Needlestick injuries among electromyographers.

The objective of this study was to determine the self-reported prevalence of needlestick injuries among practicing electromyographers. In January 2008, an anonymous electronic survey was sent to all active members of the American Association for Neuromuscular and Electrodiagnostic Medicine (AANEM) who provided e-mail addresses to the Association. Eight hundred and eight members (56% neurologists, 43% physiatrists; 97% practicing physicians, 3% trainees) responded, with a response rate of 22% (808 of 3659). The mean number of years in practice, involving electromyography (EMG) at least 1 day per week, was 16 years. A majority of physicians (64%) reported at least one needlestick injury involving EMG, and 8% reported five or more injuries. Needlestick injuries involving patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), hepatitis B, and/or hepatitis C occurred in 1 of every 11 electromyographers. Nearly half of all respondents (44%) who experienced a needlestick injury stated that they did not report at least one injury event to official centers. Injuries were most likely to occur during a routine procedure (45%) or when a patient moved (26%). The most common preventable reason for injury was a perceived lack of time.

Stiff-person syndrome associated with multiple myeloma following autologous bone marrow transplantation.

Stiff-person syndrome (SPS) is an immunologically mediated central nervous system disorder that is infrequently associated with malignancy. We report a 31-year-old woman who developed SPS after autologous bone marrow transplantation and subsequent interferon treatment for multiple myeloma. Anti-glutamic acid decarboxylase (anti-GAD) antibody serology was positive. The myeloma remains in remission 10 years posttransplant. SPS has been described in association with lung cancer and breast cancer, thymoma, and Hodgkin lymphoma. This is the second report of SPS in a patient with myeloma and the first description of SPS following autologous transplantation. Aberrant immune reconstitution is known to occur following hematopoietic progenitor cell transplantation. Interferon is also known to augment the immune response posttransplant. We speculate that an aberrant posttransplant immune response may have caused both the SPS and an autologous graft-versus-myeloma effect, resulting in prolonged remission posttransplant.

The treatment of tetanus in a rural community

It is suggested on the basis of personal experience of 13 cases of tetanus that diazepam is the present drug choice in the treatment of tetanus in country hospitals, where the nursing staff is insufficent and inadequately trained, and up-to-date equipment is not available (AU)