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PubMed2004

[Breastfeeding and early childhood caries: a critical review].

OBJECTIVE: To find scientific evidence that can prove or refute the assumption that nocturnal and on demand breastfeeding are associated with caries in infants and preschool children. SOURCES OF DATA: MEDLINE, Lilacs, and SciELO articles were searched, as well as important internet sites, technical books and consensus publications of national and international organisms. The following keywords were used: "early childhood caries", "dental caries", "dental decay" and "breastfeeding". References cited in the articles selected were also included. SUMMARY OF THE FINDINGS: Studies associating caries with breastfeeding invariably observe factors associated with how this disease develops, letting aside those associated with breastfeeding. Many of these factors act as confusing variables because in the same way as they interfere in breastfeeding, they also influence the development of caries. Besides, current studies have already demonstrated the cariogenic potential of some types of aliments given to children against the non-cariogenic potential of the human milk. CONCLUSIONS: There is no scientific evidence proving that human milk can be associated with the development of caries. This is a complex relation to be established, as it is often blurred by too many variables.

Breast Feeding↗
PubMed1980

[Mesocestoides leptothylacus n. sp. and the problem of nomenclature in the genus Mesocestoides Vaillant, 1863 (Cestoda, Mesocestoididae) (author's transl)].

M. leptothylacus n. sp., a common parasite of the Red Fox (Vulpes vulpes) in Southwest Germany, is characterized by a slender elongated cirrus pouch containing a cirrus with only one loose convolution and by approximately 90 testes surrounding the other genital organs completely, quite a number of them lying outside the lateral excretory canals.--The decision for a new name arised from the following considerations: 1. Goeze (1782) described Taenia lineata with characteristics of the genus only. 2. There is no type material left by Goeze. 3. None of the later authors could know which species was meant by T. lineata. 4. None of the later descriptions was exact enough to adjoin it to the old name today. 5. All descriptions under the name of M. lineatus have to be revised. Certkova & Kosupko (1795) in order to preserve the well known name assigned to it a completely new species but did not select a neotype nor did they choose a species from the terra typica; thus the name of that species has to be altered. 7. Goeze in the same book in which he described M. lineatus gave a very superficial account of a cestode presumed to be a variation of a Taenia cateniformis which probably was a Mesocestoides, too. The specimens apparently were not gravid so that the author neither recognized the relationship to his T. lineata nor could he be sure about a possible identity of the two. 8. Thus, the name assigned to this second description, M. literatus (Batsch, 1786) is a nomen dubium.

Animals↗
PubMed1993

A contemporary view of alternative healing modalities.

Alternative forms of healing have increasingly gained popularity in the United States as evidenced by books, healing groups, and a burgeoning variety of healing modalities. Knowledge about these modalities can facilitate health care providers' effectiveness in managing care by understanding the healing practices selected by patients, and incorporating alternative approaches into holistic case management. A matrix is presented that classifies these modalities according to preparation of the healer and methods of healing. A brief description is provided of various types of alternative healing with some of their potential risks and benefits to health. Suggestions are made regarding selection of a healer and sources of information.

Acupuncture Therapy↗
PubMed1987

An analysis of print and audiovisual materials to prevent smokeless tobacco use.

We analyzed 28 examples of smokeless tobacco educational print and audiovisual materials based on two criteria: (1) strength of the scientific bases for the selected materials, and (2) appropriateness of the materials for the known populations at risk to smokeless tobacco ever-use. We concluded that these materials in general are authoritative and provide the cancer educator with a solid scientific basis to initiate a primary prevention strategy. Nonetheless, some updating of materials to include the latest scientific findings (eg, cardiovascular and physiological/addictive effects) is needed. In terms of appropriateness of materials, we noted that the focus of materials was correctly targeted to young, white males; however, most materials tended to be aimed at seventh grade and beyond reading and social levels. Few, if any, materials were aimed at the other group at risk to smokeless tobacco adoption, namely youth in the early elementary grades. Consequently, while smokeless tobacco educational materials are generally authoritative, the cancer educator must still customize both the selection of materials and the educational approach to populations at risk.

Audiovisual Aids↗
PubMedDate not supplied

[Development of the population size, contribution of foreign breeds, inbreeding and degree of relationships of the entire Hanoverian scenthound population registered in the stud book of the kennel club Hirschmann e.V].

The entire dog population of Hanoveranian Scenthounds registered since the foundation of the kennel club Hirschmann in the year 1894 was analysed for the development of the inbreeding and relationship coefficient and the contribution of Hanoveranian Scenthound population of foreign countries. The analyses were performed using all available pedigree information. In the history, the breeding of the Hanoveranian Scenthound was difficult because of the low number of breeding dogs which was additionally reduced during World War I and II. The mean coefficient of inbreeding of the entire German population was 6.35%. From 1950 to 1990, the mean coefficient of inbreeding increased from 8.3% to 9.7%. In the birth years from 1990 to 2002, the mean coefficient of inbreeding decreased slightly to 9.2%. The rates of inbreeding decreased since 1950. For the last 8 generations the increase of the coefficients of inbreeding per generation was 0.71%. The mean degree of relationship of the entire population was 7.17%, whereby values higher than 75% were found. Gene contributions of 8 other European stud books for the Hanoveranian Scenthound could be found in the German population. Hereby, the Austrian Hanoveranian Scenthounds had the largest impact on the German population with 24.4%. The proportion of genes from the German stud book amounted to 67%.

Animals↗
PubMed2001

Dietary treatment for familial hypercholesterolaemia.

BACKGROUND: Familial hypercholesterolaemia is an inherited disorder characterised by a raised blood cholesterol, the presence of xanthomatosis and premature ischaemic heart disease. The aim of treatment is the reduction of blood LDL cholesterol concentrations in order to reduce the risk of ischaemic heart disease. Current treatment is based on a cholesterol lowering diet alone or in combination with drug therapy. Many of the drugs found to be effective in treating adults with this disease are not licensed for use in children, therefore diet is the main treatment of children with familial hypercholesterolaemia. In addition to the cholesterol-lowering diet, several other dietary interventions have been suggested and consensus has yet to be reached on the most appropriate dietary treatment for children and adults with familial hypercholesterolaemia. OBJECTIVES: To examine the evidence that in children and adults with familial hypercholesterolaemia, a cholesterol lowering diet is more effective at lowering cholesterol and reducing incidence of ischaemic heart disease than no intervention or than other dietary interventions. SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Trials Register, a specialist trials register which comprises references identified from comprehensive electronic database searches, handsearching relevant journals and handsearching abstract books of conference proceedings. Additional studies were identified from handsearching the Journal of Inherited Metabolic Disease (from inception, 1978 to 2000) and from the reference lists of identified studies. SELECTION CRITERIA: Randomised controlled trials (RCTs), both published and unpublished, where a cholesterol lowering diet in children and adults with familial hypercholesterolaemia has been compared to other forms of dietary treatment or to no dietary intervention. Trials which include patients with familial hypercholesterolaemia alongside patients with non-familial hypercholesterolaemia were only included if the group of familial patients was well defined and the results for these patients were available. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed the trial eligibility and methodological quality and one reviewer extracted the data, with independent verification of data extraction by a colleague. MAIN RESULTS: Only short term outcomes could be assessed in this review due to the length of the five eligible studies. Compliance to treatment, quality of life, mortality and evidence of ischaemic or atheromatous disease were not assessed in the studies identified. No differences were found between the cholesterol-lowering diet and all other diets for all of the short term outcomes assessed. REVIEWER'S CONCLUSIONS: No conclusions can be made about the effectiveness of the cholesterol-lowering diet, or any of the other dietary interventions suggested for familial hypercholesterolaemia, due to the lack of adequate data. A large, parallel, randomised controlled trial is needed to investigate the effectiveness of the cholesterol-lowering diet and other dietary interventions for FH. It is also possible that data from trials including subjects with both familial and non-familial hypercholesterolaemia could alter the results of future updates of this review and until further evidence is available current dietary treatment of FH should continue to be observed and monitored with care.

Adult↗
PubMed1995

Comments on "Let there be life; thermodynamic reflections on biogenesis and evolution" by Avshalom C. Elitzur.

This comment is in response to a paper previously published in the Journal entitled "Let there be life", by A. C. Elitzur. Elitzur ascribes to Eigen the proposal that life began with the appearance of an autocatalytic (self-replicating) molecule. This was discussed by biologists and philosophers in the nineteenth century. Eigen's proposal is moot: there never was a primeval soup. The absence of evidence is evidence of absence. Elitzur also confuses thermodynamics with statistical mechanics. The statistical equation of Boltzmann and Planck for entropy appears in discussions of statistical mechanics, not in discussions of classical thermodynamics. Elitzur calls the Second Law of Thermodynamics an explanation of evolution. On the contrary, his mentor Eigen wrote: "In physics we know of principles which cannot be reduced to any more fundamental laws. As axioms, they are abstracted from experience, their predictions being consistent with the consequences that can be subjected to experimental test. "Typical examples are the first and second law of thermodynamics. Darwin's principle of natural selection does not fall into the category of first principles." The reader is invited to compare the material in Elitzur's paper with the discussion in Yockey's (1992) book, Information Theory and Molecular Biology, Cambridge, Cambridge University Press.

Animals↗
PubMed2004

Role of pharmacological aids and social supports in smoking cessation associated with Quebec's 2000 Quit and Win campaign.

BACKGROUND: This evaluation of the 2000 Quit and Win campaign in the province of Quebec, Canada, assessed the use and effectiveness of pharmacological aids, social support, and support resources (clinic program, support groups, books, telephone support) among contest participants. The reach of the contest was 1.3% of adult smokers: 20,400 participants. METHODS: Six months after the contest ended, 3,033 randomly selected participants completed telephone interviews about their smoking status and their use of nonform aids, social support, support resources, and pharmacological aids during their cessation attempt. Those who were abstinent from smoking were then reinterviewed 6 months later, that is, 12 months after the contest. RESULTS: Cessation rates were 66% at contest end, 36% at 6 months, and 22% at 12 months. Heavier smokers were somewhat more likely to have quit. Overall, 41% of respondents used any form of aid (support resources and pharmacological aids) in the first 6 months; among these, 42% used bupropion and 38% used nicotine patches. Those using bupropion were more likely to successfully quit smoking. Successful quitters rated the social support received from their buddy as more useful than did relapsers, and social support was unrelated to the use of pharmacological aids. CONCLUSIONS: The results suggest that adequate investment in population-wide Quit and Win programs that provide a variety of appropriate aids to smokers, including social support and pharmacological products, can improve the reach of smokers.

Adolescent↗
PubMed1992

Electrolyte abnormalities in critically ill children.

OBJECTIVE: To provide a brief overview of the causes, diagnosis, and therapies of electrolyte abnormalities frequently seen in critically ill children. DATA SOURCE: Published articles and bibliographies identified from pertinent review articles and books published in the past 20 yrs on fluid and electrolyte therapy in children. CONSTRAINT: The review includes only human studies and articles published in the English language. STUDY SELECTION: Human studies pertaining to abnormalities of water homeostasis, sodium, potassium, calcium, and magnesium homeostasis in children were selected. Prospective randomized studies were selected as much as possible. DATA EXTRACTION: Pertinent data abstracted from multiple, independent clinical studies were used to develop an approach to electrolyte abnormalities in critically ill children. DATA SYNTHESIS: An approach to diagnosis and therapies of common electrolyte abnormalities in critically ill children. CONCLUSIONS: Electrolyte abnormalities are common in critically ill children and can be easily treated once recognized. Further studies are needed to better understand the role of ionized calcium and magnesium in neonatal and pediatric critical illness.

Calcium↗
PubMed2004

Motor conversion disorders reviewed from a neuropsychiatric perspective.

BACKGROUND: Conversion disorder is a somatoform disorder defined by the presence of pseudoneurologic symptoms relating to voluntary sensory or motor function. The correct diagnosis of conversion disorder presenting with motor symptoms is complicated by the lack of gold-standard diagnostic tests and the absence of a universally accepted set of positive diagnostic criteria. This article reviews the epidemiology, pathophysiology, presentation, differential diagnosis, treatment, and prognosis of motor conversion, placing emphasis on diagnostic validity, reliability, and utility, while evaluating the empirical evidence supporting diagnostic and treatment strategies. DATA SOURCES AND STUDY SELECTION: Literature searches were carried out in PubMed using the keywords conversion disorder, motor conversion, dystonia, psychogenic, hysteria, somatization, motion disorder, movement disorder, and patho-physiology. Articles and book chapters in the author's personal collection were also utilized. CONCLUSIONS: Advances in neuropsychiatric research are leading to significant improvements in the diagnosis and understanding of motor conversion disorders. Positive, objective, and quantitative diagnostic criteria show significant promise for enhancing diagnostic accuracy. Current pathophysiologic research has begun to provide mechanistic explanations for conversion symptoms, thus blurring the distinction between psychogenic and organic motor disorders.

Cerebral Cortex↗
PubMed2001

Invasive disease due to Mucorales: a case report and review of the literature.

OBJECTIVE: To review the mycology, pathogenesis, clinical characteristics, investigations, and treatment modalities of mucormycosis. DATA SOURCES: A local case of mucormycosis; MEDLINE and non-MEDLINE search of the literature. STUDY SELECTION: Key words for the literature search were 'mucormycosis' and 'Mucorales'; all available years of study were reviewed. DATA EXTRACTION: Original articles, review papers, meta-analyses, and relevant book chapters were reviewed. DATA SYNTHESIS: Mucormycosis is a fungal infection that is rare but increasingly recognised in the growing population of immunocompromised patients. It is caused by saprophytic non-septate hyphae of the order Mucorales. The pulmonary and disseminated forms commonly occur in patients with haematological malignancy, especially acute leukaemia and lymphoma, and those receiving treatment with immunosuppressive effects. The rhinocerebral form is more prevalent in patients with diabetes mellitus, particularly those with the complication of diabetic ketoacidosis. The use of amphotericin B combined with surgery remains the mainstay of treatment. The prognosis largely depends on prompt correction of the underlying risk factors. New strategies to combat this life-threatening infection will result from better understanding of its pathogenesis. CONCLUSION: A high index of suspicion is needed, in appropriate clinical settings, to diagnose and aggressively treat this infection in view of the high mortality rate for susceptible patients.

Humans↗
PubMed1992

A critical appraisal of in-patient neurological services in a subregional centre.

A computer database was established for the medical audit of admissions to the North Manchester General Hospital neurology unit. Over a six-month period, 277 patients completed 300 hospital stays. A higher proportion of patients were admitted from the North Manchester District compared with the peripheral districts served by the unit, suggesting that more neurology in these areas was performed by general physicians. This supports claims for an increase in the number of neurologists to improve the quality of service at district level. The introduction of a programmed investigation unit, closed at weekends, would allow financial savings since 60% of cases did not require a bed at the weekend. It would also allow more efficient pre-booking of investigations. The diagnostic yields from routine B12 and folate levels, syphilis serology, thyroid function tests, chest radiography and electrocardiography were low and should be replaced by more selective investigations. Savings might also be made by performing the 38% of myelograms restricted to the lumbar region in the out-patient department. The introduction of out-patient magnetic resonance imaging will make significant savings by obviating the need for many of the inpatient myelograms which were required in 55 patients. The simple and relatively inexpensive technology used in this study provided medical staff with valuable information on which to base changes in practice and evaluate their consequences.

England↗
PubMed1997

Attention modulates auditory pattern memory as indexed by event-related brain potentials.

The role of selective attention on auditory pattern processing was investigated using the mismatch negativity, an event-related brain potential component associated with sensory memory. Participants responded to changes in an alternating tone pattern in a designated ear while a similar auditory pattern was presented in the opposite ear. Participants were also presented with the same sequences while reading a book (no response required). In all conditions, changes in the pattern elicited a mismatch negativity (MMN) that peaked at 160-220 ms poststimulus. MMN amplitude varied with attention: the amplitude was higher in response to deviant stimuli presented in the attended ear than to the deviant stimuli presented in the unattended ear or during reading. The results show that selective attention modulates auditory pattern memory.

Acoustic Stimulation↗
PubMed2001

Aerobic exercise interventions for people with HIV/AIDS.

BACKGROUND: The profile of HIV infection is constantly changing. Although once viewed as an illness progressing to death, HIV infection now presents as a chronic infection characterized by unpredictable cycles of wellness and illness. Thus, the needs of this population have increasingly included management of impairments, disabilities and handicaps. Exercise is a key management strategy employed by rehabilitation professionals to address these issues. Exercise has been shown to improve strength, cardiovascular function, and psychological status in seronegative populations (see Eds., Bouchard, C., Shephard, R.J., & Stephens, T. (1993). Physical Activity, Fitness, and Health. Champaign, IL: Human Kinetics Publishers.) But what are the effects of exercise for people living with HIV infection? If the risks and benefits of exercise for people living with HIV infection are better understood, appropriate exercise prescription may be practiced by health care providers. Improved exercise prescription may enhance the effectiveness of HIV management, thus improving overall outcomes for people living with HIV infection. OBJECTIVES: To examine the effect of aerobic exercise interventions on cardiopulmonary, immunologic and psychological parameters in adults living with HIV infection. SEARCH STRATEGY: Studies were identified using MEDLINE, EMBASE, SCIENCE CITATION INDEX, AIDSLINE CINAHL, HEALTHSTAR, PSYCHLIT, SOCIOFILE, SCI, SSCI, ERIC, DIA and abstracts from international AIDS meetings, ICAAC, and other major meetings. Reference lists from pertinent articles and books and personal contact with authors were also used, as were Collaborative Review Group databases and results of hand searching of targeted journals. All languages were included. Searches covered the period from 1980 to July 1999. SELECTION CRITERIA: For inclusion, studies had to be randomized control trials involving HIV+ adults 18 years of age or older and had to include at least one group randomized to receive aerobic exercise performed at least three times/week for at least four weeks. DATA COLLECTION AND ANALYSIS: Data on study design, participants, interventions, and outcomes were extracted from the reports onto specifically designed data collection forms by at least two reviewers. MAIN RESULTS: Six studies satisfied the eligibility criteria. The main results indicated that performing constant or interval aerobic exercise for at least 20 minutes, at least three times per week for four weeks may lead to increased CD4 count, improved cardiopulmonary fitness, and improved psychological status. These findings are limited to those who continued to exercise and for whom there was adequate follow-up data. REVIEWER'S CONCLUSIONS: Aerobic exercise appears to be safe and may be beneficial for adults living with HIV/AIDS. These findings are limited by the small sample sizes and large drop-out rates of the included studies. Further research is required to determine the optimal parameters of aerobic exercise and stage of disease in which aerobic exercise may be most beneficial for adults living with HIV infection.

CD4 Lymphocyte Count↗
PubMed2004

Phytomedicines (medicines derived from plants) for sickle cell disease.

BACKGROUND: Sickle cell disease (SCD) is a common recessively inherited disorder of haemoglobin affecting peoples originating from sub-Saharan Africa, the Middle East and Mediterranean basin, the Indian subcontinent, the Caribbean and South America. The homozygous state (SS) is associated with complications and a reduced life expectancy. Phytomedicines (medicine derived from plants in their original state) encompass much of what the populations most affected would encounter in terms of plant-remedies from traditional healers. There has been little in the way of systematic appraisal of their benefits. OBJECTIVES: To assess the benefits and risks of phytomedicines in people with SCD of all types, of any age, in any setting. SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders group specialised register of controlled trials of haemoglobinopathies, which comprises references identified from comprehensive electronic database searches, handsearches of relevant journals and abstract books of conference proceedings. We performed an additional search of the bibliographic database of Allied and Complementary Medicine (AMED). Date of most recent search of the trials register: September 2003. SELECTION CRITERIA: All randomised or quasi-randomised trials with participants of all ages with SCD, in all settings, comparing the administration of phytomedicines, by any mode to placebo or standard treatment, including blood transfusion and hydroxyurea. DATA COLLECTION AND ANALYSIS: Both reviewers independently assessed trial quality and extracted data from the study. MAIN RESULTS: Reports of two trials were found, of which only one, including 82 participants, was eligible for inclusion in this review. This Phase IIB (pivotal) study suggests that a phytomedicine, NIPRISAN, was effective in reducing episodes of SCD crisis associated with severe pain over a six-month period. NIPRISAN did not appear to affect the risk of severe complications or the level of anaemia. No serious adverse effects were reported. REVIEWERS' CONCLUSIONS: While NIPRISAN, as a phytomedicine, appeared to be safe and effective, over a six-month follow-up period of this study, in reducing crises associated with severe pain, further studies are required to assess its role in the management of people with sickle cell disease. The results of Phase III, multicentre trials are awaited.

Anemia, Sickle Cell↗
PubMed1994

Adverse effects of nondepolarising neuromuscular blocking agents. Incidence, prevention and management.

Nondepolarising muscle relaxants block neuromuscular transmission, acting as antagonists of the nicotinic receptors at the neuromuscular junction. Their undesired effects are frequently caused by interaction with acetylcholine receptors outside this junction, and autonomic cardiovascular effects may result. Other adverse effects include anaphylactic or anaphylactoid reactions, and histamine release. Various disease states may present specific considerations in the use of nondepolarising muscle relaxants. Although many complications of these drugs (such as prolonged block or resistance) are easily treated, others may necessitate immediate intervention and vigorous therapy. Careful selection of an appropriate relaxant for a particular patient will usually prevent the occurrence of complications.

Anaphylaxis↗
PubMed1992

Vagal reflexes referred from the upper aerodigestive tract: an infrequently recognized cause of common cardiorespiratory responses.

OBJECTIVE: To review the physiologic basis for normal and abnormal vagal reflexes arising from the pharynx, larynx, and esophagus, as well as the relevance of vagal reflexes to the pathogenesis of such clinically common cardiorespiratory responses as bradycardia, tachycardia, dysrhythmia, coronary angiospasm, bronchospasm, laryngospasm, prolonged apnea, and singultus (hiccups). DATA SOURCES: Pertinent articles and reviews were identified through a MEDLINE search (April 1966 to October 1991). Older studies and others not identified in the MEDLINE search were found through a manual search of the bibliographies of the retrieved articles. STUDY SELECTION: Experimental studies in both humans and animals, as well as case series and single case reports, were selected for evaluation and citation. In instances where a similar phenomenon was described in multiple independent reports, only studies that provided a novel finding or interpretation were cited. More authoritative book chapters and peer-reviewed summaries were also cited in support of commonly accepted principles. DATA EXTRACTION AND SYNTHESIS: Most of the clinical data are derived from case reports and small case series and are therefore anecdotal; equal weight was given to all such studies. Reports of conflicting observations or interpretations were clearly identified and were cited without exception. CONCLUSIONS: Stimulation of the upper aerodigestive tract can lead to clinically significant cardiorespiratory responses. Although the prevalence of and risk factors for such responses have not been established, we suggest that a pharyngeal, a laryngeal, or an esophageal source for abnormal cardiorespiratory responses be sought whenever a detailed clinical evaluation fails to reveal a cause, particularly when there are concurrent symptoms or signs of upper aerodigestive tract disease, such as dysphagia or gastroesophageal reflux.

Cardiovascular System↗