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At least 649 records · Page 36Linked to original sources
PubMed2005

The role of leukotrienes in allergic rhinitis.

OBJECTIVE: To review the role of cysteinyl leukotrienes (cysLTs) in allergic rhinitis and the scientific rationale for therapy with leukotriene receptor antagonists (LTRAs). DATA SOURCES: Relevant basic science and clinical articles were identified by a search of the PubMed database for articles published from 1984 to 2004 using the following keywords: allergic rhinitis; nose; immune response; allergen challenge; leukotrienes C, D, and E; cysteinyl leukotriene; cysteinyl leukotriene receptor; cytokine; leukocyte; montelukast; zafirlukast; and pranlukast. STUDY SELECTION: The authors' expert opinion was used to select studies for inclusion in this review. RESULTS: CysLTs are synthesized via 5-lipoxygenase metabolism of arachidonic acid by mast cells and basophils during the early-phase response to antigen and by eosinophils and macrophages during the late phase. The cysLT levels in nasal secretions are elevated after short-term allergen instillation and in allergy season in patients with allergic rhinitis. These lipid mediators act locally and systemically by interacting with receptors, particularly the cysLT1 receptor, on target cells. Evidence derived from topical application of cysLTs in the nose and from the effects of LTRAs indicates that cysLTs contribute to nasal mucous secretion, congestion, and inflammation. CysLTs promote allergic inflammation by enhancing immune responses and the production, adhesion, migration, and survival of inflammatory cells such as eosinophils. They also increase the generation of an array of other proinflammatory mediators, such as cytokines, which in turn increase the production of and receptors for cysLTs. Clinical trials have demonstrated that LTRAs have significant but modest efficacy as single agents but additive efficacy when used with other classes of agents. CONCLUSIONS: CysLTs fulfill the criteria for relevant mediators of allergic rhinitis via their diverse effects on immune, inflammatory, and local structural components of disease. By blocking the cysLT1 receptor responsible for most of these effects, LTRAs represent a useful approach to treatment of this important and prevalent disorder.

Humans↗
PubMedDate not supplied

The use of bioabsorbable implants in the spine.

BACKGROUND CONTEXT: Bioabsorbable implants are commonplace in sports medicine surgeries, especially in shoulder and knee ligamentous reconstruction. Their use is now expanding to the realm of spinal reconstructive surgery. Newer polymers offer reduced incidence of the side effects of aseptic sterile sinus formation and have appropriate resorption time parameters for spine use. These new bioabsorbable materials confer initial and intermediate-term stability that is adequate for stable bony healing in various applications. The majority of human clinical applications in the spine that have been documented involve bone graft harvest site reconstruction, posterior spinal graft containment, anterior interbody reconstruction and anterior cervical and lumbar spine tension band plating. PURPOSE: The purpose of this review article is to highlight the indications and outcomes of the use of bioabsorbable implants in specific spinal applications. STUDY DESIGN: A comprehensive literature review of the English and non-English literature on bioabsorbable implant technology. METHODS: A comprehensive literature review was performed to gather basic science, animal and human data on the use of bioabsorbable implants in spinal surgery. RESULTS: Bioabsorbable implants have demonstrated strength and resorption characteristics commensurate with the physiologic and biomechanical requirements of the human spinal axis. Histologic sampling has demonstrated successful time-patterned resorption accompanied by bony replacement and remodeling of intervertebral cage devices in the animal model. CONCLUSION: Bioresorbable compounds appear to have a role in specific spinal reconstructive procedures. Their radiolucent nature improves image assessment of fusion healing, and their time-engineered resorption characteristics allow controlled dynamization in interbody and plate applications. Their widespread use and acceptance may increase dramatically as further research and clinical studies report on their safety and efficacy.

Absorbable Implants↗
PubMed2003

Frontal-striatal circuit functions: context, sequence, and consequence.

The exact role of the basal ganglia in both the motor and non-motor domains has proven elusive since it is virtually impossible to refer to its function in isolation of cortical, and especially frontal cortical circuits. The result is that we often speak of frontal-striatal circuits and functions but this still leaves us in the dark when trying to specify basal ganglia information processing. A critical review of the data from both basic science and clinical studies suggests that we should break down processing along a temporal continuum, including the domains of context, sequential information processing, and feedback or reinforcement (i.e., the consequences of action). This analysis would cut across other theoretical constructs, such as attention, central executive, memory, and learning functions, traditionally employed in the neuropsychological literature. Under specified behavioral constraint, the basal ganglia can then be seen to be involved in fundamental aspects of attentional control (often covert), in the guidance of the early stages of learning (especially reinforcement-based, but also encoding strategies in explicit paradigms), and in the associative binding of reward to cue salience and response sequences via dopaminergic mechanisms. Parkinson's disease is considered to offer only a limited view of basal ganglia function due to partial striatal depletion of dopamine and the potential involvement of other structures and transmitters in its pathology. It is hoped that the present formulation will suggest new heuristic research strategies for basal ganglia research, permitting a closer link to be established between neurophysiological, functional imaging and neuropsychological paradigms.

Basal Ganglia↗
PubMed2003

The application of molecular genetic approaches to the study of human evolution.

The past decade of advances in molecular genetic technology has heralded a new era for all evolutionary studies, but especially the science of human evolution. Data on various kinds of DNA variation in human populations have rapidly accumulated. There is increasing recognition of the importance of this variation for medicine and developmental biology and for understanding the history of our species. Haploid markers from mitochondrial DNA and the Y chromosome have proven invaluable for generating a standard model for evolution of modern humans. Conclusions from earlier research on protein polymorphisms have been generally supported by more sophisticated DNA analysis. Co-evolution of genes with language and some slowly evolving cultural traits, together with the genetic evolution of commensals and parasites that have accompanied modern humans in their expansion from Africa to the other continents, supports and supplements the standard model of genetic evolution. The advances in our understanding of the evolutionary history of humans attests to the advantages of multidisciplinary research.

Animals↗
PubMed2003

[Chronic diseases, psychological distress and coping -- challenges for psychosocial care in medicine].

Due to the increase of chronic diseases within the last decades the need and demand for psychosocial treatment in medicine has been realized. This review focuses on the psychosocial aspects of chronic diseases and discusses selected topics of medical and rehabilitation psychology. Recent developments in quantitative and qualitative methods have allowed the systematic analysis of psychosocial distress and coping with chronic disease as well as the consequences on social relationships. The need for psychosocial treatment in acute care and rehabilitation can be diagnosed by differential assessment tools for coping and psychiatric morbidity. Specific approaches of psychology and psychotherapy for patients with somatic diseases have been developed and may be regarded as an integrative part of medical treatment in acute care and rehabilitation. In rehabilitation, the traditional individualistic view of psychotherapy has been broadened towards vocational integration and participation in social activities as outcome criteria. Evaluation research as well as the rehabilitation sciences have provided empirical data on psychosocial treatment of chronically ill patients. Under increasing financial restrictions and problems of the health care systems there is a need for quality assurance and the proof of scientific evidence to guarantee psychosocial treatment as an integrated part of medical care in the future.

Adaptation, Psychological↗
PubMed1999

COX-1, COX-2: so what?

The discovery of the second isoform of cycloxygenase has led to a rapid expansion in basic science, pharmacology and clinical data. With the completion of phase II studies of the new COX-2 specific inhibitors this review examines some of the implications of the new data.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2026

Effects of blood flow restriction training combined with resistance training on lower-limb strength and sport-specific performance in athletes: a systematic review and meta-analysis.

BACKGROUND: In contemporary sports science, athletes and coaches continuously explore strategies to reduce training load and injury risk while increasing muscular strength and sport-specific performance. This meta-analysis evaluated the effects of blood flow restriction training (BFRT) combined with resistance training (RT) on lower-limb muscle strength and sport-specific performance in athletes. METHODS: Relevant randomized controlled trials (RCTs) were systematically searched across major databases (e.g. PubMed, Web of Science, Cochrane, CNKI, Wanfang Data, and Embase) from inception until November 2024. Two independent reviewers carefully assessed the studies. Data analysis was carried out using RevMan 5.4 software, which included heterogeneity testing, meta-analysis, subgroup analysis, and assessment of publication bias. RESULTS: Ten RCTs (181 athletes; 91 in the BFRT and RT group, 90 in the control group) were included. Outcomes determined BFRT combined with RT yielded notable enhancements in lower-limb muscle strength (SMD = 1.09, 95% CI [0.52, 1.66], p&#x2009;<&#x2009;0.05) and muscle hypertrophy (MD = 1.09, 95% CI [0.10, 2.09], p&#x2009;<&#x2009;0.05) compared to control training. However, no significant improvement in sport-specific performance was found (SMD = 0.11, 95% CI [-0.18, 0.40], p&#x2009;=&#x2009;0.46). Substantial heterogeneity was observed for strength outcomes (I2 = 75%), whereas low heterogeneity was observed for sport-specific performance and hypertrophy outcomes (I2 = 0%). No evidence of significant publication bias was detected. CONCLUSION: BFRT combined with RT appears to provide effective augmentation of lower-limb muscle strength and hypertrophy in athletes compared to RT or conventional training alone. It may be prudent to integrate this approach systematically into training cycles to optimize physiological muscle stimulation and training outcomes, despite not directly improving sport-specific performance.

Humans↗
PubMed1989

Multicentre European trials: their design, execution and relevance.

Multicentre randomized clinical trials in Europe over the past decade have made a major contribution to the practice of cardiology and will increasingly do so when the Single Europe Act becomes a fact of life in 1992. The arguments for independent scientifically based research organizations and their role in the area of coronary artery disease are outlined. These include cost-benefit considerations, the science of clinical trials, data acquisition techniques and data management requirements. The role of the pharmaceutical industry in relation to the investigator-trialist is discussed. A critique of the current fashion 'Big is beautiful', with arguments against 'simplicity' and 'large size' and the need for 'credibility' is provided. Applicability of data from trials and their economic usefulness and validity in terms of sound pathophysiological hypotheses are also discussed and illustrated by using the CABRI trial as an example.

Angioplasty, Balloon, Coronary↗
PubMed2004

Making sense of the metabolome using evolutionary computation: seeing the wood with the trees.

One should perhaps start off by asking the question, 'But what wood is it we want to see?' There are so many trees that make up the wood; within a post-genomics context, genes, transcripts, proteins, and metabolites are the more tangible ones. Rather than studying these components in isolation, a more holistic approach is to unravel the interactions between the myriad of subcellular components and this is vital to systems biology. Moreover, this will help define the phenotype of the organism under investigation. Metabolomics is complementary to transcriptomics and proteomics, and despite the immense metabolite diversity observed in plants, metabolomics has been embraced by the plant community and in particular for studying metabolic networks. Whilst post-genomic science is producing vast data torrents, it is well known that data do not equal knowledge and so the extraction of the most meaningful parts of these data is key to the generation of useful new knowledge. A metabolomics experiment is guaranteed to generate thousands of data points (e.g. samples multiplied by the levels of particular metabolites) of which only a handful might be needed to describe the problem adequately. Evolutionary computational-based methods such as genetic algorithms and genetic programming are ideal strategies for mining such high-dimensional data to generate useful relationships, rules, and predictions. This article describes these techniques and highlights their usefulness within metabolomics.

Algorithms↗
PubMed2006

Clinical trials, the renin angiotensin system and atrial fibrillation.

PURPOSE OF REVIEW: Atrial fibrillation is the most common clinical arrhythmia. Current treatment strategies are far from optimal. One new research direction is to target the atrial fibrillation substrate and to examine whether drugs can produce atrial structural and/or electrophysiological remodeling and whether this results in a reduction in atrial fibrillation burden. RECENT FINDINGS: Two prospective randomized studies have shown that the addition of an angiotensin converting enzyme inhibitor or an angiotensin receptor blocker to amiodarone reduces the recurrence rate of atrial fibrillation after electrical cardioversion. There are ten completed prospective clinical trials with atrial fibrillation as a secondary endpoint or assessed in post-hoc analysis. Five of these studies have reported a positive impact of angiotensin converting enzyme inhibitors or angiotensin receptor blockers on atrial fibrillation burden. A meta-analysis showed that active drugs reduced the overall risk of development of atrial fibrillation by 28%. Patients in the heart failure trials obtained most benefit from these drugs (relative risk reduction 44%, P = 0.07). SUMMARY: The initial basic science and clinical trial data suggest that modulation of the renin angiotensin system may be an effective treatment for atrial fibrillation. The following, however, remain to be clarified: do these drugs have a clinically meaningful impact on atrial fibrillation burden; if there is an impact, is it similar in all atrial fibrillation patients or just in certain subsets; do angiotensin converting enzyme inhibitors and angiotensin receptor blockers have similar benefits; and is there a role for aldosterone antagonists?

Angiotensin Receptor Antagonists↗
PubMed2006

Update on cryotherapy for prostate cancer in 2006.

PURPOSE OF REVIEW: With the recent introduction of novel, minimally invasive procedures for the treatment of prostate cancer, cryotherapy has become a feasible option as a viable alternative to traditional radical surgery and radiation therapy. In this review we update recent data concerning the basic science of cryobiology, technical trends, oncologic results and complications of this procedure. RECENT FINDINGS: As a result of better understanding of tumor cryodestruction at a molecular level, refinements in cryotechniques and improved patient selection, the results of cryotherapy are becoming more promising. Furthermore, the dramatic decrease in the number of complications after modern cryotherapy leads to a better quality of life, which may be a preferable option, especially for elderly patients with comorbidities. Current trends towards nerve-sparing and focal cryoablation are also discussed. Recent advances in cryobiology open up new opportunities to apply cryotherapy in combination with chemotherapy or radiotherapy for patients with intermediate or high-risk cancers. SUMMARY: Potential directions for future developments in cryosurgery include concepts to reduce side effects such as minimizing cryodamage of the neurovascular bundles (nerve-sparing procedure), and focal ablation of a specific tumor site in patients in whom saturation biopsy supports unifocal prostate cancer.

Cryosurgery↗
PubMed2005

Improved data acquisition in grazing-incidence X-ray scattering experiments using a pixel detector.

The use of an area detector in grazing-incidence X-ray experiments lends many advantages in terms of both speed and reliability. Here a discussion is given of the procedures established using the PILATUS pixel detector developed at the Swiss Light Source for optimizing data acquisition and analysis of surface diffraction data at the Materials Science beamline, especially with regard to reflectivity measurements, crystal truncation and fractional order rods, and grazing-incidence diffraction experiments.

Journal Article↗
PubMed2003

The use of quantitative medical sociology.

The present article reviews, in relation to quantitative work on the social structure, papers published in Sociology of Health and Illness during its first 25 years. Each issue published during the years 1979-2002 has been examined; and quantitative papers, relating to various aspects of the social structure, have been identified. Such papers are found to have formed a minor but substantively significant theme within the Journal. These contributions situate the journal between sociology and social epidemiology. Articles in the Journal, for example, have been part of sociological debates about the measurement of social class, and of social epidemiological debates about the relationship between income distribution and population health. The contribution of Sociology of Health and Illness to a number of such debates is reviewed. The article concludes that the present situation, in particular the intellectual crisis in social epidemiology and social science investment in large data sets, gives the Journal the chance to build on this distinguished tradition by encouraging, through its publication policy, the further development of quantitative medical sociology.

Bibliometrics↗
PubMed1983

The content of the medical curriculum at McMaster University: graduates' evaluation of their preparation for postgraduate training.

This paper describes McMaster University medical graduates' perceptions of how well their medical curriculum prepared them for postgraduate training. The graduates view their overall preparation for postgraduate work as sound. These perceptions were compared with independent assessments by internship supervisors for one graduated class. The graduates suggest their preparation for postgraduate work differs somewhat from fellow interns. Graduates reported feeling very well prepared compared to fellow postgraduate trainees in independent learning, self-evaluation and problem solving skills. They also judge their preparation in data gathering skills, behavioural science knowledge, ability to deal with social and emotional problems of patients, medical record keeping skills, preventive, follow-up and in-patient care as very good compared to peers. They identified two content areas, pharmacology and the basic medical sciences, as requiring more attention in the curriculum. These findings are discussed and related to the approach to medical education at McMaster University.

Curriculum↗
PubMedDate not supplied

Left ventricular volume reduction: new dawn or false horizon? Basic science and clinical doubts.

Left ventricular volume reduction surgery (LVVR) for end-stage dilated cardiomyopathy is a surgical option used selectively but with unclear long-term results. Increasing numbers of reports are appearing in the literature. These should be pooled into an international registry through collaborative efforts that allow for more effective analysis. Furthermore, high priority must be given to identify subgroups of patients who will potentially gain most benefit from LVVR. Basic science may add invaluable data and in this article we describe how intraoperative myocardial biopsies from patients with idiopathic dilated cardiomyopathy were utilized to isolate myocytes in an effort to determine differential physiological characteristics at the cellular level. The result showed various degrees of contractile anomalies in response to electrical stimulation associated with defective calcium handling as reflected by measurements of calcium transients. It is hoped that this approach may be extended to preoperative catheter biopsy to gain information that will facilitate patient selection to avoid unnecessary surgical failures.

Aged↗
PubMed2004

Perceived stress reported by nurse practitioner students.

PURPOSE: To explore the phenomenon of stress as perceived by nurse practitioner (NP) students enrolled in a master of science in nursing program. DATA SOURCES: The study utilized a qualitative approach for data collection and analysis consistent with grounded theory methodology. We recruited 12 students, 4 men and 8 women, during their final year of a university-based NP program. Data were collected through individual interviews and a demographic questionnaire. CONCLUSIONS: Students reported stress levels ranging from moderate to highest ever in their lives. Although reasons given for becoming an NP included increased autonomy and increased ability, high-level stress was attributed to high demands and to independent teaching-learning techniques in the NP courses. Participants also expressed concerns about time management and financial obligations. IMPLICATIONS FOR PRACTICE: Knowledge of NP students' perceptions regarding personal stress can provide insight useful for developing approaches to foster optimum learning. Practicing stress reduction techniques with students would not only facilitate their own stress reduction but would also reinforce their ability to assist clients with this need.

Adaptation, Psychological↗