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Little Scientific Evidence (little + scientific_evidence)
Selected AbstractsAssociation of type of sport and performance level with anatomical site of orthopaedic injury diagnosisEQUINE VETERINARY JOURNAL, Issue S36 2006R. C. MURRAY Summary Reason for performing study: Although anecdotal reports of increased orthopaedic injury risk in equine sports exist, there is little scientific evidence to support this. Objectives: To test whether horses undertaking a single competitive sport have increased risk of specific injuries compared to those used for general purpose riding (GP); and whether injury type varies with sport category and performance level. Methods: Data from 1069 records of horses undergoing orthopaedic evaluation (1998,2003) and meeting inclusion criteria were reviewed. Sport category (GP, showjumping, dressage, eventing, racing), level (nonelite or elite) and diagnosis were recorded. Effects of sport category and level on probability of a specific diagnosis were assessed using chisquared tests. Logistic regression was used to determine which competitive sports and levels increased risk of injury compared with GP. Results: Overall there was a significant effect of sport category and level on diagnosis (P<0.0001). There was significant difference between anatomical site injured and sport category (P<0.0001); a high risk of forelimb superficial digital flexor tendon injury in elite eventing (P<0.0001) and elite showjumping (P=0.02); distal deep digital flexor tendon (DDFT) injury in elite showjumping (P=0.002); and hindlimb suspensory ligament injury in elite (P<0.0001) and nonelite (P=0.001) dressage. There was a low risk of tarsal injury in elite eventing (P=0.01) and proximal DDFT injury in dressage (P = 0.01). Conclusions: Horses competing in different sports are predisposed to specific injuries; particular sports may increase the risk of injury at certain anatomical sites; and the type and site of injury may reflect the type and level of performance. Potential relevance: These findings could guide clinicians in the diagnosis of sport related injuries. [source] Clinical audit of the effects of low-fibre diet on irritable bowel syndromeJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2000J. T. Woolner Introduction High-fibre diets are frequently advocated for the treatment of irritable bowel syndrome (IBS) although there is little scientific evidence to support this. Experience of patients on low-fibre diets suggests that this may be an effective treatment for IBS, warranting investigation. Methods Symptoms were recorded for 204 IBS patients presenting in the gastroenterology clinic. They were then advised on a low-fibre diet with bulking agents as appropriate. Symptoms were reassessed by postal questionnaire 4 weeks later. Patients who had improved on the diet were advised on the gradual reintroduction of different types of fibre to determine the quantity and type of fibre tolerated by the individual. Results Seventy-four per cent of questionnaires were returned. A significant improvement (60,100% improvement in overall well-being) was recorded by 49% of patients. Conclusion This preliminary study suggests that low-fibre diets may be an effective treatment for some IBS patients and justifies further investigation as a full clinical trial. [source] Acute liver failure induced by green tea extracts: Case report and review of the literatureLIVER TRANSPLANTATION, Issue 12 2006Michele Molinari In industrialized countries, over-the-counter dietary supplements have become popular in preventing and treating an expanding list of medical conditions. Although most commercially available supplements have not been rigorously tested for safety and efficacy, they have found an enlarging market because they are considered natural. Oral supplements containing green tea extract have been marketed as effective for weight loss and to prevent and cure some solid tumors. Although there is little scientific evidence of the effectiveness of green tea extracts to improve the quality of health of regular consumers, there is an increasing body of medical literature supporting the hypothesis that they can cause serious side effects. Our experience adds to previous reports of acute liver toxicity observed in individuals consuming supplements containing green tea extract. We highlight the importance of obtaining a detailed history of dietary supplement consumption when evaluating a patient presenting with acute liver dysfunction. Liver Transpl 12:1892,1895, 2006. © 2006 AASLD. [source] Flaws in the U.S. Food and Drug Administration's Rationale for Supporting the Development and Approval of BiDil as a Treatment for Heart Failure Only in Black PatientsTHE JOURNAL OF LAW, MEDICINE & ETHICS, Issue 3 2008George T. H. Ellison The U.S. Food and Drug Administration's (FDA) rationale for supporting the development and approval of BiDil (a combination of hydralazine hydrochloride and isosorbide dinitrate; H-I) for heart failure specifically in black patients was based on under-powered, post hoc subgroup analyses of two relatively old trials (V-HeFT I and II), which were further complicated by substantial covariate imbalances between racial groups. Indeed, the only statistically significant difference observed between black and white patients was found without any adjustment for potential confounders in samples that were unlikely to have been adequately randomized. Meanwhile, because the accepted baseline therapy for heart failure has substantially improved since these trials took place, their results cannot be combined with data from the more recent trial (A-HeFT) amongst black patients alone. There is therefore little scientific evidence to support the approval of BiDil only for use in black patients, and the FDA's rationale fails to consider the ethical consequences of recognizing racial categories as valid markers of innate biological difference, and permitting the development of group-specific therapies that are subject to commercial incentives rather than scientific evidence or therapeutic imperatives. This paper reviews the limitations in the scientific evidence used to support the approval of BiDil only for use in black patients; calls for further analysis of the V-HeFT I and II data which might clarify whether responses to H-I vary by race; and evaluates the consequences of commercial incentives to develop racialized medicines. We recommend that the FDA revise the procedures they use to examine applications for race-based therapies to ensure that these are based on robust scientific claims and do not undermine the aims of the 1992 Revitalization Act. [source] |