ABSTRACT
INTRODUCTION: Nocardia brasiliensis is a very rarely reported cause of chronic phagedenic ulcerations. We report the case of an elderly woman who developed such an infection after falling on her right leg on the road in the Bresse country (an essentially agricultural and bovine-cattle breading region) and developed a chronic phagedenic ulcer secondarily complicated by nodular lymphangitis of the thigh. CASE REPORT: A 75 year-old woman fell on her right leg on the side of the main road outside her hamlet in the Bresse country and secondarily developed a chronique phagedenic ulceration. We first considered her as suffering from pyoderma gangrenosum. A complete scanning only revealed an autoimmune thyroiditis and a rapidly healing gastric ulceration, and none of the treatments, either local or systemic, helped the skin condition to heal. After 3 weeks of application of a local corticoid ointment, the patient developed fever, general malaise, an exacerbation of her wound and an infiltration of the skin round her knee, together with nodular lymphangitic dissemination. A supplementary bacterial swab disclosed massive proliferation of a slow-growing Gram-positive bacillus, which proved to be Nocardia brasiliensis, together with a methicillino-sensitive Staphylococcus aureus. The treatment with sulfamethoxazole-trimetoprim gave a rash after 12 hours and was changed to amoxicillin and clavulanic acid, which rapidly proved to be permanently effective. DISCUSSION: The revelation of this particular slow-growing bacteria is difficult and requires bacterial swabs. Nocardia brasiliensis is relatively rare in primary skin ulcerations and we discuss the reasons why an elderly women should find this bacteria on the road outside her hamlet in the French countryside. This particular infectious condition requires general scanning, to make sure that the primary skin condition does not extend to other organs. We review the therapeutical options for patients who exhibit allergic reactions to the classically effective antibiotic drugs.
Subject(s)
Leg Ulcer/etiology , Leg Ulcer/microbiology , Nocardia Infections/complications , Accidental Falls , Aged , Amoxicillin-Potassium Clavulanate Combination/therapeutic use , Chronic Disease , Drug Therapy, Combination/therapeutic use , Female , Humans , Lymphangitis/etiology , Nocardia/pathogenicity , Nocardia Infections/drug therapyABSTRACT
OBJECTIVE: The Saturn-Ring is a new device that claims to increase cervical strength and flexibility. Therefore, the objective was to assess if use of the Saturn-Ring with conventional exercise would increase cervical strength, flexibility and circumference over conventional exercise alone. DESIGN: Subjects were randomly divided into two matched groups and a before/after design utilized. For pretest data, collection was done in a double-blind fashion. During the post-test, only the athlete knew the group in which he had participated. SETTING: The entire study was conducted in a high school field house. PARTICIPANTS: Fifty football players randomly chosen from a high school team served as subjects for the study. One subject was randomly selected from the pool of potential players and a matched subject was selected for the second group according to age, height and weight. This continued until both groups had 25 subjects. INTERVENTION: In addition to normal football exercises and practice, the experimental group used the Saturn-Ring five times a week over the 8-wk exercise program. MAIN OUTCOME MEASURES: Cervical strength and flexibility (flexion, extension, right lateral flexion and left lateral flexion) and girth size of the neck were measured before and after an 8-wk exercise program. RESULTS: Both groups showed significant gains in strength, flexibility and neck size. Further testing determined that the post-test results for the experimental group were significantly greater than the post-test results for the control group for neck sizes and all possible strength and flexibility measurements. CONCLUSIONS: The result of this study indicate that Saturn-Ring exercises in conjunction with conventional exercises will significantly increase cervical strength, flexibility and size over conventional exercises alone. There were several implications for further study: a) replicate the study to single out the effect of the Saturn-Ring alone, b) replicate the study with a broader spectrum of the population and include injured patients and c) research is needed to assess if the use of the Saturn-Ring can decrease the potential for cervical injury.
Subject(s)
Muscles/physiology , Neck , Sports Medicine/instrumentation , Adolescent , Cervical Vertebrae , Data Interpretation, Statistical , Exercise , Humans , Male , Movement , Neck Injuries , Random AllocationABSTRACT
A system has been developed for the long-term continuous intravenous infusion of chemotherapeutic agents into unrestrained mice which allows new approaches to the toxicological and chemotherapeutic evaluation of antimetabolites. In mice, the concurrent infusion of thymidine and a source of preformed purine reversed both the toxicity and antitumor activity of MTX comparable to what was previously observed in cell culture. The infusion of thymidine alone, however, also blocked the toxicity of MTX without interfering with antitumor activity. A comparison of leucovorin rescue versus the utilization of thymidine plus preformed purine indicated that these salvage metabolites were as effective as leucovorin in reducing the toxicity of high-dose MTX while retaining antitumor activity.