Background: Due to possible antiinflammatory effects, sulfur baths are widely used for the treatment of rheumatic diseases. Previously it was demonstrated that drinking cures with sulfur can improve the antioxidative defense system and lower the peroxide levels of patients with chronic degenerative osteoarthritis. Objective: This study therefore sought to investigate the effect of 3-week therapy with sulfur baths on antioxidative defense systems, peroxide concentrations, and lipid levels in patients with degenerative osteoarthritis. Patients and Methods: After randomization one group of patients (n = 19) received sulfur baths during their stay at a health resort (sulfur group), whereas the other age-matched patient group served as controls (n = 19, control group), only receiving spa therapy. Total cholesterol levels, HDL, LDL, triglycerides and the antioxidative status, glutathione peroxidase, and superoxide dismutase (SOD) activities, and peroxide concentration, as an oxidative stress parameter, were evaluated at the begin and end of therapy. Results: A 17.2% decline in peroxide concentrations (p = 0.10, n.s.) and significant lower SOD activities (p < 0.001) were detected in the sulfur group at the end of the therapy. Until the end of therapy total cholesterol levels changed differentially (p = 0.007) in the sulfur group (from 229.11 ± 34.47 mg/dl to 217.46 ± 40.45 mg/dl) and in the control group (from 197.63 ± 34.66 mg/dl to 207.95 ± 33.02 mg/dl). A similar significant group difference was found for LDL (p = 0.017), with a 5.9% reduction in the sulfur group and a 6.1% increase in the control group. Triglyceride concentrations were nonsignificantly reduced in both groups after 3 weeks at the health resort (sulfur group 11.2%, control group 20.2%). HDL values only minimally changed in both groups. Conclusions: The results presented here suggest that a sulfur bath therapy could cause a reduction in oxidative stress, alterations of SOD activities, and a tendency towards improvement of lipid levels.
Background: In recent years, an increasing number of auto-antibodies (AB) have been detected in the CSF and serum of patients with new onset epilepsy. Some of these patients develop convulsive or nonconvulsive status epilepticus (AB-SE), necessitating intensive medical care and administration of multiple antiepileptic and immunomodulatory treatments of uncertain effectiveness. Objectives: In this retrospective multicenter survey we aimed to determine the spectrum of gravity, the duration and the prognosis of the disorder. In addition, we sought to identify the antibodies associated with this condition, as well as determine whether there is a most effective treatment regime. Methods: 12 European Neurology University Clinics, with extensive experience in the treatment of SE patients, were sent a detailed questionnaire regarding symptoms and treatment of AB-SE patients. Seven centers responded positively, providing a total of 13 patients above the age of 16. Results: AB-SE affects mainly women (12/13, 92%) with a variable age at onset (17–69 years, median: 25 years). The duration of the disease is also variable (10 days to 12 years, median: 2 months). Only the 3 oldest patients died (55–69 years). Most patients were diagnosed with anti NMDAR encephalitis (8/13) and had oligoclonal bands in the CSF (9/13). No specific treatment regimen (antiepileptic, immunomodulatory) was found to be clearly superior. Most of the surviving 10 patients (77%) recovered completely or nearly so within 2 years of index poststatus. Conclusion: AB-SE is a severe but potentially reversible condition. Long duration does not seem to imply fatal outcome; however, age older than 50 years at time of onset appears to be a risk factor for death. There was no evidence for an optimal antiepileptic or immunomodulatory treatment. A prospective multicenter study is warranted in order to stratify the optimal treatment algorithm, determine clear risk factors of unfavorable outcome and long-term prognosis.
The understanding of immunological mechanisms underlying some forms of epilepsy and encephalitis has rapidly increased for the last 10 years leading to the concept of status epilepticus of autoimmune origin. Actual treatment recommendations regarding autoimmune status epilepticus are based on retrospective case studies, pathophysiological considerations and experts' opinion. In addition, there are no clear indicators to predict outcome. In situations where autoimmune mechanisms are suspected in patients with status epilepticus, there is evidence that earlier treatment is related to better outcome. Increased awareness is mandatory to decrease the number of patients with major neurological problems or fatal outcome, which is overall about 50%. We here summarize findings of all pediatric and adult patients reported to date, and review the current state of knowledge in the field of immune therapeutic approaches of status epilepticus.
Sixty‐nine children with asthma and 86 with cystic fibrosis (CF) were assessed for lung function, respiratory muscle function and exercise tolerance. Thirty‐seven with aslhma and 41 with CF subsequently undertook an at home exercise program and the remainder were matched controls. There was no significant change in pulmonary function after 3 months of the exercise program. Compliance with the program decreased markedly towards the end of the 3 months and this lack of compliance may have contributed to the failure to show any significant training effect. A previously supervised program showed increased fitness and increased peak pressures in children with asthma following intensive exercise‐ There appears limited value in promoting unsupervised home exercise programs for children with CF and asthma. In those groups of children who will benefit with increased physical activity, supervised programs and more interesting play activities may need to be organized to obtain optimal benefit.
Instruments which measure peak shock pressures and shock positions from underground nuclear explosions have been developed, and results have been obtained from 33 detonations in alluvium, 3 in tuff, and 2 in granite. The measurement techniques in the high‐pressure region have been so refined that the probability of obtaining meaningful data from any experiment is high. In a parallel effort, a computer calculation has been produced by means of which, once the necessary dynamic material properties are known, shock‐wave parameters can be calculated as a function of time and a single space variable. For tuff and granite, the difference between most measured peak pressures and calculated values is less than 20%, with poorer agreement in the case of alluvium. Most calculated shock positions agree with measurements to within a fraction of a meter. At least half of the disagreement is due to uncertainty in relating raw data to values in the medium, caused primarily by our poor knowledge of the Hugoniots of earth and rock materials and the instrument coupling grout. Large inhomogeneities in the medium near instruments is the most likely explanation for those measurements which disagree by more than 20% with calculated values.
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