10. Rynn M, Scherrer MA, True WR. Generalized anxiety disorder GAD ; . Best Practice of Medicine. November 2000. Available at: : merck.praxis.md index ?page bpm brief&article id BPM01PS07&hilight rynn. Accessed April 7, 2004. 11. Culpepper L. Generalized anxiety disorder in primary care: emerging issues in management and treatment. J Clin Psychiatry. 2002; 63 suppl 8 ; : 35-42. 12. Kessler D, Lloyd K, Lewis G, Gray DP. Cross sectional study of symptom attribution and recognition of depression and anxiety in primary care. BMJ. 1999; 318: 436-439. Wetherell JL, Le Roux H, Gatz M. DSM-IV criteria for generalized anxiety disorder in older adults: distinguishing the worried from the well. Psychol Aging. 2003; 18: 622-627. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association; 2000.
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Rritable Bowel Syndrome IBS ; is the most common functional gastrointestinal GI ; disorder and is strikingly prevalent all over the world. It occurs in both men and women and is associated with a significantly impaired quality of life. IBS is generally subcategorised by primary bowel habits, such as IBS with constipation, IBS with diarrhoea, or IBS with alternating constipation and diarrhoea. This symptom pattern may vary over time, shifting within the same patient. Since no specific biological or structural markers exist, IBS is defined by symptoms. By consensus, an international working group has defined IBS as `a combination of chronic or recurrent GI symptoms, not explained by structural or biochemical abnormalities' that is `attributed to the intestines and associated with pain, disturbed defecation, and bloatedness and distension'. These abdominal discomforts are usually relieved by defecation.
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Long Chain Polyunsaturated Fatty Acids LCPUFA ; and ADHD Stevens' et. al. study 28 ; first reported in 1995 linked ADHD to a deficiency of certain long-chain fatty acids. Arachidonic Acid AA ; , EPA, and DHA are all metabolites of the two essential Fatty Acids, Linoleic Acid -6 ; and Alpha-Linoleic acid -3 ; . Some authors 29 ; are now leaning towards the conclusion that a subclinical deficiency in DHA is responsible for the abnormal behavior of ADHD-children. They point out that supplementation with a long-chain omega-6 fatty acid evening primrose oil ; has been unsuccessful in ameliorating ADHD because ADHD-children need more -3 acids rather than more -6 acids 30-42 ; . Researchers also found that children with ADHD were less often breast fed as infants than children without ADHD. Breast milk is an excellent source of DHA. Now, studies are carried out underway to investigate the effect of oral supplementation with DHA on the behavior of ADHD-children. DHA is the building block of human brain tissue and is particularly abundant in the gray matter of the brain and the retina. Low levels of DHA have recently been associated with depression, memory loss, dementia, and visual problems. DHA is particularly important for fetuses and infants. The DHA content of the infant's brain triples during the first three months of life. Optimal levels of DHA are, therefore, crucial for pregnant and lactating mothers. United States' breast milk's DHA average content is the lowest in the world, due to low fish's comsumption. Therefore, World Health Organization recommended in 1995 that baby formulas should provide 40 mg of DHA per Kilogram of infant's body weight. Postpartum depression, ADHD and low IQs may be all linked to the dismally low DHA intake common in the United States. Other researchers also point out that low DHA levels have been linked to low brain serotonin levels, which again are connected to an increased tendency to depression, suicide and violence 42-44 ; . DHA is abundant in marine phytoplankton and coldwater fish. Nutritionists now recommend people to consume two to three servings of fish every week to maintain DHA levels. Recent results 43-44 ; report that hyperactive children have lower levels of key fatty acids in their blood than ordinary children do. Analyses showed that boys with ADHD had significantly lower levels of AA, EPA, and DHA acids in their blood. Hyperactive children suffered more from symptoms associated with essential fatty acid deficiency thirst, frequent urination, dry hair and dry skin ; and were also much more likely to have asthma and many ear infections. Researchers conclude that ADHD may be linked to a low intake of omega-3 Fatty Acids Linoleic, EPA and DHA Acids ; or to a poorer ability to convert 18-carbon fatty acids to longer more highly unsaturated acids. As a result, they believe that supplementation with the missing fatty acids may be a useful treatment for hyperactivity 43-44 and
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Stephen G. Ellis, MD, The Cleveland Clinic Foundation; Michael Mooney, MD, Minneapolis Heart Institute, Abbott Northwestern Hospital; David J. Talley, MD, Department of MedicineCardiology, University of Arkansas for Medical Sciences; Sigmund Silber, MD, Dr Mller Hospital; Paul S. Teirstein, MD, Scripps Clinic and Research Foundation; A. Ralph Rodriguez, MD, Cardiovascular Research Department, Florida Hospital; Timothy A. Sanborn, MD, New York Presbyterian Hospital and Joan and Sanford I. Weill Medical College, Cornell University; Ted Feldman, MD, Section of Cardiology, The University of Chicago; Martin Leon, MD, Lenox Hill Hospital, Heart and Vascular Institute; Tyrone J. Collins, MD, Cardiac Catheterization Lab, Alton Ochsner Medical Foundation; James R. Wilentz, MD, Interventional Cardiology, Beth Israel Medical Center; Jorge F. Saucedo, MD, Pierre P. Leimgruber, MD, University of Arkansas for Medical Sciences; Augusto Pichard, MD, Washington Hospital Center; David J. Cohen, MD, MSc, Stephen R. Ramee, MD, Beth Israel Hospital; Richard R. Heuser, Columbia Medical Center Phoenix; Richard E. Kuntz, MD, MSc, Beth Israel-Deaconess Medical Center; and Gary Gershony, MD, Vascular Solutions. SEAL trial study sites: Alton Ochsner Medical Foundation, Beth Israel Deaconess Medical Center, Beth Israel Medical Center, The Cleveland Clinic Foundation, Cardiology Research Foundation, Columbia Medical Center Phoenix, Dr Mller Hospital, Florida Hospital, Minneapolis Heart Institute, New York HospitalCornell Medical Center, Scripps Clinic and Research, Spokane Cardiology, University of Arkansas for Medical Sciences, University of Chicago Hospitals, and University of Texas Health Science Center. This study was supported in full by Vascular Solutions, Inc, Minneapolis, Minn and
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This figure may suggest that recent public health interventions designed to educate New Zealanders about the risks of obesity and the need for a healthy diet are having some success. However, it is also possible that the differences in average growth rates of obesity are influenced substantially by variations in survey design. Moreover, past growth rates may not be a reliable predictor of likely future trends in obesity among New Zealanders. To account for this uncertainty, Access Economics has modelled a number of possible scenarios which present the range of possible outcomes depending on the success of public health interventions. These are: 1 2 Base case: obesity remains stable at current levels around 20% of the population ; into the future; Continued increase in obesity: Obesity continues to grow at an average rate of around 3% per annum or around of a percentage point of the population each year higher than the 0.4% historically since the base is now higher ; , so that around 31% of men and 33% of women are obese in 2020; and Eradication of obesity by 2020: Obesity is eradicated by 2020, with obesity falling as a percentage of the population by 1.3% for females and 1.5% for males until then. While this scenario is unlikely, it does provide a useful lower bound.
Amy C. Gruszecki, MSFS, DO * , Southwestern Institute of Forensic Sciences, 5230 Medical Center Drive, Dallas, TX 75238; Gregory G. Davis, MD, MSPH * , Jefferson County Coroner ME office, 1515 6th Avenue South, Suite 611, Birmingham, AL 35233; and J. Keith Pinckard, MD, PhD * , Southwestern Institute of Forensic Sciences, 5230 Medical Center Drive, Dallas, TX 75235 After attending this presentation, attendees will be able to 1 ; design a scientific study, including hypothesis formation and control group selection; 2 ; be familiar with the roles of HIPAA and an IRB; 3 ; be aware of funding resources for forensic research; 4 ; define standards for authorship on a research project; 5 ; understand the basics of how to write a scientific paper; 6 ; understand the publication process, including peer review and editing; and 7 ; analyze and interpret scientific literature already published. This presentation will impact the forensic community and or humanity by demonstrating Evidence collected at a crime scene or during a forensic autopsy has important implications for both victims and suspects. Medicine, in general, and forensic science, in particular, is coming under increasingly intense scrutiny and pressure to produce scientific research supporting its conclusions i.e., Daubert v. Merrell Dow Pharmaceuticals and miacalcin.
Kinetics analysis of a novel heparin-binding site KEDK ; in human tenascin-C. J Biol Chem 279: 2556225566, 2004 Jones PL, Jones FS: Tenascin-C in development and disease: gene regulation and cell function Matrix Biol 19: 581596, 2000 Jones PL, Rabinovitch M: Tenascin-C is induced with progressive pulmonary vascular disease in rats and is functionally related to increased smooth muscle cell proliferation. Circ Res 79: 11311142, 1996 LaFleur DW, Fagin JA, Forrester JS, Rubin SA, Sharifi BG: Cloning and characterization of alternatively spliced isoforms of rat tenascin: platelet-derived growth factor-BB markedly stimulates expression of spliced variants of tenascin mRNA in arterial smooth muscle cells. J Biol Chem 269: 2075720763, 1994 Marx WE, Cloft HJ, Helm GA, Short JG, Do HM, Jensen ME: Endovascular treatment of experimental aneurysms by use of biologically modified embolic devices: coil-mediated intraaneurysmal delivery of fibroblast tissue allografts. AJNR J Neuroradiol 22: 323333, 2001 Matsumoto H, Terada T, Tsuura M, Itakura T, Ogawa A: Basic fibroblast growth factor released from a platinum coil with a polyvinyl alcohol core enhances cellular proliferation and vascular wall thickness: an in vitro and in vivo study. Neurosurgery 53: 402408, 2003 Matsuura R, Imanaka-Yoshida K, Yoshida T, Sakakura T, Nakano T: Deposition of PG-M versican is a major cause of human coronary restenosis after percutaneous transluminal coronary angioplasty. J Pathol 180: 311316, 1996 Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J, Holman R: International Subarachnoid Aneurysm Trial ISAT ; Collaborative Group. International Subarachnoid Aneurysm Trial ISAT ; of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomized trial. Lancet 360: 12671274, 2002 Murayama Y, Tateshima S, Gonzalez NR, Viuela F: Matrix and bioabsorbable polymeric coils accelerate healing of intracranial aneurysms: long-term experimental study. Stroke 34: 20312037, 2003 Murayama Y, Viuela F, Tateshima S, Gonzalez NR, Song JK, Mahdavieh H, et al: Cellular responses of bioabsorbable polymeric material and Guglielmi detachable coil in experimental aneurysms. Stroke 33: 11201128, 2003 Murayama Y, Viuela F, Tateshima S, Song JK, Gonzalez NR, Wallace MP: Bioabsorbable polymeric material coils for embolization of intracranial aneurysms: a preliminary experimental study. J Neurosurg 94: 454463, 2001 Newby AC, Zaltsman AB: Fibrous cap formation or destruction-- the critical importance of vascular smooth muscle cell proliferation, migration and matrix formation. Cardiovasc Res 41: 345360, 1999 Ohyama T, Nishide T, Iwata H, Sato H, Toda M, Taki W: Vascular endothelial growth factor immobilized on platinum microcoils for the treatment of intracranial aneurysms: experimental rat model study. Neuro Med Chir 44: 279287, 2004 Sluzewski M, Menovsky T, van Rooji WJ, Wijnalda D: Coiling of very large or giant cerebral aneurysms: long-term clinical and serial angiographic results. AJNR J Neuroradiol 24: 257262, 2003 Tomasek JJ, Gabbiani G, Hinz B, Chaponnier C, Brown RA: Myofibroblasts and mechano-regulation of connective tissue remodeling. Nat Rev Mol Cell Biol 3: 349363, 2002 Tsunoda T, Inada H, Kalembeyi I, Imanaka-Yoshida K, Sakakibara M, Okada R, et al: Involvement of large tenascin-C splice variants in breast cancer progression. J Pathol 162: 18571867, 2003 Wallner K, Li C, Shah K, Fishbein MC, Forrester JS, Kaul S, et al: Tenascin-C is expressed in macrophage-rich human coronary atherosclerotic plaques. Circulation 99: 12841289, 1999 Wallner K, Sharifi BG, Shah PK, Noguchi S, DeLeon H, Wilcox JN: Adventitial remodeling after angioplasty is associated with expression of tenascin mRNA by adventitial myofibroblasts. J Coll Cardiol 37: 655661, 2001 Weber P, Zimmermann DR, Winterhalter KH, Vaughan L: Tenascin-C binds heparin by its fibronectin type III domain five. J Biol Chem 270: 46194623, 1995 Wiebers DO, Whisnant JP, Huston J III, Meissner I, Brown RD Jr, Piepgras DG, et al: International Study of Unruptured Intracranial Aneurysms Investigators: unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet 362: 103110, 2003 Yamamoto K, Onoda K, Sawada Y, Fujinaga K, Imanaka-Yoshida K, Shimpo H, et al: Tenascin-C is an essential factor for neointimal hyperplasia after aortotomy in mice. Cardiovasc Res 65: 737742, 2005 Manuscript received November 2, 2004. Accepted in final form May 2, 2005. Address reprint requests to: Naoki Toma, M.D., Department of Neurosurgery, Mie University School of Medicine, 2174 Edobashi, Tsu, Mie 514-8507, Japan. email: ntoma clin.medic e-u.ac.jp.
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