The Cochrane Database of Systematic Reviews

This issue of Physiotherapyincludes citations from an increasingly important source of evidence for healthcare interventions: The Cochrane Database of Systematic Reviews. Contained within The Cochrane Library, the Cochrane Database of Systematic Reviews is an electronic rather than a paper publication. Physiotherapists, in common with other health professionals, can no longer ignore the growth and potential usefulness of electronically disseminated information, as shown by the scope and number of recently published systematic reviews that have been conducted within the Cochrane Collaboration and are of relevance to physiotherapists. A selective list of titles after this leading article is followed by four abstracts of recently published reviews. Further selections will be published quarterly.     

Correlation between culture testing of swabs and ligase chain reaction of first void urine from patients recently treated for Chlamydia trachomatis

We assessed the correlation between ligase chain reaction (LCR) on first void urine (FVU) and cultures of urethral and cervical swabs to detect chlamydia during three post-treatment follow up visits for 10 men and 19 women with genital chlamydial infections who had been treated with azithromycin or doxcycline.     

Fixed cantilever splints on teeth with normal and reduced periodontal support

Photoelastic models were used to visualize stresses developed in teeth and supporting bone by cantilever fixed partial dentures where the most distal abutments had either crater or trough osseous defects. The effects of splinting the periodontally involved teeth to one or more additional sound teeth were studied. It was shown that for a cantilever fixed partial denture with either normal periodontal support, or a distal abutment with a moderate degree of mobility and bone loss, the following can be concluded: (1) occlusal forces on a cantilever fixed partial denture were significantly distributed to only the three teeth closest to the loaded cantilever, (2) optimum stress reduction occurred with the splinting of a periodontally compromised tooth to two periodontally sound teeth. Increasing the number of splinted abutments did not result in a proportional reduction of stress in the periodontium, and (3) no significant cross-arch sharing of occlusal loads was seen.     

The lesions of the pterygopalatine and infratemporal spaces: Computed tomography evaluation

Objective. The purpose of this study was to categorize the computed tomography features of lesions affecting the pterygopalatine fossa and infratemporal fossa and thus aid in the diagnosis of these lesions.Design. Eighty-six patients with lesions of the pterygopalatine fossa and infratemporal fossa were examined with computed tomography; the lesions were confirmed by both surgery and biopsy. The patients were divided into three groups: group I consisted of patients in whom the lesions had originated in one or both fossae; group II, of patients in whom the lesions originated in other oral and maxillofacial regions but showed extension into the pterygopalatine and infratemporal fossae; and group III, of patients in whom the lesions had multicentric origins.Results. Of the 11 cases in group I, demarcation was confined to both fossae in 4 patients, and involvement of the adjacent structures was shown on computed tomography images in 7 patients. Involved structures included the maxillary sinus (4 sides), nasal cavity (3 sides), mandibular ramus (6 sides), buccal space (2 sides), base of the skull (5 sides), palate (3 sides), and parapharyngeal space (5 sides). In the 70 cases in group II, computed tomography images showed that lesions had invaded both fossae via following routes: (1) 40 lesions in the maxillary sinus had infiltrated posterolaterally into 26 pterygopalatine and 39 infratemporal fossae; (2) two nasal cavity and three nasopharynx tumors had infiltrated laterally or lateroanteriorly into five pterygopalatine and one infratemporal fossae; (3) lesions originating in mandibular rami (9 lesions), buccal regions (4 lesions), parapharyngeal spaces (1 lesion) and parotid glands (1 lesion) had intruded medially into 15 infratemporal fossae; (4) two temporal bone tumors had encroached inferiorly on two infratemporal fossae; (5) four palate tumors had led to involvement of three pterygopalatine and four infratemporal fossae; and (6) four inflammatory diseases of the facial spaces involved two pterygopalatine and four infratemporal fossae. Group III lesions (5 cases) affecting one pterygopalatine and five infratemporal fossae were hemangiomas; one was a malignant lymphoma.Conclusion. Group I lesions may involve the adjacent anatomic structures of both pterygopalatine and infratemporal fossae in every direction. Group II lesions that correspond to the various origins of the maxillofacial region have different pathways of infiltration into the pterygopalatine or infratemporal fossae. Computed tomography examination is very important in the evaluation of lesions involving the pterygopalatine and infratemporal fossae.     

Catecholamines and serotonin in the rat central nervous system after 6-OHDA, 5-7-DHT and p-CPA

Summary The norepinephrine (NE), epinephrine (EPI), dopamine (DA) and serotonin (5-HT) contents were measured radioenzymatically in seven anatomically defined regions (frontal cerebral cortex, hippocampus, hypothalamus, midbrain, pons-medulla oblongata, cerebellum and spinal cord) in adult normal animals, after treatment with the tryptophan hydroxylase inhibitor p-chlorophenylalanine (p-CPA), and after the intraventricular administration of either 6-hydroxydopamine (6-OHDA) or 5, 7-dihydroxytryptamine (5, 7-DHT). The effects of p-CPA seemed not restricted to 5-HT, since reductions in catecholamine (CA) content were detected in several regions. After 5, 7-DHT given under desimipramine (DMI) protection, comparable reductions in 5-HT levels were obtained but the changes in CA were less severe than after p-CPA. The neurotoxin 6-OHDA decreased the CA in all regions but also 5-HT content in hippocampus, hypothalamus and ponsmedulla. The significance and the interpretation of these changes are discussed in relation to the specificity of the drugs employed, together with an assessment of the local monoamine turnover and the possible functional effects of monoamine interactions in the CNS.Abreviations CA catecholamines - NE norepinephrine - EPI epinephrine - DA dopamine - 5-HT serotonin - p-CPA para-chlorophenylalanine - 6-OHDA 6-hydroxydopamine - 5, 7-DHT 5, 7-dihydroxytryptamine     

Inhibition of the growth of human lung cancer cells by alkyl-lysophospholipid analogs

The growth inhibitory activity of two alkyl-lysophospholipid analogs (ALP) towards three different lines of human lung carcinoma cells growing in culture was determined. The alkyl-lysophospholipids, BM 41.440 and Et-18-OCH3 had significant inhibitory activity against a human lung adenocarcinoma and squamous cell carcinoma. Both drugs were less active against a human small cell carcinoma. The data indicate that drugs of this type are therefore potentially useful in the treatment of several types of human lung cancer.