Caffeinated beverages and decreased seizure control

AbstractSeizure control is often affected by seizure threshold lowering behaviours. In this case report, the authors address excessive caffeine ingestion from tea with increased seizure frequency. When decaffeinated beverages were substituted for the tea, seizure frequency returned to baseline. Similar findings occurred when the patient was re-challenged. The authors recommend avoidance of excessive caffeine in patients with epilepsy

Thinking, Talking and Acting about Public Health Ethics in the COVID-19 Pandemic

During the COVID-19 pandemic, the discipline of public ethics has struggled to find a consensus on how best to conceptualise the challenges. The transactional nature of clinical ethics is too limited to capture the range of ethically relevant concerns. Although public health ethics is broader, it fails to provide a convincing framework for the deeply political implications of the response to the pandemic. They go beyond health issues and raise questions of justice. We consider the demands of fairness for all, corrective justice for past structural wrongs, and utopian approaches that draw on our ideas about the ideal society. The lack of an agreed framework for ethical analysis is exacerbated by dwindling faith in expertise and a degradation of trust in media sources to present reliable, accurate information. These matters have undermined the quality of public reason. Although both the USA and UK had well-established anticipatory governance for pandemic influenza, it was not followed when COVID-19 took hold. The pandemic has exposed the weaknesses of our collective thinking, our readiness to discuss the issues rationally and effectively, and our ability to act effectively in the public good. Rebuilding effective public ethics in its wake will present a monumental challenge

Trastorn per dèficit d'atenció/hiperactivitat (TDAH) en gimnastes: resultats preliminars

És intrínsec a l’esport assolir el rendiment sense l’ajuda de substàncies que el millorin. Tanmateix, la prohibició de medicaments específics discrimina els competidors que pateixen determinades malalties. Per evitar aquestes desigualtats, l’Agència Mundial Antidopatge (AMA) aprovà unes normes internacionals per a les autoritzacions d’ús terapèutic (AUT). El tractament d’esportistes amb trastorn per dèficit d’atenció/hiperactivitat (TDAH) suposa un repte singular. Els estimulants, considerats un tractament de primera línea en el TDAH, estan prohibits a no ser que hagin estat provats prèviament fàrmacs alternatius i hagin resultat ineficaços. La prevalença mundial del TDAH és del 5,3%, tot i amb això no hi ha estudis de prevalença d’afectació d’aquesta malaltia en esportistes. Aquest article tracta el TDAH d’un equip masculí de gimnàstica, les repercussions en futures investigacions, utilitzant el qüestionari que es proposa per mesurar la prevalença d’aquest trastorn i els efectes en la conducta dels gimnastes, i unes consideracions ètiques

Enough intervention

AbstractPoetry is meant to express the emotions and thoughts often found difficult to state or even to put into prose. This clinician has dedicated his professional life to the rational treatment of epilepsy — for he understands only too well the consequences of varied interventions over a forty-year course of his own epilepsy. This poem is meant to remind other clinicians that quality of life may not always mean total seizure control

Secondary Sex Ratio among Women Exposed to Diethylstilbestrol in Utero

BACKGROUND. Diethylstilbestrol (DES), a synthetic estrogen widely prescribed to pregnant women during the mid-1900s, is a potent endocrine disruptor. Previous studies have suggested an association between endocrine-disrupting compounds and secondary sex ratio. METHODS. Data were provided by women participating in the National Cancer Institute (NCI) DES Combined Cohort Study. We used generalized estimating equations to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the relation of in utero DES exposure to sex ratio (proportion of male births). Models were adjusted for maternal age, child's birth year, parity, and cohort, and accounted for clustering among women with multiple pregnancies. RESULTS. The OR for having a male birth comparing DES-exposed to unexposed women was 1.05 (95% CI, 0.95-1.17). For exposed women with complete data on cumulative DES dose and timing (33%), those first exposed to DES earlier in gestation and to higher doses had the highest odds of having a male birth. The ORs were 0.91 (95% C, 0.65-1.27) for first exposure at ≥ 13 weeks gestation to < 5 g DES; 0.95 (95% CI, 0.71-1.27) for first exposure at ≥ 13 weeks to ≥ 5 g; 1.16 (95% CI, 0.96-1.41) for first exposure at < 13 weeks to < 5 g; and 1.24 (95% CI, 1.04-1.48) for first exposure at < 13 weeks to ≥ 5 g compared with no exposure. Results did not vary appreciably by maternal age, parity, cohort, or infertility history. CONCLUSIONS. Overall, no association was observed between in utero DES exposure and secondary sex ratio, but a significant increase in the proportion of male births was found among women first exposed to DES earlier in gestation and to a higher cumulative dose.National Cancer Institute (N01-CP-21168, N01-CP-51017, N01-CP-01289

Hydrilla Infestations in Florida Freshwater Bodies: How Results from a Management Needs Assessment Survey Helped Develop Suitable Information Delivery Platforms

Hydrilla is an invasive aquatic plant that is expensive to control and exhibits increasing resistance to commonly used herbicides. Alternative control tactics for implementation in novel integrated management strategies are being investigated, but information needs to be delivered to stakeholders so new tactics can be adopted and used. Here, we report results from a low-cost, Web-based survey that assessed stakeholder access to hydrilla management information in Florida. We highlight the general benefits of needs assessment surveys for project development and exemplify how results from such surveys can be used by Extension professionals to tailor their information platforms to stakeholder-preferred outlets