Atherosclerotic renovascular disease.

Atherosclerotic renovascular disease is a combination of renal artery stenosis and renal ischemia. Blood pressure does not rise until the stenosis is 60% or greater. Disease of both large and small blood vessels is often accompanied by the loss of glomerular filtration rate.

The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part II - Therapy.

Objective: To provide updated, evidence-based recommendations for the management of hypertension in adults.

Options And Outcomes: For lifestyle and pharmacological interventions, evidence from randomized, controlled trials and systematic reviews of trials was preferentially reviewed. Changes in cardiovascular morbidity and mortality were the primary outcomes of interest.

The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part I--Blood pressure measurement, diagnosis and assessment of risk.

Objective: To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with high blood pressure.

Options And Outcomes: For persons in whom a high blood pressure value is recorded, a diagnosis of hypertension is dependent on the appropriate measurement of blood pressure, the level of the blood pressure elevation, the approach used to monitor blood pressure (office, ambulatory or home/self), and the duration of follow-up. In addition, the presence of cardiovascular risk factors and target organ damage should be assessed to determine the urgency, intensity and type of treatment.

Changing perspectives of the role of chemotherapy in advanced prostate cancer.

The use of cytotoxic chemotherapy in advanced prostate adenocarcinoma has been validated by the recent demonstration of survival benefit in two large randomized phase III trials. Before publication of these landmark trials, SWOG 9916 and TAX 327, no chemotherapeutic regimen had shown survival benefit in the treatment of androgen independent prostate cancer (AIPC). These trials provide new encouragement for the use of chemotherapy in all stages of disease.

A silychristin isomer and variation of flavonolignan levels in milk thistle (Silybum marianum) fruits.

A new natural product has been isolated from silymarin, the hepatoprotective extract of milk thistle (Silybum marianum) fruits. This was shown by NMR spectroscopy to be silychristin B (8), a diastereoisomer of the known silychristin (7). Levels of these and the other flavonolignans varied markedly in fruits of different S.

Distribution and residual activity of two insecticidal proteins, avidin and aprotinin, expressed in transgenic tobacco plants, in the bodies and frass of Spodoptera litura larvae following feeding.

To understand how a major cosmopolitan pest responds to two very different insecticidal proteins and to determine whether herbivorous insects and their frass could be environmental sources of recombinant proteins from transgenic plants, Spodoptera litura (Fab.) (Lepidoptera, Noctuidae) larvae were fed on tobacco leaves expressing either the biotin-binding protein, avidin, or the protease inhibitor, aprotinin. Control larvae received non-transgenic tobacco.

The 2005 Canadian Hypertension Education Program recommendations for the management of hypertension: part II - therapy.

Objective: To provide updated, evidence-based recommendations for the management of hypertension in adults.

Options And Outcomes: For lifestyle and pharmacological interventions, evidence from randomized controlled trials and systematic reviews of trials was preferentially reviewed. While changes in cardiovascular morbidity and mortality were the primary outcomes of interest, for lifestyle interventions, blood pressure lowering was accepted as a primary outcome given the lack of long-term morbidity/mortality data in this field, and for certain comorbid conditions, other relevant outcomes, such as development of proteinuria or worsening of kidney function, were considered.

Use of recombinant human growth hormone in HIV-associated lipodystrophy.

Purpose Of Review: In the past few years there has been great interest in potential interventions for the body shape abnormalities in HIV-infected individuals that have been termed the HIV-associated lipodystrophy syndrome. This review examines the studies that have focused on the effects of recombinant human growth hormone as a treatment for the central fat accumulation that is part of this syndrome.

Recent Findings: A recent placebo-controlled trial confirmed that growth hormone leads to a significant dose-dependent improvement in trunk or visceral fat.

The Biomolecular Interaction Network Database and related tools 2005 update.

The Biomolecular Interaction Network Database (BIND) (http://bind.ca) archives biomolecular interaction, reaction, complex and pathway information. Our aim is to curate the details about molecular interactions that arise from published experimental research and to provide this information, as well as tools to enable data analysis, freely to researchers worldwide.

Eplerenone in hypertension.

Appreciation of the role of aldosterone in cardiovascular and renal disease has increased in the last 50 years. The use of spironolactone was limited by adverse sexual effects, including gynaecomastia. Eplerenone is a newer aldosterone antagonist that is much more selective, with minimal affinity for progesterone and androgenic receptors; therefore, there are very few reports of adverse sexual effects.

The impact of hydramnios on pregnancy outcome in twin gestations.

Objective: To compare pregnancy outcome in twin pregnancies with and without hydramnios.

Study Design: A database of women receiving outpatient preterm labor surveillance services was studied for the period 1988 to 2002. Included were women with twin gestations under 30 weeks' gestation at start of outpatient services.

Effects of plants genetically modified for insect resistance on nontarget organisms.

Insect resistance, based on Bacillus thuringiensis (Bt) endotoxins, is the second most widely used trait (after herbicide resistance) in commercial genetically modified (GM) crops. Other modifications for insect resistance, such as proteinase inhibitors and lectins, are also being used in many experimental crops. The extensive testing on nontarget plant-feeding insects and beneficial species that has accompanied the long-term and wide-scale use of Bt plants has not detected significant adverse effects.

Attitudes of health-care providers towards research with newborn babies.

Context: By providing information and possibly shaping parents' preferences, health-care providers are thought to play a critical role in parental decisions to enroll their infants in research. Yet, little is known about health-care providers' beliefs about research with newborns. Previous studies suggest that parents and health-care providers are often at odds regarding attitudes towards research.

Enterocutaneous fistula and ventral hernia after absorbable mesh prosthesis closure for trauma: the plain truth.

Hypothesis: The severity of abdominal injury is the determining factor for the development of enterocutaneous fistula and ventral hernia after absorbable mesh prosthesis closure (AMPC) for trauma.

Methods: We conducted a retrospective analysis of case series that included 140 consecutive trauma patients with AMPC surviving more than 48 hours from October 1, 1989, to March 31, 2000, at a Level I trauma center. The days until abdominal wall reconstruction was used as a measure of exposure of the viscera to the mesh.

Effects of perindopril on elastic and structural properties of large arteries in essential hypertension.

Background: Perindopril, an angiotensin-converting enzyme (ACE) inhibitor, is a well-recognized antihypertensive drug. Its ability to protect against cardiovascular events in hypertension has also been demonstrated. It decreases the stiffness of the larger arteries; questions remain as to the mechanisms involved and whether it is blood pressure (BP) control-dependent.

Losartan reduces the costs associated with nephropathy and end-stage renal disease from type 2 diabetes: Economic evaluation of the RENAAL study from a Canadian perspective.

Background: The Reduction of Endpoints in NIDDM [non-insulin-dependent diabetes mellitus] with the Angiotensin II Antagonist Losartan (RENAAL) study demonstrated the renoprotective effects of losartan in patients with nephropathy from type 2 diabetes.

Objective: To perform an economic evaluation of the costs associated with end-stage renal disease (ESRD) from a Canadian public health perspective, based on the clinical outcomes reported in the RENAAL study.

Methods: ESRD-related costs were determined by estimating the mean number of days with ESRD multiplied by the daily cost of ESRD (140 dollars); mean days with ESRD were calculated by subtracting the area under the Kaplan-Meier survival curve for time to the first event of ESRD or all-cause mortality from the area under the curve for all-cause mortality.

Efficacy of eplerenone versus enalapril as monotherapy in systemic hypertension.

This study compared the efficacy and tolerability of eplerenone and enalapril in 499 patients with stage 1 or 2 hypertension who were randomized to receive eplerenone or enalapril for 6 months in a 3-step titration-to-effect study. After 6 months, patients whose diastolic blood pressure (BP) was <90 mm Hg had their dosages down-titrated were followed for an additional 6 months. Diastolic BP was the primary end point.

Sesquiterpene lactones in Arnica montana: a rapid analytical method and the effects of flower maturity and simulated mechanical harvesting on quality and yield.

A rapid extraction, clean-up and RPLC procedure suitable for routine quantitative analyses of sesquiterpene lactones (SLs) in Arnica montana is described. Seven SLs were isolated of which tigloyl and methacryloyl esters of helenalin made up over 50 % of the total. This method was applied to analyses of replicated samples of different flower parts, different stages of flower maturity, and herb from different harvest methods.

Hypercalcemia in hyperthyroidism: patterns of serum calcium, parathyroid hormone, and 1,25-dihydroxyvitamin D3 levels during management of thyrotoxicosis.

Objective: To present two cases of hypercalcemia associated with thyrotoxicosis and to describe serial biochemical findings during the course of treatment of hyperthyroidism.

Methods: We report two cases, illustrate the changes in serum calcium, parathyroid hormone, and 1,25-dihydroxyvitamin D3 levels during management of thyrotoxicosis, and compare our findings with those in previous studies.

Results: Hypercalcemia attributable to thyrotoxicosis is well documented, but the mechanism for the hypercalcemia is incompletely understood.

Long-term safety and efficacy of the selective aldosterone blocker eplerenone in patients with essential hypertension.

Background: Even within the normal range, aldosterone levels are linked to end-organ toxicity and mortality in patients with hypertension. Treatment with angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers does not sufficiently reduce plasma aldosterone levels.

Objective: This study was conducted to assess the long-term safety profile and efficacy of the selective aldosterone blocker eplerenone.

Neuropsychologists' practice patterns in assessing premorbid intelligence.

The current study surveyed practicing neuropsychologists about the methods they use to estimate premorbid levels of function, and their prior training with these methods. Doctoral level psychologists, who are members of the National Academy of Neuropsychology, were sent a questionnaire developed by the authors to assess these variables. Findings suggest that there is relatively little use of strategies specifically designed to assess premorbid ability.

Methods of estimating premorbid functioning.

Clinical neuropsychological assessment frequently requires the comparison of obtained scores against some estimate of premorbid level of functioning, but only recently has significant attention been turned to objective methods to accomplish this objective. Clinical judgment, although useful in some circumstances, is generally insufficient. Other methods of estimating premorbid function include demographic regression formulae, such as the Barona formula, subtest scatter methods, such as that suggested by Lezak, and the use of current scores on tests of presumably spared abilities, such as the National Adult Reading Test (NART).

Brain death: resolving inconsistencies in the ethical declaration of death.

Purpose: The first criteria for the determination of brain death were developed in 1968 in part to address concerns that had arisen with the retrieval of organs for transplantation. Despite over 30 years of application, some professional and public doubt persists over the validity of the theoretical construct underlying this method of determining death. Our review will address historical perspectives on the development of brain death criteria, and inconsistencies in current clinical criteria.

Extraction of chili, black pepper, and ginger with near-critical CO2, propane, and dimethyl ether: analysis of the extracts by quantitative nuclear magnetic resonance.

Ginger, black pepper, and chili powder were extracted using near-critical carbon dioxide, propane, and dimethyl ether on a laboratory scale to determine the overall yield and extraction efficiency for selected pungent components. The temperature dependency of extraction yield and efficiency was also determined for black pepper and chili using propane and dimethyl ether. The pungency of the extracts was determined by using an NMR technique developed for this work.