The effect of nerve mobilization exercise in patients with rheumatoid arthritis: a pilot study.

Rheumatoid arthritis (RA) is an autoimmune disorder characterized by chronic inflammation of the joints. The neurogenic inflammatory mechanism plays an important role in the inflammatory process of RA, and pathological changes in neural tissues in RA have also been noted. We aim to investigate treatment of the nervous system to relieve joint pain and inflammation in RA. Nerve mobilization, a nervous system-specific therapeutic exercise, was applied on RA patients to determine the effect of nerve mobilization on joint inflammation. Twelve RA patients were recruited from the community and were randomised into an experimental and a control group. In the experimental group, the subjects were taught a set of nerve mobilization exercises while the subjects in the control group were taught a set of gentle joint mobilization exercises. Both groups were instructed to practice the exercises daily. After a 4-week period, their RA pain scale (RAPS) and pain scores were examined, as well as the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Subjects in the experimental group showed improvements in RAPS and pain scores after 4 weeks of nerve mobilization exercises, while CRP and ESR values remained unaffected. These preliminary data showed that nerve mobilization exercises might be beneficial in controlling joint pain in RA patients.

Seasonal asthma in Hong Kong and its management implications.

Quarterly analysis of 48,003 hospitalization episodes of asthma in Hong Kong from 1976 to 1985 reveals a consistent bimodal seasonal variation of hospitalization rates most noticeable in younger age groups. Statistical analysis shows that with a drop of relative humidity and an increase in wind speed, more episodes of asthma hospitalization are expected. During seasons of increased susceptibility, aggressive prophylaxis and vigilant monitoring should reduce hospitalization for those with seasonal predisposition.

Postvasectomy residual sperm pregnancy.

PIP: A pregnancy occuring within a few months after a successful vasectomy is sometimes attributed by a skeptical physician to sexual involvement by the spouse with a nonvasectomized man. This assumption may be unjustified because of the fact that after a vasectomy, some residual sperm which are viable enough to cause pregnancy could remain stored distal to the site of occlusion. The Maternal and Child Health Center of Taiwan documented a case history of a 32-year-old father of 2 who impregnated his wife approximately 38 days, and at least 9 ejaculations, after a successful vasectomy. The patient had no urogenital abnormalities and had an uneventful vasectomy procedure. He resumed intercourse with his wife 8 days after vasectomy and returned for 5 semen tests during the year after vasectomy. The patient's 28-year-old wife had her last menses 24 days after the vasectomy, and pregnancy test 57 days after the vasectomy confirmed the suspicion of pregnancy. Vacuum aspiration terminated the pregnancy 2 days later. There was no doubt or question at all that the patient was his wife's only sexual partner. The authors concluded that based on examination of several thousand postvasectomy semen specimens, the distribution of the biologic limits for residual sperm viability is an asymmetrical distribution skewed to the right, suggesting that the limits may even exceed 38 days for some individuals. Thus physicians should be careful in evaluating a pregnancy which occurs a few months after a successful vasectomy.^ieng