Proliferative lesions of oviduct and uterus in CD-1 mice exposed prenatally to tamoxifen

Tamoxifen (TAM) is widely used as adjuvant breast cancer therapy after surgery and as a chemopreventive agent in women of child-bearing age. However, TAM therapy has been shown to result in an increased incidence of endometrial carcinoma in women. The present study was designed to investigate the effects of TAM (5 mg/kg and 7.5 mg/kg body wt) given i.g. to pregnant CD-1 mice (1x/day, days 12 through 18 of gestation) on their female offspring. Progressive proliferative hyperplasia of the oviduct was frequently seen in TAM-exposed offspring, reaching 100% incidence by 52 weeks in both treatment groups. These females also developed progressive proliferative uterine lesions, including moderate/severe cystic endometrial hyperplasia (34-50%) and polypoid adenomas (27-30%) between 53 and 78 weeks. Deciduomas (15%) occurred at young ages (12 and 24 weeks) while leiomyomas (14%), a malignant leiomyosarcoma, and ovarian granulosa cell tumors (14%), were found between 72 and 78 weeks. Our findings thus suggest a strong association between transplacental TAM and reproductive tract abnormalities in female CD-1 mice.      

The efficacy of the ketogenic diet-1998: a prospective evaluation of intervention in 150 children

OBJECTIVE: The ketogenic diet is a high-fat, low-protein, low-carbohydrate diet developed in the 1920s for the treatment of children with difficult to control seizures. Despite advances in both the pharmacotherapy and the surgery of epilepsy, many children continue to have difficult-to-control seizures. This prospective study sought to determine the ketogenic diet's effectiveness and tolerability in children refractory to today's medications. METHODS: One hundred fifty consecutive children, ages 1 to 16 years, virtually all of whom continued to have more than two seizures per week despite adequate therapy with at least two anticonvulsant medications, were prospectively enrolled in this study, treated with the ketogenic diet, and followed for a minimum of 1 year. Seizure frequency was tabulated from patients' daily seizure calendars and seizure reduction calculated as percentage of baseline frequency. Adverse events and reasons for diet discontinuation were recorded. RESULTS: The children (mean age, 5.3 years), averaged 410 seizures per month before the diet, despite an exposure to a mean of 6.2 antiepileptic medications. Three months after diet initiation, 83% of those starting remained on the diet and 34% had >90% decrease in seizures. At 6 months, 71% still remained on the diet and 32% had a >90% decrease in seizures. At 1 year, 55% remained on the diet and 27% had a >90% decrease in seizure frequency. Most of those discontinuing the diet did so because it was either insufficiently effective or too restrictive. Seven percent stopped because of intercurrent illness. CONCLUSIONS: The ketogenic diet should be considered as alternative therapy for children with difficult-to-control seizures. It is more effective than many of the new anticonvulsant medications and is well tolerated by children and families when it is effective.     

Mononucleosis syndrome and coincidental human herpesvirus-7 and Epstein-Barr virus infection

Two girls (a 5 year old and a 21 month old) experiencing mononucleosis syndrome with coincidental human herpesvirus (HHV)-7 and Epstein-Barr virus (EBV) infections are described. One patient had primary HHV-7 infection and reactivated EBV infection. The other had primary HHV-7 and EBV infections. These cases indicated that HHV-7 is capable of inducing infectious mononucleosis-like illness. Multiple herpesvirus infection in one of the patients also suggests that interaction among herpesviruses can occur in vivo. The consequence of this interaction may have clinical implications.     

Efficacité sur la croissance et tolérance d’une préparation pour nourrissons à base de protéines de riz hydrolysées

The objective of this study was to assess the efficacy in terms of growth and tolerance of an infant formula based on hydrolyzed rice proteins.Patients and methodsHealthy infants, born at term, less than 1 month old, and exclusively fed an infant formula based on hydrolyzed rice proteins until their diet was diversified, were included in this open-label, multicenter study. The main outcome measure was daily weight gain during the study period. The infant's weight, height, body mass index (BMI), and the data concerning tolerance (digestive disorders, allergy manifestations) were collected at inclusion in the study, at 2 and 4 months, and before diversifying the infant's diet between 4 and 6 months. The growth parameters were compared to the WHO standards by calculating the Z-score.ResultsSeventy-eight infants were included. The mean daily weight gain over 5 months was 23.2 ± 4.3 g/day, identical to the WHO standards (22.2 ± 1.8 g/day, P = 0.09). During the study period, the Z-scores for weight, height, and BMI varied between +1.1 and ?0.5 SD according to the WHO standards. Formula acceptance and tolerance were both good.ConclusionThe infant formula studied, based on hydrolyzed rice proteins, was well tolerated and led to normal growth over the first few months of life, comparable to the WHO standards.     

继续医学教育活动的有效性

继续医学教育的目的是通过向医生提供最新的医学知识和技能,使医生在其整个职业生涯中,一直保持较高的医疗水平.但目前还没有充足的证据能证明继续医学教育活动的有效性,以及在继续医学教育活动中哪些教育方法和技术能最有效地传播和记忆医学知识.为了全面、系统地评估继续医学教育活动的有效性,以及了解不同的教育手段对医生知识、态度、技能、临床表现和临床效果的作用.美国约翰·霍普金斯大学医学院、美国医疗保健研究与质量管理署和美国胸科医师学会的专家共同进行了一项系统回顾性研究.