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Selected AbstractsEndoscopic Versus Conventional Radial Artery Harvest,Is Smaller Better?JOURNAL OF CARDIAC SURGERY, Issue 4 2006Oz M. Shapira M.D. Methods: Data were prospectively collected on 108 consecutive patients undergoing isolated CABG with ERH, and compared to 120 patients having conventional harvest (CH). Follow-up was achieved in 227 patients (99%). At the time of follow-up the severity of motor and sensory symptoms, as well as cosmetic result in the harvest forearm, were subjectively graded using a 5-point scale. Grade 1,high intensity deficits, poor cosmetic result. Grade 5,no deficits, excellent cosmetic result. Results: Hospital mortality, myocardial infarction, and stroke rates were similar between the groups. Follow-up mortality, reintervention rate, and average angina class were also similar. Harvest time was longer in the ERH group (61 ± 24 min vs. 45 ± 11 min, p < 0.001). Three patients in the ERH group were converted to CH and one radial artery was discarded. There were no vascular complications of the hand in either group. Average score of motor (ERH 4.4 ± 0.9, CH 4.2 ± 1.0) or sensory symptoms (ERH 3.7 ± 1.1, CH 3.8 ± 1.2) were similar. In the CH group sensory deficits were observed in the distribution of both the lateral antebrachial cutaneous and the superficial radial nerves (SRN). In contrast, sensory deficits in the ERH group were limited to the distribution of the SRN. Cosmetic result score was higher in the ERH group (ERH 4.2 ± 1.0, CH 3.1 ± 1.4, p < 0.0001). Conclusions: ERH is safe. It is technically demanding with a significant learning curve. Motor and sensory symptoms are not completely eliminated by using a smaller incision, but cosmetic results are clearly superior. [source] Assessing and Documenting General Competencies in Otolaryngology Resident Training Programs,THE LARYNGOSCOPE, Issue 5 2006Rick M. Roark PhD Abstract Objectives: The objectives of this study were to: 1) implement web-based instruments for assessing and documenting the general competencies of otolaryngology resident education, as outlined by the Accreditation Council of Graduate Medical Education (ACGME); and 2) examine the benefit and validity of this online system for measuring educational outcomes and for identifying insufficiencies in the training program as they occur. Methods: We developed an online assessment system for a surgical postgraduate education program and examined its feasibility, usability, and validity. Evaluations of behaviors, skills, and attitudes of 26 residents were completed online by faculty, peers, and nonphysician professionals during a 3-year period. Analyses included calculation and evaluation of total average performance scores of each resident by different evaluators. Evaluations were also compared with American Board of Otolaryngology-administered in-service examination (ISE) scores for each resident. Convergent validity was examined statistically by comparing ratings among the different evaluator types. Results: Questionnaires and software were found to be simple to use and efficient in collecting essential information. From July 2002 to June 2005, 1,336 evaluation forms were available for analysis. The average score assigned by faculty was 4.31, significantly lower than that by nonphysician professionals (4.66) and residents evaluating peers (4.63) (P < .001), whereas scores were similar between nonphysician professionals and resident peers. Average scores between faculty and nonphysician groups showed correlation in constructs of communication and relationship with patients, but not in those of professionalism and documentation. Correlation was observed in respect for patients but not in medical knowledge between faculty and resident peer groups. Resident ISE scores improved in the third year of the study and demonstrated high correlation with faculty perceptions of medical knowledge (r = 0.65, P = .007). Conclusions: Compliance for completion of forms was 97%. The system facilitated the educational management of our training program along multiple dimensions. The small perceptual differences among a highly selected group of residents have made the unambiguous validation of the system challenging. The instruments and approach warrant further study. Improvements are likely best achieved in broad consultation among other otolaryngology programs. [source] Withdrawal symptoms in abstinent methamphetamine-dependent subjectsADDICTION, Issue 10 2010Todd Zorick ABSTRACT Aims Withdrawal symptoms have been linked to a propensity for relapse to drug abuse. Inasmuch as this association applies to methamphetamine (MA) abuse, an understanding of the course of MA withdrawal symptoms may help to direct treatment for MA dependence. Previous studies of symptoms manifested during abstinence from MA have been limited in size and scope. We asked (i) whether debilitating psychological and/or physical symptoms appear during the first several weeks of MA abstinence, (ii) how craving for MA evolves and (iii) whether psychiatric symptoms (e.g. depression, psychosis) persist beyond a month of abstinence. Design A study of MA-dependent participants, who initiated and maintained abstinence from the drug for up to 5 weeks, compared to a matched healthy comparison group. Setting In-patient research hospital ward (MA-dependent subjects) and out-patient (comparison subjects). Participants Fifty-six MA-dependent and eighty-nine comparison subjects. Measurements Rater-assessed MA withdrawal questionnaire and self-report assessment of craving (MA-dependent subjects) and self-report assessment of psychiatric symptoms (both groups). Findings At study entry, MA-dependent subjects exhibited a wide range in severity of depressive symptoms, with the average score at a mild,moderate level of severity. Symptoms of psychosis were also prevalent. While depressive and psychotic symptoms largely resolved within a week of abstinence, craving did not decrease significantly from the time of initiating abstinence until the second week, and then continued at a reduced level to the fifth week. Conclusions Depressive and psychotic symptoms accompany acute withdrawal from methamphetamine but resolve within 1 week. Craving is also present and lasts at least 5 weeks. [source] Assessing the effects of hydromorphological degradation on macroinvertebrate indicators in rivers: examples, constraints, and outlookINTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 1 2009Nikolai Friberg Abstract An extensive amount of literature on linkages between the in-stream physical environment and river benthic macroinvertebrates reports a number of relationships across multiple spatial scales. We analyzed data on different spatial scales to elucidate the linkages between different measurements of hydromorphological degradation and commonly used macroinvertebrate indices. A regression analysis of 1049 sites from 3 countries revealed that the strongest relationship between a biotic metric,average score per taxon,and physiochemical variables (R2 = 0.61) was obtained with a multiple regression model that included concentration of total phosphorus and percent arable land in the catchment, as well as hydromorphological quality variables. Analyses of 3 data sets from streams primarily affected by hydromorphological degradation showed an overall weak relationship (max R2 = 0.25) with the River Habitat Survey data of 28 Swedish streams, whereas moderate (R2 , 0.43) relationships with more detailed measurements of morphology were found in 2 Danish studies (39 and 6 streams, respectively). Although evidence exists in the literature on the importance of physical features for in-stream biota in general and macroinvertebrates specifically, we found only relatively weak relationships between various measures of hydromorphological stress and commonly used macroinvertebrate assessment tools. We attribute this to a combination of factors, including 1) the mixed nature of pressures acting on the majority of river reaches, 2) scaling issues (spatial and temporal) when relating habitat surveys to macroinvertebrate assessments, and 3) the scope of commonly used macroinvertebrate assessment systems (mainly focusing on water chemistry perturbation, such as eutrophication and acidification). The need is urgent to develop refined and updated biological assessment systems targeting hydromorphological stress for the use of the European Water Framework Directive (WFD) and national water-related policies. [source] The relationship between work empowerment and work stress perceived by nurses at long-term care facilities in Taipei cityJOURNAL OF CLINICAL NURSING, Issue 22 2008I-Chuan Li Aim., To explore the relationships between work empowerment, including both structural and psychological empowerment and work stress among nurses at long-term care facilities in Taiwan. Design., Cross-sectional design with a descriptive correlation. Methods., Work empowerment includes both psychological and structural empowerment; 178 nurses participated in the study. Results., The results of this study showed that the average age of the subjects was 35·5 years and that 56·2% of subjects had less than two years work experience in the facility. The results indicated that there was a moderate level of psychological empowerment (mean 59·9, SD 8·1) and structural empowerment (mean 59·2, SD 11·1). A moderate level of work stress was also found with an average score of 72·3 (SD 14·4). Both psychological empowerment and structural empowerment were found to be significantly associated with total work stress (r = ,0·4, r = ,0·5, p < 0·001, respectively). The variables of age (standardised , = ,0·1), resources (standardised , = ,1·6), meaningful work (standardised , = ,0·4) and impact (standardised , = ,1·3) were significant predictors of work stress (R2 = 0·32, F = 17·3, p<0·001). Conclusion., Both psychological empowerment and structural empowerment were found to be significantly associated with work stress among nurses in this study. The four significant predictors of job satisfaction were age, resources, meaningful work and impact. Relevance to clinical practice., The managers of the facilities should provide available resources for nurses to accomplish work and to involve nurses in the development goals of the facilities to enhance their influence in the making of important changes within the organisation to decrease their work stress. [source] Effect of an interactive computerized psycho-education system on patients suffering from depressionJOURNAL OF CLINICAL NURSING, Issue 5 2008MPsychN, Mei-Feng Lin PhD Aims., The aim of this study was to examine the effect of an Interactive Computerized Psycho-Education System on patients suffering from depression and to compare the use of an Interactive Computerized Psycho-Education System vs. traditional pamphlet education approach. Background., Depression management depends on pharmacological treatment and psychotherapy and on appropriate and timely patient education. Whilst multimedia learning concepts have been applied in areas such as education, this approach has not been widely used in psychiatric outpatient departments. Design and method., A preliminary pre and post quasi-experimental design with patients with depression was employed at an hospital. Participants in the experimental group (n = 19) received an Interactive Computerized Psycho-Education System intervention programme (Interactive Computerized Psycho-Education System and the educational manual). Participants in the control group (n = 13) were exposed only to the traditional pamphlet education approach (consultation from psychiatrists and information sheets). Primary outcome was depression knowledge scores. Secondary outcomes were scores on the Compliance Behaviour Assessment Scale. Results., In the experimental group (n = 19), the time spent working on the Interactive Computerized Psycho-Education System was about 30,180 minutes per session, with an average of 67 minutes. Participants in the experimental group had a considerably decreased incidence of medication non-compliance compared with participants in the control group. Knowledge scores of the experimental group ranged from 30,100, with an average score of 74.7. Conclusion., The Interactive Computerized Psycho-Education System is acceptable and may be as more effective than a traditional education approach to achieve adherence to medications for depression. Relevance to clinical practice., Compared with a traditional approach, the combination of the Interactive Computerized Psycho-Education System and a nursing-consulting clinic may assist patients with depression to achieve and maintain better medication compliance in addition to improving their knowledge of depression. [source] Cosmetic use of polylactic acid: report of 568 patientsJOURNAL OF COSMETIC DERMATOLOGY, Issue 4 2009Alessio Redaelli MD Summary Background, There are few methods for the correction of the reduction of subcutaneous volumes. Polylactic acid is a new material with which we can achieve interesting results. Objective, To review our case histories in the assessment of this material's safety and effectiveness, its best indications, and to outline our technique. Materials and Method, Polylactic acid was prepared and diluted with 5,8 mL depending on injection sites, which included patients' face, neck and hands volume restoration, as well as arm and thigh revitalization. A total of 568 patients were treated from January 1999 to December 2007. Results, The Definitive Graduated Score varied from 6.3 to 8.4 with an average score of 7.8. The principal side effect, collagen late nodules, appeared with a very low frequency (1%) and were the result of incorrect technique. Conclusions, The fibro-connective restoration of face contours and volumes is the winning strategy for a holistic, three-dimensional approach to the aged face, neck, and hands. Since the introduction of certified courses, side effects have become less common than in other methods, and can probably be further reduced to a minimum. [source] Saline Irrigation in the Prevention of Otorrhea After Tympanostomy Tube Placement,THE LARYNGOSCOPE, Issue 2 2000Rick D. Gross MD Abstract Objectives: Comparison of intraoperative saline irrigation to otic drops in the prevention of postoperative otorrhea in children with middle ear effusion undergoing bilateral myringotomy with ventilation tubes. Study Design: This study was designed as a blinded, controlled, prospectively randomized trial. Methods: Study children were randomly assigned to receive either otic drops for 3 days postoperatively or saline irrigation of the middle ear space at the time of myringotomy. Only children with effusion present at the time of surgery were included. All children were evaluated for drainage 7 to 14 days postoperatively, and the degree of drainage was graded from 0 to 4. Results: Of the 84 patients entered into the study, 62 patients were eligible for data analysis (16 failed follow-up, 6 records were lost). Of the patients who completed the study, not all had bilateral effusions, resulting in 111 ears for inclusion in the study. Fifty-two ears underwent irrigation, and 10 were noted to have otorrhea (19.2%). Fifty-nine ears received otic drops, resulting in 21 ears with otorrhea (35.6%). Evaluating the degree of otorrhea with a five-point Leichert scale, the average score per ear was 0.42 for the saline irrigation group and 1.07 for the control group. The rate and degree of drainage were both statistically reduced in the saline irrigation group (P < .05). Conclusions: Using middle ear irrigation at the time of tympanostomy may be more effective than antibiotic drops in preventing postoperative otorrhea. [source] Dysplastic naevi with moderate to severe histological dysplasia: a risk factor for melanomaBRITISH JOURNAL OF DERMATOLOGY, Issue 5 2006A.R. Shors Summary Background, The risk of malignant melanoma associated with histologically dysplastic naevi (HDN) has not been defined. While clinically atypical naevi appear to confer an independent risk of melanoma, no study has evaluated the extent to which HDN are predictive of melanoma. Objectives, To estimate the risk of melanoma associated with HDN. Secondarily, the risk associated with number of naevi and large naevi is estimated. Methods, We enrolled 80 patients with newly diagnosed melanoma along with 80 spousal controls. After obtaining information on melanoma risk factors and performing a complete cutaneous examination, the most clinically atypical naevus was biopsied in both cases and controls. Histological dysplasia was then assessed independently by 13 dermatopathologists (0, no dysplasia; 1, mild dysplasia; 2, moderate dysplasia; 3, severe dysplasia). The dermatopathologists were blinded as to whether the naevi were from melanoma subjects or controls. Multivariate analyses were performed to determine if there was an independent association between the degree of histological dysplasia in naevi and a personal history of melanoma. Results, In persons with naevi receiving an average score of > 1 (i.e. naevi considered to have greater than mild histological dysplasia), there was an increased risk of melanoma [odds ratio (OR) 2·60, 95% confidence interval (CI) 0·99,6·86] which persisted after adjustment for confounders (OR 3·99, 95% CI 1·02,15·71). Very few dermatopathologists reliably graded naevi of subjects with melanoma as being more dysplastic than naevi of control subjects. Among the entire group, the interobserver reliability associated with grading histological dysplasia in naevi was poor (weighted kappa 0·28). Conclusions, HDN do appear to confer an independent risk of melanoma. However, this result may add more to our biological understanding of melanoma risk than to clinical assessment of risk, because HDN assessed by a single pathologist generally cannot be used to assess risk of melanoma. Future studies should be directed at establishing reproducible, predictive criteria for grading naevi. [source] Searching for a developmental typology of personality and its relations to antisocial behaviour: a longitudinal study of an adjudicated men sampleCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2003Julien Morizot The search for an empirically based personality typology has regained the interest of researchers. To date, however, empirical inquiries have mainly been cross-sectional. In this study, an empirically based developmental typology of personality was identified using data from a prospective longitudinal study of a sample of men adjudicated during their adolescence and assessed on four occasions until midlife. Cluster analyses were performed on measures of disinhibition, negative emotionality, and extraversion. Four developmental types of personality were identified. The first was characterized by average scores in the three traits in adolescence that decreased linearly until midlife (39%). The second type displayed very high scores in disinhibition and negative emotionality in adolescence that decreased rapidly during early adulthood (24%). The third type was characterized by very high scores in disinhibition and negative emotionality that remained stable until midlife, while extraversion was average during adolescence and then decreased rapidly until midlife (17%). The fourth type was characterized by high scores in disinhibition and negative emotionality in adolescence that was followed by cycles of decreases and increases until midlife (20%). These four developmental types of personality seemed to be related to known antisocial behaviour trajectories. Copyright © 2003 Whurr Publishers Ltd. [source] Gender ratios for reading difficultiesDYSLEXIA, Issue 3 2009Jesse L. Hawke Abstract The prevalence of reading difficulties is typically higher in males than females in both referred and research-identified samples, and the ratio of males to females is greater in more affected samples. To explore possible gender differences in reading performance, we analysed data from 1133 twin pairs in which at least one member of each pair had a school history of reading problems and from 684 twin pairs from a comparison sample with no reading difficulties. Although the difference between the average scores of males and females in these two samples was very small, the variance of reading performance was significantly greater for males in both groups. We suggest that a greater variance of reading performance measures in males may account at least in part for their higher prevalence of reading difficulties as well as for the higher gender ratios that are observed in more severely impaired samples. Copyright © 2009 John Wiley & Sons, Ltd. [source] Latest news and product developmentsPRESCRIBER, Issue 17 2007Article first published online: 6 NOV 200 Drug information stilllacking for mentally ill Half of people with mental illness still have no say in the medication they are prescribed and one-third are not informed about side-effects, according to the latest report by the Healthcare Commission and the Commission for Social Care Inspection (www.health-carecommission.org.uk). The annual national review of adult mental health services found overall improvement among local intervention teams in 2005/06 compared with the preceding year, though all could improve further and the performance of 46 per cent were rated as only fair or weak. A survey of 7446 people with schizophrenia also showed that only 46 per cent had access to psychological treatments. More incentives for shift of care in Scotland Scotland has made good progress on shifting NHS care into the community but joined-up thinking, better information and incentives are needed to overcome barriers to better management of long-term conditions in adults, says Audit Scotland (www.audit-scotland.gov.uk). Reviewing progress on the 2005 strategy document Delivering for Health, Audit Scotland found good progress on asthma and diabetes services , partly due to the effects of the GMS contract. Better information about clinical activity, costs and effectiveness is needed to help redesign services. Patients with more than one long-term condition do not receive co-ordinated care and many want greater involvement in their care, the report concluded. Acorn, QOF and Guy Rotherham awards Entries are invited for the 2007 annual Acorn, QOF and Guy Rotherham Awards. The awards are run in association with the NHS Alliance, Improvement Foundation, British Cardiac Society, British Cardiac Patients Society and Prescriber. The CHD QOF Award, sponsored by Schering-Plough, recognises the achievement of an individual practice that gains maximum points in the CHD and heart failure QOF domains, and a second award is given to the primary care organisation (PCO) that achieves the best average scores across its practices. The entry form can be found at www.escriber.com. The closing date is 12 October. Entries are also invited for the Guy Rotherham Award from PCOs that can demonstrate they have delivered a high-impact change resulting in better outcomes and services for patients. For online entry go to www.improvementfoundation.org/guy rotherhamaward. Closing date is 5 October. Award winners will receive free entry for three to the NHS Alliance conference and the conference dinner. The winner of the Guy Rotherham Award will also receive £3000. NICE scores five out of six NICE acted unreasonably in relying solely on the Mini-Mental State Examination (MMSE) to define severity of Alzheimer's disease in its updated technology appraisals, with the effect of discriminating against people with learning or language difficulties, the High Court has ruled. The five other claims by Eisai that NICE acted unreasonably and irrationally were not upheld. This was the first court action against NICE in its eight-year history. It has now promised to publish revised appraisals on its website on 7 September and is consulting with Eisai, Shire Pharmaceuticals and the Alzheimer's Society on the best approach. PPRS reform follows Office of Fair Trading report The Government is to renegotiate the Pharmaceutical Price Regulation Scheme (PPRS) following the critical report by the Office of Fair Trading (OFT). In February, the OFT recommended renegotiation of the PPRS to reward innovation and obtain better value for patients. In particular, it called for a pricing scheme based on value for patients, ie effectiveness, rather than profit controls. The DoH, acknowledging the report's complexity, says it will take four principles into account in its negotiations during the forthcoming months: value for money, promoting innovation, assisting the uptake of new cost-effective medicines and promoting market stability. MHRA launches e-bulletin The MHRA (www.mhra.gov.uk) has next issue can be downloaded. The launched an electronic bulletin to August bulletin includes items on provide health professionals with antidepressants and suicide, updates about the safe use of medi-adverse effects of dopamine ago-cines. Users need to sign up to nists and information about smokreceive an e-mail alert when the ing cessation and isotretinoin. DURG call for abstracts The Drug Utilisation Research Group is calling for abstracts for its 19th annual meeting ,Target-driven medicine , is this the end of prescribing freedom?' to be held on 7 February 2008 at the Royal Society of Medicine, London. Abstracts are requested on any aspects of drug utilisation research. A bursary of £500 will be awarded for the best abstract received. The closing date for receipt of abstracts is 26 November. Further information about abstract submission is available at www.durg.org.uk. GP prescribing up by half Prescription volume and costs in England increased by approximately half over the decade to 2006, according to data published by the Information Centre for Health and Social Care (www.ic.nhs.uk). The number of items dispensed per year increased by 55 per cent and the cost by 60 per cent in real terms. The average number of items per head of population was 10.0 in 1996 and 14.8 in 2006; older people received 21.2 items per head in 1996 but 40.8 in 2006. MR morphines similar Modified-release preparations of morphine are equivalent in the treatment of severe pain, according to a new review by Bandolier (www.jr2.ox.ac.uk). The analysis of 54 randomised trials, which reviewed the release mechanisms and clinical data for four brands, showed these preparations provide effective analgesia for malignant and nonmalignant pain; about 4 per cent of patients were unable to tolerate the adverse effects of morphine. NSAIDs compared in OA Etoricoxib (Arcoxia) and naproxen are equally effective in the long-term treatment of osteoarthritis (Ann Rheum Dis 2007;66:945,51). Extension studies for two one-year trials showed that, after a total of 138 weeks, the two drugs had almost identical effects on pain and function assessments. All treatments were generally well tolerated, but serious cardiovascular effects were more common with etoricoxib and serious GI effects more common with naproxen. CPN nystatin allowed Community practitioner nurses (CPNs) may now prescribe oral nystatin (Nystan) to treat oral thrush in neonates, following a special amendment to the regulations limiting their prescribing to licensed indications. CPNs may now prescribe oral nystatin at the dose recommended in the BNF for Children provided they are sure of the diagnosis. In doing so, they accept clinical and medicolegal responsibility for their actions. There are no other exceptions to the prohibition of off-label prescribing. Copyright © 2007 Wiley Interface Ltd [source] SCHOOL CHOICE AND STUDENT SORTING: EVIDENCE FROM ADACHI WARD IN JAPAN,THE JAPANESE ECONOMIC REVIEW, Issue 4 2009ATSUSHI YOSHIDA We examine whether the school choice programme of public junior high schools in Adachi ward has caused student sorting and has thus increased the differences in scores between the schools. We find that students are sorted in the sense that the students living in the school attendance areas where there is a higher proportion of high-status occupations are more likely to select private schools even after the introduction of the school choice programme, or they select public schools with higher scores. Adachi's average scores relative to the Tokyo average have improved, while the between school differences in scores have not expanded. [source] Using Screen-Based Simulation to Improve Performance During Pediatric ResuscitationACADEMIC EMERGENCY MEDICINE, Issue 2009Kevin J. Biese MD Abstract Objectives:, To assess the ability of a screen-based simulation-training program to improve emergency medicine and pediatric resident performance in critical pediatric resuscitation knowledge, confidence, and skills. Methods:, A pre,post, interventional design was used. Three measures of performance were created and assessed before and after intervention: a written pre-course knowledge examination, a self,efficacy confidence score, and a skills-based high-fidelity simulation code scenario. For the high-fidelity skills assessment, independent physician raters recorded and reviewed subject performance. The intervention consisted of eight screen-based pediatric resuscitation scenarios that subjects had 4 weeks to complete. Upon completion of the scenarios, all three measures were repeated. For the confidence assessment, summary pre- and post-test summary confidence scores were compared using a t-test, and for the skills assessment, pre-scores were compared with post-test measures for each individual using McNemar's chi-square test for paired samples. Results:, Twenty-six of 35 (71.3%) enrolled subjects completed the institutional review board,approved study. Increases were observed in written test scores, confidence, and some critical interventions in high-fidelity simulation. The mean improvement in cumulative confidence scores for all residents was 10.1 (SD ±4.9; range 0,19; p < 0.001), with no resident feeling less confident after the intervention. Although overall performance in simulated codes did not change significantly, with average scores of 6.65 (±1.76) to 7.04 (±1.37) out of 9 possible points (p = 0.58), improvement was seen in the administering of appropriate amounts of IV fluids (59,89%, p = 0.03). Conclusions:, In this study, improvements in resident knowledge, confidence, and performance of certain skills in simulated pediatric cardiac arrest scenarios suggest that screen-based simulations may be an effective way to enhance resuscitation skills of pediatric providers. These results should be confirmed using a randomized design with an appropriate control group. [source] EFFECTS OF THE NOVEL SYMBIOTIC IMMUBALANCE AS A FOOD SUPPLEMENT IN RELIEVING CLINICAL SYMPTOMS OF JAPNESE CEDAR POLLINOSIS: A PILOT STUDYCLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 2007Yukio Otsuka SUMMARY 1Probiotics have been suggested to have potential for treating food allergy in small children. Although oral probiotics have been studied extensively in animals and humans for various allergies, their effects on the prevention and/or treatment of pollinosis have not been adequately investigated. 2The aim of the present study was to examine the effects of the novel symbiotic food supplement ImmuBalance (a koji fungus (Aspergillus oryzae) and lactic acid bacteria (Pediococcus parvulus and Enterococcus faecium) soybean fermentation product; Nichimo Co. Ltd, Tokyo, Japan) on the prevention and treatment of allergic reactions in Japanese cedar pollinosis (JCP) during the pollen season. 3An open-label pilot study on seven individuals with JCP was conducted. Each participant received oral administration of 1.0,2.0 g ImmuBalance daily for 3 months, which contained 1.8 ¥ 1010/g heat-killed lactobacteria. Six participants (four men, two women; 26,55 years of age) completed the 3 months of supplementation. One participant was excluded from the study because the JCP-specific IgE in RAST scores was lower than 2 UA/mL. The clinical severity of JCP in past year for each participant was self-evaluated on a five-point scale from 0 to 4, in accordance with the guidelines of the Nasal Allergy Clinic 2002, Japan. 4Self-evaluated overall average symptom scores (1.7 ± 0.8) in the peak pollen season showed significant improvement compared with the past year (3.5 ± 0.5; P = 0.001). Furthermore, the average scores for sneezing and runny nose in the peak pollen season showed significant improvement compared with the past year. The scores for swelling and colour of the mucosa and snivel in the nasal cavity did not increase significantly in the peak pollen season compared with baseline. 5Our studies suggest that dietary ImmuBalance may be effective in the prevention and treatment of JCP. The underlying mechanisms of action and the possibility of a randomized, placebo-controlled trial are being investigated. [source] | |||||||||||||