Boerhaave's syndrome: long free interval before successful primary repair. Case report.

Aim: Report case of a 66-year-old man come to our observation for a bilateral pleural effusion, ten days after clinical manifestations of chest pain, initially misdiagnosed with a myocardial infarction.

Material Of Study: On the same day, the patient underwent an emergency chest CT scan with orally administered contrast medium that confirmed our suspicion of breakage of the esophageal wall. The patient underwent to a left thoracotomy: the visceral pleura and all the structures covered by the parietal pleura were affected by a widespread necrotic process.

Exercise programs improve mobility and balance in people with Parkinson's disease.

Compromised balance and loss of mobility are among the major consequences of Parkinson's disease (PD). The literature documents numerous effective interventions for improving balance and mobility. The purpose of this study was to verify the effectiveness of two exercise programs on balance and mobility in people with idiopathic PD.

Pulmonary artery leiomyosarcoma successfully treated by right pneumonectomy.

A 79-year-old woman had a primary tumor of the pulmonary artery, which was initially diagnosed as chronic pulmonary thromboembolism. Multislice angio-computed tomography showed a solid mass in the right pulmonary artery. Radical resection of the tumor was achieved by right pneumonectomy via a transsternal transpericardial approach.

Effects of obstacle height on obstacle crossing in mild Parkinson's disease.

The aim of this study was to compare the locomotor behavior of people with Parkinson's disease (PD) and healthy older adults during obstacle negotiation, both in the approaching and crossing phases. Twelve people with idiopathic PD, with mild to moderate disease, and 12 healthy individuals (CG) walked across an 8m pathway for three obstacle conditions: no obstacle, low obstacle and high obstacle. Each performed five trials for each obstacle condition.

Use of coagulant spray glue (Glubran 2) for aerostatic purposes in pulmonary parenchyma resections in pigs: a preliminary study.

Background: The aim of our study was to test the aerostatic validity of a cyan-acrylic glue (Glubran 2), applied by means of a spray catheter, on an experimental pig model.

Materials And Methods: 15 young pigs were divided into three study groups of 5 based on surgical techniques: (1) atypical pulmonary resection with mechanical suturing and reinforcement with continuous suturing; (2) resection of the pulmonary parenchyma with a cold scalpel, followed by local application of Glubran 2; (3) atypical pulmonary resection with mechanical suturing followed by application of Glubran 2.

Results: The mean aerostasis time was calculated at 3.

Solitary fibrous tumor of the pleura: surgery and clinical course in 18 cases.

Solitary fibrous tumors of the pleura are very rare neoplasms that can sometimes present with malignant features. Between 1984 and 2007, 18 cases were treated in our institution. There were 7 men and 11 women, with a median age of 56 years (range, 33-77 years).

[Systematized physical activity and cognitive performance in elderly with Alzheimer's dementia: a systematic review].

Objective: Despite the growing evidence of the benefits of physical exercise for cognition, there is a controversy about the systematic practice of physical activity in patients with Alzheimer's disease. Therefore, the objective of this study was to procedure a systematic review of studies that analyzed the effect of systematized physical activity on cognitive performance in elderly individuals with Alzheimer's disease.

Method: We conducted a search in PsycINFO, Biological Abstracts, Medline, Web of Science, Physical Education and SPORTDiscus Index from 1990 to 2008, using the following keywords: 'physical activity', 'physical therapy', 'exercise', 'fitness', 'aerobic', 'strength', 'intervention', 'cognition', 'cognitive performance', 'Alzheimer's disease', 'Alzheimer's dementia', 'Alzheimer's', and cross-references of selected articles.

Effects of postural threat on walking features of Parkinson's disease patients.

This study investigated whether or not gait kinematics among healthy older individuals and Parkinson's disease (PD) patients are influenced by postural threat. Eight healthy older individuals and eight PD patients were examined while walking at self-selected velocities, under three conditions of postural threat: unconstrained floor; constrained floor (19cm wide); constrained and elevated floor (19cm wide by 10cm high). Independent of the surface conditions, due to motor disturbances caused by the PD these patients walked slower, with shorter strides, and spent more time in the double support phase and less time in the swing phase than did their matched controls.

Psychopathological features in patients with Parkinson's disease and related caregivers' burden.

Background: Along with classical motor disorders in Parkinson's disease (PD), psychopathological features frequently co-occur, which may increase the caregiver's burden.

Aims: To identify the profile of psychopathological symptoms in patients with PD and the impact imposed by this condition on the caregiver's burden.

Subjects: Fifty patients with idiopathic PD seen consecutively at the Movement Disorder Outpatient Clinic at the Hospital of State University of Campinas, Brazil, and their 50 respective caregivers were studied.

Pharmacological stent deployment in the left anterior descending artery: late event indicators.

Background: The efficacy of pharmacological stents in decreasing the incidence of cardiac events is not homogeneous for all lesions or patient subgroups.

Objective: 1) To evaluate the late clinical evolution of patients submitted to pharmacological stent implantation in atherosclerotic lesions of the left anterior descending artery; 2) to identify, among the clinical, angiographic and intravascular ultrasonographic characteristics, the ones predictive of cardiac event risk.

Methods: From May 2002 to August 2005, 205 patients were treated with 236 pharmacological stent implants, guided by the intravascular US (IVUS).

Detection of colonic polyps according to insertion/withdrawal phases of colonoscopy.

Background And Aims: Issues on colonoscopy quality are crucial to reduce the advanced neoplasia miss rate of colonoscopy. Recently, a >6-min withdrawal time has been recommended. However, the relative prevalence of polyp detected during insertion and withdrawal phases of colonoscopy is unknown.

Benefits of physical exercise on executive functions in older people with Parkinson's disease.

The benefits of physical exercise on cognitive functioning have been reported in the literature, but the potential benefits to slow the eventual decline in executive functioning (EF) caused by neurodegeneration from Parkinson's Disease (PD) have rarely been studied. Thus the objective of this study was to analyze the effects of a multimodal physical exercise program on EF in older people with Parkinson's disease. The EF of the older people was evaluated by neuropsychological testing, and for confounding variables such as attention, depressive symptoms and anxiety, before and after intervention.

Patients seeking alternatives to the long waiting list: a reality faced by transplant physicians.

The need for deceased donor organs for kidney transplantation in the United States continues to increase. The increasing demand has fueled desperate attempts by patients to circumvent the long waiting list of the United Network for Organ Sharing. We report 4 patients with end-stage kidney disease who sought and obtained a live donor kidney transplant outside the United States.

Depression in patients with Parkinson's disease: impact on functioning.

Depression is a frequently observed neuropsychiatric phenomenon in Parkinson's disease (PD) and it has been lately considered as a manifestation of such disease. The aim of the study was to investigate the relationship between depression and clinical aspects of PD and to assess the impact of the co-occurrence of such condition on the burden imposed by PD. Fifty outpatients diagnosed with idiopathic PD according to the London Brain Bank criteria were examined.

A controlled clinical trial on the effects of motor intervention on balance and cognition in institutionalized elderly patients with dementia.

Purpose: To analyse the effects of two interventions on the cognition and balance of institutionalized elderly people with mixed dementia.

Methods: Fifty-four participants were allocated into three groups. Group 1 was assisted by an interdisciplinary programme comprising physiotherapy, occupational therapy and physical education.

The value of occult disease in resection margin and lymph node after extrapleural pneumonectomy for malignant mesothelioma.

Background: The purpose of this study was to examine the prognostic impact of occult disease after extrapleural pneumonectomy for malignant mesothelioma.

Methods: We reviewed the resection margin and node specimens from 41 consecutive patients undergoing extrapleural pneumonectomy for malignant pleural mesothelioma in different institutions between 1985 and 2004. The specimens were reassessed by immunohistochemical staining with anticalretinin and antimesothelin monoclonal antibodies, and results were used to draw Kaplan-Meier survival curves and perform Cox regression analyses.

Dementia and functional decline in patients with Parkinson's disease.

Unlabelled: Functional decline in Parkinson's disease (PD), characterized by reduced ability to carry out activities of daily living, usually results from typical motor impairment and may be aggravated by concomitant cognitive impairment.

Objective: To compare the functional decline in Parkinson's disease between patients with dementia and cognitively preserved patients.

Methods: From an original sample composed of 50 patients with a clinical diagnosis of idiopathic PD seen in a consecutive series, 33 non-depressed patients were selected comprising 13 with dementia and 20 cognitively preserved individuals.

Typical and atypical pulmonary carcinoids: our institutional experience.

Pulmonary carcinoids are rare malignant neoplasms, accounting for 2-5% of all lung tumors, with an approximate annual incidence of 2.3-2.8 cases per million of the population.

[Depressive symptoms and motor condition in Parkinson's disease patients].

Introduction: Complex relations between brain and psychopathology have attracted the interest of researchers, aiming to clarify the neurobiological mechanisms of depression in Parkinson's disease, obviously in addiction to mental features.

Aims: The association of motor impairment and decline of personal autonomy with severity of depressive symptoms was the hypothesis of the present study. Aiming to check this hypothesis, the objective of this study consisted in investigating relationships between the severity of depressive symptoms and motor characteristics of Parkinson's disease.

Acute massive haemopneumothorax due to solitary costal exostosis.

Acute massive haemopneumothorax is frequently related to open or blunt chest trauma, whereas spontaneous haemopneumothorax is rare and may be due to multiple hereditary exostosis (MHE). We report a case of acute massive spontaneous and relapsed haemopneumothorax occurring during a volleyball match, and caused by solitary costal exostosis. Thoracoscopy failed to disclose and remove the cause of the haemopneumothorax and so the patient underwent thoracotomy for costal resection and lung parenchyma suture.

Early impairment of cognitive functions in Parkinson's disease.

Background: Impairment in non-motor functions such as disturbances of some executive functions are also common events in Parkinson's disease patients.

Objective: To verify the performance of Parkinson's disease patients in activities requiring visuoconstructive and visuospatial skills.

Method: Thirty elderly patients with mild or moderate stages of Parkinson's disease were studied.

Quality of life (QoL) in relation to disease severity in Brazilian Parkinson's patients as measured using the WHOQOL-BREF.

This study aimed at evaluating and describing the QoL and its association with the severity of disease among Brazilian Parkinson's disease (PD) patients. In this cross-sectional study 68 PD patients were interviewed using the World Health Organization Quality of Life Instrument Short Form (WHOQOL-BREF) and the Hoehn-Yahr (HY) scale. Analysis of variance, chi(2), Kruskal-Wallis and Mann-Whitney U-tests, Spearman and Cronbach reliability coefficients were used to analyze the data.