Alterações contráteis segmentares e sua associação com arritmias ventriculares complexas, em pacientes chagásicos com eletrocardiograma normal ou borderline

INTRODUÇÃO: Morte súbita representa a principal causa de óbito em chagásicos. Eventos fatais em pacientes saudáveis, com anormalidades contráteis, foram documentados. O objetivo deste trabalho é determinar a associação entre alteração contrátil e arritmias ventriculares complexas em pacientes chagásicos, classe funcional I, eletrocardiograma normal ou borderline e função ventricular preservada. MÉTODOS: Quarenta e nove pacientes com doença de Chagas e eletrocardiograma normal ou borderline realizaram ecocardiograma, teste ergométrico e Holter. Avaliou-se a contratilidade global e segmentar dos ventrículos e a presença de arritmias ventriculares complexas induzidas no esforço e espontâneas, respectivamente. A análise estatística foi feita pelo modelo Log-Linear geral. RESULTADOS: Idade média de 56 anos; 55% mulheres. Alterações contráteis segmentares em 24,5% dos pacientes; 12% dos Holter e 18% dos testes ergométricos positivos. Houve associação entre arritmia e alteração segmentar condicionada à presença da disfunção sistólica leve do ventrículo esquerdo. CONCLUSÕES: Alterações contráteis, na presença de disfunção global leve, indicam pacientes sob maior risco de arritmias complexas.

Detection of incipient left ventricular hypertrophy in mild to moderate arterial hypertension with normal electrocardiogram and echocardiogram: a new use for signal-averaged electrocardiography

OBJECTIVE: To assess signal-averaged electrocardiogram (SAECG) for diagnosing incipient left ventricular hypertrophy (LVH). METHODS: A study with 115 individuals was carried out. The individuals were divided as follows: GI - 38 healthy individuals; GII - 47 individuals with mild to moderate hypertension and normal findings on echocardiogram and ECG; and GIII - 30 individuals with hypertension and documented LVH. The magnitude vector of the SAECG was analyzed with the high-pass cutoff frequency of 40 Hz through the bidirectional four-pole Butterworth high-pass digital filter. The mean quadratic root of the total QRS voltage (RMST) and the two-dimensional integral of the QRS area of the spectro-temporal map were analyzed between 0 and 30 Hz for the frequency domain (Int FD), and between 40 and 250 Hz for the time domain (Int TD). The electrocardiographic criterion for LVH was based on the Cornell Product. Left ventricular mass was calculated with the Devereux formula. RESULTS: All parameters analyzed increased from GI to GIII, except for Int FD (GII vs GIII) and RMST log (GII vs GIII). Int TD showed greater accuracy for detecting LVH with an appropriate cutoff > 8 (sensitivity of 55%, specificity of 81%). Positive values (> 8) were found in 56.5% of the G II patients and in 18.4% of the GI patients (p< 0.0005). CONCLUSION: SAECG can be used in the early diagnosis of LVH in hypertensive patients with normal ECG and echocardiogram.

Long-term fluctuation of relative afferent pupillary defect in subjects with normal visual function.

PURPOSE: To determine whether the relative afferent pupillary defect (RAPD) remains constant over time in normal subjects. METHODS: Seventeen normal subjects were tested with infrared pupillography and automated perimetry in four sessions over 3 years. The changes in RAPD and visual field asymmetry between testing sessions were compared. RESULTS: The range of RAPD was 0.0 to 0.3 log unit, and the difference in the mean deviation between the eyes on automated static perimetry was 0 to 3 dB. Eight subjects repeatedly had an RAPD in the same eye. There was no correlation between the RAPD and the visual field asymmetry at the same visit. Changes in the magnitude of the RAPD between any two sessions were typically small (median, 0.08 log unit; 25th percentile, 0.04 log unit; 75th percentile, 0.15 log unit). CONCLUSIONS: Some normal subjects may show a persistent but small RAPD in the absence of detectable pathologic disease. Therefore, an isolated RAPD in the range of 0.3 log unit that is not associated with any other significant historical or clinical finding should probably be considered benign.

Robust Estimators of the Generalized Log-Gamma Distribution

We propose robust estimators of the generalized log-gamma distribution and, more generally, of location-shape-scale families of distributions. A (weighted) Q tau estimator minimizes a tau scale of the differences between empirical and theoretical quantiles. It is n(1/2) consistent; unfortunately, it is not asymptotically normal and, therefore, inconvenient for inference. However, it is a convenient starting point for a one-step weighted likelihood estimator, where the weights are based on a disparity measure between the model density and a kernel density estimate. The one-step weighted likelihood estimator is asymptotically normal and fully efficient under the model. It is also highly robust under outlier contamination. Supplementary materials are available online.

Scenario-based traffic forecasts for the routes between the PENTA ports in 2020

Maritime transport is the foundation for trade in the Baltic Sea area. It represents over 15% of the world’s cargo traffic and it is predicted to increase by over 100% in the future. There are currently over 2,000 ships sailing on the Baltic Sea and both the number and the size of ships have been growing in recent years. Due to the importance of maritime traffic in the Baltic Sea Region, ports have to be ready to face future challenges and adapt to the changing operational environment. The companies within the transportation industry – in this context ports, shipowners and logistics companies – compete continuously and although the number of companies in the business is not particularly substantial because the products offered are very similar, other motives for managing the supply chain arise. The factors creating competitive advantage are often financial and related to cost efficiency, but geographical location, road infrastructure in the hinterland and vessel connections are among the most important factors. The PENTA project focuses on adding openness, transparency and sharing knowledge and information, so that the challenges of the future can be better addressed with regard to cooperation. This report presents three scenario-based traffic forecasts for routes between the PENTA ports in 2020. The chosen methodology is PESTE, in which the focus in on economic factors affecting future traffic flows. The report further analyses the findings and results of the first PENTA WP2 report “Drivers of demand in cargo and passenger traffic between PENTA ports” and utilises the same material, which was obtained through interviews and mail surveys.

Secretory immunity in overweight and obese versus normal-weight early-and late-pubertal females

Obesity is a condition associated with a wide variety of health problems including hypertension, dyslipidemia, diabetes mellitus, certain forms of cancer, cardiovascular disease, and gallstones (157). TTiere is growing evidence that obesity may also be related to compromised immune function due to altered metabolic, psychological, and physical attributes (93). The aim of this study was to compare: a) immunity-related variables such as frequency of upper respiratory tract infections (URTI) and salivary secretory immunoglobulin A (sIgA) levels between overweight/obese (OB) and normal weight (NW) early-pubertal and late-pubertal girls, and b) stress-related variables such as Cortisol, melatonin, the melatonin/cortisol ratio, testosterone and the testosterone/cortisol ratio. Physical activity levels, stress indicators, and fatigue were used to explain potential differences in the dependent variables. It was hypothesized that the OB females would have lower melatonin (M) and higher Cortisol (C) and testosterone (T) levels compared with NW girls, regardless of maturity status. The altered levels of melatonin, Cortisol, and testosterone, would result in decreased M/C and T/C ratios, despite the increase in testosterone in OB females. It was hypothesized that this altered hormonal status results in a compromised immunity marked by higher frequency of upper respiratory tract infections (URTI) and decreased levels of secretory immunoglobulin A (sIgA). It was also hypothesized that OB girls would participate in less hours of physical activity than their NW counterparts and that this would relate to their stress and immunity levels. Forty (16 early- and 24 late-pubertal) overweight and obese females were compared to fifty-three (27 eariy- and 26 late-pubertal) age-matched normal-weight control subjects. Participants were categorized as early-pubertal (EP) or late-pubertal (LP) using Tanner self-staging of secondary sex characteristics. Subjects were classified into the two adiposity groups according to relative body fat (%BF), where normal weight (NW) subjects had a %BF less than 25%, and overweight and obese (OB) subjects had a %BF greater than 27.5%. Participants completed a number of questionnaires and information was collected on menstrual history, smoking history, alcohol and caffeine consumption, and medical history. Following the determination of maturity status, a complete anthropometric assessment was made including height, body mass, and body composition. All questionnaires and measurements were completed during a one-hour visit between 1 500 and 1900 hours Relative body fat was assessed using bioelectrical impedance analysis. Resting saliva samples were obtained and assayed (ELISA) for testosterone, Cortisol, melatonin and secretory immunoglobulin A. Physical activity was self-reported using the Godin- Shephard Leisure time questionnaire, and quantified using Actigraph GTIM accelerometers, which participants wore for seven consecutive days from the time they woke up in the morning, until the time they went to bed. Late-pubertal girls also completed questionnaires on their perceived stress and fatigue. Finally, all participants also filled out a one-month health log to record frequency of symptoms of upper respiratory tract infections (URTI). Significant age effects were found for testosterone, Cortisol, incidence of sickness, and sIgA when controlling for physical activity, however there were no significant effects of adiposity on any of the variables. There was a trend which neared-significance for an effect of adiposity on sIgA (p=0.01). There were no significant differences between the groups on the total selfreported leisure-time physical activity in METs per week, however EP girls recorded significantly greater levels of moderate, hard, and very hard physical activity from accelerometers. Results of the perceived stress and fatigue questionnaires in late-pubertal girls demonstrated that contrary to what was hypothesized, NW girls reported more stress and more fatigue than OB girls. Results of the present study suggest that excess adiposity in early- and latepubescent girls may not have a negative impact on immunity as hypothesized.

Box Products in Fuzzy Topological Spaces and Related Topics

The topology as the product set with a base chosen as all products of open sets in the individual spaces. This topology is known as box topology. The main objective of this study is to extend the concept of box products to fuzzy box products and to obtain some results regarding them. Owing to the fact that box products have plenty of applications in uniform and covering properties, here made an attempt to explore some inter relations of fuzzy uniform properties and fuzzy covering properties in fuzzy box products. Even though the main focus is on fuzzy box products, some brief sketches regarding hereditarily fuzzy normal spaces and fuzzy nabla product is also provided. The main results obtained include characterization of fuzzy Hausdroffness and fuzzy regularity of box products of fuzzy topological spaces. The investigation of the completeness of fuzzy uniformities in fuzzy box products proved that a fuzzy box product of spaces is fuzzy topologically complete if each co-ordinate space is fuzzy topologically complete. The thesis also prove that the fuzzy box product of a family of fuzzy α-paracompact spaces is fuzzy topologically complete. In Fuzzy box product of hereditarily fuzzy normal spaces, the main result obtained is that if a fuzzy box product of spaces is hereditarily fuzzy normal ,then every countable subset of it is fuzzy closed. It also deals with the notion of fuzzy nabla product of spaces which is a quotient of fuzzy box product. Here the study deals the relation connecting fuzzy box product and fuzzy nabla product

Customer perceptions of Banking Products and Services in Kerala with reference to Specific Customer Segments in the Urban Area

As of 1999. the state of Kerala has 3210 offices of scheduled commercial banks (SCBS). In all, there are 48 commercial banks operating in Kerala, which includes PSBs, OPBs, NPBS. FBs, and Gramin Banks. The urban areas give a complete picture of the competition in the present day banking scenario with the presence of all bank groups. Semi-urban areas of Kerala have 2196 and urban areas have 593 as on March 1995.“ The study focuses on the selected segments ofthe urban customers in Kerala which is capable of giving the finer aspects of variation in customer behaviour in the purchase of banking products and services. Considering the exhaustive nature of such an exercise, all the districts in the state have not been brought under the purview of the study. Instead. three districts with largest volume of business in terms of deposits, advances, and number of offices have been short listed as representative regions for a focused study. The study focuses on the retail customer segment and their perceptions on the various products or services offered to them. Non Resident Indians (NRIs), and Traders and Small—ScaIe Industries segments have also been included in the study with a view to obtain a comparative picture with respect to perception on customer satisfaction and service quality dimensions and bank choice behaviour. The research is hence confined to customer behaviour and the implications for possible strategies for segmentation within the retail segment customers

Impact of Quality on Ethics and Social Responsibility in Marketing, in Industries in Kerala in the present Indian Scenario

The paper ‘Impact of Quality on Ethics and Social Responsibility in Marketing in Industries in Kerala in the present Indian scenario’ highlights the observations, based on a descriptive research carried out in five leading industries in Kerala, in the private and public sector. Ethics and social responsibilities, practiced in these industries, are reflected in the results of the survey conducted on specific queries like awareness of products/services provided by them, total understanding of the requirements of the customer, open discussion on technical matters, accountability of employees to the society and social needs, consumer ethics vis a vis business ethics etc. Team working goes a long way, in building relations, which in turn, results in a progressive and effective marketing strategy. This assumes paramount importance, considering the severe competition we are facing in the light of liberalization, privatization and globalization, which encompasses the globe. The prediction of India becoming a lead nation, along with USA, China and Japan, in this decade, can get fructified only if we follow a very high standards of ethics and social responsibility, in all domains including marketing. Organizations like TRW.Rane, Sundaram Fasteners, TVS Motors, in Chennai are a few among others in India, who have achieved the highest distinction in quality viz Deming Prize, and these demonstrate their commitment to quality, society and humanity at large. Cost effectiveness, without jeopardizing quality has become the need of the hour and MRTP has become history. This trait is being brought out through the survey and the results speak for themselves. Unethical practices like switch and bait, not only brings shame to the organization, and country but also results in the company getting wiped out from the market. Adherence to standards like ISO 14000 helps to maintain the minimum level of social responsibility and environmental friendliness. Like quality audit, safety audit etc, social audit is being insisted in all progressive countries to ensure that the organization comply with the minimum statutory requirements. The paper also touches upon Corporate Social Responsibility practiced in the industries and this becomes crystal clear through their commitment to improve the community. Green Marketing lays a lot of importance on the three Rs of environmentalism viz Reduce, Reuse and Recycle. The objective of any business is to achieve optimal profit and this is possible only by reducing the cost as well as waste. In this context, management tools like brainstorming, suggestion schemes, benchmarking etc becomes helpful. These characteristics are brought out through the analysis of survey results. The conclusions drawn throw a lot of information on the desirable practices with respect to Ethics and Social Responsibility in Marketing

Provenance, Isolation and Characterisation of Organic Matter in the Cochin Estuarine Sediment-“a Diagenetic Amino Acid Marker Scenario

Cochin estuarine system is among the most productive aquatic environment along the Southwest coast of India, exhibits unique ecological features and possess greater socioeconomic relevance. Serious investigations carried out during the past decades on the hydro biogeochemical variables pointed out variations in the health and ecological functioning of this ecosystem. Characterisation of organic matter in the estuary has been attempted in many investigations. But detailed studies covering the degradation state of organic matter using molecular level approach is not attempted. The thesis entitled Provenance, Isolation and Characterisation of Organic Matter in the Cochin Estuarine Sediment-“ A Diagenetic Amino Acid Marker Scenario” is an integrated approach to evaluate the source, quantity, quality, and degradation state of the organic matter in the surface sediments of Cochin estuarine system with the combined application of bulk and molecular level tools. Sediment and water samples from nine stations situated at Cochin estuary were collected in five seasonal sampling campaigns, for the biogeochemical assessment and their distribution pattern of sedimentary organic matter. The sampling seasons were described and abbreviated as follows: April- 2009 (pre monsoon: PRM09), August-2009 (monsoon: MON09), January-2010 (post monsoon: POM09), April-2010 (pre monsoon: PRM10) and September- 2012 (monsoon: MON12). In order to evaluate the general environmental conditions of the estuary, water samples were analysed for water quality parameters, chlorophyll pigments and nutrients by standard methods. Investigations suggested the fact that hydrographical variables and nutrients in Cochin estuary supports diverse species of flora and fauna. Moreover the sedimentary variables such as pH, Eh, texture, TOC, fractions of nitrogen and phosphorous were determined to assess the general geochemical setting as well as redox status. The periodically fluctuating oxic/ anoxic conditions and texture serve as the most significant variables controlling other variables of the aquatic environment. The organic matter in estuary comprise of a complex mixture of autochthonous as well as allochthonous materials. Autochthonous input is limited or enhanced by the nutrient elements like N and P (in their various fractions), used as a tool to evaluate their bioavailability. Bulk parameter approach like biochemical composition, stoichiometric elemental ratios and stable carbon isotope ratio was also employed to assess the quality and quantity of sedimentary organic matter in the study area. Molecular level charactersation of free sugars and amino acids were carried out by liquid chromatographic techniques. Carbohydrates are the products of primary production and their occurrence in sediments as free sugars can provide information on the estuarine productivity. Amino acid biogeochemistry provided implications on the system productivity, nature of organic matter as well as degradation status of the sedimentary organic matter in the study area. The predominance of carbohydrates over protein indicated faster mineralisation of proteinaceous organic matter in sediments and the estuary behaves as a detrital trap for the accumulation of aged organic matter. The higher lipid content and LPD/CHO ratio pointed towards the better food quality that supports benthic fauna and better accumulation of lipid compounds in the sedimentary environment. Allochthonous addition of carbohydrates via terrestrial run off was responsible for the lower PRT/CHO ratio estimated in thesediments and the lower ratios also denoted a detrital heterotrophic environment. Biopolymeric carbon and the algal contribution to BPC provided important information on the better understanding the trophic state of the estuarine system and the higher values of chlorophyll-a to phaeophytin ratio indicated deposition of phytoplankton to sediment at a rapid rate. The estimated TOC/TN ratios implied the combined input of both terrestrial and autochthonous organic matter to sedimentsAmong the free sugars, depleted levels of glucose in sediments in most of the stations and abundance of mannose at station S5 was observed during the present investigation. Among aldohexoses, concentration of galactose was found to be higher in most of the stationsRelative abundance of AAs in the estuarine sediments based on seasons followed the trend: PRM09-Leucine > Phenylalanine > Argine > Lysine, MON09-Lysine > Aspartic acid > Histidine > Tyrosine > Phenylalanine, POM09-Lysine > Histadine > Phenyalanine > Leucine > Methionine > Serine > Proline > Aspartic acid, PRM10-Valine > Aspartic acid > Histidine > Phenylalanine > Serine > Proline, MON12-Lysine > Phenylalanine > Aspartic acid > Histidine > Valine > Tyrsine > MethionineThe classification of study area into three zones based on salinity was employed in the present study for the sake of simplicity and generalized interpretations. The distribution of AAs in the three zones followed the trend: Fresh water zone (S1, S2):- Phenylalanine > Lysine > Aspartic acid > Methionine > Valine ῀ Leucine > Proline > Histidine > Glycine > Serine > Glutamic acid > Tyrosine > Arginine > Alanine > Threonine > Cysteine > Isoleucine. Estuarine zone (S3, S4, S5, S6):- Lysine > Aspartic acid > Phenylalanine > Leucine > Valine > Histidine > Methionine > Tyrosine > Serine > Glutamic acid > Proline > Glycine > Arginine > Alanine > Isoleucine > Cysteine > Threonine. Riverine /Industrial zone (S7, S8, S9):- Phenylalanine > Lysine > Aspartic acid > Histidine > Serine > Arginine > Tyrosine > Leucine > Methionine > Glutamic acid > Alanine > Glycine > Cysteine > Proline > Isoleucine > Threonine > Valine. The abundance of AAs like glutamic acid, aspartic acid, isoleucine, valine, tyrosine, and phenylalanine in sediments of the study area indicated freshly derived organic matter.

A Modeling Analysis of Changing Global Land Use as affected by Changing Demands for Wood Products

The 21st century has brought new challenges for forest management at a time when globalization in world trade is increasing and global climate change is becoming increasingly apparent. In addition to various goods and services like food, feed, timber or biofuels being provided to humans, forest ecosystems are a large store of terrestrial carbon and account for a major part of the carbon exchange between the atmosphere and the land surface. Depending on the stage of the ecosystems and/or management regimes, forests can be either sinks, or sources of carbon. At the global scale, rapid economic development and a growing world population have raised much concern over the use of natural resources, especially forest resources. The challenging question is how can the global demands for forest commodities be satisfied in an increasingly globalised economy, and where could they potentially be produced? For this purpose, wood demand estimates need to be integrated in a framework, which is able to adequately handle the competition for land between major land-use options such as residential land or agricultural land. This thesis is organised in accordance with the requirements to integrate the simulation of forest changes based on wood extraction in an existing framework for global land-use modelling called LandSHIFT. Accordingly, the following neuralgic points for research have been identified: (1) a review of existing global-scale economic forest sector models (2) simulation of global wood production under selected scenarios (3) simulation of global vegetation carbon yields and (4) the implementation of a land-use allocation procedure to simulate the impact of wood extraction on forest land-cover. Modelling the spatial dynamics of forests on the global scale requires two important inputs: (1) simulated long-term wood demand data to determine future roundwood harvests in each country and (2) the changes in the spatial distribution of woody biomass stocks to determine how much of the resource is available to satisfy the simulated wood demands. First, three global timber market models are reviewed and compared in order to select a suitable economic model to generate wood demand scenario data for the forest sector in LandSHIFT. The comparison indicates that the ‘Global Forest Products Model’ (GFPM) is most suitable for obtaining projections on future roundwood harvests for further study with the LandSHIFT forest sector. Accordingly, the GFPM is adapted and applied to simulate wood demands for the global forestry sector conditional on selected scenarios from the Millennium Ecosystem Assessment and the Global Environmental Outlook until 2050. Secondly, the Lund-Potsdam-Jena (LPJ) dynamic global vegetation model is utilized to simulate the change in potential vegetation carbon stocks for the forested locations in LandSHIFT. The LPJ data is used in collaboration with spatially explicit forest inventory data on aboveground biomass to allocate the demands for raw forest products and identify locations of deforestation. Using the previous results as an input, a methodology to simulate the spatial dynamics of forests based on wood extraction is developed within the LandSHIFT framework. The land-use allocation procedure specified in the module translates the country level demands for forest products into woody biomass requirements for forest areas, and allocates these on a five arc minute grid. In a first version, the model assumes only actual conditions through the entire study period and does not explicitly address forest age structure. Although the module is in a very preliminary stage of development, it already captures the effects of important drivers of land-use change like cropland and urban expansion. As a first plausibility test, the module performance is tested under three forest management scenarios. The module succeeds in responding to changing inputs in an expected and consistent manner. The entire methodology is applied in an exemplary scenario analysis for India. A couple of future research priorities need to be addressed, particularly the incorporation of plantation establishments; issue of age structure dynamics; as well as the implementation of a new technology change factor in the GFPM which can allow the specification of substituting raw wood products (especially fuelwood) by other non-wood products.

Estudio comparativo sobre la influencia del adulto en la actividad cognitiva del niño trisómico-niño normal entre 11 meses a 18 meses.

Conocer las bases y organización de la estructura intelectual defectuosa, comparativamente con la normal. Conocer cúal es la incidencia del adulto en dicha construcción, acentuando su papel en la elaboración de la deficiencia. 3 bebés normales observados desde los 8 meses hasta los 18 meses y 3 bebés con síndrome de Down, observados desde la edad madurativa equivalente a los 11 meses. Plantea un marco teórico basado en un punto de vista constructivista e interaccionista centrado en el eje inteligencia-acción-interacción. El marco explicativo respecto al desarrollo defectuoso es el de la teoría de la deficiencia, y el del desarrollo normal se basa en la teoría piagetiana. Plantea dos hipótesis de trabajo. Elige una muestra compuesta por seis casos de manera no aleatoria. Obtiene los datos a partir de la observación sistematizada y longitudinal de los dos grupos de la muestra (normales y trisómicos). Registra su actividad espontánea resultante de jugar con material cerrado, durante 10 minutos y en presencia de dos adultos. Realiza un análisis de datos cualitativo y cuantitativo a tres niveles : intra-sujeto, intra-grupo e inter-grupo. Observación sistemática (funcional, natural, longitudinal, comparativa). Material de juego de tipo no figurativo, favorecedor de actividades lógicas. Análisis cualitativo: codificación y categorización del material y acciones. Análisis cuantitativo: coeficiente de consistencia intra-observador de Knippendorf. Análisis log-linear mediante el paquete estadístico BMDP/4F. Concordancias entre los dos grupos: necesidad del feed-back acción niño-modelo, adulto- respuesta niño. Necesidad de la adecuación del modelo adulto a la actividad del niño. Necesidad de la intersubjetividad adulto-niño. Diferencias entre grupos respecto a: la generación del proyecto de acción y la significación conferida así como a la intersubjetividad, mostrando mayor dificultad el grupo trisómico. La regulación mutua, necesaria pero difícilmente observado en el grupo de trisómicos. La intervención del adulto en la actividad cognitiva del niño es positiva o negativa en función de la existencia o no de un proyecto de acción infantil, significación compartida, intersubjetividad, adecuación mutua adulto-niño y el feed-back entre ellos.

Natural products as alternative treatments for metabolic bone disorders and for maintenance of bone health

Bone metabolism involves a complex balance between the deposition of matrix and mineralization and resorption. There is now good evidence that dietary components and herbal products can influence these processes, particularly by inhibiting bone resorption, thus having beneficial effects on the skeleton. For example, it has been reported that a number of common vegetables, including onion, garlic and parsley, can inhibit bone resorption in ovariectomized rats. Essential oils derived from sage, rosemary, thyme and other herbs inhibit osteoclast activity in vitro and in vitro and leading to an increase in bone mineral density. Soya, a rich source of isoflavones, has shown promising results and epidemiological evidence to support a use in maintaining bone health, and various traditional herbal formulae in Chinese and Ayurvedic medicine also have demonstrable effects in pharmacological models of osteoporosis. Recently, cannabinoids have been described as having positive effects on osteoblast differentiation, and the presence of cannabinoid receptors in bone tissue indicates a more complex role in bone metabolism than previously thought. The first part of this review briefly discusses normal bone metabolism and disorders caused by its disruption, with particular reference to osteoporosis and current pharmacological treatments. The effects of natural products on bone and connective tissue are then discussed, to include items of diet, herbal extracts and food supplements, with evidence for their efficacy outlined. Copyright (c) 2006 John Wiley & Sons, Ltd.

Differences in perceived risks and benefits of herbal, over-the-counter conventional, and prescribed conventional, medicines, and the implications of this for the safe and effective use of herbal products

Objectives: To investigate people's views about the efficacy and specific risks of herbal, over-the-counter (OTC) conventional, and prescribed conventional medicines, and their likelihood of taking a second (herbal or OTC conventional) product in addition to a prescribed medicine. Methods: Experiment 1 (1 factor within-participant design); Experiment 2 (1 factor between-participant design). Convenience samples of general population were given a hypothetical scenario and required to make a number of judgements. Results: People believed herbal remedies to be less effective, but less risky than OTC and prescribed conventional medicines. Herbal medicines were not seen as being safer simply because of their easier availability. Participants indicated that they would be more likely to take a herbal medicine than a conventional OTC medicine in addition to a prescribed medicine, and less likely to consult their doctor in advance. Conclusion: People believe that herbal medicines are natural and relatively safe and can be used with less caution. People need to be given clear information about the risks and benefits of herbal medicines if they are to use such products safety and effectively. (c) 2006 Elsevier Ltd. All rights reserved.

Fatty acid compositions of inositol and choline phospholipids of breast tumours and normal breast tissue

The fatty acid compositions of the -choline and -inositol phospholipids of breast tumours of women undergoing surgery for treatment of breast disease (malignant n = 12; benign n = 10) and normal breast tissue of women undergoing breast reduction surgery (n = 6) were determined. The fatty acid compositions of erythrocyte phospholipids were also determined in the same subjects and in an additional number of normal healthy volunteers (n = 16). Levels of oleic acid were lower in both phospholipid fractions of erythrocytes of women with breast disease and in the phosphatidylcholine fraction of breast tumours compared with normal breast tissue. Significantly higher levels of linoleic acid were found in erythrocytes of tumour-bearing subjects and a similar trend was evident in the phosphatidylcholine fraction of tumour compared with normal breast tissues. Conversely, lower levels of two of the products of linoleic acid chain elongation and desaturation, dihomogamma-linolenic and arachidonic acids, were found in the erythrocyte phospholipids of tumour-bearing subjects and in the choline phospholipids of breast tumour tissues. These data suggest that in women with breast disease, there may be inhibition of 6-desaturase, and enhanced activity of 9-desaturase, enzymes which play an important role in determining membrane phospholipid fatty acid composition. This pattern of altered fatty acid composition characteristic of erythrocyte phospholipids of tumour-bearing subjects and phosphatidylcholine of breast tumour tissue was less evident in the case of the breast tumour phosphatidylinositol in which differences other than those described were seen.