Microcurrent skin patches for postoperative pain control in total knee arthroplasty: a pilot study.

Pain control following painful orthopaedic procedures such as total knee arthroplasty (TKA) is an ongoing challenge, as current pain management techniques often result in under-medication and/or complications. In a study designed to test the effect of the micro-current skin patch (MCT) on pain relief in patients following TKA, we followed 24 patients, randomly divided into two groups, one group receiving MCT plus tramadol hydrochloride (tramadol) for pain relief and a control group receiving only tramadol, for 10 days postoperatively. Tramadol was given intramuscularly in increment doses of 100 mg, as needed, for the duration of the study period. Pain was assessed daily using a visual analogue score (VAS). Other parameters, including the effect of MCT on the dose of tramadol needed for pain relief, the degree of wound healing measured at the end of the follow-up period, category of the wound 10 days postoperatively (1, 2 or 3) and total drain fluid volume, were also assessed. During the 10-day postoperative period there was a progressive decrease in pain in patients of both groups, however the patients of the MCT group showed a consistently lower VAS throughout the observation period, most markedly on those follow-up days with the highest pain scores in patients of the control group. This effect was monitored on the basis of the average dose of tramadol administered per day: 200.0+/-7.0 mg/day in the control group and 63.3+/-15.8 mg/day in the MCT group. Wound healing was better with the application of the MCT patch: grade 1 wounds were observed in 50% of the patients of the MCT group as compared to 8.3% in control group. The total drain volume was lower in patients of the MCT group compared to the controls (1020.8+/-211.6 and 1170.8+/-243.5 ml, respectively). None of the patients indicated that they wished to discontinue MCT therapy. This pilot study shows that MCT therapy led to better pain control with a markedly lower need for tramadol as compared to the control group. This better pain control was accompanied by a better healing of the wound and a lower drain volume.

[Adaptive servoventilation: effect on Cheyne-Stokes-Respiration and on quality of life]. / Adaptive Servoventilation bei chronischer Herzinsuffizienz: Wirkung auf Cheyne-Stokes-Atmung und Lebensqualität.

BACKGROUND: Adaptive servo-ventilation (ASV) (AutoSetCS, ResMed) is a novel non-invasive ventilation modality for the treatment of Cheyne-Stokes-Respiration (CSR) in patients with heart failure. This study aimed to investigate the effect of ASV on sleep disordered breathing (SDB), afternoon nap duration, urine voidings, and quality of life. METHODS: 11 patients with CSR due to heart failure (EF < 40 %) were treated with ASV for a period of 6 weeks. Apnea-Hypopnoe-Index (AHI), Arousalindex (AI), duration of afternoon nap, number of voidings, and heart specific quality of life were assessed before and at the end of the treatment period. RESULTS: The average usage time of ASV was 5.8 +/- 2.1/h per day. With ASV the AHI was reduced from 48.2 +/- 11.6 to 6.4 +/- 8.3/h (p < 0.001) and the AI from 33.9 +/- 12.5 to 18.4 +/- 9.3 /h (p < 0.05). The afternoon nap duration was significantly less (1.4 +/- 0.6 vs. 0.7 +/- 0.4 hours per day; p = 0.004) as was the number of nocturnal voidings (2.9 +/- 0.7 vs. 1.1 +/- 0.3 per night; p = 0.007). There was a significant improvement in heart specific quality of life as measured with the Minnesota Living with heart failure questionnaire (43.5 +/- 21.1 vs. 27.6 +/- 15.7 (p = 0.02). CONCLUSION: ASV is well tolerated and improves SDB and quality of life of patients with heart failure with CSR.

Cutaneous leishmaniasis as a possible predisposing factor for skin malignancy.

This paper reports a 13 year old Yemenian boy with cutaneous leishmaniasis (CL.). The histopathological picture of the CL lesions showed marked dysplasia indicating premalignancy. The possibility that CL as one of the predisposing factors for skin malignancy was discussed.

Correlation between the level of IgA and Pneumocystis carinii infection.

Sputum examination for detection of P. carinii pneumonia (PCP) can be substituted for more invasive techniques. There was a significant correlation between PCP and the increased level of IgA in serum (P less than 0.01) and sputum. The increase in IgA level in sputum was much more higher than that in the serum. This supports the concept that local antibody formation by the lung may have a more important role in the immune and inflammatory response to P. carinii.

Study on toxoplasmosis in Quasseem, Saudi Arabia.

This study presents evidence of Toxoplasma infection in Quasseem, Saudi Arabia and directs the attention that Toxoplasmosis is an important cause of repeated abortion there. Pregnant women should avoid handling or caring for pet cats. Also, raw meat and raw milk from infected animals should be avoided.

Hepatic fibrosis in hamsters experimentally infected with S. mansoni.

Adult males Schistosoma mansoni were detected in the liver of experimentally infected hamsters induced a lesser intense granulomatous reaction than that induced by living bilharzial ova. This pathological reaction may be induced by immune complex formation.