Why I would recommend complementary or alternative therapies: a physician's perspective.

The successes of science and technology have created new health challenges. The use of various complementary therapies by patients reflects a response to one of those challenges, which is the need we all have to tell our stories, find meaning, and seek healing relationships. Although several alternative medical systems are conceptually incompatible with conventional medicine, the therapeutic modalities associated with them can be evaluated by standard clinical investigative approaches.

Lifetime use of alternative therapy: a study of Florida residents.

Background: Clinically relevant questions remain about who uses alternative medicine, which treatments they use and why.

Methods: The random digit dialing survey method was used to ask Florida residents about their lifetime use of 11 different alternative therapies. The response rate was 54% (n=1,012).

Moving a graveyard: how one school prepared the way for continuous curriculum renewal.

From 1991 to 1996, the faculty at the University of Florida College of Medicine initiated several significant changes in its curriculum. These changes, included the introduction of early clinical experience in primary care settings; the enhancement of active learning experiences in small-group settings; production and use of computer-based interactive learning materials; increased clinical teaching in the ambulatory care training in an interdisciplinary primary care clerkship; effective course and faculty evaluation; establishment and use of an assessment center for instruction and performance-based evaluations utilizing standardized patients; creation of a medical education center as the focal point for logistics support of the teaching faculty and education data handling; creation of a faculty development program; and initiation of mission-based budgeting based on the faculty's teaching effort and quality. Because the faculty were relatively conservative, it was important to identify variables that would facilitate the introduction of changes and those that might hinder it.

4-Quinolones cause a selective loss of mitochondrial DNA from mouse L1210 leukemia cells.

The 4-quinolone antibiotics nalidixic acid and ciprofloxacin are potent inhibitors of the bacterial type II topoisomerase DNA gyrase. Treatment of mouse L1210 leukemia cells with these drugs resulted in a delayed inhibition of cell proliferation. Prior to inhibition of cell proliferation, there was a time-dependent decrease in the cellular content of mitochondrial DNA (mtDNA).

Relative efficacy of phenytoin and phenobarbital for the prevention of theophylline-induced seizures in mice.

We evaluated the efficacy of pretreatment with phenytoin and phenobarbital to prevent seizures in mice given convulsive doses of theophylline. The control LD50 for theophylline was determined in 48 mice by intraperitoneal injections of increasing doses without anticonvulsant treatment. Anticonvulsant effects were determined in 105 additional mice pretreated with either phenytoin 30 mg/kg (n = 35), phenobarbital 35 mg/kg (n = 30), or phenobarbital 60 mg/kg (n = 40) one hour before theophylline administration.

Synthetic polyamine analogues as antineoplastics.

In this paper, we report on the synthesis and biological activity of a number of N-alkylated spermine compounds. The dialkylspermines N1,N12-dimethylspermine (DMSPM-2), N1,N12-diethylspermine (DESPM-3), and N1,N12-dipropylspermine (DPSPM-4) are all shown to inhibit the growth of L1210 cells in culture with IC50 values of less than 1 microM at 96 h. Furthermore, DESPM-3 is shown to be similarly active against Daudi and HL-60 cells in culture.

Mitochondrial DNA damage by bleomycin.

We have modified a specific and sensitive method of detecting different forms of mitochondrial DNA (mtDNA) and utilized it to study bleomycin (BLM)-induced mtDNA damage. Intact, nicked circular, and linear forms of mtDNA were separated by gel electrophoresis, detected by Southern blot hybridization, and characterized by size markers and alkali treatment. DNA from BLM-treated mitochondria from liver, lung, and L1210 tumors were all equally sensitive to damage by BLM.

Identification of children for whom routine monitoring of aminoglycoside serum concentrations is not cost effective.

On the basis of our clinical impression that aminoglycoside serum concentration measurements did not result in dosage changes in many children with normal renal function, data collected during pharmacokinetic consultations were evaluated to identify pediatric patients for whom routine serum concentration monitoring would not be cost effective. The frequency of peak or trough concentrations outside the desired ranges was related to age and duration of therapy in 88 children with normal renal function who were given recommended doses of gentamicin or tobramycin. Trough concentrations were outside the target range (greater than 2 micrograms/ml) in five of 26 patients who had received more than 10 days of therapy or were older than 18 years of age.

Nitrofurantoin inhibition of mouse liver mitochondrial respiration involving NAD-linked substrates.

In our study, nitrofurantoin (NF) and nitrofurazone (NZ) inhibited respiration of isolated mouse (C57B/6J, adult, male) liver mitochondria. Other aromatic nitro compounds, nitroimidazole, metronidazole, and p-nitrobenzoic acid, did not have any significant effect. The primary site of activity for NF was complex I NADH-ubiquinone oxidoreductase mediated respiration, since only complex I substrates, glutamate, beta-hydroxybutyrate, and alpha-ketoglutarate-mediated respiration were decreased.

A method for assessing damage to mitochondrial DNA caused by radiation and epichlorohydrin.

This paper describes a rapid and reliable method for quantification of damage to mitochondrial DNA (mtDNA), especially strand breaks. The degree of damage to mtDNA is assessed by the proportion of physical forms (i.e.

Behavioral effects of caffeine in children. Relationship between dietary choice and effects of caffeine challenge.

From a survey of 24-hour caffeine intake of 798 grade-school children (mean age, 10.3 years), 19 "high consumers" (reported intake of 500 mg/day or more) and a matched group of 19 "low consumers" were recruited for a double-blind, placebo-controlled, caffeine challenge study. Children received 5 mg/kg of caffeine twice a day or placebo for two weeks each, using a crossover design.

Methyl mercury exposure in northern Quebec. II. Neurologic findings in children.

The relationship between prenatal exposure to methyl mercury and neurologic and developmental abnormalities was ascertained among 234 Cree Indian children aged 12 to 30 months from four northern Quebec communities. A pediatric neurologist, "blinded" to the children's level of exposure, assessed neurologic, physical, mental, and psychosocial development. Methyl mercury exposure was estimated from maternal hair segments representing the period of pregnancy.

Metabolism of caffeine by mouse liver microsomes: GSH or cytosol causes a shift in products from 1,3,7-trimethylurate to a substituted diaminouracil.

Incubation of [14C]caffeine with hepatic microsomes from male AKR/J mice resulted in the formation of several metabolites including 1,3,7-trimethylurate and 6-amino-5-(N-formylmethyl-amino)-1,3-dimethyluracil. These two compounds comprised about 60% of products and are major urinary metabolites in several animals. When cytosol was included during incubation, there was a 14-fold increase in yield of the uracil at the expense of the urate; the combination of the two metabolites remained about 60% of total products.

High intravenous phenytoin dosage requirement in a newborn infant.

A term neonate was being treated with intravenous phenytoin. To maintain a serum level above 10 micrograms per milliliter and abolish seizure activity, it was necessary to carry out repeated serum concentration measurements, administer several loading doses, and administer an unusually large maintenance dose (25 mg per kilogram per day), divided into a short dosing interval (6 hours). Declining serum levels from postnatal days 8 to 13 on a constant dose of 9 mg per kilogram per day suggested that the rate of phenytoin metabolism was gradually increasing; rapid elimination was documented on day 18 by a half-life measurement of 8.