Cardiac rehabilitation in a pediatric patient with heart retransplantation. A single case study.

BACKGROUND: Cardiac rehabilitation (CR) after heart transplantation is known to benefit physical capacity in adults, but the advantages of CR on pediatric patients with heart retransplantation remain undetermined. AIM: The purpose of the present study was to report the effect of structured CR for a boy receiving heart transplantations twice. DESIGN: Single case study. SETTING: Inpatient and outpatient rehabilitation department. POPULATION: A pediatric patient underwent heart transplantation due to dilated cardiomyopathy at 13.6 year-old and retransplantation owing to severe cardiac allograft vasculopathy at 16.2 year-old. METHODS: CR was arranged after both transplantations. Bicycle or treadmill exercises were conducted three times weekly with the intensity adjusted to the ventilatory threshold. Serial cardiopulmonary exercise tests were performed to evaluate the sequential cardiorespiratory function changes using the peak oxygen uptake (VO2peak) as the primary outcome. RESULTS: The patient had undergone 10 times of exercise tests during rehabilitation. The VO2peak increased from 12.27 to 15.63 mL·kg-1·min-1 within 6 months after the primary transplantation. However, the VO2peak dropped intensively after a rejection episode and failed to improve since the development of cardiac allograft vasculopathy. Following retransplantation, the VO2peak appeared worse initially but increased gradually with rehabilitation. One year subsequent to retransplantation, the VO2peak reached 17.7 mL·kg-1·min-1 with a 7.22 mL·kg-1·min-1 improvement compared with his baseline value. CONCLUSION: Structured CR improves aerobic capacity of a pediatric patient with heart retransplantation. CLINICAL REHABILITATION IMPACT: CR is safe and beneficial for pediatrics with heart retransplantation. Cardiopulmonary exercise testing can be considered as an adjuvant tool for detecting rejection or cardiac allograft vasculopathy in pediatric heart transplantation recipients.

Manual acupuncture for relieving pain associated with panretinal photocoagulation.

OBJECTIVE: The feasibility of manual acupuncture for reducing pain associated with panretinal photocoagulation (PRP) was investigated. METHODS: This was a prospective, comparative nonrandomized study on patients with proliferative diabetic retinopathy who were receiving PRP treatment. The protocol of PRP included three sequential sessions of treatment at 2-week intervals. Both the acupuncture (acuPRP) and control groups had no acupuncture in the first session. In the second session, acupuncture was given to the acuPRP group only. The third session of PRP completed the laser treatment course. Acupuncture performed only at GB 37 (Guangmíng) just before PRP, and the needle was removed after the treatment. An 11-point Likert-type verbal pain score test was given to all patients after each PRP treatment. RESULTS: Of 34 patients with proliferative diabetic retinopathy, 18 patients were allocated to the acuPRP group and 16 patients were allocated to the control group. After the first PRP treatment, there was no statistical difference in mean pain scores between the acuPRP and control groups (6.8±1.2 versus 6.3±2.1, respectively, p=0.383). After the second PRP treatment, the mean pain score in the acuPRP group was significantly lower, compared with the control group (3.9±1.8 versus 7.4±1.9, respectively, p<0.0001). Within the group, the mean pain scores were significantly higher during the second PRP treatment, compared with the first PRP treatment, in the control group (p=0.0003). In contrast, the mean pain scores were significantly lower during the second PRP treatment, compared with the first PRP treatment in the acuPRP group (p<0.0001). No adverse reactions or complications were noted. CONCLUSIONS: Acupuncture might help reduce pain during PRP treatment. However, further randomized studies are necessary to verify these preliminary results.

Screening from pickled vegetables the potential probiotic strains of lactic acid bacteria able to inhibit the Salmonella invasion in mice.

AIMS: To screen from pickled vegetables the potential probiotic lactic acid bacteria (LAB) strains with antagonistic activity against Salmonella invasion in host. METHODS AND RESULTS: Probiotic properties including acid and bile tolerance as well as inhibition on pathogenic bacteria were used for screening of LAB strains from pickled vegetables. Two strains, i.e Pediococcus pentosaceus MP12 and Lactobacillus plantarum LAP6, were selected and further assayed for their activities against Salmonella invasion in mouse liver and spleen. For these two LAB strains, strain LAP6 was able to adhere to the mouse intestinal epithelium cells. CONCLUSIONS: In screening of the probiotic strains able to inhibit the Salmonella invasion in host, factors other than the adherence to host intestinal epithelium may contribute some roles. SIGNIFICANCE AND IMPACT OF THE STUDY: Probiotic LAB strains with activity against Salmonella invasion in host could be isolated from vegetable origins. These strains may be used for vegetable processing.

A study of PVRL1 mutations for non-syndromic cleft lip and/or palate among Taiwanese patients.

Mutations of codons 185 and 323, especially the W185X mutation, of the PVRL1 gene among non-syndromic cleft lip and/or palate (CL/P) patients and normal controls in Taiwan were studied in order to determine whether there are mutations that play a part in the formation of non-syndromic CL/P. A total of 76 patients were enrolled; 66 sporadic non-syndromic CL/P patients and 10 normal controls. The mutation survey for codons 185 and 323 was conducted using a polymerase chain reaction and DNA sequencing. Neither mutations of codons 185 and 323 were noted for any of the 76 patients (152 alleles), nor were found any other mutations in either exon 3 or 5 of the PVRL1 gene. These results suggest that mutations of the PVRL1 gene at codons 185 and 323, especially the W185X mutation, do not participate in the formation of CL/P within the Taiwanese population examined.