Physiological dimensions of ototoxic responses in a model fish species.

Pharmaceutical agents known to be toxic to the human auditory system also impair sensory hair cells of teleosts, and this supports the use of fish models for the screening of such compounds. However, previous investigations have focused almost exclusively on anatomical changes after drug administration without assessing macro-level physiological effects. Using the goldfish (Carassius auratus), we demonstrate that the acquisition of auditory evoked potentials offers a rapid and non-invasive means for tracking ototoxin-induced shifts in auditory thresholds. Gentamicin (100mg/mL) was the agent of choice as it is an extensively-studied human ototoxin. Significant shifts (p<0.05) in hearing sensitivity were observed between 300 Hz and 600 Hz and these shifts depended on acoustic pressure, but not particle motion. This differential elevation of auditory thresholds may be caused by impairment of specific populations of auditory sensory hair cells.

High-frequency gastric electrical stimulation for the treatment of gastroparesis: a meta-analysis.

BACKGROUND & AIMS: High-frequency gastric electrical stimulation (GES) is a relatively new treatment for medically refractory gastroparesis. There have been a number of clinical studies based on the use of a high-frequency stimulator (Enterra, Medtronic, Minneapolis, MN). A meta-analysis was performed to evaluate evidence for improved clinical outcome with this device. METHODS: A literature search of major medical databases was performed for the period January 1992 to August 2008. Clinical studies involving an implanted high-frequency GES device were included and reported a range of clinical outcomes. Studies of external, temporary, and/or low-frequency GES were excluded. RESULTS: Of 13 included studies, 12 lacked controls and only one was blinded and randomized. Following GES, patients reported improvements in total symptom severity score (3/13 studies, mean difference 6.52 [confidence interval--CI: 1.32, 11.73]; P = 0.01), vomiting severity score (4/13, 1.45 [CI: 0.99, 1.91]; P < 0.0001), nausea severity score (4/13, 1.69 [CI: 1.26, 2.12]; P < 0.0001), SF-36 physical composite score (4/13, 8.05 [CI: 5.01, 11.10]; P < 0.0001), SF-36 mental composite score (4/13, 8.16 [CI: 4.85, 11.47]; P < 0.0001), requirement for enteral or parenteral nutrition (8/13, OR 5.53 [CI: 2.75, 11.13]; P < 0.001), and 4-h gastric emptying (5/13, 12.7% [CI: 9.8, 15.6]; P < 0.0001). Weight gain did not reach significance (3/13, 3.68 kg [CI: -0.23, 7.58]; P = 0.07). The device removal or reimplantation rate was 8.3%. CONCLUSIONS: Results show substantial benefits for high-frequency GES in the treatment of gastroparesis. However, caution is necessary in interpreting the results, primarily because of the limitations of uncontrolled studies. Further controlled studies are required to confirm the clinical benefits of high-frequency GES.

Alcohol screening in general practices using the AUDIT: how many response categories are necessary?

AIMS: The Alcohol Use Disorders Identification Test (AUDIT) is a common screening instrument. This study analyses if response categories of the AUDIT might be dichotomized without affecting the psychometric properties of the questionnaire. METHODS: Participants between 18 and 65 years were recruited from general practices in two northern German cities. In total, 10,803 screenings were conducted (refusal rate: 5.9%). For those who were screened positive, the Munich-Composite International Diagnostic Interview (M-CIDI) was used for identification of 12-month Alcohol Use Disorders and at-risk consumption (exceeding 20/30 g per day). Abstinent subjects and screening positives without diagnostic interview were excluded from the analysis, leaving a sample of 7,112 subjects. ROC-Curves were calculated separately for each item in order to identify an optimal cut-off value. Finally, a version of the AUDIT based on dichotomized items was compared to the original version and its short-form, the AUDIT version based on three questions dealing with consumption AUDIT-C. RESULTS: As an optimal cut-off value for items on consumption, drinking at least once a week, having more than 1-2 drinks per occasion, and drinking 6 or more drinks in one sitting at least once a month were identified. For all questions on alcohol-related problems or dependence symptoms, having 'ever occurred' differed best between subjects with and without Alcohol Use Disorders or at-risk consumption. Sensitivity and specificity of the dichotomized version of the AUDIT did not differ from the original version, and both full versions performed superior compared to the AUDIT-C. CONCLUSION: Data indicate that the AUDIT response categories may be dichotomized without affecting its validity.

Magnesium deficiency is associated with periodontal disease.

In the multifactorial pathogenesis of periodontitis, there are still unknown factors influencing the outcome of the disease. An association between magnesium and periodontitis has been suggested by preliminary studies. However, relevant clinical data are lacking. We investigated the association between magnesium status and periodontal health in a population-based analysis. We conducted a cross-sectional epidemiological investigation involving 4290 subjects aged 20-80 yrs. We recorded periodontal risk factors and determined concentrations of serum magnesium and calcium, relating them to periodontal parameters. In a matched-pair study, 60 subjects using oral magnesium-containing drugs and 120 without were compared. In subjects aged 40 yrs and older, increased serum Mg/Ca was significantly associated with reduced probing depth (p<0.001), less attachment loss (p=0.006), and a higher number of remaining teeth (p=0.005). Subjects taking Mg drugs showed less attachment loss (p<0.01) and more remaining teeth than did their matched counterparts. These results suggest that nutritional magnesium supplementation may improve periodontal health.

Gynaecological health care utilization and use of sex hormones--the study of Health in Pomerania.

BACKGROUND: In Germany, there is a lack of population-based data related to the use of gynaecological health care services. The objectives of our analyses utilizing a population-based cross-sectional survey conducted in one geographically defined area [Study of Health in Pomerania (SHIP)] are to assess the prevalences of: (i) attendance of gynaecological outpatient facilities and of (cervical) cancer screening; (ii) gynaecological and breast surgery; (iii) use of oral contraceptives (OC) and menopausal hormone therapy (MHT). METHODS: We analysed socio-demographic factors, reproductive history, gynaecological service utilization, and use of sex hormones in 2186 women aged 20-79 years. We used standard statistics and sex- and age group-specific weighting factors to reflect characteristics of the population of Western Pomerania. RESULTS: Approximately 43% of women reported surgical procedures. Participation in cancer screening at least once was reported by 78% of women (lifetime prevalence). Two-thirds of women stated ever use of OC, 28% (aged >40 years) ever use of MHT. CONCLUSIONS: Women in Western Pomerania reported a high life-time use of both OC and MHT. The use of cervical cancer screening exceeded the national average. Women had an almost 50% risk of undergoing gynaecological, breast or obstetric surgery. The high use of MHT and surgical procedures calls for efforts regarding continuing medical education and health care policy actions.