This study investigated the effects of hyperbaric oxygen (HBO) therapy on acute ankle injuries and determined if HBO therapy shortened time to recovery, decreased edema and pain, and increased range of motion and strength of the ankle. Subjects were randomly assigned to either an experimental (HBO) group (n = 4) or a control group (n = 4). All subjects received the same standardized physical therapy for lateral ankle sprains at the McGill Sport Medicine Clinic. The HBO group received 5 consecutive HBO treatments at 2.5 ATA for 90 minutes starting within 24 hours post injury. The control group received no HBO treatments. All subjects were evaluated by a physician within 24 hours of injury. All subjects suffered a second-degree lateral ankle sprain. Pain, range of motion, strength, volume displacement, and function were evaluated on the day of injury (Day 1), on Day 6 post injury, and on the day of return to play (Day RTP). There was no significant difference in time to return to play. However, the HBO group (25.5 +/- 11.6 days) did return 31% faster than the control group (36.8 +/- 19.4 days). There were no differences found between groups on the variables. There was a decrease in pain found over time (Day 1 was 57 mm, Day 6 was 18.5 mm, and Day RTP was 7 mm). The results of this study suggest that with treatment of HBO there is no effect on ankle sprains for return to play or improved function.

<p>Bruxism is an oral parafunctional habit involving clenching and grinding of the teeth that occurs mainly unconsciously, diurnally and nocturnally. It is considered an important contributory factor in the aetiology of myofascial pain (MFP) and temporomandibular disorders (TMD). The aetiology of bruxism is considered to be multifactorial, involving physiological and psychological factors. The aim of this study was to examine the relationship between the subthreshold symptoms (subtle, prodromal, atypical and subclinical symptoms of which the severity precludes diagnosis as a disorder) of anxiety and bruxism in a sample of subjects using a spectrum model.</p>

Background: The homeopathic preparation, Traumeel S, has been used as a valuable alternative to conventional non-steroidal anti-inflammatory drugs (NSAIDS) for over 30 years. This antihomotoxic, anti-phlogistic drug has been widely used by sportsmen and women in the treatment of lesions and inflammatory processes which result from exercise-induced skeletal muscle microtrauma. Although numerous randomised, double-blind placebo-controlled trials have confirmed the efficacy of Traumeel S as an anti-inflammatory agent, there are few in vivo studies which have specifically investigated the mechanism by which Traumeel S is effective in reducing inflammatory response to exercise-induced muscle cell damage. Aim: To establish whether the administration of Traumeel S during the five days before participation and three days following participation, significantly attenuates the systemic markers of the inflammatory response, following a 90-minute downhill running trial. Method: Twenty-four healthy athletes (14 men and 10 women), aged 20-50 years, were recruited for this study. Following baseline laboratory testing and familiarisation with the treadmill as well as a field test, subjects were matched according to gender, BMI, training age, training status, peak performance and foot strike patterns and randomised into Traumeel (TRS) and Control (PLAC) groups in a placebo-controlled, double-blind design. One Traumeel S or Placebo tablet was ingested three times per day for five days prior to and three days following a 90-minute exercise trial on a downhill (-6% gradient) at 75% V02 max- Blood samples were collected prior to the 90-minute trial (PRE), immediately after the trial (IPE) and 24 hours (24 PE), 48 hours (48 PE) and 72 hours (72 PE) following the trial. Each subject was also requested to complete a training record prior to the trial and keep a record of the daily symptoms of delayed onset muscle soreness (DOMS) both at rest (general pain) and during walking (daily living). Full blood counts (FBC), serum creatine kinase (CK), lactate dehydrogenase (LDH) and Cortisol concentrations were measured using standard haematological laboratory procedures and serum C-Reactive Protein (CRP) was determined by immunoturbidimetric assay. Sandwich ELISA's were used to determine myeloperoxidase (MPO) and plasma interleukin-6 (IL-6) concentrations. All results obtained were adjusted for changes in plasma volume as calculated from the red blood cell indices. Results: Mean ± SD characteristics of the gender-matched subjects in the experimental (TRS) and placebo-control (PLAC) groups did not differ significantly in terms of BMI, age, % body fat, FVC, FEVi, training age and status, foot strike pattern or peak running performance, maximal Heart Rate, VE, V02peak> RER, RPE during the maximal exercise test (p > 0.05). This indicated that the randomised pairs were well matched. The 90-minute downhill running protocol resulted in significant elevations in total circulating white blood cell count (WBC), neutrophil, CK, LDH, Cortisol, CPR, MPO and IL-6 concentrations (p < 0.001). When comparing the TRS and PLAC groups, mean ± SD total and differential WBC count, neutrophil count, CK, LDH, Cortisol, CPR, MPO and IL-6 concentrations did not differ (p > 0.05) over the 5 time points. At 24 PE, MPO concentrations were significantly higher in the TRS group than in the PLAC group (p = 0.03). The lower mean ± SD post-trial DOMS scores reported by the TRS group were not significantly different from those reported by the PLAC group (p > 0.05). Conclusion: Although the findings of this study did not identify differences in circulating CK, LDH, Cortisol, CPR and IL-6 concentrations between the TRS and PLAC groups, the elevated MPO concentration at 24 PE did provide preliminary novel evidence of enhanced activation of neutrophil oxidative burst activity following exercise-induced muscle damage which is hypothesized to accelerate the recovery process. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, 2008.

Phenylketonuria (PKU) and related forms of non-PKU hyperphenylalaninemias (HPA) result from deficiencies in phenylalanine hydroxylase (PAH), the hepatic enzyme that catalyses the conversion of phenylalanine (phe) to tyrosine (tyr). Patients are characterised by a metabolic phenotype comprising elevated levels of phe and some of its metabolites, notably phenyllactate (PLA), phenylacetate (PAA) and phenylpyruvate (PPA), in both tissue and body fluids. Treatment from birth with low-phe diet largely prevents the severe mental retardation that is its major consequence. / Mechanisms underlying the pathophysiology of PKU are still not fully understood; to this end, the availability of an orthologous animal model is relevant. A number of N-ethyl-N-nitrosourea (ENU) mutagenized mouse strains have become available. I report a new heteorallelic strain, developed by crossing female ENU1 (with mild non-PKU HPA) with a male ENU2/+ carrier of a 'severe' PKU-causing allele. I describe the new hybrid ENU1/2 strain and compare it with control (BTBR/Pas), ENU1, ENU2 and the heterozygous counterparts. The ENU1, ENU1/2 and ENU2 strains display mild, moderate and severe phenotypes, respectively, relative to the control and heterozygous counterparts. / I describe a novel method using negative ion chemical ionization gas chromatography/mass spectrometry (NICI-GC/MS) to measure the concentration of PLA, PAA and PPA in the brain of normal and mutant mice. Although elevated moderately in HPA and more so in PKU mice, concentrations of these metabolites are not sufficient to explain impaired brain function; however phe is present in brain at levels associated with harm. / Finally, I describe a new modality for treatment of HPA, compatible with better human compliance: it involves enzyme substitution with non-absorbable and protected phenylalanine ammonia lyase (PAL) in the intestinal lumen, to convert L-phenylalanine to the harmless metabolites (trans-cinnamic acid and trace ammonia). PAL, taken orally, substitutes for the deficient PAH enzyme and depletes body pools of excess phe. I describe an efficient recombinant approach to produce PAL enzyme. I also provide proofs of both pharmacologic and physiologic principles by testing PAL in the orthologous mutant mouse strains with HPA. The findings encourage further development of PAL for oral use as an ancillary treatment of human PKU.

Assisting smokers to quit and stay quit is the most important intervention clinicians can undertake to improve the length and quality of life of patients who use tobacco. The chronic, relapsing nature of tobacco dependence complicates tobacco treatment. Tobacco treatment counseling programs provide on-going support to help patients avoid relapse. Assistance with a referral increases the likelihood that patients will participate in counseling, but few clinicians regularly assist with referrals to tobacco treatment programs. This dissertation examined health system processes and clinician attitudes that influence the likelihood that clinicians will refer their patients for tobacco treatment counseling. Three papers examined health system processes, clinician attitudes, and frequency of referrals. A systematic review of the literature was conducted to evaluate strategies to increase the frequency of clinician referrals and effects on quit rates in primary care. The most effective strategies were those that combined clinician education with integrated referral systems. Integrated referral systems include non-clinician staff and clinician and staff prompts with algorithms or protocols for referrals. The second paper reports the findings of a pilot study using qualitative methods to explore experiences and strategies used for tobacco treatment by clinician champions practicing in independent primary care practices. Tobacco champions (N = 11) described experiences counseling patients but not assistance with referrals. Themes identified were: sources of knowledge and experience, understanding dependence, role perception, and treatment strategies. The final paper reports the findings of a cross- sectional, non-experimental study to examine clinician attitudes toward counseling, health system processes that facilitate referrals, and referrals to tobacco treatment counseling. Attitudes about the efficacy of tobacco counseling and the presence of processes that facilitate referrals predicted referrals. Clinicians sampled in these studies held favorable attitudes toward tobacco treatment but lacked confidence in the efficacy of community-based counseling for tobacco treatment. These findings have implications for health care policies to improve integration of processes that facilitate referrals and clinician education that includes information about counseling resources to improve chronic care for the treatment of tobacco dependence.

The need for rehabilitation of bridges has become a critical challenge due to aging and an increase in traffic loads. Many of these bridges are exceeding their design fatigue life. Since many of these bridges are structurally deficient, they need to be rehabilitated or replaced by a new bridge. The most susceptible and weak parts of steel bridges to cracks and fatigue are the welds, due to the presence of high stress concentrations, tensile residual stresses, and imperfections as a result of the welding process. Inspection and repair of welds are difficult and elimination of welded details is not possible in steel bridge construction. Ultrasonic impact treatment (UIT) is a promising and innovative post-weld treatment (PWT) method for improving the fatigue performance of existing welded steel and steel-concrete composite structures such as highway bridges. The fatigue resistance of treated joints is enhanced by improving the geometry of the weld toe, and introducing compressive residual stresses. However, a lack of tools for quality assurance has slowed UIT’s adoption by bridge authorities. The current study was undertaken to examine the fatigue performance of structural steel welds subjected to UIT at various levels, including intentional under-treatment and over-treatment, and to relate the fatigue performance of the treated welds to geometric and metallurgical properties measured to control the treatment quality. The last objective was to use the laboratory results to develop acceptance criteria for the quality control of UIT in bridge applications. Fatigue tests of non-load carrying fillet welded attachments were conducted on properly treated, under-treated, and over-treated weld toes. Statistical analyses of the fatigue life data were performed and crack growth was monitored using the alternating current potential drop (ACPD) method. Measurement of local properties (such as weld toe geometry, local hardness, and residual stresses) and examination of the weld toe microstructure were also performed on the untreated and treated welds. The effects of weld toe geometry on the local stresses in the untreated and treated welds were also investigated using elastic finite element analysis (FEA) to obtain the stress concentration factor (SCF) for the different treatment cases and to examine the changes in the SCF for the different weld toe geometries. Based on the statistical analysis performed in this research, the results illustrated that UIT significantly improved the fatigue lives of weld details regardless of the investigated level of treatment quality. The fatigue lives of welded details under constant amplitude (CA) loading and constant amplitude loading with under-loads (CA-UL) were increased up to 30 and 27 times respectively. On average, the fatigue life of the treated weld details was slightly lower under CA-UL than under CA loading. Treatment quality had little impact on the mean of the S-N curves. However, it did impact the design (95% survival probability) S-N curves, with the curve associated with a proper treatment slightly higher than the curves for poor or unknown treatment quality. Local near-surface microhardness and compressive residual stresses were greatest for the over-treated welded details, followed by the properly treated and then the under-treated welded details. Increasing the treatment speed resulted in a greater reduction in the surface microhardness and compressive residual stresses than decreasing the treatment intensity. Finite element analyses showed that changes in weld toe geometry due to UIT can cause a decrease in the SCF near the surface of the treated weld toe. The SCF was the lowest for the properly treated steel specimens and slightly higher for the under-treated specimens. For the over-treated specimens, the SCFs were nearly as high as for the untreated weld. The SCF increases as the thickness of the flange increased up to 19 mm. With further flange thickness increase to 38 mm, the SCF did not change substantially. The work presented herein demonstrated that indent depth measurements from the base metal side, commonly used for quality control, may not identify over-treatment on their own. Indent depth measurements from both the weld and the base metal sides, obtained by measurement of weld toe impressions, offer a good alternative means for identifying over-treatment. However, for identifying under-treatment, indent depth measurements should be used in conjunction with visual inspection for traces of the original weld toe.

Reduction of milk production following acute bovine mastitis causes important economic losses. In this study, two experiments were conducted to asses the ability of different antioxidants to prevent neutrophil (PMN)-induced mammary damage in acute bovine mastitis. First, a co-culture model composed of bovine mammary epithelial cell line (MAC-T cells) and bovine PMN activated by phorbol myristate acetate was used. Activated PMN release reactive oxygen species that are cytotoxic for bovine epithelial cells. Addition of dimethylthiourea or bathocuproinic acid did not induce any protective effect. On the other hand, addition of catechin, deferoxamine or glutathione ethyl ester (GEE) significantly reduced PMN-induced cytotoxicity in a dose-dependent manner as demonstrated by lower levels of released lactate dehydrogenase (LDH). The second experiment was undertaken with the last three antioxidants to evaluate their protective effects in vivo. A model of LPS-induced mastitis on dairy cows was used. The extent of cell damages was evaluated by measuring quarter milk levels of LDH and 4-methylumbelliferyl N-acetyl beta-D-glucosaminidase ( NAGase) at varying intervals before and after intramammary infusions of LPS, with or without antioxidants. Milk levels of haptoglobin and bovine serum albumin were also analysed. Catechin and GEE did not induce any protective effect whereas infusions of deferoxamine, a chelator of iron, decreased milk levels of LDH, NAGase and haptoglobin hence suggesting a protective effect against PMN-induced damage. Deferoxamine did not interfere with PMN migration into the mammary gland. Additionally, deferoxamine inhibited bacterial growth in vitro but did not affect PMN's ability to phagocytize live Escherichia coli. Overall, our results suggest that local infusion of deferoxamine may be an effective tool to protect mammary tissue against PMN-induced oxidative stress during bovine mastitis.

Herbal and homeopathic compounds have been used to aid in childbearing and pregnancy for centuries. Much of this information is anecdotal and lacks scientific support, making it difficult to evaluate safety and efficacy. Increased public interest in alternative treatments leads to the need for a systematic review on the topic. Herbal remedies are most often used to treat the most common pregnancy-related problems like nausea, stretch marks and varicose veins. In contrast to this, concerns have also been raised about the adverse effects of these remedies. The primary objective of this research project was to conduct a systematic review to assess the maternal and neonatal outcomes of ingested herbal and homeopathic remedies using during pregnancy, birth and breastfeeding.

The fungus Botrytis cinerea is an opportunistic pathogen on a wide variety of crops, causing disease known as grey mould through infections via wounds or dead plant parts. Synthetic fungicides for controlling this disease are fast becoming ineffective due to the development of resistance. This, coupled with consumers world wide becomng increasingly conscious of potential environment and health problems associated with the build up of toxic chemicals, (particularly in food products), have resulted in pressure to reduce the use of chemical pesticide volumes as well as its residues. An emerging alternative to random synthesis is the study and exploitation of naturally occurring products with fungicidal properties. There have been reports on the uses of synthetic fungicides for the control of plant pathogenic fungi. When utilized in two-way mixtures, such fungicides may maintain or enhance the level of control of a pathogen at reduced rates for both components utilized in combinations, or alone at normal rates. For this study it was hypothesize that the addition of plant extracts may enhance the antifungal efficacy of the synthetic strobilurin fungicide, kresoxim-methyl against Botrytis cinerea.

The aim of this research was to implement and evaluate guidelines that will be used by treatment support counsellors in an attempt to increase client adherence to antiretroviral treatment.