Early life origins of the insulin resistance syndrome in the aged guinea pig.

Title page, contents and abstract only. The complete thesis in print form is available from the University of Adelaide Library.In human populations, perturbed growth in early life and ageing have been identified as risk factors for the development of Insulin resistance syndrome (IRS). The consequences of restricted prenatal growth on postnatal function have been investigated using numerous experimental models of intrauterine growth retardation, mainly in the rat. These studies have shown that some, but not all, aspects of postnatal function that are programmed in humans are also programmed in the rat. This study was designed to determine whether IRS develops with increasing age in the guinea pig as it does in the human and whether the development of the syndrome is more pronounced in aged offspring which have undergone spontaneous fetal growth restriction and accelerated growth in the neonatal period. It appeared that the guinea pig is a suitable animal model of ageing, displaying many of the metabolic, cardiovascular and anthropometric changes seen in humans. Furthermore, the effects of perturbed prenatal and early postnatal growth on the development of IRS in the aged guinea pig exhibit a sexually dimorphic pattern.Thesis (Ph.D.) -- University of Adelaide, School of Molecular and Biomedical Science, 200

Safety and Efficacy of Nontherapeutic Male Circumcision: A Systematic Review

PURPOSE We wanted to assess the safety and efficacy of nontherapeutic male circumcision through a systematic review of the literature

Paravertebral block for anesthesia: A systematic review

BACKGROUND: The objective of this review was to assess the safety and efficacy of thoracic and lumbar paravertebral blocks (PVBs) for surgical anesthesia through a systematic review of the peer-reviewed literature. PVBs for surgical anesthesia were compared with general anesthesia (GA) or other regional anesthetic techniques. METHODS: We searched literature databases including MEDLINE, EMBASE, and The Cochrane Library up to May 2008. Included studies were limited to eligible randomized controlled trials. Eight randomized controlled trials were included in this review, 6 of which used PVBs for anesthesia during breast surgery, and 2 trials used PVB for anesthesia during herniorrhaphy. RESULTS: The ability to obtain firm conclusions was limited by the diversity of outcomes and how they were measured, which varied across studies. The PVB failure rate was not >13%, and patients were more satisfied with PVB than with GA. There was some indication that PVB could achieve shorter hospital stays than GA. PVB for anesthesia substantially reduces nausea and vomiting in comparison with GA (relative risk: 0.25, 95% CI: 0.13–0.50; P < 0.05), although it does carry a risk of pleural puncture and epidural spread of local anesthetic. CONCLUSIONS: In conclusion, based on the current evidence, PVBs for surgical anesthesia at the level of the thoracic and lumbar vertebrae are associated with less pain during the immediate postoperative period, as well as less postoperative nausea and vomiting, and greater patient satisfaction compared with GA.Prema Thavaneswaran, Glenda E. Rudkin, Rodney D. Cooter, Donald G. Moyes, Caryn L. Perera, and Guy J. Madder