Role of rehabilitation of chronic obstructive pulmonary disease patients in intensive care unit

To study the effects of pulmonary rehabilitation program in COPD patients in ICU. Eighty COPD patients recovering from acute respiratory failure in ICU were subjected to rehabilitation program of four different steps of increasing difficulty. Demonstrated that pulmonary rehabilitation is useful in patients considered too conditioned, while early intervention gave better results. Also, comprehensive program was superior to ambulation program in general. Follow up re-evaluation confirm the beneficial effects of home program. Therefore, early pulmonary rehabilitation program is of great importance for COPD patients in ICU and prevents further complications

Evaluation of facial nerve function in bell's palsy patients with serial GD-DTPA enhanced MRI

To find out the role of Magnetic Resonance Imaging [MRI] in diagnosing and investigating Bell's palsy. Ten patients with mild to moderate acute idiopathic facial palsy, so called Bell's palsy, were serially examined with gadolinium-DTPA-enhanced MRI [Gd-MRI] on mean days 12,35 and 92 after the onset of palsy [second follow-up n=9]. Seven out of the 10 patients demonstrated ipsilateral facial nerve enhancement, exclusively in the internal auditory canal including meatal portion [IAC/Me] at the initial examination. Four patients out of them also exhibited facial nerve enhancement at the second examination. Only one patient showed enhancement at the third examination. The reduction in facial nerve enhancement was found to be correlated with clinical and neurophysiologic improvements in the nerve function during recovery from Bell's palsy. On the other hand, the three patients who did not exhibit facial nerve enhancement had the lowest electroneurography values at the initial examination in spite of the fact that there was no clinical difference between their palsy and that of the patients with positive findings. Those three patients did not exhibit enhancement at serial follow-up examination. These findings showed the presence of enhancement does not necessarily indicate poor prognosis for recovery and that the disappearance of facial nerve enhancement was related to improved facial nerve function during recovery from mild and moderate cases with Bell's palsy

Assesment of soluble ICAM-1 and soluble E-selectin in juvenile idiopathic arthritis: clinical and laboratory correlation

To determine serum levels of soluble adhesion molecules [sICAM-1 and sE-selectin] in juvenile idiopathic arthritis patients. Also, to assess any changes in these levels during remission and exacerbation and to correlate them with clinical and laboratory variables. The serum and synovial levels of soluble intercellular adhesion molecule 1 [sICAM-1] and soluble E-selectin were determined using enzyme linked immunosorbent assay [Elisa] in 44 patients with JIA, 14 systemic [JIA-sys], 15 polyarticular [JIA-poly] and 15 oligoarticular [JIA-oligo], who had active disease or were in remission and 20 healthy controls. The erythrocyte sedimentation rate [ESR], C-reactive protein [CRP] and complete blood count [CBC] were recorded. [sICAM-1] and [E-selectin] were significantly higher in both [JIA-sys] and [JIA-poly] than in [JIA-oligo] or healthy controls. There was a significant negative correlation [sICAM-1] and [s-E-selectin] and age. There was no correlation with some sensitive markers of inflammation [ESR] or [CRP]. [sE-selectin] correlated with white blood cells [WBC] and platelet count in the remission stage .There was a significant correlation between synovial adhesion molecules concentration and total synovial leukocytic count. Increased levels of soluble adhesion molecules in both [JIA-sys] and [JIA-pol] may be due to endothelial cell activation and its persistence in spite of clinical remission could be used as markers of aggressive disease

Adrenocortical function relation to inflammatory markers in early untreated rheumatoid arthritis

To study adrenocortical function alterations in patients with early rheumatoid arthritis [RA]. 25 untreated patients with new onset RA were studied and compared with 25 age and sex-matched healthy subjects [controls]. All subjects were studied for plasma ACTH, cortisol, dehyroepiandrosterone sulfate [DHEAS], free and total testosterone, erythrocyte sedimentation rate, C-reactive protein and rheumatoid factor. No significant differences in the basal levels of ACTH, Cortisol, DHEAS, and total testosterone when comparing RA patients with controls were found, while there were statistically significant elevations in the inflammatory indices [ESR and CRP] and lower basal morning levels of free testosterone [Lower in males age >/= 45 years] in RA patients when compared with controls. From this study we concluded that adrenocortical function seem to be unaltered in early untreated RA patients