Pain relief for women with cervical intraepithelial neoplasia undergoing colposcopy treatment

Treatment for CIN is usually undertaken in an outpatient colposcopy clinic to remove the pre-cancerous cells from the cervix. It commonly involves lifting the cells off the cervix with electrically heated wire (diathermy) or laser, or destroying the abnormal cells with freezing methods (cryotherapy). This is potentially a painful procedure. The purpose of this review is to determine which, if any, pain relief should be used during cervical colposcopy treatment. We identified 17 trials and these reported different forms of pain relief before, during and after colposcopy. Evidence from two small trials showed that women having a colposcopy treatment had less pain and blood loss if the cervix was injected with a combination of a local anaesthetic drug and a drug that causes blood vessels to constrict (narrow), compared with placebo. Although taking oral pain-relieving drugs (e.g. ibuprofen) before treatment on the cervix in the colposcopy clinic is recommended by most guidelines, evidence from two small trials did not show that this practice reduced pain during the procedure. Most of the evidence in this field is of a low to moderate quality and further research may change these findings. Additionally, we were unable to obtain evidence with regards to dosage of the local anaesthetic drug or method of administering local anaesthetic into the cervix. There is need for high-quality trials with sufficient numbers of participants in order to provide the data necessary to estimate these effects

Future directions for the management of pain in osteoarthritis.

Osteoarthritis (OA) is the predominant form of arthritis worldwide, resulting in a high degree of functional impairment and reduced quality of life owing to chronic pain. To date, there are no treatments that are known to modify disease progression of OA in the long term. Current treatments are largely based on the modulation of pain, including NSAIDs, opiates and, more recently, centrally acting pharmacotherapies to avert pain. This review will focus on the rationale for new avenues in pain modulation, including inhibition with anti-NGF antibodies and centrally acting analgesics. The authors also consider the potential for structure modification in cartilage/bone using growth factors and stem cell therapies. The possible mismatch between structural change and pain perception will also be discussed, introducing recent techniques that may assist in improved patient phenotyping of pain subsets in OA. Such developments could help further stratify subgroups and treatments for people with OA in future

The National Food Consumption Survey (NFCS): South Africa, 1999

Objective: The aim of the National Food Consumption Survey (NFCS) in South Africa was to determine the nutrient intakes and anthropometric status of children (1-9 years old), as well as factors that influence their dietary intake. Design: This was a cross-sectional survey of a nationally representative sample of all children aged 1-9 years in South Africa. A nationally representative sample with provincial representation was selected using 1996 Census information. Subjects: Of the 3120 children who were originally sampled data were obtained from 2894, a response rate of 93%. Methods: The sociodemographic status of each household was assessed by a questionnaire. Dietary intake was assessed by means of a 24-hour recall and a food-frequency questionnaire from the caregivers of the children. Food purchasing practices were determined by means of a food procurement questionnaire. Hunger was assessed by a modified hunger scale questionnaire. Nutritional status was determined by means of anthropometric measurements: height, weight, head circumference and arm circumference. Results: At the national level, stunting (height-for-age below minus two standard deviations (< -2SD) from the reference median) was by far the most common nutritional disorder, affecting nearly one in five children. The children least affected (17%) were those living in urban areas. Even with regard to the latter, however, children living in informal urban areas were more severely affected (20%) compared with those living in formal urban areas (16%). A similar pattern emerged for the prevalence of underweight (weight-for-age < -2SD), with one in 10 children being affected at the national level. Furthermore, one in 10 (13%) and one in four (26%) children aged 1-3 years had an energy intake less than half and less than two-thirds of their daily energy needs, respectively. For South African children as a whole, the intakes of energy, calcium, iron, zinc, selenium, vitamins A, D, C and E, riboflavin, niacin, vitamin B6 and folic acid were below two-thirds of the Recommended Dietary Allowances. At the national level, data from the 24-hour recalls indicated that the most commonly consumed food items were maize, sugar, tea, whole milk and brown bread. For South African children overall, one in two households (52%) experienced hunger, one in four (23%) were at risk of hunger and only one in four households (25%) appeared food-secure. Conclusion: The NFCS indicated that a large majority of households were food-insecure and that energy deficit and micronutrient deficiencies were common, resulting in a high prevalence of stunting. These results were used as motivation for the introduction of mandatory fortification in South Africa. © The Authors 2005.Conference Pape

On Technological and Immunological Benefits of Multivalent Single-Injection Microsphere Vaccines

Purpose. With the aim of developing multivalent vaccines for single-injection, we examined the feasibility of combining antigens in biodegradable microspheres. Such vaccines are expected to improve vaccination coverage by reducing the number of vaccination sessions required to generate immunity. Methods. Mono- and multivalent vaccines of Haemophilus influenzae type b (Hib) conjugate, diphtheria toxoid (DT), tetanus toxoid (TT), and pertussis toxin (PT) in poly (lactic acid) and poly(lactic-coglycolic acid) microspheres were prepared by spray drying, and the influence of coencapsulated antigens and excipients on antigen loading, release, and stability was examined. Two tetravalent formulations were tested in guinea pigs. Results. Monovalent Hib and PT vaccines showed loading efficiencies of 10% (Hib) and 30% (PT) in both polymers. The loading efficiencies increased upon addition of trehalose and, even more, when the antigens were coencapsulated in di- and trivalent combinations. Highest loading efficiencies (>80%) were achieved with trivalent formulations (DT + PT + Hib) that also contained coencapsulated albumin. The percentage of antigen released during 24 h of incubation was typically 10-40% and decreased as loading efficiency increased. Enzyme-linked immunosorbent assay (ELISA) data revealed that TT, DT, and PT remained antigenic throughout the encapsulation and subsequent release processes. Finally, all antigens maintained their immunogenicity, since strong and sustained antibody responses were elicited after a single injection of tetravalent microsphere vaccines (DT + TT + PT + Hib) in guinea pigs. Conclusions. This study reveals technologic benefit as well as an immunological potential of multivalent single-injection microsphere vaccines. The results support our hypothesis that coencapsulation of several antigens may intrinsically improve entrapment of antigenic and immunogenic antigen probably by virtue of increased protein concentration during microencapsulation leading to mutual stabilization of the component

The avalanche of children requiring social services in the Western Cape

No Abstract

Simon R. Mirault: A Biography

Simon R. Mirault appeared in Savannah around 1849, possibly earlier. He was a mulatto who probably brought this country from the West Indies, or more specifically from Santo Domingo. Simon was first employed as a pastry cook in 1849, later as a confectioner, and at the time of his death, as a cotton sampler. During this time he was in Savannah, he managed to accumulate a fair-sized estate. Simon R. Mirault died in 1875 at the approximate age of 60.https://digitalcommons.georgiasouthern.edu/sav-bios-lane/1179/thumbnail.jp

Responsiveness of pain, active range of motion, and disability in patients with acute nonspecific low back pain

AbstractMany parameters are now used for investigations in clinical settings, such as pain, active range of motion (AROM), and disability, but it is not yet known which parameters are responsive in patients with acute nonspecific low back pain (LBP). This study aimed to investigate the responsiveness of pain, AROM, and disability in patients with acute nonspecific LBP. Fifty subjects were assessed for pain, AROM, and disability at baseline and after 6 weeks. The effect size (ES) was calculated for each parameter. Also, patient’s perception of change was collected after 6 weeks for correlating it with change scores for each parameter. The most responsive parameter for detecting the change in patients with acute nonspecific LBP was pain (ES, 1.57) and disability (ES, 0.93). However, AROM was proved to be less responsive. This study indicated that pain and disability were responsive in detecting the changes in patients with acute nonspecific LBP over time

Assessment of Behavior and Social Dynamics in a Newly-Forming Group of Captive Western Lowland Gorillas

This study presents behavioral data of a recently-formed western lowland gorilla (Gorilla gorilla gorilla) group at Riverbanks Zoo and Garden in Columbia, South Carolina, from the initial stages of group formation through the first several months after introduction. The group consists of a male (19 years), two half-sisters (both 10 years), and an unrelated female (20 years). I collected 15-minute focal animal samples for three hours twice a week in two observation blocks, the first lasting from 7/17/15 to 9/11/15, and the second lasting from 10/30/15 to 1/3/16. A total of 99.25 observation hours were collected. It was predicted that the frequency of affiliative behaviors would increase over time, with more affiliative interactions between related females. Also, it was hypothesized that agonism would decrease over time. Overall, the mean rates of affiliative behaviors did increase between the two observation blocks (rs=0.208, p=0.002, Wilcoxon Signed-Rank test); agonistic behaviors decreased (rs=-0.185, p=0.005, Wilcoxon Signed-Rank test). Dyadic rates of affiliation differed significantly (Q=39.401, p It was also predicted that a dominance hierarchy would result among the females, with the unrelated female being the lowest-ranking due to the already strong bonds shared by the half-sisters. Evaluation of female hierarchies showed there was no strong relationship among the females\u27 resulting ranks in approach-withdrawal (r=0.991, p=0.083) or grooming interactions (r=0.893, p=0.297). The results of this study show that the group-wide and intrasex relationships mirror those seen in wild populations and other captive groups, particularly in regard to the lack of social dominance. It appears that the members of newly-formed group adjusted well and will thrive in their new surroundings. Furthermore, these findings may help animal caretakers more effectively manage family groups and continue to ensure a high quality of life for captive gorillas

Clinical trial of amino-methylbenzol-sulphonyl-cyclohexylurea (Metahexamide) in diabetics after failure of tolbutamide

No Abstract

Diabetics: Inter-racial comparisons

No Abstract