumatologic disorders that affect elderly patients and emphasize the unique diagnostic and therapeutic challenges inherent in the management of rheumatologic diseases in this age-group.

Design: We summarize our approach to treatment and management of specific rheumatologic problems in geriatric patients and discuss pertinent studies from the literature.

Results: Among the spectrum of rheumatologic disorders frequently encountered in the elderly population are polymyalgia rheumatica, fibromyalgia, giant cell arteritis, crystalline arthropathies (gout and pseudogout), and degenerative joint disease.

Survival of low birthweight infants in central Queensland.

The survival of low birthweight infants < or = 2000 g born in the central Queensland area during the years 1979 to 1991 was examined. Five hundred and sixty such infants were either delivered at one of the two Rockhampton obstetric units (Rockhampton Base Hospital and the Mater Misericordiae Hospital) or retrieved from outlying central Queensland areas. Both hospitals had intensive care nurseries capable of ventilation and infants were transferred to tertiary centres only for cardiac or surgical treatment.

Behçet's disease.

The International Study Group's diagnostic criteria for Behçet's disease are gaining acceptance and may be further refined before the decade is over. Previously neglected clinical features of the disease, especially arterial aneurysms and phlebitis, are increasingly reported. Each poses a dilemma in the choice of treatment, which ranges from anticoagulant to immunosuppressant regimens, old and new.

Chronic inflammatory meningoencephalitis should not be mistaken for Alzheimer's disease.

We describe two patients with a chronic encephalopathy that clinically resembled dementia but that resolved after oral administration of high-dose corticosteroid therapy. Both patients had serologically documented Sjögren's syndrome, a diagnosis that was further supported by biopsy of a salivary gland in one. Neither patient had radiologic evidence of vasculitis of the central nervous system.

Clinical utility of the alizarin red S stain on permanent preparations to detect calcium-containing compounds in synovial fluid.

The alizarin red S stain for permanent cytologic preparations is a valuable test that is complementary to compensated polarized light microscopic examination to detect calcium crystals. Alizarin red S has the greatest sensitivity for detection of calcium pyrophosphate crystals because crystals are stained regardless of how weakly or strongly birefringent they may be. Alizarin red S stain does not distinguish between amorphous types of calcium compounds; therefore, the different types of calcium compounds can be distinguished only when typical crystal morphologic features are present.

Abnormalities of surfactant in children with recurrent cyanotic episodes.

The mechanism of recurrent cyanotic episodes in infants and children is not known, but a deficiency of surfactant is a possible cause. We have measured the amount of surfactant collected by bronchoalveolar lavage from two children with recurrent cyanotic episodes and from two controls with anatomical airway obstructions. We also assessed the physical properties of the surfactant by changing the surface area (A) of a monolayer and measuring its surface tension (gamma).

Vasculitis in Behçet's disease.

Vasculitis of arteries and veins is an important feature of Behçet's disease. When it occurs in systemic or pulmonary arteries or in large veins it is life threatening. Retinal vasculitis is the hallmark of eye disease, and much of the central nervous system disease is linked to small artery occlusions.