Performance characteristics of 10 home mechanical ventilators in pressure-support mode: a comparative bench study.

Objective: Inspiratory pressure (Pi) support delivered by a bilevel device has become the technique of choice for noninvasive home ventilation. Considerable progress has been made in the performance and functionality of these devices. The present bench study was designed to compare the various characteristics of 10 recently developed bilevel Pi devices under different conditions of respiratory mechanics.

A prospective assessment of cytomegalovirus infection in active inflammatory bowel disease.

Background: The prevalence and clinical significance of cytomegalovirus infection is reportedly high in patients with refractory inflammatory bowel disease but is unknown in unselected patients with active disease.

Methods: In patients admitted for active inflammatory bowel disease, we prospectively studied the presence and significance of cytomegalovirus infection using anti-cytomegalovirus antibodies, cytomegalovirus viraemia and antigenaemia and cytomegalovirus inclusions and cytomegalovirus immunochemistry staining in ileocolonic biopsies.

Results: A total of 64 patients were included (ulcerative colitis, n = 23; Crohn's disease, n = 41), 18 of whom had been on high-dose oral steroids and 11 on immunosuppressants.

Molecular identification of Fusarium species in onychomycoses.

Background: Fusarium species are isolated from about 3% of onychomycoses in the Swiss native population. On the basis of macroscopic characters and microscopic examination of the cultures, identification of Fusarium often remains difficult or uncertain because of variations from one isolate to another and overlapping characteristics between species.

Objective: To obtain information about the prevailing species of Fusarium collected from onychomycoses.

Chemotherapeutic options in the management of anal cancer.

During the past two decades, anal cancer has served as a paradigm for the successful application of chemoradiation to solid tumours; so far, it remains one of the few carcinomas of the gastrointestinal tract which are curable without the need for definitive surgery. Since the original contribution by Nigro in 1974, surprisingly few changes have been made to the standard of care in chemotherapy, which still consists of a combination of 5-fluorouracil and mitomycin C. However, many issues have yet to be clarified, such as the potential role of cisplatin as a substitute to mitomycin, as well as treatment-induced toxicity in HIV-positive patients.

Resistant pure red cell aplasia after allogeneic stem cell transplantation with major ABO mismatch treated by escalating dose donor leukocyte infusion.

We report a case of pure red cell aplasia (PRCA) following allogeneic stem cell transplantation (SCT) with major ABO mismatch which proved resistant to all standard treatment options such as change in immunosuppressive treatment, high-dose erythropoietin (EPO) or plasma exchange. We therefore proceeded to administer five cycles of Rituximab therapy, without success. Finally, escalating doses of donor-derived leukocyte infusion (DLI) resolved the PRCA of our patient 415 d after bone-marrow transplantation (BMT) and 140 d after the first infusion of donor leukocytes.

Management and evolution of insomnia complaints among non-substance-misusers in a Swiss remand prison.

Questions Under Study: Insomnia is a frequent though rarely investigated problem among prisoners. The study's aim was to examine the clinical management of insomnia complaints in non-substance-misusing (NSM) prisoners (quality of medical consultation, effectiveness of drug prescription), and the risk of leaving prison with ongoing hypnotic prescription which might provoke withdrawal symptoms and encourage further hypnotic use outside prison.

Methods: Retrospective study of the medical records of 112 NSM prisoners complaining of insomnia at medical consultation over a one year period at the outpatient-service of the Champ-Dollon remand prison (Geneva, Switzerland).

[Pericardium and cardiac valves: value of MRI and Multislice CT].

Color Doppler echocardiography has limitations, particularly in the assessment of valvular regurgitation and pericardial diseases. MRI, with the help of three dimensional morphologic data, dynamic acquisitions with cine techniques and functional evaluation with flow sensitive techniques can be envisioned as a complementary noninvasive procedure able to provide the complete information required for planning therapeutic options. Qualitative as well as accurate and reproducible quantitative information (volume measurements, cardiac function and flow velocity profiles) are unique for the evaluation of the severity of valve or pericardial diseases.

[Surgical treatment for distal rupture of the biceps tendon].

Purpose Of The Study: Avulsion of the distal biceps brachii tendon at the elbow is uncommon. We analyzed cases operated in our department in order to define etiological factors and surgical treatment outcome.

Material And Methods: We reviewed retrospectively eleven patients, ten male patients, average age 43 years (range 37-59) with distal biceps tendon ruptures repaired anatomically with a double-incision technique and one other male patient whose tendon was attached to the brachialis anterior.

Ultrastructural alterations in capillaries of the diabetic hypertensive rat retina: protective effects of ACE inhibition.

Aims/hypothesis: The ACE inhibitor cilazapril was administered to diabetic hypertensive rats to evaluate its ability to influence the development of retinal capillary alterations.

Methods: Normotensive (strain: Wistar Kyoto) and genetically hypertensive (strain: spontaneously hypertensive) rats were rendered diabetic by intravenous injections of streptozotocin. Half of the diabetic animals received cilazapril with their daily food.

[Treatment of cutaneous human papilloma virus, poxvirus and herpes simplex virus infections with topical cidofovir in HIV positive patients].

Introduction: Cidofovir (Vistide) is an antiviral marketed for the treatment of cytomegalovirus retinitis. Clinical efficacy has been reported with its broad antiviral spectrum that includes poxvirus, human papilloma virus and Herpes simplex. In immunodepressed patients, these infectious dermatoses are often recurrent and resistant.

5-Fluorouracil as protracted continuous intravenous infusion can be added to full-dose docetaxel (Taxotere)-cisplatin in advanced gastric carcinoma: a phase I-II trial.

Background: A phase I-II multicenter trial was conducted to define the maximum tolerated dose (MTD) according to tolerance and toxicity (primary objective), as well as to describe the clinical activity, in terms of response and survival (secondary objectives), of a combination of 5-fluorouracil (5-FU) in protracted continuous intravenous infusion (p.i.v.

[How should a muscular disease be studied?].

Muscle diseases are an expanding field, mainly due to the progress in genetics and biochemistry. Evaluation starts with a thorough history of the patient's symptoms and signs. The leading clinical manifestations are weakness, atrophy, myalgia, fatigue, more rarely myotonia and in the child hypotonia or walking difficulty.

Membrane hyperpolarization triggers myogenin and myocyte enhancer factor-2 expression during human myoblast differentiation.

It is widely thought that myogenin is one of the earliest detectable markers of skeletal muscle differentiation. Here we show that, during human myoblast differentiation, an inward rectifier K(+) channel (Kir2.1) and its associated hyperpolarization trigger expression and activity of the myogenic transcription factors, myogenin and myocyte enhancer factor-2 (MEF2).

Intramuscular ganglion arising from the acromioclavicular joint.

We report a case of a 80-year-old White woman presenting with a localized painless swelling in the upper parascapular region of the right shoulder. Ultrasound (US) showed a ganglion arising from the acromioclavicular joint (ACJ) and extending inside the trapezius muscle, together with a massive tear of the rotator cuff (RC). Magnetic resonance imaging (MRI) confirmed the US findings.

[Lombosacral radiculopathy (L3-S1) and specificity of multifidus EMG].

Aims Of The Study: This prospective study tried to establish, in a group of patients with lombosacral radiculopathy, whether the electromyography of the multifidus muscles following the "Paraspinal Mapping" described by Haig and colleagues (1991, 1993, 1995, 1997) allows to specify the exact level of the radiculopathy.

Material And Methods: Twenty-three patients with symptoms of mono or pluriradiculopathy were submitted to an EMG of the lower limbs and multifidus muscles at different levels in accordance to the "Paraspinal Mapping" cartography.

Results And Conclusion: No patient had signs of acute denervation in the multifidus muscles that corresponded exclusively to the suspected levels as determined by clinical and radiological examinations.

[Translation and validation of a French version of the Young Mania Rating Scale (YMRS)].

Both the Young Mania Rating Scale (YMRS) and the Mania Assessment Scale (MAS) have been widely used during the last decade for the evaluation of severity of mania in clinical trials. For both scales good inter-rater reliability, validity and sensitivity to change have been reported. The French version of the MAS has been validated.