ABSTRACT
Three tourists developed eosinophilic meningitis after visiting the Fijian Islands. Two had a severe and long lasting illness with chronic intractable pain. In one patient electrophysiological studies and MRI scan of the brain were abnormal and provided evidence of both radicular and cerebral parenchymal involvement by the most likely causative agent, Angiostrongylus cantonensis.
Subject(s)
Eosinophilia/complications , Meningitis/complications , Pain, Intractable/etiology , Adult , Angiostrongylus , Animals , Brain/pathology , Chronic Disease , Cranial Nerve Diseases/etiology , Female , Humans , Hyperalgesia/etiology , Magnetic Resonance Imaging , Male , Middle Aged , Nematode Infections/complications , Neurologic Examination , Paresthesia/etiologyABSTRACT
The results of nine patients undergoing restorative proctocolectomy with ileal reservoir are presented. Mean frequency of defaecation per 24 h is 5.8. The reservoir was removed in one patient. Continence was normal in six patients and two had minor soiling. Manometry was normal in all except one with minor soiling and electromyography showed no features of sphincter denervation.
Subject(s)
Anal Canal/surgery , Colectomy , Colitis, Ulcerative/surgery , Defecation , Ileum/surgery , Adult , Anal Canal/physiopathology , Electromyography , Evaluation Studies as Topic , Female , Humans , Male , Manometry , Middle AgedSubject(s)
Statistics as Topic , Chiropractic , Clinical Trials as Topic , Female , Humans , Male , Migraine Disorders/therapy , Random Allocation , Sex FactorsABSTRACT
A new syndrome of neonatal convulsions is described. Ninety cases were documented from one maternity hospital between 1973 and 1977. The appearance of this syndrome increased the annual incidence of neonatal convulsions from fewer than 3 to more than 16 per 1000 live births. Fits began on about the fifth day in apparently healthy babies. Investigations and therapeutic trials have not shown the cause. There were no deaths and all babies were discharged from hospital apparently well. The term fifth day fits is suggested with criteria for this diagnosis.
Subject(s)
Infant, Newborn, Diseases/etiology , Seizures/etiology , Adolescent , Adult , Australia , Female , Humans , Infant, Newborn , Infant, Newborn, Diseases/drug therapy , Infant, Newborn, Diseases/epidemiology , Labor, Obstetric , Male , Pregnancy , Seizures/drug therapy , Seizures/epidemiology , Time FactorsABSTRACT
It is generally accepted that migraine is sensitive to intervention, whether in a treatment situation or in a clinical trial, and a "placebo effect" is often suggested. The influence of a number of non-specific therapeutic ingredients was examined in a recent six-month trial of cervical manipulation for migraine, and results of a 20-month follow-up are reported. During the trial migraine attacks reduced significantly by 28%, and reduced a further 19% up to the follow-up period. The possibility of a trial effect, whereby improvement might stem from circumstances of the trial, was dismissed as an explanation for improvement. There was some evidence to suggest that placebo influences made a slight contribution to improvement, with sex, social class and subjects' optimism about the therapist at the initial treatment being weakly associated with initial improvement. The possibility that improvement levels reflected spontaneous improvement in migraine symptoms is suggested. If this possibility proves valid, clinical trials assessing migraine therapies should be designed so as to consider the natural course of migraine. Degree of improvement at follow-up could be predicted clearly from degree of improvement during the treatment phase and from degree of improvement at the end of the trial. This appears to be important to manipulative therapists who appear to practise without the benefit of valid predictors of response to therapy.
Subject(s)
Migraine Disorders/therapy , Physical Therapy Modalities , Adolescent , Adult , Attitude , Child , Clinical Trials as Topic , Female , Follow-Up Studies , Humans , Male , Middle Aged , Migraine Disorders/psychology , Placebos , Sex Factors , Social ClassABSTRACT
The efficacy of cervical manipulation for migraine was evaluated. In a six-month trial, 85 volunteers suffering from migraine were randomly allocated to three treatment groups. One group received cervical manipulation performed by a medical practitioner or by a physiotherapist, another received cervical manipulation performed by a chiropractor, while the control group received mobilization performed by a medical practitioner or by a physiotherapist. For the whole sample, migraine symptoms were significantly reduced. No difference in outcome was found between those who received cervical manipulation, performed by chiropractor or orthodox therapist, and those who received the control treatment. Chiropractic treatment was no more effective than the other two treatments in reducing frequency, duration or induced disability of migraine attacks, but chiropractic patients did report a greater reduction in pain associated with their attacks.
