Protecting breastfeeding in West and Central Africa: over 25 years of implementation of the International Code of Marketing of Breastmilk Substitutes.

Background: In 1981 the World Health Assembly (WHA) adopted the International Code of Marketing of Breastmilk Substitutes out of concern that inappropriate marketing of breastmilk substitutes was contributing to the alarming decline in breastfeeding worldwide and the increase in child malnutrition and mortality, particularly in developing countries.

Objective: To document progress, challenges, and lessons learned in the implementation of the International Code in West and Central Africa.

Methods: Data were obtained by literature review and interviews with key informants.

Rapid hydrocarbon analysis using a miniature rectilinear ion trap mass spectrometer.

A miniature ion trap mass analyzer was applied to the analysis of traces of hydrocarbons and simple heteroatomics in the vapor phase and in aqueous solution. Vapors of acetone, acetic acid, acetonitrile, benzene, butanethiol, carbon disulfide, hexane, dichloromethane, naphthalene, toluene and xylenes were detected and quantified using solid sorbent trapping and, in some cases, by passage through a membrane interface. Aqueous solutions of benzene, toluene, xylenes, hexane and a petroleum naphtha distillate were examined using the membrane interface.

Is alpha2-macroglobulin important in female stress urinary incontinence?

Background: Loss of mechanical stability of the urethra and bladder is thought to be important in the development of stress urinary incontinence (SUI). The vaginal wall is the main supporting tissue for pelvic organs and changes in components of supporting tissues are known to be involved in the pathophysiology of SUI.

Methods: We evaluated changes in expression of alpha2-macroglobulin (alpha2-M), a protease inhibitor, in vaginal wall tissues from premenopausal women (aged 42-45 years) with SUI (n = 28) compared with menstrual cycle-matched continent women (controls, n = 29).

Long-term follow-up of a transvaginal Burch urethropexy for stress urinary incontinence.

Objective: The objective of the study was to describe long-term objective and subjective success rates and complications following transvaginal Burch urethropexy for stress urinary incontinence.

Study Design: A case series of 66 women who underwent vaginal Burch urethropexy for urodynamic stress urinary incontinence with urethral hypermobility using a suture carrier device is presented. Concurrent prolapse repairs were performed as indicated.

[Features of ontogenesis of uroliths].

The aim of the study was investigation of urolith growth process using the method of ontogenetic analysis. A total of 435 autochtonic uroliths obtained after surgery or spontaneous elimination from 422 patients with urolithiasis were studied with roentgenophasic analysis on diffractometer DRON-3, IR-spectroscopy, electron-probe. The concrements incorporate several zones with a nucleus as one of the zones.

Alkali metal-cationized serine clusters studied by sonic spray ionization tandem mass spectrometry.

Serine solutions containing salts of alkali metals yield magic number clusters of the type (Ser(4)+C)(+), (Ser(8)+C)(+), (Ser(12)+C)(+), and (Ser(17)+2C)(+2) (where C = Li(+), Na(+), K(+), Rb(+), or Cs(+)), in relative abundances which are strongly dependent on the cation size. Strong selectivity for homochirality is involved in the formation of serine tetramers cationized by K(+), Rb(+), and Cs(+). This is also the case for the octamers cationized by the smaller alkalis but there is a strong preference for heterochirality in the octamers cationized by the larger alkali cations.

Incarcerated vaginal herniation of the omentum mimicking vaginal prolapse.

We present a 33-year-old woman with a history of radical hysterectomy and pelvic radiation who developed a nonreducible high anterior vaginal wall bulge, postoperative pelvic pain, and dyspareunia. Dynamic MRI revealed herniation of the omentum into the vesico-vaginal space. The incarcerated hernia was repaired transvaginally, and the patient's symptoms improved.

Variability of current symptoms in women with pelvic organ prolapse.

To describe the variability of current (day-to-day) symptoms of pelvic organ prolapse (POP) and to compare women's overall (comprehensive) and current ratings of prolapse symptoms. This was a prospective observational study of 45 women with symptomatic POP followed-up for 3 months between November 2004 and June 2005. Women had a total of three visits during the study period.

Effect of patient age on increasing morbidity and mortality following urogynecologic surgery.

Objective: The purpose of this study was to estimate the effect of age on the risk of in-hospital mortality and morbidity following urogynecologic surgery and to compare risks associated with obliterative versus reconstructive procedures for prolapse in elderly women.

Study Design: We conducted a retrospective cohort study utilizing data from 1998 to 2002 from the Nationwide Inpatient Sample. Multivariable logistic regression was performed to obtain odds ratios estimating the effect of age on risk of death and complications, adjusting for comorbidities and demographic factors.

Suburethral sling treatment of occult stress incontinence and intrinsic sphincter deficiency in women with severe vaginal prolapse of the anterior vs posterior/apical compartment.

Objective: The purpose of this study was to compare the efficacy of a Mersilene mesh suburethral sling for occult stress urinary incontinence (SUI) and intrinsic sphincter deficiency (ISD) in women with severe vaginal prolapse of the anterior compartment to the posterior/apical compartment.

Study Design: This was a retrospective study that compared women with stage or grade III/IV prolapse of the anterior compartment (group 1) with the posterior/apical compartment (group 2); both groups demonstrated occult SUI (leakage only with prolapse reduced) and ISD on urodynamics, and underwent concurrent pelvic reconstructive surgery. The sling was defined as efficacious if SUI was prevented in 85% of women and if obstructive symptoms (de novo or worsening urge incontinence, or urinary retention greater than 2 weeks) occurred in less than 10% of women.

Results of urine cytology testing and cystoscopy in women with irritative voiding symptoms.

Objective: The purpose of this study was to assess rates of urinary cytologic abnormalities and cystoscopic outcomes in women with irritative voiding symptoms who were examined at a urogynecology clinic.

Study Design: All urinary cytology studies results that were sent between January 1, 2000, and July 31, 2003, for the evaluation of irritative voiding symptoms were reviewed. Data were then extracted from the charts of a subset of these patients to evaluate cystoscopic outcomes.

The usefulness of urinary cytology testing in the evaluation of irritative voiding symptoms.

Objective: The purpose of this study was to assess the clinical usefulness of urinary cytology testing for the evaluation of urothelial cancer in women with irritative voiding symptoms who were examined at a urogynecology service.

Study Design: Urinary cytology studies results that were obtained from January 1, 2000, to December 31, 2002, were cross-matched with the Rhode Island Department of Health Cancer Registry to identify those women who were diagnosed with urinary tract malignancies. The prevalence of urothelial cancer was determined, and the sensitivity, specificity, and positive and negative predictive values of urinary cytologic testing were calculated for 2 common classification strategies: (1) consideration of atypical cytologic test results to be normal and (2) consideration of atypical cytologic test results to be abnormal.

Ultrasound examination of the postpartum uterus: what is normal?

Objective: To establish normal ultrasonographic findings for the postpartum uterus after vaginal delivery, and to characterize associated bleeding patterns.

Methods: Postpartum women were scanned by transabdominal ultrasound within 48 h after normal vaginal delivery. Uterine length, uterine width, endometrial stripe thickness and endometrial contents were evaluated by a single sonographer.

The David Jayne amendment: the story of one man's determination to improve the lives of thousands.

Stricken by ALS at the age of 27, David Jayne slowly lost the ability to walk, to eat, to speak, and to breathe. With the assistance of home health professionals, medical technologies, and volunteers, he has managed to maintain as full a life as possible, participating in some of his children's activities and even managing, with great effort, to attend a football game. However, when he was the subject of a newspaper article, his home health coverage was dropped because he didn't meet the federal definition of "homebound.

Laparoscopic morcellator-related injuries.

Study Objective: To identify and summarize all electric morcellator-related injuries published in the medical literature.

Design: Systematic review (Canadian Task Force classification II-2).

Setting: Databases.

Promoting responsiveness between mothers with depressive symptoms and their infants.

Purpose: To test the efficacy of an interactive coaching intervention to promote responsiveness between mothers experiencing postpartum depressive symptoms (PPDS) and their infants.

Design: An experimental design with 117 postpartum women in the Northeastern United States.

Methods: Participants were randomly assigned either to the treatment or control group.

[Some aspects of microsurgical decompression of neurovascular formations of the spinal canal in lumbar osteochondrosis].

Microsurgical techniques have been developed for decompression of neurovascular formations of the vertebral canal in lumbar osteochondrosis. Surgical policy has been proposed in relation to the site of hernial prolapse by the disk diameter. The use of this policy provides the minimal traumatism of surgical interventions in posterolateral hernias in particular.

Prospects for Medicare reform in the 106th Congress.

Without overwhelming pressure to act, the 106th Congress will continue to debate comprehensive Medicare reform, but pass only incremental legislation. With the expected doubling of the Medicare population in the next century, many analysts believe that new revenues will have to accompany any attempt to "modernize" Medicare without restricting access to care.

[The monitoring of gas bubbles with a pulsed Doppler ultrasonic locator in humans working in a space suit].

Presented are results of gas bubbles monitoring in decompressed humans with the use of an ultrasonic pulse-Doppler locator (PDL). Unlike the classic Doppler bubbles detectors with continuous US emission, PDL is adjusted for reception of echo from a chosen volume of the right ventricle cavity; thus, the clutter due to cardiac beats and human locomotion is successfully rejected. During simulation of Russian EVAs, venous gas bubbles were detected in 3 out of 5 experiments with test-subjects clothed in everyday wear and in 2 out of 3 experiments with suited test-subjects.

Bipartisan Commission: working to preserve Medicare's future.

The future of Medicare is uncertain. With a pressing need to address the potential crisis ahead, President Clinton appointed a National Bipartisan Commission on the Future of Medicare to examine issues and develop recommendations that address current challenges.