Odontogenic Sinusitis Resulting in Abscess Formation Within the Optic Chiasm and Tract: Case Report and Review.

A 33-year-old immunocompetent man developed rapid visual loss and a third nerve palsy secondary to acute rhinosinusitis and intracranial abscess formation. Despite endoscopic drainage of the ethmoid and sphenoid sinuses and empiric broad-spectrum antibiotics, the patient experienced progressive visual and neurological decline and ultimately required craniotomy for drainage of an optic apparatus abscess. Although odontogenic sinusitis rarely results in abscess formation of the visual pathways, early recognition and immediate treatment is imperative to decrease the risk of profound and permanent visual impairment.

Racemose neurocysticercosis.

Background: Neurocysticercosis (NCC) is an invasive parasitic infection of the central nervous system caused by the larval stage of the tapeworm Taenia solium. The clinical manifestations of NCC depend on the parasitic load and location of infection, as well as the developmental stage of the cysticerci and host immune response, with symptoms ranging from subclinical headaches to seizures, cerebrovascular events, and life-threatening hydrocephalus. Racemose NCC represents a particularly severe variant of extraparenchymal NCC characterized by the presence of multiple confluent cysts within the subarachnoid space and is associated with increased morbidity and mortality, as well as a decreased response to treatment.

Acceptability of fingerstick versus oral fluid rapid HIV testing: results from the universal screening for HIV infection in the emergency room (USHER Phase II) randomized controlled trial.

Background: Oral rapid HIV testing has been reported to have a lower sensitivity and specificity than rapid HIV testing with whole blood and has been associated with clusters of false-positive results. Patient preference for oral rapid HIV testing compared with more invasive whole blood fingerstick may influence the acceptance of rapid HIV testing.

Objective: To compare HIV test acceptance rates among patients routinely offered fingerstick compared with those routinely offered oral fluid screening in an urban hospital emergency department.

Factors associated with refusal of rapid HIV testing in an emergency department.

HIV screening studies in the emergency department (ED) have demonstrated rates of HIV test refusal ranging from 40-67%. This study aimed to determine the factors associated with refusal to undergo routine rapid HIV testing in an academic ED in Boston. HIV counselors offered routine testing to 1,959 patients; almost one-third of patients (29%) refused.

Limitations of diffusion-weighted imaging in the diagnosis of postoperative infections.

Objective: Diffusion-weighted imaging (DWI) has assumed a rapidly emerging role in the diagnosis of intracranial infection; however, its usefulness in the recognition of postoperative infection has been largely unexplored. We sought to determine the ability of DWI to accurately detect a broad range of postneurosurgical infections as well as identify individual factors that may limit its applicability.

Methods: We retrospectively identified 65 patients who had undergone surgery for the confirmed diagnosis of infection between August 2001 and February 2005 and had received preoperative magnetic resonance imaging evaluation, including DWI.

Chronobiometric identification of disorders of hunger sensation in essential obesity: therapeutic effects of dexfenfluramine.

In human beings, hunger is a proprioceptive signal that shows intraday (circadian components) and within-day (ultradian components) recursivity. Both periodic components can be investigated by chronobiometric procedures by combining the Cosinor method with spectral analysis. A 24-hour profile of hunger sensation (HS) can be plotted on a 1-to-10 scale of intensity using self-rated scores performed every half-hour of the day.

[Clinical observations on the treatment of obese patients with dexfenfluramine].

In a 12-months double-blind study 42 obese patients (5 males, 37 females) were treated either with d-fenfluramine (30 mg daily) or with placebo plus low-calorie diet (1500-1200 kcal daily). Evaluation of treatment efficacy was based on evolution of the initial cohort, weight loss, number of subjects completing treatment, tolerability and events leading to dropout. Patients receiving d-fenfluramine had statistically significant greater weight loss than the placebo group; 30 mg daily proved to be an effective and well tolerated dose of d-fenfluramine with the best long-term activity/acceptability ratio.

Ketanserin (S2-receptor blocking agents), hypertension and chronic alcoholism.

Ketanserin is a pure antagonist of serotonin S2-receptors, in blood vessels, platelets and bronchial tissue. Ketanserin has been suggested as hypotensive drug in man, but it shows as well a specific activity on platelet aggregation. An increased incidence of hypertension, of unknown origin, has been found in patients with chronic alcoholism: hypotheses have been made upon an increased incretion of catecholamines and a greater sensitivity of blood vessels' receptors to their action.

Ketanserin (S2-receptor blocking agent), platelet activity and chronic alcoholism.

Ketanserin is a pure and selective antagonist of serotonin S2-receptors in blood vessels, platelets and bronchial tissue. It antagonizes serotonin-induced vasoconstriction, bronchoconstriction and platelet aggregation, and indirectly it blocks platelet release reaction. Ketanserin has little or no effect on healthy subjects.