Relation of electromyography-induced pain to type of recording electrodes.

Pain is an important consideration in the performance of needle electromyography (EMG). Prior investigations have suggested that pain is greater with a concentric needle electrode (CNE) than monopolar needle electrode (MNE). This prospective randomized study tested this hypothesis using improved methodology and disposable rather than reusable needle electrodes. Ninety consecutive outpatients were enrolled and randomized to CNE (diameter = 0.46 mm) or MNE (diameter = 0.41 mm) arms. Subjects underwent a standardized 4 limb-muscle needle EMG protocol during which pretest and posttest verbal analog pain scale (0-10) measures were obtained. As anticipated, EMG-induced pain was significantly higher (P < 0.001) than pre-EMG baseline pain. However, analysis of variance (ANOVA) revealed no significant differences in pain ratings between the CNE and MNE arms. Among other factors analyzed, only gender significantly influenced EMG-induced pain, with females reporting higher levels than males. Thus, pain is not an important selection criterion for type of disposable needle electrode.

Inpatient interdisciplinary rehabilitation after total hip arthroplasty surgery: a comparison of revision and primary total hip arthroplasty.

OBJECTIVES: To describe outcomes of revision total hip arthroplasty (THA) patients who underwent interdisciplinary inpatient rehabilitation, and to compare them with primary THA patients. DESIGN: Descriptive and case-control study. SETTING: Forty-bed, community-based, freestanding rehabilitation hospital. PATIENTS: Thirty-nine revision THA subjects, gender- and age-matched with 39 primary THA controls. INTERVENTION: Inpatient interdisciplinary rehabilitation. MAIN OUTCOME MEASURES: FIM instrument, length of stay, hospital charges, and disposition location. RESULTS: The average revision THA patient stayed 10.5 days, improved from an admission FIM score of 89 to a discharge FIM score of 110, and incurred a hospital charge of $10,600. Of the revision THA patients, 98% were discharged home, and orthopedic-related complications were uncommon. No significant differences existed between revision and primary THA patients in any outcome measures. A trend toward higher rehabilitation charges ($12,400 vs $9500, p =.07) was found in revision THA patients who wore a hip orthosis. Otherwise, no differences were found in outcome measures based on the type of revision surgery, the presence of weight-bearing restrictions, or the presence of orthopedic complications. CONCLUSIONS: THA patients selected for inpatient rehabilitation have favorable short-term functional outcomes. The type of THA (primary vs revision) is not an independent differentiating factor.

Subchronic toxicity of benzyl selenocyanate and 1,4-phenylenebis(methylene)selenocyanate in F344 rats.

Chemopreventive agents benzyl selenocyanate (BSC) and 1,4-phenylenebis(methylene)selenocyanate (p-XSC) were fed in NIH-07 diet to male and female F344 rats (4, 2, and 0.5 mg/kg/day for BSC and 20, 10, and 5 mg/kg/day for p-XSC) for 13 weeks. Weight gains were depressed for male and female rats fed 4 and 2 mg/kg/day BSC, females fed 0.5 mg/kg/day BSC, and male rats fed 20 and 10 mg/kg/day p-XSC. At necropsy, no clear treatment-related lesions were noted, but dose-dependent hepatomegaly was observed in both sexes of BSC and p-XSC groups. Plasma transaminases AST and ALT were elevated in the higher dose groups, while hemoglobin, HCT, and RBC were reduced in most BSC and some p-XSC treatment groups. Plasma glucose was reduced in BSC-treated males. Significant histologic findings included moderate to severe hepatic centrilobular hypertrophy with fatty change in all males and females in the 4 mg/kg/day BSC groups and in 9/15 males and 3/15 females in the 2 mg/kg/day BSC groups. Dose-dependent, mild centrilobular hypertrophy with minimal fatty change was observed in the mid- and low-dose BSC groups and in all p-XSC groups. Mild to moderate renal tubular and interstitial nephritis occurred in the 4 mg/kg/day male BSC group. Dietary maximum tolerated dose levels for chemoprevention studies are 0.5 mg/kg/day (3.0 ppm Se) for BSC and 5 mg/kg/day (32.5 ppm Se) for p-XSC, compared to literature values of 2-3 ppm Se for Na2SeO3.