Zuckerkandl's tubercle: Hannibal ad Portas.
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BACKGROUND: Cow's milk allergy is frequently observed during the first year of life when nutritional requirements are critical. In those cases where breast-feeding is not available, a safe and adequate substitute to cow's milk should be offered. OBJECTIVE: The primary aim of this review is to evaluate the clinical use of milk derived from vegetable proteins, such as soy, or from animals such as goat, mare, or donkey, or elemental diet in children with cow's milk allergy. METHODS: MEDLINE searches were conducted with key words such as soy, goat's milk, donkey's milk, mare's milk, and elemental diet. Additional articles were identified from references in books or articles. Original research papers and review articles from peer-reviewed journals were chosen. RESULTS: Soy formulas are nutritionally adequate and can be used in children with immunoglobulin E-mediated nongastrointestinal manifestations of cow's milk allergy. Goat's milk is as allergenic as cow's milk. Mare's milk and donkey's milk may be used in selected cases of cow's milk allergy after appropriate modification to make them suitable for human infants. Elemental diets are usually restricted to the most severe cases of cow's milk allergy (ie, sensitivity to extensively hydrolyzed protein formulas). CONCLUSIONS: Vegetable formulas obtained from soy and milk derived from other mammals, such as mare or donkey, homemade preparations, and elemental diet may represent valid alternatives for children with cow's milk allergy. Extensive clinical trials are needed on the safety profile of any alternative mammal-derived milk. The choice of alternative milk should take into account the clinical profile of the child allergic to cow's milk, particularly as concerns age, severity of symptoms, degree of sensitivity to cow's milk proteins, and any multiple food allergies.
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Writing medical history papers can be professionally and personally rewarding, but a little overwhelming for novices. This paper offers step-by-step guidelines for the entire process, including developing appropriate topics, finding and using appropriate sources, and writing the paper. Specific reference sources are recommended.
Information in the 1999 Physician's Desk Reference as well as from the peer-reviewed published literature was used to evaluate the genotoxicity of marketed pharmaceuticals. This survey is a compendium of genotoxicity information and a means to gain perspective on the inherent genotoxicity of structurally diverse pharmaceuticals. Data from 467 marketed drugs were collected. Excluded from analysis were anti-cancer drugs and nucleosides, which are expected to be genotoxic, steroids, biologicals and peptide-based drugs. Of the 467 drugs, 115 had no published gene-tox data. This group was comprised largely of acutely administered drugs such as antibiotics, antifungals, antihistamines decongestants and anesthetics. The remaining 352 had at least one standard gene-tox assay result. Of these, 101 compounds (28.7%) had at least one positive assay result in the pre-ICH/OECD standard four-test battery (bacterial mutagenesis, in vitro cytogenetics, mouse lymphoma assay (MLA), in vivo cytogenetics). Per assay type, the percentage of positive compounds was: bacterial mutagenesis test, 27/323 (8.3%); in vitro cytogenetics 55/222 (24.8%); MLA 24/96 (25%); in vivo cytogenetics 29/252 (11.5%). Of the supplemental genetic toxicology test findings reported, the sister chromatid exchange (SCE) assay had the largest percentage of positives 17/39 (43.5%) and mammalian mutagenesis assays (excluding MLA) had the lowest percentage of positives 2/91 (2.2%). The predictive value of genetic toxicology findings for 2-year bioassay outcomes is difficult to assess since carcinogenicity can occur via non-genotoxic mechanisms. Nevertheless, the following survey findings were made: 201 drugs had both gene-tox data and rodent carcinogenicity data. Of these, 124 were negative and 77 were equivocal or positive for carcinogenicity in at least 1 gender/1 species. Of the 124 non-carcinogens, 100 had no positive gene-tox findings. Of the remaining 24, 19 were positive in in vitro cytogenetics assays. Among the 77 compounds that exhibited equivocal or positive effects in carcinogenesis studies, 26 were positive in gene-tox assays and 51 were negative. Of the 51 negatives, 47 had multiple negative gene-tox assay results suggesting that these are probably non-genotoxic carcinogens. Statistical analyses suggested that no combination of gene-tox assays provided a higher predictivity of rodent carcinogenesis than the bacterial mutagenicity test itself.
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A comparison is made between compilations of times of origination and extinction of fossil marine animal families published in 1982 and 1992. As a result of ten years of library research, half of the information in the compendia has changed: families have been added and deleted, low-resolution stratigraphic data been improved, and intervals of origination and extinction have been altered. Despite these changes, apparent macroevolutionary patterns for the entire marine fauna have remained constant. Diversity curves compiled from the two data bases are very similar, with a goodness-of-fit of 99%; the principal difference is that the 1992 curve averages 13% higher than the older curve. Both numbers and percentages of origination and extinction also match well, with fits ranging from 83% to 95%. All major events of radiation and extinction are identical. Therefore, errors in large paleontological data bases and arbitrariness of included taxa are not necessarily impediments to the analysis of pattern in the fossil record, so long as the data are sufficiently numerous.
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The Read Codes were initially developed by a general practitioner, Dr James Read from Loughborough, in the early 1980s and rapidly gained acceptance by general practitioners as a popular and useful mechanism for storing structured information about patients in individual, patient-based records, which were beginning to become popular in a few general practices at the time. This short article aims to explain the past and future development of the coding system in the National Health Service as a whole.
BACKGROUND: An important purpose of theories is to challenge practice, create new approaches to practice and remodel the structures of rules and principles. Therefore, it is of interest to study whether it is possible to make use of nursing theories in care of older people, when the aim is to support them in the process of ageing. AIM: To review 17 well-known nursing theories/models in order to delineate the views on ageing presented and discover whether there are descriptions of how nursing care of older people could be organized. METHODS: Seventeen nursing theories/models originating over a 30-year period from the early 1960s to the early 1990s were chosen. A search of CINAHL was done and lists of reference from books were used to find original sources. For the review, a list of research questions were formulated and addressed to each theory. RESULTS: Results showed that most nursing theorists see human ageing from a developmental perspective, but do not discuss what ageing implies. In only a few theories are some important aspects of nursing care of older people discussed, but no concrete instructions are given on how to apply these to nursing care. CONCLUSION: There is a need to develop a nursing care model that - more than other contemporary theories - takes into consideration human ageing.