Acute Glycemic Effects of Exercise in Adolescents with Insulin-Dependent Diabetes Mellitus

The FDA has approved a prosthetic ligament for limited use in persons with a damaged anterior cruciate ligament, and it will likely approve a second device this year. Some orthopedic surgeons say these developments herald a new era of surgery, while others warn that it is too early to tell.     

Effects of tramadol on viscero‐visceral hyperalgesia in a rat model of endometriosis plus ureteral calculosis

The effects of tramadol versus placebo administration on behavioral indicators of ureteral pain, pelvic pain and referred lumbar muscle hyperalgesia were investigated in a rat model of viscero‐visceral hyperalgesia from endometriosis plus ureteral calculosis (endo + stone). Fifty female Sprague‐Dawley rats underwent surgical induction of endometriosis and, 2 weeks later, were randomly assigned to five groups (10 each), to be treated i.p., twice a day, with tramadol (0.625, 1.25, 2.5, or 5 mg/kg) or saline for 5 days (14–18th day postendometriosis; prestone treatment). On the 21st day, they underwent laparotomy for stone formation in the upper left ureter (dental cement injection). All were video‐taped 24 h nonstop for 7 days before and 4 days after stone formation (14–25th day postendometriosis) to record ureteral and pelvic pain behaviors. Lumbar sensitivity (L1) was tested bilaterally, daily over the same period, by verifying presence/absence of vocalization upon muscle pinching at a predefined pressure (calibrated forceps). Additional fifty endo + stone rats underwent the same protocol, except that treatment was performed on 21st–25th day (poststone treatment). Tramadol vs. saline significantly reduced number and duration of ureteral crises, duration of pelvic behavior, and incidence of muscle hyperalgesia (P < 0.0001), with a dose‐dependent effect. Prestone treatment was significantly more effective than poststone treatment for the 1.25 dose for all parameters and 2.5 dose for pelvic and muscle parameters (0.003 > P < 0.02). Tramadol, even at low doses, is thus highly protective against pain from ‘viscero‐visceral hyperalgesia’ in endometriosis plus ureteral calculosis; it can represent a valid therapeutic approach in women with these comorbidities.     

Spontaneous and pokeweed mitogen induced production of rheumatoid factor and immunoglobulins in type II essential mixed cryoglobulinaemia.

In order to evaluate functional lymphocyte defects in type II essential mixed cryoglobulinaemia (EMC) in vitro production of immunoglobulins (Ig) and rheumatoid factor (RF) has been studied in basal conditions and under pokeweed mitogen (PWM) stimulation in 15 patients and in 17 control subjects. The major finding was a significantly high basal and inducible production of RF by EMC lymphocytes as compared with the RF production in controls, while synthesis of polyclonal Ig was unaffected. A good correlation existed between in vitro production and serum levels of RF. Peripheral blood SmIg+ and Ia+ cells were also significantly increased. The possibility that EMC shares some pathogenetic mechanism with rheumatoid arthritis on the one hand and with lymphoproliferative diseases on the other is considered.     

Cancers in Australia attributable to exposure to solar ultraviolet radiation and prevented by regular sunscreen use

Objectives: To estimate the proportion and numbers of cancers occurring in Australia attributable to solar ultraviolet radiation (UVR) and the proportion and numbers prevented by regular sun protection factor (SPF) 15+ sunscreen use. Methods: We estimated the population attributable fraction (PAF) and numbers of melanomas and keratinocyte cancers (i.e. basal cell carcinomas and squamous cell carcinomas) due to exposure to ambient UVR resulting from residing in Australia versus residing in the UK (for melanoma) or Scandinavia (for keratinocyte cancers). We also estimated the prevented fraction (PF): the proportion of cancers that would have occurred but were likely prevented by regular sunscreen use. Results: An estimated 7,220 melanomas (PAF 63%) and essentially all keratinocyte cancers occurring in Australia were attributable to high ambient UVR levels in Australia. We estimated that regular sunscreen use prevented around 14,190 (PF 9.3%) and 1,730 (PF 14%) people from developing SCC and melanoma, respectively. Conclusions: Although our approach was conservative, a high proportion of skin cancers in Australia are attributable to high ambient levels of UVR. Prevailing levels of sunscreen use probably reduced skin cancer incidence by 10–15%. Implications: Most skin cancers are preventable. Sunscreen should be a component of a comprehensive sun protection strategy.     

Cancers in Australia in 2010 attributable to total breastfeeding durations of 12 months or less by parous women

Objectives: To estimate the proportion and number of cancers occurring in Australia in 2010 attributable to parous women having breastfed for total durations of ≤12 months. Methods: We estimated the population attributable fraction (PAF) of breast cancers (the only cancer site with convincing evidence of causal association) associated with women breastfeeding for ≤12 months in total, using standard formulae incorporating breastfeeding prevalence data, relative risks associated with breastfeeding and cancer incidence. We also estimated the proportion change in disease incidence (potential impact fraction [PIF]) that might have occurred under two hypothetical scenarios of women breastfeeding for longer durations. Results: An estimated 235 (1.7%) breast cancer cases that occurred in Australian in 2010 could be attributed to women breastfeeding for total durations of ≤12 months. Assuming a hypothetical increase in breastfeeding, we estimated that the number of breast cancers prevented would range from 36 to 51 (prevented fraction = 0.3% to 0.4%). Conclusions: More than 200 breast cancers were attributable to women breastfeeding for total durations of ≤12 months. Implications: Policies to increase breastfeeding duration may help prevent breast cancers in the future.