Intravenous iloprost in systemic sclerosis and its effect in cardiopulmonary function: a retrospective observational study.

OBJECTIVE: This study aims at evaluating the disease progression, specifically in terms of cardiopulmonary function, in a group of consecutively enrolled systemic sclerosis (SSc) patients treated with the approved iloprost regimen. PATIENTS AND METHODS: A retrospective observational study was performed on 68 SSc patients treated with 5-6 infusions of iloprost per month for 6 hours per day at a dosage of 0.5-2.0 ng/kg/min through a portable syringe pump. All patients were evaluated for modified Rodnan skin score, systolic pulmonary arterial pressure, tricuspid annular plane systolic excursion, diffusing capacity of the lungs for carbon monoxide, forced vital capacity, alveolar volume, diffusing capacity of the lungs for carbon monoxide/alveolar volume, pro-brain natriuretic peptide (pBNP), New York Heart Association class, and the presence or absence of digital ulcers (DUs). RESULTS: After a follow-up period of 9.9±2.9 years, all patients improved in frequency and severity of the Raynaud phenomenon and showed a stabilization or improvement of cardiopulmonary parameters. The pulmonary arterial pressure and pBNP improved significantly from baseline (30.91±6.4 mmHg vs. 27.36±7.1 mmHg, and 97.20±69.3 pg/ml vs. 66.65±44.3 pg/ml, respectively; p<0.0001 for both). A significant improvement was observed in the modified Rodnan skin score in 57 patients who continued the treatment during the entire follow-up (5.09±5.7 vs. 3.30±4.2, p<0.0001). CONCLUSIONS: Despite the retrospective design and the lack of a control group, the regular and continued administration of iloprost maintained the stability of the cardiopulmonary and cutaneous parameters in SSc. It significantly reduced pBNP levels, a prognostic cardiac biomarker of SSc. Future research should be addressed to demonstrate a stronger causality of this effect.

Leiomyoma of the hand: a case report.

We report a case of leiomyoma of the finger in the right hand of a 12-year-old boy: a rare site for localization and unusual for age. This is a benign tumor originating from non-striated muscle that is very uncommon in the hand. The uterus is considered the most common location for leiomyoma and when it occurs in the extremities, it is more common in the leg, ankle and foot. It usually occurs in the third and fourth decades of life and it is rarely diagnosed before surgery as the diagnosis can only be confirmed histologically.

Amiodarona y dispersión del intervalo QTc en el infarto agudo de miocardio / Amiodarone and QTc interval dispersion in the acute myocardial infarction

La dispersión del intervalo QTc fue medida al alta hospitalaria en 193 pacientes con infarto agudo de miocardio, enrolados en un estudio de administración de amiodarona en altas dosis vs placebo desde las primeras horas del cuadro. Los resultados mostraron que no hubo diferencias significativas en la dispersión del intervalo QTc entre ambos grupos, tanto cuando fueron comparados globalmente o separados por ubicación del infarto, clase funcional Killip y Kimball y tratamientos asociados. Este hallazgo confiere una mayor seguridad a los efectos antiarrítmicos de la amiodarona

Amiodarona y dispersión del intervalo QTc en el infarto agudo de miocardio / Amiodarone and QTc interval dispersion in the acute myocardial infarction

La dispersión del intervalo QTc fue medida al alta hospitalaria en 193 pacientes con infarto agudo de miocardio, enrolados en un estudio de administración de amiodarona en altas dosis vs placebo desde las primeras horas del cuadro. Los resultados mostraron que no hubo diferencias significativas en la dispersión del intervalo QTc entre ambos grupos, tanto cuando fueron comparados globalmente o separados por ubicación del infarto, clase funcional Killip y Kimball y tratamientos asociados. Este hallazgo confiere una mayor seguridad a los efectos antiarrítmicos de la amiodarona (AU)

The use of simulations to assess the impact of an adolescent suicide response curriculum.

This study employed simulations of encounters with suicidal peers to assess the impact of classroom suicide response lessons. Students were asked to anonymously write how they would respond, and how concerned they would be in regard to two vignettes of troubled peers. On the posttest, students who had participated in the classes provided significantly more "tell an adult" responses than those in the control group, whereas no differences existed between the groups on the pretest. On both the pretest and posttest, all students expressed greater concern on the unambiguous vignette (student said that he has been thinking about killing himself) than on the ambiguous vignette (student wrote an essay about final decisions); and, overall, females expressed greater concern than males. These results provide evidence for the efficacy of the classes and the utility of the simulations for assessing their impact.

[Experiences with sclerostomy with the Holmium laser]. / Erfahrungen mit der Sklerostomie mit dem Holmium-Laser.

The THC-YAG laser (holmium laser) war used to perform ab externo sclerostomies in patients affected by various types of glaucoma. This approach was employed in 48 eyes with diagnoses of medically uncontrolled chronic open angle glaucoma, plateau iris or neovascular glaucoma. Post-operatively, 5-FU was injected. At the tend of the follow-up (mean 10.22 +/- 3.4 months), in 25 eyes (52.1%) the IOP was under control without medical therapy. In 12 eyes (25.0%) it was necessary to use antiglaucomatous topical therapy, and in 11 eyes (22.9%) the IOP was uncontrolled despite therapy. The authors stress the importance of a correct pharmacological protocol before and after operation and describe the surgical technique. They confirm the validity of this approach, owing to its minical invasiveness, the possibility of repeating the procedure, and the low complication rate.

Aging related changes of neurotransmitters in the visual system.

Different neurotransmitter systems in the retina and optic nerve can be modified during aging. An increase in GABA and dopamine receptor density in the retina of senescent rats has been demonstrated. Lack of data exists on the aging-related changes in optic nerve neurotransmitters. However, it is possible that neurotransmitter changes in the optic nerve at the lateral geniculate nucleus are similar to those in other areas of central nervous system.