RESULTS: Sea surface temperatures (SSTs) in the equatorial east Pacific ocean have anomalously increased significantly during July - October 2006 indicating the typical development of El Niño conditions. The persistence of these conditions will lead to extremes in global-scale climate anomalies as has been observed during similar conditions in the past. Positive Outgoing Longwave Radiation (OLR) anomalies, indicative of severe drought conditions, have been observed across all of Indonesia, Malaysia and most of the Philippines, which are usually the first areas to experience ENSO-related impacts. This dryness can be expected to continue, on average, for the remainder of 2006 continuing into the early part of 2007. During the period November 2006 - January 2007 climate forecasts indicate that there is a high probability for above normal rainfall in the central and eastern equatorial Pacific Islands, the Korean Peninsula, the U.S. Gulf Coast and Florida, northern South America and equatorial east Africa. Taking into consideration current observations and climate forecast information, indications are that the following regions are at increased risk for disease outbreaks: Indonesia, Malaysia, Thailand and most of the southeast Asia Islands for increased dengue fever transmission and increased respiratory illness; Coastal Peru, Ecuador, Venezuela, and Colombia for increased risk of malaria; Bangladesh and coastal India for elevated risk of cholera; East Africa for increased risk of a Rift Valley fever outbreak and elevated malaria; southwest USA for increased risk for hantavirus pulmonary syndrome and plague; southern California for increased West Nile virus transmission; and northeast Brazil for increased dengue fever and respiratory illness.
CONCLUSION: The current development of El Niño conditions has significant implications for global public health. Extremes in climate events with above normal rainfall and flooding in some regions and extended drought periods in other regions will occur. Forecasting disease is critical for timely and efficient planning of operational control programs. In this paper we describe developing global climate anomalies that suggest potential disease risks that will give decision makers additional tools to make rational judgments concerning implementation of disease prevention and mitigation strategies.
MATERIAL AND METHODS: This is an audit of an 18-year period where 173 lesions of the parotid gland (34 malignant and 139 benign lesions) were treated by the author.
RESULTS: There were 139 benign lesions, of which 123 were benign tumours and 16 non-tumour conditions. Fourteen cases of recurrent pleomorphic adenoma of parotid that had been treated elsewhere were also operated on. Near-total parotidectomy was performed on all these cases with benign lesions.
CONCLUSIONS: There has been no recurrence in all the patients who was treated this way. Near-total parotidectomy should be considered when there is a need to treat benign parotid swellings.
METHOD: A single, masked, controlled study was designed. This comprised two matched groups of 12 chronically ACLD patients awaiting reconstruction and a group of 12 matched uninjured control subjects. Only one ACLD group received a home-based exercise and educational programme. Assessment before and after the exercise intervention included: knee joint stability (clinical and KT1000 evaluation); muscle strength (Cybex II); standing balance and functional performance (agility, [corrected] and subjective tests).
RESULTS: At the time of initial assessment there were no statistically significant differences in any measures for the two ACLD groups but both ACLD groups were significantly different from the uninjured control group as regards quadriceps strength and function. Measures taken after six weeks showed no significant improvement in the untreated ACLD group or in the uninjured control group. The treated ACLD group showed significant improvement in the following measures: quadriceps strength measured at 60 degrees and 120 degrees per second (p < 0.001); single leg standing balance with eyes closed (p < 0.001); instrumented passive stability at 20 lb (89 N) force (p = 0.003); agility and subjective performance (p < 0.001). The incidence of unstable episodes had decreased in the treated ACLD group, reducing further damage to the joint.
CONCLUSION: This study leaves little doubt that pre-operative physiotherapy had a positive effect on motor function in ACLD subjects and should be prescribed routinely to maximize muscle stabilizing potential prior to reconstruction. Patients report improved stability and, in certain cases, may avoid surgery. The finding that exercise increased the passive stability of the joint was unexpected and requires further investigation.