5B), but with diminished magnitude when compared to i.m. vaccinated mice. Thus, i.m. DNA priming produced more robust nasal Ab responses to V-Ag and F1-Ag. To assess the magnitude and distribution of Ab-forming cell (AFC) responses induced

by the LTN DNA vaccines, a B cell ELISPOT was performed using lymphocytes of various lymphoid tissues at 14 wks post-primary immunization. For the i.n. immunization study, since LTN/F1-V DNA vaccine showed best efficacy against pneumonic plague challenge, only these mice were evaluated, and elevated F1- and V-Ag-specific IgA and IgG AFC responses were detected in the spleens, HNLNs, NALT, NPs, SMGs, iLP, selleck chemical and PPs from nasally LTN/F1-V DNA-immunized mice (Fig. 6). Anti-F1- and -V-Ag-specific IgA and IgG AFC responses were detected in the spleens and peripheral lymph

nodes, as well as in mucosal tissues, HNLNs, NALT, NPs, SMGs, iLP, and PPs. These results showed that the nasal LTN DNA vaccine stimulated elevated immune B cells in both the mucosal and peripheral immune compartments. For i.m. immunization study, F1- and V-Ag-specific IgA and IgG AFC responses were detected in the spleen, HNLNs, NPs, iLP, LLNs, and PopLNs from mice immunized with each of the LTN DNA vaccines (Fig. 7). In addition to show the priming effect by the LTN DNA vaccines to stimulate protective immunity against plague, www.selleckchem.com/products/VX-770.html AFC responses were also detected from F1-Ag protein-only immunized mice. Significantly greater anti-F1- and -V-Ag-specific IgA and IgG AFC responses heptaminol were detected in each lymphoid tissue from LTN DNA-vaccinated mice compared to mice immunized with F1-Ag protein only. These AFC responses were detected not only in systemic and peripheral tissues, including spleens, PopLNs, and LLNs, but also in mucosal

tissues, HNLNs, NPs, and iLP. These results suggest that i.m. priming with LTN DNA vaccine followed by nasal F1-Ag boosts induced Ag-specific B lymphocytes in both the systemic and mucosal immune compartments. To assess the types of Th cell responses elicited by the DNA priming, cytokine-forming cell (CFC) responses were measured at 7 or 14 wks post-primary immunization by cytokine-specific ELISPOT. To evaluate the precise effects of LTN DNA vaccine priming when vaccines are given nasally and not affected by nasal F1-Ag protein boosts, the nasal immunization regimen was slightly modified, eliminating the nasal protein boosts, as previously done [25] and [31]. For Th cell evaluations for i.m.-immunized mice, the vaccination regimen was left unchanged, as in the Th cell analyses [25] and [31]. Lymphocytes from spleens, HNLNs, and PPs, which were obtained from LTN/F1-V DNA-vaccinated mice at 7 wks, were restimulated with F1-Ag, V-Ag, or media for 2 days (Fig. 8A).

L’auteur considère donc qu’en cas de coronaropathie ou de risque accru d’infarctus du myocarde, l’utilisation du dabigatran doit être prudente, et le choix d’un autre NACO ou de la warfarine envisagé. De manière générale, les NACO doivent être interrompus avant un geste chirurgical, et repris après l’intervention dès que le risque hémorragique est redevenu suffisamment faible. En effet, la balance SCH772984 clinical trial entre, d’un côté, l’excès de saignement lors de la chirurgie ou peu après, et de l’autre, le risque thromboembolique pendant la période de non-traitement est nettement en faveur

d’une interruption transitoire d’anticoagulation, généralement sans relais. Le temps nécessaire à l’élimination du dabigatran est dépendant de la clairance de la créatinine. Le résumé des caractéristiques du produit (RCP) préconise donc l’arrêt du dabigatran 24 heures avant le geste si le débit de filtration glomérulaire est supérieur à 80 mL/min, 24 à 48 heures si la clairance de la créatinine est entre 50 et 80 mL/min, et 48 à 72 heures si celle-ci

est entre 30 et 50 mL/min ; un à deux jours supplémentaires est nécessaire en cas d’opération chirurgicale lourde ou de risque accru de saignement. Pour ce qui est du rivaroxaban, le RCP recommande son arrêt 24 heures avant la procédure. Pour l’apixaban, le RCP recommande son arrêt 48 heures avant une chirurgie programmée NVP-BGJ398 in vivo à risque hémorragique modéré ou important, et 24 heures avant une chirurgie à faible risque hémorragique. De nombreuses sources proposent la poursuite du traitement par anti-vitamine K lors d’une extraction dentaire réglée, cependant, les données concernant les NACO sont insuffisantes, et l’extrapolation aux NACO de ce qui est vrai pour les AVK serait hasardeuse, voire dangereuse pour les patients.

Néanmoins, une sous-étude de l’essai de non-infériorité comparant le dabigatran à la warfarine (étude RE-LY) s’est intéressée aux saignements périprocéduraux [19]. Sur les 18 113 patients inclus dans l’étude, un total de 4591 patients ont subi une procédure chirurgicale (soit 25 % de la population environ). Chez les patients assignés au traitement par dabigatran (110 mg fois deux ou 150 mg fois deux), la dernière prise Adenylyl cyclase de dabigatran était en moyenne 49 heures avant la procédure. Chez les patients assignés au traitement par warfarine, la dernière prise était en moyenne 114 heures avant la procédure. Dans cette étude, il n’a pas été observé de différence statistiquement significative en termes d’événements hémorragique dans la période périprocédurale entre les deux traitements. Cette période débutait 7 jours avant l’intervention, et durait 30 jours après celle-ci. Pour ce qui est des gestes chirurgicaux réglés sous NACO, la clairance de la créatinine (surtout pour le dabigatran), et la stratification du risque hémorragique sont des éléments clés pour décider de la durée de la fenêtre thérapeutique sans anticoagulant.

In Bangladesh, enrollment into this immunogenicity cohort ran from July to August 2007, while in Vietnam, it took place in a single month at pre-selected sites. A total of 303 infants (149 [74 PRV: 75 placebo] in Bangladesh and 154 [74 PRV: 80 placebo] in Vietnam) out of 2036 trial participants were enrolled in the immunogenicity cohort. Blood serum samples were collected from each infant before the first dose (pD1) and approximately 14 days following the third dose (PD3). The seroresponse rates and geometric mean titers (GMTs) were measured for anti-rotavirus IgA and SNA to human rotavirus serotypes G1, G2, G3, G4, and P1A[8], respectively [21]. Sero-response was defined as ≥3-fold

rise from pD1 to PD3 as described elsewhere [21], buy Obeticholic Acid [22], [23], [24] and [25]. Traditionally, a 4-fold rise criterion has been used for doubling dilution assays. For the assays employed in this study, however, as well as throughout the clinical development of PRV, a 3-fold rise in titer

has been used as validation experiments showed that Anti-cancer Compound Library price these assays were specific, reproducible, and sensitive enough to be able to detect a 3-fold difference with 90% power at the 5% significance level. Serum samples were frozen and kept at −20 °C in laboratories at ICDDR, B in Matlab, and at Pasteur Institute in Nha Trang until the samples were shipped to Merck Research Laboratories. All immunologic assays were performed at Children’s Hospital Medicine Center, Cincinnati, OH, USA. The immunogenicity analyses were based on the per-protocol population (i.e., excluding protocol violators), subjects with valid data based on laboratory results from samples taken within the protocol-specified day range, and subjects without intervening laboratory confirmed wild-type rotavirus disease. The proportion of subjects achieving a seroresponse, as measured by serum anti-rotavirus IgA responses and SNA responses to human rotavirus serotypes contained in PRV, was calculated for the two countries combined,

Histone demethylase as well as for each country. The GMTs for serum anti-rotavirus IgA and SNA were summarized at pD1 and PD3. The associated 95% confidence intervals were calculated based on binomial and normal distribution methodology, respectively. Immunogenicity analyses were also performed on sub-populations of particular interest that were not specified in the protocol (post hoc analysis), including those subjects who received OPV concomitantly (on the same day) with each of the 3 doses of PRV or placebo, and those who did not receive OPV concomitantly with each of the 3 doses of PRFV or placebo. Among the 303 infants enrolled in the immunogenicity cohort, 263 had both pD1 and PD3 data on anti-rotavirus IgA responses. Approximately 88% of these infants exhibited a ≥3-fold rise between pD1 and PD3 (Table 1).

Similar quantities of LT (0.2 μg) and eGFP (0.1 μg) were administered Hydroxychloroquine mw to those animals receiving LT + eGFP or eGFP alone. For subsequent immunisations, doses equivalent to a total of 0.4 and 0.8 μg of total protein was administered. In a second experiment, eGFPPLY was administered at the same concentration as described above for the first three immunisations, however a fourth 0.8 μg dose was also given. In this

experiment, the concentration of eGFPΔ6PLY and LT were increased tenfold resulting in concentrations of 2, 4, and 8 μg of toxins given in each subsequent dose. For the LT group an approximately similar equimolar concentration of eGFP was admixed with the toxin. Animals given eGFP alone were immunised using the concentration of eGFP administered with LT. Each dose was prepared in a final volume of 20 μl in PBS (pH 7.2) and 10 μl per nare was administered to lightly anaesthetised animals. Mice were immunised on days 1, 14, 28 and for the second experiment additionally on 42. Serum samples were collected from the tail vein of each animal on the day before each immunisation, day 13, day 27 and day 41. All animals were exsanguinated selleckchem on day 42 (expt 1) or day 56 (expt 2) by cardiac puncture. Nasal and lung lavages were performed [22] on day 42 or 56 respectively using 0.1% (w/v) bovine serum albumin in PBS. Samples were all stored at −20 °C prior to testing. Whilst immunogenicity studies

were performed in BALB/c mice to provide robust and reproducible data for statistical analysis, challenge experiments were performed in MF1 outbred mice which are more susceptible to a wider range of pneumococcal serotypes than BALB/c mice. Groups of 35 female MF1 mice were immunised i.n. as

described above on days 1, 14 and about 28 with 0.2 μg of PsaAPLY, PsaAΔ6PLY and PsaA. Fourteen days after the final immunisation, all 35 mice were sample bled and 5 mice from each group were culled and mucosal washes prepared. The PsaA specific IgG and IgA response in the blood and mucosal washes were then determined by ELISA. The remaining animals were challenged with S. pneumoniae D39 (serotype 2) and bioluminescent TIGR4 (serotype 4) and A66.1 (serotype 3) on day 56 of the experiment. Different serotypes were chosen to allow assessment of the level of cross-protection that could be observed using this vaccination protocol. Protection from colonisation and invasive disease were determined separately (n = 5 mice for each) using 5 × 107 cfu delivered in 10 μl and 5 × 106 cfu in 50 μl volumes respectively. The impact of vaccination on subsequent disease progression was determined directly by the recovery and enumeration of bacteria in the blood and mucosal tissues from the animals 72 h post-infection. Anti-PLY, anti-eGFP and anti-PsaA responses within individual serum samples were determined by enzyme linked immunosorbant assay (ELISA).

There have been some unusual presentations, including bowel obstruction caused by the intraperitoneal cord, traumatic rupture of the ectopic splenic tissue, or association with an intra-abdominal seminoma and an intra-abdominal nonseminomatous germ cell testicular tumor. Differential diagnosis with paratesticular solid mass (ie, rabdomyosarcoma, lymphoma) may be difficult when the mass is intimately attached to the gonad. MRI is helpful in selected cases in which ultrasound is not diagnostic. In patients noted preoperatively to have an extratesticular

scrotal mass a nuclear liver spleen scan may confirm the diagnosis. Abdominal and gonadal ultrasonography should be performed in siblings of patients and in patients with accessory spleen. Gonadal ultrasonography selleck chemicals llc should be performed also in patients with hemolytic anemia or idiopathic thrombocytopenic purpura to prevent recurrence after splenectomy as symptoms of hypersplenism could recur. Moreover, accessory and ectopic splenic tissue may be involved mumps, Cyclopamine nmr leukemia, mononucleosis, and even malaria. Treatment of SGF involves excision of ectopic spleen and sparing of the

testis; however, an orchiectomy was performed in 37% of cases reported.6 Laparoscopy was shown to be an excellent method for the diagnosis and treatment of SGF associated with intra-abdominal cryptorchidism. In few patients, splenic tissue has been found fused to the testicle and was not possible perform excision. As frozen sections of the mass shows the splenic nature, decision to leave in situ the splenic remnant is reasonable. Primary male infertility has been reported in a 25-year-old patient with a left SGF and a right undescended testis. In this case, ectopic splenic tissue within the unyielding tunica albuginea must have compressed the testis tissue

during development with loss of function: in fact during the left testicular biopsy showed no evidence of spermatogenesis.7 SGF is a rare developmental anomaly usually presenting scrotal mass. Preoperative or intraoperative awareness of the condition may allow excision of the scrotal spleen and testicular sparing. SGF associated with limb defect is a well-known syndrome (SGFLD). Probably a genetic disorder underlies the anomaly: SGF is anyway an accessory spleen, in our opinion accessory spleen discovered in a SGF patient’s brother supports the hypothesis of genetic pattern of disorder. Additional investigation of SGF patient’s siblings may help to answer some of the unresolved questions related to familial and inheritance feature of this pathology. “
“Large cystic abdominal masses in a newborn infant can be confusing to diagnose even with the current sophisticated imaging modalities and concerning for the physician and parents alike.

Néanmoins, l’importance pronostique de l’analyse de la différenciation

et la prise en compte de quelques cas de la littérature évoquant des présentations cliniques d’insulinomes Palbociclib chemical structure inhabituellement agressifs, nous amènent à rappeler l’intérêt pronostique de cette classification et son impact thérapeutique [22], [23] and [24]. Pour établir la classification pTNM, il est important de préciser la taille tumorale, le nombre de ganglions retirés et envahis, la présence d’une extension extra-pancréatique et le degré d’invasion. Les insulinomes sont en général découverts à un stade de tumeur localisée, résécable et guéris cliniquement dans la grande majorité des cas sans curage ganglionnaire systématique. Pour cette raison, la fréquence d’un envahissement ganglionnaire, n’est pas connue. De

même, la description du grade est manquante dans la plupart des séries d’insulinomes. La taille médiane des insulinomes malins varie de 2,3 à 6,2 cm au moment de la reconnaissance de leur malignité [7], [11], [25] and [26]. Il n’existe pas de seuil de taille, absolu, synonyme de malignité : 40 à 80 % des insulinomes métastatiques mesurent moins de 2 cm lors du diagnostic dans 3 séries de la littérature [8], [10] and [25]. Certains critères, pourtant intéressants à préciser selon nous, n’apparaissent pas ou plus dans la nouvelle classification OMS 2010 (en comparaison de la classification Ruxolitinib molecular weight OMS 2004) comme la présence de nécrose ou d’une invasion vasculaire ou péri-nerveuse. Le statut de la résection (R) ainsi que le nombre de tumeurs doivent également être notés. Les insulinomes malins sont presque toujours d’origine pancréatique (> 99 %), siégeant plus fréquemment dans la queue du pancréas d’après certains auteurs [8], [10] and [25]. En l’absence

de syndrome de masse pancréatique identifiable, on doit suspecter une lésion primitive pancréatique de petite taille ou une tumeur extra-pancréatique these dont la prise en charge thérapeutique pourrait différer [27]. Typiquement, l’insulinome malin survient à la cinquième ou sixième décade, sans prédominance de sexe démontrée. Ces tumeurs sont par définition fonctionnelles, caractérisées par l’identification de symptômes neuroglycopéniques contemporains d’une hypoglycémie et calmés par la prise d’aliments sucrés. L’évolution pondérale, la fréquence et la sévérité des épisodes hypoglycémiques sont à évaluer, tout comme l’anxiété et le risque de dépression du patient et de ses proches, leur qualité de vie face aux symptômes. Lors des hospitalisations, le caractère anxiogène des événements hypoglycémiques sur l’équipe soignante doit également être pris en compte. Les manifestations cliniques des formes malignes sont similaires à celles des formes bénignes [13], mais peuvent être plus sévères et prolongées du fait d’une plus forte production d’insuline et de pro-insuline par la masse tumorale métastatique.

Antibiotics have been the most common intervention for both acute and chronic sinusitis, and when antibiotics are prescribed for acute bacterial rhinosinusitis, amoxicillin has been recommended as the first choice (Rosenfeld et al 2007a). Frequent prescription of antibiotics can lead to an increase in antibiotic resistance (Ahovuo-Saloranta et al 2008, Ferech et al 2006) and current guidelines provide more conservative recommendations for antibiotic prescription for acute bacterial rhinosinusitis (Ahovuo-Saloranta et al 2008, Lindbaek, 2004, Rosenfeld et al 2007a). Current guidelines recommend delaying antibiotic prescription for up to 7 days in patients

without severe illness (Rosenfeld et al 2007a). Although reviews report superior effect of antibiotics compared with placebo after seven days (Lindbaek, 2004, Rosenfeld et al 2007a), others claim that antibiotics are not justified even after 7–10 days (Williamson IPI-145 mouse et al 2007, Young et al 2008). However, physicians often feel pressured check details by patients to prescribe antibiotics (Varonen et al 2004). Perhaps it is not surprising therefore that the practice of prescribing antibiotics for common infectious diseases,

including sinusitis, has not changed significantly in spite of new recommendations and efforts to implement them (Ferech et al 2006, Neumark et al 2009, Varonen et al 2007). The continuing debate and controversy about prescribing antibiotics for acute bacterial rhinosinusitis, and the resistance to change in practice, motivate a search

for alternative interventions. Rapid reduction of the symptoms of acute bacterial rhinosinusitis with therapeutic ultrasound has been observed in the clinic. However, no controlled studies have been conducted. The purpose of this study was to compare the effect of antibiotics with therapeutic ultrasound in patients with clinically diagnosed acute bacterial rhinosinusitis in primary care. The specific research questions were: 1. Is there any difference in the effect of therapeutic ultrasound and antibiotics (amoxicillin) Sclareol on pain and congestion for acute bacterial rhinosinusitis in the short-term? If therapeutic ultrasound gives symptomatic relief equivalent to amoxicillin, it may serve as an alternative to antibiotics. A randomised trial was conducted in a primary care setting in Norway. Participants were recruited from consecutive patients coming to a single general practice with sinusitislike symptoms, where they were diagnosed by a physician (AL). After collection of baseline measures, the participants were randomly allocated to an experimental or a control group. The allocation sequence was computer generated in random permutated blocks of 6 or 8 and was concealed from the recruiter and participants in sealed envelopes which were opened by a nurse. The experimental group received four consecutive days of ultrasound and the control group received a 10-day course of antibiotics.

Anti-BoHV-5 IgG (total), IgG1, IgG2a, IgG2b, and IgG3 were determined for each serum sample by ELISA, carried out essentially as previously described [10]. ELISA plates (Greiner Bio-One) were coated with the BoHV-5 suspension used for mouse immunization diluted (1:100, v/v) in carbonate-bicarbonate buffer pH 9.6 at 37 °C for 1 h. Plates were then washed three times with PBS containing 0.05% Tween 20 (PBS-T) and blocked with BSA (1% in PBS) at 37 °C for 1 h. Sera (100 μL of appropriate dilutions in PBS-T) were added in duplicates and incubated for 1 h at 37 °C. Subsequently, plates were washed three times with PBS-T. Next, 100 μL of appropriate dilutions in PBS-T of

anti-mouse IgG (Sigma Chemical Co.), IgG1 (Caltag Rapamycin price Laboratories), IgG2a, IgG2b, or IgG3 (Zimed Laboratories) were added to the wells and plates were incubated for another hour at 37 °C. After washing, 100 μL of OPD (ortho-phenylenediamine, Sigma Chemical Co.) with H2O2 were added to each well, plates were incubated

for 15 min at 37 °C and the reactions was stopped by adding 50 μL/well of 1 N HCl. The OD was measured in an ELISA plate reader (Anthos 2020) at 492 nm. Antibody titres were Paclitaxel research buy expressed in arbitrary units (AU) referred to a standard calibration curve prepared with a pool of positive sera. IgG3 titres were expressed in OD because they were much lower than those for the other isotypes. All the samples were diluted 1/100 for the determination of IgG3

titres. The presence of neutralizing antibodies to BoHV-5 in mouse sera was analyzed in a virus neutralization test with the constant virus, varying serum method, in 96-well cell culture plates, as previously described [23]. The test was performed against 100 TCID50/50 μL of BoHV-5 strain A663. Delayed type hypersensitivity responses were evaluated in three mice from each group on day 28 as previously described [10]. Briefly, mice were subcutaneously injected in one footpad of the hind limb with 10 μL of the BoHV-5 suspension used for immunization. The thickness of the injected footpads was measured 24 h later with a calliper. The swelling of mice from the control Tolmetin group injected with saline was considered to be derived from the puncture procedure (basal swelling). The BoHV-5-specific DTH response of each animal was calculated based on the thickness of its injected footpad minus the average of the basal swelling. Spleens were collected in RPMI 1640 (Gibco) under aseptic conditions 120 days after the second immunization, minced and mechanically dissociated to obtain a homogeneous cell suspension. Erythrocytes were lysed with ammonium chloride (0.8%, w/v). After centrifugation (380 × g at 4 °C for 10 min), the cell pellets were washed three times in RPMI and suspended in complete medium: RPMI 1640 supplemented with 0.05 mM 2-mercaptoethanol, 100 IU/mL penicillin, 100 μg/mL streptomycin, 2 mM l-glutamine, and 10% FBS.

The news section of the website also seemed to be under development. It encouraged the user to ‘read our press releases’ but did not list any. The site has

a clear help section and detailed information about the people behind the website. There is a list of funders and a link to the funding policy which states that money will not be accepted from pharmaceutical companies or any for-profit organisation with vested interested in the research findings. In summary, this is a very useful website and I encourage readers to visit it and to consider recommending it to colleagues, students, and computer-literate patients. “
“The IPQ-R is an 84-item self-completed instrument developed to provide a quantitative measurement of the components of illness representations, as described by Leventhal’s Common-Sense Model (CSM) of selfregulation Ibrutinib cell line (Leventhal et al 1984, 1997). It is divided into three sections: identity

subscale (14 symptoms), causal subscale (18 causes), and a third section which contains 7 subscales, including consequences, timeline acute/chronic and cyclical, personal and Rucaparib mouse treatment control/cure, illness coherence, and emotional representations. Researchers are encouraged to adapt the questionnaire wording to the specific illness under investigation by replacing the word illness with the name of the condition under investigation. Instructions to clients and scoring: For the identity subscale, respondents are asked if they have experienced a number of symptoms since their illness, and if they feel the symptoms are related to their current illness. Response is by circling ‘yes’ or ‘no’ to each question. Responses are then summed to give an overall score. For the causal subscale, respondents are asked what they perceive to be the cause of their illness and are asked to respond to each of the listed causes using a 5-point Likert style scale, ranging from strongly disagree to strongly agree. Respondents because are also asked to rank the

3 most important factors believed to be the cause of their illness. The third section (7 subscales) is scored by summing responses to each item is on a 5-point Likert style scale, ranging from strongly disagree to strongly agree. All items for each of the subscales are summed to give an overall score. High scores on the identity, consequences, timeline acute/chronic and cyclical subscales represent strongly held beliefs about the number of symptoms attributed, the negative consequences, and the chronicity and cyclical nature of the illness. High scores on the personal and treatment control and coherence subscales represent positive beliefs about controllability and a personal understanding of the illness. For non-English speaking patients the questionnaire has been translated into a number of languages, including Norwegian, French, and Dutch.

A major collaborative, international, randomised controlled trial is now underway, led by Julie Bernhardt (AVERT Trial, ACTRN12606000185561). This trial has recruited over 1700 participants and will make a substantial contribution to informing management of people following stroke. As it moves into its third decade, Cochrane has affirmed its vision of a world with improved health, where decisions about health care are

informed by high-quality, relevant and up-to-date synthesised research evidence. A new strategic plan, Strategy to 2020, includes goals that respond to current challenges in evidence synthesis and use. Cochrane will continue its emphasis on producing systematic reviews and other synthesised research evidence, but will increase focus on making Cochrane evidence accessible, both in terms of moving to an open access model of publishing and improving Pazopanib molecular weight the usability of Cochrane reviews. In pursuit of these aims, Cochrane has recently embarked on a massive translation effort. Abstracts and plain language summaries of Cochrane reviews are now available in French, Spanish and Chinese, and there are plans to extend this to the other WHO official languages – Arabic and Russian. Cochrane has always played a role in advocating for evidence-based health care, and it plans to step up its activities in this area by becoming the ‘home of evidence’ to inform health

decision-making, and building greater recognition of its role and impact. These ambitious goals will require ongoing collaborative effort across ADP ribosylation factor disciplines and regions. Cochrane will continue to rely on the buy Birinapant contributions of review authors and users of evidence. Involvement in Cochrane’s work, whether through authoring a review or by basing treatment decisions, professional development and advocacy on Cochrane evidence, represents opportunities for physiotherapy to grow the evidence base that underpins our profession, and enables us to share a vision of better health

and healthcare. For more information about becoming involved in Cochrane, see www.cochrane.org Acknowledgements: Cathie Sherrington, Julie Bernhardt. Correspondence: Professor Sally Green, Australasian Cochrane Centre, School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia. Email: [email protected] “
“Whiplash-associated disorders’ (WAD) is the term given to the variety of symptoms often reported by people following acceleration/deceleration injury to the neck, most commonly via a road traffic crash. The cardinal symptom is neck pain but neck stiffness, dizziness, paraesthesia/anaesthesia in the upper quadrant, headache and arm pain are also commonly reported. The neck-related pain is associated with disability, decreased quality of life, and psychological distress. Due to WAD often being a compensable injury, it is a controversial condition, with some still denying it as a legitimate condition.