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BACKGROUND: The quality of information gathered from homeopathic pathogenetic trials (HPTs), also known as 'provings', is fundamental to homeopathy. We systematically reviewed HPTs published in six languages (English, German, Spanish, French, Portuguese and Dutch) from 1945 to 1995, to assess their quality in terms of the validity of the information they provide. METHODS: The literature was comprehensively searched, only published reports of HPTs were included. Information was extracted by two reviewers per trial using a form with 87 items. Information on: medicines, volunteers, ethical aspects, blinding, randomization, use of placebo, adverse effects, assessments, presentation of data and number of claimed findings were recorded. Methodological quality was assessed by an index including indicators of internal and external validity, personal judgement and comments of reviewers for each study. RESULTS: 156 HPTs on 143 medicines, involving 2815 volunteers, produced 20,538 pathogenetic effects (median 6.5 per volunteer). There was wide variation in methods and results. Sample size (median 15, range 1-103) and trial duration (mean 34 days) were very variable. Most studies had design flaws, particularly absence of proper randomization, blinding, placebo control and criteria for analysis of outcomes. Mean methodological score was 5.6 (range 4-16). More symptoms were reported from HPTs of poor quality than from better ones. In 56% of trials volunteers took placebo. Pathogenetic effects were claimed in 98% of publications. On average about 84% of volunteers receiving active treatment developed symptoms. The quality of reports was in general poor, and much important information was not available. CONCLUSIONS: The HPTs were generally of low methodological quality. There is a high incidence of pathogenetic effects in publications and volunteers but this could be attributable to design flaws. Homeopathic medicines, tested in HPTs, appear safe. The central question of whether homeopathic medicines in high dilutions can provoke effects in healthy volunteers has not yet been definitively answered, because of methodological weaknesses of the reports. Improvement of the method and reporting of results of HPTs are required. REFERENCES: References to all included RCTs are available on-line at.

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OBJECTIVE: We describe the teaching methods, involving computer and Internet-based resources, used in the "Administration and Planning in Health Care" course of the undergraduate medical program at the Federal University of Rio Grande do Sul. METHOD: Description on how the curriculum guidelines for the undergraduate medical education in Brazil have been implemented at this university. The guidelines specify that graduates should be skilled and knowledgeable in health care administration and management, understand the market dynamics of health care services, and be prepared to contribute to the development of health policy. RESULTS: A required 60-hour course provides students with an opportunity to learn about the structure, planning and administration of the Brazilian and of other health care systems, and their roles, as health care professionals, within those systems. The course is also intended to allow students to develop the minimal skill set required for manipulation of health care data available from national and international databases, and to use the Internet as a source of information in health care. The curriculum includes: Module 1 - basic computer skills, an introduction to networks as an infrastructure for management, the use of spreadsheets and databases for data processing and system modelling, retrieval of Internet-based health data and on-line bibliographic searches; Module 2 - health system financing and service quality management, using a university hospital as a case study; and Module 3 - a comparison of the Brazilian public health care system (SUS) with other national health systems resulting in a term paper formatted for journal submission and presented at a simulated conference at the end of the course. CONCLUSION: Progressive shift in emphasis from theory to practice in this course has resulted in better development of the skill set required for the students.

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beta-Adrenergic receptors (R) on several tumor lymphoid cell lines were characterized both directly by beta radioligand binding of 125iodo-cyanopindolol (125I-CYP) to intact cells and membranes, and functionally by assessing hormone-dependent changes in cyclic 3',5' adenosine monophosphate (cAMP) levels on intact cells and measuring adenylate cyclase (a.c.) activity on membranes. Only two lymphoid cell types, BW 5147 (a T cell derived lymphoma cell line) and TIB 221 (a B cell derived line) displayed significant amounts of beta-adrenergic R by 125I-CYP specific binding. Despite this, no stimulation of the a.c. activity was found in the presence of beta-adrenergic agonists in these cells in comparison with native lymphocytes or cells of the well-known S49 cell line used as a positive control. beta-Adrenoceptor specific uncoupling was confirmed by aluminum tetrafluoride (AlFl4) direct activation of the a.c. system in the beta R-bearing cell membranes and by an increase in cAMP production induced by PGE1, another hormone that activates the a.c. Structural characterization of beta-adrenoceptors by photoaffinity-labeling demonstrates that uncoupling was not due to a structural alteration of the beta-adrenergic R expressed in these lymphoma cell lines, as these R gave similar results as native or S49 cells. It can be concluded that functional beta-adrenoceptors are absent in these lymphoma cells. The possible implication of alternative transmission pathways and original neuroendocrine control in tumor lymphoid cells is discussed.

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This study was undertaken to assess the knowledge and awareness of AIDS amongst children aged 15-19 years attending High School in Grand Turk. A questionnaire with 15 statements about AIDS was administered to 151 pupils who were asked to choose 1 of 3 answers: "yes", "no" and "unsure". One hundred and forty-five (145) pupils completed the questionnaire satisfactorily, and scores for Perceived, Accurate and Correct knowledge were assessed. The results showed that although knowledge concerning the transmission and prevention of AIDS was good (mean Correct response = 77 per cent, range 17-97 per cent), awareness of the serious nature of the disease and its significance as a major health problem in the Islands was poor (mean Correct response = 29 per cent, range 17-44 per cent). It is suggested that possession of the basic facts about AIDS is not enough, and a more direct approach should be made to individuals with particular emphasis on the significance of HIV status (AU)

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PIP: The Evangelical Medical Center in Nyankunde, Zaire, has had some success in treating low birth weight premature infants despite its lack of mechanical respiratory assistance and permanent parenteral feeding. But the norms and procedures for attending to newborns have varied in recent years due to frequent changes in the hospital's administration. A retrospective study was conducted of the 46 infants weighing 1800g or less who were born at the hospital between January 1985-February 1988 to determine the correlation between feeding, antibiotic therapy, and temperature control and survival of the infants. Feeding was considered accomplished if the infant accepted at least 90 ml/kg of maternal milk through a nasogastric tube on the 1st day with a progressive increase in liquids in the 3 following days. Antibiotic therapy was considered given when gentamycin, penicillin, or ampicillin was administered. The temperature was considered controlled if it was taken at least 4 times daily during the 1st 3 days. 7 of the 46 infants were excluded from the study, 3 because their birth weight was less than 1000 g and 4 for inadequate information. The 3 remaining infants had an average birth weight of 1510 g. Gestational ages at birth ranged from 30-35 weeks. 19 were male and 20 female. 27 (69%) survived and were discharged from the hospital. 8 boys and 4 girls died. The wright of those who died ranged from 1140-1760 g. 21 of the 26 who were fed survived, vs. only 6 of the 13 who were not fed. Almost all the mothers were capable of adequately breast feeding. 19 of the 24 patients receiving antibiotics survived, vs. 8 of the 15 who did not. 25 of the 34 whose temperature was routinely taken survived, vs. 2 of 5 for whom it was not. 17 of the 21 infants receiving all 3 forms of treatment survived (81%), vs. 10 of 18 who received none (56%). More detailed prospective studies are needed to confirm the effectiveness of these simple measures and to evaluate other measures appropriate for rural and poorly equipped maternity centers in developing countries.^ieng

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