A transcranial Doppler study of basilar hemodynamics in progressive carotid artery disease.

In carotid artery disease (CAD) the basilar artery (BA) may act as an important intracranial collateral to supply hypoperfused middle cerebral artery (MCA) territories. Transcranial Doppler studies were performed to study the dependency between BA hemodynamics in relation to the MCA perfusion status. BA and MCA blood flow velocities (BFV), pulsatility indices (API) and cerebrovascular reactivity (CVR) were assessed in 40 patients with a progressive MCA hypoperfusion due to progressive CAD.

Preliminary report of detecting microembolic signals in transcranial Doppler time series with nonlinear forecasting.

Background And Purpose: Most algorithms used for automatic detection of microembolic signals (MES) are based on power spectral analysis of the Doppler shift. However, controversies exist as to whether these algorithms can replace the human expert. Therefore, a different algorithm was applied that takes advantage of the periodicity of the MES.

Acid-inhibitory effects of omeprazole and lansoprazole in Helicobacter pylori-negative healthy subjects.

Background: Omeprazole 20 mg once daily (o.d.) and lansoprazole 30 mg o.

Effect of SSRI antidepressants on ejaculation: a double-blind, randomized, placebo-controlled study with fluoxetine, fluvoxamine, paroxetine, and sertraline.

Depression is a common cause of sexual dysfunction, but also antidepressant medication is often associated with sexual side effects. This article includes two related studies. The first double-blind, placebo-controlled study was conducted in men with lifelong rapid ejaculation and aimed to assess putative differences between the major selective serotonin reuptake inhibitors (SSRIs) (fluoxetine, fluvoxamine, paroxetine, and sertraline) with regard to their ejaculation-delaying effect.

Modeling the temporal fluctuations of the cerebral blood flow velocity waveforms using surrogate data testing.

The objective of this study is to find out which mathematical model best explains the temporal fluctuations of the axial blood flow velocity waveforms in the basal arteries of the brain. Blood flow velocity time series were sampled by transcranial Doppler (TCD) examination of the middle cerebral arteries in 10 healthy volunteers. A recently developed mathematical test (surrogate data analysis) was used to examine whether the spectral Doppler maximum waveform consistent with some prespecified model (null hypothesis).

Premature ejaculation and serotonergic antidepressants-induced delayed ejaculation: the involvement of the serotonergic system.

Premature ejaculation has generally been considered a psychosexual disorder with psychogenic aetiology. Although still mainly treated by behavioural therapy, in recent years double-blind studies have indicated the beneficial effects of some of the serotonergic antidepressants (SSRIs) in delaying ejaculation. We describe here the neurophysiology and the peripheral neuroanatomy of ejaculation and provide a review of the involvement of serotonin in the central nervous system in relation to serotonergic nuclei and their projections.

Aspects of food and fluid intake during labour. Policies of midwives and obstetricians in The Netherlands.

Objective: This study outlines the current policies on food and fluid intake during labour in The Netherlands and discusses the pro's and con's of food-restriction.

Study Design: 50 midwives and 30 obstetricians were asked about their actual policy on food and fluid-intake during labour.

Results: A restrictive policy during normal labour is followed by 20% of the midwives and 14% of the obstetricians.

Nonlinear dynamical analysis of periodic lateralized epileptiform discharges.

Nonlinear time series analysis can be used to investigate the dynamics underlying the generation of EEG signal. In the present study we used this approach to study the pathophysiology of PLEDs. We calculated the correlation dimension D2 of an EEG with typical PLEDs, and compared the results with those obtained for surrogate data.

Nonlinear analysis of EEG in septic encephalopathy.

Electroencephalograms (EEG) were recorded in fourteen patients who experienced a severe septic encephalopathy (SE). EEG analysis included visual inspection, spectral analysis and a recently developed nonlinear analysis (the Kaplan test). All EEGs showed decreased fast activity and an increase of slow wave activity on visual inspection.

Vitamin supplementation reduces blood homocysteine levels: a controlled trial in patients with venous thrombosis and healthy volunteers.

Hyperhomocysteinemia is a risk factor for atherosclerosis and thrombosis and is inversely related to plasma folate and vitamin B12 levels. We assessed the effects of vitamin supplementation on plasma homocysteine levels in 89 patients with a history of recurrent venous thrombosis and 227 healthy volunteers. Patients and hyperhomocysteinemic (homocysteine level >16 micromol/L) volunteers were randomized to placebo or high-dose multivitamin supplements containing 5 mg folic acid, 0.

Multicenter harmonization of common enzyme results by fresh patient-pool sera.

A region consisting of 19 clinical laboratories harmonized their calibration of seven common enzymes by using fresh patient-pool sera. One of the laboratories was chosen to act as Regional Reference Laboratory (RRL). This laboratory used internationally accepted (mostly IFCC) methods at 37 degrees C, with an intralaboratory CV < or = 2.

Can helical CT replace scintigraphy in the diagnostic process in suspected pulmonary embolism? A retrolective-prolective cohort study focusing on total diagnostic yield.

The aim of our study was to compare the diagnostic value of helical CT vs that of ventilation-perfusion (V/Q) scintigraphy as a first-line test in a diagnostic strategy in patients suspected of pulmonary embolism (PE). In a retrolective-prolective cohort study we tested the accuracy of helical CT vs V/Q scintigraphy in 123 patients suspected of PE. A diagnostic panel was asked to formulate the presumptive diagnosis on the presence or absence of PE, or of alternative disease by using two competing diagnostic strategies.

A randomized trial of geriatric liaison intervention in elderly medical inpatients.

Objective: The aim of this study was to examine the effect of psychogeriatric intervention in a group of elderly medical inpatients over 75 years of age. In addition to usual care, intervention consisted of multidisciplinary joint treatment by a psychogeriatric team. The main purpose of intervention was to obtain the optimal level of physical functioning.

An empirical operationalization study of DSM-IV diagnostic criteria for premature ejaculation.

The DSM-IV diagnostic criteria for premature ejaculation remain to be investigated by a clinical study. A prospective study was therefore conducted to investigate the DSM-IV definition and to provide an empirical operationalization of premature ejaculation. In this study 140 men suffering from lifelong premature ejaculation were interviewed separately from their partners.

Effect of omeprazole 40 mg once daily on intraduodenal and intragastric pH in H. pylori-negative healthy subjects.

There is a lack of information about the effect of omeprazole or other antisecretory drugs on intraduodenal pH. Aim of the study was to document the variation over time of intraduodenal pH during a 24-hr period and to simultaneously study the effect of omeprazole 40 mg once daily on intragastric and intraduodenal pH in healthy H. pylori-negative subjects.

Non-linear analysis of the electroencephalogram in Creutzfeldt-Jakob disease.

Creutzfeldt-Jakob disease is a rare, neurological, dementing disorder characterised by periodic sharp waves in the electroencephalogram (EEG). Non-linear analysis of these EEG changes may provide insight into the abnormal dynamics of cortical neural networks in this disorder. Babloyantz et al.

Ejaculation-retarding properties of paroxetine in patients with primary premature ejaculation: a double-blind, randomized, dose-response study.

Objective: To compare the influence of a daily dose of 20 or 40 mg of the serotonergic antidepressant drug paroxetine in delaying ejaculation in patients with primary premature ejaculation.

Patients And Methods: Thirty-four patients with primary premature ejaculation were randomly assigned to receive 20 mg or 40 mg daily of paroxetine for 7 weeks in a double-blind fixed-dose trial after an initial dose of 20 mg/day in the first week. Patients and their female partners were interviewed separately.

The low transverse Pfannenstiel incision and the prevalence of incisional hernia and nerve entrapment.

Objective: The authors determined the prevalence of incisional hernia and nerve entrapment in patients with a low transverse Pfannenstiel incision.

Summary Background Data: The literature on the Pfannenstiel incision suggests an incisional hernia rate of 0.0% to 0.

Continuous infusion of low-dose 5-Aza-2'-deoxycytidine in elderly patients with high-risk myelodysplastic syndrome.

There is no standard therapy for elderly patients with high-risk myelodysplastic syndrome (MDS). The treatment options of low-dose Ara-C and haematopoietic growth factors are disappointing in regard to response rate or response duration. We tested the treatment with a 72-h continuous infusion of low-dose 5-Aza-2'-deoxycytidine (DAC) in a group of 29 elderly patients with high-risk MDS.

The electroencephalogram during normal third trimester pregnancy and six months postpartum.

In 1942 Gibbs and Reid described a slowing of the electroencephalogram (EEG) at the end of a normal pregnancy. To the best of our knowledge this is the only report that addresses the modification of the EEG in normal pregnancy. We performed a spectral multichannel EEG analysis and revealed no differences during third trimester pregnancy and six months postpartum.

Continuous double loop closure: a new technique for repair of laparotomy wounds.

Background: Wound dehiscence after midline laparotomy is a life threatening complication, most frequently caused by sutures cutting through the fascia. Increasing the strength of the sutured wound could prevent wound rupture.

Methods: In an experimental study in the rat, the simple continuous suture (SCS), loop suture (LS), interrupted double loop closure and continuous double loop closure (CDLC) techniques were evaluated.

An irreducible superior dislocation of the glenohumeral joint.

The clinical features of a superior dislocation of the glenohumeral joint are described. Reposition, even under general anaesthesia, cannot be achieved. Associated supraspinatus tear, acromioclavicular separation and the dislocated position of the humeral head can be clearly visualized.

Continuous infusion of low-dose 5-Aza-2'-deoxycytidine in elderly patients with high-risk myelodysplastic syndrome.

There is no standard therapy for elderly patients with high-risk myelodysplastic syndrome (MDS). The treatment options of low-dose Ara-C and haematopoietic growth factors are disappointing in regard to response rate or response duration. We tested the treatment with a 72-h continuous infusion of low-dose 5-Aza-2'-deoxycytidine (DAC) in a group of 29 elderly patients with high-risk MDS.