Disease modifying agent related skin reactions in multiple sclerosis: prevention, assessment, and management.

Background: The objective for this article is to highlight some of the adverse skin manifestations associated with injectable disease modifying therapy for multiple sclerosis (MS). Early identification and intervention can often lead to minimal consequences and prolonged patient tolerance and compliance with these agents. At the University of Texas Southwestern Medical Center at Dallas and Texas Neurology in Dallas we actively follow approximately 5000 MS patients.

Naloxone fails to antagonize initial hypoalgesic effect of a manual therapy treatment for lateral epicondylalgia.

Background: Recent research has shown that Mulligan's Mobilization With Movement treatment technique for the elbow (MWM), a peripheral joint mobilization technique, produces a substantial and immediate pain relief in chronic lateral epicondylalgia (48% increase in pain-free grip strength).([1]) This hypoalgesic effect is far greater than that previously reported with spinal manual therapy treatments, prompting speculation that peripheral manual therapy treatments may differ in mechanism of action to spinal manual therapy techniques. Naloxone antagonism and tolerance studies, which employ widely accepted tests for the identification of endogenous opioid-mediated pain control mechanisms, have shown that spinal manual therapy-induced hypoalgesia does not involve an opioid mechanism.

Effects of insertion depth of cochlear implant electrodes upon speech perception.

Objective: To investigate whether the insertion depth of a cochlear implant array affects postoperative speech perception.

Design: The subjects were 48 postlingually deaf adults who received either the Nucleus 22 or the Nucleus 24 cochlear implant with a straight array. A postoperative radiograph of the cochlear electrode was used to estimate insertion depth, as either the angle of the electrode tip (angle) or the intracochlear length of the electrode (length).

A post-traumatic nasal epidermoid: an endoscopic approach.

Background: Epidermoid cysts are thought to arise as a result of implantation of epidermal cells into the deeper dermal elements. These cysts have previously been described postsurgery but not after accidental nasal trauma.

Methods: We outline a case of a nasal epidermoid occurring post-blunt nasal trauma and its subsequent excision.

A comparison of the monothermal and bithermal caloric tests.

This study considered whether the monothermal (MT) caloric test could predict the normality of the full conventional bithermal (BT) caloric test, and therefore be an alternative to full caloric investigation. This would have the advantages of reducing test time and patient discomfort as only two caloric tests would be needed instead of four. 744 BT caloric investigations were examined, and the unilateral weakness and directional preponderance calculated for the BT and the MT stimuli.

Social preferences of developing guinea pigs (Cavia porcellus) from the preweaning to the periadolescent periods.

Preference tests in a novel environment (Experiment 1) and unobtrusive observations in a specialized living environment (Experiment 2) examined the attractiveness of various classes of conspecifics for maturing guinea pigs (Cavia porcellus). It was found that (a). the young continued to remain near the mother well beyond weaning; (b).

Recent advances in therapeutic exercise for the neck: implications for patients with head and neck pain.

There have been recent advances in the rehabilitation of the muscles that control the head and neck. These advances are based on evidence of specific neck muscle dysfunction in individuals with persistent head and neck pain. Traditional rehabilitation strategies have focused predominantly on muscle strength and endurance under high loads.

Mothers' overreactive discipline and their encoding and appraisals of toddler behavior.

The relations of observed overreactive discipline with mothers' tendencies to notice negative, relative to positive, child behavior (preferential negative encoding), and mothers' negative appraisals of neutral and positive child behavior (negative appraisal bias), were examined in mothers of toddlers. The mothers rated both their own children's and unfamiliar children's behavior. Negative appraisal bias with respect to mothers' own (but not unfamiliar) children was related to mothers' overreactivity, independent of child misbehavior.

Quantitative electroencephalographic studies of cue-induced cocaine craving.

Quantitative electroencephalographic (qEEG) profiles were studied in cocaine dependent patients in response to cocaine cue exposure. Using neurometric analytical methods, the spectral power of each primary bandwidth was computed and topographically mapped. Additional measures of cue-reactivity included cocaine craving, anxiety and related subjective ratings, and physiological measures of skin conductance, skin temperature, heart rate, and plasma cortisol and HVA levels.

Disease-modifying therapy in multiple sclerosis: strategies for optimizing management.

Background: The objective for this article is to highlight several challenges faced by patients and providers in the utilization of disease-modifying agent (DMA) therapy in multiple sclerosis (MS) and to offer practical management strategies that can effectively mitigate or even prevent limiting adverse reactions and enhance treatment compliance.

Review Summary: Our discussion will be limited to the use of interferon beta1a (Avonex, Rebif), interferon beta1b (Betaseron), and glatiramer acetate (Copoxane) as these are the primary agents used in the United States for primary disease-modifying therapy in relapsing forms of MS. Some of the recommendations contained herein are derived from evidence-based studies, while others are contingent upon our collective clinical experiences.

Hypoalgesic and sympathoexcitatory effects of mobilization with movement for lateral epicondylalgia.

Background And Purpose: Mulligan has proposed the use of mobilization with movement for lateral epicondylalgia. In this study, mobilization with movement for the elbow was examined to determine whether this intervention was capable of inducing physiological effects similar to those reported for some forms of spinal manipulation.

Participants: Seven women and 17 men (mean age=48.

Revision surgery for chronic otitis media: recurrent-residual disease and hearing.

The aim of this study was to determine the effect of surgical approach, intact canal wall (ICW) or canal wall down (CWD), upon the success of revision surgery for chronic otitis media (COM). A retrospective analysis of 367 patients (including 65 children aged <15 years) who underwent revision tympanoplasty because of persistent disease was performed. Single-staged tympanoplasty was performed, preserving the canal wall when present.

The influence of seminal plasma on ovarian function in pigs--a novel inflammatory mechanism?

Seminal plasma is increasingly recognised as contributing to the reproductive process in roles apart from that of providing nutritive support and transport for spermatozoa. Seminal components elicit inflammatory responses in the female reproductive tract, including altered patterns of cytokine secretion, which have consequences for early embryo development and implantation. This review examines evidence, generated principally in the porcine model, for a more recently recognized role for seminal plasma in regulating the temporal kinetics of ovulation, corpus luteum development and steroid production in the ovary.

Transforming growth factor beta--a mediator of immune deviation in seminal plasma.

TGFbeta is a potent immune deviating agent, driving active forms of immune tolerance in peripheral tissues through effects on the induction and resolution of inflammatory responses and phenotype skewing in antigen-presenting cells and lymphocytes. The TGFbeta content of seminal plasma from human, rodent and livestock species is amongst the highest measured in biological fluids. The seminal vesicle gland is the principal source of TGFbeta in the semen of mice, where its synthesis is regulated by testosterone.

Randomized trial on the treatment of oedematous acute otitis externa using ear wicks or ribbon gauze: clinical outcome and cost.

Acute otitis externa is a common condition that can be extremely painful. When there is considerable canal oedema, packing is necessary to facilitate the passage of medication. The experience at the Royal Victoria Eye and Ear Hospital is that ear wicks generally require removal in two to three days by medical staff and can be labour intensive as they often involve serial removals following re-insertions.

The effect of soft tissue deloading tape on thoracic spine pressure pain thresholds in asymptomatic subjects.

The application of tape to deload soft tissue is used in the management of thoracic spine pain. A reported clinical feature of this treatment is reduced tenderness of the spine during postero-anterior mobilizations. A randomized, single blind, placebo controlled, repeated measures design study was employed to investigate the effects of deloading tape on pressure pain threshold measurements at the level of the T7 spinous process in an asymptomatic group of 24 subjects.

Silicone arthroplasty for trapeziometacarpal arthritis.

Twenty-three patients who had undergone trapeziectomy and Helal silicone rubber ball interposition for trapeziometacarpal arthritis were reviewed. The average age at operation was 63 (range 48-84) years and the mean follow-up was 59 (range 12-138) months. Of the 23 patients reviewed, two had pain at rest and four had some discomfort on exertion.

Functional and morphological response of the stria vascularis following a sensorineural hearing loss.

Cochlear endolymph is maintained at a potential of (+)80 mV by an active transport mechanism involving the stria vascularis (SV). This so-called endocochlear potential (EP) is integral to hair cell transduction. We compared the EP with changes in SV area and Na(+),K(+)-ATPase expression following a sensorineural hearing loss.

Delamination of layered double hydroxides in polar monomers: new LDH-acrylate nanocomposites.

The layered double hydroxide Mg2Al(OH)6(C12H25SO4) was delaminated to give high levels of inclusion in acrylate monomers; subsequent polymerisation of the monomers containing the LDH dispersion gave polyacrylates with the inorganic component still in the delaminated form.

Recovery of hearing following cisplatin ototoxicity in the guinea pig.

Background: To report a spontaneous recovery of hearing, following cisplatin ototoxicity in the guinea pig. The findings are related to the animal and human literature on recovery from hearing loss following cisplatin ototoxicity.

Materials And Methods: Hearing was measured from compound action potentials (CAP) evoked by acoustic tones, which were monitored daily from an electrode implanted onto the round window of the inner ear.

Intracranial dural arteriovenous malformations: results of stereotactic radiosurgery in 17 patients.

Aim: To assess the efficacy of stereotactic radiosurgery (STRS) for the treatment of dural arteriovenous fistulae (DAVF).

Materials And Methods: Between November 1987 and December 1998, 17 patients with a total of 18 DAVF were treated with STRS at the National Centre for Stereotactic Radiosurgery, Sheffield. Clinical and radiological data was collected retrospectively from the case notes and radiological records.

Chronic disease guidelines and the indigenous Coordinated Care Trials.

The establishment of the NT Coordinated Care Trials in 1997 provided an opportunity for the funding and development of detailed guidelines, designed specifically for the Indigenous population, covering screening and clinical management of major chronic diseases. All guidelines were incorporated into the NT Coordinated Care Trials Information System on the Tiwi Islands and in the Katherine West region, and used to generate individual and population care plans. In contrast to what is usually written, a broad range of guidelines can be developed in a relatively short period of time utilising a dedicated multi-disciplinary team and local working groups.

Social influences on cortisol and behavioral responses of preweaning, periadolescent, and adult guinea pigs.

In various species, the presence of an attachment figure can reduce hypothalamic-pituitary-adrenal (HPA) responses. In the guinea pig, the mother reduces HPA elevations of her young both prior to and following weaning. Recently, an unfamiliar female was also found to reduce the HPA responses of postweaning guinea pigs.

Partial recovery of cisplatin-induced hearing loss in the albino guinea pig in relation to cisplatin dose.

The objective of the present study was to further characterize cochlear recovery after cisplatin damage. We equipped albino guinea pigs with permanent round window electrodes. Cisplatin was injected i.