Neurophysiological and cognitive effects of Transcranial Direct Current Stimulation in three girls with Rett Syndrome with chronic language impairments.

Background: this study was based on both neurophysiological decelerated activity and communication deficits in Rett Syndrome (RTT).

Aims: the aim was to examine the neurophysiological and cognitive effects of Transcranial Direct Current Stimulation (tDCS) in three girls with RTT with chronic language impairments.

Methods And Procedures: we proposed an integrated intervention: tDCS and cognitive empowerment applied to language in order to enhance speech production (new functional sounds and new words).

Radiographic demonstration of a wireless capsule pH monitor in the esophagus.

Monitoring of esophageal pH is a major component of the evaluation of gastroesophageal reflux disease. A recent innovation has led to the replacement of the intraluminal probe by a wireless capsule. This capsule is attached to the esophageal wall and transmits the appropriate data to a patient-worn receiver.

Paratracheal air collection in a trauma patient: a case report.

The presence of a paratracheal air collection in the setting of acute trauma may indicate a wide array of etiologies. When a paratracheal air collection is found in a trauma patient, the possibility of tracheal or esophageal rupture must be considered. Tracheal diverticulae are most frequently found incidentally during autopsy, with an incidence of approximately 1%.

Acute gastric outlet obstruction secondary to papillary serous adenocarcinoma of the endometrium with peritoneal psammomatous implants: a case report.

Endometrial carcinoma is the most common gynecologic cancer in the United States. Uterine papillary serous carcinoma comprises approximately 5-10% of endometrial carcinomas. This aggressive carcinoma typically occurs in older women, characteristically arising on atrophic endometrium.

US, CT, and MR imaging of hepatic masses in Alström syndrome: a case report.

Alström syndrome is among the rarest genetic disorders described in the medical literature. It is characterized by retinal pigment degeneration, obesity, sensorineural deafness, non-insulin-dependent diabetes mellitus, progressive chronic nephropathy, cardiomyopathy, and hepatic dysfunction. Hepatic inflammation and fibrosis, which leads to cirrhosis, portal hypertension, and liver failure, is the final pathway of the hepatopathy in Alström syndrome.

Spontaneous pneumomediastinum in a patient with recent air travel.

Spontaneous pneumomediastinum (SPM) is a fairly uncommon condition in which free air is present in the mediastinum, often in young patients without injury or serious underlying pulmonary disease. We present a case of SPM in a 36-year-old man with no pertinent medical history who presented with chest pain after a 3-h flight. To the best of our knowledge, this is the first known case in radiology literature of SPM caused by increased intra-alveolar pressure secondary to increased altitude.

The Di Giacomo technique: simplified suture passing in SLAP repair.

A 30 degrees arthroscope is introduced via the posterior soft spot portal, and an anterosuperior portal is created with the use of a 7-mm disposable cannula. The anterosuperior portal is used for instrumentation. An 18-gauge spinal needle is passed via the portal of Neviaser and the rotator cuff into arthroscopic view above the superior labrum.

CT imaging of acute E. Coli-related colitis.

Patients with abdominal pain and bloody diarrhea often present in the acute setting to the emergency department for evaluation. After the appropriate clinical assessment, cross-sectional imaging is often utilized to evaluate for the severity of the disease. Although a wide spectrum of findings may be seen, diffuse colonic mural thickening, consistent with pancolitis, is most common.

Two-incision minimally invasive total hip arthroplasty: techniques and results to date.

The two-incision minimally invasive technique for total hip arthroplasty is described in detail, with attention to pearls of technique, for a prospective group of 200 patients, as well as a matched-pair group of 43 patients who underwent either the two-incision procedure or the mini-incision (single-incision posterior) procedure. The importance of a total hip critical pathway is emphasized, and the economic benefits are presented. Results reveal that the two-incision and mini-incision techniques have acceptable complication rates, are cost effective, and are beneficial to the patient, with reduced hospital stays, high patient satisfaction, and earlier return to function.

Use of iodine-123 as a diagnostic tracer for neck and whole-body scanning in patients with well-differentiated thyroid cancer.

Objective: To determine whether 123 I can be used as a safe and effective alternative tracer to 131 I for imaging remnant tissue and for searching for metastatic lesions of well-differentiated thyroid cancer.

Methods: We studied a series of 16 patients (10 women and 6 men; 29 to 73 years of age) who had well-differentiated thyroid cancer and had undergone thyroidectomy and subsequent radioiodine treatment. Diagnostic 10 mCi (either preablation or postablation) were compared with the 5- to 7-day 131 I posttherapy scans (doses, 75 to 200 mCi).

Comparison of 1-micro g and 250-micro g corticotropin stimulation tests for the evaluation of adrenal function in patients with acquired immunodeficiency syndrome.

Many patients with acquired immunodeficiency syndrome (AIDS) have symptoms suggestive of adrenal insufficiency, but a normal 250- micro g corticotropin (ACTH) stimulation test. We compared the results of 1- micro g and standard 250- micro g ACTH stimulation tests in patients with AIDS. Each patient was studied on 2 separate days.

Low dose interferon-alpha therapy for HIV-associated multicentric Castleman's disease.

Successful maintenance therapy with weekly interferon-alpha for HIV-associated multicentric Castleman's disease is described.

Obstacles to penicillin use in treating pneumococcal infection.

Objectives: To determine the pattern of penicillin use in the treatment of pneumococcal pneumonia, and factors contributing to the use of alternative antibiotics.

Methods: This study included all adult inpatients of St. Vincent's Hospital and Medical Center who had documented pneumococcal pneumonia between December 1998 and October 1999.

Neck and whole-body scanning with 5-mCi dose of (123)I as diagnostic tracer in patients with well-differentiated thyroid cancer.

Objective: To determine whether a 5-mCi dose of 123I can be used as an effective radiotracer for assessing the presence of remnant thyroid tissue and for searching for metastatic lesions in patients with well-differentiated thyroid cancer as well as to attempt to ascertain whether a scan performed only at 4 hours is sufficient for accurate diagnosis and might replace the conventional protocol of scanning at both 4 hours and 24 hours.

Methods: We prospectively studied 27 patients who had undergone near-total thyroidectomy and had a documented diagnosis of well-differentiated thyroid carcinoma. Patients underwent scanning after receiving a 5-mCi dose of 123I, at a time when they had discontinued thyroid replacement therapy and had a thyrotropin level in excess of 30 mIU/mL.

Validation of the Mental Alternation Test with the Mini-Mental State Examination in geriatric psychiatric inpatients and normal controls.

The Mental Alternation Test (MAT) is a bedside test of cognition that was used for the detection of human immunodeficiency virus (HIV)-related cognitive impairment. It has been shown to have good reproducibility and inter-rater reliability, and takes only 60 seconds to administer. To assess the utility of the MAT in the geriatric primary care and geriatric psychiatric settings, we used the Mini-Mental State Examination (MMSE) as a further validation of the test.

Lung cancer in HIV-infected patients: a one-year experience.

The relative incidence and rate of lung cancer in HIV-infected patients compared with the general US population has been a source of controversy. We sought to establish these parameters in a cohort of 2616 HIV-infected patients. Tumour type, stage of disease, patient demographics and immune parameters including viral loads were ascertained.

Analysis of reduced death and complication rates after esophageal resection.

Objective: To identify factors that have contributed to reduced rates of death and complications after esophageal resection in a 17-year period at a tertiary referral center.

Summary Background Data: There has been an evolving refinement in surgical technique and perioperative management of patients undergoing esophageal resection at Queen Mary Hospital during the past two decades. As of the end of 1998, there had been no hospital deaths among the last 105 consecutive resections performed for esophageal squamous cancer.

Cytomegalovirus ventriculoencephalitis presenting as a Wernicke's encephalopathy-like syndrome.

Cytomegalovirus ventriculoencephalitis (CMV-VE) is a devastating opportunistic infection seen most frequently in patients with AIDS. The authors describe eight patients with AIDS and CMV-VE, who developed the clinical features of the Wernicke-Korsakoff syndrome, including impaired memory, confabulation, nystagmus, ophthalmoplegia, and ataxia. CMV-VE is perhaps a more frequent cause of the Wernicke-Korsakoff syndrome than traditional associations.

Renal epithelium is a previously unrecognized site of HIV-1 infection.

The striking emergence of an epidemic of HIV-related renal disease in patients with end-stage renal disease provided the rationale for the exploration of whether HIV-1 directly infects renal parenchymal cells. Renal glomerular and tubular epithelial cells contain HIV-1 mRNA and DNA, indicating infection by HIV-1. In addition, circularized viral DNA, a marker of recent nuclear import of full-length, reverse-transcribed RNA, was detected in the biopsies, suggesting active replication in renal tissue.

Dose-response and onset/offset characteristics of rapacuronium.

Background: A rigorous study of the dose-response relation of rapacuronium has, to our knowledge, yet to be performed. In addition, there is little information available regarding the onset or offset profile of rapacuronium when administered in subparalyzing doses. These issues necessitate further study.

The emergence of resistant strains of Acinetobacter baumannii: clinical and infection control implications.

A prospective study was undertaken to determine colonization rates, susceptibility profiles, and outcomes in patients with clinical isolates of Acinetobacter baumannii. Fifty percent of patients became colonized with A. baumannii, and 29% of these patients had clinical and colonizing isolates with discordant susceptibility profiles, without apparent relation to antibiotic use.