A more palatable alternative to oral rehydration therapy for kids

Review of: Freedman SB, Willan AR, Boutis K, et al. Effect of dilute apple juice and preferred fluids vs electrolyte maintenance solution on treatment failure among children with mild gastroenteritis: a randomized clinical trial. JAMA. 2016;315:1966-1974.Stength of recommendation: B: Based on a single, good quality randomized controlled trial.A more palatable alternative to oral rehydration therapy for kids. Parents no longer need to struggle to get their kids to drink electrolyte solutions during episodes of mild gastroenteritis; apple juice works just as well. Practice changer: Recommend that parents give half-strength apple juice to children greater than or equal to 24 months of age who are minimally dehydrated following a case of simple viral gastroenteritis. The juice reduces the need for further interventions better than oral hydration therapy

Anfälligkeit neuer Kartoffelsorten gegenüber Kraut- und Knollenfäule (Phytophthora infestans) und Rhizoctonia (Rhizoctonia solani) – entscheidend für Ertrags- und Qualitätssicherung im biologischen Anbau

Potato is affected by numerous diseases. Among those diseases, late blight (Phytophthora infestans) and rhizoctonia (Rhizoctonia solani) have a strong economic impact. Organic farming doesn’t have efficient protection products to control those diseases and to guarantee yield and production quality. Furthermore, we observe that organic food chain propose the same cultivars as the traditional food chain and those cultivars are generally susceptible to late blight. Regarding to the trials managed to propose new cultivars to Swiss cultivars recommendation list, there are numerous new cultivars with interesting resistance profile. Among 141 cultivars tested, 30 could be proposed to the organic food chain. Indeed, those cultivars are less susceptible to late blight and rhizoctonia and can cover the whole range of potato utilization from boiled potato to French fries and crisps

Spatial and Seasonal Patterns of Cattle Habitat use in a Mountain Wooded Pasture

Management-oriented models of cattle habitat use often treat grazing pressure as a single variable summarizing all cattle activities. This paper addresses the following questions: How does the spatial pattern of cattle effects vary between cattle activities in a highly heterogeneous landscape? Do these patterns change over the grazing season as forage availability decreases? What are the respective roles of natural and management-introduced structures? We estimated the intensity of herbage removal, dung deposition and trampling after each of three grazing periods on a grid of 25 m × 25 m cells covering an entire paddock in the Swiss Jura Mountains. We found no significant positive correlations between cattle effects. Spatial patterns weakened through the season for grazing and trampling, whereas dunging patterns changed little between grazing periods. Redundancy analysis showed that different cattle effects were correlated with different environmental variables and that the importance of management-introduced variables was highest for herbage removal. Autocorrelograms and partial redundancy analyses using principal coordinates of neighbour matrices suggested that dunging patterns were more coarse-grained than the others. Systematic differences in the spatial and seasonal patterns of cattle effects may result in complex interactions with vegetation involving feedback effects through nutrient shift, with strong implications for ecosystem management. In heterogeneous environments, such as pasture-woodland landscapes, spatially explicit models of vegetation dynamics need to model cattle effects separately

Spatial and Seasonal Patterns of Cattle Habitat use in a Mountain Wooded Pasture

Management-oriented models of cattle habitat use often treat grazing pressure as a single variable summarizing all cattle activities. This paper addresses the following questions: How does the spatial pattern of cattle effects vary between cattle activities in a highly heterogeneous landscape? Do these patterns change over the grazing season as forage availability decreases? What are the respective roles of natural and management-introduced structures? We estimated the intensity of herbage removal, dung deposition and trampling after each of three grazing periods on a grid of 25m×25m cells covering an entire paddock in the Swiss Jura Mountains. We found no significant positive correlations between cattle effects. Spatial patterns weakened through the season for grazing and trampling, whereas dunging patterns changed little between grazing periods. Redundancy analysis showed that different cattle effects were correlated with different environmental variables and that the importance of management-introduced variables was highest for herbage removal. Autocorrelograms and partial redundancy analyses using principal coordinates of neighbour matrices suggested that dunging patterns were more coarse-grained than the others. Systematic differences in the spatial and seasonal patterns of cattle effects may result in complex interactions with vegetation involving feedback effects through nutrient shift, with strong implications for ecosystem management. In heterogeneous environments, such as pasture-woodland landscapes, spatially explicit models of vegetation dynamics need to model cattle effects separatel

Traction for low-back pain with or without sciatica.

BACKGROUND: Traction is used to treat low-back pain (LBP), often with other treatments. OBJECTIVES: To determine traction's effectiveness, compared to reference treatments, placebo, sham traction or no treatment for LBP. SEARCH STRATEGY: We searched CENTRAL (The Cochrane Library 2006, issue 4), MEDLINE, EMBASE, and CINAHL to October 2006, references in relevant reviews and personal files. SELECTION CRITERIA: Randomized controlled trials (RCTs) involving traction to treat acute (less than four weeks duration), sub-acute (four to 12 weeks) or chronic (more than 12 weeks) non-specific LBP with or without sciatica. DATA COLLECTION AND ANALYSIS: Study selection, methodological quality assessment and data extraction were done independently by two authors. As there were insufficient data for statistical pooling, we performed a qualitative analysis. MAIN RESULTS: We included 25 RCTs (2206 patients; 1045 receiving traction). Five trials were considered high quality.For patients with mixed symptom patterns (acute, sub-acute and chronic LBP with and without sciatica) there is: strong evidence of no statistically significant difference in outcomes between traction as a single treatment and placebo, sham or no treatment; moderate evidence that traction as a single treatment is no more effective than other treatments; limited evidence of no significant difference in outcomes between a standard physical therapy program with or without continuous traction. For LBP patients with sciatica (with acute, sub-acute or chronic pain), there is conflicting evidence in several comparisons: autotraction compared to placebo, sham or no treatment; other forms of traction compared to other treatments; different forms of traction. In other comparisons, there were no statistically significant differences; the evidence is moderate for continuous or intermittent traction compared to placebo, sham or no treatment, and limited for light versus normal force traction. AUTHORS' CONCLUSIONS: Implications for practice: The results of the available studies involving mixed groups of acute, sub-acute and chronic patients with LBP with and without sciatica were quite consistent, indicating that continuous or intermittent traction as a single treatment for LBP is not likely effective for this group. Traction for patients with sciatica cannot be judged effective at present either, due to inconsistent results and methodological problems in most studies. We conclude that traction as a single treatment for LBP is probably not effective. Implications for research: Any future research on traction for patients with LBP should distinguish between symptom pattern and duration, and should be carried out according to the highest methodological standards

Changing the computer-patient-physician relationship : a qualitative evaluation of 30-inch computer screens in family medicine exam rooms

The electronic health record (EHR) and use of computers in today's exam rooms is a dramatic change in medicine from decades past. There are concerns about how the computer and EHR might adversely affect patient-provider interaction and that it may be detrimental to PCC. Patient-centered care (PCC) promotes active involvement of the patient in their medical care. Several positive outcomes have been associated with PCC, including: better emotional health, improved symptom burden, improved recovery, and fewer diagnostic tests and referrals both at the time of the visit and in the subsequent 2 months. PCC can therefore help to decrease medical expenditures while improving patient outcomes and satisfaction. It has been proposed that certain exam room and computer configurations combined with uses of the EHR may enhance PCC. If we can better determine how different types of computers affect this interaction, it would help suggest improvements for increasing PCC, thus gaining the aforementioned benefits of decreased cost and improved health outcomes

Percutaneous aspiration of lumbar zygapophyseal joint synovial cyst under fluoroscopic guidance -A case report-

A 51-year-old man with a 1-month history of lower back pain and radiating pain visited to our pain clinic. A magnetic resonance imaging (MRI) scan demonstrated a cyst like mass at the level of the L4-5 interspace and compression of the thecal sac and the nerve root on the right side. We performed percutaneous needle aspiration of the lumbar zygapophyseal joint synovial cyst under fluoroscopic guidance. The patient felt an immediate relief of symptoms after the aspiration, and had no signs or symptoms of recurrence at the follow-up 6 months later. No demonstrable lesion was found in the 6 months follow-up MRI