Pharmacology of cyclooxygenase-2 inhibitors and preemptive analgesia in acute pain management.

Purpose Of Review: NSAIDs have served as analgesic, antiinflammatory, and antipyretic medicines for over a century. A novel class of NSAIDs, cyclooxygenase-2 inhibitors, was introduced in 1999. All NSAIDs and aspirin inhibit active sites of cyclooxygenase-1 and cyclooxygenase-2.

Roles of plasma interleukin-6 and tumor necrosis factor-alpha and FFA and TG in the development of insulin resistance induced by high-fat diet.

The role of adipokines in development of insulin resistance still remains controversial. The purpose of the present study was to examine the dynamic changes of fasting plasma levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), free fatty acids (FFA) and insulin in a Sprague-Dawley rat insulin resistant model induced by high-fat diet. Heterotopic deposition of triglycerides (TG) in liver, skeletal muscles and pancreatic islet was also investigated.

Medical care provided during a disaster should be immune from liability or criminal prosecution.

On August 29, 2005, Hurricane Katrina struck the Gulf Coast and resulted in widespread devastation. The collapse of social services including medical care was followed by chaos and resulted in many deaths. In this aftermath, a physician and two nurses were charged with homicide in the deaths of four patients who were under their care at a New Orleans Hospital.

Hurricanes provide impetus for health system reform in Louisiana.

The clear lesson, for Louisiana and any other state that is contemplating the potential disruption of health care following large-scale dislocations caused by either natural or man-made major disasters, is that proper mechanisms must be put in place before the event. This is necessary to provide greater portability of health care coverage and alternatively, temporary finance that coverage. Our Louisiana State Medical Society's plan Health Access Louisiana will help Louisiana recover from the devastating effects of Hurricanes Katrina and Rita and serve as a model for the reform of our healthcare coverage system for our country.

Adherence issues related to the selection of antistaphylococcal or antifungal antibiotic suspensions for children.

To evaluate the palatability and cost as variables in the selection of antimicrobial suspensions to treat staphylococcal infections and oral thrush, 31 physicians and health care personnel randomly sampled 7 antistaphylococcal antibiotics and 2 antifungal agents, evaluating them in categories of appearance, smell, texture, taste, and aftertaste. Final scoring was then adjusted for cost. Overall taste (palatability) ranking of antistaphylococcal antibiotics, highest to lowest, was as follows: rifampin, cephalexin, EES, TMP/SMX, clindamycin with FLAVORx, linezolid, and clindamycin without FLAVORx.

Chronic sinusitis in children.

Clinical practice guidelines for the management of acute sinusitis in children have been published by the American Academy of Pediatrics. Of note is that in this document, a brief discussion of chronic disease concluded that the pathogenesis and management are essentially unknown. Although there are insufficient data in the literature to develop evidence-based clinical guidelines, a careful review of the literature and clinical experience of experts who manage pediatric chronic sinusitis is presented in an effort to develop specific recommendations and to offer practical treatment options.

Mycobacterium avium complex pulmonary disease in immunocompetent patients.

Mycobacterium avium complex is becoming increasingly recognized as one of the most common mycobacterial pathogens in humans. It is rapidly becoming a significant cause of pulmonary disease even in those with an intact immunity. In 1997, the American Thoracic Society published recommendations for the diagnosis and treatment of nontuberculous mycobacteria.

CT-angiography for the detection of a lower gastrointestinal bleeding source.

The evaluation of lower gastrointestinal bleeding (LGIB) often involves the collaborative efforts of the gastroenterologist, radiologist, and surgeon. Efforts to localize the acute LGIB have traditionally involved colonoscopy, technetium-labeled red blood cell (RBC) scintigraphy, angiography, or a combination of these modalities. The sensitivity of each method of diagnosis is limited, with the most common cause of a negative study the spontaneous cessation of hemorrhage.

Transient in utero knockout (TIUKO) of C-MYC affects late lung and intestinal development in the mouse.

Background: Developmentally important genes often result in early lethality in knockout animals. Thus, the direct role of genes in late gestation organogenesis cannot be assessed directly. In utero delivery of transgenes was shown previously to result in high efficiency transfer to pulmonary and intestinal epithelial stem cells.

Defining the antihypertensive properties of the angiotensin receptor blocker telmisartan by a practice-based clinical trial.

Traditional randomized controlled clinical trials are designed to define the specific properties of individual antihypertensive drugs but do not provide full information about their use in clinical practice. To carry out a large-scale practice-based open-label trial to evaluate the safety and efficacy of an angiotensin receptor blocker (ARB) in controlling blood pressure (BP) in the community setting, 703 practitioners recruited 2705 hypertensive patients. There were three groups: untreated at the time of study entry with uncontrolled BP (>/=140/90 mm Hg) (N = 1957); treated but uncontrolled on current monotherapy (N = 685); and treated and controlled, but with unacceptable side effects (N = 63).

Health services for homeless adolescents.

This prospective review was designed to determine the effectiveness of a broad-spectrum health intervention program for homeless and runaway youth. Diagnosis, treatment, and counseling for drug use, sexually transmitted diseases (STDs), and other health issues were provided to all new admissions to a residential care facility during a 7(1/2)-year enrollment. Education was continued during a minimum follow-up period of 9 months based on the program entitled Bright Futures, previously developed and published by the National Center for Education in Maternal and Child Health.

Gynecology: select topics.

Menopause, premenstrual syndrome, dysmenorrhea, female fertility, and mastalgia are common problems not easily treated by conventional medicine. Women often seek alternative therapies to help address these conditions. Some evidence points to the efficacy of black cohosh, exercise, and possibly Kava and St.