Sciences University (science + university)

Distribution by Scientific Domains

Selected Abstracts

Does food allergy cause atopic dermatitis?

Food challenge testing to dissociate eczematous from immediate reactions
ABSTRACT:, The objective is to evaluate and diagnose, in a controlled setting, suspected food allergy causation in patients hospitalized for management of severe, unremitting atopic dermatitis (AD). Nineteen children were hospitalized at Oregon Health and Science University with atopic dermatitis from 1986 to 2003 for food restriction, then challenge, following standard recommendations. Challenges were prioritized by categories of (a) critical foods (e.g., milk, wheat, egg, soy); (b) important foods; and (c) other suspected foods. Patients were closely observed for evidence of pruritus, eczematous responses, or IgE-mediated reactions. If results were inconsistent, double-blind, placebo-controlled food challenge was performed. A total of 17 children with atopic dermatitis were assessed. Two could not be fully evaluated, thus were excluded from data tabulations. Only one positive eczematous food response was observed of 58 challenges. Three children had well-documented histories of food-induced IgE-mediated anaphylactoid or urticaria reactions to seafood and/or nuts and were not challenged with those foods. Atopic dermatitis, even in the highest-risk patients, is rarely induced by foods. Undocumented assumptions of food causation detract from proper anti-inflammatory management and should be discouraged. Immediate IgE-mediated food reactions are common in atopic dermatitis patients; such reactions are rapid onset, typically detected outside the clinic, and must be distinguished from eczematous reactions. Diagnosis of food-induced eczema cannot be made without food challenge testing. Such tests can be practical and useful for dispelling unrealistic assumptions about food allergy causation of atopic dermatitis. [source]

Goat milk acceptance and promotion methods in Japan: The questionnaire survey to middle class households

Takeyuki OZAWA
ABSTRACT A consumer questionnaire conducted with the purpose of ascertaining the acceptability of goat milk and related products in Japan was carried out on 345 guarantees of Nippon Veterinary and Life Science University in December 2006. 275 effective responses (79%) representing middle class urban households were returned. The results revealed that (1) 30% of respondents have experienced drinking goat milk and only 10% are aware of the current retail situation of goat milk and related products; (2) over 70% of goat milk drinkers raised goats by hand at some point in their past and their first experience drinking goat milk was in infancy; (3) those with experience in drinking goat milk expressed a vague evaluation and minimal understanding of drinking goat milk; (4) respondents who were inexperienced goat milk drinkers expressed a strong desire to taste and a weak desire to purchase goat milk; (5) respondents expressed low recognition regarding retailed goat milk products, but those who had already purchased goat milk products expressed a high evaluation and strong desire to purchase these products again; and (6) recognition of goat milk characteristics is low, but those with high recognition also rate goat milk highly. Goats are perceived as being ,mild and familiar.' It is necessary for those who manage goat husbandry to present goat milk and related product tasting opportunities to consumers. The key point is to make the functional differences between cow and goat milk clear and present the advantages of goat milk at the fore of this promotion. Goat milk should not be promoted merely as a drink that is similar to cow milk, but must be positioned as a functional drink or health food in order to expand the Japanese goat milk market. [source]

The Emergency Informatics Transition Course: A Flexible, Online Course in Health Informatics for Emergency Medicine Clinicians and Trainees

Michael Wadman
Increasing emphasis on health information technology (HIT) as a mechanism to control costs and increase quality in health care is accelerating the diffusion of more advanced health information systems into emergency medicine. This has created an increased demand for informatics-trained emergency physicians to provide clinical input. In response to this need we partnered with the American College of Emergency Physicians (ACEP) to adapt an existing informatics educational program to emergency medicine. The American Medical Informatics Association (AMIA) 10X10 program is an effort to provide formal informatics training to 10,000 clinicians by 2010. Our first AMIA-ACEP 10X10 Emergency Informatics Transition Course matriculated 37 emergency physicians this fall. This 12 week online course is an adaption of the Oregon Health & Science University (OHSU) introductory informatics 10X10 course where students complete weekly assignments and participate in online discussions. At the end of the course they meet face-to-face at the ACEP Scientific Assembly where they present their projects and discuss common themes. The online design of the course proved adaptable for a widely varied enrollment. The first class contained students from the United States and four other countries, both large urban and small rural hospitals, and both new and experienced clinicians. Extensive input from the students will assist us in further refining this annual course to better meet the needs of emergency clinicians. We will demonstrate the design of this course, which we believe offers interested residents and fellows in emergency medicine a flexible opportunity to advance their informatics training. [source]

The spectrum of barriers to and facilitators of research utilization in Iranian nursing

Neda Mehrdad MSN
Aim., The focus of the study is the identification of barriers to and facilitators of research utilization in nursing practice from the perspective of Iranian nurses. Background., In Iran, research utilization is a new phenomenon thus our knowledge with regard to those factors that promote or discourage research use is limited. No overall picture of the state of research utilization in Iran therefore exists. Method., A descriptive design is used. The questionnaire was distributed to 410 nurses from educational hospitals and nursing schools affiliated with Tehran Medical Sciences University in Iran. Results., The major barriers to research utilization were that the nurses do not have time to read research; facilities are inadequate for implementation; and nurses do not feel they have enough authority to change patient care procedures. Findings revealed a number of facilitators which were categorised into two main groups of human resources and individual/organisational factors. Conclusion., The healthcare system in Iran does not provide the incentive for nurses to engage in research or to avail themselves of research findings. Also, time is the major issue owing to a nursing shortage. If research utilization is to increase in Iran, therefore, the most important organisational change that needs to occur is the provision of available facilities for nurses to use research evidence. Relevance to clinical practice., Key factors that need attention in implementing research results into practice are suggested. Clearly, identification of barriers and facilitators is useful potentially to overcome barriers and enforce facilitators and this could ultimately improve nursing practice. [source]

Chronic myelogenous leukaemia , new therapeutic principles

Michael E. O'Dwyer
O'Dwyer ME, Druker BJ (Oregon Health Sciences University, Portland, USA). Chronic myelogenous leukaemia , new therapeutic principles. J. Intern Med 2001; 250: 3,9 The deregulated tyrosine kinase activity of the BCR-ABL fusion protein is the cause of malignant transformation in almost all cases of chronic myelogenous leukaemia (CML), making BCR-ABL an ideal target for pharmacological inhibition. Signal transduction inhibitor (STI571) (formerly CGP57 148B), is an ABL specific, tyrosine kinase inhibitor. In preclinical studies, it has been shown to selectively kill BCR-ABL expressing cells, both in-vitro and in vivo. The results of clinical studies to date are highly encourageing and STI571 promises to be an important addition to the therapy of CML. [source]

Etiology of Late Free Flap Failures Occurring After Hospital Discharge,

Mark K. Wax MD
Abstract Objectives: Vascular compromise of free flaps most commonly occurs in the immediate postoperative period in association with failure of the microvascular anastomosis. Rarely do flaps fail in the late postoperative period. It is not well understood why free flaps can fail after 7 postoperative days. We undertook a case review series to assess possible causes of late free flap failure. Study Design: Retrospective review at two tertiary referral centers: Oregon Health Sciences University and University of Alabama at Birmingham. Methods: A review of 1,530 flaps performed in 1,592 patients between 1998 and 2006 were evaluated to identify late flap failure. Late flap failure was defined as failure occurring after postoperative day 7 or on follow-up visits after hospital discharge. A prospective database with the following variables was examined: age, medical comorbidities, postreconstructive complications (fistula or infection), hematoma, seroma, previous surgery, radiation therapy, intraoperative findings at the time of debridement, nutrition, and, possibly, etiologies. Results: A total of 13 patients with late graft failure were identified in this study population of 1,530 (less than 1%) flaps; 6 radial forearm fasciocutaneous flaps, 2 rectus abdominis myocutaneous flaps, 4 fibular flaps, and 1 latissimus dorsi myocutaneous flap underwent late failure. The time to necrosis was a median of 21 (range, 7,90) days. Etiology was believed to possibly be pressure on the pedicle in the postoperative period in four patients (no sign of local wound issues at the pedicle), infection (abscess formation) in three patients, and regrowth of residual tumor in six patients. Loss occurring within 1 month was more common in radial forearm flaps and was presented in the context of a normal appearing wound at the anastomotic site, as opposed to loss occurring after 1 month, which happened more commonly in fibula flaps secondary to recurrence. Conclusion: Although late free flap failure is rare, local factors such as infection and possibly pressure on the pedicle can be contributing factors. Patients presenting with late flap failure should be evaluated for residual tumor growth. [source]

External Beam Radiation Followed by Planned Neck Dissection and Brachytherapy for Base of Tongue Squamous Cell Carcinoma,

David M. Kaylie MD
Abstract Background Surgical resection of tongue base cancer can leave the patient with significant functional deficits. Other therapies, such as external beam radiation followed by neck dissection and radiation implants, have shown equal tumor control with good functional outcome. Methods Between March 1991 and July 1999, 12 patients at Oregon Health Sciences University, the Portland Veterans Administration Medical Center and West Virginia University School of Medicine Hospital were treated with external beam radiation followed by neck dissection and Ir192 implants. Two patients had T1 disease, two had T2, five patients had T3 tumors, and three had T4 tumors. Six had N2a necks, three had N2b necks, and three had N2c. Follow-up ranged from 13 months to 8 years. Results After external beam radiation, five patients had complete response and seven had partial response in the neck without complications. One patient underwent a unilateral radical neck dissection, eight had unilateral selective neck dissections involving levels I to IV, and three had dissections involving levels I to III. One of the five patients who had a complete clinical response in the neck had pathologically positive nodes. One patient had a pulmonary embolus that was treated and had no permanent sequelae. There were three complications from brachytherapy. Two patients had soft tissue necrosis at the primary site and one patient had radionecrosis of the mandible. All healed without further therapy. One patient had persistent disease and underwent a partial glossectomy but died of local disease. Distant metastasis developed in two patients. All others show no evidence of disease and are able to eat a normal diet by mouth. Conclusion This combination of therapies should be considered when treating tongue base cancer. [source]


ABSTRACT A survey on beliefs and purchase intent of irradiated foods was conducted among 300 Argentine students, covering secondary/high school, food science and nonfood science university, and 100 nonstudent adults. Other factors considered were the type of information provided (introductory, process description and benefits) and the city of residence (small agricultural city and big city). The most important benefits were considered to be microorganism reduction and improved sanitation. On the other hand, insecurity and doubts were the main reasons why respondents would not buy these foods. Only 14% said they would definitely buy irradiated foods. Considering their doubts and insecurities, it is probable that if these respondents see a food labeled as "irradiated," they would not choose to buy it. Within developing countries such as Argentina, the promotion of this technology by government agencies would be very costly, and at present, these costs would not seem to be justified. PRACTICAL APPLICATIONS The negative perceptions of consumers would hinder the successful implementation of food irradiation. The doubts or insecurities that consumers of developing countries have are similar to those that consumers of developed countries have. Most respondents answered that irradiated foods should be labeled as such. If food irradiation was to be pursued further, the place to start would be in food science curricula as this is the basis of future professionals in charge of researching its use and/or implementing the process. [source]