			Home About us Contact

State-of-the-art Knowledge (state-of-the-art + knowledge)

Distribution by Scientific Domains

Medical Sciences	80%

Selected Abstracts

A global perspective on changes in the burden of caries and periodontitis: implications for dentistry,

JOURNAL OF ORAL REHABILITATION, Issue 12 2007
V. BAELUM
Summary, The structure and contents of most oral health care systems and the contents of dental curricula reflect a deep-rooted tradition for attempting to cure oral diseases by refined technological means. However, better oral health conditions for the world's populations necessitate the application of up-to-date scientific knowledge to control the major oral diseases. This review points out that not only should the structure and contents of oral health care delivery systems be based on state-of-the-art knowledge about the biology of the oral diseases; they must also take into account the trends for change in caries and periodontal diseases within and between populations, and acknowledge the impact of changes in treatment philosophies for these trends. The oral disease profiles for populations in low- and high-income countries are briefly described, and it is concluded that the rapidly changing disease profiles observed in high-income countries necessitate re-thinking of the future role and organization of dentistry in such countries. The priorities for low- and middle-income countries must be to avoid repeating the mistakes made in the high-income countries. Instead, these societies might take advantage of setting priorities based on a population-based common risk factor approach. If such an approach is adopted, the training of personnel with oral health care competence must be rethought. The authors suggest three different cadres of dental care providers to be considered for an approach that allows health care planners in different populations around the world to prioritize appropriate oral health care with due respect for the socio-economic conditions prevailing. [source]

Turning the tide: Enabling sustainable development for Africa's mobile pastoralists

NATURAL RESOURCES FORUM, Issue 3 2008
Jonathan Davies
Abstract Sustainable development for Africa's mobile pastoralists is slowly becoming a reality. Success depends to a large extent on understanding the dynamics of drylands environments, accepting the logic of customary mobile livestock keeping, and enabling effective governance. Appropriate investment in pastoralism requires a clear understanding of the values that are attached to it and innovative approaches to marketing of the goods and services that emanate from the system. To make development truly sustainable it is imperative that the environmental services of pastoralism are recognised, rewarded and promoted. Constraints to sustainable pastoral development include low and misdirected public and private investment, weak security of resource rights, low human capital, weak pastoral voice and poor governance. Successful and sustainable development is observed in pastoral regions where customary governance has been legitimized, resource rights secured and economic development of the pastoral sector, as opposed to transformation of livestock keeping, has prevailed. This article presents state-of-the-art knowledge on sustainable pastoralism, gathered through the GEF/UNDP/IUCN World Initiative for Sustainable Pastoralism (WISP), with data and case studies taken from three recently published WISP reports: "Global Economic Review of Pastoralism", "Pastoralism as Conservation in the Horn of Africa", and "Policy Impacts on Pastoral Environments". [source]

The Management of Peyronie's Disease: Evidence-based 2010 Guidelines

THE JOURNAL OF SEXUAL MEDICINE, Issue 7 2010
David Ralph MD
ABSTRACT Introduction., The field of Peyronie's disease is evolving and there is need for a state-of-the-art information in this area. Aim., To develop an evidence-based state-of-the-art consensus report on the management of Peyronie's disease. Methods., To provide state-of-the-art knowledge regarding the prevalence, etiology, medical and surgical management of Peyronie's Disease, representing the opinion of leading experts developed in a consensus process over a 2-year period. Main Outcome Measures., Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. Conclusions., The real etiology of Peyronie's disease and the mechanisms of formation of the plaque still remain obscure. Although conservative management is obtaining a progressively larger consensus among the experts, surgical correction still remains the mainstay treatment for this condition. Ralph D, Gonzalez-Cadavid N, Mirone V, Perovic S, Sohn M, Usta M, and Levine L. The management of Peyronie's disease: Evidence-based 2010 guidelines. J Sex Med 2010;7:2359,2374. [source]

Implants, Mechanical Devices, and Vascular Surgery for Erectile Dysfunction

THE JOURNAL OF SEXUAL MEDICINE, Issue 1pt2 2010
Wayne J.G. Hellstrom MD
ABSTRACT Introduction., The field of erectile dysfunction (ED) is evolving and there is a need for state-of-the-art information in the area of treatment. Aim., To develop an evidence-based, state-of-the-art consensus report on the treatment of erectile dysfunction by implants, mechanical devices, and vascular surgery. Methods., To provide state-of-the-art knowledge concerning treatment of erectile dysfunction by implant, mechanical device, and vascular surgery, representing the opinions of 7 experts from 5 countries developed in a consensus process over a 2-year period. Main Outcome Measure., Expert opinion was based on the grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. Results., The inflatable penile prosthesis (IPP) is indicated for the treatment of organic erectile dysfunction after failure or rejection of other treatment options. Comparisons between the IPP and other forms of ED therapy generally reveal a higher satisfaction rate in men with ED who chose the prosthesis. Organic ED responds well to vacuum erection device (VED) therapy, especially among men with a suboptimal response to intracavernosal pharmacotherapy. After radical prostatectomy, VED therapy combined with phosphodiesterase type 5 therapy improved sexual satisfaction in patients dissatisfied with VED alone. Penile revascularization surgery seems most successful in young men with absence of venous leakage and isolated stenosis of the internal pudendal artery following perineal or pelvic trauma. Currently, surgery to limit venous leakage is not recommended. Conclusions., It is important for the future of the field that patients be made aware of all treatment options for erectile dysfunction in order to make an informed decision. The treating physician should be aware of the patient's medical and sexual history in helping to guide the decision. More research is needed in the area of revascularization surgery, in particular, venous outflow surgery. Hellstrom WJG, Montague DK, Moncada I, Carson C, Minhas S, Faria G, and Krishnamurti S. Implants, mechanical devices, and vascular surgery for erectile dysfunction. J Sex Med 2010;7:501,523. [source]

Endocrine Aspects of Sexual Dysfunction in Men

THE JOURNAL OF SEXUAL MEDICINE, Issue 1 2004
Alvaro Morales MD
ABSTRACT Introduction., Endocrine disorders of sex steroid hormones may adversely affect men's sexual function. Aim., To provide expert opinions/recommendations concerning state-of-the-art knowledge for the pathophysiology, diagnosis and treatment of endocrinologic sexual medicine disorders. Methods., An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a scientific and debate process. Concerning the Endocrine committee, there were eight experts from seven countries. Main Outcome Measure., Expert opinions/recommendations are based on grading of evidence-based medical literature, extensive internal committee discussion over 2 years, public presentation and deliberation. Results., Hypogonadism is a clinical and biochemical syndrome characterized by a deficiency in serum androgen levels which may decrease sexual interest, quality of erections and quality of life. Biochemical investigations include testosterone and either bioavailable or calculated free testosterone; prolactin should be considered when hypogonadism has been documented. If clinically indicated, androgen therapy should maintain testosterone within the physiological range avoiding supraphysiologic values. Digital rectal examination and determination of serum prostate specific antigen values are mandatory prior to therapy and regularly thereafter. Androgen therapy is usually long-term requiring regular follow-up, frequent monitoring of blood levels and beneficial and adverse therapeutic responses. Conclusions., Safe and effective treatments for endocrinologic sexual medicine disorders examined by prospective, placebo-controlled, multi-institutional clinical trials are needed. [source]