bluuebunny/crossref_metadata_2025 huggingface dataset:
Current Understanding of Feline Diabetes: Part 2, Treatment
Authors: Martin G , Rand J
Published: September 2002

When treating diabetic cats, the primary aim is to control clinical signs without causing clinical hypoglycaemia. Secondary goals are to maximise the chances of attaining diabetic remission and to minimise the risk of complications due to chronic hyperglycaemia. A treatment plan that is convenient for the owner is important for compliance. Underweight or overweight diabetic cats should be fed with the aim of normalising bodyweight. Current evidence suggests that non-obese diabetic cats can be fed ad libitum. The oral hypoglycaemic drug glipizide is well established as a treatment for about a third of diabetic cats, which have residual beta cell function. Preliminary studies on other oral agents such as vanadium salts, metformin, and troglitazone indicate a potential use in some diabetic cats. Insulin treatment remains the treatment of choice for the majority of diabetic cats. Choice of insulin, dose rates and monitoring of treatment are discussed.
Dietary Management of Feline Chronic Renal Failure: Where are We Now? In What Direction are We Headed?
Authors: Polzin D J , Osborne C A , Ross S , Jacob F
Published: September 2002

Dietary modification is of primary importance in managing cats with chronic renal failure. Diets designed for cats with chronic renal failure are typically formulated to be pH neutral and contain reduced quantities of protein, phosphorus and sodium and an increased quantity of potassium. These changes in diet formulation are designed to ameliorate clinical signs of renal failure by adapting dietary intakes to meet the limited ability of failing kidneys to adapt to the normal range of dietary intakes. Important recent clinical trials support the therapeutic value of dietary therapy in cats with chronic renal failure.
The Use of Sevoflurane in a 2:1 Mixture of Nitrous Oxide and Oxygen for Rapid Mask Induction of Anaesthesia in the Cat
Authors: Tzannes S , Govendir M , Zaki S , Miyake Y , Packiarajah P , Malik R
Published: September 2002

An inhalational technique for rapid induction of anaesthesia in unsedated cats using sevoflurane and nitrous oxide is described. Using a pliable, tight-fitting, face mask, sevoflurane (7.5–8%) was delivered from an out-of-circuit precision vaporiser connected to a coaxial non-rebreathing system using a fresh gas flow of 1 l oxygen and 2 l nitrous oxide per min. Cats were restrained with gentle but firm pressure applied by scruffing the dorsal cervical skin until the righting reflex was lost and the patient could be positioned in lateral recumbency. Typically, cats could be positioned on their side in a light plane of anaesthesia within 1 min of applying the mask, at which time the sevoflurane concentration was reduced to 5% or less. A similar protocol, using a lower initial concentration of sevoflurane, is recommended for old or debilitated patients. Maintenance of light sevoflurane (2–4%) anaesthesia by mask permitted minor interventions to be performed readily, including blood collection, intravenous chemotherapy, abdominal palpation, radiography and ultrasonography. More painful procedures, such as bone marrow aspiration, required a deeper plane of anaesthesia. Cats were sufficiently deep to be intubated, if this was required, about 3 min after commencing the induction. Recovery from sevoflurane/nitrous oxide anaesthesia was smooth and rapid, with most cats being able to right within 5 min of discontinuing the agents. This protocol for rapid inhalational induction and recovery is particularly suited to feline practice, where rendering an uncooperative patient unconscious greatly facilitates the completion of many minor diagnostic and therapeutic procedures, especially when these must be performed on successive days or when peripheral vascular access is limited. For longer procedures, isoflurane may be substituted for sevoflurane for maintenance of anaesthesia in order to minimise cost.
Spontaneous Lumbar Intervertebral Disc Protrusion in Cats: Literature Review and Case Presentations
Authors: Kathmann I , Cizinauskas S , Rytz U , Lang J , Jaggy A
Published: September 2002

Reports on intervertebral disc disease in cats are rare in the veterinary literature. It has been postulated that intervertebral disc protrusion is a frequent finding during necropsy in cats, without having any clinical relevance (King and Smith 1958, King & Smith 1960a, King & Smith 1960b). However, a total of six cases with disc protrusions and clinically significant neurological deficits have been reported over the past decade. (Heavner 1971, Seim & Nafe 1981, Gilmore 1983, Littlewood et al 1984, Sparkes & Skerry 1990, Bagley et al 1995). As in dogs, there are also two types of intervertebral disc disease in cats: Hansen's type I (extrusion), and type II (herniation). Cervical spinal cord involvement was more commonly recognised in cats than the lumbar or the thoraco lumbar area. Cats over 15 years were mainly affected (King & Smith 1958, King & Smith 1960a, King & Smith 1960b). We describe two cats with lumbar intervertebral disc protrusions. Emphasis is placed on differential diagnoses, treatment and follow-up.
Plasma Leptin Concentrations in Cats: Reference Range, Effect of Weight Gain and Relationship with Adiposity as Measured by Dual Energy X-Ray Absorptiometry
Authors: Appleton D J , Rand J S , Sunvold G D
Published: September 2002

The aims of our study were to determine a reference range for plasma leptin in healthy, normal-weight cats and to measure the effect of weight gain on plasma leptin levels. To increase our understanding of the association between leptin and feline obesity, we investigated the relationship between plasma leptin and measures of adiposity in cats. Twenty-six normal-weight cats were used to determine the reference range for feline leptin using a multispecies radioimmunoassay. In the second part of the study, plasma leptin concentrations were determined in 16 cats before and after approximately 10 months of spontaneous weight gain. Dual energy X-ray absorptiometry scans (DEXA) were performed after weight gain. The tolerance interval for plasma leptin concentrations was 0.92–11.9 ng/ml Human Equivalent (HE) with a mean concentration of 6.41 ± 2.19 ng/ml HE. In part two of the study, 16 cats gained on average 44.2% bodyweight over 10 months. The percentage of body fat in obese cats ranged from 34.2 to 48.7%. Mean plasma leptin concentrations increased from 7.88 ± 4.02 ng/ml HE before weight gain to 24.5 ± 12.1 ng/ml HE after weight gain, ( P < 0.001). Total body fat and body fat per cent were the strongest predictors of plasma leptin in obese cats ( r = 0.8 and r = 0.78, P < 0.001, respectively). In conclusion, plasma leptin concentrations increased three-fold in cats as a result of weight gain and were strongly correlated with the amount of adipose tissue present. Despite elevated leptin levels, cats continued to eat and gain weight, suggesting decreased sensitivity to leptin. This investigation into the biology of leptin in cats may aid the overall understanding of the role of leptin and the development of future treatments to help prevent and manage feline obesity.
Cerebral Cryptococcal Granuloma in a Cat
Authors: Foster S F , Charles J A , Parker G , Krockenberger M , Churcher R M , Malik R
Published: September 2002

In the December issue of Journal of Feline Medicine and Surgery, the following case report was published with several errors. The corrected version of this case report follows in full. The publishers apologise for this error.

A 7-year-old spayed domestic shorthaired cat presented with a history of having two seizures in the previous 6 weeks. During the seizures, the cat lost consciousness, paddled its limbs, rolled and urinated. There were no pre-ictal signs but the cat was weak and unable to walk normally in the post-ictal period.
Management of Anorexia in the Cat
Authors: Michel KE
Published: September 2002

One of the most frequent motivations for seeking veterinary attention for a cat is when the owner recognises a loss of normal appetite in his pet. The medical term for a lack of appetite for food is ‘anorexia’, and it may be partial or complete. While anorexia is a common manifestation of disease, the mechanisms underlying decreased food intake are complex and not completely understood. The regulation of appetite involves interaction of external stimuli with signals from the gastrointestinal tract and central nervous system. Aberrations in any of the internal control systems for hunger and satiety, or changes in external factors such as diet or feeding environment, can result in partial or total anorexia. The challenge for the practitioner is not only to diagnose and treat the underlying condition, but to recognise at what point inadequate food intake has or will impinge on the patient's nutritional status to the extent that it might deleteriously affect clinical outcome. It is also important to bear in mind the significance that the patient's appetite and food intake has for the cat owner in his overall perception of his pet's condition and quality of life.
Ocular Manifestations of Feline Herpesvirus
Authors: Andrew SE
Published: September 2002

Feline herpesvirus-1 (FHV-1) infection is ubiquitous in the domestic cat population worldwide. The most common clinical ocular manifestations of infection with FHV-1 are conjunctivitis and keratitis. This paper reviews the pathogenesis of feline herpesvirus-1 and discusses the various clinical ocular manifestations, diagnostic techniques and treatment of FHV-1-induced diseases. Ocular manifestations include: conjunctivitis, keratitis, stromal keratitis, keratoconjunctivitis sicca, ophthalmia neonatorium, symblepharon, corneal sequestrum, eosinophilic keratitis and anterior uveitis. Diagnostic techniques discussed include: virus isolation, fluorescent antibody testing, serum neutralising titers, ELISA and polymerase chain reaction. Various therapies are also discussed.
Iatrogenic Hyperadrenocorticism in a Cat following a Short Therapeutic Course of Methylprednisolone Acetate
Authors: Ferasin L
Published: September 2002

Iatrogenic hyperadrenocorticism (or iatrogenic Cushing's syndrome) is an adrenal disorder that may result from long-term administration of glucocorticoids for therapeutic purposes, most often given to treat allergic or immune-mediated disorders. Prolonged treatment with synthetic glucocorticoids can suppress hypothalamic corticotrophin releasing hormone and plasma adrenocorticotrophic hormone (ACTH), thus causing a functional inactivity of the adrenal cortex. The result is a clinical syndrome of hyperadrenocorticism but with basal and ACTH-stimulated plasma cortisol concentrations that are consistent with spontaneous hypoadrenocorticism (Addison's disease).

Whilst iatrogenic hyperadrenocorticism is relatively frequent in dogs, the diagnosis of iatrogenic hyperadrenocorticism in cats is very uncommon because this species has been found to be remarkably resistant to prolonged administration of glucocorticoids. To the author's knowledge, there are only two published clinical cases of feline iatrogenic Cushing's syndrome. This report describes a case of iatrogenic hyperadrenocorticism in a cat, and shows how normalisation of the adrenal function was achieved with supportive treatment and withdrawal of glucocorticoid administration.
An Investigation into the Effects of Storage on the Diagnosis of Crystalluria in Cats
Authors: Sturgess CP , Hesford A , Owen H , Privett R
Published: September 2002

Urinalysis was performed on 41 cats with no history of urinary tract disease. Samples were divided into aliquots, stored under differing condition and then examined for the presence of crystalluria. Crystalluria was detected in at least one stored sample in 92% of cats fed a mixed wet/dry food diet compared to 24% in the fresh sample. Crystalluria was not detected in any sample or aliquot from cats fed all wet food diets.
Laboratory Profiles in Cats with Different Pathological and Immunohistochemical Findings Due to Feline Infectious Peritonitis (FIP)
Authors: Paltrinieri S , Grieco V , Comazzi S , Parodi M Cammarata
Published: September 2002

Blood was collected from 55 cats with feline infectious peritonitis (FIP) and from 50 control cats in order to define whether differences in pathological findings and in distribution of feline coronaviruses (FCoV) can be associated with changes in haemograms, serum protein electrophoresis, and antibody titres. Compared to controls, the whole group of FIP-affected cats had blood changes consistent with FIP. Based on the pathological findings or on the immunohistochemical distribution of viral antigen, FIP-affected cats were divided in the following groups: subacute against acute lesions; low against strong intensity of positivity; intracellular against extracellular positivities; positive against negative lymph nodes. Lymphopenia was more evident in cats with acute forms, strong intensity of positivity, extracellular antigen and negative lymph nodes. Cats with positive lymph nodes had the most evident changes in the protein estimations. These results suggest that differences in pathological findings might depend on different reactive patterns to the FCoVs.
Insulin Sensitivity Decreases with Obesity, and Lean Cats with Low Insulin Sensitivity are at Greatest Risk of Glucose Intolerance with Weight Gain
Authors: Appleton DJ , Rand JS , Sunvold GD
Published: September 2002

This study quantifies the effects of marked weight gain on glucose and insulin metabolism in 16 cats which increased their weight by an average of 44.2% over 10 months.

Significantly, the development of feline obesity was accompanied by a 52% decrease in tissue sensitivity to insulin and diminished glucose effectiveness. In addition, glucose intolerance and abnormal insulin response occurred in some cats.

An important finding was that normal weight cats with low insulin sensitivity and glucose effectiveness were at increased risk of developing impaired glucose tolerance with obesity. High basal insulin concentrations or low acute insulin response to glucose also independently increased the risk for developing impaired glucose tolerance.

Male cats gained more weight relative to females and this, combined with their tendency to lower insulin sensitivity and higher insulin concentrations, may explain why male cats are at greater risk for diabetes.

Results suggest an underlying predisposition for glucose intolerance in some cats, which is exacerbated by obesity. These cats may be more at risk of progressing to overt type 2 diabetes mellitus.
Feline Nasal and Paranasal Sinus Tumours: Clinicopathological Study, Histomorphological Description and Diagnostic Immunohistochemistry of 123 Cases
Authors: Mukaratirwa S , van der Linde-Sipman JS , Gruys E
Published: September 2002

Histological examination was performed in 123 cats with primary nasal and paranasal sinus tumours; 117 had undergone surgical biopsy and six necropsy. Special stains and immunohistochemistry were performed on poorly differentiated cases. Ninety-two percent (113/123) of the tumours were malignant. There was an increased risk for old cats (mean age of 10.9 years), and a male predilection (59% males). Clinical signs and breeds varied with the histological type of tumour. Thirty-nine percent (48/123) of the cases presented with nasal discharge, 21% (26/123) with dyspnea, 20% (24/123) with facial swelling, and 15% (19/123) with epistaxis. Forty-three percent (53/123) of the tumours were of epithelial origin. Adenocarcinomas (18/53) and squamous cell carcinomas (17/53) were the most common epithelial tumours. Fifty percent (26/53) of the epithelial tumours originated from the pseudo-stratified respiratory epithelium of the nasal cavity, 28% (15/53) from the stratified squamous epithelium of the vestibule, 9% (5/53) from olfactory epithelium, 9% (5/53) from submucosal glands and 4% (2/53) from minor salivary glands. Malignant lymphoma (35/123) was the most common tumour. Seventy-one percent (25/35) of the malignant lymphomas were B-cell tumours and 29% (10/35) were T-cell tumours. Six cases of malignant lymphomas were proved to be epitheliotropic T-cell lymphomas. This is the first report of a primary nasal epitheliotropic T-cell lymphoma in cats.
Acute Intervertebral Disc Extrusion in a Cat: Clinical and MRI Findings
Authors: Lu D , Lamb CR , Wesselingh K , Targett MP
Published: September 2002

A 5 year old, neutered male, domestic shorthaired cat had acute left hemiparesis and Horner's syndrome. Magnetic resonance imaging (MRI) revealed a loss of the normal signal from the nucleus pulposus of the intervertebral disc at C3/4, narrowing of the ventral subarachnoid space and slight dorsal displacement of the spinal cord and a focal hyperintense lesion affecting the left side of the spinal cord at the same level. The presumptive diagnosis was focal spinal cord oedema associated with intervertebral disc extrusion. A traumatic aetiology was suspected. The cat was treated conservatively and improved gradually over a period of 6 months.
A retrospective study of cardiac rhythm disorders
Authors: Van Wassenhoven Michel
Published: September 2002

Retrospective studies can be considered as the first step towards an evaluation and improvement of homoeopathic practice. Through these preliminary studies, criteria for future prospective studies can be chosen as well as suitable homoeopathic practitioners to conduct them. From this study, we can conclude that disorders of heart rhythm seem to be an excellent subject for research into the efficacy of homoeopathy. Especially for paroxysmal supraventricular tachycardia, all patients were cured and able to discontinue their allopathic medication. In view of the fact that 50% of the patients included in this study stopped the use of allopathic drugs, one can conclude that homoeopathy certainly has a place in the treatment strategy of these diseases.
Biotypology I: Scope and history
Authors: Marino F
Published: September 2002

From ancient times, the principal medical cultures tried to classify individuals according to their morpho-functional characteristics in order to study and understand their tendencies in terms of health and sickness. In the last two centuries, in Europe and America, a number of academic schools emerged whose theoretical concepts and ideas were important theroretically but had relatively little practical application. By contrast, in France and Italy, there was the joining of biotypological schools and homoeopathy, which permitted the correlation between biotypes and their relevant homoeopathic remedies. This article outlines the evolution of biotypological thinking and the results of the above said merger.
The early work of Dr. Edward Bach
Authors: Leary B
Published: September 2002

The work of Edward Bach, prior to his discovery of the Flower remedies, is described. He demonstrated non-lactose-fermenting bacteria in patients’ stools. These were later used as the basis of some of the Bowel Nosodes.
Homeopathic effect on heart rate variability
Authors: Ruiz G , Torres J-L , Michel O , Navarro R
Published: September 2002

We record ECGs from healthy human subjects during 24-h long intervals, using ambulatory equipment. We calculate from the data various parameters, searching for those that change in a clear and systematic way under a homoepathic stimulus, (Strophantus hispidus 30 c). The energy fraction at high frequencies in the power spectrum of heart rate variability fulfills this condition, and we are able to interpret our results in a way consistent with the information on this medicine in the homeopathic Materia Medica.
Was Kent a Hahnemannian?
Authors: Cassam A
Published: September 2002

This article voices concern at the trend among an influential section of homeopaths the world over, to jettison Hahnemann’s similimum principle and replace it with Kent’s almost exclusive concentration on mental and psychic symptoms. This concern raises the question whether Kent was a true Hahnemannian.

In order to discuss this question, two schools of thoughts are investigated. The first argues that Hahnemann’s theories were scientific whereas Kent’s were metaphysical. The second criticises Kent’s more severely for being metaphysical. At the same time, it accuses Hahnemann himself of increasingly losing his way, with increasing age, into metaphysical homeopathy.

The author believes there was no break in Hahnemann’s thinking as alleged, but a gradual development with increasing experience, together with judicious use of
rational
insight, when scientific explanation was not yet available. The yardstick used to accuse Hahnemann of being metaphysical is
crudely
empirical and long outdated.
The toxicology of the Chironex fleckeri jelly fish: the Australian sea wasp
Authors: Bonnet MS
Published: September 2002

Potential new homeopathic remedy based on the toxicology of the Box Jellyfish, Chironex fleckeri
Homeopathic terminology: A consensus quest
Authors: Guajardo G , Bellavite P , Wynn S , Searcy R , Fernandez R , Kayne S
Published: September 2002

The aim of this project is to develop a common homeopathic terminology to improve communication. A questionnaire was sent by email to an international group of experts. As a result of an iterative process we propose that a number of terms which are inaccurate, unclear or have become outdated should be replaced by new terms. The main areas in which terminology should be updated are: concepts relating to: homeopathic pharmacology, research, homeopathic medicine, the principle of similarity, homeostasis and disease imitation, miasms, experimental homeopathy, provings and pathogenic trials.
The relationship between homeopathy and the Dr Bach system of flower remedies: A critical appraisal
Authors: van Haselen RA
Published: September 2002

The relationship between homeopathy and the Dr Bach system of flower remedies is explored. A historical perspective is given, doctrinal similarities and dissimilarities between both systems are discussed and the relationship between remedies used in homeopathy as well as in Dr Bach's system of flower remedies is explored. It is concluded that although both systems are clearly different, some common ground exists and that both systems may have a complementary role which is perhaps insufficiently recognised.
An epidemiological study of a homeopathic practice
Authors: Colin P
Published: September 2002

An analysis of 2148 consultations in a private general medical homeopathic practice in France was conducted in 12 periods of 7–10 days of study over four years. The results show that homeopathy is mainly used in mental, infectious and rheumatological disorders. It is suggested that homeopathy is a useful alternative in these illnesses, as it avoids the abuse of, and the adverse effects of, sedatives, antibiotics and anti-inflammatories.
Evaluation of 2LHERP in preventing recurrences of genital herpes
Authors: Jenaer M , Henry MF , Garcia A , Marichal B
Published: September 2002

The objective of the study was to evaluate the effectiveness of a homeopathic complex in terms of intensity of attacks and duration of remission between attacks of genital herpes. Fifty three patients aged 18 or over with a minimum of four attacks annually were followed in this open multicentre study in a primary care setting. The principal parameters analysed were: frequency of attacks; intensity of symptoms, during treatment and/or after stopping treatment; treatment tolerance.

Eighty-two percent of patients treated for recurrent genital herpes benefited. In 41% of cases, there was no recurrence after the first treatment with follow-up of between 8 and 50 months. In 32% of patients, one or two relapses, in 9% of patients recurrences continued but with reduced frequency and intensity.
Is homeopathic ‘immunotherapy’ effective? A double-blind, placebo-controlled trial with the isopathic remedy Betula 30c for patients with birch pollen allergy
Authors: Aabel S , Laerum E , Dølvik S , Djupesland P
Published: September 2002

The objective of the study was to examine the effect of the homeopathic remedy Betula 30c
vs
placebo for patients with birch pollen allergy. A double-blind, randomized, placebo-controlled trial was carried out. Tablets were given for 4 weeks during the birch pollen season. The setting was Oslo, Norway, May 1995.

Patients were aged between 18 and 50 y; 32 patients received Betula 30c tablets and 34 patients received placebo tablets.

The main outcome measure was the total score of 17 different allergy symptoms. Daily total scores were calculated, as well as differences and ratios between the run-in and the following time periods. Point estimates of the median difference between the experimental and placebo groups, with their 95% confidence intervals, were the main measure of effect.

No statistically significant difference between the groups was found during the first and last period of May. However, from 8 to 18 May, a clinically interesting difference was revealed between the groups, those receiving Betula 30c having fewer and less serious symptoms. For some days these differences were statistically significant. Surprisingly, this group reported more aggravation from the tablets than did the placebo group.

With a statistical power of 70% for a defined clinically interesting difference (25%), the present results indicate that treatment with Betula 30c during the pollen season deserves further attention.
The toxicology of Heloderma suspectum: the Gila monster
Authors: Bonnet MS
Published: September 2002

The biotoxicology of Heloderma suspectum, the Gila monster, is presented in order to complement the homeopathic provings.
Homeopathic remedies for the treatment of osteoarthritis: a systematic review
Authors: Long L , Ernst E
Published: September 2002

Osteoarthritis is a common rheumatic disease. Limitations of conventional medical management of this condition indicate a real need for safe and effective treatment of osteoarthritic patients. The authors review the clinical evidence for and against the effectiveness of homeopathic medicines in the treatment of patients with osteoarthritis. A systematic review of all randomised controlled clinical trials of homeopathic treatment of patients with this condition is presented. A comprehensive search yielded four trials which are discussed in detail. The authors conclude that the small number of randomised clinical trials conducted to date, although favouring homeopathic treatment, do not allow a firm conclusion as to the effectiveness of homeopathic remedies in the treatment of patients with osteoarthritis. The clinical evidence appears promising, however, and more research into this area seems warranted.
On the investigation of homeopathic potencies using low resolution NMR T2 relaxation times: an experimental and critical survey of the work of Roland Conte et al
Authors: Milgrom LR , King KR , Lee J , Pinkus AS
Published: September 2002

We have attempted to reproduce differences in low resolution nuclear magnetic resonance (NMR) T2 spin–spin relaxation times between homeopathically potentised and unpotentised Nitric acid (nit-ac) solutions previously reported by Conte, et al. Using similar instrumentation and experimental protocols, we have shown that it is likely that Conte's original results are attributable to experimental artifact originating in the glassware used for the manufacture of the NMR tubes.
Nuclear magnetic resonance (NMR) studies of homeopathic solutions
Authors: Aabel S , Fossheim S , Rise F
Published: September 2002

The efficacy of homeopathy is controversial. Nuclear magnetic resonance (NMR) has been used to study homeopathic solutions, showing provocative results. We examined the reproducibility of one of the allegedly positive studies.

1H NMR spectra were recorded for Sulphur D4, diluted and succussed up to D30 (called potentization) at two different frequencies (300 and 500 MHz). The Sulphur solution had been potentiated according to homeopathic principles with deionized water and alcohol. Water proton T1 relaxation measurements were performed also at 20 MHz for the different potentiated Sulphur solutions. Furthermore, the homeopathic remedy Betula alba 30c (birch pollen extract) and appropriate control solution (deionized water, unsuccussed solutions and placebo globules) were measured analogously, both with frequencies giving spectra and T1 relaxometry.

The Sulphur remedies showed identical one dimensional proton spectra (1H NMR) at 300 and 500 MHz, regardless of dilution/succussion stage, from D4 to D30. Furthermore, Betula 30c as a potentiated solution and its controls (ethanol dilutions and Betula diluted but not succussed) showed identical spectra. Nor were there any statistically significant differences in longitudinal (T1) relaxation times between deionized water and Sulphur D10 to D30 preparations. The shorter T1 of the Sulphur D4 preparation could be ascribed to the higher microviscosity within the sample matrix caused by the high concentration of dissolved material. Also, the T1 values of the Betula alba 30c preparation (in globular form) and control placebo globules were identical.

In conclusion, published results from NMR research on homeopathy indicating differences between homeopathic solutions and control samples could not be reproduced.
Clinical verification of symptom pictures of homeopathic medicines
Authors: Fayeton S , van Wassenhoven M
Published: September 2002

This invitation for co-operation is addressed to all interested groups. Its purpose is data collection for clinical verification of symptoms from homeopathic proving and collection of clinical symptoms not derived from homeopathic pathogenetic trials (provings). To date no consensus exists on this topic. The European Committee for Homoeopathy (ECH) research sub-committee has created a working group on this topic. This paper is the result of a review of papers on the topic, exchanges between members and a meeting.
Homeopathic Secretin in autism: a clinical pilot study
Authors: Robinson TW
Published: September 2002

Autism is a condition characterised by impairments of social communication, social interaction and social imagination. The exact aetiology of autism is unknown but some autistic features have been explained by the ‘opioid excess theory’ in which excess brain peptide levels have a morphine-like activity. Reduction of peptide levels by administration of the duodenal enzyme Secretin has been found to improve social and language skills in autistic patients. Homeopathic Secretin has been said to produce similar effects. A pilot study was undertaken to study these effects by administration of Secretin to a group of autistic patients. Weekly assessment for 12 weeks was performed by the patients' care workers. Statistical analysis of the mean pre-treatment results compared with the mean treatment results suggested a worsening in the autistic symptoms during treatment. Discussion with the care workers revealed changes and some improvements that were not recordable on the scoring system. Further research into Secretin treatment of autism using a more detailed and customised scoring system would be justified. Following this pilot study a randomised controlled trial of Secretin vs placebo would be appropriate.
The long-term effects of homeopathic treatment of chronic headaches: one year follow-up and single case time series analysis
Authors: Walach H , Lowes T , Mussbach D , Schamell U , Springer W , Stritzl G , Haag G
Published: September 2002

Little is known about long-term effects of homeopathic treatment. Following a double-blind, placebo controlled trial of classical homeopathy in chronic headaches, we conducted a 1-year observational study of 18 patients following the double-blind phase, and a complete follow-up study of all trial participants. Eighteen patients received free treatment for daily diary data (frequency, intensity, duration of headaches) over the course of 1 y. All patients enrolled in the double-blind study were sent a 6-week headache diary, a follow-up questionnaire, a personality inventory and a complaint list. Eighty-seven, of the original 98 patients enrolled returned questionnaires, 81 returned diaries. There was no additional change from the end of the trial to the one-year follow-up. The improvement seen at the end of the 12-week trial was stable after 1 y. No differential effects according to treatment after the trial could be seen. Patients with no treatment following the trial had the most improvement after 1 y. Five of 18 patients can be counted responders according to ARIMA analysis of single-case time-series. Patients with double diagnoses and longer treatment duration tended to have clearer improvements than the rest of the patients. Approximately 30% of patients in homeopathic treatment will benefit after 1 y of treatment. There is no indication of a specific, or of a delayed effect of homeopathy.
Can homeopaths detect homeopathic medicines? A pilot study for a randomised, double-blind, placebo controlled investigation of the proving hypothesis
Authors: Vickers A , McCarney R , Fisher P , van Haselen R
Published: September 2002

Homeopaths believe that a medicine, which causes a particular symptom in a healthy volunteer, will cure a similar symptom in a sick patient. From this phenomenon, it is possible to deduce a hypothesis: homeopaths should be able to distinguish a homeopathic medicine from a placebo by taking both and observing their effects. If true, this would support an effect of homeopathic medicines different from that of placebo. If false, it casts serious doubt on the contemporary homeopathic knowledge base and on homeopathic pathogenetic trials (HPTs) as currently practised. The study design was a double-blinded, crossover trial. It consisted of a 1-week study medication period, a 2-week washout period and a further 1-week on study medication. Bryonia in a 12c potency was chosen as the trial medication. Participants were recruited in the UK from the Faculty of Homeopathy and the Society of Homeopaths and were currently healthy, aged 18 or over with at least three years' clinical experience of homeopathy. Of the 500 recruitment packs despatched, we received 88 responses (17.6%). Seventy homeopaths were randomised of whom 50 completed the trial. In the main analysis 60% correctly identified the bottle containing Bryonia (n=40; 95% confidence interval 43%, 75%; P=0.27). There was evidence of an order effect: subjects were much more likely to think they received active Bryonia in the first rather than the second period. In this study a promising trend was observed that symptoms reported by some homeopaths may not be completely attributable to placebo. A multi-national, large-scale trial will be required to investigate this phenomena with adequate statistical power.
Patient benefit survey: Liverpool Regional Department of Homoeopathic Medicine
Authors: Richardson WR
Published: September 2002

We report an Outcome Survey carried out at Liverpool Regional Department of Homoeopathic Medicine, over a 12-month period between 1 June 1999 and 31 May 2000, using self-assessment by the Glasgow Homoeopathic Hospital Outcome Score (GHHOS). Overall 76.6% of patients reported an improvement in their conditions since starting homeopathic treatment, while 60.3% scored +2,+3 or+4 on the GHHOS. Fifty-two percent of patients reduced their conventional medication.
Homeopathy in acute otitis media in children: treatment effect or spontaneous resolution?
Authors: Frei H , Thurneysen A
Published: September 2002

The conventional antibiotic treatment of acute otitis media (AOM) faces a number of problems, including antibiotic resistance. Homeopathy has been shown to be capable of treating AOM successfully. As AOM has a high rate of spontaneous resolution, a trial to prove any treatment-effect has to demonstrate very fast resolution of symptoms. The purpose of this study was to find out how many children with AOM are relieved of pain within 12 h after the beginning of homeopathic treatment, making additional measures unnecessary. Two hundred and thirty children with AOM received a first individualized homeopathic medicine in the paediatric office. If pain-reduction was not sufficient after 6 h, a second (different) homeopathic medicine was given. After a further 6 h, children who had not reached pain control were started on antibiotics. Pain control was achieved in 39% of the patients after 6 h, another 33% after 12 h. This resolution rate is 2.4 times faster than in placebo controls. There were no complications observed in the study group, and compared to conventional treatment the approach was 14% cheaper.
Treatment for hyperactive children: homeopathy and methylphenidate compared in a family setting
Authors: Frei H , Thurneysen A
Published: September 2002

The sharp increase of the prescription of methylphenidate (MPD) in hyperactive children in recent years is a matter of increasing uneasiness among professionals, parents and politicians. There is little awareness of treatment alternatives. The purpose of this prospective trial was to assess the efficacy of homeopathy in hyperactive patients and to compare it MPD. The study was performed in a paediatric practice with conventional and homeopathic backgrounds. Children aged 3–17 y, conforming to the DSM-IV criteria for attention deficit hyperactivity disorder (ADHD) with a Conners Global Index (CGI) of 14 or higher were eligible for the study. All of them received an individual homeopathic treatment. When clinical improvement reached 50%, the parents were asked to reevaluate the symptoms. Those who did not improve sufficiently on homeopathy were changed to MPD, and again evaluated after 3 months. One hundred and fifteen children (92 boys, 23 girls) with a mean age of 8.3 y at diagnosis were included in the study. Prior to treatment the mean CGI was 20.63 (14–30), the mean index of the homeopathy group 20.52 and of the MPD-group 20.94. After an average treatment time of 3.5 months 86 children (75%) had responded to homeopathy, reaching a clinical improvement rating of 73% and an amelioration of the CGI of 55%. Twenty-five children (22%) needed MPD; the average duration of homeopathic (pre-) treatment in this group was 22 months. Clinical improvement under MPD reached 65%, the lowering of the CGI 48%. Three children did not respond to homeopathy nor to MPD, and one left the study. In cases where treatment of a hyperactive child is not urgent, homeopathy is a valuable alternative to MPD. The reported results of homeopathic treatment appear to be similar to the effects of MPD. Only children who did not reach the high level of sensory integration for school had to be changed to MPD. In preschoolers, homeopathy appears a particularly useful treatment for ADHD.
Compartment Syndrome of the Hand Following Intra-Arterial Injection of Heroin
Authors: FUNK L. , GROVER D. , DE SILVA H.
Published: September 2002

We report two cases of compartment syndrome of the hand and forearm, due to intra-arterial injection of heroin, managed by surgical fasciotomies alone. We also review the literature on the management of this condition.
Flexor Tendon Repair in a Rabbit Model using a “Core” of Extensor Retinaculum with Synovial Membrane
Authors: CHUREI Y. , YOSHIZU T. , MAKI Y. , TSUBOKAWA N.
Published: September 2002

In this histological and biomechanical study in two groups of rabbits, a piece of the extensor retinaculum with its synovial membrane was inserted as a biological “core” into a hole at the centre of both stumps of a severed tendon, which was repaired with interrupted sutures. In the other group, the tendon was sutured without a “core”. In the “core” group, proliferation and migration of fibroblasts from both tendon surfaces and the “core” surface toward the deep layer of the suture site was seen 2 weeks after operation. New collagen fibres, aligned parallel to the long axis of the tendon, could also be seen 4 weeks after operation, and healing was more advanced than in the coreless model. The maximum force to produce a gap in the “core” tendon was 82% greater than in the coreless tendon 4 weeks after operation.
Ilizarov’s Technique used to Expand Skin from a Groin Flap
Authors: LOW C. K. , LOOI K. P.
Published: September 2002

We report a case in which a groin flap was used to cover the degloved fingers. Subsequently, Ilizarov’s technique was used to expand the groin flap before the syndactylized digits were separated.
Posterior Interosseous Nerve Syndrome Due to Pseudogout
Authors: TANIGUCHI Y. , YOSHIDA M. , TAMAKI T.
Published: September 2002

Posterior interosseous nerve palsy associated with pseudogout of the elbow joint in a 71-year-old woman is described. Local steroid injection and administration of a nonsteroidal anti-inflammatory drug was effective in treatment.
Myositis Ossificans of the Hand
Authors: KUSUMA S. , LOURIE G. M. , LINS R. E.
Published: September 2002

We present a case of myositis ossificans of the hand and review the clinical, radiological, and histological presentation, as well as the appropriate therapeutic management.
Lymphangiosarcoma in Chronic Lymphoedema
Authors: AYGIT A. C. , YILDIRIM A. M. , DERVISOGLU S.
Published: September 2002

A case of post-mastectomy lymphangiosarcoma is reported. Lymphangiosarcoma is an extremely rare but highly lethal complication of chronic lymphoedema. Our patient was treated by amputation and died 6 months later. Treatment of post-mastectomy lymphangiosarcoma is still unsatisfactory. Early recognition and radical ablative surgery seem to provide best chance for survival.
The Thermal Effects of Kirschner Wire Fixation on Small Bones
Authors: KHANNA A. , PLESSAS S. J. , BARRETT P. , BAINBRIDGE L. C.
Published: September 2002

The aim of this study was to assess bone heating caused by the passage of fine (<2 mm) K-wires of different types. Stainless steel K-wires of trocar and diamond point configurations (0.8–2.0 mm) were drilled into the metatarsal bones from a freshly amputated lower limb at a constant force. Temperature measurements were made by miniature thermocouples inserted into the bones, at 3 second intervals over a period of 3 minutes while each K-wire was drilled three times. The temperature reached varied with the tip configurations and the diameter of the K-wires. Regardless of point configuration, thinner wires generated more heat than thicker ones.
Pseudarthrosis of the Capitate
Authors: RICO Á. A. , HOLGUIN P. H. , MARTIN J. G.
Published: September 2002

Nonunion of an isolated fracture of the capitate is an infrequent condition. The authors present a patient who had few symptoms. Computed tomography showed more bone destruction than the standard X-ray. The nonunion healed with the use of a cancellous bone graft.
Use of the Homodigital Adipofascial Turnover Flap for Dorsal Cover of Distal Interphalangeal Joint Defects
Authors: JEFFERY S. L. A. , PICKFORD M. A.
Published: September 2002

The homodigital adipofascial turnover flap was originally described by Voche and Merle (1994) for dorsal cover of the proximal interphalangeal joint. We present three patients in whom this flap was used to cover dorsal defects of the distal interphalangeal joint, and describe an adaptation to allow greater flap mobility.
Time Off Work Due to Scaphoid Fractures and Other Carpal Injuries in the Netherlands in the Period 1990 to 1993
Authors: MINK VAN DER MOLEN A. B. , GROOTHOFF J. W. , VISSER G. J. P. , ROBINSON P. H. , EISMA W. H.
Published: September 2002

This study assessed the epidemiology, treatment, disability and time off work due to carpal injuries in the Netherlands in the period from 1990 to 1993. Most injuries were scaphoid fractures and carpal instabilities were rare. The time off work was considerable (mean, 155 days; median, 105 days; range, 12–1708 days). Patients with non-scaphoid fractures had the shortest time off work, followed by those with scaphoid fractures; patients with carpal instabilities had the longest time off work. Despite the significant time off work, the prognosis for return to work was excellent.
Microsurgical Reconstruction of Partial Thumb Defects
Authors: WOO S. H. , KIM J. S. , KIM H. H. , SEUL J. H.
Published: September 2002

We have reconstructed thumb defects using microsurgical techniques in 43 patients. The flap survival was 100% and functional improvement with near normal appearance was obtained in the reconstructed thumbs. In order to obtain satisfactory results, donor sites were confined to the great toe and its adjacent structures and adventitia was removed from the vascular pedicle, which was transferred by subcutaneous tunnelling to minimize scar formation in the reconstructed thumb. The width of transferred nail and pulp volume were matched to the defect in the thumb before transfer.
Wrist Extensor Muscle Pathology in Lateral Epicondylitis
Authors: LJUNG B.-O. , LIEBER R. L. , FRIDÉN J.
Published: September 2002

The morphology of the extensor carpi radialis brevis (ECRB) muscle was investigated in 20 patients with longstanding lateral epicondylitis. Muscle biopsies were obtained from the proximal or distal portion of the ECRB and analysed by enzyme- and immunohistochemical methods. Morphological abnormalities were significantly more frequent in patients than controls and included moth-eaten fibres, fibre necrosis and signs of muscle fibre regeneration as well as higher percentages of the fast-twitch oxidative (type 2A) fibre type. Changes were equally distributed proximally and distally. It is concluded that these changes, directly or indirectly, may reflect the cumulative effect of mechanical and/or metabolic overload and that decreased muscular performance in patients with lateral epicondylitis may be due to both elbow pain and physical damage to the ECRB muscle.
The Hand Injury Severity Scoring System and Workers’ Compensation Cases in Wisconsin, USA
Authors: MINK VAN DER MOLEN A. B. , MATLOUB H. S. , DZWIERZYNSKI W. , SANGER J. R.
Published: September 2002

The Hand Injury Severity Score was retrospectively applied to a group of workers’ compensation cases in Wisconsin, USA. A statistically significant correlation was found between the score and the time interval between injury and the end of healing. These results are comparable to the findings in the original study of Campbell and Kay (1996) . We provide some suggestions for further development of this scoring system.
Time Off Work After Occupational Hand Injuries
Authors: SKOV O. , JEUNE B. , LAURITSEN J. M. , BARFRED T.
Published: September 2002

This study analysed the impact of several factors on the start and duration of time off work among 802 patients with occupational hand injuries, in order to identify prognostic indicators. The study showed that external factors such as work and social condition seemed to have less influence on time off work than expected, whereas advice from doctors, flashbacks and impairment symptoms were important determinants.
Blatt’s Capsulodesis for Chronic Scapholunate Dissociation
Authors: DESHMUKH S. C. , GIVISSIS P. , BELLOSO D. , STANLEY J. K. , TRAIL I. A.
Published: September 2002

We have reviewed prospectively 44 cases of chronic scapholunate dissociation treated by Blatt’s dorsal capsulodesis. The diagnosis was based on clinical and arthroscopic criteria. The minimum follow-up was 2 years. The results were analysed clinically and radiologically. Postoperatively statistically significant reductions in wrist movements and grip strengths were noted. Delay in surgery and presence of compensation claims were also statistically significant factors. Patients with a high column/row index had higher overall good and excellent results. The scapholunate gap, scapholunate angle, carpal height and the type of instability as diagnosed on arthroscopy and cineradiography did not affect the outcome significantly. The scapholunate gap, scapholunate angle and the carpal height did not change significantly after operation.
Bilateral Proximal Radial and Scaphoid Fractures in a Child
Authors: KAY R. M. , KUSCHNER S. H.
Published: September 2002

A 13-year-old boy fell and suffered concomitant bilateral fractures of the proximal radius and scaphoid. Ipsilateral fractures of the proximal radius and scaphoid have been reported only once previously in a child, and never bilaterally. This article reviews paediatric proximal radial fractures and scaphoid fractures and their associated injuries. This report underlines the importance of examining for other injuries when a child presents with an apparently isolated upper extremity fracture.