Two-year follow-up of a controlled trial of intradiscal electrothermal anuloplasty for chronic low back pain resulting from internal disc disruption.

Background: On the basis of observational data, intradiscal electrothermal anuloplasty (IDETA) has been implemented as a treatment for back pain resulting from internal disc disruption.

Purpose: To assess the efficacy of IDETA.

Study Design: Prospective cohort study with comparison group and 2-year follow-up.

Cellular receptor interactions of C-cluster human group A coxsackieviruses.

The cellular receptor complex of coxsackievirus A21 (CVA21), a C-cluster human enterovirus, is formed by the subtle interaction of individual cellular receptors, decay accelerating factor (DAF) and intercellular adhesion molecule-1 (ICAM-1). In this receptor complex, DAF functions in the membrane sequestration of the virus, while the role of ICAM-1 is as the functional cellular internalization receptor. However, despite the elucidation of the CVA21-cell receptor interactions, there have been few definite investigations into cellular receptor usage of other coxsackie A viruses (CVAs) belonging to the C-cluster.

The anatomy and pathophysiology of neck pain.

This article carefully itemizes the various anatomic structures that can evoke neck pain, putting in perspective what clinicians know, what they assume, and what they need to understand better about neck pain and pain referred from the neck. The critique of many of the accepted entities in the differential diagnosis of neck pain is crucial to an understanding of the causes of neck pain and an ability to implement appropriate therapies.

Bisphosphonate resistance in Paget's disease of bone.

Objective: To determine whether resistance to one bisphosphonate predicts resistance to another bisphosphonate.

Methods: One hundred patients with Paget's disease were treated with intravenous (IV) pamidronate. The initial dose was 120 mg, followed by further doses of 240 mg, until either biochemical remission was achieved or a total dose of 1 gm was given.

Regulation of innate and adaptive immunity by the female sex hormones oestradiol and progesterone.

Women mount more vigorous antibody- and cell-mediated immune responses following either infection or vaccination than men. The incidence of most autoimmune diseases is also higher in women than in men; however, during pregnancy many autoimmune diseases go into remission, only to flare again in the early post-partum period. Successful pregnancy requires that the female immune system tolerate the presence of a semi-allogeneic graft for 9 months.

Immunobiotics and the probiotic evolution.

The term 'probiotic' was coined by the food industry to describe microbes beneficial to health. Scientific criticism based on poorly characterised isolates, soft clinical targets, and an absence of a mechanistic framework limited value of this concept. Current clinical and animal model studies support a role for certain 'probiotics', activating the common mucosal system through the stimulation of gut antigen-presenting cells to both promote protection and to switch regulatory mechanisms.

Complementary and alternative medicine (CAM) use among elderly Australian women who have cancer.

The use of complementary and alternative medicine (CAM) in the general population has grown considerably in recent years. However, little is known about the prevalence of CAM use amongst women with cancer. Our research provides the first step in addressing this gap in knowledge by reporting on a survey of 9375 Australian women aged 73-78.

Can the response to eradication therapy in Helicobacter pylori infection be predicted?

The failure to eradicate Helicobacter pylori infection with antibiotic therapy has become a major clinical problem, not entirely accounted for by either poor compliance or antibiotic resistance. Recognition that failed eradication is one outcome of the host-parasite relationship focuses attention on impaired host protection as a determinant of nonresponse to antibiotics. A secreted interleukin (IL)-4 whole blood assay was developed to determine whether persistent infection was contributed to by impaired cytokine responses.

Meta-analyses of molecular association studies: methodologic lessons for genetic epidemiology.

Meta-analyses of population-based molecular association studies have become increasingly common over the last 10 years, but little attention has been paid to methodology. In addition to the traditional considerations pertinent to any meta-analysis, there are genetic issues particular to molecular association studies: checking Hardy-Weinberg equilibrium, handling data from more than two groups while avoiding multiple comparisons, and pooling data in a way that is sensitive to genetic models. We systematically reviewed all meta-analyses of molecular association studies identified via MEDLINE.

Molecular characterization of M1146, an American isolate of Ljungan virus (LV) reveals the presence of a new LV genotype.

Ljungan virus (LV) is a suspected human pathogen recently isolated from bank voles in Sweden. This study describes the genetic characterization of a virus, M1146, which was isolated in 1962 from another vole species (Microtus montanus), trapped in Oregon, USA. Based on antigenic properties, M1146 was postulated previously as a putative member of the family PICORNAVIRIDAE: The near complete genomic sequence verifies that M1146 is a member of the Picornaviridae, most closely related to LVs isolated in Sweden.

The problems of sleep for older women: changes in health outcomes.

Objective: to identify the continuance of sleeping difficulty and medication use in a cohort of older Australian women from baseline to 3-year follow-up and to explore the relationship between these factors and health-related quality of life scores, falls and other health care use.

Method: a 3-year longitudinal survey of 10,430 Australian women aged 70-75 years at baseline. These women were participants in the Australian Longitudinal Study on Women's Health randomly selected from the Australian Medicare database.

Evaluation of an instrument to assess the needs of men diagnosed with prostate carcinoma: an assessment of the validity and reliability of a self-administered questionnaire developed to measure the needs experienced by men diagnosed with prostate carcinoma.

Background: This study was conducted to evaluate a self-administered questionnaire developed to measure the needs experienced by men diagnosed with prostate carcinoma (the Prostate Cancer Needs Questionnaire [PCNQv1.1]). The PCNQv1.

Development of surrogate markers for oral immunisation against Candida albicans.

We have developed an oral vaccine using the blastococcoid form of Candida albicans with a murine model of oral candidiasis with infection-resistant (BALB/c) and infection-prone (DBA/2) mice. Previous studies had demonstrated that enhanced clearance was linked to increased production of both Th1 and Th2 cytokines (IFN-gamma and IL-4, respectively) in regional lymph nodes, and increased secretion of IFN-gamma and NO in saliva. Subsequent study using oral Lactobacillus acidophilus (LAVRI-A1) induced a local cytokine pattern and enhanced clearance of intra-oral C.

Diagnostic nerve blocks in chronic pain.

Diagnostic blocks are used to obtain information about the source of a patient's pain. As such they differ in principle and in practice from regional anaesthetic blocks. In order to be valid, diagnostic blocks must be precise and target-specific.

Radiofrequency neurotomy for the treatment of third occipital headache.

Objective: To evaluate the efficacy of a revised technique of percutaneous radiofrequency neurotomy for third occipital headache.

Methods: The revisions included using a large gauge electrode, ensuring minimum separation between the three electrode placements, and holding the electrode in place by hand. The revised technique was used to treat 51 nerves in 49 patients diagnosed as suffering from third occipital headache on the basis of controlled diagnostic blocks of the third occipital nerve.

Epstein-Barr virus reactivation and upper-respiratory illness in elite swimmers.

Purpose: The aim of this study was to investigate the relationships between latent viral shedding of Epstein-Barr virus (EBV) in saliva, upper-respiratory illness, and mucosal immune suppression in a cohort of highly trained swimmers undertaking intensive training.

Methods: Saliva was collected before selected training sessions from 14 elite male swimmers during a 30-d period of intensive training. Prior infection with EBV was determined by EBV antibody serology.

Safety, efficacy, and cost effectiveness of evidence-based guidelines for the management of acute low back pain in primary care.

Study Design: A case-control study involving parallel benchmarking audits was conducted.

Objective: To compare the safety, efficacy, and cost effectiveness of evidence-based medical care and usual care for acute low back pain.

Summary Of Background Data: Although several sets of guidelines have been promoted for the management of acute low back pain, there is no evidence that following guidelines results in better outcomes.

Pharmaceutical industry-sponsored meetings: good value or just a free meal?

Although the role of the pharmaceutical industry in continuing medical education (CME) has been debated for many years, industry CME funding continues to increase. Because of concern about the educational quality of industry CME, the Hunter Postgraduate Medical Institute (HPMI), an independent Newcastle and Hunter Valley CME provider, evaluated the use and quality of industry CME as reported by rural and urban general practitioners, physicians and psychiatrists. Furthermore, clinicians were asked if they supported increased industry-funded independent CME.

A prognostic index for 30-day mortality after stroke.

The objective of this study was to develop a simplified scoring system to predict 30-day mortality in patients with acute ischemic stroke. A retrospective cohort study was performed in a tertiary referral hospital in the Hunter Region of Australia. A prognostic index was created by assigning points to the variables in a Cox model.

The optimal form of urinary drainage after acute retention of urine.

Objective: To assess the outcome of different forms of urinary drainage, particularly for urinary tract infection (UTI), operative findings and patient preference, in patients treated for acute urinary retention (AUR).

Patients And Methods: A feasibility trial was conducted of men presenting with AUR; after a short period of indwelling catheterization (IDC) patients were taught how to use clean intermittent self-catheterization (CISC). Patients who failed this were re-catheterized and taught to manage a valve, or failing this a leg bag, and then discharged home.

Cervicogenic headache: anatomic basis and pathophysiologic mechanisms.

Cervicogenic headache is pain perceived in the head but referred from a primary source in the cervical spine. The physiologic basis for this pain is convergence between trigeminal afferents and afferents from the upper three cervical spinal nerves. The possible sources of cervicogenic headache lie in the structures innervated by the C1 to C3 spinal nerves, and include the upper cervical synovial joints, the upper cervical muscles, the C2-3 disc, the vertebral and internal carotid arteries, and the dura mater of the upper spinal cord and posterior cranial fossa.

Biomechanics of the cervical spine Part 3: minor injuries.

Minor injuries of the cervical spine are essentially defined as injuries that do not involve a fracture. Archetypical of minor cervical injury is the whiplash injury. Among other reasons, neck pain after whiplash has been controversial because critics do not credit that an injury to the neck can occur in a whiplash accident.