The care and feeding of evidence based medicine.

Wide interest in evidence based medicine (EBM) and its value in patient care, insurance payment decisions, and public health planning has triggered intense medical journal and media coverage that merits review, explanation, and comment. Published EBM data vary in quality for reasons that have been the subject of many perceptive literature reviews. Study design can be faulted, and conflicts of interest, personal and economic, can potentially bias study results and their publication.

Koch's postulates, carnivorous cows, and tuberculosis today.

With Koch's announcement in 1882 of his work with the tubercle bacillus, his famous postulates launched the rational world of infectious disease and an abrupt social change--strict patient isolation. The postulates, so successful at their inception, soon began to show some problems, particularly with cholera, which clearly violated some of Koch's requirements. Subsequent studies of other diseases and the discovery of entirely new ones have so altered and expanded the original postulates that they now are little but a precious touch of history.

Human injury from atomic particles and photon exposure: fears, myths, risks, and mortality.

Energy absorbtion from particles and photons moving at relativistic speeds has been a fundamental part of life on earth and wherever else life might exist. Heat and visible light have deeply influenced the course of human evolution, affecting habitat and nutrition. The photons of ionizing radiation that over time can possibly affect evolution, contribute to the more immediate problem of morbidity and mortality of cancer This review addresses our radiative energy absorbtion, from both natural and manmade sources, and its relationship with disease and death.

Reproducibility of ultrasound scan in the assessment of volume flow in the veins of the lower extremities.

Purpose: The purpose of this study was the identification of the optimal settings of ultrasound scan flow measurement in the veins and the determination of whether the standardization of these settings can provide acceptable reproducibility of the venous flow measurements in individual segments of the lower extremity veins.

Methods: The venous cross-sectional area, the time average mean velocity, and the venous volume flow of 25 healthy volunteers were examined with duplex ultrasound scanning. Reproducibility was examined with different measurement settings.

Exploring unconventional medical systems.

Exotic medical systems still exist in the world's developing areas. These systems often embrace a unique pharmacopaeia and remarkable human relationships. Here is a guide for your personal exploration and appreciation of health care systems unfamiliar to Western medicine.

A practical guide to creating compliance programs.

Regardless of size or corporate structure, all home care agencies will feel the heavy hand of the government's efforts to detect fraud and abuse in health care. By preparing ahead of time, agency owners can be confident that any investigation will have a satisfactory conclusion.

Clinical report on long-term bone density after short-term EMF application.

A 1984 study determined the effect of a 72 Hz pulsating electromagnetic field (PEMF) on bone density of the radii of post-menopausal (osteoporosis-prone) women, during and after treatment of 10 h daily for 12 weeks. Bone mineral densities of the treated radii increased significantly in the immediate area of the field during the exposure period and decreased during the following 36 weeks. Bone density determination of the radii of these women, remeasured after eight years, suggests no long-term changes.

Baromedicine today--rational uses of hyperbaric oxygen therapy.

Compressed air, and more recently hyperbaric oxygen, have been used and misused in medical treatment for more than 300 years. Advances in physiology have led to rational protocols for hyperbaric oxygen use. Hyperbaric oxygen will enhance wound healing by fibroblast and capillary proliferation, suppress infection, reduce edema, reverse CNS damage from carbon monoxide and cyanide poisoning, and reduce clostridial alpha toxins.

Enhanced mutagenic effect of a 60 Hz time-varying magnetic field on numbers of azide-induced TA100 revertant colonies.

Forty-eight hours exposure to a two Gauss (0.2 mT) rms 60 Hz time varying sinusoidal electromagnetic field increased the number of azide induced TA100 revertant colonies of Salmonella typhimurium 14% as compared with controls in the ambient < 2 milli-Gauss 60 Hz field. In the absence of the electromagnetic field, the numbers of mutant colonies grown within and outside the non-energized coil were nearly identical.

Electromagnetic fields: biological and clinical aspects.

Our entire biosphere is immersed in a sea of man-made electromagnetic fields (EMF). Occupational and public health data suggest that these fields may be a health hazard, possibly involving cancer and fetal loss. This paper reviews the history and pertinent physics of electromagnetic fields and presents evidence from the authors' work, and that of others, of biological interaction with living systems.

Bone density changes in osteoporosis-prone women exposed to pulsed electromagnetic fields (PEMFs).

To determine the effect of a 72 Hz pulsating electromagnetic field (PEMF) on bone density of the radii of osteoporosis-prone women, the nondominant forearms of 20 subjects were exposed to PEMF 10 h daily for a period of 12 weeks. Bone density before, during, and after the exposure period was determined by use of a Norland-Cameron bone mineral analyzer. Bone mineral densities of the treated radii measured by single-photon densitometry increased significantly in the immediate area of the field during the exposure period and decreased during the following 36 weeks.

Ethanol vapour modulation of Lewis lung carcinoma, a murine pulmonary tumour.

Pure ethanol in experimental animal studies, may not primarily be carcinogenic, but secondarily it can act chemically and synergistically as a co-carcinogen via its endogenous metabolites and associated dietary and exogenous factors. However, ethanol, being a small molecule and miscible with water and most lipids, can readily enter cell membranes and directly affect cell function. In an in vitro study where ethanol was added to the culture medium for Lewis lung carcinoma, a dose-dependent suppression of tumour growth occurred.

Simultaneous outbreaks of Guillain-Barré syndrome and Bell's palsy in Hawaii in 1981.

Simultaneous outbreaks of Guillain-Barré syndrome (GBS) and Bell's palsy occurred among residents of Hawaii during the three-month period June through August 1981. The outbreak of GBS (six cases) involved children, while the outbreak of Bell's palsy (22 cases) involved primarily adults. Four of the six patients with GBS had serological evidence of recent infection with cytomegalovirus (CMV) v none of 24 control subjects; no such association with CMV infection could be demonstrated for patients with Bell's palsy.

Clinical experience with the Lillehei-Kaster valve prosthesis.

The Lillehei-Kaster valve was used in 215 patients over a 7-year period. The aortic valve was replaced in 81 of them. Hospital mortality was 21% (17 patients).

Weak A.C. magnetic field effects: changes in cell sodium pump activity following whole animal exposure.

A biological system consisting of a cell membrane enzyme (Na+-K+)-ATPase responded to exposure to a weak A.C. magnetic field.

Effects of gravitational and magnetic fields on transplanted neuroblastoma vascularity.

Transplanted neuroblastomas were subjected to altered neural influences and imposed gravitational and magnetic fields, either separately or in combination. In each case impaired vascularity, and greater extravasation of blood with associated tumor necrosis occurred in the experimental animals. The combination of both hypergravity and alternating magnetic field resulted in definite macroscopic but less marked microscopic changes than with either force alone.

Effect of alternating magnetic fields (60--100 gauss, 60 Hz) on Tetrahymena pyriformis.

Tetrahymena pyriformis and neuroblastoma cells were studied following exposure to low intensity low frequency alternating magnetic fields. Tetrahymena showed cytomorphologic changes, with delayed and reduced cell division concurrent with increased oxygen uptake. The resulting dead cells appeared intact, as compared with dissolution characteristic of the control group.