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Studies Need (studies + need)
Kinds of Studies Need Selected AbstractsDoes the Emergency Exception from Informed Consent Process Protect Research Subjects?ACADEMIC EMERGENCY MEDICINE, Issue 11 2005Nicole M. Delorio MD Abstract Although subject protection is the cornerstone of medical ethics, when considered in the context of research using emergency exception from informed consent, its success is debatable. The participants of a breakout session at the 2005 Academic Emergency Medicine Consensus Conference discussed the issues surrounding subject protection and advanced the following recommendations. 1) There are no outcome measures that define "protection"; therefore, it is not currently known whether or not subjects are protected under the current rules. 2) Care must be taken to protect not only the individual from harm during research but also to protect society from unregulated research in other countries and an inability to appropriately advance medical knowledge. 3) Some surrogate markers/methods of protection whose efficacies are debatable include data safety monitoring board activity, the community consultation and public notification (CC/PN) process, and institutional review board approval. 4) Minimal-risk studies should be held to different standards of protection than those that involve more significant risk to the subject. 5) A handful of studies have been published regarding community consultation and notification, and the majority are case studies. Those that are specifically designed to discover the most successful methods are hindered by a lack of formal outcomes measures and tend to have negative results. 6) Follow-up data from the CC/PN process should be disclosed to the Food and Drug Administration and incorporated into study designs. 7) Focus groups and/or random-digit dialing have been suggested as promising methods for fulfilling the CC/PN requirements. 8) Studies need to be funded and performed that formally investigate the best means of CC/PN. 9) More funding for this research should be a priority in the emergency medicine and critical care communities. More data regarding terminated studies should be made available to the research community. 10) Quantifiable markers of success for CC/PN must be validated so that research may determine the most successful methods. 11) Data regarding subjects' and family members' experiences with exception from informed consent studies need to be obtained. [source] The value of infrared thermography for research on mammals: previous applications and future directionsMAMMAL REVIEW, Issue 3 2007DOMINIC J. MCCAFFERTY ABSTRACT 1Infrared thermography (IRT) involves the precise measurement of infrared radiation which allows surface temperature to be determined according to simple physical laws. This review describes previous applications of IRT in studies of thermal physiology, veterinary diagnosis of disease or injury and population surveys on domestic and wild mammals. 2IRT is a useful technique because it is non-invasive and measurements can be made at distances of <1 m to examine specific sites of heat loss to >1000 m to count large mammals. Detailed measurements of surface temperature variation can be made where large numbers of temperature sensors would otherwise be required and where conventional solid sensors can give false readings on mammal coats. Studies need to take into account sources of error due to variation in emissivity, evaporative cooling and radiative heating of the coat. 3Recent advances in thermal imaging technology have produced lightweight, portable systems that store digital images with high temperature and spatial resolution. For these reasons, there are many further opportunities for IRT in studies of captive and wild mammals. [source] Cost-of-illness studies of dementia: a systematic review focusing on stage dependency of costsACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2010W. Quentin Quentin W, Riedel-Heller SG, Luppa M, Rudolph A, König H-H. Cost-of-illness studies of dementia: a systematic review focusing on stage dependency of costs. Objective:, To review cost-of-illness (COI) studies of dementia from Europe and North America which report costs per patient by disease stage. Method:, A systematic literature search was performed in electronic databases. Studies were classified according to important determinants of costs. Results were converted into year 2006 USD-PPP, and summarized as costs for formal and informal care in mild, moderate and severe dementia. Results:, 28 studies were evaluated. They used a wide range of methods. Costs more than doubled from mild to severe dementia. Patterns and size of estimated costs depended primarily on study objectives (estimation of total costs,net costs), living arrangements of patients (community-dwelling,institutionalized) and inclusion of informal care. Conclusion:, This review is the first to have focused on costs in different stages of dementia. The stage is an important determinant of costs. However, characteristics of individual studies need to be considered, when making use of their results. [source] The relation between different dimensions of alcohol consumption and burden of disease: an overviewADDICTION, Issue 5 2010Jürgen Rehm ABSTRACT Aims As part of a larger study to estimate the global burden of disease and injury attributable to alcohol: to evaluate the evidence for a causal impact of average volume of alcohol consumption and pattern of drinking on diseases and injuries; to quantify relationships identified as causal based on published meta-analyses; to separate the impact on mortality versus morbidity where possible; and to assess the impact of the quality of alcohol on burden of disease. Methods Systematic literature reviews were used to identify alcohol-related diseases, birth complications and injuries using standard epidemiological criteria to determine causality. The extent of the risk relations was taken from meta-analyses. Results Evidence of a causal impact of average volume of alcohol consumption was found for the following major diseases: tuberculosis, mouth, nasopharynx, other pharynx and oropharynx cancer, oesophageal cancer, colon and rectum cancer, liver cancer, female breast cancer, diabetes mellitus, alcohol use disorders, unipolar depressive disorders, epilepsy, hypertensive heart disease, ischaemic heart disease (IHD), ischaemic and haemorrhagic stroke, conduction disorders and other dysrhythmias, lower respiratory infections (pneumonia), cirrhosis of the liver, preterm birth complications and fetal alcohol syndrome. Dose,response relationships could be quantified for all disease categories except for depressive disorders, with the relative risk increasing with increased level of alcohol consumption for most diseases. Both average volume and drinking pattern were linked causally to IHD, fetal alcohol syndrome and unintentional and intentional injuries. For IHD, ischaemic stroke and diabetes mellitus beneficial effects were observed for patterns of light to moderate drinking without heavy drinking occasions (as defined by 60+ g pure alcohol per day). For several disease and injury categories, the effects were stronger on mortality compared to morbidity. There was insufficient evidence to establish whether quality of alcohol had a major impact on disease burden. Conclusions Overall, these findings indicate that alcohol impacts many disease outcomes causally, both chronic and acute, and injuries. In addition, a pattern of heavy episodic drinking increases risk for some disease and all injury outcomes. Future studies need to address a number of methodological issues, especially the differential role of average volume versus drinking pattern, in order to obtain more accurate risk estimates and to understand more clearly the nature of alcohol,disease relationships. [source] ,You can't go without a fag . . . you need it for your hash',a qualitative exploration of smoking, cannabis and young peopleADDICTION, Issue 1 2004Amanda Amos ABSTRACT Aims To examine the relationship between smoking tobacco and cannabis use among smokers in their mid-to-late teens. Design and participants Two qualitative studies in Scotland. One study used semistructured paired interviews involving 99 16,19-year-old smokers, the other comprised eight focus groups involving 46 15,16-year-old smokers. Measurement The interviews and focus groups explored the role and meaning of smoking in the participants' lives, smoking histories and future cessation intentions and how these related to other aspects of their lives, particularly cannabis use. Findings Cannabis use was regarded as an important and enjoyable aspect of many of the participants' lives. Importantly, cannabis use and cigarette smoking were linked inextricably. Several reported how smoking joints had been a ,gateway' to smoking cigarettes. While most wanted to quit smoking cigarettes, cannabis use reinforced their cigarette smoking and few wanted to stop using cannabis. Conclusion National studies need to be conducted to examine how widespread the problem identified is and tobacco control initiatives and smoking cessation treatment services need to consider urgently how to overcome the barrier that a desire on the part of young people to continue cannabis smoking poses to achieving a reduction in tobacco use. [source] Benefits and risks of interferon therapy for hepatitis B,HEPATOLOGY, Issue S5 2009Robert Perrillo Alpha interferon is the only licensed drug for hepatitis B with immunomodulatory as well as viral inhibitory properties. Potential advantages of interferon compared to nucleoside analogs include a lack of drug resistance, a finite and defined treatment course, and a higher likelihood for hepatitis B surface antigen (HBsAg) clearance. Approximately 30% of hepatitis B e antigen (HBeAg)-positive and 40% of HBeAg-negative cases have a sustained virological response (when defined as HBeAg seroconversion and/or hepatitis B virus (HBV) DNA levels below 20,000 copies/mL, respectively) 6 months after completion of a 48-week course of peginterferon alfa-2a These responses remain durable in 80% and 50% of cases, respectively, when evaluated several years later. Recent studies have shown that changes in HBsAg and HBeAg concentration during treatment predict sustained virological response and serial monitoring of HBsAg is helpful in predicting HBsAg clearance. HBeAg-positive patients with genotype A have higher rates of HBeAg and HBsAg clearance, whereas HBeAg-negative patients with genotype D have the lowest rate of response to interferon therapy. Long-term follow-up of virological responders to either standard alpha interferon or peginterferon has demonstrated a progressive increase in the rate of HBsAg clearance, particularly in patients who were initially HBeAg-positive. Future studies need to address if specific virological benchmarks during therapy can be used to tailor treatment duration. Conclusion: Peginterferon alfa has a place as first-line therapy of hepatitis B in patients who are carefully selected on the basis of pretreatment serum HBV DNA and aminotransferase levels, safety considerations, and viral genotype. (HEPATOLOGY 2009;49:S103,S111.) [source] Reliability in multi-site psychiatric studiesINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 1 2001Morven N. Leese Abstract Multi-site psychiatric studies need to take account of cultural and sometimes also linguistic differences and the reliability of the instruments used may need to be re-established. The analysis of reliability data in these circumstances presents special problems, arising from the requirements to make the best use of all the available data and to compare reliability coefficients across sites, interpreting any differences found in terms of measurement errors and/or sample heterogeneity. Focusing on statistical issues, this paper discusses some topics that should ideally be considered when planning, conducting and analysing such studies. A number of practical examples using data from a recent European study involving the translation and cultural adaptation of five instruments used in mental health service research (the EPSILON Study) are used to illustrate the issues. Copyright © 2001 Whurr Publishers Ltd. [source] Psychosocial interventions for non-professional carers of people with Parkinson's disease: a systematic scoping reviewJOURNAL OF ADVANCED NURSING, Issue 3 2008Susanne Hempel Abstract Title.,Psychosocial interventions for non-professional carers of people with Parkinson's disease: a systematic scoping review. Aim., This paper is a report of a scoping review to systematically identify and collate the evidence on psychosocial interventions for non-professional carers of people with Parkinson's disease. Background., Carers are critical to people with Parkinson's disease maintaining independent living and quality of life. Parkinson's disease imposes a challenging constellation of symptoms and no summary of effective interventions for carers and their unique support needs exists. Data sources., Thirty electronic databases were searched from their inception to July 2006, and bibliographies and specific internet sites were scanned. Methods., Eligible studies were categorized according to design, type of economic evaluation where applicable, number of participants, country of evaluation, intervention, orientation, provider, setting, method of delivery, carer population, patient population, carer outcomes, patient outcomes and authors' conclusions. Data were extracted by one reviewer and checked by another reviewer; discrepancies were resolved through discussion or arbitration by a third reviewer. Findings., Thirty studies met the inclusion criteria. Most investigated relatively unique interventions involving multiple elements; the majority were not aimed primarily at carers but were embedded in patient treatment programmes. Many were pilot studies, employing weak research designs and involving very small numbers of participants and most were not designed to assess the clinical or cost effectiveness of the intervention for the carers. Conclusion., Several interventions merit further investigation but there is currently little evidence to show which approaches are effective and cost effective in supporting carers. Future studies need to employ appropriate and rigorous research designs with adequate samples and outcome measures, and with more focus on the carer. [source] Feeding and dementia: a systematic literature reviewJOURNAL OF ADVANCED NURSING, Issue 1 2006Roger Watson PhD RN FIBiol FRSA Aim., This paper reports a systematic review of the literature on interventions to promote oral nutritional intake of older people with dementia and feeding difficulty between 1993 and 2003. Background., Older people with dementia commonly experience difficulty with feeding, especially in the later stages of the condition. This topic and related nursing care was reviewed in 1993 and the conclusion was that there was little research into interventions that nurses could use to alleviate feeding difficulty. Method., A systematic review of the literature was carried out using the CINAHL, Medline, EMBASE and Cochrane databases and the search terms ,feeding', ,eating' and ,dementia' combined as follows: ,(feeding or eating) and (dementia)'. A second search was carried out combining the search terms ,mealtimes' and ,dementia' as follows: ,mealtimes and dementia'. The literature search was carried out on 1 December 2003 and papers were included in the review if retrieved by 31 December 2003. English language papers only were retrieved. Results., Sixty-seven papers were retrieved, of which 13 addressed interventions aimed at helping older people with dementia to feed. All studies reported positive outcomes but only one randomized controlled trial was reported. Music was the most common intervention but there were no standardized interventions or outcomes across the studies and none reported the use of power analysis to decide on sample size. There were problems in some studies with confounding variables. Conclusions., Further research is needed into interventions aimed at how nurses can help older people with dementia to feed. There are some promising lines of enquiry, with music being one of these, but future studies need to use adequate samples and to use power calculations and account adequately for confounding variables. There is also a need to standardize interventions and outcomes across such studies to facilitate meta-analysis. [source] Anonymity and Self-Disclosure on WeblogsJOURNAL OF COMPUTER-MEDIATED COMMUNICATION, Issue 4 2007Hua Qian Bloggers are typically cautious about engaging in self-disclosure because of concerns that what they post may have negative consequences. This article examines the relationship between anonymity (both visual and discursive) and self-disclosure on weblogs through an online survey. The results suggest that increased visual anonymity is not associated with greater self-disclosure, and the findings about the role of discursive anonymity are mixed. Bloggers whose target audience does not include people they know offline report a higher degree of anonymity than those whose audience does. Future studies need to explore the reasons why bloggers visually and discursively identify themselves in particular ways. [source] Comparative Response to a Survey Executed by Post, E-mail, & Web FormJOURNAL OF COMPUTER-MEDIATED COMMUNICATION, Issue 1 2000Gi Woong Yun Recent developments in communication technologies have created alternative survey methods through e-mail and Web sites. Both methods use electronic text communication, require fewer resources, and provide faster responses than traditional paper and pencil methods. However, new survey methodologies also generate problems involving sampling, response consistency and participant motivation. Empirical studies need to be done to address these issues as researchers implement electronic survey methods. In this study we conduct an analysis of the characteristics of three survey response modes: post, e-mail, and Web site. Data are from a survey of the National Association of Science Writers (NASW), in which science writers' professional use of e-mail and the Web is evaluated. Our analysis offers two lessons. First, a caution. We detect a number of potentially important differences in the response characteristics of these three groups. Researchers using multi-mode survey techniques should keep in mind that subtle effects might be at play in their analyses. Second, an encouragement. We do not observe significant influences of survey mode in our substantive analyses. We feel, at least in this case, that the differences detected in the response groups indicate that using multi-mode survey techniques improved the representativeness of the sample without biasing other results. [source] Breast Binding , Is It All That It's Wrapped Up To Be?JOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 3 2003IBCLC, Kathy Swift MSN Objective: To investigate the difference in breast symptoms between breast binding and support bra wearing in nonbreastfeeding postpartum mothers. Design: A systematic replication of an earlier study by Bristol using a pre-experimental posttest design. Setting: A private, for-profit hospital in a city in the south-central region of the United States. Participants: Sixty nonbreastfeeding postpartum women who gave birth to viable newborns of singleton gestations, had an uncomplicated postpartum, and did not receive hormonal lactation suppressants. Main Outcome Measures: Postpartum breast engorgement, leakage, tenderness, and use of pain relief measures as measured by the Bristol Record of Symptoms. Results: Analysis of the data revealed no significant difference relative to breast engorgement between the two groups during the first 10 postpartum days. However, the breast-binder group reported a greater degree of breast tenderness, breast leakage, and use of other pain relief measures. Conclusion: Breast binding should be discontinued as a method of lactation suppression and use of support bras encouraged. Future studies need to focus on comfort for nonbreastfeeding, postpartum mothers. [source] Genetics and Asthma Disease Susceptibility in the US Latino PopulationMOUNT SINAI JOURNAL OF MEDICINE: A JOURNAL OF PERSONALIZED AND TRANSLATIONAL MEDICINE, Issue 2 2010Joan Reibman MD Abstract The US Latino population is heterogeneous with diversity in environmental exposures and socioeconomic status. Moreover, the US Hispanic population derives from numerous countries previously under Spanish rule, and many Hispanics have complex proportions of European, Native American, and African ancestry. Disparities in asthma severity and control are due to complex interactions between environmental exposures, socioeconomic factors, and genetic variations. In addition, diseases within the Latino community may also differ by country of origin. Although US Census data show low asthma rates in the Hispanic population as a whole, there is a lot of variability in the prevalence and morbidity of asthma, with a prevalence of 5.0% in Mexican Americans versus 17.0% in Puerto Ricans. The diversity and population admixture make the study of the genetics of asthma complex in Latino populations. However, an understanding of the genetics of asthma in all populations, including the Latino population, can enhance risk identification, help us to target pharmacological therapy, and guide environmental regulations, all of which can promote a reduction in health disparities. The inclusion of markers of ancestral diversity and the incorporation of techniques to adjust for stratification now make these studies feasible in complex populations, including the Latino population. To date, studies using linkage analyses, genome-wide associations, or candidate gene analyses have identified an association of asthma or asthma-related phenotypes with candidate genes, including interleukin 13, ,-2 adrenergic receptor, a disintegrin and metalloproteinase 33, orosomucoid 1-like 3, and thymic stromal lymphopoietin. As reviewed here, although these genes have been identified in diverse populations, limited studies have been performed in Latino populations, and they have had variable replication. There is a need for the development of registries with well-phenotyped pediatric and adult Latino populations and subgroups for inclusion in the rapidly expanding field of genetic studies, and these studies need to be used to reduce health disparities. Mt Sinai J Med 77:140,148, 2010. © 2010 Mount Sinai School of Medicine [source] Serotonin and Parkinson's disease: On movement, mood, and madness,MOVEMENT DISORDERS, Issue 9 2009Susan H. Fox MRCP Abstract An appreciation of the multiple roles that serotonin (5-HT) may play in Parkinson's disease (PD) has increased in recent years. Early pathological studies in PD demonstrated nonselective reductions of 5-HT in brain tissue but little correlation to comorbidities such as dyskinesia and mood disturbance. This, combined with treatment failures using serotonergic drugs in comparison to levodopa, meant the field was largely neglected until recently. The multitude of subtypes of 5-HT receptors in the brain and an increased understanding of the potential function 5-HT may play in modulating other neurotransmitter systems, including dopamine, GABA, and glutamate, have meant an expansion in efforts to develop potential serotonergic drugs for both motor and nonmotor symptoms in PD. However, several unanswered questions remain, and future studies need to focus on correlating changes in 5-HT neurotransmission in both pathological and in vivo imaging studies with a full clinical phenotype. © 2009 Movement Disorder Society [source] Plasticity and ambiguity of the electrophysiological phenotypes of enteric neuronsNEUROGASTROENTEROLOGY & MOTILITY, Issue 9 2009K. Nurgali Abstract, Advances in knowledge of enteric neurons electrophysiological characteristics have led to the realisation that the properties of the neurons are dependent on the state of the intestine, the region, the method of recording and the species. Thus, under different experimental conditions, electrophysiological studies cannot provide a reliable signature that identifies the functional type of neuron. In the normal guinea-pig small intestine, taken as a model tissue, neurons can be separated into two electrophysiological groups, S and AH neurons. Combined morphological and physiological studies place several classes of motor and interneurons in the S group, and intrinsic primary afferent neurons in the AH group. There is some evidence for subgroups of S neurons, in which electrophysiological differences are correlated with functional subtypes, but these subgroups have been incompletely investigated. Morphologically characterized Dogiel type II (DII) neurons are recognisable in many species, from mouse to human, but their electrophysiological characteristics are only partly conserved across species or cannot be satisfactorily defined due to technical difficulties. There is a strong need for a comprehensive analysis of channels and currents of S/Dogiel type I neuron subtypes, similar to the comprehensive analysis of AH/DII neurons in the guinea-pig, and similar studies need to be conducted in human and other species. The purpose of this review is to highlight that criteria used for electrophysiological definition of enteric neurons might not be sufficient to distinguish between functional classes of neurons, due to intrinsic properties of neuronal subpopulations, plasticity in pathological conditions and differences in recording techniques. [source] Monounsaturated Fat and Cardiovascular RiskNUTRITION REVIEWS, Issue 2006Jose López-Miranda MD On the basis of the information discussed in this review, we can conclude that the effects of a high intake of monounsaturated fatty acids (MUFA) from olive oil include a wide range of healthy benefits beyond improvement in cholesterol levels, suggesting that this type of diet has great potential in preventing cardiovascular disease. MUFA-enriched diets reduce insulin requirements and decrease plasma concentrations of glucose and insulin in type 2 diabetic patients, unlike high-saturated fatty acid and low-fat, high-carbohydrate diets. Moreover, some data show that this dietary model could have a hypotensive effect. There is also substantial evidence that oleic-enriched low-density lipoprotein (LDL) is more resistant to oxidative modifications and that dietary MUFA may influence various components and functions related to the endothelium. These include endothelium-dependent vasodilatation and a reduced capacity of oleicenriched LDL to promote the adhesion and chemotaxis of monocytes. On the other hand, a MUFA diet decreases the prothrombotic environment, modifying platelet adhesion, coagulation, and fibrinolysis. Its reducing effect on PAI-1 plasma levels is of particular relevance. This wide range of anti-atherogenic effects could explain the low rate of cardiovascular mortality found in Mediterranean countries, where there is a moderate to high supply of dietary MUFA. Future studies need to focus on uncovering the mechanisms by which the Mediterranean diet exerts its beneficial effects [source] Modification of sunflower oil quality by seed-specific expression of a heterologous ,9-stearoyl-(acyl carrier protein) desaturase genePLANT BREEDING, Issue 2 2002P. Rousselin Abstract The coding sequence of ,9-stearoyl-(acyl carrier protein) desaturase from Ricinus communis was introduced into sunflower, under the control of seed-specific promoter and terminator sequences of the late embryogenesis abundant gene from sunflower, Hads10. Two independent primary transformants contained three and six copies of the T-DNA, as demonstrated by hybridization using nptII as a probe. The transgene proved genetically stable and was transmitted as a Mendelian trait. Transcript analysis of the heterologous ,9-stearoyl-(acyl carrier protein) desaturase under control of the Hads10 promoter verified tissue-specific expression in the developing embryos and not in the leaves. Fatty acid composition of the seed oil was followed over five generations under greenhouse and open field conditions. Some of the transgenic lines produced oil with a significantly reduced stearic acid content compared with non-transformed plants under greenhouse and field conditions. However, additional studies need to be performed to assess whether or not physiologically stable lines can be developed from these transgenic lines. [source] Single-dose oral fluconazole versus topical clotrimazole in patients with pityriasis versicolor: A double-blind randomized controlled trialTHE JOURNAL OF DERMATOLOGY, Issue 8 2010Mohammad DEHGHAN Abstract This study was designed to compare the therapeutic effects of topical clotrimazole and systemic fluconazole in pityriasis versicolor. A double-blind randomized controlled trial was carried out in the dermatological clinic of Gorgan, northern Iran, between April 2006 and May 2007. All consecutive patients with pityriasis versicolor were included and randomly divided into two groups. In the first group (G1), patients underwent treatment with a single dose of fluconazole capsule (400 mg) and placebo cream. In the second group (G2), patients underwent treatment with clotrimazole cream (twice daily) and placebo capsule. The course of treatment was 2 weeks. All subjects were re-evaluated 2, 4 and 12 weeks after the end of the therapeutic course. After 2 weeks, the rate of complete resolution of disease was significantly higher in G2 than G1 (49.1% vs 30%). After 4 weeks, 41 patients (81.2%) of G1 and 52 patients (94.9%) of G2 showed complete resolution. After 12 weeks, 46 patients (92%) in G1 and 45 patients (81.8%) in G2 showed complete resolution. Recurrence rate in G1 and G2 were 6% and 18.2%, respectively. No complications were seen in either group. In this study, clinical response at week 4 was greater in the clotrimazole group than the fluconazole group. Recurrence at week 12 after treatment was less with oral fluconazole than clotrimazole cream. So, for better evaluation, more studies need to be done. [source] Angiogenesis Therapy for the Treatment of Erectile DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 7 2010Jeffrey J. Lysiak PhD ABSTRACT Introduction., Over the past 15 years, significant advances have been made in the treatment of erectile dysfunction (ED). The most significant of these advances has been pharmacological treatment of ED with phosphodiesterase type 5 (PDE5) inhibitors. This therapy greatly increased the awareness of ED and has helped stimulate research into the underlying causes of ED. While treatment with PDE5 inhibitors continues to be the current therapy of choice, approximately 40% of men treated with PDE5 inhibitors fail to have significant improvement in erectile function and PDE5 inhibitors do not reverse the vasculopathic processes associated with ED. With this in mind, new therapies must be developed. The treatment with angiogenic growth factors such as vascular endothelial cell growth factor (VEGF) may be one such therapy. Aim., This review will focus on defining key terms in the angiogenic process, angiogenic growth factors, and different delivery methods, and summarize results from angiogenic therapies for the treatment of ED. Methods., A review of the literature was performed on all angiogenic therapies for the treatment of ED. A brief review on the angiogenic factors was also performed Results., Angiogenic therapies for the treatment of ED are possible and promising; however, further investigation is needed to advance clinically. Conclusions., Although numerous studies have now employed angiogenic factors for the possible treatment of ED in several animal models, we are still not at the point to begin human investigations. Future studies need to examine proper dosage of the angiogenic agent, route of delivery, time course for delivery, and combination therapies. Lysiak JJ, Kavoussi PK, Ellati RT, Steers WD, and Annex BH. Angiogenesis therapy for the treatment of erectile dysfunction. J Sex Med 2010;7:2554,2563. [source] Lymphatic Mapping and Sentinel Lymphadenectomy for 106 Head and Neck Lesions: Contrasts Between Oral Cavity and Cutaneous Malignancy,THE LARYNGOSCOPE, Issue S109 2006FACS, Francisco J. Civantos MD Abstract Objectives: The objectives of this prospective series were to present our results in 106 sequential cases of lymphatic mapping and sentinel lymph node biopsy (SLNB) in the head and neck region and contrast the experience in oral cancer with that for cutaneous lesions. Hypotheses: SLNB has an acceptably low complication rate in the head and neck. Lymphatic mapping and gamma probe-guided lymphadenectomy can improve the management of malignancies of the head and neck by more accurate identification of the nodal basins at risk and more accurate staging of the lymphatics. For appropriately selected patients, radionuclide lymphatic mapping may safely allow for minimally invasive sentinel lymphadenectomy without formal completion selective lymphadenectomy. Methods: One hundred six patients underwent intralesional radionuclide injection and radiologic lymphoscintigraphy (LS) on Institutional Review Board-approved protocols and 103 of these underwent successful SLNB. These included 35 patients with malignant melanoma, 10 cutaneous squamous cell carcinomas, four lip cancers, eight Merkel cell carcinomas, two rare cutaneous lesions, and 43 oral cancers. Mean follow up was 24 months. Patients with oral cavity malignancy underwent concurrent selective neck dissection after narrow-exposure sentinel lymph node excision. In this group, the SLNB histopathology could be correlated with the completion neck specimen histopathology. Patients with cutaneous malignancy underwent SLNB alone and only received regional lymphadenectomy based on positive histology or clinical indications. Data were tabulated for anatomic drainage patterns, complications, histopathology, and patterns of cancer recurrence. Results: Surgical complications were rare. No temporary or permanent dysfunction of facial or spinal accessory nerves occurred with sentinel node biopsy. Lymphatic drainage to areas dramatically outside of the expected lymphatic basins occurred in 13.6%. Predictive value of a negative sentinel node was 98.2% for cutaneous malignancies (based on regional recurrence) and 92% with oral cancer (based on pathologic correlation). Gross tumor replacement of lymph nodes and redirection of lymphatic flow represented a significant technical issue in oral squamous cell carcinoma. Sixteen percent of patients with oral cancer were upstaged from N0 to N1 after extended sectioning and immunohistochemistry of the sentinel node. Conclusions: LS and SLNB can be performed with technical success in the head and neck region. Complications are minimal. More accurate staging and mapping of lymphatic drainage may improve the quality of standard lymphadenectomy. The potential for minimally invasive surgery based on this technology exists, but there is a small risk of missing positive disease. Whether the failure rate is greater than that of standard lymphadenectomy without gamma probe guidance is not known. New studies need to focus on refinements of technique and validation of accuracy as well as biologic correlates for the prediction of metastases. [source] RISK FACTORS FOR SURGICAL WOUND INFECTION AND BACTERAEMIA FOLLOWING CORONARY ARTERY BYPASS SURGERYANZ JOURNAL OF SURGERY, Issue 1 2000Denis W. Spelman Background: There has been no consensus from previous studies of risk factors for surgical wound infections (SWI) and postoperative bacteraemia for patients undergoing coronary artery bypass graft (CABG) surgery. Methods: Data on 15 potential risk factors were prospectively collected on all patients undergoing CABG surgery during a 12-month period. Results: Of 693 patients, 62 developed 65 SWI using the Centres for Disease Control definition: 23 were sternal wound infections and 42 were arm or leg wound infections at the site of conduit harvest. There were 19 episodes of postoperative bacteraemia. Multivariate analysis revealed that: (i) diabetes, obesity and previous cardiovascular procedure were independent predictors of SWI; and (ii) obesity was an independent risk factor for postoperative bacteraemia. Conclusions: These findings suggest that improved diabetic control and pre-operative weight reduction may result in a decrease in the incidence of SWI. But further prospective studies need to be undertaken to examine (i) whether the increased SWI risk in diabetes occurs with both insulin- and non-insulin-requiring diabetes, and whether improved peri-operative diabetes control decreases SWI; and (ii) what degree of obesity confers a risk of SWI and postoperative bacteraemia, and whether pre-operative weight reduction, if a realistic strategy in this patient group, results in a decrease in SWI. [source] Predictors of parenting self-efficacy in mothers and fathers of toddlersCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 2 2010P. R. Sevigny Abstract Background Researchers interested in child developmental outcomes have highlighted the role that parenting self-efficacy (PSE) plays in psychosocial child adjustment. PSE is a cognitive construct that can be broadly defined as an individual's appraisal of his or her competence in the parental role. PSE has emerged in the literature as an important variable when exploring variance in parenting skills. Despite this, much remains to be learned about PSE. Little is known about the predictors of PSE, with much of the existing research conducted in a piecemeal fashion that lacks a solid theoretical framework. In addition, PSE in fathers has been understudied and relatively little is known about PSE in families with toddler age children. Informed by Belsky's process model of parenting, this study explored similarities and differences in PSE and the predictors of PSE for mothers and fathers of toddlers. Methods A total of 62 cohabiting couples whose first-born child was 18,36 months old completed self-report measures of PSE, general self-efficacy, depression, marital satisfaction, parenting stress, child difficultness and family functioning. Results For fathers, parenting stress and their relational functioning (i.e. marital satisfaction and family functioning) with their spouse predicted PSE scores. For mothers, general self-efficacy and relational functioning were predictive of PSE. Conclusions and limitations The results of this study support the use of Belsky's process model of parenting to study the predictors of PSE. Important differences were found in the prediction models for mothers and fathers. Future studies need to clarify the nature of parental self-efficacy beliefs in fathers and continue to use comprehensive theoretical models to identify potentially relevant covariates of PSE. Limitations of the current investigation include reliance on self-report measures and the homogeneity of the sample. [source] How do you initiate oestrogen therapy in a girl who has not undergone puberty?CLINICAL ENDOCRINOLOGY, Issue 1 2009Peter C. Hindmarsh Summary The physiology of puberty needs to be taken into consideration in the induction of puberty. Puberty is a relatively slow process and replacement therapy should mimic this. Long-term maintenance requires careful monitoring and long-term assessment of risk-benefit. This has not been appreciably defined in the adolescent population. Options for fertility need careful consideration and may depend on the adequacy of pubertal induction in terms of uterine development. A number of regimens are available for pubertal induction but the lack of comparisons makes it difficult to advocate for a particular regimen. There remain a number of areas of uncertainty, and future studies need to consider these issues and whether there are cardiovascular risk factor advantages to certain preparations. The long-term risks of breast and gynaecological malignancy remain uncertain. Long-term cohort studies are required to address these issues. [source] | ||||||||||||||||