Complementary and alternative medicine for children's asthma: satisfaction, care provider responsiveness, and networks of care

We explain why some caretakers opt for alternative medicine for the treatment of children's asthma whereas others do not. In the past 15 years, asthma care has been standardized, with clinical practice guidelines centered on advanced pharmacological regimes. Clinicians argue that with proper biomedical treatment and environmental control, asthma should be a manageable chronic disease. Yet many patients forego available pharmacological treatments for alternative medicine or complement prescribed drugs with unconventional treatments. On the basis of open-ended, in-depth qualitative interviews with 50 mothers of children with asthma, we argue that the experience with biomedical treatments, social influence in mother's network of care, concerns about adverse and long-term effects, health care providers' responsiveness to such concerns, and familiarity with alternative treatments explain why some families rely on alternative medicine and others do not.     

Are the osseous and tendinous-cartilaginous tibial tuberosity-trochlear groove distances the same on CT and MRI?

Objective

To verify whether the tibial tuberosity-trochlear groove distance (TT-TG) and the tendinous-cartilaginous TT-TG (the distance between the patellar tendon and trochlear groove: PT-TG) are identical using computed tomography (CT) and magnetic resonance imaging (MRI) techniques.

Subjects and methods

The TT-TG and PT-TG distances were measured on the same knee samples by three observers (two measurements per observer) using CT and MRI scans collected retrospectively. The reproducibility of the measurements was assessed using the interclass correlation coefficient (ICC). The means and standard deviations of four measurements were calculated for each patient. A paired t-test was used to assess differences between measurements.

Results

Fifty knee samples (32 with patellar instability and 18 with other conditions) were evaluated. The inter- and intraobserver reliability was excellent for all four measurements (>0.8). On average, the TT-TG distance on MRI was 3.1–3.6 mm smaller than that on CT, and the PT-TG distance on MRI was 1.0–3.4 mm larger than the TT-TG distance on MRI.

Conclusion

The osseous TT-TG and tendinous-cartilaginous PT-TG distances determined by CT and MRI were not identical.

     

Insulin‐like growth factor 1 expression correlates with clinical outcome in K‐RAS wild type colorectal cancer patients treated with cetuximab and irinotecan

Seventy to 40% of K‐RAS wild type colorectal tumors does not seem to benefit from treatment with antiepidermal growth factor receptor (anti‐EGFR) monoclonal antibodies. Recent data suggested that in presence of IGF‐1 system, altered activation colorectal cancer cells may escape anti‐EGFR mediated cell death. The interaction between IGF‐1 expression and K‐RAS mutational analysis was tested to verify the ability of IGF‐1 to identify a subgroup of patients more likely to benefit from EGFR‐targeted antibodies treatment. IGF‐1 expression and K‐RAS mutational status was assessed in advanced colorectal cancer patients receiving irinotecan/cetuximab. One hundred twelve patients were analyzed. IGF‐1 was negative in 30 patients (27%) and overexpressed in the remaining 82 cases (73%). In IGF‐1 negative and IGF‐1 positive tumors, we observed progressive disease in 9 (30%) and 55 (67%) patients, respectively (p = 0.001). Median progression‐free survival was 7.5 mo in patients showing IGF‐1 negative tumors and 3 mo for IGF‐1 expressing tumors (p = 0.002). Among K‐RAS wild type patients, IGF‐1 negative and positive tumors showed a partial response to cetuximab‐irinotecan in 13 (65%) and 11 (22%) cases, respectively (p = 0.002). Median progression‐free survival in IGF‐1 negative tumors was 10 mo and 3.2 mo in IGF‐1 positive colorectal cancers (p = 0.02). IGF‐1 proved to be a possible predictive factor for resistance to anti‐EGFR monoclonal antibodies in K‐RAS wild type colorectal cancer. Combined IGF‐1 and K‐RAS analysis may represent an effective strategy for a better selection of responding colorectal cancer patients.     

Saturated polyesters as emulsifiers for emulsion copolymerization of unsaturated polyester resins with styrene

Intramolecularly crosslinked macromolecules (ICM) from unsaturated polyesters (UP) and styrene, respectively from technical divinylbenzene (t-DVB), were prepared by emulsion copolymerization (ECP). Saturated polyesters of different compositions and molar masses between 1200 and 2400 were used as emulsifiers (ESP). The influence of molar mass and structure at various concentrations of the ESP on yield, number and diameter of the ICM and their composition was studied. For comparison, also sodium dodecyl sulfate (SDS) was used as emulsifier.     

Relationship between Vmax and conduction velocity in uniform anisotropic canine ventricular muscle: differences between the effects of lidocaine and amiodarone.

The purpose of these experiments was to determine if Vmax in anisotropic myocardium varies approximately as the square of the conduction velocity (theta) after the addition of lidocaine (6.5 micrograms/ml) and amiodarone (20 micrograms/ml). We measured Vmax and theta in 16 epicardial strips of uniform anisotropic ventricular muscles, over a wide range of stimulation frequencies. The relationship of Vmax to theta 2 was evaluated by linear regression analysis. We found that the decrease in Vmax was proportional to the square of the decrease in theta in the presence of lidocaine both during longitudinal (LP) and transverse (TP) propagation (mean slope +/- SEM: 0.961 +/- 0.047 and 0.918 +/- 0.068, respectively). The changes in Vmax, in the presence of amiodarone, were not predicted by the quadratic changes in theta during TP. However, during LP, the changes in Vmax and theta were well fitted by the predicted relationship. The slope was significantly different from that of lidocaine (2.399 +/- 0.673 vs. 0.961 +/- 0.047, p less than 0.05). On the other hand, the predicted values of theta, assuming theta = square root of Vmax x k, were significantly more depressed than the measured values. We conclude that in uniform anisotropic ventricular muscle, when the changes in Vmax and theta are solely due to a decrease in sodium conductance, a quadratic relationship between the changes in both variables is seen and the slope of the regression line should be 1, such as we have shown for lidocaine.(ABSTRACT TRUNCATED AT 250 WORDS)