Treat or treatment: a qualitative study analyzing patients' use of complementary and alternative medicine.

Objectives: We analyzed how patients use complementary and alternative medicine (CAM) and examined how patients' perspectives relate to existing, expert-led taxonomies.

Methods: We conducted semistructured interviews with 46 people who used CAM in southern England, then performed a qualitative thematic analysis of the interviews.

Results: CAM appeared to be used in 4 different ways: as treats, and as alternative, complementary, or conventional treatments.

Treatment appraisals and beliefs predict adherence to complementary therapies: a prospective study using a dynamic extended self-regulation model.

Objectives: Complementary and alternative medicine (CAM) is used by large numbers of the general public and is increasingly becoming integrated into the mainstream. An understanding of why people use CAM in general has been developed in the literature, but relatively little is known specifically about adherence to CAM. We tested hypotheses (derived from a dynamic extended version of Leventhal's common-sense model) that patients' beliefs about treatment, perceptions of illness, and treatment appraisals would predict adherence to CAM.

A systematic review of beliefs involved in the use of complementary and alternative medicine.

People might be attracted to and use complementary and alternative medicines (CAM) because they hold beliefs that are congruent with CAM. This article collates, examines and synthesizes the evidence surrounding this hypothesis. Most studies are cross-sectional and focus on a limited number of beliefs.

Recurrent infrasellar clival craniopharyngioma.

The patient is a 44-year-old man who underwent resection of a posterior nasopharynx tumor 12 years earlier via left lateral rhinotomy approach. The final pathological analysis indicated the tumor was a craniopharyngioma, and the patient subsequently underwent focal radiation. The patient returned to medical attention complaining of dysequilibrium.

Glutaric aciduria type 1 presenting as bilateral subdural hematomas mimicking nonaccidental trauma. Case report and review of the literature.

Glutaric aciduria type 1 (GA1) is a rare neurometabolic disorder with characteristic neuroimaging and clinicopathological features. The authors describe a case of GA1 in a 7-month-old girl presenting with macrocephaly and bilateral subdural hematomas (SDHs) who was initially evaluated for nonaccidental trauma (NAT). Bilateral subdural drains were placed because of significant mass effect from the chronic SDHs, with subsequent neurological and neuroimaging-documented improvement.

Gabapentin in the treatment of fibromyalgia: a randomized, double-blind, placebo-controlled, multicenter trial.

Objective: To assess the efficacy and safety of gabapentin in patients with fibromyalgia.

Methods: A 12-week, randomized, double-blind study was designed to compare gabapentin (1,200-2,400 mg/day) (n=75 patients) with placebo (n=75 patients) for efficacy and safety in treating pain associated with fibromyalgia. The primary outcome measure was the Brief Pain Inventory (BPI) average pain severity score (range 0-10, where 0=no pain and 10=pain as bad as you can imagine).

Older people's views of falls-prevention interventions in six European countries.

Purpose: Our study identified factors common to a variety of populations and settings that may promote or inhibit uptake and adherence to falls-related interventions.

Design And Methods: Semistructured interviews to assess perceived advantages and barriers to taking part in falls-related interventions were carried out in six European countries with 69 people aged 68 to 97 years. The sample was selected to include people with very different experiences of participation or nonparticipation in falls-related interventions, but all individuals were asked about interventions that included strength and balance training.

Developing a measure of treatment beliefs: the complementary and alternative medicine beliefs inventory.

Objectives: The study aimed to develop a comprehensive generic measure of treatment beliefs, the Complementary and Alternative Medicine Beliefs Inventory (CAMBI), and to identify distinct dimensions of CAM-related beliefs.

Methods: The CAMBI and other measures were presented and advertised online.

Results: 328 completed questionnaires were received.

Constructing agency in treatment decisions: negotiating responsibility in cancer.

People belonging to cancer patient support groups participated in focus groups concerning their experiences of orthodox and complementary medicine. Their accounts of treatment decisions for cancer were analysed through discourse analysis. Accounts of both complementary and orthodox medicine addressed an ideological dilemma concerning the positioning of individuals as active or passive.

Adjustable and non-adjustable strabismus surgery: a retrospective case-matched study.

Adjustable suture strabismus surgery was introduced to improve results in unpredictable strabismus cases. However, its usage is increasing and in some centres is routine. The present authors propose that the routine use of the adjustable suture technique can only be justified if it can be shown to confer an advantage to the patient.

Scanning laser tomography of full thickness idiopathic macular holes.

Aim: We used a retinal tomographic analyser to study the profile of the retinal surface in patients with stage 3 and 4 idiopathic macular holes, to attempt to elucidate the direction of forces present.

Methods: The Heidelberg retina tomograph was used to acquire a three-dimensional tomographic image of the macula in each eye of 21 consecutive patients with full thickness macular hole.

Results: The surface profile showed an elevated rim around the 24 macular holes imaged, with a gently sloping outside edge and a steeply sloping inside edge.

The earliest case of retinopathy of prematurity?

Retinopathy of prematurity (ROP) is a well-recognized condition in premature babies born today and in the recent past. One would not normally expect to come across evidence of its existence among older patients. We present a case of apparent regressed ROP in a lady born in May 1939, prior to the documented reports of the first cases.

Topiramate and phenytoin pharmacokinetics during repetitive monotherapy and combination therapy to epileptic patients.

Purpose: To evaluate the potential pharmacokinetic interactions between topiramate (TPM) and phenytoin (PHT) in patients with epilepsy by studying their pharmacokinetics (PK) after monotherapy and concomitant TPM/PHT treatment.

Methods: Twelve patients with epilepsy stabilized on PHT monotherapy were enrolled in this study, with 10 and seven patients completing the phases with 400 and 800 mg TPM daily doses, respectively. TPM was added at escalating doses, and after stabilization at the highest tolerated TPM dose, PHT doses were tapered.

Influence of stiripentol on cytochrome P450-mediated metabolic pathways in humans: in vitro and in vivo comparison and calculation of in vivo inhibition constants.

Objective: The spectrum of cytochrome P450 inhibition of stiripentol, a new anticonvulsant, was characterized in vitro and in vivo.

Methods: Stiripentol was incubated in vitro with (R)-warfarin, coumarin, (S)-warfarin, (S)-mephenytoin, bufuralol, p-nitrophenol, and carbamazepine as probes for CYPs 1A2, 2A6, 2C9, 2C19, 2D6, 2E1, and 3A4, respectively. Caffeine demethylation and the 6 beta-hydroxycortisol/cortisol ratio were monitored in vivo before and after 14 days of treatment with stiripentol as measures of CYP1A2 and CYP3A4 activity, and dextromethorphan O- and N-demethylation were used to measure CYP2D6 and CYP3A4 activity, respectively.

Pharmacokinetics and metabolism of the novel anticonvulsant agent N-(2,6-dimethylphenyl)-5-methyl-3-isoxazolecarboxamide (D2624) in rats and humans.

N-(2,6-dimethylphenyl)-5-methyl-3-isoxazolecarboxamide (D2624) belongs to a new series of experimental anticonvulsants related to lidocaine. This study was undertaken to understand the pharmacokinetics and metabolism of D2624 in rats and humans, with emphasis on the possible formation of 2,6-dimethylaniline (2,6-DMA). After oral administration of stable isotope-labeled parent drug to rats and GC/MS analysis of plasma samples, two metabolites were identified: D3017, which is the primary alcohol, and 2,6-DMA, formed by amide bond hydrolysis of either D2624 or D3017.

Open-mouth posture and maxillary arch width in young children: a three-year evaluation.

A large biracial sample of children were assessed for open mouth posture and maxillary arch width once a year for 3 years. Analyses revealed that although the youngsters exhibited open-mouth posture at high levels, over time, there was a significant decrease in this behavior. Racial and gender differences, as well as a race-by-time interaction, were also evidenced.

A longitudinal evaluation of open mouth posture and maxillary arch width in children.

Open mouth posture and maxillary arch width were assessed annually for 4 years in a group of children. While younger children exhibited high levels of open mouth posture, this behavior decreased significantly over time. Racial and sex differences, as well as a race-by-time interaction were also evident.

Open mouth posture and cross-sectional nasal area in young children.

A biracial sample of two-hundred ninety-six children were assessed for open-mouth posture (OMP) in the natural environment. In addition, rhinometry was performed on 288 of the youngsters. Means were computed for percent OMP and cross-sectional nasal airway.