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Migraine pathogenesis and state of pharmacological treatment optionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Migraine is a largely inherited disorder of the brain characterised by a complex but stereotypical dysfunction of sensory processing. The most obvious clinical symptom often is head pain, but non-headache symptoms such as photophobia, phonophobia and nausea are clearly part of the typical presentation. This review discusses current pathophysiological concepts of migraine and migraine aura, such as a possible brainstem dysfunction and cortical spreading depression. Acute and preventive migraine treatment approaches are briefly covered with a focus on shortcomings of the currently available treatment options. A number of dif...
Source: BMC Medicine - November 16, 2009 Category: Internal Medicine Authors: Peter GoadsbyTill Sprenger Source Type: journals

Oral high dose ascorbic acid treatment for one year in young CMT1A patients: a randomised, double-blind, placebo-controlled phase II trialEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Oral high dose ascorbic acid for one year did not improve myelination of the median nerve in young Charcot-Marie-Tooth type 1A patients. Treatment was relatively safe.Trial registration: Current Controlled Trials ISRCTN56968278, ClinicalTrials.gov NCT00271635. (Source: BMC Medicine)
Source: BMC Medicine - November 12, 2009 Category: Internal Medicine Authors: Camiel VerhammeRob de HaanMarinus VermeulenFrank BaasMarianne de VisserIvo van Schaik Source Type: journals

Human papillomavirus testing with Pap triage for cervical cancer prevention in Canada: a cost-effectiveness analysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: A strategy of human papillomavirus testing beginning at age 25, with Pap triage for women with positive human papillomavirus results may be more effective at reducing cervical cancer at a lower cost than the current recommended strategy for screening in Canada. (Source: BMC Medicine)
Source: BMC Medicine - November 9, 2009 Category: Internal Medicine Authors: Shalini KulasingamRaghu RajanYvan St.PierreC. Victoria AtwoodEvan MyersEduardo Franco Source Type: journals

Adherence to isoniazid prophylaxis among HIV-infected children: a randomized controlled trial comparing two dosing schedulesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Adherence to isoniazid was excellent regardless of the dosing schedule used. Intermittent dosing of isoniazid prophylaxis can be considered as an alternative to daily dosing, without compromising adherence or efficacy.Trial registration - Clinical Trials NCT00330304 (Source: BMC Medicine)
Source: BMC Medicine - November 3, 2009 Category: Internal Medicine Authors: Stanzi le RouxMark CottonJonathan GolubDavid le RouxLesley WorkmanHeather Zar Source Type: journals

Accumulation of neutral lipids in peripheral blood mononuclear cells as a distinctive trait of Alzheimer patients and asymptomatic subjects at risk of diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: We suggest that neutral lipid-peripheral blood mononuclear cells and plasma high density lipoprotein-cholesterol determinations might be of interest to outline a distinctive metabolic profile applying to both Alzheimer's disease patients and asymptomatic subjects at higher risk of disease. (Source: BMC Medicine)
Source: BMC Medicine - November 2, 2009 Category: Internal Medicine Authors: Alessandra PaniAntonella MandasGiacomo DiazClaudia AbetePier Luigi CoccoFabrizio AngiusAnnalisa BrunduNico MucakaMaria Elena PaisAntonio SabaLuigi BarberiniCristina ZaruManuela PalmasPaolo PutzuAlessandra MocaliFrancesco PaolettiPaolo La CollaSandra Dessi Source Type: journals

Development of lower limb range of motion from early childhood to adolescence in cerebral palsy: a population-based studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: We found a decreasing ROM in children with CP from 2-14 years of age. This information is important for both the treatment and follow-up planning of the individual child as well as for the planning of health care programmes for all children with CP. (Source: BMC Medicine)
Source: BMC Medicine - October 28, 2009 Category: Internal Medicine Authors: Eva NordmarkGunnar HagglundHenrik Lauge-PedersenPhilippe WagnerLena Westbom Source Type: journals

Genomic and epigenetic evidence for oxytocin receptor deficiency in autismEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Together, these data provide further evidence for the role of OXTR and the oxytocin signaling pathway in the etiology of autism and, for the first time, implicate the epigenetic regulation of OXTR in the development of the disorder.See the related commentary by Gurrieri and Neri: http://www.biomedcentral.com/1741-7015/7/63 (Source: BMC Medicine)
Source: BMC Medicine - October 21, 2009 Category: Internal Medicine Authors: Simon GregoryJessica ConnellyAaron TowersJessica JohnsonDhani BiscochoChristina MarkunasCarla LintasRuth AbramsonHarry WrightPeter EllisCordelia LangfordGordon WorleyG Robert DelongSusan MurphyMichael CuccaroAntonello PersicoMargaret Pericak-Vance Source Type: journals

Defective oxytocin function: a clue to understanding the cause of autism?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The autism spectrum disorders are a group of conditions with neurobehavioral impairment affecting approximately 0.6% of children. The clinical presentation is complex and the etiology is largely unknown, although a major role of genetic factors is widely accepted. A number of genetic studies led to the identification of genes and/or copy number variants whose alterations are associated with autism, but no specific factor has been found so far to be responsible for a substantial proportion of cases. Epigenetic modifications may also play a role, as demonstrated by the occurrence of autism in genetic conditions caused by mut...
Source: BMC Medicine - October 21, 2009 Category: Internal Medicine Authors: Fiorella GurrieriGiovanni Neri Source Type: journals

Suicidal ideation during treatment of depression with escitalopram and nortriptyline in Genome-Based Therapeutic Drugs for Depression (GENDEP): a clinical trialEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Increases in suicidal ideation were associated with depression severity and decreased during antidepressant treatment. In men, treatment with escitalopram is associated with lower risk of suicidal ideation compared to nortriptyline. Clinicians should remain alert to suicidal ideation beyond the initial weeks of antidepressant treatment.Trial registration: EudraCT (No.2004-001723-38) and ISRCTN (No. 03693000). (Source: BMC Medicine)
Source: BMC Medicine - October 14, 2009 Category: Internal Medicine Authors: Nader PerroudRudolf UherAndrej MarusicMarcella RietschelOle MorsNeven HenigsbergJoanna HauserWolfgang MaierDaniel SoueryAnna PlacentinoAleksandra SzczepankiewiczLisbeth JorgensenJana StrohmaierAstrid ZobelCaterina GiovanniniAmanda ElkinCerisse GunasingheJ Source Type: journals

Trends of the public health research output from India during 2001-2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: An understanding of how public health research output from India is changing in relation to the disease burden and public health priorities is required in order to inform relevant research development. We therefore studied the trends in the public health research output from India during 2001-2008 that was readily available in the public domain. Methods: The scope and type of the published research from India in 2007 that was included in the PubMed database was assessed and compared with a previous similar assessment for 2002. Papers were classified based on the review of abstracts and original public health re...
Source: BMC Medicine - October 13, 2009 Category: Internal Medicine Authors: Lalit DandonaMagdalena RabanRama GuggillaAarushi BhatnagarRakhi Dandona Source Type: journals

An evaluation of exclusionary medical/psychiatric conditions in the definition of chronic fatigue syndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Medical and psychiatric illnesses associated with fatigue are common among the unwell. Those who fulfill CFS-like criteria need to be evaluated for potentially treatable conditions. Those with exclusionary conditions are equally impaired as those without exclusions.See the related commentary by Harvey and Wessely: http://www.biomedcentral.com/1741-7015/7/58 (Source: BMC Medicine)
Source: BMC Medicine - October 11, 2009 Category: Internal Medicine Authors: James JonesJin-Mann LinElizabeth MaloneyRoumiana BonevaUrs NaterElizabeth UngerWilliam Reeves Source Type: journals

Chronic fatigue syndrome: identifying zebras amongst the horsesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
There are currently no investigative tools or physical signs that can confirm or refute the presence of chronic fatigue syndrome (CFS). As a result, clinicians must decide how long to keep looking for alternative explanations for fatigue before settling on a diagnosis of CFS. Too little investigation risks serious or easily treatable causes of fatigue being overlooked, whilst too many increases the risk of iatrogenic harm and reduces the opportunity for early focused treatment. A paper by Jones et al published this month in BMC Medicine may help clinicians in deciding how to undertake such investigations. Their results sug...
Source: BMC Medicine - October 11, 2009 Category: Internal Medicine Authors: Samuel HarveySimon Wessely Source Type: journals

A vision of the future for BMC Medicine: serving science, medicine and authorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In June 2009, BMC Medicine received its first official impact factor of 3.28 from Thomson Reuters. In recognition of this landmark event, the BMC Medicine editorial team present and discuss the vision and aims of the journal. (Source: BMC Medicine)
Source: BMC Medicine - October 6, 2009 Category: Internal Medicine Authors: Robin Cassady-CainJoanne ApplefordJigisha PatelMick AulakhMelissa Norton Source Type: journals

Chemical and environmental vector control as a contribution to the elimination of visceral leishmaniasis on the Indian subcontinent: cluster randomized controlled trials in Bangladesh, India and NepalEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Sand fly control can contribute to the regional VL elimination programme; IRS should be strengthened in India and Nepal but in Bangladesh, where vector control has largely been abandoned during the last decades, the insecticide treatment of existing bed nets (coverage above 90% in VL endemic districts) could bring about an immediate reduction of vector populations; operational research to inform policy makers about the efficacious options for VL vector control and programme performance should be strengthened in the three countries. (Source: BMC Medicine)
Source: BMC Medicine - October 4, 2009 Category: Internal Medicine Authors: Anand JoshiMurari DasShireen AkhterRajib ChowdhuryDinesh MondalVijay KumarPradeep DasAxel KroegerMarleen BoelaertMax Petzold Source Type: journals

Self-perceived psychological stress and ischemic stroke: a case-control studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: In this case-control study, we found an independent association between self-perceived psychological stress and ischemic stroke. A novel finding was that this association differed by ischemic stroke subtype. Our results emphasize the need for further prospective studies addressing the potential role for psychological stress as a risk factor for ischemic stroke. In such studies ischemic stroke subtypes should be taken into consideration. (Source: BMC Medicine)
Source: BMC Medicine - September 30, 2009 Category: Internal Medicine Authors: Katarina JoodPetra RedforsAnnika RosengrenChristian BlomstrandChristina Jern Source Type: journals

Who uses firearms as a means of suicide? A population study exploring firearm accessibility and method choiceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study, accessing all cases of suicide 1997-2004, explores factors which may impact on the choice of firearms as a suicide method, including current licence possession and previous history of legal access. Methods: Detailed information on all Queensland suicides (1997-2004) was obtained from the Queensland Suicide Register, with additional details of firearm licence history accessed from the Firearm Registry (Queensland Police Service). Cases were compared against licence history and method choice (firearms or other method). Odds ratios (OR) assessed the risk of firearms suicide and suicide by any method against licenc...
Source: BMC Medicine - September 23, 2009 Category: Internal Medicine Authors: Helen KlieveJerneja SveticicDiego De Leo Source Type: journals

The economics of treating stroke as an acute brain attackEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Currently, treatments for ischemic stroke focus on restoring or improving perfusion to the ischemic area using thrombolytics. The increased hospitalization costs related to thrombolysis are offset by a decrease in rehabilitation costs, for a net cost savings to the healthcare system. However, early treatment is essential. The benefit of thrombolysis is time-dependent but only a very small proportion of patients, 2%, are presently being treated with tPA. In the United States, if the proportion of all ischemic stroke patients that receive tPA were increased to 4, 6, 8, 10, 15, or 20%, the realized cost saving would be approx...
Source: BMC Medicine - September 22, 2009 Category: Internal Medicine Authors: Julien BogousslavskyMaurizio Paciaroni Source Type: journals

Quality of medication use in primary care - mapping the problem, working to a solution: a systematic review of the literatureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: By adopting the whole system approach from a management perspective we have found where failures in quality occur in medication use in primary care in the UK, and where weaknesses occur in the associated evidence base. Quality management approaches have allowed us to develop a coherent change and research agenda in order to tackle these, so far, fairly intractable problems. (Source: BMC Medicine)
Source: BMC Medicine - September 20, 2009 Category: Internal Medicine Authors: Sara GarfieldNick BarberPaul WalleyAlan WillsonLina Eliasson Source Type: journals

Evaluation of a multiple ecological level child obesity prevention program: Switch what you Do, View, and ChewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The results indicate that the Switch program yielded small-to-modest treatment effects for promoting children's FV fruit and vegetable consumption and minimizing ST. The Switch program, which targets multiple behaviors through multiple channels, offers promise for use in youth obesity prevention. (Source: BMC Medicine)
Source: BMC Medicine - September 17, 2009 Category: Internal Medicine Authors: Douglas GentileGregory WelkJoey EisenmannRachel ReimerDavid WalshDaniel RussellRandi CallahanMonica WalshSarah StricklandKatie Fritz Source Type: journals

Childhood emotional problems and self-perceptions predict weight gain in a longitudinal regression modelEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Emotional problems, low self-esteem and an external locus of control in childhood predict weight gain into adulthood. This has important clinical implications as it highlights a direction for early intervention strategies that may contribute to efforts to combat the current obesity epidemic. (Source: BMC Medicine)
Source: BMC Medicine - September 10, 2009 Category: Internal Medicine Authors: Andrew TernouthDavid CollierBarbara Maughan Source Type: journals

Seasonal transmission potential and activity peaks of the new influenza A(H1N1): a Monte Carlo likelihood analysis based on human mobilityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The analysis shows the potential for an early epidemic peak occurring in October/November in the Northern hemisphere, likely before large-scale vaccination campaigns could be carried out. The baseline results refer to a worst-case scenario in which additional mitigation policies are not considered. We suggest that the planning of additional mitigation policies such as systematic antiviral treatments might be the key to delay the activity peak in order to restore the effectiveness of the vaccination programs. (Source: BMC Medicine)
Source: BMC Medicine - September 9, 2009 Category: Internal Medicine Authors: Duygu BalcanHao HuBruno GoncalvesPaolo BajardiChiara PolettoJose RamascoDaniela PaolottiNicola PerraMichele TizzoniWouter Van den BroeckVittoria ColizzaAlessandro Vespignani Source Type: journals

Safety and tolerability of the antimicrobial peptide human lactoferrin 1-11 (hLF1-11)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The new antimicrobial hLF1-11 is well tolerated in healthy volunteers with repeated daily doses up to 5 mg. The side-effect profile is very favourable for an antimicrobial, the only undesirable effect being a possible elevation of transaminases, which may be related to hLF1-11 although the current data do not allow conclusive interpretation of treatment relationship. A lower dose is recommended for the forthcoming multiple dosing studies in HSCT patients.Trial registration: ClinicalTrials.gov: nct00509938. (Source: BMC Medicine)
Source: BMC Medicine - September 7, 2009 Category: Internal Medicine Authors: Walter van der VeldenThijs van IerselNicole BlijlevensJ Peter Donnelly Source Type: journals

Modelling the progression of pandemic influenza A (H1N1) in Vietnam and the opportunities for reassortment with other influenza virusesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: It is likely that, in the absence of effective interventions, the introduction of a novel H1N1 into a densely populated country such as Vietnam will result in a widespread epidemic. A large epidemic in a country with intense human-animal interaction and continued co-circulation of other seasonal and avian viruses would provide substantial opportunities for H1N1 to acquire new genes. (Source: BMC Medicine)
Source: BMC Medicine - September 2, 2009 Category: Internal Medicine Authors: Maciej BoniBui ManhPham ThaiJeremy FarrarTran HienNguyen HienNguyen KinhPeter Horby Source Type: journals

Phosphorylated ERK is a potential predictor of sensitivity to sorafenib when treating hepatocellular carcinoma: evidence from an in vitro studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: In this in vitro study, pERK was confirmed to be a potential biomarker predictive of sensitivity to sorafenib in treating HCC. The RAF/MEK/ERK pathway may be involved in drug resistance to traditional chemotherapy in HCC. (Source: BMC Medicine)
Source: BMC Medicine - August 23, 2009 Category: Internal Medicine Authors: Zhe ZhangXiaoyun ZhouHujia ShenDexing WangYanhong Wang Source Type: journals

Predicting the response to sorafenib in hepatocellular carcinoma: where is the evidence for phosphorylated extracellular signaling-regulated kinase (pERK)?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The approval of sorafenib and active development of many other molecularly targeted agents in hepatocellular carcinoma (HCC) have presented a challenge to understand the mechanism of action of sorafenib and identify predictive biomarkers to select patients more likely to benefit from sorafenib. The preclinical study by Zhang and celleagues published this month in BMC Medicine provides preliminary evidence that baseline phosphorylated extracellular signaling-regulated kinase (pERK) may be a relevant marker to reflect the level of constitutive activation of the RAF/mitogen-activated protein kinase kinase (MEK)/ERK signaling ...
Source: BMC Medicine - August 23, 2009 Category: Internal Medicine Authors: Andrew Zhu Source Type: journals

Management and prevention of chronic obstructive pulmonary disease exacerbations: a state of the art reviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Exacerbations of chronic obstructive pulmonary disease (COPD) are important events in the natural history of this prevalent and devastating condition. This review provides a concise, state of the art summary on prevention and management of exacerbations. Considerable new data underpins evidence in support of many preventative interventions, pharmacological and non-pharmacological, that are now available. Challenges remain in developing new approaches, and delivering those that already exist to the right patient at the right time. Management of an exacerbation remains stepwise according to clinical severity, but there is no...
Source: BMC Medicine - August 6, 2009 Category: Internal Medicine Authors: John HurstJadwiga Wedzicha Source Type: journals

Hospital variation in transfusion and infection after cardiac surgery: a cohort studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Allogeneic blood transfusion was associated with an increased risk of infection at multiple sites, suggesting a system-wide immune response. Hospital variation in transfusion practices after coronary artery bypass grafting was considerable, indicating that quality efforts may be able to influence practice and improve outcomes. (Source: BMC Medicine)
Source: BMC Medicine - July 30, 2009 Category: Internal Medicine Authors: Mary RogersNeil BlumbergSanjay SaintKenneth LangaBrahmajee Nallamothu Source Type: journals

Does blood transfusion harm cardiac surgery patients?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Allogeneic blood transfusion was associated with an increased risk of infection at multiple sites, suggesting a system-wide immune response. Hospital variation in transfusion practices after coronary artery bypass grafting was considerable, indicating that quality efforts may be able to influence practice and improve outcomes. (Source: BMC Medicine)
Source: BMC Medicine - July 30, 2009 Category: Internal Medicine Authors: Gavin Murphy Source Type: journals

RNA viruses in community-acquired childhood pneumonia in semi-urban Nepal; a cross-sectional studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: Pneumonia is among the main causes of illness and death in children (Source: BMC Medicine)
Source: BMC Medicine - July 26, 2009 Category: Internal Medicine Authors: Maria MathisenTor StrandBiswa SharmaRam ChandyoPalle Valentiner-BranthSudha BasnetRamesh AdhikariDag HvidstenPrakash ShresthaHalvor Sommerfelt Source Type: journals

Identification of pediatric septic shock subclasses based on genome-wide expression profilingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Genome-wide expression profiling can identify pediatric septic shock subclasses having clinically relevant phenotypes. (Source: BMC Medicine)
Source: BMC Medicine - July 21, 2009 Category: Internal Medicine Authors: Hector WongNatalie CvijanovichRichard LinGeoffrey AllenNeal ThomasDouglas WillsonRobert FreishtatNick AnasKeith MeyerPaul ChecchiaMarie MonacoKelli OdomsThomas Shanley Source Type: journals

Effects of clinical pathways in the joint replacement: a meta-analysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The results of this meta-analysis show that clinical pathways can significantly improve the quality of care even if it is not possible to conclude that the implementation of clinical pathways is a cost-effective process, because none of the included studies analysed the cost of the development and implementation of the pathways. Based on the results we assume that pathways have impact on the organisation of care if the care process is structured in a standardised way, teams critically analyse the actual organisation of the process and the multidisciplinary team is highly involved in the re-organisation. Further...
Source: BMC Medicine - June 30, 2009 Category: Internal Medicine Authors: A BarbieriK VanhaechtP Van HerckW SermeusF FaggianoS MarchisioM Panella Source Type: journals

Modeling influenza epidemics and pandemics: insights into the future of swine flu (H1N1)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Here we present a review of the literature of influenza modeling studies, and discuss how these models can provide insights into the future of the currently circulating novel strain of influenza A (H1N1), formerly known as swine flu. We discuss how the feasibility of controlling an epidemic critically depends on the value of the Basic Reproduction Number (R0). The R0 for novel influenza A (H1N1) has recently been estimated to be between 1.4 and 1.6. This value is below values of R0 estimated for the 1918-1919 pandemic strain (mean R0 ~ 2: range 1.4 to 2.8) and is comparable to R0 values estimated for seasonal strains of in...
Source: BMC Medicine - June 21, 2009 Category: Internal Medicine Authors: Brian CoburnBradley WagnerSally Blower Source Type: journals

Measuring the effect of enhanced cleaning in a UK hospital: a prospective cross-over studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Introducing one extra cleaner produced a measurable effect on the clinical environment, with apparent benefit to patients regarding meticillin-resistant S. aureus infection. Molecular epidemiological methods supported the possibility that patients acquired meticillin-resistant S. aureus from environmental sources. These findings suggest that additional research is warranted to further clarify the environmental, clinical and economic impact of enhanced hygienic cleaning as a component in the control of hospital-acquired infection. (Source: BMC Medicine)
Source: BMC Medicine - June 8, 2009 Category: Internal Medicine Authors: Stephanie DancerLiza WhiteJim LambE GirvanChris Robertson Source Type: journals

Calculating the return on investment of mobile healthcareEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: By using published data that quantify the value of prevention practices and the value of preventing unnecessary use of emergency departments, an empirical method was developed to determine the value of a typical mobile health clinic. The Family Van, a mobile health clinic that has been serving the medically disenfranchised of Boston for 16 years, was evaluated accordingly and found to have return on investment of $36 for every $1 invested in the program. (Source: BMC Medicine)
Source: BMC Medicine - June 2, 2009 Category: Internal Medicine Authors: Nancy OriolPaul CoteAnthony VavasisJennifer BennetDarien DeLorenzoPhillip BlancIsaac Kohane Source Type: journals

Varicella vaccination in Europe - taking the practical approachEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Varicella is a common viral disease affecting almost the entire birth cohort. Although usually self-limiting, some cases of varicella can be serious, with 2 to 6% of cases attending a general practice resulting in complications. The hospitalisation rate for varicella in Europe ranges from 1.3 to 4.5 per 100,000 population/year and up to 10.1% of hospitalised patients report permanent or possible permanent sequelae (for example, scarring or ataxia). However, in many countries the epidemiology of varicella remains largely unknown or incomplete.In countries where routine childhood vaccination against varicella has been implem...
Source: BMC Medicine - May 28, 2009 Category: Internal Medicine Authors: Paolo BonanniJudith BreuerAnne GershonMichael GershonWaleria HryniewiczVana PapaevangelouBernard RentierHans RumkeCatherine Sadzot-DelvauxJacques SenterreCatherine Weil-OlivierPeter Wutzler Source Type: journals

Sodium bicarbonate-based hydration prevents contrast-induced nephropathy: a meta-analysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Sodium bicarbonate-based hydration was found to be superior to normal saline in prevention of contrast-induced nephropathy in this updated meta-analysis. (Source: BMC Medicine)
Source: BMC Medicine - May 13, 2009 Category: Internal Medicine Authors: Pascal Meier, Dennis T Ko, Akira Tamura, Umesh Tamhane and Hitinder S Gurm Source Type: journals

Preventing contrast-induced nephropathy: problems, challenges and future directionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Contrast-induced nephropathy is an injury to the kidney occurring as a result of exposure to intravascular contrast media. It results in both short- and long-term adverse events including mortality. Since treatment of the injury after it has occurred is ineffective, efforts to prevent the injury are the focus of investigators and clinicians alike. In this commentary, the pathogenesis and clinical relevance of contrast-induced nephropathy are reviewed. Prophylactic strategies are discussed with a focus on the use of meta-analysis of small single-center trials. (Source: BMC Medicine)
Source: BMC Medicine - May 13, 2009 Category: Internal Medicine Authors: Richard Solomon Source Type: journals

Zinc and copper supplementation in acute diarrhea in children: a double-blind randomized controlled trialEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The expected beneficial effects of zinc supplementation for acute diarrhea were not observed. Therapeutic Zn or Zn and Cu supplementation may not have a universal beneficial impact on the duration of acute diarrhea in children. Trial registration The study was registered as an International Standard Randomized Controlled Trial (ISRCTN85071383). (Source: BMC Medicine)
Source: BMC Medicine - May 5, 2009 Category: Internal Medicine Authors: Archana Patel, Michael J Dibley, Manju Mamtani, Neetu Badhoniya and Hemant Kulkarni Source Type: journals

Regional block versus general anaesthesia for caesarean section and neonatal outcomes: a population-based studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: Anaesthesia guidelines recommend regional anaesthesia for most caesarean sections due to the risk of failed intubation and aspiration with general anaesthesia. However, general anaesthesia is considered to be safe for the foetus, based on limited evidence, and is still used for caesarean sections. Methods: Cohorts of caesarean sections by indication (that is, planned repeat caesarean section, failure to progress, foetal distress) were selected from the period 1998 to 2004 (N = 50,806). Deliveries performed under general anaesthesia were compared with those performed under spinal or epidural, for the outcomes of...
Source: BMC Medicine - April 29, 2009 Category: Internal Medicine Authors: Charles S Algert, Jennifer R Bowen, Warwick B Giles, Greg E Knoblanche, Samantha L Lain and Christine L Roberts Source Type: journals

Immunogenicity and safety of concomitant administration of a measles, mumps and rubella vaccine (M-M-RvaxPro(R)) and a varicella vaccine (VARIVAX(R)) by intramuscular or subcutaneous routes at separate injection sites: a randomised clinical trialEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The immunogenicities of M-M-RvaxPro and VARIVAX administered by the intramuscular route were comparable with those following subcutaneous administration, and the tolerability of the two vaccines was comparable regardless of administration route. Integration of both administration routes in the current European indications for the two vaccines will now allow physicians in Europe to choose their preferred administration route in routine clinical practice. Trial registration: ClinicalTrials.gov NCT00432523 (Source: BMC Medicine)
Source: BMC Medicine - April 14, 2009 Category: Internal Medicine Authors: Yves Gillet, Pirmin Habermehl, Stephane Thomas, Cecile Eymin and Anne Fiquet Source Type: journals

Different atrophy-hypertrophy transcription pathways in muscles affected by severe and mild spinal muscular atrophyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Our study suggests a different picture of atrophy pathways in each of the two forms of SMA. In particular, p38 may be the regulator of protein synthesis in SMA I. The SMA III profile appears as the result of the concurrent presence of atrophic and hypertrophic fibers. This more favorable condition might be due to the over-expression of MTOR that, given its role in the activation of protein synthesis, could lead to compensatory hypertrophy in SMA III muscle fibers. (Source: BMC Medicine)
Source: BMC Medicine - April 7, 2009 Category: Internal Medicine Authors: Caterina Millino, Marina Fanin, Andrea Vettori, Paolo Laveder, Maria Luisa Mostacciuolo, Corrado Angelini and Gerolamo Lanfranchi Source Type: journals

Intradermal influenza vaccination of healthy adults using a new microinjection system: a 3-year randomised controlled safety and immunogenicity trialEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: An influenza vaccine with 9ug of haemagglutinin/strain given using an intradermal microinjection system showed comparable immunogenic and safety profiles to a licensed intramuscular vaccine, and presents a promising alternative to intramuscular vaccination for influenza for adults younger than 60 years. Trial registration: Clinicaltrials.gov NCT00703651. (Source: BMC Medicine)
Source: BMC Medicine - April 2, 2009 Category: Internal Medicine Authors: Jiri Beran, Arvydas Ambrozaitis, Alvydas Laiskonis, Narseta Mickuviene, Patrick Bacart, Yvan Calozet, Etienne Demanet, Stephane Heijmans, Paul Van Belle, Francoise Weber and Camille Salamand Source Type: journals

Sex differences in rheumatoid arthritis: more than meets the eye...Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sex differences in the prevalence of autoimmune diseases such as rheumatoid arthritis (RA) are well described, but the literature is not as clear about sex differences in RA disease course and prognosis. A recent study from a very large cross-sectional international cohort demonstrated slightly worse levels of disease activity and function in female patients with RA, compared with men. These findings are discussed in the context of our evolving knowledge of sex differences in the expression of this prototypic autoimmune disease, both in terms of the actual disease activity level, the effects that the disease has on physica...
Source: BMC Medicine - March 30, 2009 Category: Internal Medicine Authors: Ronald F van Vollenhoven Source Type: journals

Estimation of proteinuria as a predictor of complications of pre-eclampsia: a systematic reviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Measure of proteinuria is a poor predictor of either maternal or fetal complications in women with pre-eclampsia. (Source: BMC Medicine)
Source: BMC Medicine - March 24, 2009 Category: Internal Medicine Authors: Shakila Thangaratinam, Arri Coomarasamy, Fidelma O'Mahony, Steve Sharp, Javier Zamora, Khalid S Khan and Khaled MK Ismail Source Type: journals

Proteinuria as a predictor of complications of pre-eclampsiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Proteinuria is a defining criterion for the diagnosis of pre-eclampsia. The amount of protein lost per day has been thought by some to predict both maternal and fetal outcome. The systematic review of 16 primary papers including over 6700 patients by Thangaratinam and colleagues published this month in BMC Medicine suggests otherwise. This finding may influence our management of pre-eclampsia. (Source: BMC Medicine)
Source: BMC Medicine - March 24, 2009 Category: Internal Medicine Authors: G Justus Hofmeyr and Michael Belfort Source Type: journals

A compact VEGF signature associated with distant metastases and poor outcomesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: These data identify a compact in vivo hypoxia signature that tends to be present in distant metastasis samples, and which portends a poor outcome in multiple tumor types. This signature suggests that the response to hypoxia includes the ability to promote new blood and lymphatic vessel formation, and that the dual targeting of multiple cell types and pathways will be needed to prevent metastatic spread. (Source: BMC Medicine)
Source: BMC Medicine - March 16, 2009 Category: Internal Medicine Authors: Zhiyuan Hu, Cheng Fan, Chad Livasy, Xiaping He, Daniel S Oh, Matthew G Ewend, Lisa A Carey, Subbaya Subramanian, Robert West, Francis Ikpatt, Olufunmilayo I Olopade, Matt van de Rijn and Charles M Perou Source Type: journals

Lack of utility of risk score and gynecological examination for screening for sexually transmitted infections in sexually active adolescentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The prevalence of infection by C. trachomatis and N. gonorrhoeae was high among these sexually active adolescents. The syndromic approach is clearly inadequate for screening and treating these infections in this population. Therefore, the implantation of other strategies to control these infections among adolescents is urgently required. (Source: BMC Medicine)
Source: BMC Medicine - March 11, 2009 Category: Internal Medicine Authors: Eleuse MB Guimaraes, Mark DC Guimaraes, Maria Aparecida S Vieira, Nadia M Bontempo, Mirian SS Seixas, Monica SD Garcia, Lyana ES Daud, Rejane LM Cortes and Maria de Fatima C Alves Source Type: journals

Recent developments in Alzheimer's disease therapeuticsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Alzheimer's disease is a devastating neurological disorder that affects more than 37 million people worldwide. The economic burden of Alzheimer's disease is massive; in the United States alone, the estimated direct and indirect annual cost of patient care is at least $100 billion. Current FDA-approved drugs for Alzheimer's disease do not prevent or reverse the disease, and provide only modest symptomatic benefits. Driven by the clear unmet medical need and a growing understanding of the molecular pathophysiology of Alzheimer's disease, the number of agents in development has increased dramatically in recent years. Truly 'd...
Source: BMC Medicine - February 19, 2009 Category: Internal Medicine Authors: Michael S Rafii and Paul S Aisen Source Type: journals

Development of the probability of return of spontaneous circulation in intervals without chest compressions during out-of-hospital cardiac arrest: an observational studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: During pre-shock pauses in chest compressions mean probability of return of spontaneous circulation decreases in a steady manner for cases at all initial levels. Regardless of initial level there is a relative decrease in the probability of return of spontaneous circulation of about 23% from 3 to 27 seconds into such a pause. (Source: BMC Medicine)
Source: BMC Medicine - February 6, 2009 Category: Internal Medicine Authors: Kenneth Gundersen, Jan Terje Kvaloy, Jo Kramer-Johansen, Petter Andreas Steen and Trygve Eftestol Source Type: journals

Trait-specific tracking and determinants of body composition: a 7-year follow-up study of pubertal growth in girlsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: Understanding how bone (BM), lean (LM) and fat mass (FM) develop through childhood, puberty and adolescence is vital since it holds key information regarding current and future health. Our study aimed to determine how BM, LM and FM track from prepuberty to early adulthood in girls and what factors are associated with intra- and inter-individual variation in these three tissues. Methods: The study was a 7-year longitudinal cohort study. BM, LM and FM measured using dual-energy X-ray absorptiometry, self-reported dietary information, leisure time physical activity (LTPA) and other factors were assessed one to eig...
Source: BMC Medicine - January 26, 2009 Category: Internal Medicine Authors: Sulin Cheng, Eszter Volgyi, Frances A Tylavsky, Arja Lyytikainen, Timo Tormakangas, Leiting Xu, Shu Mei Cheng, Heikki Kroger, Markku Alen and Urho M Kujala Source Type: journals