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Sample records for regimen shows clear

  1. Combined Approach to Lysis Utilizing Eptifibatide and rt-PA in Acute Ischemic Stroke-Full Dose Regimen (CLEAR-FDR Stroke Trial)

    Science.gov (United States)

    Adeoye, Opeolu; Sucharew, Heidi; Khoury, Jane; Vagal, Achala; Schmit, Pamela A.; Ewing, Irene; Levine, Steven R.; Demel, Stacie; Eckerle, Bryan; Katz, Brian; Kleindorfer, Dawn; Stettler, Brian; Woo, Daniel; Khatri, Pooja; Broderick, Joseph P.; Pancioli, Arthur M.

    2015-01-01

    Background and Purpose The Combined Approach to Lysis Utilizing Eptifibatide and rt-PA in Acute Ischemic Stroke (CLEAR) and CLEAR-Enhanced Regimen (CLEAR-ER) trials demonstrated safety of reduced dose recombinant tissue plasminogen activator (rt-PA) plus the glycoprotein 2b/3a inhibitor, eptifibatide, in acute ischemic stroke (AIS) compared to rt-PA alone. The objective of the CLEAR-Full Dose Regimen (CLEAR-FDR) trial was to estimate the rate of symptomatic intracerebral hemorrhage (sICH) in AIS patients treated with the combination of full dose rt-PA plus eptifibatide. Methods CLEAR-FDR was a single-arm, prospective, open-label, multi-site study. Patients aged 18-85 years treated with 0.9 mg/kg IV rt-PA within three hours of symptom onset were enrolled. After obtaining consent, eptifibatide (135 mcg/kg bolus and 2 hour infusion at 0.75 mcg/kg/min) was administered. The primary endpoint was the proportion of patients who experienced sICH within 36 hours. An independent clinical monitor adjudicated if a sICH had occurred and an independent neuroradiologist reviewed all images. The stopping rule was three sICHs within the first 19 patients or four sICHs within 29 patients. Results From October 2013 to December 2014, 27 AIS patients were enrolled. Median age was 73 years (Range 34-85, IQR 65-80) and median NIHSS was 12 (Range 6-26, IQR 9-16). One sICH (3.7%, 95% CI 0.7%-18%) was observed. Conclusion These results demonstrate comparable safety of full dose rt-PA plus eptifibatide with historical rates of sICH with rt-PA alone and support proceeding with a phase 3 trial evaluating full dose rt-PA combined with eptifibatide to improve outcomes after AIS. PMID:26243231

  2. A Simple Experimental Setup to Clearly Show That Light Does Not Recombine after Passing through Two Prisms

    Science.gov (United States)

    Garcia-Molina, Rafael; del Mazo, Alejandro; Velasco, Santiago

    2018-01-01

    We present a simple and cheap experimental setup that clearly shows how the colors of the white light spectrum after passing a prism do not recombine when emerging from an identical second prism, as it is still found in many references.

  3. Unique technological voice method (The YUBA Method) shows clear improvement in patients with cochlear implants in singing.

    Science.gov (United States)

    Yuba, T; Itoh, T; Kaga, K

    2009-01-01

    It is known that children with cochlear implants tend to sing off-key, monotonously, and flat. There are a few reports that it is possible to improve off-key singing mainly through instruction using the falsetto voice for people with normal hearing. We examined whether their singing skills could be improved through instruction. Eight subjects (five boys and three girls aged 10.4+/-2.4 years) with cochlear implants were selected. Speech perception scores of short sentences were on average 66.5%+/-26.5%. We diagnosed their singing acuity by letting them sing a nursery song, well known to all of them, before and after the instruction. The mean fundamental frequencies of their singing approached the mean Musical Instrument Digital Interface (MIDI)-specified frequencies as references and the deviation between fundamental frequencies of their singing and reference MIDI sounds became smaller. This study shows a clear improvement in the singing ability of children with cochlear implants through a unique technological voice method, mainly focused on the falsetto voice in this experiment.

  4. Local Populations ofArabidopsis thalianaShow Clear Relationship between Photoperiodic Sensitivity of Flowering Time and Altitude.

    Science.gov (United States)

    Lewandowska-Sabat, Anna M; Fjellheim, Siri; Olsen, Jorunn E; Rognli, Odd A

    2017-01-01

    Adaptation of plants to local conditions that vary substantially within their geographic range is essential for seasonal timing of flowering, a major determinant of plant reproductive success. This study investigates photoperiodic responses in natural populations of Arabidopsis thaliana from high northern latitudes and their significance for local adaptation. Thirty lineages from ten local A. thaliana populations, representing different locations across an altitudinal gradient (2-850 m a.s.l.) in Norway, were grown under uniform controlled conditions, and used to screen for responses to five different photoperiods. We studied relationships between variation in photoperiodic sensitivity of flowering time, altitude, and climatic factors associated with the sites of origin. We found that variation in response to photoperiod is significantly correlated with altitude and climatic variables associated with the sites of origin of the populations. Populations originating from lower altitudes showed stronger photoperiodic sensitivity than populations from higher altitudes. Our results indicate that the altitudinal climatic gradient generates clinal variation in adaptive traits in A. thaliana .

  5. Death of the (traveling) salesman: primates do not show clear evidence of multi-step route planning.

    Science.gov (United States)

    Janson, Charles

    2014-05-01

    Several comparative studies have linked larger brain size to a fruit-eating diet in primates and other animals. The general explanation for this correlation is that fruit is a complex resource base, consisting of many discrete patches of many species, each with distinct nutritional traits, the production of which changes predictably both within and between seasons. Using this information to devise optimal spatial foraging strategies is among the most difficult problems to solve in all of mathematics, a version of the famous Traveling Salesman Problem. Several authors have suggested that primates might use their large brains and complex cognition to plan foraging strategies that approximate optimal solutions to this problem. Three empirical studies have examined how captive primates move when confronted with the simplest version of the problem: a spatial array of equally valuable goals. These studies have all concluded that the subjects remember many food source locations and show very efficient travel paths; some authors also inferred that the subjects may plan their movements based on considering combinations of three or more future goals at a time. This analysis re-examines critically the claims of planned movement sequences from the evidence presented. The efficiency of observed travel paths is largely consistent with use of the simplest of foraging rules, such as visiting the nearest unused "known" resource. Detailed movement sequences by test subjects are most consistent with a rule that mentally sums spatial information from all unused resources in a given trial into a single "gravity" measure that guides movements to one destination at a time. © 2013 Wiley Periodicals, Inc.

  6. Difference of the Nuclear Green Light Intensity between Papillary Carcinoma Cells Showing Clear Nuclei and Non-neoplastic Follicular Epithelia in Papillary Thyroid Carcinoma

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    Hyekyung Lee

    2016-09-01

    Full Text Available Background There is subjective disagreement regarding nuclear clearing in papillary thyroid carcinoma. In this study, using digital instruments, we were able to quantify many ambiguous pathologic features and use numeric data to express our findings. Methods We examined 30 papillary thyroid carcinomas. For each case, we selected representative cancer cells showing clear nuclei and surrounding non-neoplastic follicular epithelial cells and evaluated objective values of green light intensity (GLI for quantitative analysis of nuclear clearing in papillary thyroid carcinoma. Results From 16,274 GLI values from 600 cancer cell nuclei and 13,752 GLI values from 596 non-neoplastic follicular epithelial nuclei, we found a high correlation of 94.9% between GLI and clear nuclei. GLI between the cancer group showing clear nuclei and non-neoplastic follicular epithelia was statistically significant. The overall average level of GLI in the cancer group was over two times higher than the non-neoplastic group despite a wide range of GLI. On a polygonal line graph, there was a fluctuating unique difference between both the cancer and non-neoplastic groups in each patient, which was comparable to the microscopic findings. Conclusions Nuclear GLI could be a useful factor for discriminating between carcinoma cells showing clear nuclei and non-neoplastic follicular epithelia in papillary thyroid carcinoma.

  7. Dysplastic (or Atypical) Nevi Showing Moderate or Severe Atypia With Clear Margins on the Shave Removal Specimens Are Most Likely Completely Excised.

    Science.gov (United States)

    Maghari, Amin

    Dysplastic nevi (DN) are graded by their degree of atypia into 3 categories of mild, moderate, and severe. In many practices, DN with moderate or severe atypia are generally excised regardless of the status of the shave specimen margins. With a new approach toward the margins on the shave removal specimens (SRS), the goal herein is to assess whether the shave removal procedure can sufficiently remove DN with moderate or severe atypia. A total of 426 SRS diagnosed with DN showing moderate or severe atypia between January and December 2015 along with their post-shave excision specimens were reviewed. Based on the author's experience, clear or negative margins on the SRS were defined as neoplastic melanocytes confined within >0.2 mm of the lateral and deep specimen margins. The biopsy specimens were accompanied by Melan-A highlighting the subtle neoplastic cells. With a negative predictive value (NPV) of 98.4% (confidence interval: 97.2% to 100%, P < .001), DN showing moderate or severe atypia with clear margins are most likely removed by the shave procedure. Routine excision of DN showing moderate or severe atypia with clear margins on SRS is not necessary. Regular surveillance is sufficient.

  8. Clear retainer

    Directory of Open Access Journals (Sweden)

    Priyakorn Chaimongkol

    2017-01-01

    Full Text Available A clear retainer is a removable retainer that is popular in the present day. Compared with conventional fixed and removable orthodontic retainers, it is a more esthetic, comfortable, and inexpensive appliance. Although several studies have been published about clear retainers, it could be difficult to interpret the results because of the variety of study designs, sample sizes, and research methods. This article is intended to compile the content from previous studies and discuss advantages, disadvantages, fabrication, insertion, and adjustment. Moreover, the effectiveness in maintaining dental position, occlusion, retention protocols, thickness, and survival rate of clear retainers is discussed.

  9. Urachal Carcinoma with Choroidal, Lung, Lymph Node, Adrenal, Mammary, and Bone Metastases and Peritoneal Carcinomatosis Showing Partial Response after Chemotherapy Treatment with a Modified Docetaxel, Cisplatin and 5-Fluorouracil Regimen

    Directory of Open Access Journals (Sweden)

    Kathleen Dekeister

    2016-04-01

    Full Text Available Urachal carcinoma (UC is a rare tumor mainly affecting middle-aged males. Metastases occur most frequently in lymph nodes and the lungs. There are no standard adjuvant and metastatic treatments. We report the case of a 36-year-old female with UC treated with partial cystectomy who relapsed 3 years after surgery with left choroidal, lung, mediastinal lymph node, right adrenal, mammary, and bone metastases as well as peritoneal carcinomatosis. She obtained a partial response after 10 cycles of chemotherapy with a modified docetaxel, cisplatin and 5-fluorouracil (mTPF regimen. This is the first report on the use of the mTPF regimen in UC and on the existence of choroidal, adrenal, and mammary metastases.

  10. Metronomic chemotherapy regimens in oncology

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    M. Yu. Fedyanin

    2016-01-01

    Full Text Available Metronomic chemotherapy implies the regular use of cytotoxic agents in doses much smaller than the maximum tolerable doses for a long time. Preclinical experiments show that this treatment option has a many-sided (antiangiogenic, immunostimulating, and direct cytotoxic effect on tumor. Moreover, this approach has gained the widest acceptance in treating patients with metastatic breast cancer in clinical practice. By taking into account the high activity of angiogenesis in colon cancer progression, it is interesting to study the impact of metronomic chemotherapy regimens for this nosological entity as well. This literature review considers not only the history of metronomic chemotherapy, the mechanisms of action, and a range of drugs having an antitumor effect in the metronomic regimens, but also analyzes clinical trials of metronomic chemotherapy regimens in patients with metastatic colon cancer.

  11. Classifying insulin regimens

    DEFF Research Database (Denmark)

    Neu, A; Lange, K; Barrett, T

    2015-01-01

    defined. The proposed new classification for insulin management will be comprehensive, simple, and catchy. Currently available terms were included. This classification may offer the opportunity to compare therapeutic strategies without the currently existing confusion on the insulin regimen....

  12. Antibiotic regimens for postpartum endometritis.

    Science.gov (United States)

    Mackeen, A Dhanya; Packard, Roger E; Ota, Erika; Speer, Linda

    2015-02-02

    Postpartum endometritis occurs when vaginal organisms invade the endometrial cavity during the labor process and cause infection. This is more common following cesarean birth. The condition warrants antibiotic treatment. Systematically, to review treatment failure and other complications of different antibiotic regimens for postpartum endometritis. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2014) and reference lists of retrieved studies. We included randomized trials of different antibiotic regimens after cesarean birth or vaginal birth; no quasi-randomized trials were included. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The review includes a total of 42 trials, and 40 of these trials contributed data on 4240 participants.Regarding the primary outcomes, seven studies compared clindamycin plus an aminoglycoside versus penicillins and showed fewer treatment failures (risk ratio (RR) 0.65, 95% confidence interval (CI) 0.46 to 0.90). There were more treatment failures in those treated with an aminoglycoside plus penicillin when compared to those treated with gentamycin/clindamycin (RR 2.57, 95% CI 1.48 to 4.46). There were more treatment failures (RR 1.66, 95% CI 1.01 to 2.74) and wound infections (RR 1.88, 95% CI 1.08 to 3.28) in those treated with second or third generation cephalosporins (excluding cephamycins) versus those treated with clindamycin plus gentamycin. In four studies comparing once-daily with thrice-daily dosing of gentamicin, there were fewer failures with once-daily dosing. There were more treatment failures (RR 1.94, 95% CI 1.38 to 2.72) and wound infections (RR 1.88, 95% CI 1.17 to 3.02) in those treated with a regimen with poor activity against penicillin-resistant anaerobic bacteria as compared to those treated with a regimen with good activity against penicillin-resistant anaerobic bacteria. There were no differences

  13. Clear cell melanoma: a cutaneous clear cell malignancy.

    Science.gov (United States)

    Pletneva, Maria A; Andea, Aleodor; Palanisamy, Nallasivam; Betz, Bryan L; Carskadon, Shannon; Wang, Min; Patel, Rajiv M; Fullen, Douglas R; Harms, Paul W

    2014-10-01

    Clear cell melanoma is a rare clear cell malignancy. Accurate diagnosis of clear cell melanoma requires integration of immunohistochemical and morphologic findings, with molecular studies to rule out clear cell sarcoma. The differential diagnosis includes melanoma, carcinoma, perivascular epithelioid cell tumor, and epidermotropic clear cell sarcoma. We use a case of a lesion on the helix of an 86-year-old man as an example. Histologic examination revealed an ulcerated clear cell malignant tumor. Tumor cell cytoplasm contained periodic acid-Schiff-positive, diastase-sensitive glycogen. Tumor cells showed positive labeling for S100, HMB-45, and Melan-A, and negative labeling for cytokeratins, p63, and smooth muscle actin. Molecular studies demonstrated BRAF V600E mutation, copy gains at the 6p25 (RREB1) and 11q13 (CCND1) loci, and absence of EWSR1-ATF1 fusion. These findings supported a diagnosis of clear cell melanoma. The rare pure clear cell morphology occurs due to accumulation of intracytoplasmic glycogen. We review the differential diagnosis of clear cell melanoma and describe the utility of immunohistochemical and molecular studies in confirming this diagnosis.

  14. Optical clearing of articular cartilage: a comparison of clearing agents

    Science.gov (United States)

    Bykov, Alexander; Hautala, Tapio; Kinnunen, Matti; Popov, Alexey; Karhula, Sakari; Saarakkala, Simo; Nieminen, Miika T.; Tuchin, Valery

    2015-07-01

    Optical clearing technique was applied to the problem of OCT imaging of articular cartilage and subchondral bone. We show that optical clearing significantly enhances visualization of articular cartilage and cartilage-bone interface. The effect of different clearing agents was analyzed. For the clearing, iohexol solution and propylene glycol (PG) were used. Clearing was performed in vitro at room temperature by immersion method. Cylindrical osteochondral samples (d=4.8mm) were drilled from bovine lateral femur and stored in phosphate-buffered saline at -20°C until clearing. Monitoring of clearing process was performed using high-speed spectral-domain OCT system providing axial resolution of 5.8μm at 930nm. Total duration of experiment was 90-100min to ensure saturation of clearing. We have shown that iohexol solution and PG are capable to optically clear articular cartilage enabling reliable characterization of cartilagebone interface with OCT. Being a low osmolarity agent, iohexol provides minimal changes to the thickness of cartilage sample. Clearing saturation time for the cartilage sample with the thickness of 0.9 mm measured with OCT is of 50 min. However, less than 15 min is enough to reliably detect the rear cartilage boundary. Alternatively, PG significantly (60%) reduces the cartilage thickness enabling better visualization of subchondral bone. It was observed that PG has higher clearing rate. The clearing saturation time is of 30 min, however less than 5 min is enough to detect cartilage-bone interface. We conclude that iohexol solution is superior for OCT imaging of cartilage and cartilage-bone interface, while PG suits better for subhondral bone visualization.

  15. CLEAR test facility

    CERN Multimedia

    Ordan, Julien Marius

    2017-01-01

    A new user facility for accelerator R&D, the CERN Linear Electron Accelerator for Research (CLEAR), started operation in August 2017. CLEAR evolved from the former CLIC Test Facility 3 (CTF3) used by the Compact Linear Collider (CLIC). The new facility is able to host and test a broad range of ideas in the accelerator field.

  16. Diet - clear liquid

    Science.gov (United States)

    ... things such as: Clear broth Tea Cranberry juice Jell-O Popsicles Why you may Need This Diet You ... sodas, such as ginger ale and Sprite Gelatin (Jell-O) Popsicles that do not have bits of fruit, ...

  17. Prophylactic antibiotic regimens in tumor surgery (PARITY survey

    Directory of Open Access Journals (Sweden)

    Hasan Khaled

    2012-06-01

    Full Text Available Abstract Background Deep infection following endoprosthetic limb reconstruction for sarcoma of the long bones is a devastating complication occurring in 15% of sarcoma patients. Optimizing infection protocols and conducting definitive surgical trials are critical to improving outcomes. In this study, the PARITY (Prophylactic Antibiotic Regimens in Tumor Surgery investigators aimed to examine surgeon preferences in antibiotic prophylaxis and perceptions about current evidence, as well as to ascertain interest in resolving uncertainty in the evidence with clinical trials. Methods We used a cross-sectional survey to examine current practice in the prescription of prophylactic antibiotics in Musculoskeletal Tumor Surgery. The survey was approved by our institution’s Ethics Board and emailed to all Active Members of the Musculoskeletal Tumor Society (MSTS and Canadian Orthopaedic Oncology Society (CANOOS. Survey answers were collected using an anonymous online survey tool. Results Of the 96 surgeons who received the questionnaire, 72 responded (75% response rate (% CI: 65.5, 82.5%. While almost all respondents agreed antibiotic regimens were important in reducing the risk of infection, respondents varied considerably in their choices of antibiotic regimens and dosages. Although 73% (95% CI: 61, 82% of respondents prescribe a first generation cephalosporin, 25% favor additional coverage with an aminoglycoside and/or Vancomycin. Of those who prescribe a cephalosporin, 33% prescribe a dosage of one gram for all patients and the reminder prescribe up to 2 grams based on body weight. One in three surgeons (95% CI: 25, 48% believes antibiotics could be discontinued after 24 hours but 40% (95% CI: 30, 53% continue antibiotics until the suction drain is removed. Given the ongoing uncertainty in evidence to guide best practices, 90% (95% CI: 81, 95% of respondents agreed that they would change their practice if a large randomized controlled trial showed

  18. Clear Cell Adenocarcinoma of the Renal Pelvis in a Male Patient

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    Sarawut Kongkarnka

    2013-01-01

    Full Text Available Carcinoma of the renal pelvis is an uncommon renal neoplasm. Clear cell adenocarcinoma in the urinary tract is rare and has a histomorphology resembling that of the female genital tract. We herein present a case of clear cell adenocarcinoma of the renal pelvis, which is the first example in a male patient to our knowledge. A 54-year-old man presented with right flank pain. The tumor was associated with renal stones and hydronephrosis and invaded into the peripelvic fat tissue with regional lymph node metastasis. The patient died of metastatic disease six months postoperatively. Histologically, the tumor showed complex papillary architecture lined with clear and hobnail cells. Clear cell adenocarcinoma of the renal pelvis may pose a diagnostic challenge on histological grounds, particularly in the distinction from renal cell carcinoma. The immunohistochemical stains could help confirm the diagnosis. Due to its rarity, an effective treatment regimen remains to be determined.

  19. The CLEAR 2007 Evaluation

    Science.gov (United States)

    2007-01-01

    FBK-IRST), the Universitat Politécnica de Catalunya , Barcelona, Spain (UPC), the Laboratoire d’Informatique pour la mécanique et les sciences de...especially in natural, application-near scenarios such as in CLEAR, still poses some difficult questions that must be investigated. Appendix A

  20. Fludarabine-based versus CHOP-like regimens with or without rituximab in patients with previously untreated indolent lymphoma: a retrospective analysis of safety and efficacy

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    Xu XX

    2013-10-01

    Full Text Available Xiao-xiao Xu,1 Bei Yan,2 Zhen-xing Wang,3 Yong Yu,1 Xiao-xiong Wu,2 Yi-zhuo Zhang11Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, 2Department of Hematology, First Affiliated Hospital of Chinese People's Liberation Army General Hospital, Beijing, 3Department of Stomach Oncology, TianJin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of ChinaAbstract: Fludarabine-based regimens and CHOP (doxorubicin, cyclophosphamide, vincristine, prednisone-like regimens with or without rituximab are the most common treatment modalities for indolent lymphoma. However, there is no clear evidence to date about which chemotherapy regimen should be the proper initial treatment of indolent lymphoma. More recently, the use of fludarabine has raised concerns due to its high number of toxicities, especially hematological toxicity and infectious complications. The present study aimed to retrospectively evaluate both the efficacy and the potential toxicities of the two main regimens (fludarabine-based and CHOP-like regimens in patients with previously untreated indolent lymphoma. Among a total of 107 patients assessed, 54 patients received fludarabine-based regimens (FLU arm and 53 received CHOP or CHOPE (doxorubicin, cyclophosphamide, vincristine, prednisone, or plus etoposide regimens (CHOP arm. The results demonstrated that fludarabine-based regimens could induce significantly improved progression-free survival (PFS compared with CHOP-like regimens. However, the FLU arm showed overall survival, complete response, and overall response rates similar to those of the CHOP arm. Grade 3–4 neutropenia occurred in 42.6% of the FLU arm and 7.5% of the CHOP arm (P 60 years and presentation of grade 3–4 myelosuppression were the independent factors to infection, and the FLU arm had significantly

  1. Impacts of 12-dose regimen for latent tuberculosis infection

    Science.gov (United States)

    Huang, Yi-Wen; Yang, Shun-Fa; Yeh, Yen-Po; Tsao, Thomas Chang-Yao; Tsao, Shih-Ming

    2016-01-01

    Abstract Treatment of latent tuberculosis infection (LTBI) is essential for eradicating tuberculosis (TB). Moreover, the patient adherence is crucial in determining the effectiveness of TB control. Isoniazid given by DOTS daily for 9 months (9H) is the standard treatment for LTBI in Taiwan. However, the completion rate is low due to the long treatment period and its side effects. The combined regimen using a high dose of rifapentine/isoniazid once weekly for 12 weeks (3HP) has been used as an alternative treatment option for LTBI in the United States. This may result in a higher completion rate. In this pilot study, patient adherence and cost of these 2 treatment regimens were investigated. Thus, we aimed to assess the treatment completion rate and costs of 3HP and compare to those with 9H. Data from 691 cases of LTBI treatments including 590 cases using the conventional regimen and 101 cases with rifapentine/Isoniazid were collected. The cost was the sum of the cost of treatment with Isoniazid for 9 months or with rifapentin/Isoniazid for 3 months of all contacts. The effectiveness was the cost of cases of tuberculosis avoided. In this study, the treatment completion rate for patients prescribed with the 3 months rifapentine/isoniazid regimen (97.03%) was higher than those given the conventional 9-month isoniazid regimen (87.29%) (P rifapentine/isoniazid regimen due to undesirable side effects. This was the first study to compare the 2 treatment regimens in Taiwan, and it showed that a short-term high-dosage rifapentine/isoniazid treatment regimen reduced costs and resulted in higher treatment completion than the standard LTBI isoniazid treatment. PMID:27559940

  2. Single-tablet regimens (STRs enhance patients’ acceptability of HAART

    Directory of Open Access Journals (Sweden)

    F Maggiolo

    2012-11-01

    pill intake (39% and number of pills (27% were the major reasons of patients’ low acceptability of HAART. High acceptability is one of the winning characteristics of a regimen, favoring long-term adherence, durability and efficacy. Although highly subjective, acceptability may be positively influenced by characteristics of the HAART regimen such as simplicity. According to our results, STRs show a higher acceptability compared to more complex regimens.

  3. Exploration of optimal dosing regimens of vancomycin in patients infected with methicillin-resistant Staphylococcus aureus by modeling and simulation.

    Science.gov (United States)

    Lim, H-S; Chong, Y P; Noh, Y-H; Jung, J-A; Kim, Y S

    2014-04-01

    Vancomycin is the drug of choice for methicillin-resistant Staphylococcus aureus (MRSA) infection and shows time-dependent bacterial killing. The current study evaluated the pharmacokinetics (PK) and pharmacodynamics (PD) of vancomycin and explored its optimal dosing regimens by modeling and simulation. Pharmacokinetics study was performed for 20 patients who were treated with vancomycin intravenously, 1000 mg, every 12 h, and blood for PK was randomly drawn within prespecified time windows. PD study was in vitro time-kill experiment for vancomycin against 20 MRSA strains independent of the PK study, where bacterial titre was measured at 0, 2, 4, 8, 24 h after the beginning of vancomycin exposure at 0, 1, 2, 4, 8, 16, 32× minimum inhibitory concentrations. PK and PD models were built from each data set, and simulation for MRSA titre changes over time in human body was performed for various vancomycin dosing regimens using NONMEM(®) . Vancomycin followed a two-compartment PK model, and creatinine clearance was the significant covariate affecting the clearance of vancomycin. PD model described the in vitro time-kill data well. The PK/PD model predicted clear dose-response relationships of vancomycin. The therapeutic dosing regimens of vancomycin, suggested by the simulation studies, showed good agreement with the current clinical practice guidance, which indicates that this PK/PD modeling and simulation approach could prove useful for identifying optimal dosing regimens of other antibiotics and expediting novel antibiotic development. Using PD model from in vitro time-kill study and human PK model from phase 1 study, we could predict whether the drug is going to be efficacious or obtain insight into the optimal dosing regimens for a novel antibiotic agent in the early phases of drug development process. © 2014 John Wiley & Sons Ltd.

  4. Tuberculosis treatment and drug regimens.

    Science.gov (United States)

    Sotgiu, Giovanni; Centis, Rosella; D'ambrosio, Lia; Migliori, Giovanni Battista

    2015-01-08

    Tuberculosis is an airborne infectious disease treated with combination therapeutic regimens. Adherence to long-term antituberculosis therapy is crucial for maintaining adequate blood drug level. The emergence and spread of drug-resistant Mycobacterium tuberculosis strains are mainly favored by the inadequate medical management of the patients. The therapeutic approach for drug-resistant tuberculosis is cumbersome, because of the poor, expensive, less-effective, and toxic alternatives to the first-line drugs. New antituberculosis drugs (bedaquiline and delamanid) have been recently approved by the health authorities, but they cannot represent the definitive solution to the clinical management of drug-resistant tuberculosis forms, particularly in intermediate economy settings where the prevalence of drug resistance is high (China, India, and former Soviet Union countries). New research and development activities are urgently needed. Public health policies are required to preserve the new and old therapeutic options. Copyright © 2015 Cold Spring Harbor Laboratory Press; all rights reserved.

  5. Intravenous and intramuscular magnesium sulphate regimens in ...

    African Journals Online (AJOL)

    1993-09-03

    Sep 3, 1993 ... management of severe pre-eclampsia. It is given parenterally, usually according to one of two popular regimens: the intramuscular (IM) regimen introduced by. Pritchard' and a continuous intravenous (IV) infusion described by Zuspan! Sibai et a/.3 have reported that lower serum magnesium values are ...

  6. FOLFOX and FLOX regimens for the adjuvant treatment of resected stage II and III colon cancer.

    Science.gov (United States)

    Sharif, Saima; O'Connell, Michael J; Yothers, Greg; Lopa, Samia; Wolmark, Norman

    2008-11-01

    The MOSAIC trial showed that the use of adjuvant oxaliplatin and an infusional regimen of 5-FU/LV in the treatment of stage II/III colon cancer improved disease-free survival (DFS). The NSABP's C-07 trial evaluated the addition of oxaliplatin to a weekly Roswell Park regimen of bolus 5-FU/LV and found a similar improvement in DFS. The benefit of oxaliplatin appears to be independent of the 5-FU/LV regimen used. This paper reviews the efficacy and toxicities of these two regimens and is meant to serve as a guide for clinical practice.

  7. Optical clearing: impact of optical and dielectric properties of clearing solutions on pulmonary tissue mechanics.

    Science.gov (United States)

    Schwenninger, David; Priebe, Hans-Joachim; Schneider, Matthias; Runck, Hanna; Guttmann, Josef

    2017-07-01

    Optical clearing allows tissue visualization under preservation of organ integrity. Optical clearing of organs with a physiological change in three-dimensional geometry (such as the lung) would additionally allow visualization of macroscopic and microscopic tissue geometry. A prerequisite, however, is the preservation of the native tissue mechanics of the optically cleared lung tissue. We investigated the impact of optical and dielectric properties of clearing solutions on biomechanics and clearing potency in porcine tissue strips of healthy lungs. After fixation, bleaching, and rehydration, four methods of optical clearing were investigated using eight different protocols. The mechanical and optical properties of the cleared lung tissue strips were investigated by uniaxial tensile testing and by analyzing optical transparency and translucency for red, green, and blue light before, during, and after the biochemical optical clearing process. Fresh tissue strips were used as controls. Best balance between efficient clearing and preserved mechanics was found for clearing with a 1:1 mixture of dimethyl sulfoxide (DMSO) and aniline. Our findings show that 1) the degree of tissue transparency and translucency correlated with the refractive index of the clearing solution index (r = 0.976, P = 0.0004; and r = 0.91, P = 0.0046, respectively), 2) tissue mechanics were affected by dehydration and the type of clearing solution, and 3) tissue biomechanics and geometry correlated with the dielectric constant of the clearing solution (r = -0.98, P dielectric constant of the clearing solutions, the larger the effect on tissue stiffness. This suggests that the dielectric constant is an important measure in determining the effect of a clearing solution on lung tissue biomechanics. Optimal tissue transparency requires complete tissue dehydration and a refractive index of 1.55 of the clearing solution.NEW & NOTEWORTHY Investigating optical clearing in porcine lung tissue strips, we

  8. Nicaragua: la consolidacion de un regimen hibrido

    National Research Council Canada - National Science Library

    Puig Marti, Salvador

    2013-01-01

    El texto tiene como objetivo exponer el proceso de conversion y consolidacion del sistema politico nicaraguense en un regimen hibrido, senalando como episodio "clave" las elecciones municipales del 4...

  9. Anticoagulation Regimens During Pregnancy in Patients With Mechanical Heart Valves: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Xu, Zhe; Fan, Jin; Luo, Xin; Zhang, Wen-Bo; Ma, Jun; Lin, Yu-Bi; Ma, Shao-Hong; Chen, Xin; Wang, Zhi-Ping; Ou, Jing-Song; Zhang, Xi

    2016-10-01

    Managing anticoagulation in pregnant women with mechanical heart valves remains challenging. Our aim was to evaluate the effectiveness and safety of 4 regimens in these women. Relevant studies published before June 2015 were collected in several databases and analyzed with RevMan version 5.3 and SPSS version 19.0. Four regimens were defined as follows: a regimen of a vitamin K antagonist (VKA) throughout pregnancy; a heparin (H)/VKA regimen using VKAs except for unfractionated heparin (UFH) or low molecular weight heparin (LMWH) during 6-12 weeks of pregnancy; a LMWH regimen of adjusted LMWH doses throughout pregnancy; and a UFH regimen of adjusted UFH doses throughout pregnancy. The low warfarin dose in the VKA regimen was defined as 5 mg/d or less. Fifty-one studies comprising 2113 pregnancies in 1538 women were included. The rate of fetal wastage was significantly higher in the high warfarin dose subgroup than in the low dose one. Compared with the H/VKA regimen, the rate of maternal major thromboembolic event in the low-dose VKA regimen group was significantly lower, although the fetal outcomes were similar. Compared with the H/VKA regimen, the rate of fetal wastage in the LMWH regimen group was significantly lower, and the maternal outcomes were similar. The UFH regimen presented the worst maternal and fetal outcomes. In the absence of large prospective trials, this meta-analysis showed that the VKA regimen should be best for pregnant women with a low warfarin dose, and the H/VKA regimen might be reasonable for those with a high warfarin dose. The LMWH regimen could be used for those who refuse VKA. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  10. Alternative magnesium sulphate regimens for women with pre-eclampsia and eclampsia.

    Science.gov (United States)

    Duley, Lelia; Matar, Hosam E; Almerie, Muhammad Qutayba; Hall, David R

    2010-08-04

    Magnesium sulphate remains the drug of choice for both prevention and treatment of women with eclampsia. Regimens for administration of this drug have evolved over the years, but have not yet been formally evaluated. To assess the comparative effects of alternative regimens for the administration of magnesium sulphate when used for the care of women with pre-eclampsia or eclampsia, or both. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (June 2010). Randomised trials comparing different regimens for administration of magnesium sulphate used for the care of women with pre-eclampsia or eclampsia, or both. All four review authors assessed trial quality and extracted data independently. We identified 17 studies of which six (866 women) met the inclusion criteria: two trials (451 women) compared regimens for women with eclampsia and four (415 women) for women with pre-eclampsia.Treatment of eclampsia: one trial compared loading dose alone with loading dose plus maintenance therapy for 24 hours (401 women). There was no clear difference between the groups in the risk ratio (RR) of recurrence of convulsions (RR 1.13, 95% confidence interval (CI) 0.42 to 3.05) or stillbirth (RR 1.13, 95% CI 0.66 to 1.92), and the CIs are wide. One trial compared a low dose regimen with a standard dose regimen over 24 hours (50 women). This study was too small for any reliable conclusions about the comparative effects.Prevention of eclampsia: one trial compared intravenous with intramuscular maintenance regimen for 24 hours (17 women). This trial was too small for any reliable conclusions. Three trials compared short maintenance regimens postpartum with continuing for 24 hours after the birth (398 women), even taken together these trials were too small for any reliable conclusions. Although strong evidence supports the use of magnesium sulphate for prevention and treatment of eclampsia, trials comparing alternative treatment regimens are too small for reliable

  11. Clear cell carcinoma of the ovary: Is there a role of histology-specific treatment?

    Directory of Open Access Journals (Sweden)

    Takano Masashi

    2012-06-01

    Full Text Available Abstract Several clinical trials to establish standard treatment modality for ovarian cancers included a high abundance of patients with serous histologic tumors, which were quite sensitive to platinum-based chemotherapy. On the other hand, ovarian tumor with rare histologic subtypes such as clear cell or mucinous tumors have been recognized to show chemo-resistant phenotype, leading to poorer prognosis. Especially, clear cell carcinoma of the ovary (CCC is a distinctive tumor, deriving from endometriosis or clear cell adenofibroma, and response rate to platinum-based therapy is extremely low. It was implied that complete surgical staging enabled us to distinguish a high risk group of recurrence in CCC patients whose disease was confined to the ovary (pT1M0; however, complete surgical staging procedures could not lead to improved survival. Moreover, the status of peritoneal cytology was recognized as an independent prognostic factor in early-staged CCC patients, even after complete surgical staging. In advanced cases with CCC, the patients with no residual tumor had significantly better survival than those with the tumor less than 1 cm or those with tumor diameter more than 1 cm. Therefore, the importance of achieving no macroscopic residual disease at primary surgery is so important compared with other histologic subtypes. On the other hand, many studies have shown that conventional platinum-based chemotherapy regimens yielded a poorer prognosis in patients with CCC than in patients with serous subtypes. The response rate by paclitaxel plus carboplatin (TC was slightly higher, ranging from 22% to 56%, which was not satisfactory enough. Another regimen for CCC tumors is now being explored: irinotecan plus cisplatin, and molecular targeting agents. In this review article, we discuss the surgical issues for early-staged and advanced CCC including possibility of fertility-sparing surgery, and the chemotherapy for CCC disease.

  12. We can see clearly now: optical clearing and kidney morphometrics.

    Science.gov (United States)

    Puelles, Victor G; Moeller, Marcus J; Bertram, John F

    2017-05-01

    For more than a century, kidney microscopic imaging was driven by the need for greater and greater resolution. This was in part provided by the analysis of thinner tissue sections. As a result, most kidney morphometry was performed in 'two' dimensions, largely ignoring the three-dimensionality of kidney tissue and cells. Although stereological techniques address this issue, they have generally been considered laborious and expensive and thereby unattractive for routine use. The past 2 decades have witnessed the development of optical clearing techniques, which enables visualization of thick slices of kidney tissue and even whole kidneys. This review describes the three main optical clearing strategies (solvent-based, aqueous-based and hydrogel embedding) with their respective advantages and disadvantages. We also describe how optical clearing provides new approaches to kidney morphometrics, including general kidney morphology (i.e. identification and quantitation of atubular glomeruli), glomerular numbers and volumes, numbers of specific glomerular cells (i.e. podocytes) and cell-specific stress-related changes (i.e. foot process effacement). The new clearing and morphometric approaches described in this review provide a new toolbox for imaging and quantification of kidney microanatomy. These approaches will make it easier to visualize the three-dimensional microanatomy of the kidney and decrease our reliance on biased two-dimensional morphometric techniques and time-consuming stereological approaches. They will also accelerate our research of structure-function relations in the healthy and diseased kidney.

  13. Media Language, Clear or Obscure

    DEFF Research Database (Denmark)

    Jakobsen, Bjarne le Fevre; Ejstrup, Michael

    2015-01-01

    growth in diversity, means that media need to be very cognizant of the stringency with which they handle the advice to be linguistically clear and concise. The need to pay great attention to situational awareness is highly visible and intrusive. Attention to situational awareness seems to be crucial...... where it is important for mutual understanding that we be clear and concise. This is true of instructions for electronic equipment and for household appliances. Here, linguistic brevity and clarity may be preferable, but not in other cases. Culture, globalization, and the recognition of ever faster...

  14. Media Language, Clear or Obscure

    DEFF Research Database (Denmark)

    Ejstrup, Michael; le Fevre Jakobsen, Bjarne

    2015-01-01

    it is important for mutual understanding that we be clear and concise. This is true of instructions for electronic equipment and for household appliances. Here, linguistic brevity and clarity may be preferable, but not in other cases. Culture, globalization, and the recognition of ever faster growth in diversity...

  15. Central Clearing of OTC Derivatives

    DEFF Research Database (Denmark)

    Cont, Rama; Kokholm, Thomas

    2014-01-01

    We study the impact of central clearing of over-the-counter (OTC) transactions on counterparty exposures in a market with OTC transactions across several asset classes with heterogeneous characteristics. The impact of introducing a central counterparty (CCP) on expected interdealer exposure is de...

  16. Media Language, Clear or Obscure

    DEFF Research Database (Denmark)

    Ejstrup, Michael; le Fevre Jakobsen, Bjarne

    2015-01-01

    , means that media need to be very cognizant of the stringency with which they handle the advice to be linguistically clear and concise. The need to pay great attention to situational awareness is highly visible and intrusive. Attention to situational awareness seems to be crucial for the survival of free...

  17. Prophylactic antibiotic regimens in tumour surgery (PARITY)

    DEFF Research Database (Denmark)

    Petersen, Michael Mørk; Hettwer, Werner H; Grum-Schwensen, Tomas

    2015-01-01

    -day regimen of post-operative antibiotics, in comparison to a 24-hour regimen, decreases surgical site infections in patients undergoing endoprosthetic reconstruction for lower extremity primary bone tumours. METHODS: We performed a pilot international multi-centre RCT. We used central randomisation...... to conceal treatment allocation and sham antibiotics to blind participants, surgeons, and data collectors. We determined feasibility by measuring patient enrolment, completeness of follow-up, and protocol deviations for the antibiotic regimens. RESULTS: We screened 96 patients and enrolled 60 participants......% at one year (the remainder with partial data or pending queries). In total, 18 participants missed at least one dose of antibiotics or placebo post-operatively, but 93% of all post-operative doses were administered per protocol. CONCLUSIONS: It is feasible to conduct a definitive multi-centre RCT of post...

  18. Transfusion regimens in thalassemia intermedia

    Directory of Open Access Journals (Sweden)

    Z. Karakas

    2011-12-01

    Full Text Available Thalassemia intermedia (TI is a heterogeneous disease, in terms of both clinical manifestations and underlying molecular defects. Some TI patients are asymptomatic until adult life, whereas others are symptomatic from early childhood. In contrast with patients with Thalassemia major (TM, the severity of anemia is less and the patients do not require transfusions during at least the first few years of life. Many patients with TI, especially older ones, have been exposed to the multiple long-term effects of chronic anemia and tissue hypoxia and their compensatory reactions, including enhanced erythropoiesis and increased iron absorption. Bone marrow expansion and extramedullary hematopoiesis lead to bone deformities and liver and spleen enlargement. Therapeutic strategies in TI are not clear and different criteria are used to decide the initiation of transfusion and chelation therapy, modulation of fetal hemoglobin production, and hematopoietic stem cell transplantation on an individual basis. The clinical picture of well-treated TM patients with regular transfusionchelation therapy is better from TI patients who have not received adequate transfusion therapy. There is a significant role of early blood transfusion to prevent and treat complications commonly associated with TI, such as extramedullary erythropoiesis and bone deformities, autoimmune hemolytic anemia, leg ulcers, gallstones, pseudoxantoma elasticum, hyperuricosuria, gout and pulmonary hypertension, which are rarely seen in thalassemia major. Nowadays, indications of transfusion in patients with TI are chronic anemia (Hb < 7 g/dL, bone deformities, growth failure, extramedullary erythropoiesis, heart failure, pregnancy and preparation for surgical procedures. Conclusion: Adequate (regular or tailored transfusion therapy is an important treatment modality for increasing the quality of life in patients with thalassemia intermedia during childhood. 就临床表象和潜在的分子缺

  19. The art of thinking clearly

    CERN Document Server

    Dobelli, Rolf

    2013-01-01

    The Art of Thinking Clearly by world-class thinker and entrepreneur Rolf Dobelli is an eye-opening look at human psychology and reasoning — essential reading for anyone who wants to avoid “cognitive errors” and make better choices in all aspects of their lives. Have you ever: Invested time in something that, with hindsight, just wasn’t worth it? Or continued doing something you knew was bad for you? These are examples of cognitive biases, simple errors we all make in our day-to-day thinking. But by knowing what they are and how to spot them, we can avoid them and make better decisions. Simple, clear, and always surprising, this indispensable book will change the way you think and transform your decision-making—work, at home, every day. It reveals, in 99 short chapters, the most common errors of judgment, and how to avoid them.

  20. Common snook fed in alternate and continuous regimens with diet supplemented with Bacillus subtilis probiotic

    Directory of Open Access Journals (Sweden)

    André Pedro Noffs

    2015-04-01

    Full Text Available The objective of this work was to evaluate the addition of Bacillus subtilis probiotic to the feed of common snook (Centropomus undecimalis fingerlings, in alternate and continuous regimens. Six hundred and sixty fish, with average length of 5.90±0.88 cm and weight of 1.92±0.28 g, were stocked in 12 cages of 1.0 m3, with 55 fish each. The experimental design was completely randomized, with three treatments and four replicates. The treatments consisted of diet with the addition of probiotic, provided in alternate regimen for 7 days and in continuous regimen; besides a control without probiotic in the feed. Zootechnical performance, body composition, immune response, and blood parameters were evaluated. No significant differences were observed in zootechnical performance indexes and in body composition of fish treated with probiotic, when compared to the control. Fish from the alternate regimen showed an increment in respiratory burst and a lower total erythrocyte count than fish from the continuous regimen and the control. Fish from the continuous regimen did not differ from those of the control. The addition of Bacillus subtilis does not increase growth rates of common snook fingerlings; however, it has an immunostimulant action when supplied in alternate regimen.

  1. Comparison of "Nil by Mouth" Versus Early Oral Intake in Three Different Diet Regimens Following Esophagectomy

    DEFF Research Database (Denmark)

    Eberhard, Kristine Elisabeth; Achiam, Michael Patrick; Rolff, Hans Christian

    2017-01-01

    BACKGROUND: The literature on oral intake after esophagectomy and its influence on anastomotic leakage and complications is sparse. METHODS: This retrospective study included 359 patients undergoing esophagectomy between January 2011 and August 2015. Three oral intake protocols were evaluated......: regimen 1, nil by mouth until postoperative day (POD) 7 followed by a normal diet; regimen 2, oral intake of clear fluids from POD 1 followed by a normal diet; regimen 3, nil by mouth until POD 7 followed by a slow increase to a blended diet. The outcome endpoints were: (1) anastomotic leakage, (2......) complications [severity and number described using the Dindo-Clavien Classification and Comprehensive Complication Index (CCI)] and (3) length of stay. A multivariate logistic regression model was obtained for CCI and anastomotic leakage using Wald's stepwise selection. RESULTS: CCI was significantly lower...

  2. 17 CFR 16.00 - Clearing member reports.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Clearing member reports. 16.00... MARKETS § 16.00 Clearing member reports. (a) Information to be provided. Each reporting market shall... day, showing for each clearing member, by proprietary and customer account, the following information...

  3. Comparison of "Nil by Mouth" Versus Early Oral Intake in Three Different Diet Regimens Following Esophagectomy.

    Science.gov (United States)

    Eberhard, Kristine Elisabeth; Achiam, Michael Patrick; Rolff, Hans Christian; Belmouhand, Mohamed; Svendsen, Lars Bo; Thorsteinsson, Morten

    2017-06-01

    The literature on oral intake after esophagectomy and its influence on anastomotic leakage and complications is sparse. This retrospective study included 359 patients undergoing esophagectomy between January 2011 and August 2015. Three oral intake protocols were evaluated: regimen 1, nil by mouth until postoperative day (POD) 7 followed by a normal diet; regimen 2, oral intake of clear fluids from POD 1 followed by a normal diet; regimen 3, nil by mouth until POD 7 followed by a slow increase to a blended diet. The outcome endpoints were: (1) anastomotic leakage, (2) complications [severity and number described using the Dindo-Clavien Classification and Comprehensive Complication Index (CCI)] and (3) length of stay. A multivariate logistic regression model was obtained for CCI and anastomotic leakage using Wald's stepwise selection. CCI was significantly lower in regimen 3 (16 vs. 22 and 26 in regimen 1 and 2, p = 0.027). Additionally, significantly fewer patients in regimen 3 suffered from severe complications of Dindo-Clavien grade IIIb-IV (p = 0.025). The incidence of anastomotic leakage reached its lowest in regimen 3, 2%, compared to 7-9%. Multivariate analyses revealed that high American Society of Anesthesiologist score was a predicting factor for both CCI and anastomotic leakage. The study indicates that nil by mouth until postoperative day 7 followed by a slow increase to a blended diet after esophagectomy results in less severe complications and a tendency of fewer anastomotic leakages. Multiple comorbidities proved to be an important predictive factor of the postoperative course.

  4. Randomized controlled study of a novel triple nitazoxanide (NTZ)-containing therapeutic regimen versus the traditional regimen for eradication of Helicobacter pylori infection.

    Science.gov (United States)

    Shehata, Mona Ah; Talaat, Raghda; Soliman, Samah; Elmesseri, Huda; Soliman, Shaimaa; Abd-Elsalam, Sherief

    2017-10-01

    Helicobacter pylori infection has become more and more resistant to conventional first-line treatment regimens. So, there is a considerable interest in evaluating new antibiotic combinations and regimens. Nitazoxanide is an anti-infective drug with demonstrated activity against protozoa and anaerobic bacteria including H. pylori. This work is designed to evaluate the efficacy and safety of a unique triple nitazoxanide-containing regimen as a treatment regimen in Egyptian patients with H. pylori infection. Two hundred and 24 patients with upper gastrointestinal tract (GIT) dyspeptic symptoms in whom H. pylori -induced GIT disease was confirmed were included in the study. They have been randomized to receive either nitazoxanide 500 mg b.i.d., clarithromycin 500 mg b.i.d., and omeprazole 40 mg twice daily for 14 days or metronidazole 500 mg b.i.d., clarithromycin 500 mg b.i.d., and omeprazole 40  mg twice daily for 14 days. Laboratory evaluation for H. pylori antigen within the stool was performed 6 weeks after cessation of H. pylori treatment regimens to assess the response. The response to treatment was significantly higher in group 1 of nitazoxanide treatment regimen than group 2 of traditional treatment regimen. One hundred and six cases (94.6%) of 112 patients who completed the study in group 1 showed complete cure, while only 63 cases (60.6%) of 104 patients who completed the study in group 2 showed the same response according to per-protocol (PP) analysis (Ppylori. (ClinicalTrials.gov Identifier: NCT02422706). © 2017 John Wiley & Sons Ltd.

  5. Borderline Clear Cell Adenofibroma of the Ovary

    Directory of Open Access Journals (Sweden)

    Pilaiwan Kleebkaow

    2017-01-01

    Full Text Available Borderline clear cell tumors are extremely rare, and few cases have been reported in the literature. Herein, we present a case of borderline clear cell adenofibroma of the ovary in a 58-year-old woman who presented with a pelvic mass and constipation. Physical examination revealed a 10 cm solid midline pelvic mass. Computed tomography showed an 8 cm heterogeneous enhancing mass attached to the left posterolateral wall of the uterus. The patient’s serum CA 125 levels were slightly elevated (80.9 U/ml. The patient was given a total abdominal hysterectomy with bilateral salpingooophorectomy. On gross examination, it was found that the left ovarian tumor was an 8.0 × 7.5 × 8.0 cm solid multilobulated mass containing tiny cysts. Histologically, the tumor was composed of small glands in dense fibrous and myxoid stroma. The glands were lined with cuboidal cells with clear cytoplasm and mild to moderate nuclear atypia. No stromal invasion was observed. The pathological diagnosis was borderline clear cell adenofibroma of the left ovary. There was no reoccurrence 36 months post operation.

  6. La gestion del regimen cambiario en Brasil

    National Research Council Canada - National Science Library

    Prates, Daniela M; Cunha, Andre M; Lelis, Marcos T.C

    2009-01-01

    ...) en esta singular experiencia se combina un contexto de amplia movilidad de capitales con la existencia de mercados de derivados financieros amplios y liquidos y el elevado costo fiscal de la politica de acumulacion de reservas; iv) hasta abril de 2006, el patron de acumulacion de reservas en el sistema cambiarlo fluctuante fue similar al del regimen de bandas cambiarias; desde entonces se observaron cambios debido al crecimiento acelerado de las reservas. PALABRAS CLAVE Politica monetaria Tipos de cambio flota...

  7. New Treatment Regimen for Latent Tuberculosis Infection

    Centers for Disease Control (CDC) Podcasts

    2012-03-15

    In this podcast, Dr. Kenneth Castro, Director of the Division of Tuberculosis Elimination, discusses the December 9, 2011 CDC guidelines for the use of a new regimen for the treatment of persons with latent tuberculosis infection.  Created: 3/15/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 3/15/2012.

  8. Optimal intake of clear liquids during preparation for afternoon colonoscopy with low-volume polyethylene glycol plus ascorbic acid.

    Science.gov (United States)

    Tajika, Masahiro; Tanaka, Tsutomu; Ishihara, Makoto; Hirayama, Yutaka; Oonishi, Sachiyo; Mizuno, Nobumasa; Hara, Kazuo; Hijioka, Susumu; Imaoka, Hiroshi; Fujiyoshi, Toshihisa; Hieda, Nobuhiro; Okuno, Nozomi; Yoshida, Tsukasa; Yamao, Kenji; Bhatia, Vikram; Ando, Masahiko; Niwa, Yasumasa

    2017-06-01

    The standard colonoscopy preparation regimen in Japan for afternoon procedures is sequential intake of 1 L of polyethylene glycol electrolyte lavage solution containing ascorbic acid (PEG-ASC), 0.5 L of clear liquid, 0.5 L of PEG-ASC, and finally 0.25 L of clear fluids (all at a rate of 0.25 L every 15 min). However, this regimen seems poorly tolerated and complicated for many patients compared to previous regimen of polyethylene glycol electrolyte lavage solution. The aim of this study was to evaluate an alternate regimen of 0.5 L of PEG-ASC followed by 0.25 L clear liquids, repeated 3 times. This was a single-blinded, non-inferiority, randomized controlled study. Subjects were randomized to the standard regimen or the alternate regimen using a web-based registry system. All patients were instructed to eat a pre-packaged, low residue diet and to take sodium picosulfate hydrate the day before colonoscopy. The Boston Bowel Preparation Scale was used to evaluate bowel cleansing, and a 3-point scale was used to assess mucosal visibility. The primary endpoint was successful bowel cleansing. The acceptability, tolerability, safety, and endoscopic findings of these two regimens were secondary endpoints.  A total of 409 patients were randomized to either the standard regimen (n = 204, males 54.0 %, mean age 65.5 years) or the alternate regimen (n = 205, 54.6 %, 65.0 years). The rates of successful bowel cleansing were 71.1 % (64.3 - 77.2 %) with the standard regimen vs. 75.1 % (68.6 - 80.9 %) with the alternate regimen (95 % lower confidence limit, for the difference = - 4.6, non-inferiority P  < 0.05). No significant differences were found in tolerability, safety, and endoscopic findings.  The alternate regimen and standard regimen are clinically equivalent with respect to cleansing efficacy and acceptability, tolerability, safety, and endoscopic findings. These results are good news for patients with difficulty

  9. Assessment of adherence to tuberculosis drug regimen

    Directory of Open Access Journals (Sweden)

    Khalili H.

    2008-03-01

    Full Text Available Background and the purpose of the study: Tuberculosis is curable if patients take sufficient uninterrupted therapy. Most experts acknowledge importance of patient adherence in efforts to control of the disease. This cross-sectional study was designed to evaluate the rate of compliance to anti-tuberculosis regimens by means of urine tests in newly diagnosed tuberculosis patients.Method: Investigation was carried out in Tehran University of Medical Sciences Teaching Hospitals, Tehran, IRAN. Fifty patients completed the study. The patients' urine samples were obtained at 0, 1, 2, 4 and 6 months of the study. Simple chemical methods were used to detect Isoniazid, Rifampin, and pyrazinamide, the three main drugs in tuberculosis treatment regimens. Urine tests at months of 0 and l of the study were considered as control tests.Results: After the first month, the patients' compliance was about 96%. At months of second, fourth and sixth, the whole adherence rates were 56 %, 76% and 81% respectively. Conclusion: About 30% of patients were non-compliant with treatment regimen which was more frequent than presumed; therefore detection of non-adherent patients is an essential subject in developing countries.

  10. Effect of maternal canthaxanthin and 25-hydroxycholecalciferol supplementation on the performance of ducklings under two different vitamin regimens.

    Science.gov (United States)

    Ren, Z Z; Jiang, S Z; Zeng, Q F; Ding, X M; Bai, S P; Wang, J P; Luo, Y H; Su, Z W; Xuan, Y; Zhang, K Y

    2017-04-01

    This study investigated the effects of maternal canthaxanthin (CX, 6 mg/kg) and 25-hydroxycholecalciferol (25-OH-D3 , 0.069 mg/kg) supplementation on the performance of Cherry Valley ducklings under two different vitamin regimens. A total of 780 duck breeder females and 156 males were randomly allotted to two diets with or without the addition of the mixture of CX and 25-OH-D3 (CX+25-OH-D3 ) for 32 weeks. Ducklings (males and females separately) hatched from eggs laid at 24 weeks of the duck breeder trial were fed with a NRC vitamin regimen, and ducklings (males and females separately) hatched from eggs laid at 32 weeks of the duck breeder trial were fed with a HIGH vitamin regimen (had higher levels of all vitamins except biotin than NRC vitamin regimen), for 14 days. The results showed that, maternal CX+25-OH-D3 supplementation increased the shank pigmentation for 7-days post hatch in ducklings under a NRC vitamin regimen, and for 14-days post hatch in ducklings under a HIGH vitamin regimen. Growth performance, antioxidant status and serum phosphorus of ducklings under a NRC vitamin regimen were increased by maternal CX+25-OH-D3 supplementation; however, these positive effects were not observed in ducklings under a HIGH vitamin regimen. Males revealed increased growth performance in ducklings under both NRC and HIGH vitamin regimens. Sexual differences in shank pigmentation, antioxidant status, tibia strength and serum phosphorus were not consistent as they were dependent on maternal CX+25-OH-D3 status or dietary vitamin regimens. Data suggest that maternal CX+25-OH-D3 supplementation is important for starter ducklings under a NRC vitamin regimen, but not HIGH vitamin regimen. Journal of Animal Physiology and Animal Nutrition © 2016 Blackwell Verlag GmbH.

  11. Optimizing the immunosuppressive regimen in heart transplantation.

    Science.gov (United States)

    Eisen, Howard; Ross, Heather

    2004-05-01

    The use of immunosuppression regimens containing a calcineurin inhibitor (CNI), an adjunct immunosuppressant (e.g., azathioprine, everolimus or mycophenolate mofetil) and corticosteroids has effectively reduced the risk of early graft loss due to acute rejection in heart transplant recipients. At present, late graft loss due to cardiac allograft vasculopathy (CAV) remains a major challenge for transplant teams. CAV is characterized by intimal hyperplasia as a result of endothelial cell injury. Factors relating to the transplant procedure itself (e.g., ischemic time and reperfusion injury), cardiovascular risks (e.g., donor age, hypertension, hyperlipidemia, pre-existing diabetes and new-onset diabetes after transplantation), immunologic risks (e.g., acute rejection episodes, anti-HLA antibodies) and the side effects of immunosuppression with CNIs or corticosteroids (e.g., cytomegalovirus infection, nephrotoxicity) have all been implicated in the development of CAV. The 2 main approaches to the prevention of CAV are modification of underlying risk factors (e.g., treatment with anti-hypertensive agents and lipid-lowering drugs, and optimizing the immunosuppressive regimen) and improvement in immunosuppression. CNIs remain the cornerstone of immunosuppressive regimens in heart transplantation, but new parameters for monitoring CNI exposure and new immunosuppressive regimens hold the promise of reduced overall CNI exposure with consequent reductions in vascular toxicity and improved clinical outcomes. Traditionally, trough levels of cyclosporine (C(0)) have been used to monitor exposure to cyclosporine and to assess the need for dose adjustment. However, optimal cyclosporine exposure can now be achieved through monitoring of cyclosporine levels 2 hours after dosing (C(2) monitoring). Furthermore, in a pivotal trial in heart transplantation, the new proliferation signal inhibitor, everolimus, plus full-dose cyclosporine and corticosteroids, has been shown to have

  12. Assessment of non-standard HIV antiretroviral therapy regimens at ...

    African Journals Online (AJOL)

    2016-03-06

    Mar 6, 2016 ... Lighthouse Trust in Lilongwe, Malawi serves approximately 25,000 patients with HIV antiretroviral therapy (ART) regimens standardized according to national treatment .... Table 2: Most common non-standard antiretroviral therapy regimens. The most .... patients, three-NRTI regimens can maintain HIV-RNA.

  13. mtct regimen choice, drug resistance and the treatment of hiv

    African Journals Online (AJOL)

    considered in order for the clinician to assist in the choice of the initial ARV regimen. It is not known whether ARV choices for infants who have been exposed to non- suppressive ARV regimens used to prevent MTCT should be modified. The efficacy of first-line highly active antiretroviral therapy (HAART) treatment regimens.

  14. Treatment of patients hospitalized for exacerbations of chronic obstructive pulmonary disease: comparison of an oral/metered-dose inhaler regimen and an intravenous/nebulizer regimen.

    Science.gov (United States)

    Shortall, Sean P; Blum, James; Oldenburg, Frederick A; Rodgerson, Lorraine; Branscombe, John M; Harrow, Edward M

    2002-02-01

    Compare the therapeutic efficacy of an oral/metered-dose inhaler (oral/MDI) regimen to an intravenous/nebulizer (I.V./neb) regimen of methylprednisolone, cefuroxime, and inhaled albuterol and ipratropium bromide in patients hospitalized for exacerbations of chronic obstructive pulmonary disease (COPD). Randomized, nonblinded, therapeutic trial. Two community hospitals in Bangor, Maine. 34 individuals with severe COPD. The mean admission forced expiratory volume in the first second was 0.75 L (oral/MDI 0.78 L, I.V./neb 0.71 L). Baseline demographic, laboratory, comorbidity, and ventilatory values determined in 19 patients who received the oral/MDI regimen and 15 patients treated with the I.V./neb regimen indicated comparability of the two groups. Outcome variables that compared oral/MDI to I.V./neb, including mean change in forced expiratory volume in the first second (0.12 L vs 0.13 L), mean length of stay (4.3 vs 5.1 d), and treatment failures (32% vs 33%), showed no significant differences. Patients hospitalized for COPD exacerbations can be successfully (and potentially less expensively) treated with an oral/MDI treatment regimen.

  15. Cost-Utility Analysis of IEV Drug Regimen Versus ESHAP Drug Regimen for the Patients With Relapsed and Refractory Hodgkin and Non-Hodgkin's Lymphoma in Iran.

    Science.gov (United States)

    Hatam, Nahid; Dehghani, Mehdi; Habibian, Mostafa; Jafari, Abdosaleh

    2015-10-01

    Chemotherapy for lymph nodes cancer is often composed of several drugs that are used in a treatment program. The aim of this study was to perform a cost-utility analysis of IEV regimen (ifosfamide, epirubicin and etoposide) versus ESHAP regimen (etoposide, methylprednisolone, high-dose cytarabine, and cisplatin) in patients with lymphoma in the south of Iran. This was a cost-utility analysis done as a cross-sectional study in the south of Iran. Using decision tree, expected costs, quality -adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) were estimated. In addition, the robustness of results was examined by sensitivity analysis. The results of this study indicated that the total lymphoma patients were about 65 people that 27 patients received IEV regimen and 38 patients ESHAP (43 patients with Hodgkin's and 22 with non-Hodgkin lymphoma). The results of decision tree showed that in the IEV arm, the expected cost was $20952.93 and the expected QALYs was 3.89 and in the ESHAP arm, the expected cost was $31691.74 and the expected QALYs was 3.86. Based on the results of the study, IEV regimen was cost-effective alternative to the ESHAP regimen. According to the results of this study, it is recommended that oncologists use IEV instead of ESHAP in the treatment of patients with lymphoma and because of high costs of IEV drug costs, it is suggested that IEV drugs should be covered by insurance.

  16. Variability in Antibiotic Regimens for Surgical Necrotizing Enterocolitis Highlights the Need for New Guidelines.

    Science.gov (United States)

    Blackwood, Brian P; Hunter, Catherine J; Grabowski, Julia

    Necrotizing enterocolitis or NEC is the most common gastrointestinal emergency in the newborn. The etiology of NEC remains unknown, and treatment consists of antibiotic therapy and supportive care with the addition of surgical intervention as necessary. Unlike most surgical diseases, clear guidelines for the type and duration of peri-operative antibiotic therapy have not been established. Our aim was to review the antibiotic regimen(s) applied to surgical patients with NEC within a single neonatal intensive care unit (NICU) and to evaluate outcomes and help develop guidelines for antibiotic administration in this patient population. A single-center retrospective review was performed of all patients who underwent surgical intervention for NEC from August 1, 2005 through August 1, 2015. Relevant data were extracted including gestational age, age at diagnosis, gender, pre-operative antibiotic treatment, post-operative antibiotic treatment, development of stricture, and mortality. Patients were excluded if there was incomplete data documentation. A total of 90 patients were identified who met inclusion criteria. There were 56 male patients and 34 female patients. The average gestational age was 30 5/7 wks and average age of diagnosis 16.7 d. A total of 22 different pre-operative antibiotic regimens were identified with an average duration of 10.6 d. The most common pre-operative regimen was ampicillin, gentamicin, and metronidazole for 14 d. A total of 15 different post-operative antibiotic regimens were identified with an average duration of 6.6 d. The most common post-operative regimen was ampicillin, gentamicin, and metronidazole for two days. There were 26 strictures and 15 deaths. No regimen or duration proved superior. We found that there is a high degree of variability in the antibiotic regimen for the treatment of NEC, even within a single NICU, with no regimen appearing superior over another. As data emerge that demonstrate the adverse effects of

  17. Tuberculosis defaulters from the "dots" regimen in Jimma zone, southwest Ethiopia.

    Science.gov (United States)

    Michael, Kifle W; Belachew, Tefera; Jira, Challi

    2004-10-01

    A cross-sectional study was conducted among patients with tuberculosis on the DOTS regimen in the four teaching health centers of Jimma zone to determine rate of defaulting and factors associated with it. All tuberculosis patients registered and treated using DOTS regimen in the 4 teaching health centers (THC's) from the second half of 1999 to December 30, 2000 were included in the study. A sub-sample of one hundred and fourteen 114 (56.2%) defaulters were traced at their homes and interviewed to elicit their reasons for defaulting. The study showed that overall rate of defaulting was 6.7%. The default rate from the DOTS regimen was found to be quite low when compared to the rate of defaulting from the standard regimen in Jimma zone. Socio-economic factors including distance of patients' residence from the health institution, lack of money for paying transportation and poor awareness about the disease were the major reasons contributing to poor compliance and defaulting. Designing community based strategies for DOTS regimen in order to make the drug available within the vicinity of the grass root community and strong information education and communication activities need to be employed in order to reduce the defaulter rate and improve the quality of treatment of tuberculosis cases by the DOTS regimen.

  18. Comparison Between 10- and 14-Day Hybrid Regimens for Helicobacter pylori Eradication: A Randomized Clinical Trial.

    Science.gov (United States)

    Metanat, Hassan Ali; Valizadeh, Seyed Mohammad; Fakheri, Hafez; Maleki, Iradj; Taghvaei, Tarang; Hosseini, Vahid; Bari, Zohreh

    2015-08-01

    Helicobacter pylori (H. pylori) eradication has always been a concern. In our previous study, 14-day hybrid regimen showed ideal results. Based on these findings, we decided to compare the efficacy of 10- and 14-day hybrid regimens for H. pylori eradication. Two hundred and seventy patients with peptic ulcer disease and H. pylori infection were enrolled in the study. One hundred and thirty-four patients received 10-day hybrid regimen (PACT-10): pantoprazole, 40 mg, and amoxicillin, 1 g, both twice daily for 10 days; plus clarithromycin, 500 mg, and tinidazole, 500 mg, both twice daily just during the last 5 days. One hundred and thirty-six patients received 14-day hybrid regimen (PACT-14): pantoprazole, 40 mg, and amoxicillin, 1 g, both twice a day for 14 days; plus clarithromycin, 500 mg, and tinidazole, 500 mg, both twice daily just for the last 7 days. Eight weeks after treatment, (14) C-urea breath test was performed to evaluate H. pylori eradication. Two hundred and fifty patients (124 patients in PACT-10 and 126 patients in PACT-14 regimens) completed the study. The intention-to-treat eradication rates were 77.6% (95% confidence interval (CI): 70.6-84.6%) and 86% (95% CI: 80-92%) for the two regimens, respectively (p = .17). Per-protocol eradication rates were 83.8% (95% CI: 80-86%) and 92.8% (95% CI: 88-96%), respectively (p pylori eradication in Iran. © 2015 John Wiley & Sons Ltd.

  19. Perceived gender in clear and conversational speech

    Science.gov (United States)

    Booz, Jaime A.

    Although many studies have examined acoustic and sociolinguistic differences between male and female speech, the relationship between talker speaking style and perceived gender has not yet been explored. The present study attempts to determine whether clear speech, a style adopted by talkers who perceive some barrier to effective communication, shifts perceptions of femininity for male and female talkers. Much of our understanding of gender perception in voice and speech is based on sustained vowels or single words, eliminating temporal, prosodic, and articulatory cues available in more naturalistic, connected speech. Thus, clear and conversational sentence stimuli, selected from the 41 talkers of the Ferguson Clear Speech Database (Ferguson, 2004) were presented to 17 normal-hearing listeners, aged 18 to 30. They rated the talkers' gender using a visual analog scale with "masculine" and "feminine" endpoints. This response method was chosen to account for within-category shifts of gender perception by allowing nonbinary responses. Mixed-effects regression analysis of listener responses revealed a small but significant effect of speaking style, and this effect was larger for male talkers than female talkers. Because of the high degree of talker variability observed for talker gender, acoustic analyses of these sentences were undertaken to determine the relationship between acoustic changes in clear and conversational speech and perceived femininity. Results of these analyses showed that mean fundamental frequency (fo) and f o standard deviation were significantly correlated to perceived gender for both male and female talkers, and vowel space was significantly correlated only for male talkers. Speaking rate and breathiness measures (CPPS) were not significantly related for either group. Outcomes of this study indicate that adopting a clear speaking style is correlated with increases in perceived femininity. Although the increase was small, some changes associated

  20. Single Versus Multidrug Regimen for Surgical Infection Prophylaxis in Left Ventricular Assist Device Implantation.

    Science.gov (United States)

    Aburjania, Nana; Ertmer, Brennan M; Farid, Saira; Berg, Melody; Nienaber, Juhsien J C; Tchantchaleishvili, Vakhtang; Stulak, John M; Sohail, Muhammad R

    2017-10-31

    Infection is a serious complication of left ventricular assist device (LVAD) therapy. However, an optimal antimicrobial surgical infection prophylaxis (SIP) regimen for LVAD implantation is not well established. We retrospectively reviewed all adults who underwent continuous-flow LVAD implantation from February 2007 to March 2015 at Mayo Clinic Rochester. Left ventricular assist device infection (LVADI) was defined using criteria published by the International Society for Heart and Lung Transplant. Patients excluded from the analysis included those who did not have HeartMate II or HeartWare device, patients with incomplete documentation of SIP, and those with an actively treated infection at the time of LVAD implantation. We compared risk of LVAD-specific and LVAD-related infections and all-cause mortality between SIP regimens at postoperative day 90 and 1 year using Kaplan-Meier time-to-event analyses. During study period, 239 adults underwent continuous-flow LVAD implantation at our institution where 199 patients received single-drug and 40 received multidrug SIP regimen. Median patient age was 62 years. Left ventricular assist device infection occurred in three patients (1.5%) in the single-drug group versus two patients (5.0%) in the multidrug group at 90 days (p = 0.4). There was no difference in infection-free (p = 0.4) and overall survival (p = 0.9) between two groups at 1 year. In conclusion, there was no clear benefit of using multidrug regimen as it did not impact infection-free survival or all-cause mortality compared with single-drug regimen. Prospective clinical trials are needed to further define the optimal SIP regimen for LVAD implantation.

  1. Effectiveness of oral contraceptive pills in a large U.S. cohort comparing progestogen and regimen.

    Science.gov (United States)

    Dinger, Jürgen; Minh, Thai Do; Buttmann, Nina; Bardenheuer, Kristina

    2011-01-01

    To estimate real-life effectiveness of oral contraceptive pills by progestogen, length of pill-free interval, and body mass index while focusing on the effect of progestogens with a long half-life and on 24-day oral contraceptive pills regimens. Outcome data from 52,218 U.S. participants in the International Active Surveillance of Women Taking Oral Contraceptives—a large, prospective, controlled, noninterventional, long-term cohort study with active surveillance of the study participants—were used to analyze contraceptive failure in association with oral contraceptive pills use. Low loss to follow-up is ensured by a comprehensive follow-up procedure. Contraceptive failure rates are described by Pearl Index and life-table analysis. Inferential statistics for contraceptive failure are based on Cox regression models. Analyses are based on 1,634 unintended pregnancies during 73,269 woman-years of oral contraceptive pills exposure. Life-table estimates of contraceptive failure for a 24-day regimen of drospirenone and ethinyl estradiol and 21-day regimens of other progestogens were 2.1% and 3.5% after the first study year, and 4.7% and 6.7% after the third year. The adjusted hazard ratio was 0.7 (95% confidence interval 0.6–0.8). Direct comparisons of the 24-day and 21-day regimens of drospirenone and norethisterone, respectively, showed also lower contraceptive failure rates for 24-day regimens. Contraceptive failure rates adjusted for age, parity and educational level showed a slight increase with higher body mass index. The 24-day oral contraceptive regimens containing a progestogen with a long half-life show higher contraceptive effectiveness under routine medical conditions compared with conventional 21-day regimens. Obesity seems to be associated with a slight reduction of contraceptive effectiveness. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00335257. II

  2. Efficacy and completion rates of rifapentine and isoniazid (3HP) compared to other treatment regimens for latent tuberculosis infection: a systematic review with network meta-analyses.

    Science.gov (United States)

    Pease, Christopher; Hutton, Brian; Yazdi, Fatemeh; Wolfe, Dianna; Hamel, Candyce; Quach, Pauline; Skidmore, Becky; Moher, David; Alvarez, Gonzalo G

    2017-04-11

    We conducted a systematic review and network meta-analysis (NMA) to examine the efficacy and completion rates of treatments for latent tuberculosis infection (LTBI). While a previous review found newer, short-duration regimens to be effective, several included studies did not confirm LTBI, and analyses did not account for variable follow-up or assess completion. We searched MEDLINE, Embase, CENTRAL, PubMed, and additional sources to identify RCTs in patients with confirmed LTBI that involved a regimen of interest and reported on efficacy or completion. Regimens of interest included isoniazid (INH) with rifapentine once weekly for 12 weeks (INH/RPT-3), 6 and 9 months of daily INH (INH-6; INH-9), 3-4 months daily INH plus rifampicin (INH/RFMP 3-4), and 4 months daily rifampicin alone (RFMP-4). NMAs were performed to compare regimens for both endpoints. Sixteen RCTs (n = 44,149) and 14 RCTs (n = 44,128) were included in analyses of efficacy and completion. Studies were published between 1968 and 2015, and there was diversity in patient age and comorbidities. All regimens of interest except INH-9 showed significant benefits in preventing active TB compared to placebo. Comparisons between active regimens did not reveal significant differences. While definitions of regimen completion varied across studies, regimens of 3-4 months were associated with a greater likelihood of adequate completion. Most of the active regimens showed an ability to reduce the risk of active TB relative to no treatment, however important differences between active regimens were not found. Shorter rifamycin-based regimens may offer comparable benefits to longer INH regimens. Regimens of 3-4 months duration are more likely to be completed than longer regimens.

  3. Comprehensive comparison of three different immunosuppressive regimens for liver transplant patients with hepatocellular carcinoma: steroid-free immunosuppression, induction immunosuppression and standard immunosuppression.

    Directory of Open Access Journals (Sweden)

    Yuan-Yuan Liu

    Full Text Available The different choices of immunosuppression (IS regimens influenced the outcomes of liver transplantation. Steroid was applied as a standard IS to prevent and treat rejections. However, steroid-related complications were increasingly prominent. This study compared the efficacy and safety of standard IS regimens with the efficacy and safety of steroid-free IS regimen and induction IS regimen in Chinese liver transplantation recipients for hepatocellular carcinoma (HCC. A total of 329 patients who underwent liver transplantation from January 2008 to December 2012 were retrospectively reviewed. Three different groups of patients received standard triple-drug IS regimen of steroid, tacrolimus (TAC and mycophenolate mofetil (MMF (triple-drug regimen group; n=57, induction-contained IS regimen of basiliximab, steroid, TAC and MMF (BS group; n=241, and induction-contained and steroid-free regimen of basiliximab, TAC and MMF (SF group; n=31, respectively. There were no significant differences in terms of patient, tumor-free and graft survival rates. The acute rejection rate and rejection time were equivalent in different groups. But compared with BS group, higher incidences of biliary complications (11.52% vs. 30.77%, p=0.013 and graft dysfunction (0.48% vs. 13.64%, p=0.003 were observed in SF group. Furthermore, compared with the two groups, incidence of pleural effusion was also higher in SF group (15.79%, 11.96% vs. 45.45%, respectively, both p<0.01. And a trend towards less proportion of De novo diabetes was revealed in SF group. Although it was found that patient, tumor-free and graft survival rates were equivalent among three IS regimens, higher incidences of complications were demonstrated in steroid-free regimen in patients for HCC. These findings suggested that steroid-free IS regimen has no clear advantages in comparison with standard IS regimens for liver transplant recipients with HCC and the postoperative complications should be treated with

  4. Acoustic characteristics of clearly spoken English tense and lax vowels.

    Science.gov (United States)

    Leung, Keith K W; Jongman, Allard; Wang, Yue; Sereno, Joan A

    2016-07-01

    Clearly produced vowels exhibit longer duration and more extreme spectral properties than plain, conversational vowels. These features also characterize tense relative to lax vowels. This study explored the interaction of clear-speech and tensity effects by comparing clear and plain productions of three English tense-lax vowel pairs (/i-ɪ/, /ɑ-ʌ/, /u-ʊ/ in /kVd/ words). Both temporal and spectral acoustic features were examined, including vowel duration, vowel-to-word duration ratio, formant frequency, and dynamic spectral characteristics. Results revealed that the tense-lax vowel difference was generally enhanced in clear relative to plain speech, but clear-speech modifications for tense and lax vowels showed a trade-off in the use of temporal and spectral cues. While plain-to-clear vowel lengthening was greater for tense than lax vowels, clear-speech modifications in spectral change were larger for lax than tense vowels. Moreover, peripheral tense vowels showed more consistent clear-speech modifications in the temporal than spectral domain. Presumably, articulatory constraints limit the spectral variation of these extreme vowels, so clear-speech modifications resort to temporal features and reserve the primary spectral features for tensity contrasts. These findings suggest that clear-speech and tensity interactions involve compensatory modifications in different acoustic domains.

  5. Automating the medication regimen complexity index.

    Science.gov (United States)

    McDonald, Margaret V; Peng, Timothy R; Sridharan, Sridevi; Foust, Janice B; Kogan, Polina; Pezzin, Liliana E; Feldman, Penny H

    2013-05-01

    To adapt and automate the medication regimen complexity index (MRCI) within the structure of a commercial medication database in the post-acute home care setting. In phase 1, medication data from 89 645 electronic health records were abstracted to line up with the components of the MRCI: dosage form, dosing frequency, and additional administrative directions. A committee reviewed output to assign index weights and determine necessary adaptations. In phase 2 we examined the face validity of the modified MRCI through analysis of automatic tabulations and descriptive statistics. The mean number of medications per patient record was 7.6 (SD 3.8); mean MRCI score was 16.1 (SD 9.0). The number of medications and MRCI were highly associated, but there was a wide range of MRCI scores for each number of medications. Most patients (55%) were taking only oral medications in tablet/capsule form, although 16% had regimens with three or more medications with different routes/forms. The biggest contributor to the MRCI score was dosing frequency (mean 11.9). Over 36% of patients needed to remember two or more special instructions (eg, take on alternate days, dissolve). Medication complexity can be tabulated through an automated process with some adaptation for local organizational systems. The MRCI provides a more nuanced way of measuring and assessing complexity than a simple medication count. An automated MRCI may help to identify patients who are at higher risk of adverse events, and could potentially be used in research and clinical decision support to improve medication management and patient outcomes.

  6. A Simplified 4-Site Economical Intradermal Post-Exposure Rabies Vaccine Regimen: A Randomised Controlled Comparison with Standard Methods

    Science.gov (United States)

    Warrell, Mary J.; Riddell, Anna; Yu, Ly-Mee; Phipps, Judith; Diggle, Linda; Bourhy, Hervé; Deeks, Jonathan J.; Fooks, Anthony R.; Audry, Laurent; Brookes, Sharon M.; Meslin, François-Xavier; Moxon, Richard; Pollard, Andrew J.; Warrell, David A.

    2008-01-01

    Background The need for economical rabies post-exposure prophylaxis (PEP) is increasing in developing countries. Implementation of the two currently approved economical intradermal (ID) vaccine regimens is restricted due to confusion over different vaccines, regimens and dosages, lack of confidence in intradermal technique, and pharmaceutical regulations. We therefore compared a simplified 4-site economical PEP regimen with standard methods. Methods Two hundred and fifty-four volunteers were randomly allocated to a single blind controlled trial. Each received purified vero cell rabies vaccine by one of four PEP regimens: the currently accepted 2-site ID; the 8-site regimen using 0.05 ml per ID site; a new 4-site ID regimen (on day 0, approximately 0.1 ml at 4 ID sites, using the whole 0.5 ml ampoule of vaccine; on day 7, 0.1 ml ID at 2 sites and at one site on days 28 and 90); or the standard 5-dose intramuscular regimen. All ID regimens required the same total amount of vaccine, 60% less than the intramuscular method. Neutralising antibody responses were measured five times over a year in 229 people, for whom complete data were available. Findings All ID regimens showed similar immunogenicity. The intramuscular regimen gave the lowest geometric mean antibody titres. Using the rapid fluorescent focus inhibition test, some sera had unexpectedly high antibody levels that were not attributable to previous vaccination. The results were confirmed using the fluorescent antibody virus neutralisation method. Conclusions This 4-site PEP regimen proved as immunogenic as current regimens, and has the advantages of requiring fewer clinic visits, being more practicable, and having a wider margin of safety, especially in inexperienced hands, than the 2-site regimen. It is more convenient than the 8-site method, and can be used economically with vaccines formulated in 1.0 or 0.5 ml ampoules. The 4-site regimen now meets all requirements of immunogenicity for PEP and can be

  7. A simplified 4-site economical intradermal post-exposure rabies vaccine regimen: a randomised controlled comparison with standard methods.

    Directory of Open Access Journals (Sweden)

    Mary J Warrell

    2008-04-01

    Full Text Available The need for economical rabies post-exposure prophylaxis (PEP is increasing in developing countries. Implementation of the two currently approved economical intradermal (ID vaccine regimens is restricted due to confusion over different vaccines, regimens and dosages, lack of confidence in intradermal technique, and pharmaceutical regulations. We therefore compared a simplified 4-site economical PEP regimen with standard methods.Two hundred and fifty-four volunteers were randomly allocated to a single blind controlled trial. Each received purified vero cell rabies vaccine by one of four PEP regimens: the currently accepted 2-site ID; the 8-site regimen using 0.05 ml per ID site; a new 4-site ID regimen (on day 0, approximately 0.1 ml at 4 ID sites, using the whole 0.5 ml ampoule of vaccine; on day 7, 0.1 ml ID at 2 sites and at one site on days 28 and 90; or the standard 5-dose intramuscular regimen. All ID regimens required the same total amount of vaccine, 60% less than the intramuscular method. Neutralising antibody responses were measured five times over a year in 229 people, for whom complete data were available.All ID regimens showed similar immunogenicity. The intramuscular regimen gave the lowest geometric mean antibody titres. Using the rapid fluorescent focus inhibition test, some sera had unexpectedly high antibody levels that were not attributable to previous vaccination. The results were confirmed using the fluorescent antibody virus neutralisation method.This 4-site PEP regimen proved as immunogenic as current regimens, and has the advantages of requiring fewer clinic visits, being more practicable, and having a wider margin of safety, especially in inexperienced hands, than the 2-site regimen. It is more convenient than the 8-site method, and can be used economically with vaccines formulated in 1.0 or 0.5 ml ampoules. The 4-site regimen now meets all requirements of immunogenicity for PEP and can be introduced without further

  8. The filtering, clear-cornea diathermal keratostomy

    DEFF Research Database (Denmark)

    Kessing, Svend Vedel; Nissen, Ole I; Thygesen, John

    2012-01-01

    Is the new micropenetrating, clear-cornea procedure, intrastromal diathermal keratostomy (IDK), an alternative to the intricate "modern trabeculectomy"?......Is the new micropenetrating, clear-cornea procedure, intrastromal diathermal keratostomy (IDK), an alternative to the intricate "modern trabeculectomy"?...

  9. Glycogen-rich clear cell carcinoma of the breast

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt; Paulsen, S M

    1987-01-01

    The light microscopic, immunohistochemical and ultrastructural features of a clear cell carcinoma of the breast have been studied. Both intraductal and invasive components were found. Histochemistry showed large amounts of intracytoplasmic glycogen and sparse neutral mucin in the tumour. The tumour...... was classified as a mucin-containing variant of glycogen-rich, clear cell carcinoma of the breast....

  10. Glycogen-rich clear cell carcinoma of the breast

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt; Paulsen, S M

    1987-01-01

    The light microscopic, immunohistochemical and ultrastructural features of a clear cell carcinoma of the breast have been studied. Both intraductal and invasive components were found. Histochemistry showed large amounts of intracytoplasmic glycogen and sparse neutral mucin in the tumour. The tumo...... was classified as a mucin-containing variant of glycogen-rich, clear cell carcinoma of the breast....

  11. Intraventricular metastatic clear cell renal carcinoma.

    Science.gov (United States)

    Sava, I; Sava, Anca; Şapte, Elena; Mihailov, Claudia; Dumitrescu, Gabriela; Poeată, I; Sava, Florina; Haba, Danisia

    2013-01-01

    Intraventricular tumors represent a diagnostic problem, due to a wide range of differential diagnosis, with an important variability of tumoral histological types in adult and pediatric population. Patient, Our case is represented by a patient, aged 48 years, without any history of significant personal pathology, accusing nausea, vomiting, and intensive headache. In the morning, he became confused, having hallucinations for a short period of time, and has accused drowsiness for several weeks. Imaging (CT and MRI) shows a neoformation in the third ventricle, accompanied by bilateral lateral ventricles dilatation, with predominantly annular enhancement. During surgery, through the middle third transcallosal interhemispheric approach, it was revealed a reddish, well-demarcated intraventricular mass, well vascularized and with a firm consistency. Final pathologic diagnosis was metastatic clear cell renal carcinoma. Initial postoperative evolution was good, and then neurological and respiratory condition worsened as a bronchopneumonia lead to patient's death in 12 days after surgery. Clear cell carcinoma metastasis located in the third ventricle should be taken into consideration for patients presenting a single intraventricular lesion even they have no documented primary malignancy.

  12. Rapidly curable electrically conductive clear coatings

    Energy Technology Data Exchange (ETDEWEB)

    Bowman, Mark P.; Anderson, Lawrence G.; Post, Gordon L.

    2018-01-16

    Rapidly curable electrically conductive clear coatings are applied to substrates. The electrically conductive clear coating includes to clear layer having a resinous binder with ultrafine non-stoichiometric tungsten oxide particles dispersed therein. The clear coating may be rapidly cured by subjecting the coating to infrared radiation that heats the tungsten oxide particles and surrounding resinous binder. Localized heating increases the temperature of the coating to thereby thermally cure the coating, while avoiding unwanted heating of the underlying substrate.

  13. 76 FR 45724 - Clearing Member Risk Management

    Science.gov (United States)

    2011-08-01

    ... COMMISSION 17 CFR Parts 1 and 23 RIN 3038-AD51 Clearing Member Risk Management AGENCY: Commodity Futures... are clearing members. DATES: Submit comments on or before September 30, 2011. ADDRESSES: You may... requirement that a DCO adopt rules addressing each clearing member's risk management policies and procedures...

  14. Polypathology, polypharmacy, medication regimen complexity and drug therapy appropriateness.

    Science.gov (United States)

    Gómez Aguirre, N; Caudevilla Martínez, A; Bellostas Muñoz, L; Crespo Avellana, M; Velilla Marco, J; Díez-Manglano, J

    Polypathological patients are usually elderly and take numerous drugs. Polypharmacy affects 85% of these individuals and is not associated with greater survival. On the contrary, polypharmacy exposes these individuals to more adverse effects, such as weight loss, falls, functional and cognitive impairment and hospitalisations. The complexity of a drug regimen covers more aspects than the simple number of drugs consumed. The galenic form, the dosage and the method for preparing the drug can impede the understanding of and compliance with prescriptions. Both polypharmacy and therapeutic complexity are associated with poorer adherence by patients. To prevent polypharmacy, reduce complexity and improve adherence, the appropriate use of drugs is needed. Proper prescribing consists of selecting drugs that have clear evidence for their use in the indication, which are appropriate for the patient's circumstances, are well tolerated and cost-effective and whose benefits outweigh the risks. To improve the drug prescription, periodic reviews of the drugs need to be conducted, especially when the patient changes doctor and during healthcare transitions. The Beers and STOPP/START (Screening Tool of Older Person's potentially inappropriate Prescriptions/Screening Tool to Alert doctors to the Right Treatment) criteria are effective tools for this improvement. Deprescription for polymedicated polypathological patients that considers their clinical circumstances, prognosis and preferences can contribute to a more appropriate use of drugs. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  15. Bilateral clear cell sarcoma of the kidney

    Directory of Open Access Journals (Sweden)

    Wael Zekri

    2015-06-01

    Full Text Available Clear cell sarcoma of the kidney (CCSK accounts for 2–5% of all pediatric renal malignancies, and is known for its propensity to metastasize to bone and other sites. We are reporting two cases with bilateral CCSK that were diagnosed at our institution. One patient initially presented with bilateral renal masses, as well as pulmonary, hepatic and bone metastasis; while other present only with bilateral masses with no evident distant metastasis. Both patients received aggressive neo-adjuvant chemotherapy to decrease tumor size. One patient completed his designated treatment and initially showed complete remission (CR; eventually suffering from relapse. The other patient’s tumor progressed during the course of chemotherapy. Both cases manifested brain dissemination at the time of relapse or progression. This emphasizes the importance of staging stratification in CCSK. This also illustrates CCSK’s ability to metastasize to bone and other sites including the brain (a primary relapse site in our cases.

  16. Different treatment regimens of magnesium sulphate for tocolysis in women in preterm labour.

    Science.gov (United States)

    McNamara, Helen C; Crowther, Caroline A; Brown, Julie

    2015-12-14

    /hour continuous infusion and increased by 1 g/hour hourly until successful tocolysis or failure of treatment).There were no differences seen between high-dose magnesium sulphate regimens compared with low-dose magnesium sulphate regimens for the primary outcome of fetal, neonatal and infant death (risk ratio (RR) 0.43, 95% confidence interval (CI) 0.12 to 1.56; one trial, 100 infants). Using the GRADE approach, the evidence for fetal, neonatal and infant death was considered to be VERY LOW quality. No data were reported for any of the other primary maternal and infant health outcomes (birth less than 48 hours after trial entry; composite serious infant outcome; composite serious maternal outcome).There were no clear differences seen between high-dose magnesium sulphate regimens compared with low-dose magnesium sulphate regimens for the secondary infant health outcomes of fetal death; neonatal death; and rate of hypocalcaemia, osteopenia or fracture; and secondary maternal health outcomes of rate of caesarean birth; pulmonary oedema; and maternal self-reported adverse effects. Pulmonary oedema was reported in two women given high-dose magnesium sulphate, but not in any of the women given low-dose magnesium sulphate.In a single trial of high and low doses of magnesium sulphate for tocolysis including 100 infants, the risk of respiratory distress syndrome was lower with use of a high-dose regimen compared with a low-dose regimen (RR 0.31, 95% CI 0.11 to 0.88; one trial, 100 infants). Using the GRADE approach, the evidence for respiratory distress syndrome was judged to be LOW quality. No difference was seen in the rate of admission to the neonatal intensive care unit. However, for those babies admitted, a high-dose regimen was associated with a reduction in the length of stay in the neonatal intensive care unit compared with a low-dose regimen (mean difference -3.10 days, 95% confidence interval -5.48 to -0.72).We found no data for the majority of our secondary outcomes. There are

  17. Changes in terpenoid composition of milk and cheese from commercial sheep flocks associated with seasonal feeding regimens throughout lactation.

    Science.gov (United States)

    Valdivielso, Izaskun; de Renobales, Mertxe; Aldai, Noelia; Barron, Luis Javier R

    2017-01-01

    Changes in the terpenoid content of milk and cheese from commercial sheep flocks monitored throughout lactation in the Cantabrian area of northern Spain were investigated. The flocks followed the same seasonal feeding strategy during lactation: indoor feeding in winter (early lactation) based on concentrate and forage; part-time grazing in the valley in early spring (mid lactation); and from mid spring on (late lactation), flocks were managed under extensive mountain grazing. In the present study design, seasonal feeding and lactation stage were intrinsically linked and could not be considered in isolation, and a holistic approach was necessary to consider the whole production management of the commercial flocks studied. Furthermore, the study focused on the identification of sesquiterpenoid ratios to differentiate milks and cheeses produced under extensive mountain grazing from those produced under other seasonal feeding regimens. Total abundance of mono- and sesquiterpenoids and that of individual compounds such as α-pinene, β-caryophyllene, α-humulene, α-amorphene, and γ-cadinene significantly increased in milk and cheese from indoor feeding to mountain extensive grazing. Sesquiterpenoid ratios such as γ-cadinene/α-muurolene, γ-cadinene/δ-cadinene, β-caryophyllene/α-muurolene, and (β-caryophyllene + γ-cadinene)/α-muurolene were used to differentiate mountain milks and cheeses from those from indoor feeding and part-time grazing in the valley. Multivariate discriminant analysis applied to individual terpenoids and sesquiterpenoid ratios showed milk and cheese samples classified into 2 groups: samples from indoor feeding and part-time grazing in the valley were classified together, and clearly separated from mountain milks and cheeses. The results of the present study showed that the sesquiterpenoid ratios approach could help to differentiate mountain dairy products from others obtained under other specific feeding regimens in a local environment

  18. Characterization of ovarian clear cell carcinoma using target drug-based molecular biomarkers: implications for personalized cancer therapy

    OpenAIRE

    Li, Mengjiao; Li, Haoran; Liu, Fei; Bi, Rui; Tu, Xiaoyu; Chen, Lihua; Ye, Shuang; Cheng, Xi

    2017-01-01

    Background It has long been appreciated that different subtypes (serous, clear cell, endometrioid and mucinous) of epithelial ovarian carcinoma (EOC) have distinct pathogenetic pathways. However, clinical management, especially chemotherapeutic regimens, for EOC patients is not subtype specific. Ovarian clear cell carcinoma (CCC) is a rare histological subtype of EOC, which exhibits high rates of recurrence and low chemosensitivity. We assessed potential therapeutic targets for ovarian CCC pa...

  19. [Potential role of rilpivirine in simplification regimens].

    Science.gov (United States)

    Casado, José L; Moreno, Santiago

    2013-06-01

    Antiretroviral simplification is a useful strategy to improve adherence and quality of life and prevent or reverse adverse effects in patients with HIV infection. The availability of new drugs with high efficacy and better tolerability in once-daily formulations or in fixed-dose combinations may be a better option for prolonged treatment. Rilpivirine, a new nonnucleoside reverse transcriptase inhibitor (NNRTI), has shown high antiviral efficacy in clinical trials with treatment-naïve patients, with a lower incidence of adverse effects and good tolerability. Its use in simplification regimens has been evaluated after the switch from efavirenz, demonstrating that dose adjustment is not required. In a large randomized study in patients who were receiving protease inhibitors, virological efficacy was maintained, with a lower incidence of adverse effects and improved lipid parameters and cardiovascular risk score. Given the ease of administration and good tolerability of this drug, recent communications at congresses have shown the rapid applicability of the results of studies in daily clinical practice in this scenario. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  20. Contribution of Oxazolidinones to the Efficacy of Novel Regimens Containing Bedaquiline and Pretomanid in a Mouse Model of Tuberculosis.

    Science.gov (United States)

    Tasneen, Rokeya; Betoudji, Fabrice; Tyagi, Sandeep; Li, Si-Yang; Williams, Kathy; Converse, Paul J; Dartois, Véronique; Yang, Tian; Mendel, Carl M; Mdluli, Khisimuzi E; Nuermberger, Eric L

    2015-10-26

    New regimens based on two or more novel agents are sought to shorten or simplify treatment of tuberculosis (TB). Pretomanid (PMD) is a nitroimidazole in phase 3 trials that has significant bactericidal activity alone and in combination with bedaquiline (BDQ) and/or pyrazinamide (PZA). We previously showed that the novel combination of BDQ+PMD plus the oxazolidinone sutezolid (SZD) had sterilizing activity superior to that of the first-line regimen in a murine model of TB. The present experiments compared the activity of different oxazolidinones in combination with BDQ+PMD with or without PZA in the same model. The 3-drug regimen of BDQ+PMD plus linezolid (LZD) had sterilizing activity approaching that of BDQ+PMD+SZD and superior to that of the first-line regimen. The addition of PZA further enhanced activity. Reducing the duration of LZD to 1 month did not significantly affect the activity of the regimen. Halving the LZD dose or replacing LZD with RWJ-416457 modestly reduced activity over the first month but not after 2 months. AZD5847 and tedizolid also increased the bactericidal activity of BDQ+PMD, but they were less effective than the other oxazolidinones. These results provide optimism for safe, short-course oral regimens for drug-resistant TB that may also be superior to the current first-line regimen for drug-susceptible TB. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  1. Assessment of two emergency contraceptive regimens in Iran ...

    African Journals Online (AJOL)

    allocated in levonorgestrol group (n=62) andYuzpe (n=60).The levonorgestrel regimen consisted of two pills: 0.75 mg levonorgestrel, taken twice in the 12-h interval within 72h after unprotected intercourse. The Yuzpe method included twoHDcontraceptive pills taken as another regimen.Datawere collected by questionnaire ...

  2. The Sex Res Non Naturales and the Regimen of Health

    DEFF Research Database (Denmark)

    Agerholm, Frank Juul

    The paper discusses the ethical and social soundness of the classical idea of diaita/regimen vis-à-vis the contemporary focus on healthy lifestyle......The paper discusses the ethical and social soundness of the classical idea of diaita/regimen vis-à-vis the contemporary focus on healthy lifestyle...

  3. Intranasal capsaicin reduces nasal hyperreactivity in idiopathic rhinitis: a double-blind randomized application regimen study

    NARCIS (Netherlands)

    van Rijswijk, J. B.; Boeke, E. L.; Keizer, J. M.; Mulder, P. G. H.; Blom, H. M.; Fokkens, W. J.

    2003-01-01

    BACKGROUND: In a recent study, we showed that intranasal capsaicin spray gives a significant and long-term reduction of symptoms in nonallergic noninfectious perennial rhinitis patients. However, in daily practice, the studied application regimen proved to be impractical because of the large number

  4. Thalidomide-based induction regimens are as effective as bortezomib-based regimens in elderly patients with multiple myeloma with cereblon expression.

    Science.gov (United States)

    Jung, Sung-Hoon; Choi, Hyun-Jung; Shin, Myung-Geun; Lee, Seung-Shin; Hwang, Eu Chang; Jung, Tae-Young; Cho, Min-Seok; Yang, Deok-Hwan; Ahn, Jae-Sook; Kim, Yeo-Kyeoung; Kim, Hyeoung-Joon; Lee, Je-Jung

    2016-10-01

    Cereblon (CRBN) has been identified as a primary target of immunomodulatory drugs and is considered a biomarker for the prediction of outcomes after thalidomide- or lenalidomide-based treatments. In this study, we evaluated CRBN expression in bone marrow (BM) tissue at diagnosis and investigated the relationship between CRBN expression and treatment outcomes after thalidomide- or bortezomib-based front-line therapies in 89 elderly patients with multiple myeloma (MM). CRBN expression at the time of diagnosis was evaluated with immunohistochemical (IHC) staining for myeloma cells in paraffin wax-embedded BM tissue. CRBN-immunostained slides were scored by intensity and diffuseness, and a total score of >6 was defined as CRBN-positive (CRBN(+)). Thirty-eight patients (45.2 %) were CRBN(+). Among patients treated with thalidomide-based regimens, CRBN(+) patients showed a better treatment response than did CRBN-negative patients (35.0 vs. 11.8 % complete response rate, respectively; HR = 4.038, P = 0.137). During a median follow-up of 31.8 months, patients treated with bortezomib-based regimens had a longer time to progression (TTP) than did patients treated with thalidomide-based regimens (15.6 vs. 13.2 months, respectively; P = 0.047), but early mortality occurred frequently in patients treated with bortezomib-based regimens. Additionally, there was no significant difference in survival outcomes between thalidomide- and bortezomib-based regimens in CRBN(+) patients (median TTP, 13.8 vs. 15.6 months, respectively; P = 0.842 and median OS, 39.3 vs. 30.1 months, respectively; P = 0.074). These data suggest that thalidomide-based regimens are as effective as bortezomib-based regimens in elderly patients with MM who are CRBN(+). Thus, CRBN positivity, by IHC staining, may be useful in deciding appropriate treatment options in elderly patients with MM.

  5. Cost-Utility Analysis of IEV Drug Regimen Versus ESHAP Drug Regimen for the Patients With Relapsed and Refractory Hodgkin and Non-Hodgkin’s Lymphoma in Iran

    Science.gov (United States)

    Hatam, Nahid; Dehghani, Mehdi; Habibian, Mostafa; Jafari, Abdosaleh

    2015-01-01

    Background: Chemotherapy for lymph nodes cancer is often composed of several drugs that are used in a treatment program. Objectives: The aim of this study was to perform a cost-utility analysis of IEV regimen (ifosfamide, epirubicin and etoposide) versus ESHAP regimen (etoposide, methylprednisolone, high-dose cytarabine, and cisplatin) in patients with lymphoma in the south of Iran. Patients and Methods: This was a cost-utility analysis done as a cross-sectional study in the south of Iran. Using decision tree, expected costs, quality -adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) were estimated. In addition, the robustness of results was examined by sensitivity analysis. Results: The results of this study indicated that the total lymphoma patients were about 65 people that 27 patients received IEV regimen and 38 patients ESHAP (43 patients with Hodgkin’s and 22 with non-Hodgkin lymphoma). The results of decision tree showed that in the IEV arm, the expected cost was $20952.93 and the expected QALYs was 3.89 and in the ESHAP arm, the expected cost was $31691.74 and the expected QALYs was 3.86. Based on the results of the study, IEV regimen was cost-effective alternative to the ESHAP regimen. Conclusions: According to the results of this study, it is recommended that oncologists use IEV instead of ESHAP in the treatment of patients with lymphoma and because of high costs of IEV drug costs, it is suggested that IEV drugs should be covered by insurance. PMID:26634115

  6. Durability of the first combined antiretroviral regimen in patients with AIDS at a reference center in Belo Horizonte, Brazil, from 1996 to 2005.

    Science.gov (United States)

    Ribeiro, Flávia Andrade; Tupinambás, Unaí; Fonseca, Marise Oliveira; Greco, Dirceu Bartolomeu

    2012-01-01

    Finding a better first antiretroviral regimen is one of the strategies used to improve span and quality of life of HIV/AIDS patients. 891 patients were followed during 24 months or until interruption/abandonment of treatment, changing regimen or death. At the end of 6 months, 69% of the patients were still being treated with the first regimen, 54% at 12 months, 48% at 18 months and 39% at 24 months. AZT-3TC-EFV was the most prescribed regimen and with the lesser discontinuation. NNRTI regimens showed high effectiveness and durability compared to PI regimens. Irregular medication dispensation was the only risk factor for failure/interruption of treatment in multivariate analyses. Intolerance/adverse effects were mainly responsible for first regimen discontinuation, followed by abandonment/non-adherence and virologic failure. Results showed significant difference between causes of interruption of first HAART with higher percentage of intolerance/adverse effects with PI regimens and higher immunologic failure with NNRTI regimens. Even with the availability of more potent and tolerable drugs, lack of adherence to HAART and high level of adverse effects are still the most important barriers to prolonged success of treatment. This study adds relevant information about durability and effectiveness of HAART in the first decade of its use in Brazil.

  7. Durability of the first combined antiretroviral regimen in patients with AIDS at a reference center in Belo Horizonte, Brazil, from 1996 to 2005

    Directory of Open Access Journals (Sweden)

    Flávia Andrade Ribeiro

    Full Text Available Finding a better first antiretroviral regimen is one of the strategies used to improve span and quality of life of HIV/AIDS patients. 891 patients were followed during 24 months or until interruption/abandonment of treatment, changing regimen or death. At the end of 6 months, 69% of the patients were still being treated with the first regimen, 54% at 12 months, 48% at 18 months and 39% at 24 months. AZT-3TC-EFV was the most prescribed regimen and with the lesser discontinuation. NNRTI regimens showed high effectiveness and durability compared to PI regimens. Irregular medication dispensation was the only risk factor for failure/interruption of treatment in multivariate analyses. Intolerance/adverse effects were mainly responsible for first regimen discontinuation, followed by abandonment/non-adherence and virologic failure. Results showed significant difference between causes of interruption of first HAART with higher percentage of intolerance/adverse effects with PI regimens and higher immunologic failure with NNRTI regimens. Even with the availability of more potent and tolerable drugs, lack of adherence to HAART and high level of adverse effects are still the most important barriers to prolonged success of treatment. This study adds relevant information about durability and effectiveness of HAART in the first decade of its use in Brazil.

  8. Comparison of skin optical clearing by different drug delivery method

    Energy Technology Data Exchange (ETDEWEB)

    Mao, Z; Ge, X [Department of Fundamental Theories, Shandong Sports University, Jinan, 250102 (China); Li, E, E-mail: mm73@163.com [Institute of Physical Education, Huazhong Normal University, Wuhan, 430079 (China)

    2011-01-01

    Previous studies have shown that optical clearing techniques have great potential for optical diagnosis and therapy. In order to further discuss the effect by different drug delivery method, diffusion chambers were used to simulate in vivo physiological environment; and the optical clearing agents were acted on the surface of porcine skin, the saline was contacted with the dermal side (epidermal application). Then they were compared with the traditional method-samples immersed in the optical clearing agents (mainly dermal immersion). The transmission intensity of skin was monitored by an integrating sphere system. The changes in thickness were measured before and after experiments. The results showed that the optical clearing effect and the changes in thickness are not coincident under the two different methods. It indicates that the optical clearing effect and mechanism may relate to the drug delivery method.

  9. Trastuzumab containing regimens for early breast cancer.

    Science.gov (United States)

    Moja, Lorenzo; Tagliabue, Ludovica; Balduzzi, Sara; Parmelli, Elena; Pistotti, Vanna; Guarneri, Valentina; D'Amico, Roberto

    2012-04-18

    Approximately one-fifth of women who develop early breast cancer have HER2-positive tumours, which if untreated, have a worse prognosis than HER2-negative tumours. Trastuzumab is a selective treatment targeting the HER2 pathway. Although the results on efficacy seem to support its use, there are potential cardiac toxicities which need to be considered, especially for women at lower risk of recurrence, or those at increased cardiovascular risk. To assess the evidence on the efficacy and safety of therapy with trastuzumab, overall and in relation to its duration, concurrent or sequential administration with the standard chemotherapy regimen in patients with HER2-positive early breast cancer. We searched the Cochrane Breast Cancer Group's (CBCGs) Specialised Trials Register, and used the search strategy developed by the CBCG to search for randomised controlled trials (RCTs) in CENTRAL, MEDLINE, EMBASE, BIOSIS, TOXNET, and the WHO ICTRP search portal (up to February 2010). RCTs comparing the efficacy and safety of trastuzumab alone, or in combination with chemotherapy, or no treatment, or standard chemotherapy alone, in women with HER2-positive early breast cancer including women with locally advanced breast cancer. We collected data from published and unpublished trials. We used hazard ratios (HRs) for time-to-event outcomes and risk ratio (RRs) for binary outcomes. Subgroup analyses included duration (less or greater than six months) and concurrent or sequential trastuzumab administration. We included eight studies involving 11,991 patients. The combined HRs for overall survival (OS) and disease-free survival (DFS) significantly favoured the trastuzumab-containing regimens (HR 0.66; 95% confidence interval (CI) 0.57 to 0.77, P < 0.00001; and HR 0.60; 95% CI 0.50 to 0.71, P < 0.00001, respectively). Trastuzumab significantly increased the risk of congestive heart failure (CHF: RR 5.11; 90% CI 3.00 to 8.72, P < 0.00001); and left ventricular ejection fraction decline

  10. Pharmacokinetics of cyclophosphamide and thiotepa in a conventional fractionated high-dose regimen compared with a novel simplified unfractionated regimen

    NARCIS (Netherlands)

    Ekhart, Corine; Rodenhuis, Sjoerd; Beijnen, Jos H.; Huitema, Alwin D. R.

    2009-01-01

    High-dose alkylating chemotherapy with cyclophosphamide (4000 or 6000 mg/m2) and thiotepa (320 or 480 mg/m2) has commonly been administered in a fractionated regimen over 4 days. A simplified unfractionated regimen would be preferable, especially because cyclophosphamide and thiotepa have been shown

  11. Hybrid clear cell odontogenic carcinoma and ameloblastic ...

    African Journals Online (AJOL)

    Clear cell odontogenic carcinoma (CCOC) which was previously designated clear cell odontogenic tumor also exhibits an aggressive biologic behavior and a tendency to metastasize to distant locations. Both lesions are rare. We report an odontogenic carcinoma with a dual histomorphologic feature of CCOC and AC ...

  12. Acoustics of Clear Speech: Effect of Instruction

    Science.gov (United States)

    Lam, Jennifer; Tjaden, Kris; Wilding, Greg

    2012-01-01

    Purpose: This study investigated how different instructions for eliciting clear speech affected selected acoustic measures of speech. Method: Twelve speakers were audio-recorded reading 18 different sentences from the Assessment of Intelligibility of Dysarthric Speech (Yorkston & Beukelman, 1984). Sentences were produced in habitual, clear,…

  13. Hybrid clear cell odontogenic carcinoma and ameloblastic ...

    African Journals Online (AJOL)

    Ameloblastic carcinoma (AC) produces extensive local destruction, perforation of the cortical plate, extension into surrounding soft tissues, numerous recurrent lesions, and metastasis, usually to cervical lymph nodes. Clear cell odontogenic carcinoma (CCOC) which was previously designated clear cell odontogenic tumor ...

  14. Chemical Literature Exercises and Resources (CLEAR).

    Science.gov (United States)

    Hostettler, John D.; And Others

    These materials were developed to make the structure and use of the chemical literature clear to chemistry students and to help them become independent and intelligent users of the library. The design of Chemical Literature Exercises and Resources (CLEAR) includes a users' note and five main parts: introduction to chemical literature, chemical…

  15. 17 CFR 256.184 - Clearing accounts.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Clearing accounts. 256.184 Section 256.184 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) UNIFORM... COMPANY ACT OF 1935 4. Deferred Debits § 256.184 Clearing accounts. This account shall include...

  16. 27 CFR 9.99 - Clear Lake.

    Science.gov (United States)

    2010-04-01

    ...) Boundaries. The Clear Lake viticultural area is located in southwestern Lake County, California. The....S. maps. The maps are titled as follows: (1) “Lower Lake Quadrangle, California,” 15 minute series... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Clear Lake. 9.99 Section 9...

  17. Internalization, Clearing and Settlement, and Liquidity

    NARCIS (Netherlands)

    Degryse, H.A.; van Achter, M.; Wuyts, G.

    2012-01-01

    Abstract: We study the relation between liquidity in financial markets and post-trading fees (i.e. clearing and settlement fees). The clearing and settlement agent (CSD) faces different marginal costs for different types of transactions. Costs are lower for an internalized transaction, i.e. when

  18. 220 AUTOMATED CLEARING SYSTEM AND THE BANKING ...

    African Journals Online (AJOL)

    clearing system. The result revealed that automated clearing system has a significant positive impact on the general payment system. The paper concludes that the post NACS era is more efficient and hence we recommend the ..... Nzotta S.M. (2004) Money Banking and Finance: Theory and Practice Bon Publishers. Owerri.

  19. Clear cell carcinoma of the palate.

    Science.gov (United States)

    Grenevicki, L F; Barker, B F; Fiorella, R M; Mosby, E L

    2001-10-01

    A case of minor salivary gland clear cell adenocarcinoma of the palate with metastasis to the lungs in a 53-year-old female is presented. Histologically, the cells were characterized by glycogen rich clear cells arranged in solid nests, trabeculae, surrounded by hyalinized fibrous stroma. We believe this represents an aggressive form of this type of tumor.

  20. SNOW CLEARING SERVICE WINTER 2001-2002

    CERN Multimedia

    ST-HM Group; Tel. 72202

    2001-01-01

    As usual at this time of the year, the snowing clearing service, which comes under the control of the Transport Group (ST-HM), is preparing for the start of snow-clearing operations (timetable, stand-by service, personnel responsible for driving vehicles and machines, preparation of useful and necessary equipment, work instructions, etc.) in collaboration with the Cleaning Service (ST-TFM) and the Fire Brigade (TIS-FB). The main difficulty for the snow-clearing service is the car parks, which cannot be properly cleared because of the presence of CERN and private vehicles parked there overnight in different parts of the parking areas. The ST-HM Transport Group would therefore like to invite you to park vehicles together in order to facilitate the access of the snow ploughs, thus allowing the car parks to be cleared more efficiently before the personnel arrives for work in the mornings.

  1. Esomeprazole regimens for reflux symptoms in Chinese patients with chronic gastritis.

    Science.gov (United States)

    Sun, Jing; Yuan, Yao-Zong; Hou, Xiao-Hua; Zou, Duo-Wu; Lu, Bin; Chen, Min-Hu; Liu, Fei; Wu, Kai-Chun; Zou, Xiao-Ping; Li, Yan-Qing; Zhou, Li-Ya

    2015-06-14

    To compare symptom control with esomeprazole regimens for non-erosive reflux disease and chronic gastritis in patients with a negative endoscopy. This randomized, open-label study was designed in line with clinical practice in China. Patients with typical reflux symptoms for ≥ 3 mo and a negative endoscopy who had a Gastroesophageal Reflux Disease Questionnaire score ≥ 8 were randomized to initial treatment with esomeprazole 20 mg once daily either for 8 wk or for 2 wk. Patients with symptom relief could enter another 24 wk of maintenance/on-demand treatment, where further courses of esomeprazole 20 mg once daily were given if symptoms recurred. The primary endpoint was the symptom control rate at week 24 of the maintenance/on-demand treatment period. Secondary endpoints were symptom relief rate, success rate (defined as patients who had symptom relief after initial treatment and after 24 wk of maintenance treatment), time-to-first-relapse and satisfaction rate. Based on the data collected in the modified intention-to-treat population (MITT; patients in the ITT population with symptom relief after initial esomeprazole treatment, n = 262), the symptom control rate showed a small but statistically significant difference in favor of the 8-wk regimen (94.9% vs 87.3%, P = 0.0473). Among the secondary endpoints, based on the data collected in the ITT population (n = 305), the 8-wk group presented marginally better results in symptom relief after initial esomeprazole treatment (88.3% vs 83.4%, P = 0.2513) and success rate over the whole study (83.8% vs 72.8%, P = 0.0258). The 8-wk regimen was found to provide a 46% reduction in risk of relapse vs the 2-wk regimen (HR = 0.543; 95%CI: 0.388-0.761). In addition, fewer unscheduled visits and higher patient satisfaction supported the therapeutic benefits of the 8-wk regimen over the 2-wk regimen. Safety was comparable between the two groups, with both regimens being well tolerated. Chinese patients diagnosed with chronic

  2. Olanzapine-Based Triple Regimens Versus Neurokinin-1 Receptor Antagonist-Based Triple Regimens in Preventing Chemotherapy-Induced Nausea and Vomiting Associated with Highly Emetogenic Chemotherapy: A Network Meta-Analysis.

    Science.gov (United States)

    Zhang, Zhonghan; Zhang, Yaxiong; Chen, Gang; Hong, Shaodong; Yang, Yunpeng; Fang, Wenfeng; Luo, Fan; Chen, Xi; Ma, Yuxiang; Zhao, Yuanyuan; Zhan, Jianhua; Xue, Cong; Hou, Xue; Zhou, Ting; Ma, Shuxiang; Gao, Fangfang; Huang, Yan; Chen, Likun; Zhou, Ningning; Zhao, Hongyun; Zhang, Li

    2018-01-12

    The current antiemetic prophylaxis for patients treated with highly emetogenic chemotherapy (HEC) included the olanzapine-based triplet and neurokinin-1 receptor antagonists (NK-1RAs)-based triplet. However, which one shows better antiemetic effect remained unclear. We systematically reviewed 43 trials, involving 16,609 patients with HEC, which compared the following antiemetics at therapeutic dose range for the treatment of chemotherapy-induced nausea and vomiting: olanzapine, aprepitant, casopitant, fosaprepitant, netupitant, and rolapitant. The main outcomes were the proportion of patients who achieved no nausea, complete response (CR), and drug-related adverse events. A Bayesian network meta-analysis was performed. Olanzapine-based triple regimens showed significantly better no-nausea rate in overall phase and delayed phase than aprepitant-based triplet (odds ratios 3.18, 3.00, respectively), casopitant-based triplet (3.78, 4.12, respectively), fosaprepitant-based triplet (3.08, 4.10, respectively), rolapitant-based triplet (3.45, 3.20, respectively), and conventional duplex regimens (4.66, 4.38, respectively). CRs of olanzapine-based triplet were roughly equal to different NK-1RAs-based triplet but better than the conventional duplet. Moreover, no significant drug-related adverse events were observed in olanzapine-based triple regimens when compared with NK-1RAs-based triple regimens and duplex regimens. Additionally, the costs of olanzapine-based regimens were obviously much lower than the NK-1RA-based regimens. Olanzapine-based triplet stood out in terms of nausea control and drug price but represented no significant difference of CRs in comparison with NK-1RAs-based triplet. Olanzapine-based triple regimens should be an optional antiemetic choice for patients with HEC, especially those suffering from delayed phase nausea. According to the results of this study, olanzapine-based triple antiemetic regimens were superior in both overall and delayed

  3. Primary clear cell sarcoma of rib

    Energy Technology Data Exchange (ETDEWEB)

    Hersekli, Murat Ali [Baskent University Medical Faculty, Department of Orthopedics and Traumatology, Adana (Turkey); Baskent University Medical Faculty, Adana Medical Center, Yuregir Adana (Turkey); Ozkoc, Gurkan; Akpinar, Sercan; Ozalay, Metin; Tandogan, Reha N. [Baskent University Medical Faculty, Department of Orthopedics and Traumatology, Adana (Turkey); Bircan, Sema [Suleyman Demirel University Medical Faculty, Department of Pathology, Adana (Turkey); Tuncer, Ilhan [Baskent University Medical Faculty, Department of Pathology, Adana (Turkey)

    2005-03-01

    Clear cell sarcoma (malignant melanoma of soft tissues) is a very rare soft tissue neoplasm. It generally arises in tendons and aponeuroses. Although metastasis of malignant melanoma to bone is not uncommon, primary clear cell sarcoma of bone is an extremely rare neoplasm. To our knowledge five cases have been reported in the English literature. We present a case of primary clear cell sarcoma of bone in a 28-year-old woman arising in the left ninth rib. We treated the patient with total excision of the mass and postoperative radiotherapy. The patient is alive and well without local recurrence or distant metastasis at 33 months after surgery. (orig.)

  4. High Altitude Clear Air Turbulence Project

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Air Force Flight Dynamics Laboratory conducted the High Altitude Clear Air Turbulence Project in the mid 1960s with the intention of better understanding air...

  5. Clear corneal incision in cataract surgery.

    Science.gov (United States)

    Al Mahmood, Ammar M; Al-Swailem, Samar A; Behrens, Ashley

    2014-01-01

    Since the introduction of sutureless clear corneal cataract incisions, the procedure has gained increasing popularity worldwide because it offers several advantages over the traditional sutured scleral tunnels and limbal incisions. Some of these benefits include lack of conjunctival trauma, less discomfort and bleeding, absence of suture-induced astigmatism, and faster visual rehabilitation. However, an increasing incidence of postoperative endophthalmitis after clear corneal cataract surgery has been reported. Different authors have shown a significant increase up to 15-fold in the incidence of endophthalmitis following clear corneal incision compared to scleral tunnels. The aim of this report is to review the advantages and disadvantages of clear corneal incisions in cataract surgery, emphasizing on wound construction recommendations based on published literature.

  6. Clear-cell chondrosarcoma of the humerus

    OpenAIRE

    Elojeimy, Saeed; Ahrens, William A.; Howard, Brian; Patt, Joshua C.; Stone, Taylor; Kneisl, Jeffrey S.; Bhargava, Puneet

    2015-01-01

    Clear-cell chondrosarcoma is a rare, low-grade variant of chondrosarcoma characterized by slow growth, low metastatic potential, and a predilection for local recurrence long after treatment. We report an unusually aggressive case of clear-cell chondrosarcoma of the humerus with early metastasis to multiple bony sites including femur, thoracic and lumbar spine, sacrum, and iliac bone. Our purpose is to alert physicians to the sarcoma's potential for aggressive behavior, necessitating closer an...

  7. CO2 efflux from cleared mangrove peat.

    Directory of Open Access Journals (Sweden)

    Catherine E Lovelock

    Full Text Available BACKGROUND: CO(2 emissions from cleared mangrove areas may be substantial, increasing the costs of continued losses of these ecosystems, particularly in mangroves that have highly organic soils. METHODOLOGY/PRINCIPAL FINDINGS: We measured CO(2 efflux from mangrove soils that had been cleared for up to 20 years on the islands of Twin Cays, Belize. We also disturbed these cleared peat soils to assess what disturbance of soils after clearing may have on CO(2 efflux. CO(2 efflux from soils declines from time of clearing from ∼10,600 tonnes km(-2 year(-1 in the first year to 3000 tonnes km(2 year(-1 after 20 years since clearing. Disturbing peat leads to short term increases in CO(2 efflux (27 umol m(-2 s(-1, but this had returned to baseline levels within 2 days. CONCLUSIONS/SIGNIFICANCE: Deforesting mangroves that grow on peat soils results in CO(2 emissions that are comparable to rates estimated for peat collapse in other tropical ecosystems. Preventing deforestation presents an opportunity for countries to benefit from carbon payments for preservation of threatened carbon stocks.

  8. Chemotherapy Regimen Extends Survival in Advanced Pancreatic Cancer Patients

    Science.gov (United States)

    A four-drug chemotherapy regimen has produced the longest improvement in survival ever seen in a phase III clinical trial of patients with metastatic pancreatic cancer, one of the deadliest types of cancer.

  9. Impacts of 12-dose regimen for latent tuberculosis infection: Treatment completion rate and cost-effectiveness in Taiwan.

    Science.gov (United States)

    Huang, Yi-Wen; Yang, Shun-Fa; Yeh, Yen-Po; Tsao, Thomas Chang-Yao; Tsao, Shih-Ming

    2016-08-01

    Treatment of latent tuberculosis infection (LTBI) is essential for eradicating tuberculosis (TB). Moreover, the patient adherence is crucial in determining the effectiveness of TB control. Isoniazid given by DOTS daily for 9 months (9H) is the standard treatment for LTBI in Taiwan. However, the completion rate is low due to the long treatment period and its side effects. The combined regimen using a high dose of rifapentine/isoniazid once weekly for 12 weeks (3HP) has been used as an alternative treatment option for LTBI in the United States. This may result in a higher completion rate. In this pilot study, patient adherence and cost of these 2 treatment regimens were investigated. Thus, we aimed to assess the treatment completion rate and costs of 3HP and compare to those with 9H.Data from 691 cases of LTBI treatments including 590 cases using the conventional regimen and 101 cases with rifapentine/Isoniazid were collected. The cost was the sum of the cost of treatment with Isoniazid for 9 months or with rifapentin/Isoniazid for 3 months of all contacts. The effectiveness was the cost of cases of tuberculosis avoided.In this study, the treatment completion rate for patients prescribed with the 3 months rifapentine/isoniazid regimen (97.03%) was higher than those given the conventional 9-month isoniazid regimen (87.29%) (P rifapentine/isoniazid regimen due to undesirable side effects.This was the first study to compare the 2 treatment regimens in Taiwan, and it showed that a short-term high-dosage rifapentine/isoniazid treatment regimen reduced costs and resulted in higher treatment completion than the standard LTBI isoniazid treatment.

  10. COMPARISON OF EFFICACY AND FETOMATERNAL OUTCOME WITH LOW DOSE AND STANDARD PRITCHARD’S REGIMEN OF MAGNESIUM SULPHATE IN ECLAMPSIA

    Directory of Open Access Journals (Sweden)

    Nirmala Chamakuri

    2017-11-01

    Full Text Available BACKGROUND Eclampsia, a hypertensive disorder of pregnancy is a common obstetric emergency, which leads to significant maternal morbidity, perinatal morbidity and mortality. The Pritchard’s regimen of magnesium sulphate remains as the standard regimen worldwide. The aim of this study is to compare the effectiveness, side effects and fetomaternal outcome using low-dose magnesium sulphate with the results of Pritchard regime. MATERIALS AND METHODS A comparative prospective study including 120 eclampsia patients designed into group I and group II treated with low-dose magnesium sulphate and Pritchard’s regimen was conducted in the Department of Obstetrics and Gynaecology for a period of 18 months between January 2015 to June 2016. RESULTS In the present study, there was 100% control of seizures in both the groups. No recurrence of seizures were seen in 57 (95% of cases in group II (low-dose regimen and 3 (5% cases showed recurrence, which were controlled by giving additional doses. In group II, loss of patellar reflexes was seen in 6 (10%, reduced urine output was seen in 3 (5% of cases, mild PPH was observed in 3 (5% cases and perinatal mortality in 18 (30% cases, which were lower than that of group I (Pritchard’s regimen. CONCLUSION Low-dose magnesium sulphate is effective in controlling convulsions in eclampsia. This regimen is highly suitable for use in Indian women who are known to have low body mass index

  11. A comparison of sedation-related events for two multiagent oral sedation regimens in pediatric dental patients.

    Science.gov (United States)

    McCormack, Laura; Chen, Jung-Wei; Trapp, Larry; Job, Allen

    2014-01-01

    This study compared the incidence of adverse sedation-related events occurring with two different multiagent oral sedation regimens in pediatric dental patients. Forty healthy patients (three to six years old), received either a sedation regimen of chloral hydrate, meperidine, and hydroxyzine with nitrous oxide (CH/M/H/N2O; N=19) or a regimen of midazolam, meperidine, and hydroxyzine with nitrous oxide (MZ/M/H/N2O; N=21). The two treating dentists answered a questionnaire regarding the perioperative period. Parents received two phone interviews at eight and 24 hours after sedation. Statistical analysis included chi-square, Pearson correlation coefficient, and t-test (Phours after discharge. Children sedated with CH/M/H/N2O showed a significant increase in frequency of sleeping, talking less than normal after arriving home, and an increased need for postoperative pain medication. Different oral sedation regimens produce different adverse sedation-related events. The provider of pediatric oral sedation should select a sedative regimen with an adverse sedation-related profile that he/she believes is optimal for the patient being treated. Parents should be counseled as to possible postsedation effects anticipated based on the sedative regimen administered.

  12. 76 FR 47529 - Customer Clearing Documentation and Timing of Acceptance for Clearing; Correction

    Science.gov (United States)

    2011-08-05

    ... From the Federal Register Online via the Government Publishing Office COMMODITY FUTURES TRADING COMMISSION 17 CFR Parts 1, 23, and 39 RIN 3038-AD51 Customer Clearing Documentation and Timing of Acceptance... August 1, 2011, regarding Customer Clearing Documentation and Timing of Acceptance for Clearing. FOR...

  13. Clear plastic cups: a childhood choking hazard.

    Science.gov (United States)

    Weiss, R L; Goldstein, M N; Dharia, A; Zahtz, G; Abramson, A L; Patel, M

    1996-11-01

    The disposable plastic beverage cup is not usually regarded as hazardous to young children. Certain varieties of these products however, are manufactured from a brittle, clear plastic that easily cracks and fragments. While most conscientious parents keep their children safe from peanuts, balloons, and other known choking hazards, a child can surreptitiously bite a cup edge and aspirate the fragment. We report two cases of foreign body aspiration involving clear plastic cups that went undetected one of which remained 21 months following a negative rigid bronchoscopy. Diagnostic difficulties are related to the transparency and radiolucency of these objects. When suspicious of foreign body aspiration in children, otolaryngologists should inquire about the availability of clear plastic cups in the household and be mindful of the diagnostic pitfalls. Further investigations including CT scanning and repeat bronchoscopy may be helpful in cases of suspected missed foreign bodies. An educational campaign aimed at prevention and placement of product package warning labels should be established.

  14. Dissolved oxygen regimen (PO2 may affect osmorespiratory compromise in European sea bass (Dicentrarchus labrax, L.

    Directory of Open Access Journals (Sweden)

    Genciana Terova

    2010-02-01

    Full Text Available Fundamentally, in land based mediterranean aquaculture, two techniques are applied to supply water with oxygen: paddling water aeration and application of pure oxygen. The two oxygenation techniques result in quite different PO2 regimens and, consequently, different fish growth performance and gill morphology. Data exist showing a reduction in total respiratory surface (RSA and increasing gas diffusion distance (GDD in gills of sea bass (Dicentrarchus labrax, L. farmed under elevated PO2 regimens. That such a modification might have an effect on the ion regulation has been defined elsewhere as osmorespiratory compromise. In this study, European sea bass previously acclimatized to two PO2 regimens, mild hypoxia and mild hyperoxia (70-80% and 130-140% of the saturation value, respectively, were challenged for 1 hour with hypo-osmotic plus manipulation stress in two separate trials. During the first trial, when only Na+ loss was determined, the ion efflux during the first 5 min resulted in a rate of 163.72±31 and 112.23±87 nmol g-1min-1 from hypoxia and hyperoxia sea bass groups, respectively, and, if sustained, would approach 15.3 and 11.2% per hour of the total body Na+, respectively. During the second trial, in which both Na+ and Cl- loss were determined, after 60 min the Na+ loss was shown to be 76.86±12 and 179.28±32 nmol g-1 min-1 for the fish previously acclimatized to hyperoxia and hypoxia regimens, respectively, whereas for Cl- this loss was 62.02±11 and 157.28±28 nmol g-1min-1, respectively. Our data are compatible with the hypothesis of an osmotic advantage of sea bass exposed to an elevated PO2 regimen, achievable with application of pure oxygen, instead of simple water aeration.

  15. Practical regimen for amiodarone use in preventing postoperative atrial fibrillation.

    Science.gov (United States)

    Zebis, Lars R; Christensen, Thomas D; Thomsen, Henrik F; Mikkelsen, Martin M; Folkersen, Lars; Sørensen, Henrik T; Hjortdal, Vibeke E

    2007-04-01

    Postoperative atrial fibrillation occurs in 5% to 65% of patients undergoing cardiac surgery. Although postoperative atrial fibrillation is often regarded as a temporary, benign, operation-related problem, it is associated with a twofold to threefold increase in risk of adverse events, including permanent or transient stroke, acute myocardial infarction, and death. This randomized, controlled, double-blinded trial included 250 eligible consecutively enrolled patients undergoing coronary artery bypass grafting (CABG). They received 300 mg of amiodarone/placebo administered intravenously over 20 minutes on the first postoperative day and an oral dose of 600 mg of amiodarone or placebo twice daily for the first 5 postoperative days. The patients in amiodarone prophylaxis experienced a reduction in risk of atrial fibrillation of 14% (95% confidence interval [CI], 5.0% to 24%), with the number needed to treat at 6.9 (95% CI, 4.2 to 20), and the results for symptomatic atrial fibrillation showed a risk reduction of 18% (95% CI, 9.4% to 26), with the number needed to treat at 5.7 (95% CI, 3.9 to 11). Of the patients who developed atrial fibrillation in the placebo group, 84% experienced a symptomatic attack versus only 43% in the amiodarone group. Postoperative prophylaxis with a high dose of oral amiodarone after an intravenous bolus infusion is a safe, practical, feasible, and effective regimen for CABG patients. It significantly diminishes the occurrence of postoperative atrial fibrillation.

  16. Geophysical study of the Clear Lake region, California

    Energy Technology Data Exchange (ETDEWEB)

    Chapman, R.H.

    1975-01-01

    Results of geophysical studies in the Clear Lake region of California, north of San Francisco, have revealed a prominent, nearly circular negative gravity anomaly with an amplitude of more than 25 milligals (mgal) and an areal extent of approximately 250 square miles and, in addition, a number of smaller positive and negative anomalies. The major negative gravity anomaly is closely associated with the Clear Lake volcanic field and with an area characterized by hot springs and geothermal fields. However, the anomaly cannot be explained by mapped surface geologic features of the area. Aeromagnetic data in the Clear Lake region show no apparent correlation with the major negative gravity anomaly; the local magnetic field is affected principally by serpentine. An electrical resistivity low marks the central part of the gravity minimum, and a concentration of earthquake epicenters characterizes the Clear Lake volcanic field area. The primary cause of the major negative gravity anomaly is believed to be a hot intrusive mass, possibly a magma chamber, that may underlie the Clear Lake volcanic field and vicinity. This mass may serve as a source of heat for the geothermal phenomena in the area. Other smaller gravity anomalies in the Clear Lake region are apparently caused by near-surface geologic features, including relatively dense units of the Franciscan Formation and less dense Cenozoic sedimentary and volcanic rock units.

  17. Efficacy and Tolerability of Tenofovir Disoproxil Fumarate Based Regimen as Compared to Zidovudine Based Regimens: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Tegene Legese Dadi

    2017-01-01

    Full Text Available Background. Although tenofovir (TDF/emtricitabine (FTC/efavirenz (EFV and zidovudine (ZDV/lamivudine (3TC/efavirenz (EFV are used as preferred first line regimen, their head-to-head comparison in terms of their efficacy and tolerability was limited. This review aimed to synthesize the best available evidence on the comparative efficacy and tolerability of the two regimens. Methods. Seven sites and databases in addition to Google search until August 20, 2016, were searched. Only randomized clinical trials conducted on adult population were included in this study. Our primary outcome was viral load suppression while secondary outcomes were death and tolerability. Undetectable viral load is defined as <50 Human Immunodeficiency Virus (HIV ribonucleic acid (RNA copies/ml. Joanna Briggs institute meta-analysis of statistics assessment and review instrument (JBI-MAStARI and critical appraisal and data extraction tool were applied for critical assessment and data extraction, respectively. We performed a random effect meta-analysis to pool the relative risk (RR for viral load suppression (<50 HIV RNA copies/ml and <400 HIV RNA copies/ml, tolerability, and death. Result. Data was extracted from four articles, which included a total of 2381 participants. We found superior viral load suppression among tenofovir (TDF arm compared to zidovudine (ZDV arm. Tenofovir arm achieves viral load <50 HIV RNA copies/ml (RR = 1.12, 95% confidence interval (CI [1.04, 1.21], I2=0% higher than zidovudine arm. Similarly TDF arm is superior in viral load suppression to <400 HIV RNA copies/ml (RR = 1.19, 95% CI [1.11, 1.27], I2=0%. Moreover, TDF based regimens were more likely to be tolerated than ZDV based regimens (4 trials, 2381 participants (RR = 1.06, 95% CI [1.02, 1.10], I2=51%. However, forest plot of death shows that it was not significant (RR = 0.91, 95% CI [0.51, 1.62]. Conclusion. The use of TDF/FTC/EFV as first line regimen for naïve HIV-1 infected adult patient

  18. Clear cell odontogenic carcinoma: a diagnostic and therapeutic dilemma

    Directory of Open Access Journals (Sweden)

    Rakheja Dinesh

    2006-12-01

    Full Text Available Abstract Background Clear cell odontogenic carcinoma is a rare odontogenic tumor occurring in the anterior region of the mandible in 5th–7th decades and shows a female preponderance. It is potentially aggressive, capable of frequent recurrences and loco-regional and distant metastases. Case presentation A 45- year- old woman presented with a radiolucent left mandibular swelling associated with loss of teeth. Left cervical lymph nodes were enlarged on palpation. The patient underwent resection of the tumor but consequent to resected margins being positive for tumor cells underwent left hemimandibulectomy with ipsilateral functional neck dissection and was free of recurrence at 8 months follow-up. Conclusion Clear cell odontogenic carcinoma should be considered in the differential diagnosis of jaw tumors with conspicuous clear cell component. Curettage or conservative resection inevitably results in recurrences and/or metastasis and more radical resection is warranted in these tumors, especially when they are large and show soft tissue invasion.

  19. Lake Mead--clear and vital

    Science.gov (United States)

    Wessells, Stephen M.; Rosen, Michael

    2013-01-01

    “Lake Mead – Clear and Vital” is a 13 minute documentary relating the crucial role of science in maintaining high water quality in Lake Mead. The program was produced coincident with release of the Lakes Mead and Mohave Circular a USGS publication covering past and on-going research in the lakes and tributaries of the Lake Mead National Recreation Area.

  20. Plant Histology: Clearing and the Optical Section.

    Science.gov (United States)

    Freeman, H. E.

    1985-01-01

    Clearing is a simple and rapid technique in which 75 percent lactic acid is used to remove pigments and cytoplasmic contents of fresh leaves, enabling microscopic view of various internal leaf layers. Procedures for using the technique (which helps students gain a more thorough understanding of plant anatomy) are given. (DH)

  1. EGGS: CLEARING THE CHARGES, EXPLORING THE POTENTIAL ...

    African Journals Online (AJOL)

    0655711075

    EGGS: CLEARING THE CHARGES, EXPLORING THE POTENTIAL! Of all the different kinds of foods, an egg is special for its combination of all essential food nutrients in one item. Chicken eggs have an average weight of (~50g) with two distinct parts that have distinct nutritional values: the yolk (17g); and white (33g).

  2. CLARINO Resources: Lisence clearance and clearing ownership

    OpenAIRE

    Lyse, Gunn Inger; Gjesdal, Anje Müller

    2014-01-01

    Presentation held at a CLARINO meeting at the University of Bergen, 08.05.13 The presentation outlines the relationship between CLARIN and CLARINO, introduces basic IPR and licensing concepts, presents relevant license models and templates (e.g. Creative Commons, CLARIN licenses), presents guidelines for clearing ownership and for choosing a license. CLARINO

  3. A case of clear cell sarcoma

    DEFF Research Database (Denmark)

    Juel, Jacob; Ibrahim, Rami Mossad

    2017-01-01

    INTRODUCTION: Clear cell sarcoma (CCS) is a rare tumour of the soft tissue often misdiagnosed, as it shares characteristics with malignant melanoma (MM). Previously, CCS has been characterised, as malignant melanoma of the soft tissue, contemporary immunohistochemical techniques, however, have ma...

  4. Show-Bix &

    DEFF Research Database (Denmark)

    2014-01-01

    The anti-reenactment 'Show-Bix &' consists of 5 dias projectors, a dial phone, quintophonic sound, and interactive elements. A responsive interface will enable the Dias projectors to show copies of original dias slides from the Show-Bix piece ”March på Stedet”, 265 images in total. The copies...... are made from digital scans of the original dias slides located in the collection of the Museum of Contemporary Art in Roskilde. In front of the audience entering the space and placed on it’s own stand, is an original 60s style telephone with turning dial. Action begins when the audience lift the phone...... and dial a number. Any number will make the Dias change. All numbers are also assigned to specific sound documents: clips form rare interviews and the complete sound-re-enactment of the Show-Bix piece ‘Omringning’ (‘Surrounding’) in five channels (a quintophonie). This was originally produced...

  5. Show and Tell

    DEFF Research Database (Denmark)

    2013-01-01

    Fredag d. 1 november blev Kunsthal Charlottenborg indtaget af performanceprogrammet Show & Tell med et bredspektret program af danske og internationale kunstnere indenfor performance-, lyd- og installationskunst. Programmet præsenterer værker, der undersøger kroppens stadig mere symbiotiske forhold...... og studienævnet på Performance-design. Show & Tell - Performance program: kl. 16.30-19 Adresse: Kunsthal Charlottenborg, Nyhavn 2, 1051 København K...

  6. Efficacy of an Optimised Bacteriophage Cocktail to Clear Clostridium difficile in a Batch Fermentation Model

    Directory of Open Access Journals (Sweden)

    Janet Y. Nale

    2018-02-01

    Full Text Available Clostridium difficile infection (CDI is a major cause of infectious diarrhea. Conventional antibiotics are not universally effective for all ribotypes, and can trigger dysbiosis, resistance and recurrent infection. Thus, novel therapeutics are needed to replace and/or supplement the current antibiotics. Here, we describe the activity of an optimised 4-phage cocktail to clear cultures of a clinical ribotype 014/020 strain in fermentation vessels spiked with combined fecal slurries from four healthy volunteers. After 5 h, we observed ~6-log reductions in C. difficile abundance in the prophylaxis regimen and complete C. difficile eradication after 24 h following prophylactic or remedial regimens. Viability assays revealed that commensal enterococci, bifidobacteria, lactobacilli, total anaerobes, and enterobacteria were not affected by either regimens, but a ~2-log increase in the enterobacteria, lactobacilli, and total anaerobe abundance was seen in the phage-only-treated vessel compared to other treatments. The impact of the phage treatments on components of the microbiota was further assayed using metagenomic analysis. Together, our data supports the therapeutic application of our optimised phage cocktail to treat CDI. Also, the increase in specific commensals observed in the phage-treated control could prevent further colonisation of C. difficile, and thus provide protection from infection being able to establish.

  7. Do we prescribe what patients prefer? Pilot study to assess patient preferences for medication regimen characteristics

    Directory of Open Access Journals (Sweden)

    Witticke D

    2012-09-01

    Full Text Available Diana Witticke,1,2 Hanna Marita Seidling,1,2 Hans-Dieter Klimm,3 Walter Emil Haefeli1,21Department of Clinical Pharmacology and Pharmacoepidemiology, 2Cooperation Unit Clinical Pharmacy, 3Department of General Practice and Health Service Research, University of Heidelberg, Heidelberg, GermanyBackground: The aim of this pilot study was to evaluate patients' self-reported attitudes towards medication-related factors known to impair adherence and to assess their prevalence in ambulatory care as an essential prerequisite to improve patient adherence.Methods: We conducted a face-to-face interview with 110 primary care patients maintained on at least one drug. For each drug, the patient was asked to specify medication-related factors of interest, ie, dosage form, dosage interval, required relationship with food intake, and the planned time of day for intake, and to rate the individual relevance of each prevalent parameter on a three-point Likert scale (discriminating between prefer, neutral, and dislike.Results: Tablets with a once-daily dosage frequency were the most preferred dosage form, with a high prevalence in the ambulatory setting. Drug intake in the morning and evening were most preferred, and drug intake at noon was least preferred, but also had a low prevalence in contrast with drug intake independent of meals that was most preferred. Interestingly, only one quarter (26.4% of all the patients were able to indicate clear preferences or dislikes.Conclusion: When patients are asked to specify their preferences for relevant medication regimen characteristics, they clearly indicated regimens that have been associated with better adherence in earlier studies. Therefore, our results suggest that adaptation of drug regimens to individual preferences might be a promising strategy to improve adherence. Because the German health care system may differ from other systems in relevant aspects, our findings should be confirmed by evaluation of patient

  8. Case Report: Clear Cell Odontogenic Carcinoma: A Rarity ...

    African Journals Online (AJOL)

    Background: Clear odontogenic carcinoma is an unusual tumor in the buccal cavity, mandible or maxilla. There is slight female preponderance and the peak age of occurance is in the 6th and 7th decades of life. It shows loco-regional and distant metastasis thereby resulting to great challenges in diagnosis and treatment.

  9. Clearing the Fog from the Undergraduate Course in Linear Algebra

    Science.gov (United States)

    Scott, Damon

    2007-01-01

    For over a decade it has been a common observation that a "fog" passes over the course in linear algebra once abstract vector spaces are presented. See [2, 3]. We show how this fog may be cleared by having the students translate "abstract" vector-space problems to isomorphic "concrete" settings, solve the "concrete" problem either by hand or with…

  10. Hybrid Therapy Regimen for Helicobacter Pylori Eradication

    Directory of Open Access Journals (Sweden)

    Zhi-Qiang Song

    2016-01-01

    Conclusions: Hybrid therapy showed wide differences in the efficacy but consistently good compliance and safety across different regions. Dual clarithromycin and metronidazole resistance were the key factor to efficacy. Hybrid therapy was similar to sequential or concomitant therapy in the efficacy, safety, and compliance.

  11. Cellulose Degradation by Cellulose-Clearing and Non-Cellulose-Clearing Brown-Rot Fungi

    OpenAIRE

    Highley, Terry L.

    1980-01-01

    Cellulose degradation by four cellulose-clearing brown-rot fungi in the Coniophoraceae—Coniophora prasinoides, C. puteana, Leucogyrophana arizonica, and L. olivascens—is compared with that of a non-cellulose-clearing brown-rot fungus, Poria placenta. The cellulose- and the non-cellulose-clearing brown-rot fungi apparently employ similar mechanisms to depolymerize cellulose; most likely a nonenzymatic mechanism is involved.

  12. SPECIAL MINING MANAGEMENT ZONE - CLEAR CREEK, IDAHO.

    Science.gov (United States)

    Lund, Karen; Esparza, Leon E.

    1984-01-01

    On the basis of mineral-resource surveys, a substantiated resource potential for sediment-hosted cobalt-copper-gold-silver deposits has been identified in the Elkhorn and upper Garden Creek areas of the Special Mining Management Zone - Clear Creek, Idaho. Areas of favorable host rock, but with less strong evidence of mineralization, were classified as having probable resource potential for the same kind of deposit. A probable resource potential for porphyry-type copper-molybdenum deposits is assigned to areas along Clear Creek and upper Squaw Gulch based on the presence of extensive stockwork fracturing and alteration of the nonporphyritic granite, introduced disseminated magnetite, and the close proximity of known Tertiary plutons. The nature of the geologic terrain makes the occurrence of organic fuels on geothermal resources extremely unlikely.

  13. CLEARING MAGNET DESIGN FOR APS-U

    Energy Technology Data Exchange (ETDEWEB)

    Abliz, M.; Grimmer, J.; Jaski, Y.; Westferro, F.; Ramanathan, M.

    2017-06-25

    The Advanced Photon Source is in the process of developing an upgrade (APS-U) of the storage ring. The upgrade will be converting the current double bend achromat (DBA) lattice to a multi-bend achromat (MBA) lattice. In addition, the storage ring will be operated at 6 GeV and 200 mA with regular swap-out injection to keep the stored beam current constant [1]. The swap-out injection will take place with beamline shutters open. For radiation safety to ensure that no electrons can exit the storage ring, a passive method of protecting the beamline and containing the electrons inside the storage ring is proposed. A clearing magnet will be located in all beamline front ends inside the storage ring tunnel. This article will discuss the features and design of the clearing magnet scheme for APS-U.

  14. Roadmap-Based Level Clearing of Buildings

    KAUST Repository

    Rodriguez, Samuel

    2011-01-01

    In this paper we describe a roadmap-based approach for a multi-agent search strategy to clear a building or multi-story environment. This approach utilizes an encoding of the environment in the form of a graph (roadmap) that is used to encode feasible paths through the environment. The roadmap is partitioned into regions, e.g., one per level, and we design region-based search strategies to cover and clear the environment. We can provide certain guarantees within this roadmap-based framework on coverage and the number of agents needed. Our approach can handle complex and realistic environments where many approaches are restricted to simple 2D environments. © 2011 Springer-Verlag.

  15. Utilization and evaluation of noncore chemotherapy regimens within an academic medical center.

    Science.gov (United States)

    Jared, Jason R; Mably, Mary S; Makielski, Rory; Reed, Michael P; Fallon, Michael J; Liu, Glenn; Mulkerin, Daniel; Callander, Natalie S

    2017-10-01

    Uniformity of evidence-based chemotherapy prescribing using approved, standard, or "core" regimens provides systems-based safety. Noncore chemotherapy regimens are non-standard-of-care regimens requested by physicians on a patient-by-patient basis. Chemotherapy Council, a Pharmacy & Therapeutics subcommittee, assesses all requests and determines approval status based upon submitted evidence and patient-specific factors. This study's purpose is to describe noncore chemotherapy regimens utilization, efficacy, and clinical outcomes in patients receiving noncore chemotherapy regimens. This retrospective chart review includes a two-stage utilization and outcomes evaluation of patients receiving noncore chemotherapy regimens. Stage I, a demographics and utilization assessment of patients receiving noncore chemotherapy regimens, has data collection including patient age, sex, performance score, malignancy, and noncore chemotherapy regimen use justification. Stage II assesses noncore chemotherapy regimen-related, patient-specific outcomes of breast cancer noncore chemotherapy regimen patients. Breast cancer patients were evaluated on regimen and clinical outcomes including disease stage, regimen duration, discontinuation reason, subsequent chemotherapy, survival, and time from noncore chemotherapy regimen until death. Within stage I, 307 patient-specific noncore chemotherapy regimen requests were submitted. The most commonly submitted rationale was modification of a core regimen (33%), followed by patient-specific factors (29%) and salvage therapy (22%). For stage II, 29 breast cancer patients received a noncore chemotherapy regimen and most (54%) received a modified core regimen. The vast majority of noncore chemotherapy regimen discontinuation was due to either regimen completion (42%) or disease progression (42%). Nonelective hospitalizations (35%) and mortality (30%) were found during the median 13.3 months of follow up. Noncore chemotherapy regimen use provides

  16. Double-blind, multicenter comparison of efficacy, cycle control, and tolerability of a 23-day versus a 21-day low-dose oral contraceptive regimen containing 20 microg ethinyl estradiol and 75 microg gestodene.

    Science.gov (United States)

    Endrikat, J; Cronin, M; Gerlinger, C; Ruebig, A; Schmidt, W; Düsterberg, B

    2001-08-01

    This prospective, double-blind, randomized study was conducted to compare the contraceptive reliability, cycle control, and tolerability of a 23-day versus a 21-day oral contraceptive regimen containing 20 microg ethinyl estradiol and 75 microg gestodene. Participants took trial medication daily for 28 days, either 23 tablets with active substances plus 5 placebo tablets or 21 tablets with active substances plus 7 placebo tablets. Contraceptive efficacy, cycle control, and tolerability were evaluated over a period of seven cycles. Efficacy data gathered from 4,878 treatment cycles (23-day regimen: 2,362 cycles; 21-day regimen: 2,516 cycles) were obtained from 703 participants (23-day regimen, n = 342; 21-day regimen, n = 361). Both preparations proved to be effective contraceptives and provided good cycle control. One pregnancy because of method failure was recorded in each treatment group. This resulted in a study Pearl Index of 0.5 for each treatment. For the 23-day regimen, 36.0% of participants reported at least one intracyclic bleeding episode during Cycles 2-4 (primary target) compared to 37.1% in the 21-day regimen. In the 23-day regimen group, intracyclic bleeding episodes were reported by 42.4% of the participants in Cycle 1 but only in 14% in Cycle 7 and in the 21-day regimen group by 44.6% in Cycle 1 and only 17.3% in Cycle 7. Overall, intracyclic bleeding was reported in 21.9% of the 23-day regimen cycles and in 22.7% of the 21-day regimen cycles.A greater number of 23-day regimen participants had shorter withdrawal bleeding periods than with the 21-day regimen. In significantly (p <0.0001) more cycles in the 23-day regimen group, participants reported withdrawal bleeding periods that lasted only 1-4 days compared to the 21-day regimen group. For the majority of the treatment cycles, the median number of bleeding days in the 23-day regimen group was 4 days and in the 21-day regimen group 5 days. Both preparations were well tolerated and showed a similar

  17. Double-blind, placebo-controlled psychometric studies on the effects of a combined estrogen-progestin regimen versus estrogen alone on performance, mood and personality of menopausal syndrome patients.

    Science.gov (United States)

    Linzmayer, L; Semlitsch, H V; Saletu, B; Böck, G; Saletu-Zyhlarz, G; Zoghlami, A; Gruber, D; Metka, M; Huber, J; Oettel, M; Gräser, T; Grünberger, J

    2001-01-01

    The influence of a combined estrogen-progestin regimen (Climodien) on noopsyche, thymopsyche, personality and psychophysiological measures of menopausal syndrome patients was investigated in a double-blind, placebo-controlled, comparative, randomized 3-arm trial phase (Climodien 2/3 = estradiol valerate (CAS 979-32-8) 2 mg + the progestin dienogest (CAS 65928-58-7) 3 mg = regimen A, estradiol valerate 2 mg = regimen EV, and placebo = regimen P) followed by an open-label phase in which all patients received Climodien 2/2 (estradiol valerate 2 mg + dienogest 2 mg) = regimen A*. 49 women (16, 17, 16 valid patients per arm) aged between 46 and 67 years (mean 58, 58, 56 years, respectively) with the diagnoses of insomnia (G 47.0) related to postmenopausal syndrome (N 95.1) were included in the analysis of the double-blind phase. Both the double-blind and the open-label phase lasted 2 months. Noopsychic investigations demonstrated an improvement in associative verbal memory after 2 months of regimen A, which was significant as compared with both baseline and placebo. Regarding visual memory, regimen A* induced an improvement, which was significantly different from the decline in correct reproductions in the Benton Test observed under estradiol. Errors in the Benton Test decreased significantly after regimen A* as compared with regimen EV. These findings suggest that hormone replacement therapy with estradiol, and even more in combination with dienogest, improves verbal and visual memory, which is in line with the improvement in information processing speed and capacity objectified by event-related potentials (ERP). Thymopsychic investigations demonstrated a significant improvement in somatic complaints and trait anxiety after both regimen A and regimen EV as compared with baseline. State anxiety decreased significantly under regimen A* as compared with EV. The Freiburger Personality Inventory showed an improvement in aggressivity after regimen A* as compared with the

  18. Tropospheric haze and colors of the clear daytime sky.

    Science.gov (United States)

    Lee, Raymond L

    2015-02-01

    To casual observers, haze's visible effects on clear daytime skies may seem mundane: significant scattering by tropospheric aerosols visibly (1) reduces the luminance contrast of distant objects and (2) desaturates sky blueness. However, few published measurements of hazy-sky spectra and chromaticities exist to compare with these naked-eye observations. Hyperspectral imaging along sky meridians of clear and hazy skies at one inland and two coastal sites shows that they have characteristic colorimetric signatures of scattering and absorption by haze aerosols. In addition, a simple spectral transfer function and a second-order scattering model of skylight reveal the net spectral and colorimetric effects of haze.

  19. Skin optical clearing for improvement of laser tattoo removal

    Science.gov (United States)

    Bashkatov, A. N.; Genina, E. A.; Tuchin, V. V.; Altshuler, G. B.

    2009-06-01

    The possibility of improvement of laser tattoo removal due to the optical clearing of human skin is investigated. It is shown experimentally that previously perforation of skin stratum corneum allows increasing tattoo image contrast at topical administration of immersion agent in contrast with non-perforated skin. Computer Monte Carlo simulation shows that at the optical clearing of upper skin layers the tattoo image contrast and the photon fraction absorbed in the tattoo area at the depths of 0.5 or 1.0 mm increase, that allows significant decreasing of the power of laser radiation used at laser thermolysis.

  20. Clearing and settlement in a legal perspective

    OpenAIRE

    Andersen, Niels C.

    2004-01-01

    This paper describes how the two most important clearing and settlement systems in Denmark, VP and the Sumclearing, work in practice. Further it analyses, how the legal framework in the Securities Trading Act, STA, based on directive 98/26/EC on settlement finality in payment and securities settlement systems works in relation to the functionality of VP and the Sumclearing. The functionality for both systems encompasses net settlement (multilateral netting). The description of the two systems...

  1. Clearing og afvikling i et retligt perspektiv

    OpenAIRE

    Andersen, Niels C.

    2004-01-01

    This paper describes how the two most important clearing and settlement systems in Denmark, VP and the Sumclearing, work in practice. Further it analyses, how the legal framework in the Securities Trading Act, STA, based on directive 98/26/EC on settlement finality in payment and securities settlement systems works in relation to the functionality of VP and the Sumclearing. The functionality for both systems encompasses net settlement (multilateral netting). The description of the two systems...

  2. Internet compromise clears way for WSIS agreement

    CERN Multimedia

    Ermert, M

    2003-01-01

    A working group under the leadership of United Nations Secretary General Kofi Annan himself will try to resolve the deep differences on the question of Internet governance, officials said here. The group, whose exact membership wasn't immediately clear, is to propose a solution to the controversial issue that has given negotiators at the World Summit of the Information Society (WSIS) a headache (1/2 page).

  3. Imaging of ovarian clear cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Hayashi, Toshihiko; Sawano, Seishi; Yamada, Keiko [Japanese Foundation for Cancer Research, Tokyo (Japan). Hospital] (and others)

    1999-12-01

    The aim of this study is to examine the appearance of ovarian clear cell adenocarcinoma (OCCA) on MR, CT, US. In 39 cases with OCCA, the imaging characteristics of OCCA were evaluated morphologically and classified into three groups, that was, monomural nodule type, multi-mural nodule type and predominantly solid type. Forty-three percent of the patients had endometriosis. Contrast material-enhanced MRI was the most useful method for diagnosis of OCCA. (author)

  4. [Prospective randomized study of HMVP, MVP, and HVP regimens in treatment of advanced non-small cell lung cancer].

    Science.gov (United States)

    Gao, Jian-Fei; Li, Chang-Sheng; Zhang, Bi-Cheng; Du, Guang-Zu; Zhang, Xin-Hua; Wang, Jun; Zhu, Yu-Ze; Ou, Wu-Ling; Yang, Bo

    2004-04-01

    Non-small cell lung cancer (NSCLC) is hyposensitive to the normal first and second-line chemotherapy regimens. Camptothecin derivative is becoming a hot point in the treatment of advanced NSCLC. The objective of this article was to evaluate the response, toxicity, and survival time of HMVP, MVP, and HVP regimens (detail in below) in the treatment of advanced NSCLC. A total of 134 cases with advanced NSCLC was randomized into three groups: HMVP group [46 patients, hydroxycamptothecin (HCPT) 12 mg/m(2) from d1 to d5, mitomycin C (MMC) 6 mg/m(2) d1, vindesine (VDS) 2.5-3 mg/m(2) d1 and d8, cisplatin (DDP) 50 mg/m(2) d2 and d3], MVP group (44 patients, MMC, VDS and DDP were the same as HMVP group) and HVP group (44 patients, HCPT, VDS, DDP were the same as HMVP group). The response rates were 39.54% (17/43), 35.57% (15/42), and 26.19% (11/42) in HMVP, MVP, and HVP groups, respectively; no significant difference was detected among the three groups (P >0.05). No significant difference was detected in the median time of remission, median survival time, and 1-, 2-year survival rates among the three groups. Moreover, no significant difference was detected in grade III-IV leukopenia, grade III-IV thrombocytopenia, grade III-IV nausea and vomiting and grade III-IV constipation among the three groups. The response rate of MVP regimen is slightly lower than that of HMVP regimen, but HMVP regimen do not show obvious superiority. It may increase toxicities such as leukopenia, nausea/vomiting, and constipation. The response rate of HVP regimen is slightly lower than that of MVP regimen.

  5. Characteristics of HIV antiretroviral regimen and treatment adherence

    Directory of Open Access Journals (Sweden)

    Vera Lúcia da Silveira

    Full Text Available The relationship between characteristics of HIV antiretroviral regimens and treatment adherence was studied in adolescent and adult patients who underwent antiretroviral therapy from January 1998 to September 2000, at the Service for Specialized Assistance in Pelotas. The patients were interviewed on two occasions, and the use of antiretrovirals during the previous 48 hours was investigated by a self-report. Adherence was defined as use of 95% or more of the prescribed medication. Social-demographic variables were collected through direct questionnaires. The antiretroviral regimen and clinical data were copied from the patients' records. Associations between the independent variables and adherence were analyzed by means of logistic regression. The multivariate analysis included characteristics of the antiretroviral regimens, social-demographic variables, as well as perception of negative effects, negative physiological states, and adverse effects of the treatment. Among the 224 selected patients, 194 participated in our study. Their ages varied from 17 to 67 years; most patients were men, with few years of schooling and a low family income. Only 49% adhered to the treatment. Adherence to treatment regimens was reduced when more daily doses were indicated: three to four doses (odds ratio of adherence to treatment (OR=0.47, 95% confidence interval (CI 0.22-1.01 and five to six (OR=0.24, 95% CI 0.09-0.62; two or more doses taken in a fasting state (OR=0.59, 95% CI 0.11-0.68, and for patients who reported adverse effects to the treatment (OR=0.39, 95% CI 0.19-0.77. Most of the regimens with more than two daily doses of medication included at least one dose apart from mealtimes. The results suggest that, if possible, regimens with a reduced number of doses should be chosen, with no compulsory fasting, and with few adverse effects. Strategies to minimize these effects should be discussed with the patients.

  6. Talking with TV shows

    DEFF Research Database (Denmark)

    Sandvik, Kjetil; Laursen, Ditte

    2014-01-01

    User interaction with radio and television programmes is not a new thing. However, with new cross-media production concepts such as X Factor and Voice, this is changing dramatically. The second-screen logic of these productions encourages viewers, along with TV’s traditional one-way communication...... mode, to communicate on interactive (dialogue-enabling) devices such as laptops, smartphones and tablets. Using the TV show Voice as our example, this article shows how the technological and situational set-up of the production invites viewers to engage in new ways of interaction and communication....... More specifically, the article demonstrates how online comments posted on the day of Voice’s 2012 season finale can be grouped into four basic action types: (1) Invitation to consume content, (2) Request for participation, (3) Request for collaboration and (4) Online commenting. These action types...

  7. Um show de cacau

    OpenAIRE

    Rezende, José Francisco; UNIGRANRIO / PPGA; Mello, Simone; UNIGRANRIO

    2016-01-01

    O caso de ensino apresenta a trajetória de Alexandre Tadeu da Costa e da chocolateria Cacau Show. Seu objetivo é levar os estudantes a identificar alternativas e tomar decisões sobre posicionamento para continuidade do desenvolvimento de vantagens competitivas, sustentação de competência logística e possíveis abordagens ao mercado externo. 

  8. Clearing skeletal muscle with CLARITY for light microscopy imaging.

    Science.gov (United States)

    Milgroom, Andrew; Ralston, Evelyn

    2016-04-01

    Viewing subcellular details over large tissue volumes is becoming an essential condition of the success of large-scale projects aimed at visualizing cell connections in whole organs or tissues. However, tissue opacity remains an obstacle to deep tissue imaging. This situation has brought renewed interest for techniques of tissue clearing; new protocols, such as CLARITY (Clear Lipid-exchanged Acrylamide-hybridized Rigid Imaging/Immunostaining/In situ hybridization-compatible Tissue-hYdrogel), have recently been developed. So far, most of the tests of these techniques have been applied to brain or other soft tissues. Here we show that CLARITY clears mouse hindlimb skeletal muscles and maintains the basic structural features of muscle and its fibers. However, tagging with fluorescent markers was not successful. © Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  9. Clear New View of a Classic Spiral

    Science.gov (United States)

    2010-05-01

    ESO is releasing a beautiful image of the nearby galaxy Messier 83 taken by the HAWK-I instrument on ESO's Very Large Telescope (VLT) at the Paranal Observatory in Chile. The picture shows the galaxy in infrared light and demonstrates the impressive power of the camera to create one of the sharpest and most detailed pictures of Messier 83 ever taken from the ground. The galaxy Messier 83 (eso0825) is located about 15 million light-years away in the constellation of Hydra (the Sea Serpent). It spans over 40 000 light-years, only 40 percent the size of the Milky Way, but in many ways is quite similar to our home galaxy, both in its spiral shape and the presence of a bar of stars across its centre. Messier 83 is famous among astronomers for its many supernovae: vast explosions that end the lives of some stars. Over the last century, six supernovae have been observed in Messier 83 - a record number that is matched by only one other galaxy. Even without supernovae, Messier 83 is one of the brightest nearby galaxies, visible using just binoculars. Messier 83 has been observed in the infrared part of the spectrum using HAWK-I [1], a powerful camera on ESO's Very Large Telescope (VLT). When viewed in infrared light most of the obscuring dust that hides much of Messier 83 becomes transparent. The brightly lit gas around hot young stars in the spiral arms is also less prominent in infrared pictures. As a result much more of the structure of the galaxy and the vast hordes of its constituent stars can be seen. This clear view is important for astronomers looking for clusters of young stars, especially those hidden in dusty regions of the galaxy. Studying such star clusters was one of the main scientific goals of these observations [2]. When compared to earlier images, the acute vision of HAWK-I reveals far more stars within the galaxy. The combination of the huge mirror of the VLT, the large field of view and great sensitivity of the camera, and the superb observing conditions

  10. Modelling and analysis of the feeding regimen induced entrainment of hepatocyte circadian oscillators using petri nets.

    Directory of Open Access Journals (Sweden)

    Samar Hayat Khan Tareen

    Full Text Available Circadian rhythms are certain periodic behaviours exhibited by living organism at different levels, including cellular and system-wide scales. Recent studies have found that the circadian rhythms of several peripheral organs in mammals, such as the liver, are able to entrain their clocks to received signals independent of other system level clocks, in particular when responding to signals generated during feeding. These studies have found SIRT1, PARP1, and HSF1 proteins to be the major influencers of the core CLOCKBMAL1:PER-CRY circadian clock. These entities, along with abstracted feeding induced signals were modelled collectively in this study using Petri Nets. The properties of the model show that the circadian system itself is strongly robust, and is able to continually evolve. The modelled feeding regimens suggest that the usual 3 meals/day and 2 meals/day feeding regimens are beneficial with any more or less meals/day negatively affecting the system.

  11. The influence of patient beliefs and treatment satisfaction on the discontinuation of current first-line antiretroviral regimens.

    Science.gov (United States)

    Casado, J L; Marín, A; Romero, V; Bañón, S; Moreno, A; Perez-Elías, M J; Moreno, S; Rodriguez-Sagrado, M A

    2016-01-01

    Large cohort studies have shown a high rate of first-line combination antiretroviral therapy (cART) regimen discontinuation in HIV-infected patients, attributed to characteristics of the cART regimen or toxicity. A cohort study of 274 patients receiving a first-line regimen was carried out. Patients' perceptions and beliefs prior to initiation were assessed using an attitude towards medication scale (0-15 points), and their satisfaction during therapy was assessed using an HIV treatment satisfaction questionnaire (HIVTSQ). Treatment discontinuation was defined as any switch in the cART regimen. During 474.8 person-years of follow-up, 63 (23%) patients changed their cART regimen, mainly because of toxicity/intolerance (42; 67%). The overall rate of change was 13.2 per 100 patient-years [95% confidence interval (CI) 11.1-16.4 per 100 patient-years]. An efavirenz (EFV)-based single tablet regimen showed the highest rate of adverse events (27%), but the lowest rate of change (16%; 7.44 per 100 patient-years). Cox regression revealed a decreased hazard of first regimen termination with better initial attitude towards drugs [hazard ratio (HR) 0.76; 95% CI 0.62-0.93; P satisfaction (HR 0.94; 95% CI 0.89-0.99; P = 0.01), and an increased hazard of termination with the presence of adverse events (HR 7.7; 95% CI 2.4-11.6; P patients (18 of 59; 31%) with mild/moderate adverse events (which were mainly central nervous system symptoms) continued the regimen; these patients, compared with those discontinuing therapy, showed better perception of therapy (mean score 14.4 versus 12.1, respectively; P = 0.05) and greater satisfaction during therapy (mean score 50.6 versus 44.6, respectively; P = 0.04). Patients' beliefs and satisfaction with therapy influence the durability of the first antiretroviral regimen. These patient-related factors modulate the impact of mild adverse events, and could explain differences in the rate of discontinuation. © 2015 British HIV

  12. Taking in a Show.

    Science.gov (United States)

    Boden, Timothy W

    2016-01-01

    Many medical practices have cut back on education and staff development expenses, especially those costs associated with conventions and conferences. But there are hard-to-value returns on your investment in these live events--beyond the obvious benefits of acquired knowledge and skills. Major vendors still exhibit their services and wares at many events, and the exhibit hall is a treasure-house of information and resources for the savvy physician or administrator. Make and stick to a purposeful plan to exploit the trade show. You can compare products, gain new insights and ideas, and even negotiate better deals with representatives anxious to realize returns on their exhibition investments.

  13. Once-daily dose regimen of ribavirin is interchangeable with a twice-daily dose regimen: randomized open clinical trial

    Directory of Open Access Journals (Sweden)

    Balk JM

    2015-08-01

    Full Text Available Jiska M Balk,1 Guido RMM Haenen,1 Özgür M Koc,2 Ron Peters,3 Aalt Bast,1 Wim JF van der Vijgh,1 Ger H Koek,4 1Department of Toxicology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, 2Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, 3DSM Resolve, Geleen, 4Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, the Netherlands Background: The combination of ribavirin (RBV and pegylated interferon (PEG-IFN is effective in the treatment of chronic hepatitis C infection. Reducing the frequency of RBV intake from twice to once a day will improve compliance and opens up the opportunity to combine RBV with new and more specific direct-acting agents in one pill. Therefore, the purpose of this study was to evaluate the pharmacokinetic profile of RBV in a once-daily to twice-daily regimen. The secondary aim was to determine tolerability as well as the severity and differences in side effects of both treatment regimens. Methods: In this randomized open-label crossover study, twelve patients with chronic type 1 hepatitis C infection and weighing more than 75 kg were treated with 180 µg of PEG-IFN weekly and 1,200 mg RBV daily for 24 weeks. The patients received RBV dosed as 1,200 mg once-daily for 12 weeks followed by RBV dosed as 600 mg twice-daily for 12 weeks, or vice versa. In addition to the pharmacokinetic profile, the hematological profile and side effects were recorded. The RBV concentrations in plasma were determined using liquid chromatography-tandem mass spectrometry. Results: Eight of twelve patients completed the study. Neither the time taken for RBV to reach peak plasma concentration nor the AUC0-last (adjusted for difference in dose was significantly different between the two groups (P>0.05. Furthermore, the once-daily regimen did not give more side effects than the twice-daily regimen (P>0

  14. ClearedLeavesDB: an online database of cleared plant leaf images.

    Science.gov (United States)

    Das, Abhiram; Bucksch, Alexander; Price, Charles A; Weitz, Joshua S

    2014-03-28

    Leaf vein networks are critical to both the structure and function of leaves. A growing body of recent work has linked leaf vein network structure to the physiology, ecology and evolution of land plants. In the process, multiple institutions and individual researchers have assembled collections of cleared leaf specimens in which vascular bundles (veins) are rendered visible. In an effort to facilitate analysis and digitally preserve these specimens, high-resolution images are usually created, either of entire leaves or of magnified leaf subsections. In a few cases, collections of digital images of cleared leaves are available for use online. However, these collections do not share a common platform nor is there a means to digitally archive cleared leaf images held by individual researchers (in addition to those held by institutions). Hence, there is a growing need for a digital archive that enables online viewing, sharing and disseminating of cleared leaf image collections held by both institutions and individual researchers. The Cleared Leaf Image Database (ClearedLeavesDB), is an online web-based resource for a community of researchers to contribute, access and share cleared leaf images. ClearedLeavesDB leverages resources of large-scale, curated collections while enabling the aggregation of small-scale collections within the same online platform. ClearedLeavesDB is built on Drupal, an open source content management platform. It allows plant biologists to store leaf images online with corresponding meta-data, share image collections with a user community and discuss images and collections via a common forum. We provide tools to upload processed images and results to the database via a web services client application that can be downloaded from the database. We developed ClearedLeavesDB, a database focusing on cleared leaf images that combines interactions between users and data via an intuitive web interface. The web interface allows storage of large collections

  15. Treatment burden, clinical outcomes, and comorbidities in COPD: an examination of the utility of medication regimen complexity index in COPD.

    Science.gov (United States)

    Negewo, Netsanet A; Gibson, Peter G; Wark, Peter Ab; Simpson, Jodie L; McDonald, Vanessa M

    2017-01-01

    COPD patients are often prescribed multiple medications for their respiratory disease and comorbidities. This can lead to complex medication regimens resulting in poor adherence, medication errors, and drug-drug interactions. The relationship between clinical outcomes and medication burden beyond medication count in COPD is largely unknown. The aim of this study was to explore the relationships of medication burden in COPD with clinical outcomes, comorbidities, and multidimensional indices. In a cross-sectional study, COPD patients (n=222) were assessed for demographic information, comorbidities, medication use, and clinical outcomes. Complexity of medication regimens was quantified using the validated medication regimen complexity index (MRCI). Participants (58.6% males) had a mean (SD) age of 69.1 (8.3) years with a postbronchodilator forced expiratory volume in 1 second % predicted of 56.5 (20.4) and a median of five comorbidities. The median ( q 1, q 3) total MRCI score was 24 (18.5, 31). COPD-specific medication regimens were more complex than those of non-COPD medications (median MRCI: 14.5 versus 9, respectively; P Index and COPD-specific comorbidity test showed the highest degree of correlation with total MRCI score ( ρ =0.289 and ρ =0.326; P <0.0001, respectively). In COPD patients, complex medication regimens are associated with disease severity and specific class of comorbidities.

  16. Evaluation of the effect of duration of application of Smear Clear in removing intracanal smear layer: SEM study

    OpenAIRE

    Ankur Dua; Deepti Dua; Uppin, Veerendra M

    2015-01-01

    Aim: To evaluate the effect of duration of application of 17% ethylene diamine tetraacetic acid (EDTA) and SmearClear on the removal of intracanal smear layer by SEM. Materials and Methods: Seventy-two extracted maxillary incisors were root canal instrumented and randomly distributed into three groups of 24 teeth each according to different final irrigation regimens, Group A-17% EDTA + 1% sodium hypochlorite (NaOCl), Group B-SmearClear + 1% NaOCl, Group C (Control group)-Distilled water + 1% ...

  17. Showing Value (Editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2009-06-01

    Full Text Available When Su Cleyle and I first decided to start Evidence Based Library and Information Practice, one of the things we agreed upon immediately was that the journal be open access. We knew that a major obstacle to librarians using the research literature was that they did not have access to the research literature. Although Su and I are both academic librarians who can access a wide variety of library and information literature from our institutions, we belong to a profession where not everyone has equal access to the research in our field. Without such access to our own body of literature, how can we ever hope for practitioners to use research evidence in their decision making? It would have been contradictory to the principles of evidence based library and information practice to do otherwise.One of the specific groups we thought could use such an open access venue for discovering research literature was school librarians. School librarians are often isolated and lacking access to the research literature that may help them prove to stakeholders the importance of their libraries and their role within schools. Certainly, school libraries have been in decline and the use of evidence to show value is needed. As Ken Haycock noted in his 2003 report, The Crisis in Canada’s School Libraries: The Case for Reform and Reinvestment, “Across the country, teacher-librarians are losing their jobs or being reassigned. Collections are becoming depleted owing to budget cuts. Some principals believe that in the age of the Internet and the classroom workstation, the school library is an artifact” (9. Within this context, school librarians are looking to our research literature for evidence of the impact that school library programs have on learning outcomes and student success. They are integrating that evidence into their practice, and reflecting upon what can be improved locally. They are focusing on students and showing the impact of school libraries and

  18. Comparison of different insulin regimens in elderly patients with NIDDM

    NARCIS (Netherlands)

    Wolffenbuttel, B H; Sels, J P; Rondas-Colbers, G J; Menheere, P P; Nieuwenhuijzen Kruseman, A C

    1996-01-01

    OBJECTIVE: To compare the metabolic effects of three different frequently used regimens of insulin administration on blood glucose control and serum lipids, and the costs associated with this treatment, in subjects with NIDDM, who were poorly controlled with oral antihyperglycemic agents. RESEARCH

  19. Causes for antiretroviral regimen change among HIV/AIDS patients ...

    African Journals Online (AJOL)

    2010-03-01

    This was a retrospective cross-sectional study conducted from January 1 to March 1, 2010 in two primary hospitals and one health centre in central Ethiopia. Information cards of HIV/AIDS patients who have had their antiretroviral regimen switched were reviewed. Data from patients below 18 years old and those who did not ...

  20. Gonzalez Regimen (PDQ®)—Health Professional Version

    Science.gov (United States)

    The Gonzalez regimen is a specialized diet that uses enzymes, supplements, and other factors in cancer management based on a theory that involves the use of pancreatic enzymes to help the body get rid of toxins that lead to cancer. Read about existing clinical data in this expert-reviewed summary.

  1. Unnecessary complexity of home medication regimens among seniors.

    Science.gov (United States)

    Lindquist, Lee A; Lindquist, Lucy M; Zickuhr, Lisa; Friesema, Elisha; Wolf, Michael S

    2014-07-01

    To determine whether seniors consolidate their home medications or if there is evidence of unnecessary regimen complexity. Face-to-face interviews were conducted with 200 community-dwelling seniors >70 years in their homes. Subjects demonstrated how they took their medications in a typical day and the number of times a day patients would take medications was calculated. A pharmacist and physician blinded to patient characteristics examined medication regimens and determined the fewest number of times a day they could be taken by subjects. Home medication regimens could be simplified for 85 (42.5%) subjects. Of those subjects not optimally consolidating their medications, 53 (26.5%) could have had the number of times a day medications were taken reduced by one time per day; 32 (16.0%) reduced by two times or more. The three most common causes of overcomplexity were (1) misunderstanding medication instructions, (2) concern over drug absorption (i.e. before meals), and (3) perceived drug-drug interactions. Almost half of seniors had medication regimens that were unnecessarily complicated and could be simplified. This lack of consolidation potentially impedes medication adherence. Health care providers should ask patients to explicitly detail when medication consumption occurs in the home. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. The liberal peace security regimen: a gramscian critique of its ...

    African Journals Online (AJOL)

    Current security regimens are grounded in the advancement of liberal peace. All inter-governmental organizations, most states and most donor agencies more or less accept as common sense the self-evident virtuosity and truth of the liberal peace project. However, there is a profound contradiction within this project in ...

  3. Influence of different final irrigation regimens and various ...

    African Journals Online (AJOL)

    2015-04-28

    Apr 28, 2015 ... Aim: The aim of this study was to evaluate the influence of different endodontic materials and final irrigation regimens on vertical root fracture ... [11] A recently introduced bioceramic‑based root canal sealer ..... Ari H, Yasar E, Belli S. Effects of NaOCl on bond strengths of resin cements to root canal dentin.

  4. Efficacy of Some Combination Regimens of Oral Hypoglycaemic ...

    African Journals Online (AJOL)

    Purpose: To examine the efficacy of selected oral hypoglycaemic agent (OHA) regimens in a small group of patients receiving such treatment. Methods: This was a retrospective, observational study that involved patients who had been diagnosed with type 2 diabetes mellitus and undergoing routine follow-up at a teaching ...

  5. Assessment of non-standard HIV antiretroviral therapy regimens at ...

    African Journals Online (AJOL)

    2016-03-06

    Mar 6, 2016 ... Challenges in quantifying these regimens have resulted in medication stockouts in the past, .... their HIV management. The most common NS-ARTs used are listed in Table 2. Table 2: Most .... impact of uncertainty in Malawi's ART supply chain. Malawi has struggled with national medication stockouts in the ...

  6. eight month regimen recommended by the nigerian national ...

    African Journals Online (AJOL)

    The clinical outcome in terms of the time of sputum conversion, prognosis, radiological changes at the endof ... groups using the prognosis, side-effects profile, sputum conversion and radiological clearance at the end of chemotherapy. The regimen .... Isoniazid (H) 7.5 mg/kg (daily) 2 months Therapy. 4. Pyrazinamide (Z) ...

  7. Influence of different final irrigation regimens and various ...

    African Journals Online (AJOL)

    Aim: The aim of this study was to evaluate the influence of different endodontic materials and final irrigation regimens on vertical root fracture (VRF) resistance. Materials and Methods: Eighty human teeth were prepared then assigned into two groups (n = 40) according to the final irrigations. G1: 5 mL, 5.25% sodium ...

  8. Rapid spheroid clearing on a microfluidic chip.

    Science.gov (United States)

    Silva Santisteban, Tomas; Rabajania, Omid; Kalinina, Iana; Robinson, Stephen; Meier, Matthias

    2017-12-19

    Spheroids are three-dimensional (3D) cell cultures that aim to bridge the gap between the use of whole animals and cellular monolayers. Microfluidics is regarded as an enabling technology to actively control the chemical environment of 3D cell cultures. Although a wide variety of platforms have been developed to handle spheroid cultures, the development of analytical systems for spheroids remains a major challenge. In this study, we engineered a microfluidic large-scale integration (mLSI) chip platform for tissue-clearing and imaging. To enable handling and culturing of spheroids on mLSI chips, with diameters within hundreds of microns, we first developed a general rapid prototyping procedure, which allows scaling up of the size of pneumatic membrane valves (PMV). The presented prototyping method makes use of milled poly(methylmethacrylate) (PMMA) molds for obtaining semi-circular microchannels with heights up to 750 μm. Semi-circular channel profiles are required for the functioning of the commonly used PMVs in normally open configuration. Height limits to tens of microns for this channel profile on photolithographic molds have hampered the application of 3D tissue models on mLSI chips. The prototyping technique was applied to produce an mLSI chip for miniaturization, automation, and integration of the steps involved in the tissue clearing method CLARITY, including spheroid fixation, acrylamide hydrogel infiltration, temperature-initiated hydrogel polymerization, lipid extraction, and immuno-fluorescence staining of the mitochondrial protein COX-IV, and metabolic enzyme GAPDH. Precise fluidic control over the liquids in the spheroid culturing chambers allowed implementation of a local hydrogel polymerization reaction, exclusively within the spheroid tissue. Hydrogel-embedded spheroids undergo swelling and shrinkage depending on the pH of the surrounding buffer solution. A pH-jump from 8.5 to 5.5 shrinks the hydrogel-embedded spheroid volume by 108% with a rate

  9. A comparison of linaclotide and lubiprostone dosing regimens on ion transport responses in human colonic mucosa.

    Science.gov (United States)

    Kang, Sang Bum; Marchelletta, Ronald R; Penrose, Harrison; Docherty, Michael J; McCole, Declan F

    2015-03-01

    Linaclotide, a synthetic guanylyl cyclase C (GC-C) agonist, and the prostone analog, Lubiprostone, are approved to manage chronic idiopathic constipation and constipation-predominant irritable bowel syndrome. Lubiprostone also protects intestinal mucosal barrier function in ischemia. GC-C signaling regulates local fluid balance and other components of intestinal mucosal homeostasis including epithelial barrier function. The aim of this study was to compare if select dosing regimens differentially affect linaclotide and lubiprostone modulation of ion transport and barrier properties of normal human colonic mucosa. Normal sigmoid colon biopsies from healthy subjects were mounted in Ussing chambers. Tissues were treated with linaclotide, lubiprostone, or vehicle to determine effects on short-circuit current (I sc). Subsequent I sc responses to the cAMP agonist, forskolin, and the calcium agonist, carbachol, were also measured to assess if either drug caused desensitization. Barrier properties were assessed by measuring transepithelial electrical resistance. I sc responses to linaclotide and lubiprostone were significantly higher than vehicle control when administered bilaterally or to the mucosal side only. Single versus cumulative concentrations of linaclotide showed differences in efficacy while cumulative but not single dosing caused desensitization to forskolin. Lubiprostone reduced forskolin responses under all conditions. Linaclotide and lubiprostone exerted a positive effect on TER that was dependent on the dosing regimen. Linaclotide and lubiprostone increase ion transport responses across normal human colon but linaclotide displays increased sensitivity to the dosing regimen used. These findings may have implications for dosing protocols of these agents in patients with constipation.

  10. [Effectiveness of short course intermittent regimen on different categories of retreated patients with pulmonary tuberculosis].

    Science.gov (United States)

    Wang, X; Dai, Y; Cao, J

    2001-08-01

    To evaluate the efficacy of short course intermittent regimen in the different categories of retreated patients with tuberculosis. 303 retreated patients with smear-positive pulmonary tuberculosis were recruited for the study. They were divided into three groups based on the history of tuberculosis and anti-tuberculosis treatment. 87 were in relapse group, 21 in failure group (failure after the initial treatment) and 195 in other retreatment group. Sputum Mycobacterium tuberculosis culture and drug susceptibility test were conducted before treatment. The same retreatment regimen (2-3H3R3Z3E3S3/5-6H3R3E3) was employed for all three groups of patients. Drug resistance and the outcomes of three groups of retreatment tuberculosis were analysed. The drug resistance rates and efficacy of retreatment showed no statistical difference among three groups (P > 0.05). In other retreatment group, the drug resistant rate in patients who received anti-TB drugs for more than 12 months (79.5%) was significantly higher than those for less than 12 months (59.8%, 0.01 short course intermittent regimen.

  11. Evolution of treatment regimens in multiple myeloma: a social network analysis.

    Directory of Open Access Journals (Sweden)

    Helen Mahony

    Full Text Available Randomized controlled trials (RCTs are considered the gold standard for assessing the efficacy of new treatments compared to standard treatments. However, the reasoning behind treatment selection in RCTs is often unclear. Here, we focus on a cohort of RCTs in multiple myeloma (MM to understand the patterns of competing treatment selections.We used social network analysis (SNA to study relationships between treatment regimens in MM RCTs and to examine the topology of RCT treatment networks. All trials considering induction or autologous stem cell transplant among patients with MM were eligible for our analysis. Medline and abstracts from the annual proceedings of the American Society of Hematology and American Society for Clinical Oncology, as well as all references from relevant publications were searched. We extracted data on treatment regimens, year of publication, funding type, and number of patients enrolled. The SNA metrics used are related to node and network level centrality and to node positioning characterization.135 RCTs enrolling a total of 36,869 patients were included. The density of the RCT network was low indicating little cohesion among treatments. Network Betweenness was also low signifying that the network does not facilitate exchange of information. The maximum geodesic distance was equal to 4, indicating that all connected treatments could reach each other in four "steps" within the same pathway of development. The distance between many important treatment regimens was greater than 1, indicating that no RCTs have compared these regimens.Our findings show that research programs in myeloma, which is a relatively small field, are surprisingly decentralized with a lack of connectivity among various research pathways. As a result there is much crucial research left unexplored. Using SNA to visually and analytically examine treatment networks prior to designing a clinical trial can lead to better designed studies.

  12. [Comparison of the Cost-Effectiveness of the SOX and COX Regimens in Patients with Unresectable Advanced and Recurrent Colorectal Cancer Using a Clinical Decision Analysis Approach].

    Science.gov (United States)

    Nagase, Satoshi; Iyoda, Tomokazu; Kanno, Hiroshi; Akase, Tomohide; Arakawa, Ichiro; Inoue, Tadao; Uetsuka, Yoshio

    2016-10-01

    Phase III clinical trials have comfirmed that the S-1 plus oxaliplatin(SOX)is inferior to the capecitabine plus oxaliplatin (COX)regimen in the treatment of metastatic colorectal cancer.On the basis of these findings, we compared, using a clinical decision analysis-based approach, the cost-effectiveness of the SOX and COX regimens.Herein, we simulated the expected effects and costs of the SOX and COX regimens using the markov model.Clinical data were obtained from Hong's 2012 report.The cost data comprised the costs for pharmacist labor, material, inspection, and treatment for adverse event, as well as the total cost of care at the advanced stage.The result showed that the expected cost of the SOX and COX regimen was 1,538,330 yen, and 1,429,596 yen, respectively, with an expected survival rate of 29.18 months, and 28.63 months, respectively.The incremental cost-effectiveness ratio of the SOX regimen was 197,698 yen/month; thus, the SOX regimen was found to be more cost-effective that the COX regimen.

  13. Gene set-based integrative analysis of ovarian clear cell carcinoma

    Directory of Open Access Journals (Sweden)

    Chia-Ming Chang

    2016-08-01

    Conclusion: Our pioneering works using the functionome, which was converted from microarray gene expression profiles for integrative analysis, showed a clear distinction of functional changes between the clear cell carcinomas and normal ovarian controls. This approach might provide a comprehensive view of the deregulated functions of clear cell carcinomas for further investigation.

  14. Clear air turbulence over South Africa

    Science.gov (United States)

    de Villiers, M. P.; van Heerden, J.

    2001-03-01

    Clear air turbulence (CAT) at high altitude remains a hazard to aviation which can result in passenger injury and aircraft damage. Two limited surveys of CAT events over South Africa, 1993-1995 (inclusive) and 1998, are used to illustrate the most likely synoptic conditions under which CAT can be expected. A case study of CAT associated with an upper-air trough and a mountain wave is presented. The study also evaluates the effectiveness of the Ellrod Turbulence Index (ETI) derived from model data provided by the UK Met. Office. A forecast of ETI derived from the Global Spectral Model of the United States National Center for Environmental Prediction (NCEP) is also reviewed.

  15. Optical clearing mechanisms characterization in muscle

    Directory of Open Access Journals (Sweden)

    Luís Oliveira

    2016-09-01

    Full Text Available Optical immersion clearing is a technique that has been widely studied for more than two decades and that is used to originate a temporary transparency effect in biological tissues. If applied in cooperation with clinical methods it provides optimization of diagnosis and treatment procedures. This technique turns biological tissues more transparent through two main mechanisms — tissue dehydration and refractive index (RI matching between tissue components. Such matching is obtained by partial replacement of interstitial water by a biocompatible agent that presents higher RI and it can be completely reversible by natural rehydration in vivo or by assisted rehydration in ex vivo tissues. Experimental data to characterize and discriminate between the two mechanisms and to find new ones are necessary. Using a simple method, based on collimated transmittance and thickness measurements made from muscle samples under treatment, we have estimated the diffusion properties of glucose, ethylene glycol (EG and water that were used to perform such characterization and discrimination. Comparing these properties with data from literature that characterize their diffusion in water we have observed that muscle cell membrane permeability limits agent and water diffusion in the muscle. The same experimental data has allowed to calculate the optical clearing (OC efficiency and make an interpretation of the internal changes that occurred in muscle during the treatments. The same methodology can now be used to perform similar studies with other agents and in other tissues in order to solve engineering problems at design of inexpensive and robust technologies for a considerable improvement of optical tomographic techniques with better contrast and in-depth imaging.

  16. Clear-Air Propagation Modeling using Parabolic Equation Method

    Directory of Open Access Journals (Sweden)

    V. Kvicera

    2003-12-01

    Full Text Available Propagation of radio waves under clear-air conditions is affected bythe distribution of atmospheric refractivity between the transmitterand the receiver. The measurement of refractivity was carried out onthe TV Tower Prague to access evolution of a refractivity profile. Inthis paper, the parabolic equation method is used in modelingpropagation of microwaves when using the measured data. This paperbriefly describes the method and shows some practical results ofsimulation of microwave propagation using real vertical profiles ofatmospheric refractivity.

  17. Paclitaxel/oxaliplatin/fluorouracil (TOF) regimen versus S-1/oxaliplatin (SOX) regimen for metastatic gastric cancer patients.

    Science.gov (United States)

    Dai, Xichao; Zhang, Xizhi; Wang, Chaomin; Jiang, Jingting; Wu, Changping

    2017-05-02

    This study was designed to compare the efficacy and safety of paclitaxel/oxaliplatin/fluorouracil (TOF) regimen and S-1/oxaliplatin (SOX) regimen for metastatic gastric cancer (GC) patients. Sixty patients were divided into TOF group and SOX groups randomly. Patients in the TOF group received paclitaxel (135 mg/m2 iv) on day 1, oxaliplatin (100 mg/m2 iv) on day 1, fluorouracil (500 mg/m2 continuous iv) on day 1-5. The patients in the SOX group received oxaliplatin (130 mg/m2 iv) on day 1 and S-1 (40 mg~60mg orally twice/day based on body surface area) on days 1-14. All the treatments were repeated every 21d for 4-6 cycles. The ORR and DCR of TOF group was 43.3% and 60.0%, respectively while that of SOX group was 36.7% and 56.7%. There were no statistical differences between the ORRs (χ2 = 0.278) and the DCRs (χ2 = 0.069) of the 2 groups. The majority of adverse events of two groups were hematological and digestive ones. Most of them were grade I and II. The adverse event rate of TOF group was higher than SOX group. The PFS times of TOF and SOX groups were 6.5 and 5.8 months, respectively. There was no statistical difference between the PFSs of the 2 groups (P = 0.451). The efficacies of TOF and SOX regimens are similar but the safety of SOX regimen better than TOF regimen.

  18. Transcriptome profiling of Arabian horse blood during training regimens.

    Science.gov (United States)

    Ropka-Molik, Katarzyna; Stefaniuk-Szmukier, Monika; Żukowski, Kacper; Piórkowska, Katarzyna; Gurgul, Artur; Bugno-Poniewierska, Monika

    2017-04-05

    Arabian horses are believed to be one of the oldest and most influential horse breeds in the world. Blood is the main tissue involved in maintaining body homeostasis, and it is considered a marker of the processes taking place in the other tissues. Thus, the aim of our study was to identify the genetic basis of changes occurring in the blood of Arabian horses subjected to a training regimen and to compare the global gene expression profiles between different training periods (T1: after a slow canter phase that is considered a conditioning phase, T2: after an intense gallop phase, and T3: at the end of the racing season) and between trained and untrained horses (T0). RNA sequencing was performed on 37 samples with a 75-bp single-end run on a HiScanSQ platform (Illumina), and differentially expressed genes (DEGs) were identified based on DESeq2 (v1.11.25) software. An increase in the number of DEGs between subsequent training periods was observed, and the highest amount of DEGs (440) was detected between untrained horses (T0) and horses at the end of the racing season (T3). The comparisons of the T2 vs. T3 transcriptomes and the T0 vs. T3 transcriptomes showed a significant gain of up-regulated genes during long-term exercise (up-regulation of 266 and 389 DEGs in the T3 period compared to T2 and T0, respectively). Forty differentially expressed genes were detected between the T1 and T2 periods, and 296 between T2 and T3. Functional annotation showed that the most abundant genes up-regulated in exercise were involved in pathways regulating cell cycle (PI3K-Akt signalling pathway), cell communication (cAMP-dependent pathway), proliferation, differentiation and apoptosis, as well as immunity processes (Jak-STAT signalling pathway). We investigated whether training causes permanent transcriptome changes in horse blood as a reflection of adaptation to conditioning and the maintenance of fitness to compete in flat races. The present study identified the overrepresented

  19. Response of broiler chickens to different dietary crude protein and feeding regimens

    Directory of Open Access Journals (Sweden)

    JO Oyedeji

    2005-09-01

    Full Text Available Five isocaloric (3200kcal/kg diets were used in an experiment designed to investigate the effects of dietary crude protein (CP and feeding regimens on broiler performance. Day-old broilers were randomly distributed into four groups using a completely randomized design. Each group was replicated three times with ten broiler chicks per replicate. The experiment lasted for eight weeks. Broilers in group 1 received 23% CP from 0 to 3 weeks, 20% CP from 3 to 6 weeks and 18% CP from 6 to 8 weeks, while broilers in group 2 received 23% CP between 0 and 6 weeks and 18% CP between 6 and 8 weeks. Besides, broilers in group 3 were fed 23% CP from 0 to 4 weeks and 16% CP from 4 to 8 weeks, whereas group 4 was given 18% CP from 0 to weeks. Water was supplied ad libitum for broilers in the different dietary groups. A metabolic trial was carried out on the third week of the experiment using a total collection method. Proximate analyses of diets and faecal samples were performed according to the methods outlined by the Association Of the Official Analytical Chemists. Results at market age showed that broiler performance with respect to feed intake, weight gain, feed to gain ratio and water intake were not significantly influenced by CP regimens (p>0.05. Furthermore, CP regimens did not significantly influence broilers liveability (p>0.05. Protein retention, fat utilization and available fiber were not significantly influenced among treatments (p> 0.05. Economic data showed that cost to benefit ratio of producing broilers was comparable among broilers for all CP regimens used in this trial (p>0.05. It was concluded that a single diet of 18% CP and 3200kcal/kg metabolizable energy would be most suitable and convenient for farmers who are engaged in on-farm feed production for broilers as compared with the standard feeding regimens of broiler starter and broiler finisher diets.

  20. Noncompliance with Medical Regimen in Haemodialysis Treatment: A Case Study

    Directory of Open Access Journals (Sweden)

    Paraskevi Theofilou

    2011-01-01

    Full Text Available Patients undergoing haemodialysis treatment have a high burden of disease (particularly cardiovascular comorbidities affecting their quality of life and dramatically shortening life expectancy. Effective chronic kidney disease (CKD control requires regular preventive medication and a response to that medication. Poor receptiveness to CKD medication can be related to individual variability in the dose needed to achieve a response, as well as to low-adherent behaviour in relation to the CKD medication regimen. Some patients, though not many, according to studies' findings, abuse the medical regimen as a result of suicidal tendencies. The present case gave us the opportunity to consider the causes and clinical findings and review the specific psychological interventions for patients with CKD.

  1. Basis for selecting optimum antibiotic regimens for secondary peritonitis.

    Science.gov (United States)

    Maseda, Emilio; Gimenez, Maria-Jose; Gilsanz, Fernando; Aguilar, Lorenzo

    2016-01-01

    Adequate management of severely ill patients with secondary peritonitis requires supportive therapy of organ dysfunction, source control of infection and antimicrobial therapy. Since secondary peritonitis is polymicrobial, appropriate empiric therapy requires combination therapy in order to achieve the needed coverage for both common and more unusual organisms. This article reviews etiological agents, resistance mechanisms and their prevalence, how and when to cover them and guidelines for treatment in the literature. Local surveillances are the basis for the selection of compounds in antibiotic regimens, which should be further adapted to the increasing number of patients with risk factors for resistance (clinical setting, comorbidities, previous antibiotic treatments, previous colonization, severity…). Inadequate antimicrobial regimens are strongly associated with unfavorable outcomes. Awareness of resistance epidemiology and of clinical consequences of inadequate therapy against resistant bacteria is crucial for clinicians treating secondary peritonitis, with delicate balance between optimization of empirical therapy (improving outcomes) and antimicrobial overuse (increasing resistance emergence).

  2. Impacts of 12-dose regimen for latent tuberculosis infection

    OpenAIRE

    Huang, Yi-Wen; Yang, Shun-Fa; Yeh, Yen-Po; Tsao, Thomas Chang-Yao; Tsao, Shih-Ming

    2016-01-01

    Abstract Treatment of latent tuberculosis infection (LTBI) is essential for eradicating tuberculosis (TB). Moreover, the patient adherence is crucial in determining the effectiveness of TB control. Isoniazid given by DOTS daily for 9 months (9H) is the standard treatment for LTBI in Taiwan. However, the completion rate is low due to the long treatment period and its side effects. The combined regimen using a high dose of rifapentine/isoniazid once weekly for 12 weeks (3HP) has been used as an...

  3. Progesterone profiles around the time of insemination do not show clear differences between of pregnant and not pregnant dairy cows

    DEFF Research Database (Denmark)

    Gorzecka, Justyna; Codrea, Marius Cosmin; Friggens, Nicolas C

    2011-01-01

    differences between the groups. However, the analysis correctly classified 75% of true pregnant cows. Conversely, only 60% of not pregnant animals were classified as such by the discriminate analysis. Individual analysis of progesterone profile features in pregnant and not pregnant groups of estrous cycles...

  4. Eradication of Helicobacter pylori infection: which regimen first?

    Science.gov (United States)

    Federico, Alessandro; Gravina, Antonietta Gerarda; Miranda, Agnese; Loguercio, Carmela; Romano, Marco

    2014-01-21

    Helicobacter pylori (H. pylori) is a well-known human pathogen that plays an essential role in the pathogenesis of chronic gastritis, peptic ulcer disease, and gastric malignancies. Although H. pylori is susceptible to several antimicrobials, this infection has proven challenging to cure because of the increasing prevalence of bacterial strains that are resistant to the most commonly used antimicrobials, particularly clarithromycin. An effective (i.e., > 90%) first-line therapy is mandatory for avoiding supplementary treatments and testing, and more importantly for preventing the development of secondary resistance. This study reviews the recent literature on first-line therapies for H. pylori. The eradication rates following standard triple therapy (a proton pump inhibitor plus amoxicillin and clarithromycin) for H. pylori infection are declining worldwide. Several first-line strategies have been proposed to increase the eradication rate, including extending the treatment duration to 14 d, the use of a four-drug regimen (bismuth-containing quadruple, sequential, and concomitant treatments), and the use of novel antibiotics, such as fluoroquinolones. However, the efficacy of these regimens is controversial. A first-line eradication regimen should be based on what works best in a defined geographical area and must take into account the prevalence of antimicrobial resistance in that region.

  5. A comparative study of eyelid cleaning regimens in chronic blepharitis.

    Science.gov (United States)

    Key, J E

    1996-07-01

    Blepharitis, an intrinsic eyelid inflammation with crusting and irritation, presents a great problem for patients wearing contact lenses. An important part of blepharitis therapy is eyelid hygiene, including the use of either soap, dilute baby shampoo, or commercial lid scrubs. In this study, a comparison was made between these three cleaning regimens in a group of 25 patients, 80% of whom (20/25) wore contact lenses. Patients used commercial eyelid scrub on right eyelids and a hypo-allergenic bar soap on left eyelids. Patient symptoms, slit lamp findings, and overall preferences were determined at the end of 4 months. A subgroup of 10 patients using lid scrub on right eyelids and dilute baby shampoo on left eyelids was followed for an additional 3 months. At the end of 4 months, 24% (6/25) of the patients noted no difference between soap and lid scrub, but 89% (17/19) of the others preferred the lid scrub. In the group using baby shampoo, 50% (5/10) noted no difference in 3 months, but 80% (4/5) of the remaining patients preferred the lid scrub. All patients improved in slit lamp findings with all three regimens, and patient preference was overwhelmingly in favor of the lid scrub regimen for convenience and ease of use.

  6. Pediatric evaluation of the ClearVoice™ speech enhancement algorithm in everyday life

    Directory of Open Access Journals (Sweden)

    Nathalie Noël-Petroff

    2013-12-01

    Full Text Available ClearVoice™ enables Advanced Bionics cochlear implant users to improve their speech understanding in difficult listening environments, without compromising performance in quiet situations. The aim of the study was to evaluate the benefits of ClearVoice in children. Children between six and fourteen years of age randomly tested two modalities of ClearVoice for one month each. The baseline program, HiRes 120™, and both ClearVoice programs were evaluated with a sentence test in quiet and noise. Parents and teachers completed a questionnaire related to everyday noisy situations. The switchover to ClearVoice was uneventful for both modalities. Adjustments to thresholds and comfort levels were required. Seven out of the nine children preferred a ClearVoice program. No impact of ClearVoice on performance in quiet was observed and both modalities of ClearVoice improved speech understanding in noise compared to the baseline program, significantly with ClearVoice high. Positive outcomes were obtained from the questionnaires and discussions with parents and children. This study showed that children benefited from using ClearVoice in their daily life. There was a clear trend towards improved speech understanding in noise with ClearVoice, without affecting performance in quiet; therefore ClearVoice can be used by children all day, without having to change programs.

  7. Clear cell syringofibroadenoma (of Mascaro) of the nail.

    Science.gov (United States)

    Fouilloux, B; Perrin, C; Dutoit, M; Cambazard, F

    2001-03-01

    Eccrine syringofibroadenoma (ESFA) is a rare disorder. We report the first case of ESFA of the nail apparatus, which presented as a yellow longitudinal onycholytic band of the left fourth finger over an intermittently painful subungual filamentous tumour. Histological examination showed features of ESFA with a digitate pattern of papillomatosis due to the specialized physiological longitudinal arrangement of the ridges in the nail bed. In addition, we describe a new feature of colloidal iron-positive clear cells. In our case, the presence of two types of cells with a central ductal differentiation and a significant amount of mucopolysaccharides in clear cells could suggest differentiation towards both the ductal and the secretory portion of the eccrine gland.

  8. Alternative regimens of magnesium sulfate for treatment of preeclampsia and eclampsia: a systematic review of non-randomized studies.

    Science.gov (United States)

    Pratt, Jeremy J; Niedle, Polina S; Vogel, Joshua P; Oladapo, Olufemi T; Bohren, Meghan; Tunçalp, Özge; Gülmezoglu, Ahmet Metin

    2016-02-01

    The optimal dosing regimen of magnesium sulfate for treating preeclampsia and eclampsia is unclear. Evidence from the Cochrane review of randomized controlled trials (RCTs) was inconclusive due to lack of relevant data. To complement the evidence from the Cochrane review, we assessed available data from non-randomized studies on the comparative efficacy and safety of alternative magnesium sulfate regimens for the management of preeclampsia and eclampsia. Sources included Medline, EMBASE, Popline, CINAHL, Global Health Library, African Index Medicus, Biological abstract, BIOSIS and reference lists of eligible studies. We selected non-randomized study designs including quasi-RCTs, cohort, case-control and cross-sectional studies that compared magnesium sulfate regimens in women with preeclampsia or eclampsia. Of 6178 citations identified, 248 were reviewed in full text and five studies of low to very low quality were included. Compared with standard regimens, lower-dose regimens appeared equally as good in terms of preventing seizures [odds ratio (OR) 1.02, 95% confidence interval (CI) 0.46-2.28, 899 women, four studies], maternal morbidity (OR 0.47, 95%CI 0.32-0.71, 796 women, three studies), and fetal and/or neonatal mortality (OR 0.87, 95%CI 0.38-2.00, 800 women, four studies). Comparison of loading dose only with maintenance dose regimens showed no differences in seizure rates (OR 0.99, 95%CI 0.22-4.50, 146 women, two studies), maternal morbidity (OR 0.53, 95%CI 0.15-1.93, 146 women, two studies), maternal mortality (OR 0.63, 95%CI 0.05-7.50, 146 women, two studies), and fetal and/or neonatal mortality (OR 0.49, 95%CI 0.23-1.03, 146 women, two studies). Lower-dose and loading dose-only regimens could be as safe and efficacious as standard regimens; however, this evidence comes from low to very low quality studies and further high quality studies are needed. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  9. Clear Channel Assessment in Integrated Medical Environments

    Directory of Open Access Journals (Sweden)

    Hara Shinsuke

    2008-01-01

    Full Text Available Abstract Complementary WLAN and WPAN technologies as well as other wireless technologies will play a fundamental role in the medical environments to support ubiquitous healthcare delivery. This paper investigates clear channel assessment (CCA and its impact on the coexistence of WLAN (IEEE 802.11 high rate direct sequence spread spectrum (HR/DSSS PHY and WPAN (IEEE 802.15.4b in the 2.4 GHz industrial, scientific, and medical (ISM band. We derived closed-form expressions of both energy-based CCA and feature-based CCA. We qualified unequal sensing abilities between them and termed this inequality asymmetric CCA, which is different from the traditional "hidden node" or "exposed node" issues in the homogeneous network. The energy-based CCA was considered in the considered integrated medical environment because the 2.4 GHz ISM band is too crowded to apply feature-based CCA. The WPAN is oversensitive to the 802.11 HR/DSSS signals and the WLAN is insensitive to the 802.15.4b signals. Choosing an optimal CCA threshold requires some prior knowledge of the underlying signals. In the integrated medical environment we considered here, energy-based CCA can effectively avoid possible packet collisions when they are close within the "heterogeneous exclusive CCA range" (HECR. However, when they are separated beyond the HECR, WPAN can still sense the 802.11 HR/DSSS signals, but WLAN loses its sense to the 802.15.4b signals. The asymmetric CCA leads to WPAN traffic in a position secondary to WLAN traffic.

  10. Clear cell sarcoma: the Roswell Park experience.

    Science.gov (United States)

    Finley, J W; Hanypsiak, B; McGrath, B; Kraybill, W; Gibbs, J F

    2001-05-01

    Clear cell sarcoma of the tendons and aponeuroses (CCSTA) is an aggressive, rare soft-tissue tumor with approximately 300 reported cases. Although it appears to be histogenetically related to melanoma, its clinical behavior resembles soft tissue sarcoma with a propensity for lymph node metastases. We report our experience at a tertiary cancer center. Eight cases of CCSTA evaluated at Roswell Park Cancer Institute between 1970 and 1998 were reviewed retrospectively. Patient data analyzed included patient age, gender, anatomic location, size of tumor, development of local, regional and distant recurrence, and patient status at last follow up. Six of eight patients were alive at 2 years, while three of seven patients were alive at 5 years. Of the patients alive with no evidence of recurrence, two had tumors of less than 2 cm, and the remaining patient had incomplete information regarding tumor size. Five patients recurred within 2 years of definitive surgical management. Four had tumors > 5 cm. All five patients progressed to metastatic disease at a median follow up of 20 months (range 1-108 months) following definitive surgical management and all eventually died of their disease at a median of 3 months (range 0-24 months) from presentation with metastatic disease. Four of five patients with lesions > 5 cm received adjuvant chemotherapy with intent to cure, but all eventually died of disease at 4, 22, 34, and 41 months from initial presentation. CCSTA is an aggressive tumor of the soft tissues. Early recognition and management are associated with an excellent long-term prognosis. Tumors greater than 5 cm warrant aggressive surgical management and treatment, and are at high risk of the development of distant disease. Aggressive multiagent chemotherapy appeared to have no impact on outcome. Other adjuvant therapeutic options including immunotherapy should be investigated. Copyright 2001 Wiley-Liss, Inc.

  11. Premixed vs basal-bolus insulin regimen in Type 2 diabetes: comparison of clinical outcomes from randomized controlled trials and real-world data.

    Science.gov (United States)

    Anyanwagu, U; Mamza, J; Gordon, J; Donnelly, R; Idris, I

    2017-12-01

    To evaluate the concordance between data derived from randomized controlled trial (RCT) and real-world estimates of HbA1c and weight change after 24 weeks of initiation of a basal-bolus compared with a premixed insulin regimen in people with Type 2 diabetes. Data eight RCTs were pooled after a systematic review of studies examining basal-bolus (n = 1893) or premixed (n = 1517) regimens. Real-world data were extracted from the UK primary care dataset for people on basal-bolus (n = 7483) or premixed insulin regimens (n=10 744). The mean differences between HbA1c and weight from baseline were calculated using t-tests, while analysis of variance was used to compare the two treatment regimens. Linear regression analyses were used to determine the predictors of this change. Both insulin regimens were associated with HbA1c reductions (real-world data -0.28%; RCT data, -1.4%) and weight gain (real-world data, +0.27 kg; RCT data, +2.96 kg) but there were no significant differences between basal-bolus and premixed insulin. Discordances in the pattern of treatment response were observed, however, between real-world and RCT data for both insulin regimens. For any given baseline HbA1c concentration, the change in HbA1c in the RCTs was greater than in real-world conditions and for those with baseline weight above ~60 kg, RCT data showed overall weight gain in contrast to slight weight loss in the real-world population. Lastly, for both randomized controlled trial and real-world populations, while greater baseline weight was associated with reduced response to treatment, the association was much steeper in the RCT than in the real-world population. In addition, greater baseline weight was associated with greater weight reductions in both premixed insulin and basal-bolus insulin regimens, although to a lesser extent with the latter. These results highlight specific discrepancies in the HbA1c reduction and weight change in insulin regimen between real world versus RCT populations

  12. Standardised nomenclature for glucocorticoid dosages and glucocorticoid treatment regimens : current questions and tentative answers in rheumatology

    NARCIS (Netherlands)

    Buttgereit, F; da Silva, JAP; Burmester, GR; Cutolo, M; Jacobs, J; Kirwan, J; Kohler, L; van Riel, P; Vischer, T; Bijlsma, JWJ

    In rheumatology and other medical specialties there is a discrepancy between the widespread use and the imprecise designation of glucocorticoid treatment regimens. Verbal descriptions of glucocorticoid treatment regimens used in various phases of diseases vary between countries and institutions.

  13. Chemotherapy for pulmonary large cell neuroendocrine carcinomas : Does the regimen matter?

    NARCIS (Netherlands)

    Derks, Jules L.; van Suylen, Robert Jan; Thunnissen, Erik; den Bakker, Michael A.; Groen, Harry J.; Smit, Egbert F.; Damhuis, Ronald A.; van den Broek, Esther C.; Speel, Ernst-Jan M.; Dingemans, Anne-Marie C.

    Pulmonary large cell neuroendocrine carcinoma (LCNEC) is rare. Chemotherapy for metastatic LCNEC ranges from small cell lung carcinoma (SCLC) regimens to nonsmall cell lung carcinoma (NSCLC) chemotherapy regimens. We analysed outcomes of chemotherapy treatments for LCNEC. The Netherlands Cancer

  14. MODIS Collection 6 Clear Sky Restoral (CSR): Filtering Cloud Mast 'Not Clear' Pixels

    Science.gov (United States)

    Meyer, Kerry G.; Platnick, Steven Edward; Wind, Galina; Riedi, Jerome

    2014-01-01

    Correctly identifying cloudy pixels appropriate for the MOD06 cloud optical and microphysical property retrievals is accomplished in large part using results from the MOD35 1km cloud mask tests (note there are also two 250m subpixel cloud mask tests that can convert the 1km cloudy designations to clear sky). However, because MOD35 is by design clear sky conservative (i.e., it identifies "not clear" pixels), certain situations exist in which pixels identified by MOD35 as "cloudy" are nevertheless likely to be poor retrieval candidates. For instance, near the edge of clouds or within broken cloud fields, a given 1km MODIS field of view (FOV) may in fact only be partially cloudy. This can be problematic for the MOD06 retrievals because in these cases the assumptions of a completely overcast homogenous cloudy FOV and 1-dimensional plane-parallel radiative transfer no longer hold, and subsequent retrievals will be of low confidence. Furthermore, some pixels may be identified by MOD35 as "cloudy" for reasons other than the presence of clouds, such as scenes with thick smoke or lofted dust, and should therefore not be retrieved as clouds. With such situations in mind, a Clear Sky Restoral (CSR) algorithm was introduced in C5 that attempts to identify pixels expected to be poor retrieval candidates. Table 1 provides SDS locations for CSR and partly cloudy (PCL) pixels.

  15. Characterization of avalanche photodiode arrays for the ClearPEM and ClearPEM-Sonic scanners

    Science.gov (United States)

    Bugalho, R.; Carriço, B.; Ferreira, C. S.; Frade, M.; Ferreira, M.; Moura, R.; Neves, J.; Ortigão, C.; Pinheiro, J. F.; Rodrigues, P.; Rolo, I.; Silva, J. C.; Silva, R.; Trindade, A.; Varela, J.

    2009-09-01

    The ClearPEM scanner is a high-resolution Positron Emission Mammography prototype, developed by the Portuguese PET Consortium in the framework of the Crystal Clear Collaboration at the European Organization for Nuclear Research (CERN). The scanner is based on a novel readout scheme which uses fine-pitch scintillator crystals, avalanche photodiodes, low-noise high-gain integrated electronics and a fast reconfigurable digital data acquisition system. The scanner uses two planar detector heads each composed of 96 detector modules. The detector module is composed of a matrix of 32 identical 2 × 2 × 20 mm3 LYSO:Ce scintillator crystals, coupled at both ends to Hamamatsu S8550 APD arrays for Depth-of-Interaction (DOI) measurements. More recently, a new scanner named ClearPEM-Sonic which combines the ClearPEM technology with an Ultrasound apparatus, is being produced. A set of 984 APD arrays used in both scanner assemblies followed a quality control protocol and a characterization procedure. This paper describes the methods used in these measurements and the results obtained with the full APD production batch.

  16. Assessment of the ovarian reserve with anti-Müllerian hormone in women who underwent allogeneic hematopoietic stem cell transplantation using reduced-intensity conditioning regimens or myeloablative regimens with ovarian shielding.

    Science.gov (United States)

    Nakano, Hirofumi; Ashizawa, Masahiro; Akahoshi, Yu; Ugai, Tomotaka; Wada, Hidenori; Yamasaki, Ryoko; Ishihara, Yuko; Kawamura, Koji; Sakamoto, Kana; Sato, Miki; Terasako-Saito, Kiriko; Kimura, Shun-Ichi; Kikuchi, Misato; Nakasone, Hideki; Kako, Shinichi; Kanda, Junya; Yamazaki, Rie; Tanihara, Aki; Nishida, Junji; Kanda, Yoshinobu

    2016-07-01

    Conditioning regimens that include cyclophosphamide (CY) and total body irradiation (TBI) induce severe gonadal toxicity and permanent infertility in approximately 90 % of female patients who undergo hematopoietic stem cell transplantation (HSCT). However, the use of ovarian shielding or non-myeloablative regimens may preserve ovarian function. To evaluate the ovarian reserve, serum anti-Müllerian hormone (AMH) levels were retrospectively measured in 11 female HSCT recipients aged less than 40 years, including seven with acute leukemia (AL) and four with aplastic anemia (AA), who received a myeloablative conditioning regimen with ovarian shielding or a reduced-intensity conditioning regimen. In most patients, menstruation had stopped and AMH level had decreased to an undetectable level (<0.1 ng/ml) after HSCT. Most patients showed a recovery of regular menstruation, but AMH levels did not increase immediately after the resumption of menstruation. However, in three AL patients and two AA patients who were evaluable for long-term recovery, AMH level increased gradually beyond 1 year after HSCT. In conclusion, recovery of the serum AMH level may be delayed after HSCT, and the AMH level early after HSCT may not accurately reflect ovarian reserve. A prospective study is required to address the usefulness of measuring the AMH level in HSCT recipients.

  17. Simple visual aids make health risks clear

    OpenAIRE

    Rocío García-Retamero; Dafina Petrova

    2017-01-01

    Transparent risk communication is an essential component of informed decision making. Unfortunately, many people struggle to understand risks because they lack practical mathematical and risk literacy skills. Our research shows that well-designed visual aids improve risk understanding by encouraging more thorough deliberation and reducing biased risk representations.

  18. Simple visual aids make health risks clear

    Directory of Open Access Journals (Sweden)

    Rocío García-Retamero

    2017-01-01

    Full Text Available Transparent risk communication is an essential component of informed decision making. Unfortunately, many people struggle to understand risks because they lack practical mathematical and risk literacy skills. Our research shows that well-designed visual aids improve risk understanding by encouraging more thorough deliberation and reducing biased risk representations.

  19. Treatment of Light Chain Deposition Disease Using Bortezomib-Based Regimen Followed by Thalidomide-Based Regimen in a Saudi Male

    Directory of Open Access Journals (Sweden)

    Bappa Adamu

    2016-01-01

    Full Text Available Light chain deposition disease (LCDD is a rare illness with, as yet, no clear evidence-based guidelines for its treatment. To the best of our knowledge, LCDD has not been previously reported from Saudi Arabia. We present in this report, a 38-year-old Saudi male who presented with clinical features suggestive of hypertensive nephropathy but kidney biopsy later revealed the diagnosis of LCDD. His serum creatinine at presentation was 297 μmol/L which came down to 194 μmol/L on treatment with Bortezomib, Cyclophosphamide and Dexamethasone. His 24-hour protein excretion at presentation was 6 g/L which also came down to less than 1 g/day. He was later placed on Cyclophosphamide, Thalidomide, and Dexamethasone regimen because of persistent high titres of serum free light chains. He went into remission with undetectable serum free light chains and remained so for three years at the time of writing this report. We conclude that LCDD, though rare, does occur in Saudi population. The treatment of LCDD is challenging but the use of Bortezomib, a proteosome inhibitor, is promising. However, suboptimal response may require further treatment with other therapeutic options such as chemotherapy with alkylating agents or high-dose Melphalan with autologous stem cell transplant.

  20. Efficacy of a twice-daily, 3-step, over-the-counter skincare regimen for the treatment of acne vulgaris.

    Science.gov (United States)

    Rodan, Katie; Fields, Kathy; Falla, Timothy J

    2017-01-01

    Acne vulgaris (acne) is the most common skin disorder producing physical and emotional scars that can persist for years. An estimated 83% of acne sufferers self-treat, but there is lack of studies documenting the effectiveness of over-the-counter (OTC) acne treatment products. This study was conducted to determine the effectiveness of an OTC, 3-step, anti-acne skincare regimen in treating acne and improving the appearance of red/inflamed facial skin. This 6-week, open-label clinical study included both genders aged between 12 and 35 years with mild-to-moderate acne. All subjects were required to have an acne score of 1-3 (Cook's acne grading scale: 0=clear to 7=very severe) and a moderate redness score of ≥2 (0=none and 4=severe). Subjects completed a 3-step facial treatment regimen every morning and evening using an OTC cleanser, toner, and acne treatment. Evaluations for effectiveness and safety were done at baseline and weeks 2, 4, and 6 using digital photographs (Visia-CR(®) digital imaging system) of the face and analyzed using Image-Pro(®) software for the grading of acne, red/inflamed skin, and the number and type of lesions. Thirty subjects (12 males and 18 females) were enrolled (mean age of 19 years; range 12-34 years). This skincare regimen resulted in statistically significant improvements in acne grading scores after 2 weeks of use, with mean scores continuing to improve after 4 and 6 weeks of use (Pacne skincare regimen in significantly improving acne and the overall appearance of skin in the majority of subjects who had mild-to-moderate acne.

  1. Cranial osteopathy: its fate seems clear

    Science.gov (United States)

    Hartman, Steve E

    2006-01-01

    Background According to the original model of cranial osteopathy, intrinsic rhythmic movements of the human brain cause rhythmic fluctuations of cerebrospinal fluid and specific relational changes among dural membranes, cranial bones, and the sacrum. Practitioners believe they can palpably modify parameters of this mechanism to a patient's health advantage. Discussion This treatment regime lacks a biologically plausible mechanism, shows no diagnostic reliability, and offers little hope that any direct clinical effect will ever be shown. In spite of almost uniformly negative research findings, "cranial" methods remain popular with many practitioners and patients. Summary Until outcome studies show that these techniques produce a direct and positive clinical effect, they should be dropped from all academic curricula; insurance companies should stop paying for them; and patients should invest their time, money, and health elsewhere. PMID:16762070

  2. Cranial osteopathy: its fate seems clear

    Directory of Open Access Journals (Sweden)

    Hartman Steve E

    2006-06-01

    Full Text Available Abstract Background According to the original model of cranial osteopathy, intrinsic rhythmic movements of the human brain cause rhythmic fluctuations of cerebrospinal fluid and specific relational changes among dural membranes, cranial bones, and the sacrum. Practitioners believe they can palpably modify parameters of this mechanism to a patient's health advantage. Discussion This treatment regime lacks a biologically plausible mechanism, shows no diagnostic reliability, and offers little hope that any direct clinical effect will ever be shown. In spite of almost uniformly negative research findings, "cranial" methods remain popular with many practitioners and patients. Summary Until outcome studies show that these techniques produce a direct and positive clinical effect, they should be dropped from all academic curricula; insurance companies should stop paying for them; and patients should invest their time, money, and health elsewhere.

  3. Cranial osteopathy: its fate seems clear

    OpenAIRE

    Hartman, Steve E

    2006-01-01

    Abstract Background According to the original model of cranial osteopathy, intrinsic rhythmic movements of the human brain cause rhythmic fluctuations of cerebrospinal fluid and specific relational changes among dural membranes, cranial bones, and the sacrum. Practitioners believe they can palpably modify parameters of this mechanism to a patient's health advantage. Discussion This treatment regime lacks a biologically plausible mechanism, shows no diagnostic reliability, and offers little ho...

  4. Heterologous Prime-Boost HIV-1 Vaccination Regimens in Pre-Clinical and Clinical Trials

    Directory of Open Access Journals (Sweden)

    Julia L. Hurwitz

    2010-02-01

    Full Text Available Currently, there are more than 30 million people infected with HIV-1 and thousands more are infected each day. Vaccination is the single most effective mechanism for prevention of viral disease, and after more than 25 years of research, one vaccine has shown somewhat encouraging results in an advanced clinical efficacy trial. A modified intent-to-treat analysis of trial results showed that infection was approximately 30% lower in the vaccine group compared to the placebo group. The vaccine was administered using a heterologous prime-boost regimen in which both target antigens and delivery vehicles were changed during the course of inoculations. Here we examine the complexity of heterologous prime-boost immunizations. We show that the use of different delivery vehicles in prime and boost inoculations can help to avert the inhibitory effects caused by vector-specific immune responses. We also show that the introduction of new antigens into boost inoculations can be advantageous, demonstrating that the effect of ‘original antigenic sin’ is not absolute. Pre-clinical and clinical studies are reviewed, including our own work with a three-vector vaccination regimen using recombinant DNA, virus (Sendai virus or vaccinia virus and protein. Promising preliminary results suggest that the heterologous prime-boost strategy may possibly provide a foundation for the future prevention of HIV-1 infections in humans.

  5. Study on Dosage Regimens of Asthma Medications in Pediatric Patients of Dr. M. Djamil Padang Hospital

    Directory of Open Access Journals (Sweden)

    Rahmi Yosmar

    2015-12-01

    Full Text Available A study on dosage regimens of asthma medications in pediatric patients hospitalized at the pediatrics ward DR. M. Djamil Padang hospital has been carried out. The purpose of this study was to determine and compare the suitability of dosage regimen given to pediatric patients in the pediatrics ward of Dr. M. Djamil Padang hospital with the literature. This study was conducted retrospectively with consecutive sampling technique. Samples were obtained from medical records during 2013. The results showed that the appropriate dosage administration of asthma medication for the prednisone, Combivent® and ambroxol were 100%, salbutamol 75%, and theophylline 0%. On the other hand, the entire medications showed 100% suitability concerning the route of administration. While for the interval of administration, the study showed that dexamethasone, prednisone, salbutamol, theophylline and ambroxol were 100% appropriate, but Combivent® was lower at 95.24%. The study concludes that the dose and interval of administration are not in accordance with the literature, while the route of administration is considered to be in accordance with the literature.

  6. 78 FR 50259 - Derivatives Clearing Organizations and International Standards

    Science.gov (United States)

    2013-08-16

    .... (``CME''), ICE Clear Credit LLC (``ICE Clear Credit''), and The Options Clearing Corporation (``OCC... is the Supervisory Agency only for CME and ICE Clear Credit, the SEC serves as OCC's Supervisory... and central banks from around the world including, Argentina, Australia, Belgium, Brazil, Canada...

  7. First-line cART regimen impacts the course of CD8+ T-cell counts in HIV-infected patients that achieve sustained undetectable viral load.

    Science.gov (United States)

    Poizot-Martin, Isabelle; Allavena, Clotilde; Delpierre, Cyrille; Duvivier, Claudine; Obry-Roguet, Véronique; Cano, Carla E; Guillouet de Salvador, Francine; Rey, David; Dellamonica, Pierre; Cheret, Antoine; Cuzin, Lise; Katlama, Christine; Cabié, André; Hoen, Bruno

    2016-10-01

    The aim of the study was to investigate the impact of first-line combined antiretroviral therapy (cART) regimen on the course of CD8 T-cell counts in human immunodeficiency virus (HIV)-infected patients.A retrospective observational study conducted on the French DAT'AIDS Cohort of HIV-infected patients.We selected 605 patients initiating a first-line cART between 2002 and 2009, and which achieved a sustained undetectable HIV plasma viral load (pVL) for at least 12 months without cART modification. The evolution of CD8 T-cell counts according to cART regimen was assessed.CD8 T-cell counts were assessed in 572 patients treated with 2NRTIs+1PI/r (n= 297), 2NRTIs+1NNRTI (n= 207) and 3NRTIs (n= 68). In multivariate analysis, after 12 months of follow-up, the 3NRTIs regimen was associated with a significantly smaller decrease of CD8 T-cell count compared with NNRTI-containing regimens (-10.2 cells/μL in 3NRTIs vs -105.1 cells/μL; P=0.02) but not compared with PI-containing regimens (10.2 vs -60.9 cells/μL; P=0.21). After 24 months, the 3NRTIs regimen was associated with a smaller decrease of CD8 T-cell count and % compared with PI/r- and NNRTI-containing regimens (0.2 in 3NRTIs vs -9.9 with PI/r-regimens, P=0.001, and vs -11.1 with NNRTI-regimens, p < 0.0001). A focus analysis on 11 patients treated with an INSTI-containing cART regimen during the study period showed after 12 months of follow-up, a median decrease of CD8 T-cell count of -155 [inter quartile range: -302; -22] cells/μL.Our data highlight the fact that cART regimens have differential effects on CD8 pool down regulation.

  8. Esquemas alternativos de hemodiálise Alternative hemodialysis regimens

    Directory of Open Access Journals (Sweden)

    Jorge Paulo Strogoff de Matos

    2010-03-01

    Full Text Available A taxa de mortalidade entre os pacientes em hemodiálise (HD é extremamente elevada. A expectativa de vida restante de um paciente ao iniciar HD é apenas cerca de um quarto daquela da população geral com a mesma idade. O esquema convencional de HD, com três sessões semanais de cerca de quatro horas, foi estabelecido de maneira empírica há cerca de quatro décadas e merece ser reavaliado criticamente. Desde a falha do Estudo HEMO em demonstrar benefícios clínicos com o aumento do Kt/V de ureia nos pacientes em esquema convencional de HD, tem havido um crescente interesse pelos esquemas alternativos de HD com o intuito de prover um tratamento associado com uma melhor sobrevida. Dentre os esquemas mais promissores, destacam-se a HD diária de curta duração e a HD noturna prolongada. As limitações econômicas que inibem a aplicação dos conhecimentos emergentes nesta área devem ser vencidas.The mortality rate among patients on hemodialysis (HD is extremely high. Remaining life expectancy for a patient initiating HD is only approximately one quarter of that of the general population at the same age bracket. The conventional HD regimen based on four-hour sessions three times a week was empirically established nearly four decades ago and needs to be revisited. Since the failure of the HEMO Study to demonstrate the clinical benefits of higher urea Kt/V for patients on conventional HD, an increasing interest for alternative HD regimens has emerged aiming at providing a treatment for improving survival rates. Short daily HD and long nocturnal HD stand out as the most promising alternative regimens. Economical obstacles which could hinder the clinical application of emerging knowledge in the field should be overcome.

  9. Metastatic clear cell carcinoma of the kidney: therapeutic role of bevacizumab.

    Science.gov (United States)

    Bukowski, Ronald M

    2010-03-26

    The biology and pathogenesis of clear cell carcinoma of the kidney has been extensively investgated, and the role of von Hipple-Landau gene inactivation and tumor associated angiogenesis is now recognized. Development of vascular endothelial growth factor inhibitors and phase 3 clinical trials utilizing this class of agents has produced a new treatment paradigm for patients with metastatic renal cell carcinoma (RCC). One of the active regimens identified is the combination of bevacizumab and interferon-α. Recently published reports provided evidence of the clinical and biologic activity of this therapy. The current manuscript reviews the background and rationale for the activity of bevacizumab in RCC, and results from recent clinical trials with this agent alone or in combination with targeted agents or cytokines. The role of this therapy in contrast to other targeted agents is reviewed, and the potential utility as well as questions raised by recent studies are discussed.

  10. Medication regimen complexity in ambulatory older adults with heart failure.

    Science.gov (United States)

    Cobretti, Michael R; Page, Robert L; Linnebur, Sunny A; Deininger, Kimberly M; Ambardekar, Amrut V; Lindenfeld, JoAnn; Aquilante, Christina L

    2017-01-01

    Heart failure prevalence is increasing in older adults, and polypharmacy is a major problem in this population. We compared medication regimen complexity using the validated patient-level Medication Regimen Complexity Index (pMRCI) tool in "young-old" (60-74 years) versus "old-old" (75-89 years) patients with heart failure. We also compared pMRCI between patients with ischemic cardiomyopathy (ISCM) versus nonischemic cardiomyopathy (NISCM). Medication lists were retrospectively abstracted from the electronic medical records of ambulatory patients aged 60-89 years with heart failure. Medications were categorized into three types - heart failure prescription medications, other prescription medications, and over-the-counter (OTC) medications - and scored using the pMRCI tool. The study evaluated 145 patients (n=80 young-old, n=65 old-old, n=85 ISCM, n=60 NISCM, mean age 73±7 years, 64% men, 81% Caucasian). Mean total pMRCI scores (32.1±14.4, range 3-84) and total medication counts (13.3±4.8, range 2-30) were high for the entire cohort, of which 72% of patients were taking eleven or more total medications. Total and subtype pMRCI scores and medication counts did not differ significantly between the young-old and old-old groups, with the exception of OTC medication pMRCI score (6.2±4 young-old versus 7.8±5.8 old-old, P=0.04). With regard to heart failure etiology, total pMRCI scores and medication counts were significantly higher in patients with ISCM versus NISCM (pMRCI score 34.5±15.2 versus 28.8±12.7, P=0.009; medication count 14.1±4.9 versus 12.2±4.5, P=0.008), which was largely driven by other prescription medications. Medication regimen complexity is high in older adults with heart failure, and differs based on heart failure etiology. Additional work is needed to address polypharmacy and to determine if medication regimen complexity influences adherence and clinical outcomes in this population.

  11. Management of patients using unproven regimens for arthritis.

    Science.gov (United States)

    Wolman, P G

    1987-09-01

    Such treatments as vegetarian diets, fresh or raw diets, allergy diets, no-dairy-products diets, fasting, vitamin and mineral supplementation, apple cider vinegar, and honey drinks are touted in the popular press as effective for the treatment of arthritis. In contrast to conventional therapies, the unproven treatments promise not only relief from symptoms but freedom from the disease as long as the diet regimen is followed. Several of the remedies appear to be harmless, but others are dangerous, especially if followed for prolonged periods. Nutrition professionals should be aware of the nature of these treatments and be prepared to offer sound, scientifically based but nonjudgmental care and information.

  12. Evaluation of current treatment regimens for prepatellar and olecranon bursitis in Switzerland.

    Science.gov (United States)

    Baumbach, S F; Wyen, H; Perez, C; Kanz, K-G; Uçkay, I

    2013-02-01

    Bursitis is a common entity. However, evidence for the best treatment procedures is lacking, with management concepts varying internationally. We evaluated current treatment regimens for septic (SB) and nonseptic (NSB) prepatellar (PB) and (OB) olecranon bursitis in Switzerland and compared them to the published literature. A voluntary 23-item online survey was distributed amongst all registered Swiss infectiologists and orthopedic surgeons in December 2011. The literature comparison was based on a systematic literature review. Overall response rate was 14 % (n = 117); 11 % (n = 92) were included in the final analysis. The overwhelming majority (91 %) of the respondents differentiated between SB and NSB, with determination predominantly based on clinical presentation (83 %), blood chemistry (75 %), and bursal aspirate (66 %). NSB was predominantly treated conservatively via immobilization (78 %) and anti-inflammatory medication (73 %). For SB, 85 % indicated surgical intervention, with 73 % prescribing concomitant antibiotics. Regarding antibiotic choice, 90 % used an aminopenicillin or its derivatives for a mean of 11 ± 5 days. The literature review revealed 66 relevant publications with an overall level of evidence of 2b, arguing for a conservative treatment approach in cases of SB or NSB. Therapeutic regimens for OB/PB differed considerably within Switzerland. Surgical intervention and antibiotic treatment was the most common therapy for SB, whereas a conservative approach predominated for NSB, which contrasts with the international literature. Clearly, prospective multicenter and multidisciplinary studies are needed to identify an optimal and cost-saving approach to the treatment of these common clinical entities.

  13. Comparison of different regimens of proton pump inhibitors for acute peptic ulcer bleeding.

    Science.gov (United States)

    Neumann, Ignacio; Letelier, Luz M; Rada, Gabriel; Claro, Juan Carlos; Martin, Janet; Howden, Colin W; Yuan, Yuhong; Leontiadis, Grigorios I

    2013-06-12

    -regression analysis did not show any statistically significant associations between treatment effect (for the outcomes of mortality, rebleeding and surgical intervention) and the three study-level factors that were assessed (geographical location (Asia versus not Asia), route of PPI administration (intravenous versus oral), within-study ratio among the 72-hour cumulative doses of the two PPI regimens). There is insufficient evidence for concluding superiority, inferiority or equivalence of high dose PPI treatment over lower doses in peptic ulcer bleeding.

  14. EXPERIMENTAL CONFIRMATION FOR SELECTION OF IRRADIATION REGIMENS FOR INTRAPERITONEAL PHOTODYNAMIC THERAPY WITH PORPHYRIN AND PHTHALOCYANINE PHOTOSENSITIZERS

    Directory of Open Access Journals (Sweden)

    A. A. Pankratov

    2017-01-01

    Full Text Available Optimized irradiation regimens for intraperitoneal photodynamic therapy with porphyrin and phthalocyanine photosensitizers are determined in in vitro and in vivo studies.The experimental  study on НЕр2 cell line showed that reduce of power density for constant  light dose increased significantly the efficacy of photodynamic therapy (the reduce of power density from 20-80 mW/cm2 to 10 mW/cm2 had the same results (90% cell death for half as much concentration of the photosensitizer.The obtained results were confirmed in vivo in mice with grafted tumor S-37. For light dose of 90 J/cm2  and power density of 25 mW/cm2 none of animals in the experimental  group had total resorption of the tumor. For the same light dose and decrease  of power density to 12 mW/cm2  total tumor resorption was achieved in 34% of animals, 66% of animals died from phototoxic  shock. For twofold decrease  of light dose – to 45 J/cm2  with the same low-intensity power density (12 mW/cm2 we managed total tumor resorption in 100% of animals.In the following studies of optimized irradiation regimen for intrapleural photodynamic therapy the reaction of intact peritoneum of rats on photodynamic exposure was assessed and optimized parameters of laser irradiation, which did not cause necrosis and intense inflammatory reaction of peritoneum, were determined – light dose of 10 J/cm2  with power density of mW/cm2.Thus, the reasonability for use of low-intensity regimens of irradiation for intraperitoneal photodynamic therapy was confirmed experimentally with possibility of high efficacy of treatment without inflammatory reactions of peritoneum.

  15. Safety and efficacy of alternative alglucosidase alfa regimens in Pompe disease.

    Science.gov (United States)

    Case, Laura E; Bjartmar, Carl; Morgan, Claire; Casey, Robin; Charrow, Joel; Clancy, John P; Dasouki, Majed; DeArmey, Stephanie; Nedd, Khan; Nevins, Mary; Peters, Heidi; Phillips, Dawn; Spigelman, Zachary; Tifft, Cynthia; Kishnani, Priya S

    2015-04-01

    Emerging phenotypes in long-term survivors with Pompe disease on standard enzyme replacement therapy (ERT) (alglucosidase alfa 20 mg/kg/2 weeks) can include patients with worsening motor function. Whether higher doses of ERT improve skeletal function in these patients has not been systematically studied. This exploratory, randomized, open-label, 52-week study examined the safety and efficacy of 2 ERT regimens of alglucosidase alfa (20 mg/kg/week or 40 mg/kg/2 weeks) in 13 patients with Pompe disease and clinical decline or a lack of improvement on standard ERT: late-onset (n = 4), infantile-onset (n = 9). Cross-reactive immunologic material assay-negative patients were excluded. Eleven of 13 patients completed the study. Trends for improvement were seen in total gross motor function, but not mobility; however, 6 (late-onset, 2; infantile-onset, 4) of 11 patients (55%) who met the entry criteria of motor decline (late-onset, 4; infantile-onset, 7) showed improvement in motor and/or mobility skills. No between-regimen differences in efficacy emerged. Two case studies highlight the benefits of increased ERT dose in patients with Pompe disease experiencing clinical decline. Both alternative regimens were generally well tolerated. This study was limited by the small sample size, which is not uncommon for small clinical studies of rare diseases. Additionally, the study did not include direct assessment of muscle pathology, which may have identified potential causes of decreased response to ERT. Results were inconclusive but suggest that increased ERT dose may be beneficial in some patients with Pompe disease experiencing motor decline. Controlled studies are needed to clarify the benefits and risks of this strategy. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  16. Comparison of four physiotherapy regimens in the treatment of long-term mechanical low back pain.

    Science.gov (United States)

    Johnson, Olubusola E; Adegoke, Babatunde O A; Ogunlade, Samuel O

    2010-01-01

    This study compared efficacy of combinations of Back Muscles Endurance Exercise (BMEE) and McKenzie Exercise (ME) and McKenzie Back Care Education (MBE) in the management of long term mechanical Low Back Pain (LBP). A single-blind randomized controlled comparative trial was employed. Seventy three participants mean age 45.3 ± 8.1 years were recruited for the study but only 53 completed the study. Participants in group A were treated with a combination of BMEE, ME and MBE. Group B: A combination BMEE and MBE. Group C: A combination of ME and MBE. Group D: MBE only. Participants were seen thrice weekly for 8 weeks. They were measured for pain intensity, lumbar flexibility, activities limitation and self esteem. Data were analysed using descriptive and inferential statistics of F-test. Significance was set at 0.05 alpha-level. At the end of the study, the four treatment groups had significant reduction in pain intensity p<0.05. Post hoc analysis showed groups A, B, and C had significantly greater reduction than D, and groups A and C had significantly greater reduction than B. Groups A, B and C also had significant improvement in activities limitation p<0.05. Post hoc analysis showed groups A, B and C had significantly greater improvement than D, and group B significantly greater improvement than C. Combination physiotherapy regimens proved effective in the management of long- term mechanical LBP. Regimen A is recommended in managing long-term mechanical LBP.

  17. Comparative efficacy and safety results of two topical combination acne regimens.

    Science.gov (United States)

    Kircik, Leon H

    2009-07-01

    Combination therapy has become the standard for the management of acne, particularly for moderate-to-severe cases. Among these combinations, those regimens containing benzoyl peroxide (BPO), clindamycin and a retinoid have been used frequently as they address most aspects of acne pathogenesis. This study compares the efficacy and safety of two common topical treatment regimens in the treatment of a moderate to severe facial acne vulgaris: fixed-combination gel containing BPO 5% and clindamycin 1% (BPO/C) plus tretinoin microsphere gel 0.04% (RAM) versus a regimen of a fixed-combination gel containing clindamycin phosphate 1.2% and tretinoin 0.025% (CPT) plus a once-daily BPO 5% wash. While both regimens were safe and effective, regimen BPO/C+RAM yielded a more rapid onset of effect versus regimen CPT+BPO against both non-inflammatory and inflammatory lesions. Both treatment regimens were well-tolerated.

  18. Influence of ventilation regimen on micro-environment and on ewe welfare and milk yield in summer

    Directory of Open Access Journals (Sweden)

    Mariangela Caroprese

    2010-01-01

    during the second half of the trial. No significant differences emerged in ewe immune and endocrine responses.Results show that ventilation regimen had a moderate impact on ewe behavior, physiology and production performance.This experiment suggests that the length of ventilation cycles and air speed, together with ventilation rate, arecritical for efficient ventilation regimens.

  19. Ovarian clear cell carcinoma with plasma cell-rich inflammatory stroma: a clear cell carcinoma subgroup with distinct clinicopathological features.

    Science.gov (United States)

    Kato, Noriko; Kurotaki, Hidekachi; Uchigasaki, Shinya; Fukase, Masayuki; Kurose, Akira

    2016-03-01

    Ovarian clear cell carcinoma has a unique stroma. Although a hyalinized or mucoid stroma is more common, the stroma sometimes shows a dense inflammatory infiltrate, simulating a dysgerminoma. The aim of this study was to analyse the character and significance of the inflammatory stroma. Twelve of 60 (20%) clear cell carcinomas showed an inflammatory stroma. The inflammatory stroma and hyalinized/mucoid stroma were mutually exclusive. Inflammatory cells were predominantly composed of CD138-positive plasma cells. As compared with the non-inflammatory cases, the epithelial component frequently showed a solid growth pattern and immunoreactivity for cyclooxygenase-2, one of the critical proinflammatory enzymes (P cell carcinoma cell lines into athymic nude mice. In particular, xenografts of one cell line (JHOC-5) were infiltrated by mature plasma cells, indicating that plasma cell differentiation was stimulated by JHOC-5 cells, independently of T lymphocytes. Clinicopathologically, the frequency of International Federation of Gynaecology and Obstetrics stage III was higher in the cases with an inflammatory stroma than in those without it (P cell carcinomas with an inflammatory stroma constitute a distinct clinicopathological subgroup. It is strongly suggested that tumour cells themselves are responsible for inducing inflammation and stimulating plasma cell differentiation in a paracrine manner. © 2015 The Authors. Histopathology Published by John Wiley & Sons Ltd.

  20. A systematic review of effectiveness and safety of different regimens of levonorgestrel oral tablets for emergency contraception.

    Science.gov (United States)

    Shohel, Mohammad; Rahman, Mohammad Mahfuzur; Zaman, Asif; Uddin, Mir Muhammad Nasir; Al-Amin, Md Mamun; Reza, Hasan Mahmud

    2014-04-04

    Unintended pregnancy is a complex phenomenon which raise to take an emergency decision. Low contraceptive prevalence and high user failure rates are the leading causes of this unexpected situation. High user failure rates suggest the vital role of emergency contraception to prevent unplanned pregnancy. Levonorgestrel - a commonly used progestin for emergency contraception. However, little is known about its pharmacokinetics and optimal dose for use. Hence, there is a need to conduct a systematic review of the available evidences. Randomized, double-blind trials were sought, evaluating healthy women with regular menstrual cycles, who requested emergency contraception within 72 h of unprotected coitus, to one of three regimens: 1.5 mg single dose levonorgestrel, two doses of 0.75 mg levonorgestrel given 12 h apart or two doses of 0.75 mg levonorgestrel given 24 h apart. The primary outcome was unintended pregnancy; other outcomes were side-effects and timing of next menstruation. Every trial under consideration successfully established the contraceptive effectiveness of levonorgestrel for preventing unintended pregnancy. Moreover, a single dose of levonorgestrel 1.5 mg for emergency contraception supports its safety and efficacy profile. If two doses of levonorgestrel 0.75 mg are intended for administration, the second dose can positively be taken 12-24 h after the first dose without compromising its contraceptive efficacy. The main side effect was frequent menstrual irregularities. No serious adverse events were reported. The review shows that, emergency contraceptive regimen of single-dose levonorgestrel is not inferior in efficacy to the two-dose regimen. All the regimens studied were very efficacious for emergency contraception and prevented a high proportion of pregnancies if taken within 72 h of unprotected coitus. Single levonorgestrel dose (1.5 mg) can substitute two 0.75 mg doses 12 or 24 h apart. With either regimen, the earlier the treatment is given

  1. Comparison of Ciprofloxacin-Based Triple Therapy with Conventional Triple Regimen for Helicobacter pylori Eradication in Children.

    Science.gov (United States)

    Farahmand, Fatemeh; Mohammadi, Tayebeh; Najafi, Mehri; Fallahi, Gholamhosein; Khodadad, Ahmad; Motamed, Farzaneh; Mahdi Marashi, Sayed; Shoaran, Maryam; Nabavizadeh Rafsanjani, Raheleh

    2016-06-01

    Helicobacter pylori infection is a prevalent disease among Iranian children. The purpose of this study was to compare the effect of ciprofloxacin and furazolidone on eradicating helicobacter pylori in Iranian children in combination with amoxicillin and omeprazole. In this cohort study, helicobacter pylori infection was confirmed by gastroscopy, rapid urease test or pathologic assessments. A total of 66 children were randomly enrolled; based on the random number table, and were divided into two groups; first, a combination regimen consisting of ciprofloxacin, amoxicillin, and omeprazole; second, a three-medication regimen consisting of amoxicillin, furazolidone, and omeprazole. The effect of both medical regimens on the successful eradication of helicobacter pylori infection was assessed and compared. Chi-square test was used for evaluating the association between quantitative variables. All comparisons were made at the significance of P<0.05. Endoscopic tests prior to initiating treatments showed that 66.7% of the patients had a degree of nodularity while peptic ulcer was only observed in one patient. One month after the end of the treatments, eradication of the helicobacter pylori infection was reported 87.9% (29/33) in the first group (CAO) and 60.6% (20.33) in the second group (FAO) (P=0.011). It appears that a major advantage of our proposed regimen over others is a lack of wide use of fluoroquinolones for treating children's diseases. Given FDA's recommendation about the possibility of prescribing ciprofloxacin for infected patients with multidrug resistance, we can use the regimen proposed in this study in patients with resistance to standard treatments.

  2. Comparison of Ciprofloxacin-Based Triple Therapy with Conventional Triple Regimen for Helicobacter pylori Eradication in Children

    Directory of Open Access Journals (Sweden)

    Fatemeh Farahmand

    2016-06-01

    Full Text Available Helicobacter pylori infection is a prevalent disease among Iranian children. The purpose of this study was to compare the effect of ciprofloxacin and furazolidone on eradicating helicobacter pylori in Iranian children in combination with amoxicillin and omeprazole. In this cohort study, helicobacter pylori infection was confirmed by gastroscopy, rapid urease test or pathologic assessments. A total of 66 children were randomly enrolled; based on the random number table, and were divided into two groups; first, a combination regimen consisting of ciprofloxacin, amoxicillin, and omeprazole; second, a three-medication regimen consisting of amoxicillin, furazolidone, and omeprazole. The effect of both medical regimens on the successful eradication of helicobacter pylori infection was assessed and compared. Chi-square test was used for evaluating the association between quantitative variables. All comparisons were made at the significance of P<0.05. Endoscopic tests prior to initiating treatments showed that 66.7% of the patients had a degree of nodularity while peptic ulcer was only observed in one patient. One month after the end of the treatments, eradication of the helicobacter pylori infection was reported 87.9% (29/33 in the first group (CAO and 60.6% (20.33 in the second group (FAO (P=0.011. It appears that a major advantage of our proposed regimen over others is a lack of wide use of fluoroquinolones for treating children’s diseases. Given FDA’s recommendation about the possibility of prescribing ciprofloxacin for infected patients with multidrug resistance, we can use the regimen proposed in this study in patients with resistance to standard treatments.

  3. Clear cell carcinoid tumor of the distal common bile duct

    Directory of Open Access Journals (Sweden)

    Tsukada Katsuhiko

    2007-01-01

    Full Text Available Abstract Background Carcinoid tumors rarely arise in the extrahepatic bile duct and can be difficult to distinguish from carcinoma. There are no reports of clear cell carcinoid (CCC tumors in the distal bile duct (DBD to the best of our knowledge. Herein, we report a CCC tumor in the DBD and review the literature concerning extrahepatic bile duct carcinoid tumors. Case presentation A 73-old man presented with fever and occult obstructive jaundice. Ultrasonography, computed tomography (CT and magnetic resonance cholangiopancreaticography (MRCP demonstrated a nodular tumor projection in the DBD without regional lymph node swelling. Under suspicion of carcinoma, we resected the head of the pancreas along with 2nd portion duodenectomy and a lymph node dissection. The surgical specimen showed a golden yellow polypoid tumor in the DBD (0.8 × 0.6 × 0.5 cm in size. The lesion was composed of clear polygonal cells arranged in nests and a trabecular pattern. The tumor invaded through the wall into the fibromuscular layer. Immunohistochemical stains showed that neoplastic cells were positive for neuron-specific enolase (NSE, chromogranin A, synaptophysin, and pancreatic polypeptide and negative for inhibin, keratin, CD56, serotonin, gastrin and somatostatin. The postoperative course was uneventful and he is living well without relapse 12 months after surgery. Conclusion Given the preoperative difficulty in differentiating carcinoid from carcinoma, the pancreaticoduodenectomy is an appropriate treatment choice for carcinoid tumors located within the intra-pancreatic bile duct.

  4. The effect of methadone dose regimen on neonatal abstinence syndrome.

    Science.gov (United States)

    McCarthy, John J; Leamon, Martin H; Willits, Neil H; Salo, Ruth

    2015-01-01

    To evaluate the effects of a multiple daily dose methadone regimen in pregnancy on neonatal outcomes. Although methadone maintenance has been the standard for the treatment of opioid dependence in pregnancy, there is no consensus on proper dosing. Single daily dosing is the most common strategy. Because of accelerated metabolism of methadone in pregnancy, this regimen may expose mother and fetus to daily episodes of withdrawal and possibly contribute to more severe Neonatal Abstinence Syndrome (NAS). This study reports on a protocol that increased both methadone dose and dose frequency in response to maternal reports of withdrawal. Treatment of NAS was needed in 29% of neonates, compared to a published rate of 60% to 80%. The mean methadone dose was 152 mg at delivery, divided into 2 to 6 doses per day. Ninety-two percent of mothers were free of illicit drug use at delivery. There was no relationship between methadone dose and treatment of NAS. Female babies had a treatment rate of 16% versus 38% for male babies. Beyond abstinence symptoms, cohort outcomes in terms of gestational age, birth weight, prematurity, Caesarian sections, and breastfeeding equaled or approximated US population norms. The protocol was associated with low rates of treatment of NAS and high rates of maternal recovery. High rates of treatment for NAS reported in methadone-exposed neonates might relate in part to iatrogenic factors and be reduced through the use of divided daily doses and protocols that minimize maternal withdrawal.

  5. New anti-tuberculosis drugs and regimens: 2015 update

    Directory of Open Access Journals (Sweden)

    Lia D'Ambrosio

    2015-05-01

    Full Text Available Over 480 000 cases of multidrug-resistant (MDR tuberculosis (TB occur every year globally, 9% of them being affected by extensively drug-resistant (XDR strains of Mycobacterium tuberculosis. The treatment of MDR/XDR-TB is unfortunately long, toxic and expensive, and the success rate largely unsatisfactory (<20% among cases with resistance patterns beyond XDR. The aim of this review is to summarise the available evidence-based updated international recommendations to manage MDR/XDR-TB, and to update the reader on the role of newly developed drugs (delamanid, bedaquiline and pretomanid as well as repurposed drugs (linezolid and meropenem clavulanate, among others used to treat these conditions within new regimens. A nonsystematic review based on historical trials results as well as on recent literature and World Health Organization (WHO guidelines has been performed, with special focus on the approach to managing MDR/XDR-TB. The new, innovative global public health interventions, recently approved by WHO and known as the “End TB Strategy”, support the vision of a TB-free world with zero death, disease and suffering due to TB. Adequate, universally accessed treatment is a pre-requisite to reach TB elimination. New shorter, cheap, safe and effective anti-TB regimens are necessary to boost TB elimination.

  6. Postcesarean Thromboprophylaxis with Two Different Regimens of Bemiparin

    Science.gov (United States)

    Cruz, Milagros; Fernández-Alonso, Ana M.; Rodríguez, Isabel; Garrigosa, Loreto; Caño, Africa; Carretero, Pilar; Vizcaíno, Amelia; Gonzalez-Ramirez, Amanda Rocío

    2011-01-01

    Objectives. To compare the effectiveness of postcesarean thromboprophylaxis with two different regimens of bemiparin. Material and Methods. The study included 646 women with cesarean delivery in our hospital within a 1-year period, randomly assigned to one of two groups for prophylaxis with 3500 IU bemiparin once daily for 5 days or 3500 IU bemiparin once daily for 10 days. Results. There was one case of pulmonary embolism (first day following cesarean). An additional risk factor was present in 98.52% of the women, most frequently emergency cesarean, anemia, or obesity. The only risk factors for thromboembolic disease significantly related to pulmonary thromboembolism were placental abruption and prematurity. There were no differences in thromboembolic events among the two thromboprophylaxis regimens. Conclusions. Cesarean-related thromboembolic events were reduced in our study population due to the thromboprophylactic measures taken. Thromboprophylaxis with 3500 IU bemiparin once daily for 5 days following cesarean was sufficient to avoid thromboembolic events. PMID:22242023

  7. A Systematic Review of Recall Regimen and Maintenance Regimen of Patients with Dental Restorations. Part 2: Implant-Borne Restorations.

    Science.gov (United States)

    Bidra, Avinash S; Daubert, Diane M; Garcia, Lily T; Gauthier, Marissa F; Kosinski, Timothy F; Nenn, Conrad A; Olsen, John A; Platt, Jeffrey A; Wingrove, Susan S; Chandler, Nancy Deal; Curtis, Donald A

    2016-01-01

    To evaluate the current scientific evidence on patient recall and maintenance of implant-supported restorations, to standardize patient care regimens and improve maintenance of oral health. An additional purpose was to examine areas of deficiency in the current scientific literature and provide recommendations for future studies. An electronic search for articles in the English language literature from the past 10 years was performed independently by multiple investigators using a systematic search process. After application of predetermined inclusion and exclusion criteria, the final list of articles was reviewed to meet the objectives of this review. The initial electronic search resulted in 2816 titles. The systematic application of inclusion and exclusion criteria resulted in 14 articles that satisfied the study objectives. An additional 6 articles were added through a supplemental search process for a total of 20 studies. Of these, 11 were randomized controlled clinical trials, and 9 were observational studies. The majority of the studies (15 out of 20) were conducted in the past 5 years and most studies were conducted in Europe (15), followed by Asia (2), South America (1), the United States (1), and the Middle East (1). Results from the qualitative data on a combined 1088 patients indicated that outcome improvements in recall and maintenance regimen were related to (1) patient/treatment characteristic (type of prosthesis, type of prosthetic components, and type of restorative materials); (2) specific oral topical agents or oral hygiene aids (electric toothbrush, interdental brush, chlorhexidine, triclosan, water flossers) and (3) professional intervention (oral hygiene maintenance, and maintenance of the prosthesis). There is minimal evidence related to recall regimens in patients with implant-borne removable and fixed restorations; however, a considerable body of evidence indicates that patients with implant-borne removable and fixed restorations require

  8. Clear Cell Adenocarcinoma Arising from Abdominal Wall Endometriosis

    Directory of Open Access Journals (Sweden)

    Thouraya Achach

    2008-01-01

    Full Text Available Endometriosis is a frequent benign disorder. Malignancy arising in extraovarian endometriosis is a rare event. A 49-year-old woman is presented with a large painful abdominal wall mass. She underwent a myomectomy, 20 years before, for uterus leiomyoma. Computed tomography suggested that this was a desmoid tumor and she underwent surgery. Histological examination showed a clear cell adenocarcinoma associated with endometriosis foci. Pelvic ultrasound, computed tomography, and endometrial curettage did not show any malignancy or endometriosis in the uterus and ovaries. Adjuvant chemotherapy was recommended, but the patient was lost to follow up. Six months later, she returned with a recurrence of the abdominal wall mass. She was given chemotherapy and then she was reoperated.

  9. Treatment of cystic cavities in X-linked juvenile retinoschisis: The first sequential cross-over treatment regimen with dorzolamide

    Directory of Open Access Journals (Sweden)

    Razek Georges Coussa

    2017-12-01

    Conclusion and importance: Previous reports showed the benefit of dorzolamide in treating foveal cystic cavities in XLRS. To our knowledge, this is the first case of XLRS demonstrating the benefits of topical dorzolamide based on a sequential cross-over treatment regimen. It may also represent a case with the longest ophthalmic follow-up providing, in consequence, long-term understanding of the natural history and complications of this rare disease After ruling out major causes of cystoid macular edema, XLRS patients presenting with worsening of their visual acuities due to larger cystic macular changes may benefit from an alternating ON/OFF regimen of topical dorzolamide, which offers a significant treatment advantage outweighing its well-known side effects. Our study consolidates the importance of “medication vacation” by showing its efficacy in providing anatomical and visual functional improvements in patients with chronic cystic macular changes.

  10. Temporal co-registration for TROPOMI cloud clearing

    Directory of Open Access Journals (Sweden)

    I. Genkova

    2012-03-01

    Full Text Available The TROPOspheric Monitoring Instrument (TROPOMI is anticipated to provide high-quality and timely global atmospheric composition information through observations of atmospheric constituents such as ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide, methane, formaldehyde and aerosol properties. The methane and the aerosol retrievals require very precise cloud clearing, which is difficult to achieve at the TROPOMI spatial resolution (7 by 7 km and without thermal IR measurements. The TROPOMI carrier – the Sentinel 5 Precursor (S5P, does not include a cloud imager, thus it is planned to fly the S5P mission in a constellation with an instrument yielding an accurate cloud mask. The cloud imagery data will be provided by the US NPOESS Preparatory Project (NPP mission, which will have the Visible Infrared Imager Radiometer Suite (VIIRS on board (Scalione, 2004. This paper investigates the temporal co-registration requirements for suitable time differences between the VIIRS measurements of clouds and the TROPOMI methane and aerosol measurements, so that the former could be used for cloud clearing. The temporal co-registration is studied using Meteosat Second Generation (MSG Spinning Enhanced Visible and Infrared Imager (SEVIRI data with 15 min temporal resolution (Veefkind, 2008b, and with data from the Geostationary Operational Environmental Satellite – 10 (GOES-10 having 1 min temporal resolution. The aim is to understand and assess the relation between the amount of allowed cloud contamination and the required time difference between the two satellites' overflights. Quantitative analysis shows that a time difference of approximately 5 min is sufficient (in most conditions to use the cloud information from the first instrument for cloud clearing in the retrievals using data from the second instrument. In recent years the A-train constellation demonstrated the benefit of flying satellites in formation. Therefore this study's findings will be

  11. Efficacy of a twice-daily, 3-step, over-the-counter skincare regimen for the treatment of acne vulgaris

    Directory of Open Access Journals (Sweden)

    Rodan K

    2017-01-01

    Full Text Available Katie Rodan, Kathy Fields, Timothy J Falla Rodan + Fields, San Francisco, CA, USA Background: Acne vulgaris (acne is the most common skin disorder producing physical and emotional scars that can persist for years. An estimated 83% of acne sufferers self-treat, but there is lack of studies documenting the effectiveness of over-the-counter (OTC acne treatment products.Objective: This study was conducted to determine the effectiveness of an OTC, 3-step, anti-acne skincare regimen in treating acne and improving the appearance of red/inflamed facial skin.Methods: This 6-week, open-label clinical study included both genders aged between 12 and 35 years with mild-to-moderate acne. All subjects were required to have an acne score of 1–3 (Cook’s acne grading scale: 0=clear to 7=very severe and a moderate redness score of ≥2 (0=none and 4=severe. Subjects completed a 3-step facial treatment regimen every morning and evening using an OTC cleanser, toner, and acne treatment. Evaluations for effectiveness and safety were done at baseline and weeks 2, 4, and 6 using digital photographs (Visia-CR® digital imaging system of the face and analyzed using Image-Pro® software for the grading of acne, red/inflamed skin, and the number and type of lesions.Results: Thirty subjects (12 males and 18 females were enrolled (mean age of 19 years; range 12–34 years. This skincare regimen resulted in statistically significant improvements in acne grading scores after 2 weeks of use, with mean scores continuing to improve after 4 and 6 weeks of use (P<0.001. Statistically significant improvements from baseline in red/inflamed skin, open and closed comedones, and papules were detected at all time points and for nodules at week 6, compared to their respective baselines (P<0.05.Conclusion: This clinical study demonstrated the effectiveness of an OTC 3-step, anti-acne skincare regimen in significantly improving acne and the overall appearance of skin in the majority

  12. A comparative study of fixed tapering dose regimen versus symptom-triggered regimen of lorazepam for alcohol detoxification.

    Science.gov (United States)

    Sachdeva, Ankur; Chandra, Mina; Deshpande, Smita N

    2014-01-01

    The study aimed at comparing the fixed tapering dose and the symptom-triggered regimens of lorazepam for alcohol detoxification. We carried out a prospective, randomized, double blind controlled trial involving 63 consecutive consenting male patients admitted with diagnosis of uncomplicated alcohol withdrawal. The patients were randomized into two groups based on the type of lorazepam dosage: symptom-triggered (n = 33) and fixed tapering dose regimens (n = 30). Alcohol withdrawal symptoms were rated on CIWA-Ar (Clinical Institute Withdrawal Assessment - Alcohol revised). The main outcome measures were the total amount and duration of lorazepam treatment and the incidence of adverse events or complications. The mean lorazepam dose administered in the symptom-triggered group was significantly lower than in the fixed tapering dose group (9.5 versus 19.9 mg, P lorazepam treatment for alcohol withdrawal resulted in administration of lower total doses of medication for a shorter duration of treatment and was as safe as the fixed tapering dose.

  13. Protease inhibitors as preferred initial regimen for antiretroviral-naive HIV patients.

    Science.gov (United States)

    Tejerina, Francisco; Bernaldo de Quirós, Juan Carlos López

    2011-01-01

    At present, the majority of patients who have initiated their first antiretroviral therapy have received a combination comprising a nonnucleoside and two nucleoside analogues. The use of nonnucleosides as first-line therapy has been favored for their more convenient dosing, with less pill numbers, and the possibility of co-formulation with nucleoside analogues. Although protease inhibitors are also considered to be a preferred standard, they have been less frequently used as first regimen of choice because of their adverse effects in the short to medium term. The introduction of darunavir and atazanavir as new protease inhibitors boosted with ritonavir has resulted in a significant change in this area. These drugs show a lower incidence of adverse effects, allow once-a-day administration, and have a high barrier to resistance that prevents the selection of resistance mutations in case of virologic failure. On this basis, it is likely that over the next few years these drugs will become a standard of care, gaining acceptance and being used more frequently as preferred first-line regimen.

  14. A Clear Label Strategy for Food Additives : Ingredient Marketing

    NARCIS (Netherlands)

    Diaz, J.

    2016-01-01

    Clear label is a strategic approach that food companies, policy makers and consumer groups can use to bring balance and clarity into food labeling. The first of a two-part report on a clear label strategy.

  15. Nitrogen dynamics in land cleared of alien vegetation ( Acacia ...

    African Journals Online (AJOL)

    Fabaceae family), are currently cleared in South African catchments to reduce water loss and preserve streamflow, and for the restoration of the ecosystem. This study tested the hypothesis that clearing invasive alien vegetation may disturb the ...

  16. Chemical clearing and dehydration of GFP expressing mouse brains

    National Research Council Canada - National Science Library

    Becker, Klaus; Jährling, Nina; Saghafi, Saiedeh; Weiler, Reto; Dodt, Hans-Ulrich

    2012-01-01

    ...) can be applied as a more GFP-friendly clearing medium. Clearing with dibenzyl ether provides improved tissue transparency and strikingly improved fluorescence intensity in GFP expressing mouse brains and other samples as mouse spinal cords, or embryos...

  17. Combined Approach to Lysis Utilizing Eptifibatide and Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke–Enhanced Regimen Stroke Trial

    Science.gov (United States)

    Pancioli, Arthur M.; Adeoye, Opeolu; Schmit, Pamela A.; Khoury, Jane; Levine, Steven R.; Tomsick, Thomas A.; Sucharew, Heidi; Brooks, Claudette E.; Crocco, Todd J.; Gutmann, Laurie; Hemmen, Thomas M.; Kasner, Scott E.; Kleindorfer, Dawn; Knight, William A.; Martini, Sharyl; McKinney, James S.; Meurer, William J.; Meyer, Brett C.; Schneider, Alexander; Scott, Phillip A.; Starkman, Sidney; Warach, Steven; Broderick, Joseph P.

    2014-01-01

    Background and Purpose In a previous study, 0.3 and 0.45 mg/kg of intravenous recombinant tissue plasminogen activator (rt-PA) were safe when combined with eptifibatide 75 mcg/kg bolus and a 2-hour infusion (0.75 mcg/kg per minute). The Combined Approach to Lysis Utilizing Eptifibatide and rt-PA in Acute Ischemic Stroke–Enhanced Regimen (CLEAR-ER) trial sought to determine the safety of a higher-dose regimen and to establish evidence for a phase III trial. Methods CLEAR-ER was a multicenter, double-blind, randomized safety study. Ischemic stroke patients were randomized to 0.6 mg/kg rt-PA plus eptifibatide (135 mcg/kg bolus and a 2-hour infusion at 0.75 mcg/kg per minute) versus standard rt-PA (0.9 mg/kg). The primary safety end point was the incidence of symptomatic intracranial hemorrhage within 36 hours. The primary efficacy outcome measure was the modified Rankin Scale (mRS) score ≤1 or return to baseline mRS at 90 days. Analysis of the safety and efficacy outcomes was done with multiple logistic regression. Results Of 126 subjects, 101 received combination therapy, and 25 received standard rt-PA. Two (2%) patients in the combination group and 3 (12%) in the standard group had symptomatic intracranial hemorrhage (odds ratio, 0.15; 95% confidence interval, 0.01–1.40; P=0.053). At 90 days, 49.5% of the combination group had mRS ≤1 or return to baseline mRS versus 36.0% in the standard group (odds ratio, 1.74; 95% confidence interval, 0.70–4.31; P=0.23). After adjusting for age, baseline National Institutes of Health Stroke Scale, time to intravenous rt-PA, and baseline mRS, the odds ratio was 1.38 (95% confidence interval, 0.51–3.76; P=0.52). Conclusions The combined regimen of intravenous rt-PA and eptifibatide studied in this trial was safe and provides evidence that a phase III trial is warranted to determine efficacy of the regimen. PMID:23887841

  18. Combined approach to lysis utilizing eptifibatide and recombinant tissue plasminogen activator in acute ischemic stroke-enhanced regimen stroke trial.

    Science.gov (United States)

    Pancioli, Arthur M; Adeoye, Opeolu; Schmit, Pamela A; Khoury, Jane; Levine, Steven R; Tomsick, Thomas A; Sucharew, Heidi; Brooks, Claudette E; Crocco, Todd J; Gutmann, Laurie; Hemmen, Thomas M; Kasner, Scott E; Kleindorfer, Dawn; Knight, William A; Martini, Sharyl; McKinney, James S; Meurer, William J; Meyer, Brett C; Schneider, Alexander; Scott, Phillip A; Starkman, Sidney; Warach, Steven; Broderick, Joseph P

    2013-09-01

    In a previous study, 0.3 and 0.45 mg/kg of intravenous recombinant tissue plasminogen activator (rt-PA) were safe when combined with eptifibatide 75 mcg/kg bolus and a 2-hour infusion (0.75 mcg/kg per minute). The Combined Approach to Lysis Utilizing Eptifibatide and rt-PA in Acute Ischemic Stroke-Enhanced Regimen (CLEAR-ER) trial sought to determine the safety of a higher-dose regimen and to establish evidence for a phase III trial. CLEAR-ER was a multicenter, double-blind, randomized safety study. Ischemic stroke patients were randomized to 0.6 mg/kg rt-PA plus eptifibatide (135 mcg/kg bolus and a 2-hour infusion at 0.75 mcg/kg per minute) versus standard rt-PA (0.9 mg/kg). The primary safety end point was the incidence of symptomatic intracranial hemorrhage within 36 hours. The primary efficacy outcome measure was the modified Rankin Scale (mRS) score ≤1 or return to baseline mRS at 90 days. Analysis of the safety and efficacy outcomes was done with multiple logistic regression. Of 126 subjects, 101 received combination therapy, and 25 received standard rt-PA. Two (2%) patients in the combination group and 3 (12%) in the standard group had symptomatic intracranial hemorrhage (odds ratio, 0.15; 95% confidence interval, 0.01-1.40; P=0.053). At 90 days, 49.5% of the combination group had mRS ≤1 or return to baseline mRS versus 36.0% in the standard group (odds ratio, 1.74; 95% confidence interval, 0.70-4.31; P=0.23). After adjusting for age, baseline National Institutes of Health Stroke Scale, time to intravenous rt-PA, and baseline mRS, the odds ratio was 1.38 (95% confidence interval, 0.51-3.76; P=0.52). The combined regimen of intravenous rt-PA and eptifibatide studied in this trial was safe and provides evidence that a phase III trial is warranted to determine efficacy of the regimen. http://www.clinicaltrials.gov. Unique identifier: NCT00894803.

  19. Solubility determination from clear points upon solvent addition

    NARCIS (Netherlands)

    Reus, M.A.; Heijden, A.E.D.M. van der; Horst, J.H. ter

    2015-01-01

    A method is described for determining the solubility of multicomponent crystalline compounds from clear points upon sample dilution at a constant temperature. Clear points are established by continuously adding a solvent mixture to a suspension of known composition until a clear solution appears.

  20. 78 FR 72475 - Derivatives Clearing Organizations and International Standards

    Science.gov (United States)

    2013-12-02

    ....aspx . \\13\\ While Chicago Mercantile Exchange, Inc. (``CME Clearing''), ICE Clear Credit LLC (``ICE... and ICE Clear Credit; the Securities and Exchange Commission (``SEC'') serves as OCC's Supervisory... around the world including, Argentina, Australia, Belgium, Brazil, Canada, China, France, Germany, Hong...

  1. Medication regimen complexity in ambulatory older adults with heart failure

    Directory of Open Access Journals (Sweden)

    Cobretti MR

    2017-04-01

    Full Text Available Michael R Cobretti,1 Robert L Page II,2 Sunny A Linnebur,2 Kimberly M Deininger,1 Amrut V Ambardekar,3 JoAnn Lindenfeld,4 Christina L Aquilante1 1Department of Pharmaceutical Sciences, 2Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, 3Division of Cardiology, School of Medicine, University of Colorado, Aurora, CO, 4Advanced Heart Failure and Cardiac Transplant Program, Vanderbilt Heart and Vascular Institute, Nashville, TN, USA Purpose: Heart failure prevalence is increasing in older adults, and polypharmacy is a major problem in this population. We compared medication regimen complexity using the validated patient-level Medication Regimen Complexity Index (pMRCI tool in “young-old” (60–74 years versus “old-old” (75–89 years patients with heart failure. We also compared pMRCI between patients with ischemic cardiomyopathy (ISCM versus nonischemic cardiomyopathy (NISCM.Patients and methods: Medication lists were retrospectively abstracted from the electronic medical records of ambulatory patients aged 60–89 years with heart failure. Medications were categorized into three types – heart failure prescription medications, other prescription medications, and over-the-counter (OTC medications – and scored using the pMRCI tool.Results: The study evaluated 145 patients (n=80 young-old, n=65 old-old, n=85 ISCM, n=60 NISCM, mean age 73±7 years, 64% men, 81% Caucasian. Mean total pMRCI scores (32.1±14.4, range 3–84 and total medication counts (13.3±4.8, range 2–30 were high for the entire cohort, of which 72% of patients were taking eleven or more total medications. Total and subtype pMRCI scores and medication counts did not differ significantly between the young-old and old-old groups, with the exception of OTC medication pMRCI score (6.2±4 young-old versus 7.8±5.8 old-old, P=0.04. With regard to heart failure etiology, total pMRCI scores and medication

  2. Immunogenicity, safety and antibody persistence of a purified vero cell cultured rabies vaccine (Speeda) administered by the Zagreb regimen or Essen regimen in post-exposure subjects.

    Science.gov (United States)

    Shi, Nianmin; Zhang, Yibin; Zheng, Huizhen; Zhu, Zhenggang; Wang, Dingming; Li, Sihai; Li, Yuhua; Yang, Liqing; Zhang, Junnan; Bai, Yunhua; Lu, Qiang; Zhang, Zheng; Luo, Fengji; Yu, Chun; Li, Li

    2017-06-03

    To compare the safety, immunogenicity and long-term effect of a purified vero cell cultured rabies vaccine in post-exposure subjects following 2 intramuscular regimens, Zagreb or Essen regimen. Serum samples were collected before vaccination and on days 7, 14, 42, 180 and 365 post vaccination. Solicited adverse events were recorded for 7 d following each vaccine dose, and unsolicited adverse events throughout the entire study period. This study was registered with ClinicalTrials.gov (NCT01821911 and NCT01827917). No serious adverse events were reported. Although Zagreb regimen had a higher incidence of adverse reactions than Essen regimen at the first and second injection, the incidence was similar at the third and fourth injection between these 2 groups as well. At day 42, 100% subjects developed adequate rabies virus neutralizing antibody concentrations (≥ 0.5IU/ml) for both regimens. At days 180 and 365, the antibody level decreased dramatically, however, the percentage of subjects with adequate antibody concentrations still remained high (above 75% and 50% respectively). None of confirmed rabies virus exposured subjects had rabies one year later, and percentage of subjects with adequate antibody concentrations reached 100% at days 14 and 42. Rabies post-exposure prophylaxis vaccination with PVRV following a Zagreb regimen had a similar safety, immunogenicity and long-term effect to the Essen regimen in China.

  3. Breast Cancer Screening in an Era of Personalized Regimens

    Science.gov (United States)

    Onega, Tracy; Beaber, Elisabeth F.; Sprague, Brian L.; Barlow, William E.; Haas, Jennifer S.; Tosteson, Anna N.A.; Schnall, Mitchell D.; Armstrong, Katrina; Schapira, Marilyn M.; Geller, Berta; Weaver, Donald L.; Conant, Emily F.

    2014-01-01

    Breast cancer screening holds a prominent place in public health, health care delivery, policy, and women’s health care decisions. Several factors are driving shifts in how population-based breast cancer screening is approached, including advanced imaging technologies, health system performance measures, health care reform, concern for “overdiagnosis,” and improved understanding of risk. Maximizing benefits while minimizing the harms of screening requires moving from a “1-size-fits-all” guideline paradigm to more personalized strategies. A refined conceptual model for breast cancer screening is needed to align women’s risks and preferences with screening regimens. A conceptual model of personalized breast cancer screening is presented herein that emphasizes key domains and transitions throughout the screening process, as well as multilevel perspectives. The key domains of screening awareness, detection, diagnosis, and treatment and survivorship are conceptualized to function at the level of the patient, provider, facility, health care system, and population/policy arena. Personalized breast cancer screening can be assessed across these domains with both process and outcome measures. Identifying, evaluating, and monitoring process measures in screening is a focus of a National Cancer Institute initiative entitled PROSPR (Population-based Research Optimizing Screening through Personalized Regimens), which will provide generalizable evidence for a risk-based model of breast cancer screening, The model presented builds on prior breast cancer screening models and may serve to identify new measures to optimize benefits-to-harms tradeoffs in population-based screening, which is a timely goal in the era of health care reform. PMID:24830599

  4. [PAD regimen for relapsed or refractory patients with multiple myeloma].

    Science.gov (United States)

    Zhang, Yong-Qing; Liang, Rong; Bai, Qing-Xian; Zhang, Tao; Yang, Lan; Wang, Yi-Wei; Wang, Wen-Qing; Gu, Hong-Tao; Shu, Mi-Mi; Zhu, Hua-Feng; Bai, Yan-Ni; Chen, Xie-Qun

    2009-04-01

    To investigate the efficacy and safety of PAD [bortezomib (PS-341), doxorubicin and dexamethasone] regimen for relapsed or refractory multiple myeloma (MM). Seventeen patients with relapsed or refractory MM received two to four 21-day cycles of PAD: an intravenous bolus of bortezomib (1.3 mg/m2) on days 1, 4, 8, and 11; doxorubicin 10 mg per day on days 1 to 4, and dexamethasone 40 mg on days 1-4. Response was evaluated according to International Myeloma Working Group Criteria (IMWG 2006), toxicity was graded according to NCI CTCAE (common terminology criteria for adverse events) v 3.0. After 2-4 courses of PAD, 14 patients (82.4%) response, including complete response (CR) in 4 (23.5%), very good partial response (VGPR) in 4 (23.5%), partial response (PR) in 6 (35.3%) and stable disease (SD) in 3 (17.6%). Median time to progression was 9.5 months. The median course to response was 1.6 (1-3). All of 5 patients with extramedullary plasmacytoma achieved at least PR after the first cycle therapy; the plasmacytoma disappeared after 1-2 cycles of PAD. The efficacy was independent of other prognostic factors such as beta2-MG. Adverse events included thrombocytopenia in 9 patients (52.9%), leukopenia in 4 (23.5%), peripheral neuropathy in 4 (23.5%), varicella herpes zoster in 3 (17.6%), fatigue in 6 (35.3%) and diarrhea in 2 (11.7%). All of these adverse reactions could be controlled with routine supportive treatment, only one patient died from respiratory failure during his fifth PAD cycle. PAD regimen should be considered as an appropriate treatment for relapsed or refractory MM, especially for MM with extramedullary plasmacytoma. Its efficacy is independent of traditional prognostic factors. The side effects are usually manageable.

  5. Regimen selection in the OPTIONS trial of HIV salvage therapy: drug resistance, prior therapy, and race–ethnicity determine the degree of regimen complexity

    Science.gov (United States)

    Tashima, Karen T.; Mollan, Katie R.; Na, Lumine; Gandhi, Rajesh T.; Klingman, Karin L.; Fichtenbaum, Carl J.; Andrade, Adriana; Johnson, Victoria A.; Eron, Joseph J.; Smeaton, Laura; Haubrich, Richard H.

    2015-01-01

    Background Regimen selection for highly treatment-experienced patients is complicated. Methods Using a web-based utility, study team members reviewed antiretroviral (ARV) history and resistance data and recommended individual ARV regimens and nucleoside reverse transcriptase inhibitor (NRTI) options for treatment-experienced participants consisting of 3–4 of the following agents: raltegravir (RAL), darunavir (DRV)/ritonavir, tipranavir (TPV)/ritonavir, etravirine (ETR), maraviroc (MVC), and enfuvirtide (ENF). We evaluated team recommendations and site selection of regimen and NRTIs. Associations between baseline factors and the selection of a complex regimen (defined as including four ARV agents or ENF) were explored with logistic regression. Results A total of 413 participants entered the study. Participants initiated the first or second recommended regimen 86% of the time and 21% of participants started a complex regimen. In a multivariable model, ARV resistance to NRTI (odds ratio [OR]=2.2), non-nucleoside reverse transcriptase inhibitor (NNRTI, OR=6.2) or boosted protease inhibitor (PI, OR=6.6), prior use of integrase strand transfer inhibitor (INSTI, OR=25), and race–ethnicity (all P≤0.01) were associated with selection of a complex regimen. Black non-Hispanic (OR=0.5) and Hispanic participants from the continental US (OR=0.2) were less likely to start a complex regimen, compared to white non-Hispanics. Conclusions In this multi-center trial, we developed a web-based utility that facilitated treatment recommendations for highly treatment-experienced patients. Drug resistance, prior INSTI use, and race–ethnicity were key factors in decisions to select a more complex regimen. PMID:26212575

  6. Regimen selection in the OPTIONS trial of HIV salvage therapy: drug resistance, prior therapy, and race-ethnicity determine the degree of regimen complexity.

    Science.gov (United States)

    Tashima, Karen T; Mollan, Katie R; Na, Lumine; Gandhi, Rajesh T; Klingman, Karin L; Fichtenbaum, Carl J; Andrade, Adriana; Johnson, Victoria A; Eron, Joseph J; Smeaton, Laura; Haubrich, Richard H

    2015-08-01

    Regimen selection for highly treatment-experienced patients is complicated. Using a web-based utility, study team members reviewed antiretroviral (ARV) history and resistance data and recommended individual ARV regimens and nucleoside reverse transcriptase inhibitor (NRTI) options for treatment-experienced participants consisting of 3-4 of the following agents: raltegravir (RAL), darunavir (DRV)/ritonavir, tipranavir (TPV)/ritonavir, etravirine (ETR), maraviroc (MVC), and enfuvirtide (ENF). We evaluated team recommendations and site selection of regimen and NRTIs. Associations between baseline factors and the selection of a complex regimen (defined as including four ARV agents or ENF) were explored with logistic regression. A total of 413 participants entered the study. Participants initiated the first or second recommended regimen 86% of the time and 21% of participants started a complex regimen. In a multivariable model, ARV resistance to NRTI (odds ratio [OR] = 2.2), non-nucleoside reverse transcriptase inhibitor (NNRTI, OR = 6.2) or boosted protease inhibitor (PI, OR = 6.6), prior use of integrase strand transfer inhibitor (INSTI, OR = 25), and race-ethnicity (all P ≤ 0.01) were associated with selection of a complex regimen. Black non-Hispanic (OR = 0.5) and Hispanic participants from the continental US (OR = 0.2) were less likely to start a complex regimen, compared to white non-Hispanics. In this multi-center trial, we developed a web-based utility that facilitated treatment recommendations for highly treatment-experienced patients. Drug resistance, prior INSTI use, and race-ethnicity were key factors in decisions to select a more complex regimen.

  7. Induction regimens for transplant-eligible patients with newly diagnosed multiple myeloma: a network meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Zeng ZH

    2017-07-01

    Full Text Available Zi-Hang Zeng,1,2 Jia-Feng Chen,1,2 Yi-Xuan Li,1,2 Ran Zhang,1,2 Ling-Fei Xiao,1,2 Xiang-Yu Meng1,2 1Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, 2Department of Evidence-Based Medicine and Clinical Epidemiology, Second Clinical College of Wuhan University, Wuhan, People’s Republic of China Objective: The aim of this study was to compare the early efficacy and survivals of induction regimens for transplant-eligible patients with untreated multiple myeloma. Materials and methods: A comprehensive literature search in electronic databases was conducted for relevant randomized controlled trials (RCTs. Eligible studies were selected according to the predefined selection criteria, before they were evaluated for methodological quality. Basic characteristics and data for network meta-analysis (NMA were extracted from included trials and pooled in our meta-analysis. The end points were the overall response rate (ORR, progression-free survival (PFS, and overall survival (OS. Results: A total of 14 RCTs that included 4,763 patients were analyzed. The post-induction ORR was higher with bortezomib plus thalidomide plus dexamethasone (VTD regimens, and VTD was better than the majority of other regimens. For OS, VTD plus cyclophosphamide (VTDC regimens showed potential superiority over other regimens, but the difference was not statistically significant. The PFS was longer with thalidomide plus doxorubicin plus dexamethasone (TAD regimens for transplant-eligible patients with newly diagnosed multiple myeloma (NDMM. Conclusion: The NMA demonstrated that the VTD, VTDC, and TAD regimens are most beneficial in terms of ORR, OS, and PFS for transplant-eligible patients with NDMM, respectively. Keywords: multiple myeloma, newly diagnosed, transplant-eligible, induction therapies, network meta-analysis

  8. Temporal variation of clear-water scour at compound Abutments

    Directory of Open Access Journals (Sweden)

    Aminuddin Ab. Ghani

    2016-12-01

    Full Text Available Most of actual abutments in rivers are built on foundation, while there is limited number of study available on the effects of the foundation on the local scour. In this study, temporal variation of local scour around compound abutment was investigated experimentally under clear-water conditions. The results showed that a suitable level of foundation is able to decrease the scour depth and increase scour time during the flood events. The trend of temporal scour depth at compound pier and abutment is similar. The scour depth develops to top of foundation quickly, and then the foundation postpones the scour development (lag–time. Duration of lag–time depends on the foundation level, velocity ratio (U/Uc and foundation dimension. This study highlights that proper design of foundation level increases duration of scouring and provides enough time to treat bridge foundation after the flood events.

  9. Antisepsis regimen in the surgical treatment of HPV generated cervical lesions: polyhexamethylene biguanide vs chlorhexidine. A randomized, double blind study.

    Science.gov (United States)

    Gerli, S; Bavetta, F; Di Renzo, G C

    2012-12-01

    To reduce the risk of local infections after surgical treatments for HPV infected cervical lesions, the post-operative regimen is generally based on the use of vaginal antimicrobial agents. The efficacy and safety of polyhexamethylene biguanide-based vaginal suppositories was compared to a similar chlorhexidine-based treatment, in the post recovery regimen after surgical treatment of cervical lesions. 50 women who underwent to CO2 laser therapy for cervical lesions were randomly assigned to receive 10 days of antiseptic treatment with chlorhexidine digluconate vaginal suppositories, or polyhexamethylene biguanide vaginal suppositories (Monogin®/Biguanelle® ovuli, Lo.Li. Pharma, Italy). A weekly follow-up check was performed for 6 weeks. Polyhexamethylene biguanide-based treatment showed improved efficacy compared to chlorhexidine, in terms of healing process and prevention of bacterial infections. Due to its safety and effectiveness, the vaginal treatment with polyhexamethylene biguanide is preferred to chlorexidine, in accordance with previously reported in vitro evidences.

  10. Congenital syphilis after treatment of maternal syphilis with a penicillin regimen exceeding CDC guidelines.

    OpenAIRE

    Conover, C S; Rend, C A; Miller, G B; Schmid, G P

    1998-01-01

    BACKGROUND: Although congenital syphilis usually occurs as a result of a failure to detect and treat syphilis in pregnant women, failures of the currently recommended regimen to prevent congenital syphilis have been reported. CASE: This report describes an infant with congenital syphilis despite maternal treatment with a regimen exceeding current CDC guidelines. CONCLUSION: Regardless of the regimen used to treat syphilis during pregnancy, clinicians should recognize the possibility of occasi...

  11. Congenital Syphilis After Treatment of Maternal Syphilis With a Penicillin Regimen Exceeding CDC Guidelines

    OpenAIRE

    Craig S. Conover; Rend, Charles A.; Grayson B. Miller; Schmid, George P

    1998-01-01

    Background: Although congenital syphilis usually occurs as a result of a failure to detect and treat syphilis in pregnant women, failures of the currently recommended regimen to prevent congenital syphilis have been reported.Case: This report describes an infant with congenital syphilis despite maternal treatment with a regimen exceeding current CDC guidelines .Conclusion: Regardless of the regimen used to treat syphilis during pregnancy, clinicians should recognize the possibility of occasio...

  12. Outcomes of Patients With Revised Stage I Clear Cell Sarcoma of Kidney Treated in National Wilms Tumor Studies 1-5

    Energy Technology Data Exchange (ETDEWEB)

    Kalapurakal, John A., E-mail: j-kalapurakal@northwestern.edu [Northwestern University, Chicago, Illinois (United States); Perlman, Elizabeth J. [Northwestern University, Chicago, Illinois (United States); Seibel, Nita L. [Cancer Therapy and Evaluation Program, Bethesda, Maryland (United States); Ritchey, Michael [Phoenix Children' s Hospital, Phoenix, Arizona (United States); Dome, Jeffrey S. [Children' s National Medical Center, Washington, District of Columbia (United States); Grundy, Paul E. [University of Alberta, Edmonton, AB (Canada)

    2013-02-01

    Purpose: To report the clinical outcomes of children with revised stage I clear cell sarcoma of the kidney (CCSK) using the National Wilms Tumor Study Group (NWTS)-5 staging criteria after multimodality treatment on NWTS 1-5 protocols. Methods and Materials: All CCSK patients enrolled in the National Wilms Tumor Study Group protocols had their pathology slides reviewed, and only those determined to have revised stage I tumors according to the NWTS-5 staging criteria were included in the present analysis. All patients were treated with multimodality therapy according to the NWTS 1-5 protocols. Results: A total of 53 children were identified as having stage I CCSK. All patients underwent primary surgery with radical nephrectomy. The chemotherapy regimens used were as follows: regimen A, C, F, or EE in 4 children (8%); regimen DD or DD4A in 33 children (62%); regimen J in 4 children (8%); and regimen I in 12 children (22%). Forty-six patients (87%) received flank radiation therapy (RT). Seven children (13%) did not receive flank RT. The median delay between surgery and the initiation of RT was 9 days (range, 3-61). The median RT dose was 10.8 Gy (range, 10-36). The flank RT doses were as follows: 10.5 or 10.8 Gy in 25 patients (47%), 11-19.9 Gy in 2 patients (4%), 20-29.9 Gy in 9 patients (17%), and 30-40 Gy in 10 patients (19%). The median follow-up for the entire group was 17 years (range, 2-36). The relapse-free and cancer-specific survival rate was 100% at the last follow-up examination. Conclusions: The present results have demonstrated that children with revised stage I CCSK using the NWTS-5 staging criteria have excellent survival rates despite the use of varying RT doses and chemotherapy regimens in the NWTS 1-5 protocols.

  13. Preparation of Samples for Leaf Architecture Studies, A Method for Mounting Cleared Leaves

    Directory of Open Access Journals (Sweden)

    Alejandra Vasco

    2014-09-01

    Full Text Available Premise of the study: Several recent waves of interest in leaf architecture have shown an expanding range of approaches and applications across a number of disciplines. Despite this increased interest, examination of existing archives of cleared and mounted leaves shows that current methods for mounting, in particular, yield unsatisfactory results and deterioration of samples over relatively short periods. Although techniques for clearing and staining leaves are numerous, published techniques for mounting leaves are scarce. Methods and Results: Here we present a complete protocol and recommendations for clearing, staining, and imaging leaves, and, most importantly, a method to permanently mount cleared leaves. Conclusions: The mounting protocol is faster than other methods, inexpensive, and straightforward; moreover, it yields clear and permanent samples that can easily be imaged, scanned, and stored. Specimens mounted with this method preserve well, with leaves that were mounted more than 35 years ago showing no signs of bubbling or discoloration.

  14. Effectiveness of multi-drug regimen chemotherapy treatment in osteosarcoma patients: a network meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Wang, Xiaojie; Zheng, Hong; Shou, Tao; Tang, Chunming; Miao, Kun; Wang, Ping

    2017-03-29

    . The OS analysis showed that the T12 protocol plus vincristine or the T12 protocol with the removal of cisplatinum might be a better regimen for improving the OS of patients. However, well-designed randomized controlled trials of chemotherapeutic protocols are still necessary.

  15. Therapeutic Response In Mycetoma â€" A Study Of Different Regimens

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    Kaliswaran A V

    2003-01-01

    Full Text Available Treatment of mycetoma is always considered a challenge to the dermatologists. Hence this study was undertaken to determine the efficacy of various therapeutic regimens in actinomycotic and eumycotic mycetoma. A total of 25 patients including 18 cases of actinomycotic mycetoma and 7 cases of eumycotic mycetoma was included. Combinations of trimethoprim-sulfamethoxazole (TS with rifampicin (regimen-3, and TS monotherapy (regimen-4 were used in 9,2,1 and 6 patients with actinomycotic mycetoma respectively. Ketoconazole (regimen-A and itraconazole (regimen-B were used in patients with eumycotic mycetoma along with surgical excision (in amenable cases. Remission was observed in 10 cases of actinomycotic mycetoma (eight with Welsh regimen and one case of eumycetoma who was subjected to surgical excision followed by oral ketoconazole. Improvement was seen in 2 cases of actinomycetoma treated one each with Welsh regimen and regimen4: in 2 cases of eumycetoma treated with ketoconazole in one and itraconazole in the other. No significant adverse effect was noted in the study except ototoxicity and reaction to streptomycin in one patient. In general, therapeutic outcome was excellent in patients with actinomycotic mycetoma particularly with Welsh regimen, whereas the response to medical therapy in eumycetoma is not satisfactory. Complete surgical excision followed by antifungal therapy at an early stage for eumycotic mycetoma is perhaps the best possible therapeutic modality in the present scenario.

  16. Comparison of safety and immunogenicity of purified chick embryo cell vaccine using Zagreb and Essen regimens in patients with category II exposure in China.

    Science.gov (United States)

    Hu, Quan; Liu, Man-Qing; Zhu, Zheng-Gang; Zhu, Ze-Rong; Lu, Sha

    2014-01-01

    The aim was to compare the safety and immunogenicity of purified chick embryo cell vaccine (PCECV) with Zagreb 2-1-1 and Essen 1-1-1-1-1 regimens in patients with WHO category II exposure in China. Side effects including systemic and local symptoms were recorded for all patients during vaccination with purified chick embryo cell vaccine (PCECV) under Zagreb 2-1-1 or Essen 1-1-1-1-1 regimens, and the rabies neutralization antibody titers in patients' serum at days 0, 7, 14, 45, 365 post-immunization were measured to determine the immunogenicity. Fever and pain were the most common events for systemic and local symptoms respectively, and most side effects (86.78%, 105/121) occurred after the first dose of vaccination. Safety analysis showed differences in side effects inEssen regimens, especially after the first dose of vaccination (P = 0.043). Immunogenicity analysis indicated that Zagreb can achieve higher neutralization antibody titers and a greater seroconversion rate in a shorter time but had less persistence than Essen. When compared with the Essen regimen, the Zagreb regimen had a different immunogenicity in all study subjects, and different safety profile in young children, and a further study with a larger population and longer surveillance is warranted.

  17. Mas alla del consenso y la oposicion: las actitudes de la "gente corriente" en regimenes dictatoriales. Una propuesta de analisis desde el regimen franquista

    National Research Council Canada - National Science Library

    Hernandez Burgos, Claudio

    2014-01-01

    El objetivo de este articulo es analizar las actitudes sociales en regimenes dictatoriales, investigando los instrumentos utilizados para cosechar apoyos sociales y la compleja relacion entre Estado y sociedad...

  18. Time for individualized colonoscopy bowel-prep regimens? A randomized controlled trial comparing sodium picosulphate and magnesium citrate versus 4-liter split-dose polyethylene glycol.

    Science.gov (United States)

    Voiosu, Theodor; Ratiu, Iulia; Voiosu, Andrei; Iordache, Tiberiu; Schipor, Adrian; Baicus, Cristian; Sporea, Ioan; Voiosu, Radu

    2013-06-01

    Good bowel cleansing is essential to achieving optimal endoscopic evaluation of the colon. There are many different regimens available, but none have shown consistently superior results in achieving a clean colon. We compared the efficiency of two regimens with regard to bowel cleansing and patient satisfaction. The study also aimed to identify patient-related factors that influenced the quality of the bowel cleansing. We conducted a single-blind, multicenter, randomized controlled trial comparing sodium picosulphate and magnesium citrate versus 4-liter split-dose polyethylene glycol (PEG). Consecutive patients presenting for colonoscopy at two tertiary referral centers were invited to participate. The main outcomes were colon cleanliness and patient satisfaction with the preparation regimen. The quality of bowel cleansing was assessed by the endoscopist with the use of a 4-grade scale. Patients completed questionnaires evaluating their experience during the preparation process. Multivariate analysis was conducted in order to compare the two regimens and identify patient-related factors that influenced the main outcomes. One hundred eighty-one patients were randomized and 165 completed the trial (91.1%). PEG was slightly superior to sodium picosulphate with regard to bowel cleansing (p=0.01), while patient satisfaction was higher with sodium picosulphate (p=0.008). Patients with higher education and patients reporting high adherence to instructions achieved better colon cleansing using PEG. There seems to be no clear advantage for one bowel preparation solution over the other. However, by taking into account individual patient characteristics, opting for a particular regimen could increase the likelihood of achieving a cleaner colon.

  19. Cost-Utility Analysis of IEV Drug Regimen Versus ESHAP Drug Regimen for the Patients With Relapsed and Refractory Hodgkin and Non-Hodgkin?s Lymphoma in Iran

    OpenAIRE

    Hatam, Nahid; Dehghani, Mehdi; Habibian, Mostafa; Jafari, Abdosaleh

    2015-01-01

    Background: Chemotherapy for lymph nodes cancer is often composed of several drugs that are used in a treatment program. Objectives: The aim of this study was to perform a cost-utility analysis of IEV regimen (ifosfamide, epirubicin and etoposide) versus ESHAP regimen (etoposide, methylprednisolone, high-dose cytarabine, and cisplatin) in patients with lymphoma in the south of Iran. Patients and Methods: This was a cost-utility analysis done as a cross-sectional study in the south of Iran. Us...

  20. Cisplatin-based chemotherapy: Add high-frequency audiometry in the regimen.

    Science.gov (United States)

    Arora, R; Thakur, J S; Azad, R K; Mohindroo, N K; Sharma, D R; Seam, R K

    2009-01-01

    Cisplatin-induced ototoxicity shows high interindividual variability and is often accompanied by transient or permanent tinnitus. It is not possible to identify the susceptible individuals before commencement of the treatment. We conducted a prospective, randomized and observational study in a tertiary care centre and evaluated the effects of different doses of cisplatin on hearing. Fifty-seven patients scheduled for cisplatin-based chemotherapy were included in the study. All patients were divided into three groups depending on the dose of cisplatin infused in 3 weeks. The subjective hearing loss was found in seven patients, while six patients had tinnitus during the chemotherapy. The hearing loss was sensorineural, dose dependent, symmetrical, bilateral and irreversible. Higher frequencies were first to be affected in cisplatin chemotherapy. As use of high-frequency audiometry is still limited in research work only, we need a strict protocol of adding high-frequency audiometry in the cisplatin-based chemotherapy regimen.

  1. Atypical Reversible Leucoencephalopathy Syndrome after Bevacizumab/Folfox Regimen for Metastatic Colon Cancer

    Directory of Open Access Journals (Sweden)

    Narimane Salmi

    2014-01-01

    Full Text Available We are reporting a case of multifocal reversible leucoencephalopathy syndrome induced by chemotherapy based on Folfox-Bevacizumab regimen. A 44-year-old female, with no history of hypertension, received a chemotherapy based on Folfox-Bevacizumab for her metastatic colon cancer (5 FU: 325 mg/m2 d1 by intravenous infusion, Oxaliplatin 80 mg/m2 d1, and Bevacizumab: 7.5 mg/Kg d1. During the fourth cure, she presented delirium, seizures, and visual disturbances. The computed tomography (CT of the brain showed hypodense lesions of the white matter of frontal, parietal, and occipital lobes, which were bilateral and symmetrical. The clinical table was reversible under symptomatic treatment.

  2. Patient Care and Support Measures Overcome Reluctance to Initiate New Regimen Containing Enfuvirtide

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    Benoit Trottier

    2007-01-01

    Full Text Available Patients can be resistant to initiation of enfuvirtide therapy because of concerns about self-injection and related issues. Because the introduction of a new drug class can substantially enhance the efficacy of an antiretroviral regimen, supporting the patient in the introduction of enfuvirtide, a safe and efficacious agent in a new class, offers therapeutic benefits. In the present patient, who showed resistance to all three of the major antiretroviral drug classes, enfuvirtide was successfully introduced with clinic and peer support group assistance. The patient’s acceptance was enhanced by the use of a needle-free injection system (Biojector, with minimal side effects and significantly improved virological and immunological control.

  3. Showing the Good Side, Too

    Science.gov (United States)

    Alley, R. B.

    2016-12-01

    With very high scientific confidence, we are raising atmospheric CO2 primarily by burning fossil fuels, this is changing the climate, and this will affect us, with each degree of warming more costly than the previous degree. The uncertainties of continuing to burn fossil fuels and release the CO2 include futures a little less challenging or a little more challenging or a lot more challenging; the possibility of "really bad" is not balanced by a similar possibility of "really good". But, we are the first generation that knows how to build a sustainable energy system, and the evidence is quite clear that wise policies respecting the science can help the economy as well as the environment. If the "social cost of carbon" were viewed as "the profit waiting to be made", perhaps students would more accurately evaluate the choices available to them.

  4. Aggressive regimens for multidrug-resistant tuberculosis decrease all-cause mortality.

    Directory of Open Access Journals (Sweden)

    Carole D Mitnick

    Full Text Available A better understanding of the composition of optimal treatment regimens for multidrug-resistant tuberculosis (MDR-TB is essential for expanding universal access to effective treatment and for developing new therapies for MDR-TB. Analysis of observational data may inform the definition of an optimized regimen.This study assessed the impact of an aggressive regimen-one containing at least five likely effective drugs, including a fluoroquinolone and injectable-on treatment outcomes in a large MDR-TB patient cohort.This was a retrospective cohort study of patients treated in a national outpatient program in Peru between 1999 and 2002. We examined the association between receiving an aggressive regimen and the rate of death.In total, 669 patients were treated with individualized regimens for laboratory-confirmed MDR-TB. Isolates were resistant to a mean of 5.4 (SD 1.7 drugs. Cure or completion was achieved in 66.1% (442 of patients; death occurred in 20.8% (139. Patients who received an aggressive regimen were less likely to die (crude hazard ratio [HR]: 0.62; 95% CI: 0.44,0.89, compared to those who did not receive such a regimen. This association held in analyses adjusted for comorbidities and indicators of severity (adjusted HR: 0.63; 95% CI: 0.43,0.93.The aggressive regimen is a robust predictor of MDR-TB treatment outcome. TB policy makers and program directors should consider this standard as they design and implement regimens for patients with drug-resistant disease. Furthermore, the aggressive regimen should be considered the standard background regimen when designing randomized trials of treatment for drug-resistant TB.

  5. Four-drugs regimen containing raltegravir is highly effective in HIV patients starting therapy with >500,000 copies/mL viral load

    Science.gov (United States)

    Sterrantino, Gaetana; Zaccarelli, Mauro; Prati, Francesca; Boschi, Andrea; Sighinolfi, Laura; Borghi, Vanni

    2014-01-01

    Introduction Assessing virological response of four-drugs antiretroviral regimen that include raltegravir (RAL) in naïve patients with high viral load (>500,000 copies/mL) selected from a multicentre Italian database. Methods Naïve patients with HIV RNA>500,000 copies/mL, who began standard antiretroviral regimens either based on non-nucleoside reverse transcriptase inhibitors (NNRTI) or boosted-PI (PI/r), or a standard regimen plus RAL between 2008 and 2013 were analyzed. Observation was censored at 12 months and the percentage of patients who achieved a viral load below the limit of detection (BLD) was calculated. Virological failure was defined as two consecutive viral loads>40 copies/mL. Results Overall, 179 patients were included (13% with primary HIV infection (PHI), and 42.5% with AIDS diagnosis). Of them, 156 started standard three-drugs antiretroviral regimen (75.6% PI/r-based, 24.4% NNRTI-based. Among patients with PHI, 23 patients (12.8%), 6 (25%) started a four-drugs antiretroviral regimen containing both RAL and PI/r. Patients’ characteristics were as follows: males 74%, median age 42 years (IQR 35–51), sexually transmission 75.1%, median CD4 count 156 cells/µL (IQR 47–368) and median HIV-RNA 6.1 log10 copies/mL (IQR 5.8–6.4). 91 of 179 patients (50.8%) reached BLD viral load during the twelve months of observation. Three patients (1.7%) who began regimens PI/r-based with three-drugs had virological rebound after reaching BLD viral load. By use of survival analysis, we show that those patients who added RAL to the standard regimen have reached the primary end point faster (mean 8.4 months (95% CI 7.2–9.6) vs 11.4 (95% CI 11.0–11.8) in PI group and 10.3 (95% CI 9.4–11.1) in NNRTI group; p500,000 copies/mL HIV-RNA had virological success at 12 months. The success was reached faster using the RAL-containing four-drugs regimen, suggesting that strengthening the initial regimen could be an option in patients with very high viral load to

  6. Childhood to adolescence: dust and gas clearing in protoplanetary disks

    Science.gov (United States)

    Brown, Joanna Margaret

    Disks are ubiquitous around young stars. Over time, disks dissipate, revealing planets that formed hidden by their natal dust. Since direct detection of young planets at small orbital radii is currently impossible, other tracers of planet formation must be found. One sign of disk evolution, potentially linked to planet formation, is the opening of a gap or inner hole in the disk. In this thesis, I have identified and characterized several cold disks with large inner gaps but retaining massive primordial outer disks. While cold disks are not common, with ~5% of disks showing signs of inner gaps, they provide proof that at least some disks evolve from the inside-out. These large gaps are equivalent to dust clearing from inside the Earth's orbit to Neptune's orbit or even the inner Kuiper belt. Unlike more evolved systems like our own, the central star is often still accreting and a large outer disk remains. I identified four cold disks in Spitzer 5-40 μm spectra and modeled these disks using a 2-D radiative transfer code to determine the gap properties. Outer gap radii of 20-45 AU were derived. However, spectrophotometric identification is indirect and model-dependent. To validate this interpretation, I observed three disks with a submillimeter interferometer and obtained the first direct images of the central holes. The images agree well with the gap sizes derived from the spectrophotometry. One system, LkH&alpha 330, has a very steep outer gap edge which seems more consistent with gravitational perturbation rather than gradual processes, such as grain growth and settling. Roughly 70% of cold disks show CO v=1&rarr 0 gas emission from the inner 1 AU and therefore are unlikely to have evolved due to photoevaporation. The derived rotation temperatures are significantly lower for the cold disks than disks without gaps. Unresolved (sub)millimeter photometry shows that cold disks have steeper colors, indicating that they are optically thin at these wavelengths, unlike

  7. Pivotal Role of Mediterranean Dietary Regimen in the Increase of Serum Magnesium Concentration in Patients with Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Nimah Bahreini

    2013-01-01

    Full Text Available Background. Recent studies confirmed cardioprotective role of intravenous magnesium for the prevention of cardiac events, but effect of dietary intake of this mineral via recommended dietary regimens on control and inhibition of coronary artery disease (CAD risk factors has been questioned. The aim of the present study was to determine effect of Mediterranean dietary approach on serum magnesium concentration among Iranian patients with CAD. Method. Baseline characteristics and clinical data of 102 consecutive patients with the diagnosis of CAD and candidates for isolated coronary artery bypass surgery were entered into the study. Laboratory parameters especially serum magnesium concentration were measured after 12–14 h of overnight fasting and before operation. Nutritional status was assessed by food frequency questionnaire and the diet score was calculated on the basis of Mediterranean diet quality index (Med-DQI. Results. No significant differences were found in the concentrations of albumin, last fasting blood sugar, last creatinine, and lipid profiles between the groups with Mediterranean dietary score < 5 and the group with higher dietary score; however, serum magnesium concentration in the first group was higher than that in the group with higher dietary score. Linear multivariate regression analysis showed that the lower Mediterranean dietary score was a predictor for serum magnesium concentration after adjusting for confounders. Conclusion. Taking Mediterranean dietary regimen can be associated with increased level of serum magnesium concentration, and thus this regimen can be cardioprotective because of its effects on serum magnesium.

  8. Efficacy of a nonsurgical treatment regimen in patients with bisphosphonate-related osteonecrosis of the jaws in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mohammad M Alsehimy

    2014-02-01

    Full Text Available Objectives: The objective of this study was to evaluate the effectiveness of a nonsurgical treatment regimen in the long-term control of necrotic areas of the jaws and pain in such patients. Methods: A total of 96 patients suffering from the disease were included in this study. All patients received nonsurgical treatment regimen for 10 days, and repeated every 3 months for 2 years. The size of the osteonecrotic lesions was measured and the pain level was self-assessed with a visual analog scale. Results: The patients showed a statistically significant (F = 16.1; p < .01; r2 = .95 gradual decrease in the size of exposed bone areas during the nonsurgical therapy (from 12.5 to 8.8 mm. Pain scores ranged from 0 to 3 score scale. Complete resolution of the disease was observed in some patients. Conclusions: This conservative nonsurgical treatment regimen seems to provide successful treatment in reduction of the sizes of exposed bone areas in the majority of patients.

  9. Bayesian adaptive randomization in a clinical trial to identify new regimens for MDR-TB: the endTB trial.

    Science.gov (United States)

    Cellamare, M; Milstein, M; Ventz, S; Baudin, E; Trippa, L; Mitnick, C D

    2016-12-01

    Evidence-based optimization of treatment for multidrug-resistant tuberculosis (MDR-TB), including integration of new drugs, is urgent. Such optimization would benefit from efficient trial designs requiring fewer patients. Implementation of such innovative designs could accelerate improvements in and access to MDR-TB treatment. To describe the application, advantages, and challenges of Bayesian adaptive randomization in a Phase III non-inferiority trial of MDR-TB treatment. endTB is the first Phase III non-inferiority trial of MDR-TB treatment to use Bayesian adaptive randomization. We present a simulation study with assumptions for treatment response at 8, 39, and 73 weeks after randomization, on which sample size calculations are based. We show differences between Bayesian adaptive randomization and balanced randomization designs in sample size and number of patients exposed to ineffective regimens. With 750 participants, 27% fewer than required by balanced randomization, the study had 80% power to detect up to two (of five) novel treatment regimens that are non-inferior (margin 12%) to the control (70% estimated efficacy) at 73 weeks post randomization. Comparing Bayesian adaptive randomization to balanced randomization, up to 25% more participants would receive non-inferior regimens. Bayesian adaptive randomization may expose fewer participants to ineffective treatments and enhance the efficiency of MDR-TB treatment trials.

  10. [An Elderly Patient with Multiple Lung Metastases after Colectomy Successfully Treated with a Combination Oral UFT/LV Chemotherapy Regimen].

    Science.gov (United States)

    Shiraishi, Takehiro; Moriya, Tomoyuki; Ueno, Hideki; Shinto, Eiji; Kajiwara, Yoshiki; Sueyama, Takahiro; Watanabe, Tomoki; Yamadera, Masato; Yamamoto, Junji; Hase, Kazuo

    2016-07-01

    We report an 84-year-old woman with multiple lung metastases from sigmoid colon cancer successfully treated with an oral combination chemotherapeutic agent regimen(UFT/LV).The patient had undergone colectomy for sigmoid colon cancer. Histological examination confirmed a pT4a, pN3, pM1a(LYM), pStage IV tumor.The patient refused adjuvant chemotherapy. However, approximately 9 months postoperatively, she developed a severe cough.Chest radiography and computed tomography(CT)revealed multiple progressive lung metastases.Thereafter, considering her advanced age and general condition, an oral UFT/LV regimen(UFT 300mg/LV 75mg for 7 days every 14 days)was initiated.Two and a half months after initiating chemotherapy, symptom amelioration was observed.Chest radiography and CT showed disappearance of several of the lung metastases, indicating a Partial Response(PR).For the nearly one year to date since diagnosis, she has remained free of cough and the PR has been maintained without chemotherapy-associated adverse events.She is currently being managed on an outpatient basis.The oral UFT/LV regimen is considered to be among the potentially effective and safe treatments for elderly patients with postoperative metastases from colon cancer.

  11. Three different up-titration regimens of ponesimod, an S1P1 receptor modulator, in healthy subjects.

    Science.gov (United States)

    Scherz, Michael W; Brossard, Patrick; D'Ambrosio, Daniele; Ipek, Murat; Dingemanse, Jasper

    2015-06-01

    Ponesimod is a selective S1P1 receptor modulator, and induces dose-dependent reduction of circulating lymphocytes upon oral dosing. Previous studies showed that single doses up to 75 mg or multiple doses up to 40 mg once daily are well tolerated, and heart rate (HR) reduction and atrio-ventricular conduction delays upon treatment initiation are reduced by gradual up-titration to the maintenance dose. This single-center, open-label, randomized, multiple-dose, 3-treatment, 3-way crossover study compared the tolerability, safety, pharmacokinetics, cardiodynamics, and effects on lymphocytes of 3 different up-titration regimens of ponesimod in healthy male and female subjects. Up-titration regimens comprised escalating periods of b.i.d. dosing (2.5 or 5 mg) and q.d. dosing (10 or 20 mg or both). After the third up-titration period a variable-duration washout period of 1-3 days was followed by re-challenge with a single 20-mg dose of ponesimod. Adverse events were transient and mild to moderate in intensity, not different between regimens. HR decrease after the first dose was greater than after all subsequent doses, including up-titration doses. Little or no HR change was observed with morning doses of b.i.d. regimens, suggesting that 2.5 and 5 mg b.i.d. are sufficient to sustain cardiac desensitization for the 12-hours dosing interval. © 2015, The American College of Clinical Pharmacology.

  12. Pharmacist-patient communication about medication regimen adjustment during Ramadan.

    Science.gov (United States)

    Amin, Mohamed E K; Chewning, Betty

    2016-12-01

    During Ramadan, Muslims fast from dawn to sunset while abstaining from food and drink. Although Muslim patients may be aware of their religious exemption from fasting, many patients still choose not to take that exemption and fast. This study examines pharmacists' initiation and timing of communication about medication regimen adjustment (MRA) with patients related to Ramadan. Predictors for initiating this communication with patients were also explored. A probability sample of community pharmacists in Alexandria, Egypt was surveyed. The self-administered instrument covered timing and likelihood of initiating discussion about MRA. Using ordered logistic regression, a model was estimated to predict pharmacists' initiation of the conversation on MRA during Ramadan. Ninety-three percent of the 298 approached pharmacists completed surveys. Only 16% of the pharmacists reported that they themselves usually initiated the conversation on MRA. Pharmacists' initiation of these conversations was associated with pharmacists' perceived importance of MRA on pharmacy revenue odds ratio ((OR) = 1.24, CI = 1.03-1.48). Eighty percent of the responding pharmacists reported the MRA conversation for chronic conditions started either 1-3 days before, or during the first week of Ramadan. These results suggest considerable pharmacist patient communication gaps regarding medication use during Ramadan. It is especially important for pharmacists and other health professionals to initiate communication with Muslim patients early enough to identify how best to help patients transition safely into and out of Ramadan as they fast. © 2016 Royal Pharmaceutical Society.

  13. Analytical verification of waterborne chemical treatment regimens in hatchery raceways

    Science.gov (United States)

    Rach, J.J.; Ramsay, R.T.

    2000-01-01

    Chemical therapy for control and prevention of fish diseases is a necessary and common practice in aquaculture. Many factors affect the accuracy of a chemical treatment application, such as the functioning of the chemical delivery system, calculation of chemical quantities to be delivered, water temperature, geometry of the culture unit, inlet-outlet structure, the influence of aerators, wind movement, and measurement of water volumes and flow rates. Three separate trials were conducted at the Osceola Fish Hatchery, a facility of the Wisconsin Department of Natural Resources, evaluating the accuracy of flow-through hydrogen peroxide treatments applied to 1, 3, or 9 raceways that were connected in series. Raceways were treated with 50 or 75 ??L/L of hydrogen peroxide for 30 min. Chemical concentrations were determined titrimetrically. The target treatment regimen was not realized in any of the applications. Chemical concentrations dropped and exposure times increased with each additional raceway treated in series. Single introduction of a therapeutant to more than three raceways in series is not recommended. Factors that interfered with the accuracy of the treatments were culture unit configuration, aeration, and flow rates. Several treatment modifications were identified that would result in more accurate chemical treatments.

  14. Oxygen regimen in the human peripheral tissue during space flights

    Science.gov (United States)

    Haase, H.; Kovalenko, E. A.; Vacek, A.; Bobrovnickij, M. P.; Jarsumbeck, B.; Semencov, V. N.; Sarol, Z.; Hideg, J.; Zlatarev, K.

    A survey of the results of the experiment "Oxygen," carried out within the scope of the INTERKOSMOS program in members of the permanent crews and of international visiting expeditions to the Soviet orbital station Salyut-6, is given. During the 7-day space flights of the international visiting expeditions a significant decrease in pO 2 ic by 3.28 kPa was observed. Local oxygen utilization reduced significantly by 0.44 kPa. During hyperventilation testing after return to earth a statistically significant decrease in the peak value by 1.39 kPa was noted. In the long-term crews of the orbital station Salyut-6 the highest decrease in pO 2 ic of 3.8 kPa and the absolutely lowest value of 3.4 ± 0.5 kPa during space flight were observed. The decrease in local oxygen utilization during the flight of 0.8 kPa/min was greater than that of the visiting crews. The results indicate the importance of investigating the dynamics of the oxygen regimen for medical control of the crew members both during the space flight and during the readaptation phase after return to earth.

  15. TREATMENT OF ACUTE PROMYELOCYTIC LEUKEMIA WITH AIDA BASED REGIMEN

    Directory of Open Access Journals (Sweden)

    Ramzi Jeddi

    2011-09-01

    Full Text Available In Tunisia, the ATRA era began in 1998 with the use, consecutively, of two regimens combining ATRA and an anthracycline with cytarabine (APL93, and without cytarabine (LPA99. From 2004, 51 patients with confirmed APL either by t(15;17 or PML/RARA were treated according to the PETHEMA LPA 99 trial. Forty three patients achieved CR (86%. The remaining seven patients had early death (one died before treatment onset: four caused by differentiation syndrome (DS and three died from central nervous system hemorrhage. Multivariate analysis revealed that female gender (P=0.045, baseline WBC> 10 G/L ( P=0.041 and serum creatinine > 1.4mg/dl ( P=0.021 were predictive of mortality during induction. DS was observed in 16 patients (32% after a median onset time of 15 days from treatment onset (range, 2–29. Body mass index ≥ 30 (P=0.01 was the only independent predictor of DS. Occurrence of hypertensive peaks significantly predicted occurrence of DS (P=0.011 and was significantly associated with high BMI (p=0.003. With a median follow-up of 50 months, 5 year cumulative incidence of relapse, event free and overall survival were 4.7%, 74% and 78%, respectively.

  16. Pharmacokinetics and pharmacodynamics of levofloxacin injection in healthy Chinese volunteers and dosing regimen optimization

    Science.gov (United States)

    Cao, G; Zhang, J; Wu, X; Yu, J; Chen, Y; Ye, X; Zhu, D; Zhang, Y; Guo, B; Shi, Y

    2013-01-01

    What is known and objective The pharmacokinetics (PK) and pharmacodynamics (PD) of levofloxacin were investigated following administration of levofloxacin injection in healthy Chinese volunteers for optimizing dosing regimen. Methods The PK study included single-dose (750 mg/150 mL) and multiple-dose (750 mg/150 mL once daily for 7 days) phases. The concentration of levofloxacin in blood and urine was determined using HPLC method. Both non-compartmental and compartmental analyses were performed to estimate PK parameters. Taking fCmax/MIC ≥5 and fAUC24 h/MIC ≥30 as a target, the cumulative fraction of response (CFR) of levofloxacin 750 mg for treatment of community-acquired pneumonia (CAP) was calculated using Monte Carlo simulation. The probability of target attainment (PTA) of levofloxacin at various minimal inhibitory concentrations (MICs) was also evaluated. Results and discussion The results of PK study showed that the Cmax and AUC0–∞ of levofloxacin were 14·94 μg/mL and 80·14 μg h/mL following single-dose infusion of levofloxacin. The half-life and average cumulative urine excretion ratio within 72 h post-dosing were 7·75 h and 86·95%, respectively. The mean Css,max, Css,min and AUC0–τ of levofloxacin at steady state following multiple doses were 13·31 μg/mL, 0·031 μg/mL and 103·7 μg h/mL, respectively. The accumulation coefficient was 1·22. PK/PD analysis revealed that the CFR value of levofloxacin 750-mg regimen against Streptococcus pneumoniae was 96·2% and 95·4%, respectively, in terms of fCmax/MIC and fAUC/MIC targets. What is new and conclusion The regimen of 750-mg levofloxacin once daily provides a satisfactory PK/PD profile against the main pathogenic bacteria of CAP, which implies promising clinical and bacteriological efficacy for patients with CAP. A large-scale clinical study is warranted to confirm these results. PMID:23701411

  17. Following an HIV Regimen: Steps to Take Before and After Starting HIV Medicines

    Science.gov (United States)

    ... with adherence before you start your HIV regimen. After you start an HIV regimen, use a variety of strategies to maintain adherence. To maintain adherence over the long term, try some of the following strategies: Use a 7-day pill box. Once a week, fill the pill box ...

  18. A Modified Prophylactic Regimen for the Prevention of Otitis Externa in Saturation Divers

    Science.gov (United States)

    2013-10-01

    Prophylactic Regimen for the Prevention of Otitis Externa in Saturation Divers Authors: DISTRIBUTION STATEMENT A. Paul C. Algra, LT, MC...May 2012 – May 2013 4. TITLE AND SUBTITLE A Modified Prophylactic Regimen for the Prevention of Otitis Externa in Saturation Divers...SUPPLEMENTARY NOTES 14. ABSTRACT To prevent acute otitis externa (AOE) in the saturation setting and to decrease the side effects

  19. Comparison of the effects on pupil size and accommodation of three regimens of topical dapiprazole.

    Science.gov (United States)

    Wilcox, C S; Heiser, J F; Crowder, A M; Wassom, N J; Katz, B B; Dale, J L

    1995-01-01

    BACKGROUND--Patients who have their pupils dilated for an eye examination traditionally have to wait several hours before their pupils return to normal size and their blurred vision (caused by paralysis of accommodation) resolves. Earlier studies with dapiprazole have demonstrated an accelerated reversal of dilatation. METHODS--Three regimens of dapiprazole were studied to determine the effects on pupil diameter and accommodation after mydriasis produced by 2.5% phenylephrine and 0.5% tropicamide. Test regimens included one drop and 1 + 1 drop regimens, compared with a 2 + 2 drop reference regimen. Dapiprazole was administered in one eye and placebo in the other. Mean change from baseline was analysed for pupil diameter and accommodation at various time points after drug administration. Also, for the same variables, 90% confidence intervals for the areas under the curve (AUC) were computed. RESULTS--Both test regimens were equivalent to the reference regimen on the basis of mean change from baseline for pupil diameter and accommodation at individual time points, and for the mean AUC. Most signs and symptoms (injection, stinging, burning, lid oedema, and ptosis) were less frequent in the test regimen treated eyes. There was no significant interaction between regimen and eye colour. CONCLUSION--This study indicates that a lower dosage (for example, one drop) is also efficacious and has the added benefit of fewer side effects. PMID:7626570

  20. The Clearing: Heidegger’s Lichtung and The Big Scrub

    Directory of Open Access Journals (Sweden)

    Rob Garbutt

    2010-02-01

    Full Text Available Clearings make settlement possible. Whether on a small scale using an axe and other hand implements to make way for a dwelling and a garden, or on a large scale with a chain strung between two D9 bulldozers in preparation for a major agribusiness development, the process of clearing creates spaces for installing something new. This paper uses the idea of (the clearing, as practice, process, outcome and metaphor, to examine the installation of the locals in a settler society. Using Lismore on the far-north coast of New South Wales, Australia, as a case example, the particular work of clearing that is discussed here is a practice that enables a form of colonisation and settlement that distances itself from its history of migration. This is a history of settler locals who were 'always here', and a colonial form of clearing clears the land and the mind of troubling pasts and of troubling presences. For the locals within a place, then, clearing manages and simplifies a complex set of social and material relations, histories and identities. Using Anthony Appiah's concept the 'space clearing gesture', the paper concludes with a reflection on the space in which the idea of "the clearing" and this paper appears. Do places, in this instance rural places, provide a type of clearing in which certain ideas might appear that may not appear elsewhere? If situatedness matters then the diversity of places where thinking is done is important for our ecology of thought, and in connection with this, perhaps what 'rural cultural studies' does is clear a particular type of space for thinking.

  1. Clear Cell Renal Cell Carcinoma With Borderline Features of Clear Cell Papillary Renal Cell Carcinoma: Combined Morphologic, Immunohistochemical, and Cytogenetic Analysis.

    Science.gov (United States)

    Williamson, Sean R; Gupta, Nilesh S; Eble, John N; Rogers, Craig G; Michalowski, Susan; Zhang, Shaobo; Wang, Mingsheng; Grignon, David J; Cheng, Liang

    2015-11-01

    Clear cell papillary renal cell carcinoma is increasingly recognized as a distinct tumor with unique morphology, immunohistochemistry, and cytogenetics. Histopathology often mimics clear cell renal cell carcinoma; however, metastasis has not been reported, emphasizing the clinical value of recognizing these likely nonaggressive tumors. We studied tumors with borderline morphology of clear cell papillary renal cell carcinoma, utilizing immunohistochemistry and fluorescence in situ hybridization or karyotyping. Tumors from 22 patients (ages 33 to 82 y) were analyzed. Clear cell papillary renal cell carcinoma-like morphology varied from 10% to 90% of the tumor (median 25%). Sources of resemblance included: branched glands (95%), nuclear alignment (68%), small papillary tufts (32%), focal branching papillae (27%), and prominent papillary structures (9%). Carbonic anhydrase IX uniformly revealed diffuse positivity. Staining for cytokeratin 7 (CK7) was focal (64%) or negative (18%) in most tumors (82%); however, >50% labeling was present in 4 (18%). Reactivity for both CD10 and α-methyl-acyl-CoA-racemase (AMACR) was usually present (median 80% and 60% of cells). Seven tumors showed reactivity for high-molecular weight keratin (32%). Chromosome 3p loss was confirmed in 15 tumors (68%), including 4/7 with labeling for high-molecular weight keratin or >50% reactivity for CK7. A discordant immunohistochemical pattern typically correlates with loss of material from chromosome 3p in tumors with incomplete morphology of clear cell papillary renal cell carcinoma, supporting classification as clear cell renal cell carcinoma. Diffuse labeling for CK7 can uncommonly be observed in clear cell renal cell carcinomas confirmed to have chromosome 3p loss, although these do not exhibit the expected staining pattern of clear cell papillary renal cell carcinoma, including positivity for CD10 and AMACR.

  2. The Adverse Effect of the 2-1-1 Regimen for Rabies PEP in Preschool Children.

    Science.gov (United States)

    Liu, Shu Qing; Tao, Xiao Yan; Yu, Peng Cheng; Jin, Chun Qiu; Yu, Hong Jie; Chen, Mei Shun; Zhu, Wu Yang

    2017-05-01

    Post-exposure prophylaxis (PEP) has proved to be the most important measure for rabies prevention and control. There is little information regarding adverse reactions to the Essen and 2-1-1 regimens in preschool children (aged 0-6). We reexamined the outcomes of 1,109 preschool children who were vaccinated using SPEEDA under the Essen regimen between January 2011 and December 2012 and 1,267 preschool children under the 2-1-1 regimen between January 2013 and December 2014. We find that, in preschool children, the febrile reaction after the first 2-dose injection in the 2-1-1 regimen was significantly higher than that induced by the first 1-dose in the Essen procedure. Thus, we recommend that the Essen regimen should still be used for rabies PEP in preschool children. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  3. Comparison of bumetanide- and metolazone-based diuretic regimens to furosemide in acute heart failure.

    Science.gov (United States)

    Ng, Tien M H; Konopka, Erica; Hyderi, Alifiya F; Hshieh, Shenche; Tsuji, Yuki; Kim, Brian J; Han, Song Y; Phan, Duc H; Jeng, Aaron I; Lou, Mimi; Elkayam, Uri

    2013-07-01

    Limited data exist comparing the efficacy and safety of bumetanide- or metolazone-based diuretic regimens to furosemide in acute heart failure (HF). Our purpose was to evaluate the comparative effect on urine output (UO) and renal function between these regimens. A retrospective study of hospitalized HF patients treated with continuous infusion furosemide (CIF), combination furosemide plus metolazone (F + M), or continuous infusion bumetanide (CIB). Primary end points were between regimen comparisons for change in mean hourly UO versus baseline and incidence of worsening renal function. Data on 242 patients with acute HF (age 58 ± 12 years, 63% male, left ventricular ejection fraction 38% ± 17%) were analyzed (160 CIF, 42 F + M, 40 CIB). The mean duration of diuretic regimens was 41 ± 32 hours. Compared to baseline, all regimens increased mean hourly UO (P furosemide is combined with metolazone or when bumetanide is used. These therapeutic differences warrant prospective study.

  4. Why Stop Now? Extended and Continuous Regimens of Combined Hormonal Contraceptive Methods.

    Science.gov (United States)

    Benson, Lyndsey S; Micks, Elizabeth A

    2015-12-01

    Combined hormonal contraceptives (CHCs) have traditionally been prescribed in 28-day cycles, with 21 days of active hormones followed by a 7-day hormone-free interval. Extended and continuous CHC regimens, defined as regimens with greater than 28 days of active hormones, offer many benefits, including a decrease in estrogen-withdrawal symptoms and likely greater efficacy because of more reliable ovulation suppression. Bleeding profiles are favorable, and unscheduled bleeding decreases over time with these regimens. Extended and continuous regimens of combined oral contraceptives and the contraceptive vaginal ring are safe and have high user acceptability and satisfaction. However, despite numerous benefits, extended and continuous CHC regimens are underused. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. The genetic landscape of endometrial clear cell carcinomas.

    Science.gov (United States)

    DeLair, Deborah F; Burke, Kathleen A; Selenica, Pier; Lim, Raymond S; Scott, Sasinya N; Middha, Sumit; Mohanty, Abhinita S; Cheng, Donavan T; Berger, Michael F; Soslow, Robert A; Weigelt, Britta

    2017-10-01

    Clear cell carcinoma of the endometrium is a rare type of endometrial cancer that is generally associated with an aggressive clinical behaviour. Here, we sought to define the repertoire of somatic genetic alterations in endometrial clear cell carcinomas (ECCs), and whether ECCs could be classified into the molecular subtypes described for endometrial endometrioid and serous carcinomas. We performed a rigorous histopathological review, immunohistochemical analysis and massively parallel sequencing targeting 300 cancer-related genes of 32 pure ECCs. Eleven (34%), seven (22%) and six (19%) ECCs showed abnormal expression patterns for p53, ARID1A, and at least one DNA mismatch repair (MMR) protein, respectively. Targeted sequencing data were obtained from 30 of the 32 ECCs included in this study, and these revealed that two ECCs (7%) were ultramutated and harboured mutations affecting the exonuclease domain of POLE. In POLE wild-type ECCs, TP53 (46%), PIK3CA (36%), PPP2R1A (36%), FBXW7 (25%), ARID1A (21%), PIK3R1 (18%) and SPOP (18%) were the genes most commonly affected by mutations; 18% and 11% harboured CCNE1 and ERBB2 amplifications, respectively, and 11% showed DAXX homozygous deletions. ECCs less frequently harboured mutations affecting CTNNB1 and PTEN but more frequently harboured PPP2R1A and TP53 mutations than non-POLE endometrioid carcinomas from The Cancer Genome Atlas (TCGA). Compared to endometrial serous carcinomas (TCGA), ECCs less frequently harboured TP53 mutations. When a surrogate model for the molecular-based TCGA classification was used, all molecular subtypes previously identified in endometrial endometrioid and serous carcinomas were present in the ECCs studied, including POLE, MMR-deficient, copy-number high (serous-like)/p53 abnormal, and copy-number low (endometrioid)/p53 wild-type, which were significantly associated with disease-free survival in univariate analysis. These findings demonstrate that ECCs constitute a histologically and

  6. 76 FR 14471 - Clearing Agency Standards for Operation and Governance

    Science.gov (United States)

    2011-03-16

    ... Operation and Governance; Proposed Rule #0;#0;Federal Register / Vol. 76, No. 51 / Wednesday, March 16, 2011... Standards for Operation and Governance AGENCY: Securities and Exchange Commission. ACTION: Proposed rule... clearing agencies and standards for the operation and governance of clearing agencies. The proposed rules...

  7. ClearPEM: prototype PET device dedicated to breast imaging

    CERN Document Server

    Joao Varela

    2009-01-01

    Clinical trials have begun in Portugal on a new breast imaging system (ClearPEM) using positron emission tomography (PET). The system, developed by a Portuguese consortium in collaboration with CERN and laboratories participating in the Crystal Clear collaboration, will detect even the smallest tumours and thus help avoid unnecessary biopsies.

  8. Automated clearing system and the banking sector performance: the ...

    African Journals Online (AJOL)

    This study investigated the impact of automated clearing system on the Nigerian banking system. Secondary data were mostly sourced through The Central Bank of Nigeria publications and analyzed using t test statistics, which tested the significant difference between pre, and post automated clearing system. The result ...

  9. Land clearing and wood use in Delaware, 1972

    Science.gov (United States)

    James T. Bones; Joseph E. Barnard

    1973-01-01

    Changing land use often results in removal of the existing forest cover. During a resurvey of Delaware's timber resources, a study was made to measure the losses of wood fiber that resulted from forest land clearing. It was estimated that nearly 33 million cubic feet of growing stock was destroyed on the 37,000 acres of commercial forest land that was cleared...

  10. A New Type of distributed Enamel based Clearing Electrode

    CERN Document Server

    Kroyer, T; Caspers, Friedhelm; Hellmond, P; Métral, E; Wendel, J C; Zimmermann, F

    2007-01-01

    Clearing electrodes can be used for electron cloud (EC) suppression in high intensity particle accelerators. In this paper the use of low and highly resistive layers on a dielectric substrate are examined. The beam coupling impedance of such a structure is evaluated. Furthermore the clearing efficiency as well as technological issues are discussed.

  11. A simple formula for determining globally clear skies

    Energy Technology Data Exchange (ETDEWEB)

    Long, C.N.; George, A.T.; Mace, G.G. [Penn State Univ., University Park, PA (United States)] [and others

    1996-04-01

    Surface measurements to serve as {open_quotes}ground truth{close_quotes} are of primary importance in the development of retrieval algorithms using satellite measurements to predict surface irradiance. The most basic algorithms of this type deal with clear sky (i.e., cloudless) top-to-surface shortwave (SW) transfer, serving as a necessary prerequisite towards treating both clear and cloudy conditions. Recently, atmosphere SW cloud forcing to infer the possibility of excess atmospheric absorption (compared with model results) in cloudy atmospheres. The surface component of this ratio relies on inferring the expected clear sky SW irradiance to determine the effects of clouds on the SW energy budget. Solar renewable energy applications make use of clear and cloud fraction climatologies to assess solar radiation resources. All of the above depend to some extent on the identification of globally clear sky conditions and the attendant measurements of downwelling SW irradiance.

  12. The efficiency of contact lens care regimens on protein removal from hydrogel and silicone hydrogel lenses

    Science.gov (United States)

    Heynen, Miriam; Liu, Lina; Sheardown, Heather; Jones, Lyndon

    2010-01-01

    Purpose To investigate the efficiency of lysozyme and albumin removal from silicone hydrogel and conventional contact lenses, using a polyhexamethylene biguanide multipurpose solution (MPS) in a soaking or rubbing/soaking application and a hydrogen peroxide system (H2O2). Methods Etafilcon A, lotrafilcon B and balafilcon A materials were incubated in protein solutions for up to 14 days. Lenses were either placed in radiolabeled protein to quantify the amount deposited or in fluorescent-conjugated protein to identify its location, using confocal laser scanning microscopy (CLSM). Lenses were either rinsed with PBS or soaked overnight in H2O2 or MPS with and without lens rubbing. Results After 14 days lysozyme was highest on etafilcon A (2,200 μg) >balafilcon A (50 µg) >lotrafilcon B (9.7 µg) and albumin was highest on balafilcon A (1.9 µg) =lotrafilcon B (1.8 µg) >etafilcon A (0.2 µg). Lysozyme removal was greatest for balafilcon A >etafilcon A >lotrafilcon B, with etafilcon A showing the most change in protein distribution. Albumin removal was highest from etafilcon A >balafilcon A >lotrafilcon B. H2O2 exhibited greater lysozyme removal from etafilcon A compared to both MPS procedures (plenses (p>0.62). Albumin removal was solely material specific, while all care regimens performed to a similar degree (p>0.69). Conclusions Protein removal efficiency for the regimens evaluated depended on the lens material and protein type. Overall, lens rubbing with MPS before soaking did not reduce the protein content on the lenses compared to nonrubbed lenses (p=0.89). PMID:20098668

  13. Treatment outcomes of recommended first-line antiretroviral regimens in resource-limited clinics.

    Science.gov (United States)

    Amoroso, Anthony; Etienne-Mesubi, Martine; Edozien, Anthony; Ojoo, Sylvia; Sheneberger, Robert; Obiefune, Michael; Hossain, Mian Bazle; Stafford, Kristen; Redfield, Robert R

    2012-07-01

    Although used globally, little data exist on the efficacy of nevirapine (NVP) used in combination with tenofovir (TDF)/emtricitabine or lamivudine (XTC), and no large randomized prospective control trials exists comparing this combination with efavirenz (EFV)/TDF/(XTC). As part of the AIDSRelief program, a retrospective review of patient medical chart information along with a cross-sectional viral load, and adherence measurement was conducted between 2004 and 2009. An on-treatment analysis excluded patients who died, transferred out of care, or were lost to follow-up. A switch of antiretrovirals for any reason was considered a failure in the intent-to-treat analysis. Patients with only clinically relevant reasons for switching such as toxicity, adverse effects, viral failure or clinical/immunological failure, lost to follow-up, and death were considered failures as part of the modified-intent-to-treat analysis. Step-wise multiple regression analysis was used to identify variables that were associated with viral suppression. A random sample of 3862 patients met criteria and were included in this analysis. In the on-treatment analysis, older age (P XTC/EFV achieved higher rates of viral suppression compared with patients on TDF/XTC/NVP or azidothymidine (AZT)/lamivudine (3TC)/NVP. Our data show that patients on TDF/XTC/EFV had better outcomes than patients on TDF/XTC/NVP, AZT/3TC/EFV, or AZT/3TC/NVP. High rates of virologic suppression seen in patients on this regimen are consistent with previous studies and indicate the need to increase use of this regimen in HIV programs to promote sustainable viral suppression over time.

  14. Weight change trajectory in women with breast cancer receiving chemotherapy and the effect of different regimens.

    Science.gov (United States)

    Liu, Li-Ni; Wen, Fur-Hsing; Miaskowski, Christine; Lin, Yung-Chang; Wang, Jong-Shyan; Jeng, Chii; Chen, Mei-Ling

    2014-10-01

    To investigate the trajectory of weight change in Taiwanese women with breast cancer after starting chemotherapy and the impact of chemotherapy regimens on weight change while controlling for age, menopausal status, body mass index, lymph node involvement and changes in habits of dietary fat intake and exercise. Weight gain after adjuvant chemotherapy in women with breast cancer has negative impact on health outcomes. Longitudinal, clinical observational study. Weights were repeatedly measured in 147 women with breast cancer stages I-III. Hierarchical linear modelling was used to analyse these longitudinal data. The overall pattern of weight change was a cubic form beginning with a mean of 56·9 kg before chemotherapy. It gradually increased to 59·4 kg at 8·5 months after the first chemotherapy followed by a decrease to 58·5 kg at 21·5 months. During the last 2·5 months, weight increased slightly and never returned to the initial level. After controlling for confounders, steeper weight change was observed among women receiving cyclophosphamide, methotrexate and fluorouracil. The highest weight gain in the cyclophosphamide, methotrexate and fluorouracil group was 2·9 kg (5%) vs. 0·9 kg (1%) in the anthracycline-based group. The trajectory of body weight change within two years after chemotherapy shows a trend of gradual ascent, followed by a small decline and a slight increase in the last 2·5 months. The chemotherapy regimen can predict the trend after controlling for other confounders; women on cyclophosphamide, methotrexate and fluorouracil have a steeper weight change. Nurses can inform women with breast cancer about the expected changes in body weight after chemotherapy to reduce their uncertainty. Future studies on effective interventions to minimise chemotherapy-induced weight gain are needed. © 2014 John Wiley & Sons Ltd.

  15. Hey Teacher, Your Personality's Showing!

    Science.gov (United States)

    Paulsen, James R.

    1977-01-01

    A study of 30 fourth, fifth, and sixth grade teachers and 300 of their students showed that a teacher's age, sex, and years of experience did not relate to students' mathematics achievement, but that more effective teachers showed greater "freedom from defensive behavior" than did less effective teachers. (DT)

  16. Planning a Successful Tech Show

    Science.gov (United States)

    Nikirk, Martin

    2011-01-01

    Tech shows are a great way to introduce prospective students, parents, and local business and industry to a technology and engineering or career and technical education program. In addition to showcasing instructional programs, a tech show allows students to demonstrate their professionalism and skills, practice public presentations, and interact…

  17. Aggressive Regimens for Multidrug-Resistant Tuberculosis Decrease All-Cause Mortality

    Science.gov (United States)

    Mitnick, Carole D.; Franke, Molly F.; Rich, Michael L.; Alcantara Viru, Felix A.; Appleton, Sasha C.; Atwood, Sidney S.; Bayona, Jaime N.; Bonilla, Cesar A.; Chalco, Katiuska; Fraser, Hamish S. F.; Furin, Jennifer J.; Guerra, Dalia; Hurtado, Rocio M.; Joseph, Keith; Llaro, Karim; Mestanza, Lorena; Mukherjee, Joia S.; Muñoz, Maribel; Palacios, Eda; Sanchez, Epifanio; Seung, Kwonjune J.; Shin, Sonya S.; Sloutsky, Alexander; Tolman, Arielle W.; Becerra, Mercedes C.

    2013-01-01

    Rationale A better understanding of the composition of optimal treatment regimens for multidrug-resistant tuberculosis (MDR-TB) is essential for expanding universal access to effective treatment and for developing new therapies for MDR-TB. Analysis of observational data may inform the definition of an optimized regimen. Objectives This study assessed the impact of an aggressive regimen–one containing at least five likely effective drugs, including a fluoroquinolone and injectable–on treatment outcomes in a large MDR-TB patient cohort. Methods This was a retrospective cohort study of patients treated in a national outpatient program in Peru between 1999 and 2002. We examined the association between receiving an aggressive regimen and the rate of death. Measurements and Main Results In total, 669 patients were treated with individualized regimens for laboratory-confirmed MDR-TB. Isolates were resistant to a mean of 5.4 (SD 1.7) drugs. Cure or completion was achieved in 66.1% (442) of patients; death occurred in 20.8% (139). Patients who received an aggressive regimen were less likely to die (crude hazard ratio [HR]: 0.62; 95% CI: 0.44,0.89), compared to those who did not receive such a regimen. This association held in analyses adjusted for comorbidities and indicators of severity (adjusted HR: 0.63; 95% CI: 0.43,0.93). Conclusions The aggressive regimen is a robust predictor of MDR-TB treatment outcome. TB policy makers and program directors should consider this standard as they design and implement regimens for patients with drug-resistant disease. Furthermore, the aggressive regimen should be considered the standard background regimen when designing randomized trials of treatment for drug-resistant TB. PMID:23516529

  18. Comparison of two neoadjuvant chemoradiotherapy regimens in patients with potentially curable esophageal carcinoma.

    Science.gov (United States)

    Blom, R L G M; Sosef, M N; Nap, M; Lammering, G; van den Berkmortel, F; Hulshof, M C C M; Meijer, S L; Wilmink, H W; van Berge Henegouwen, M I

    2014-01-01

    The implementation of neoadjuvant chemoradiotherapy (CRT) in esophageal cancer (EC) patients has led to improved survival rates. Worldwide, different CRT regimens are applied. It is unknown how these regimens relate to each other regarding efficacy. Therefore, the aim of this study was to determine the preferred regimen regarding toxicity of, response to CRT, and long-term survival after esophagectomy in EC patients. EC patients in two centers who underwent CRT with different regimens prior to surgery were included in this study. CRT consisted of 50.4Gy combined with two cycles of cisplatin and 5-FU(center A), or 41.4Gy combined with five cycles of carboplatin and paclitaxel (center B). Toxicity, response to therapy and long-term survival were compared between groups. One hundred sisty-five patients were included. Forty-one percent of patients in center A developed ≥1 toxicity ≥ grade 3 versus 25% in center B (P = 0.025). CRT with a cisplatin-based regimen was an independent predictor for development of toxicity ≥ grade 3 (P = 0.043). There were no differences in response between both regimens (P = 0.904). Three-year survival was 61% (A) versus 57% (B) (P = 0.725). The carboplatin/paclitaxel/41.4Gy regimen causes less toxicity compared to the cisplatin/5-FU/50.4Gy regimen with nonsignificant differences in response rates and long-term survival; therefore our results support this regimen to be the preferred regimen for EC patients. © 2013 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  19. Long-term CD4+ T-cell count evolution after switching from regimens including HIV nucleoside reverse transcriptase inhibitors (NRTI plus protease inhibitors to regimens containing NRTI plus non-NRTI or only NRTI

    Directory of Open Access Journals (Sweden)

    Cicconi Paola

    2011-01-01

    Full Text Available Abstract Background Data regarding CD4+ recovery after switching from protease inhibitor (PI-based regimens to regimens not containing PI are scarce. Methods Subjects with virological success on first-PI-regimens who switched to NNRTI therapy (NNRTI group or to nucleoside reverse transcriptase (NRTI-only (NRTI group were studied. The effect of the switch on the ongoing CD4+ trend was assessed by two-phase linear regression (TPLR, allowing us to evaluate whether a change in the CD4+ trend (hinge occurred and the time of its occurrence. Furthermore, we described the evolution of the frequencies in CD4-count classes across four relevant time-points (baseline, before and immediately after the switch, and last visit. Finally, we explored whether the CD4+ counts evolved differently in patients who switched to NNRTI or NRTI-only regimens by considering: the overall CD4+ trends, the time to CD4+≥ 500/mm3 after the switch, and the area-under-the-curve (AUC of the CD4+ after the switch. Results Eight hundred and ninety-six patients, followed for a median of 2,121 days, were included. At TPLR, hinges occurred in 581/844 (68.9%, but in only 40/581 (6.9% within a time interval (180 days compatible with a possible relationship to the switch; furthermore, in 19/40 cases, CD4+ counts appeared to decrease after the hinges. In comparison with the NNRTI group, the NRTI group showed CD4+ count greater at baseline (P = 0.0234 and before the switch (P ≤ 0.0001, superior CD4+ T-cell increases after HAART was started, lower probability of not achieving CD4+ ≥ 500/mm3 (P = 0.0024, and, finally, no significant differences in the CD4+ T-cell AUC after the switch after adjusting for possible confounders (propensity score and pre-switch AUC. Persistence at CD4+ 3 was observed in 34/435 (7.5% patients, and a decrease below this level was found in only 10/259 (3.9% with baseline CD4+ ≥ 350/mm3. Conclusions Switching from first-line PI to NNRTI- or NRTI-based regimens

  20. Risk Aversion in Game Shows

    DEFF Research Database (Denmark)

    Andersen, Steffen; Harrison, Glenn W.; Lau, Morten I.

    2008-01-01

    We review the use of behavior from television game shows to infer risk attitudes. These shows provide evidence when contestants are making decisions over very large stakes, and in a replicated, structured way. Inferences are generally confounded by the subjective assessment of skill in some games......, and the dynamic nature of the task in most games. We consider the game shows Card Sharks, Jeopardy!, Lingo, and finally Deal Or No Deal. We provide a detailed case study of the analyses of Deal Or No Deal, since it is suitable for inference about risk attitudes and has attracted considerable attention....

  1. Comparison of the efficacy and safety of S-1-based and capecitabine-based regimens in gastrointestinal cancer: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Xunlei Zhang

    Full Text Available PURPOSE: Oral fluoropyrimidine (S-1, capecitabine has been considered as an important part of various regimens. We aimed to evaluate the efficacy and safety of S-1-based therapy versus capecitabine -based therapy in gastrointestinal cancers. METHODS: Eligible studies were identified from Pubmed, EMBASE. Additionally, abstracts presented at American Society of Clinical Oncology (ASCO conferences held between 2000 and 2013 were searched to identify relevant clinical trials. The outcome included overall survival (OS, progression-free survival (PFS, overall response rate (ORR, disease control rate (DCR and advent events. RESULTS: A total of 6 studies (4 RCTs and 2 retrospective analysis studies containing 790 participants were included in this meta-analysis, including 401 patients in the S-1-based group and 389 patients in the capecitabine-based group. Results of our meta-analysis indicated that S-1-based and capecitabine-based regimens showed very similar efficacy in terms of PFS (HR 0.92, 95% CI 0.78-1.09, P = 0.360, OS (HR 1.01, 95% CI 0.84-1.21, P = 0.949, ORR (HR 1.04, 95% CI 0.87-1.25, P = 0.683 and DCR (HR 1.02, 95% CI 0.94-1.10, P = 0.639. There was also no significant difference in toxicity between regimens other than mild more hand-foot syndrome in capecitabine-based regimens. CONCLUSION: Both the S-1-based and capecitabine-based regimens are equally active and well tolerated, and have the potential of backbone chemotherapy regimen in further studies of gastrointestinal cancers.

  2. MCPIP1 contributes to clear cell renal cell carcinomas development.

    Science.gov (United States)

    Ligeza, Janusz; Marona, Paulina; Gach, Natalia; Lipert, Barbara; Miekus, Katarzyna; Wilk, Waclaw; Jaszczynski, Janusz; Stelmach, Andrzej; Loboda, Agnieszka; Dulak, Jozef; Branicki, Wojciech; Rys, Janusz; Jura, Jolanta

    2017-08-01

    Monocyte Chemoattractant protein-induced protein 1 (MCPIP1), also known as Regnase-1, is encoded by the ZC3H12a gene, and it mediates inflammatory processes by regulating the stability of transcripts coding for proinflammatory cytokines and controlling activity of transcription factors, such as NF-κB and AP1. We found that MCPIP1 transcript and protein levels are strongly downregulated in clear cell renal cell carcinoma (ccRCC) samples, which were derived from patients surgically treated for renal cancer compared to surrounded normal tissues. Using Caki-1 cells as a model, we analyzed the role of MCPIP1 in cancer development. We showed that MCPIP1 expression depends on the proteasome activity; however, hypoxia and hypoxia inducible factor 2 alfa (HIF2α) are key factors lowering MCPIP1 expression. Furthermore, we found that MCPIP1 negatively regulates HIF1α and HIF2α levels and in the case of the last one, the mechanism is based on the regulation of the half time of transcript coding for HIF2α. Enhanced expression of MCPIP1 in Caki-1 cells results in a downregulation of transcripts encoding VEGFA, GLUT1, and IL-6. Furthermore, MCPIP1 decreases the activity of mTOR and protein kinase B (Akt) in normoxic conditions. Taken together, MCPIP1 contributes to the ccRCC development.

  3. Measuring performance at trade shows

    DEFF Research Database (Denmark)

    Hansen, Kåre

    2004-01-01

    Trade shows is an increasingly important marketing activity to many companies, but current measures of trade show performance do not adequately capture dimensions important to exhibitors. Based on the marketing literature's outcome and behavior-based control system taxonomy, a model is built...... that captures a outcome-based sales dimension and four behavior-based dimensions (i.e. information-gathering, relationship building, image building, and motivation activities). A 16-item instrument is developed for assessing exhibitors perceptions of their trade show performance. The paper presents evidence...... of the scale's reliability, factor structure, and validity on the basis of analyzing data from independent samples of exhibitors at the international trade shows SIAL (Paris) and ANUGA (Cologne); and it concludes with a discussion of potential managerial applications and implications for future research. New...

  4. Possibility of increasing the efficiency of laser-induced tattoo removal by optical skin clearing

    Science.gov (United States)

    Genina, E. A.; Bashkatov, A. N.; Tuchin, V. V.; Altshuler, G. B.; Yaroslavskii, I. V.

    2008-06-01

    The possibility of selective laser photothermolysis improvement for the removal of tattoo pigments due to the optical clearing of human skin is investigated. It is shown experimentally that the optical skin clearing increases the tattoo image contrast. Computer Monte Carlo simulations show that by decreasing the laser beam scattering in upper skin layers, it is possible to reduce the radiation power required for tattoo removal by 30%—40% and, therefore, to increase the the photothermolysis efficiency.

  5. One Clear Image? Challenging Simplicity in Place Branding

    DEFF Research Database (Denmark)

    Ren, Carina Bregnholm; Blichfeldt, Bodil Stilling

    2011-01-01

    and socio-material practices at the tourist destination. Based on these findings, place marketers are encouraged to embrace and benefit from the multiple destination rather than seeking to reduce its multiplicity. It is argued that diversity branding might actually be deployed, strategically, in order......Unique selling points! Simplicity sells! One clear identity! One clear image! These are some of the place branding mantras of today. In this paper, this “simplicity trend” is critically examined and challenged by raising the question whether clear images and simplicity are truly the only options...

  6. 3D confocal imaging in CUBIC-cleared mouse heart

    Energy Technology Data Exchange (ETDEWEB)

    Nehrhoff, I.; Bocancea, D.; Vaquero, J.; Vaquero, J.J.; Lorrio, M.T.; Ripoll, J.; Desco, M.; Gomez-Gaviro, M.V.

    2016-07-01

    Acquiring high resolution 3D images of the heart enables the ability to study heart diseases more in detail. Here, the CUBIC (clear, unobstructed brain imaging cocktails and computational analysis) clearing protocol was adapted for thick mouse heart sections to increase the penetration depth of the confocal microscope lasers into the tissue. The adapted CUBIC clearing of the heart lets the antibody penetrate deeper into the tissue by a factor of five. The here shown protocol enables deep 3D highresolution image acquisition in the heart. This allows a much more accurate assessment of the cellular and structural changes that underlie heart diseases. (Author)

  7. Clear-PEM, a dedicated PET camera for mammography

    CERN Document Server

    Lecoq, P

    2002-01-01

    Preliminary results suggest that Positron Emission Mammography (PEM) can offer a noninvasive method for the diagnosis of breast cancer. Metabolic images from PEM contain unique information not available from conventional morphologic imaging techniques and aid in expeditiously establishing the diagnosis of cancer. A dedicated machine seems to offer better perspectives in terms of position resolution and sensitivity. This paper describes the concept of Clear-PEM, the system presently developed by the Crystal Clear Collaboration at CERN for an evaluation of this approach. This device is based on new crystals introduced by the Crystal Clear as well as on modern data acquisition techniques developed for the large experiments in high energy physics experiments.

  8. Differences in Lipid Measurements by Antiretroviral Regimen Exposure in Cohorts from Asia and Australia

    Directory of Open Access Journals (Sweden)

    Amit C. Achhra

    2012-01-01

    Full Text Available We explored the mean differences in routinely measured lipids (total cholesterol, triglycerides, and high-density lipoprotein cholesterol according to exposure to different combination antiretroviral regimens in Asian (n=2051 and Australian (predominantly Caucasian, n=794 cohorts. The regimen was defined as at least 3 antiretroviral drugs with at least 2 nucleoside-reverse transcriptases (NRTIs and either of at least one protease inhibitor (PI or non-nucleoside-reverse transcriptases (NNRTIs. We categorised cART regimens as: NRTIs as tenofovir based or not; NNRTIs as nevirapine or efavirenz (but not both; and PI as atazanavir based or not. We found that the impact of various antiretroviral regimens on lipids in Asian and Australian cohorts was only different by cohort for total cholesterol (P for interaction between regimen and cohort: 0.05. The differences in total cholesterol were however small and unlikely to be of clinical significance. Overall, tenofovir with nevirapine or atazanavir was associated with the most favorable lipids, while the PI regimens without tenofovir and atazanavir were associated with least favorable lipids. We conclude that the impact of various ART regimens on lipids is largely similar in Asian and Australian cohorts and that the newer drugs such as tenofovir and atazanavir are likely to provide similar benefit in terms of lipid profiles in both populations.

  9. Tokyo Motor Show 2003; Tokyo Motor Show 2003

    Energy Technology Data Exchange (ETDEWEB)

    Joly, E.

    2004-01-01

    The text which follows present the different techniques exposed during the 37. Tokyo Motor Show. The report points out the great tendencies of developments of the Japanese automobile industry. The hybrid electric-powered vehicles or those equipped with fuel cells have been highlighted by the Japanese manufacturers which allow considerable budgets in the research of less polluting vehicles. The exposed models, although being all different according to the manufacturer, use always a hybrid system: fuel cell/battery. The manufacturers have stressed too on the intelligent systems for navigation and safety as well as on the design and comfort. (O.M.)

  10. Elimination of Pasteurella pneumotropica from a mouse barrier facility by using a modified enrofloxacin treatment regimen.

    Science.gov (United States)

    Towne, Justin W; Wagner, April M; Griffin, Kurt J; Buntzman, Adam S; Frelinger, Jeffrey A; Besselsen, David G

    2014-09-01

    Multiple NOD. Cg-Prkdc(scid)Il2rg(tm1Wjl)Tg(HLA-A2.1)Enge/Sz (NSG/A2) transgenic mice maintained in a mouse barrier facility were submitted for necropsy to determine the cause of facial alopecia, tachypnea, dyspnea, and sudden death. Pneumonia and soft-tissue abscesses were observed, and Pasteurella pneumotropica biotype Jawetz was consistently isolated from the upper respiratory tract, lung, and abscesses. Epidemiologic investigation within the facility revealed presence of this pathogen in mice generated or rederived by the intramural Genetically Engineered Mouse Model (GEMM) Core but not in mice procured from several approved commercial vendors. Epidemiologic data suggested the infection originated from female or vasectomized male ND4 mice obtained from a commercial vendor and then comingled by the GEMM Core to induce pseudopregnancy in female mice for embryo implantation. Enrofloxacin delivered in drinking water (85 mg/kg body weight daily) for 14 d was sufficient to clear bacterial infection in normal, breeding, and immune-deficient mice without the need to change the antibiotic water source. This modified treatment regimen was administered to 2400 cages of mice to eradicate Pasteurella pneumotropica from the facility. Follow-up PCR testing for P. pneumotropica biotype Jawetz remained uniformly negative at 2, 6, 12, and 52 wk after treatment in multiple strains of mice that were originally infected. Together, these data indicate that enrofloxacin can eradicate P. pneumotropica from infected mice in a less labor-intensive approach that does not require breeding cessation and that is easily adaptable to the standard biweekly cage change schedule for individually ventilated cages.

  11. Doctor talk: physicians' use of clear verbal communication.

    Science.gov (United States)

    Howard, Tera; Jacobson, Kara L; Kripalani, Sunil

    2013-08-01

    Low health literacy negatively affects processes and outcomes of care. Physicians do not routinely use communication techniques recommended for use with low health literate patients. This study was conducted to compare the self-reported and actual use of clear verbal communication among medical residents and to identify characteristics associated with clear communication. Residents self-assessed their communication behaviors and then completed a low health literacy standardized patient encounter. Answers on the self-assessment were compared with behaviors observed in the standardized patient encounter. Residents (N = 82) reported frequent use of techniques recommended for clear verbal communication, including plain language (88%) and teach-back (48%). However, during the standardized patient encounter, they used an average of 2 jargon terms per minute, and only 22% used teach-back. No resident characteristics consistently predicted better communication. In conclusion, the study found that medical residents used clear communication techniques infrequently and tended to overestimate the clarity with which they communicate.

  12. Molecular Air Data Clear Air Turbulence Sensor: MADCAT Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Clear air turbulence (CAT), often referred to as "air pockets," is attributed to Kelvin-Helmholtz instabilities at altitudes usually above 18,000ft, often without...

  13. Reconstruction of Clear-PEM data with STIR

    CERN Document Server

    Martins, M V; Rodrigues, P; Trindade, A; Oliveira, N; Correia, M; Cordeiro, H; Ferreira, N C; Varela, J; Almeida, P

    2006-01-01

    The Clear-PEM scanner is a device based on planar detectors that is currently under development within the Crystal Clear Collaboration, at CERN. The basis for 3D image reconstruction in Clear-PEM is the software for tomographic image reconstruction (STIR). STIR is an open source object-oriented library that efficiently deals with the 3D positron emission tomography data sets. This library was originally designed for the traditional cylindrical scanners. In order to make its use compatible with planar scanner data, new functionalities were introduced into the library's framework. In this work, Monte Carlo simulations of the Clear-PEM scanner acquisitions were used as input for image reconstruction with the 3D OSEM algorithm available in STIR. The results presented indicate that dual plate PEM data can be accurately reconstructed using the enhanced STIR framework.

  14. CBFS: high performance feature selection algorithm based on feature clearness.

    Directory of Open Access Journals (Sweden)

    Minseok Seo

    Full Text Available BACKGROUND: The goal of feature selection is to select useful features and simultaneously exclude garbage features from a given dataset for classification purposes. This is expected to bring reduction of processing time and improvement of classification accuracy. METHODOLOGY: In this study, we devised a new feature selection algorithm (CBFS based on clearness of features. Feature clearness expresses separability among classes in a feature. Highly clear features contribute towards obtaining high classification accuracy. CScore is a measure to score clearness of each feature and is based on clustered samples to centroid of classes in a feature. We also suggest combining CBFS and other algorithms to improve classification accuracy. CONCLUSIONS/SIGNIFICANCE: From the experiment we confirm that CBFS is more excellent than up-to-date feature selection algorithms including FeaLect. CBFS can be applied to microarray gene selection, text categorization, and image classification.

  15. 19 CFR 4.60 - Vessels required to clear.

    Science.gov (United States)

    2010-04-01

    ... contiguous country otherwise than by sea. (c) Vessels which will merely transit the Panama Canal without... of clearance and related papers shall be surrendered. (e) No vessel shall be cleared for the high...

  16. Bridge pressure flow scour for clear water conditions

    Science.gov (United States)

    2009-10-01

    The equilibrium scour at a bridge caused by pressure flow with critical approach velocity in clear-water simulation conditions was studied both analytically and experimentally. The flume experiments revealed that (1) the measured equilibrium scour pr...

  17. Molecular Air Data Clear Air Turbulence Sensor: MADCAT Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Clear air turbulence (CAT), often referred to as "air pockets," is attributed to Kelvin-Helmholtz instabilities at altitudes generally above 18,000ft, often in the...

  18. Metastatic clear cell carcinoma of the kidney: therapeutic role of bevacizumab

    Directory of Open Access Journals (Sweden)

    Ronald M Bukowski

    2010-03-01

    Full Text Available Ronald M BukowskiCleveland Clinic Taussig Cancer Center, CCF Lerner College of Medicine of CWRU Cleveland, OH, USAAbstract: The biology and pathogenesis of clear cell carcinoma of the kidney has been extensively investgated, and the role of von Hipple-Landau gene inactivation and tumor associated angiogenesis is now recognized. Development of vascular endothelial growth factor inhibitors and phase 3 clinical trials utilizing this class of agents has produced a new treatment paradigm for patients with metastatic renal cell carcinoma (RCC. One of the active regimens identified is the combination of bevacizumab and interferon-α. Recently published reports provided evidence of the clinical and biologic activity of this therapy. The current manuscript reviews the background and rationale for the activity of bevacizumab in RCC, and results from recent clinical trials with this agent alone or in combination with targeted agents or cytokines. The role of this therapy in contrast to other targeted agents is reviewed, and the potential utility as well as questions raised by recent studies are discussed.Keywords: metastatic renal cell carcinoma, bevacizumab, interferon-α

  19. International Organization of Standardization (ISO) and Cambridge Filter Test (CFT) Smoking Regimen Data Comparisons in Tobacco Product Marketing Applications.

    Science.gov (United States)

    Chae, Changyu; Walters, Matthew J; Holman, Matthew R

    2017-07-01

    We investigated the differences in TNCO (tar, nicotine, and carbon monoxide) smoke yields generated under the International Organization of Standardization (ISO) and Federal Trade Commission (FTC) Cambridge Filter Test (CFT) smoking regimens. Twenty-nine commercial cigarette products from the US marketplace were acquired in 2015 and tested by measuring the TNCO smoke yields generated under these 2 nonintense smoking regimens. Data obtained demonstrated a linear relationship between the TNCO yields produced under the 2 smoking regimens (R 2 > 0.99). TNCO yields produced by each product were higher under the CFT smoking regimen than the ISO smoking regimen. We found that tar, nicotine, and carbon monoxide yields were consistently 10% to 13% higher under the CFT smoking regimen than under the ISO smoking regimen. This strong correlation indicates that the 2 smoking regimens can be used to apply a correlation correction to CFT TNCO data and allow its comparison to ISO TNCO data in tobacco product marketing applications.

  20. Chronic dietary oxalate nephropathy after intensive dietary weight loss regimen.

    Science.gov (United States)

    Khneizer, Gebran; Al-Taee, Ahmad; Mallick, Meher S; Bastani, Bahar

    2017-07-01

    Hyperoxaluria has been associated with nephrolithiasis as well as acute and chronic kidney disease. We present a case of end stage renal failure caused by excessive dietary oxalate intake in a dietary weight loss regimen. A 51-year-old Caucasian male with the past medical history of type 2 diabetes mellitus, gout, hypertension and morbid obesity was referred to the primary care clinic after being found pale and easily fatigued. The patient had lost 36 kg over a 7-month period by implementing exercise and intense dietary measures that included 6 meals of spinach, kale, berries, and nuts. Physical examination revealed a blood pressure of 188/93 mm Hg with sunken eyes and dry mucus membranes. Laboratory workup was notable for blood urea nitrogen of 122 mg/dL, creatinine of 12 mg/dL, and estimated glomerular filtration rate (eGFR) of 4.4 mL/min/1.73m2. Patient denied any history of renal disease or renal stones, or taking herbal products, non-steroidal anti-inflammatory drugs, antifreeze (ethylene glycol), or any type of "diet pills." Family history was unremarkable for any renal diseases. After failing intravenous fluid resuscitation, patient was started on maintenance hemodialysis. Abdominal imaging was consistent with chronic renal parenchymal disease with no evidence of nephrolithiasis. Renal biopsy revealed numerous polarized oxalate crystal deposition and diabetic nephropathy class IIA. At this point the patient was instructed to adopt a low oxalate diet. A 24-hour urine collection was remarkable for pH 4.7, citrate <50 mg, and oxalate 46 mg. Importantly, serum oxalate level was undetectable. Repeat renal biopsy 5 months later while patient was still on maintenance hemodialysis revealed persistence of extensive oxalate crystal deposition. Patient has been referred for evaluation for renal transplantation. Clinicians need to maintain a high index of suspicion for dietary hyperoxaluria as a potential etiology for acute or chronic kidney failure, particularly in

  1. Study of optical clearing of blood by immersion method

    Science.gov (United States)

    Zhernovaya, Olga S.; Jonathan, Enock; Tuchin, Valery V.; Leahy, Martin J.

    2011-03-01

    Light scattering in blood caused by refractive index mismatch between erythrocyte cytoplasm and blood plasma leads to a reduction in imaging spatial resolution, imaging depth and contrast of optical imaging techniques. A possible solution to this problem is of the addition of biocompatible clearing agents, such as glucose, fructose, glycerol, dextrans etc. The basic principle of the optical clearing technique is refractive index matching between erythrocyte cytoplasm and blood plasma. Optical clearing, a technique that has been successfully demonstrated with biologic tissue, represents a promising approach to increasing the imaging depth for various techniques, for example optical coherence tomography (OCT). OCT is based on low-coherence interferometry to produce cross-sectional tomographic imaging of the internal microstructure in materials and biological tissues by measuring the echo time delay and magnitude of backscattered light. One of the main advantages of this technique is the ability to investigate turbid and highly scattering media, such as whole blood. To determine the optimal concentration of clearing agents required for blood optical clearing in order to improve light penetration depth for optical coherence tomography, clearing agents such as glucose and fructose, with various concentrations were added to blood and investigated by OCT. Changes in light attenuation and sedimentation and aggregation properties of blood depending on particular agent and its concentration were studied.

  2. Clearing of ventilating emissions in low temperature environment of plasma

    Science.gov (United States)

    Mansurov, R. Sh; Rafalskaya, T. A.

    2017-11-01

    The method of high-temperature processing of streams of the ventilating air which is a subject clearing from organic pollutions is developed. Data about its efficiency, including on a number of economic parameters are obtained. Results of work are recommended for use, first of all, by development clearing plasma-thermal reactors (CPTR) for clearing air, especially from toxic substances, and also for large technological clearing installations, containing organic ventilating emissions (OVE). It is created experimental CPTR. Laws of the expiration of a plasma jet in stream of OVE limited by cylindrical walls, water-cooled channel are experimentally investigated. Dependences of a trajectory and long-range the plasma jet blown radially in stream of OVE are received. Heat exchange of stream of OVE with walls of CPTR after blowing a plasma jet is experimentally investigated; dependences of distribution of temperatures on length of a reactor and a thermal stream in a wall of channel of CPTR are received. Are investigated chemical compound of OVE after plasma-thermal clearing, some experimental data by formation of oxides of nitrogen and mono-oxide of carbon during clearing are received.

  3. Coastal sediment elevation change following anthropogenic mangrove clearing

    Science.gov (United States)

    Hayden, Heather L.; Granek, Elise F.

    2015-11-01

    Coastal mangrove forests along tropical shorelines serve as an important interface between land and sea. They provide a physical buffer protecting the coastline from erosion and act as sediment "traps" catching terrestrial sediment, thus preventing smothering of subtidal coral reefs. Coastal development that removes mangrove habitat may impact adjacent nearshore coral reefs through sedimentation and nutrient loading. We examined differences in sediment elevation change between patches of open-coast intact and anthropogenically cleared red mangroves (Rhizophora mangle) on the east side of Turneffe Atoll, Belize, to quantify changes following mangrove clearing. Samples were collected over a 24 month period at five study sites, each containing paired intact (+mangrove) and cleared (-mangrove) plots. Five sediment elevation pins were deployed in each plot: behind areas cleared of mangroves (-mangrove) and behind adjacent intact mangroves (+mangrove). Sediment elevation increased at intact mangrove sites (M = +3.83 mm, SE = 0.95) whereas cleared mangrove areas suffered elevation loss (M = -7.30 mm, SE = 3.38). Mangroves inshore of partial or continuous gaps in the adjacent fringing reefs had higher rates of elevation loss (M = -15.05 mm) than mangroves inshore of continuous fringing reefs (M = -1.90 mm). Our findings provide information on potential effects of mangrove clearing and the role of offshore habitat characteristics on coastal sediment trapping and maintenance of sediment elevation by mangroves. With implications for coastline capacity to adjust to sea level rise, these findings are relevant to management of coastal fringing mangrove forests across the Caribbean.

  4. Global horizontal irradiance clear sky models : implementation and analysis.

    Energy Technology Data Exchange (ETDEWEB)

    Stein, Joshua S.; Hansen, Clifford W.; Reno, Matthew J.

    2012-03-01

    Clear sky models estimate the terrestrial solar radiation under a cloudless sky as a function of the solar elevation angle, site altitude, aerosol concentration, water vapor, and various atmospheric conditions. This report provides an overview of a number of global horizontal irradiance (GHI) clear sky models from very simple to complex. Validation of clear-sky models requires comparison of model results to measured irradiance during clear-sky periods. To facilitate validation, we present a new algorithm for automatically identifying clear-sky periods in a time series of GHI measurements. We evaluate the performance of selected clear-sky models using measured data from 30 different sites, totaling about 300 site-years of data. We analyze the variation of these errors across time and location. In terms of error averaged over all locations and times, we found that complex models that correctly account for all the atmospheric parameters are slightly more accurate than other models, but, primarily at low elevations, comparable accuracy can be obtained from some simpler models. However, simpler models often exhibit errors that vary with time of day and season, whereas the errors for complex models vary less over time.

  5. Update of adjustable fortification regimen for preterm infants: a new protocol.

    Science.gov (United States)

    Arslanoglu, S; Bertino, E; Coscia, A; Tonetto, P; Giuliani, F; Moro, G E

    2012-01-01

    Preterm infants fed fortified human milk in standard fashion receive less protein than they need due to customary assumptions. Protein is limiting for growth and neurocognitive development,and shortfalls of protein are not acceptable. Adjustable fortification regimen has been proven as an effective way to provide adequate protein intakes and appropriate growth in this group of infants. Italian Association of Human Milk Banks (AIBLUD) has promoted and implemented this Adjustable fortification regimen in neonatal intensive care units (NICUs) with success. This paper presents an update of Adjustable fortification regimen; a new protocol already utilized in several italian NICUs.

  6. Reality show: um paradoxo nietzschiano

    Directory of Open Access Journals (Sweden)

    Ilana Feldman

    2011-01-01

    Full Text Available

    O fenômeno dos reality shows - e a subseqüente relação entre imagem e verdade - assenta-se sobre uma série de paradoxos. Tais paradoxos podem ser compreendidos à luz do pensamento do filósofo alemão Friedrich Nietzsche, que, através dos usos de formulações paradoxais, concebia a realidade como um mundo de pura aparência e a verdade como um acréscimo ficcional, como um efeito. A ficção é então tomada, na filosofia de Nietzsche, não em seu aspecto falsificante e desrealizador - como sempre pleiteou nossa tradição metafísica -, mas como condição necessária para que certa espécie de invenção possa operar como verdade. Sendo assim, a própria expressão reality show, através de sua formulação paradoxal, engendra explicitamente um mundo de pura aparência, em que a verdade, a parte reality da proposição, é da ordem do suplemento, daquilo que se acrescenta ficcionalmente - como um adjetivo - a show. O ornamento, nesse caso, passa a ocupar o lugar central, apontando para o efeito produzido: o efeito-de-verdade. Seguindo, então, o pensamento nietzschiano e sua atualização na contemporaneidade, investigaremos de que forma os televisivos “shows de realidade” operam paradoxalmente, em consonância com nossas paradoxais práticas culturais.

  7. On the impact of self-clearing on electroactive polymer (EAP) actuators

    Science.gov (United States)

    Ahmed, Saad; Ounaies, Zoubeida; Lanagan, Michael T.

    2017-10-01

    Electroactive polymer (EAP)-based actuators have large potential for a wide array of applications; however, their practical implementation is still a challenge because of the requirement of high driving voltage, which most often leads to premature defect-driven electrical breakdown. Polymer-based capacitors have the ability to clear defects with partial electrical breakdown and subsequent removal of a localized electrode section near the defect. In this study, this process, which is known as self-clearing, is adopted for EAP technologies. We report a methodical approach to self-clear an EAP, more specifically P(VDF-TrFE-CTFE) terpolymer, to delay premature defect-driven electrical breakdown of the terpolymer actuators at high operating electric fields. Breakdown results show that electrical breakdown strength is improved up to 18% in comparison to a control sample after self-clearing. Furthermore, the electromechanical performance in terms of blocked force and free displacement of P(VDF-TrFE-CTFE) terpolymer-based bending actuators are examined after self-clearing and precleared samples show improved blocked force, free displacement and maximum sustainable electric field compared to control samples. The study demonstrates that controlled self-clearing of EAPs improves the breakdown limit and reliability of the EAP actuators for practical applications without impeding their electromechanical performance.

  8. Magnetic Resonance Imaging Characteristics of Ovarian Clear Cell Carcinoma.

    Directory of Open Access Journals (Sweden)

    Wei Wang

    Full Text Available To probe the magnetic resonance imaging (MRI features of ovarian clear cell carcinoma (OCCC.This study retrospectively collected MRI data for 21 pathology-confirmed OCCCs from 19 female patients. The MRI findings were analyzed to determine the tumor size, shape/edge, shape and number of protrusions within the cyst, cystic or necrotic components, signal intensity (SI and enhancement features.The age of the 19 patients ranged from 28 to 63 years (mean age: 53 years. Unilateral tumors were found in 17 patients (17/19, 89%; the average size of all tumors was 10.8 cm. The tumors on MRI were classified into two categories: (a "cystic adnexal mass with solid protrusions" in 12 (57% and (b "solid adnexal mass with cystic areas or necrosis" in 9 (43%. For group a, high to very high SI was observed for most tumors (10/12, 83% on T1-weighted images (T1WIs, and very high SI was observed on T2-weighted images (T2WIs for all 12 tumors. Most solid protrusions were irregular and few in number and exhibited heterogeneous intermediate SI on T1WIs and T2WIs and prolonged enhanced SI in the contrast study. All 9 OCCCs in group b were predominantly solid masses with unequally sized necrotic or cystic areas in which some cysts were located at the periphery of the tumor (4/9, 44%. The solid components in all 9 tumors showed iso- or slightly high SI on T1WIs, heterogeneous iso-high SI on T2WIs and heterogeneous prolonged enhancement. According to FIGO classification, 14 tumors (14/19, 74% were stages I-II, and 5 (5/19, 26% were stages III-IV.On MRI, OCCCs present as large unilateral multilocular or unilocular cystic masses with irregular intermediate SI solid protrusions or predominantly solid masses with cysts or necrosis at an early FIGO stage.

  9. Changes in biotic and abiotic processes following mangrove clearing

    Science.gov (United States)

    Granek, Elise; Ruttenberg, Benjamin I.

    2008-12-01

    Mangrove forests, important tropical coastal habitats, are in decline worldwide primarily due to removal by humans. Changes to mangrove systems can alter ecosystem properties through direct effects on abiotic factors such as temperature, light and nutrient supply or through changes in biotic factors such as primary productivity or species composition. Despite the importance of mangroves as transitional habitats between land and sea, little research has examined changes that occur when they are cleared. We examined changes in a number of biotic and abiotic factors following the anthropogenic removal of red mangroves ( Rhizophora mangle) in the Panamanian Caribbean, including algal biomass, algal diversity, algal grazing rates, light penetration, temperature, sedimentation rates and sediment organic content. In this first study examining multiple ecosystem-level effects of mangrove disturbance, we found that areas cleared of mangroves had higher algal biomass and richness than intact mangrove areas. This increase in algal biomass and richness was likely due to changes in abiotic factors (e.g. light intensity, temperature), but not biotic factors (fish herbivory). Additionally the algal and cyanobacterial genera dominating mangrove-cleared areas were rare in intact mangroves and included a number of genera that compete with coral for space on reefs. Interestingly, sedimentation rates did not differ between intact and cleared areas, but the sediments that accumulated in intact mangroves had higher organic content. These findings are the first to demonstrate that anthropogenic clearing of mangroves changes multiple biotic and abiotic processes in mangrove forests and that some of these changes may influence adjacent habitats such as coral reefs and seagrass beds. Additional research is needed to further explore the community and ecosystem-level effects of mangrove clearing and their influence on adjacent habitats, but it is clear that mangrove conservation is an

  10. A novel combinatorial nanotechnology-based oral chemopreventive regimen demonstrates significant suppression of pancreatic cancer neoplastic lesions.

    Science.gov (United States)

    Grandhi, B Karthik; Thakkar, Arvind; Wang, Jeffrey; Prabhu, Sunil

    2013-10-01

    Pancreatic cancer is a deadly disease killing 37,000 Americans each year. Despite two decades of research on treatment options, the chances of survival are still less than 5% upon diagnosis. Recently, chemopreventive strategies have gained considerable attention as an alternative to treatment. We have previously shown significant in vitro chemopreventive effects with low-dose combinations of aspirin, curcumin, and sulforaphane (ACS) on pancreatic cancer cell lines. Here, we report the results of 24-week chemopreventive study with the oral administration of ACS combinations on the N-nitrosobis (2-oxopropyl) amine (BOP)-treated Syrian golden hamster model to suppress the progression of pancreatic intraepithelial neoplasms (PanIN) using unmodified (free drug) combinations of ACS, and nanoencapsulated (solid lipid nanoparticles; SLN) combinations of aspirin, curcumin, and free sulforaphane. The use of three different doses (low, medium, and high) of unmodified ACS combinations exhibited reduction in tumor incidence by 18%, 50%, and 68.7% respectively; whereas the modified nanoencapsulated ACS regimens reduced tumor incidence by 33%, 67%, and 75%, respectively, at 10 times lower dose compared with the free drug combinations. Similarly, although the unmodified free ACS showed a notable reduction in cell proliferation, the SLN encapsulated ACS regimens showed significant reduction in cell proliferation at 6.3%, 58.6%, and 72.8% as evidenced by proliferating cell nuclear antigen expression. Cell apoptotic indices were also upregulated by 1.5, 2.8, and 3.2 times, respectively, compared with BOP control. These studies provide a proof-of-concept for the use of an oral, low-dose, nanotechnology-based combinatorial regimen for the long-term chemoprevention of pancreatic cancer.

  11. High-dose versus low-dose oxytocin infusion regimens for induction of labour at term.

    Science.gov (United States)

    Budden, Aaron; Chen, Lily J Y; Henry, Amanda

    2014-10-09

    meta-analysis but these results may be confounded by poor quality trials. High-dose oxytocin was shown to increase the rate of uterine hyperstimulation but the effects of this are not clear. The conclusions here are specific to the definitions used in this review. Further trials evaluating the effects of high-dose regimens of oxytocin for induction of labour should consider all important maternal and infant outcomes.

  12. Respiratory adverse effects of Sofosbuvir-based regimens for treatment of chronic hepatitis C virus

    Directory of Open Access Journals (Sweden)

    Dina Abouelkheir Abdalla

    2017-04-01

    Conclusion: Sofosbuvir-based regimens used for treatment of chronic HCV infection are considered safe with minor respiratory adverse effects. However, larger multicenter studies are required for further assessment.

  13. Evaluacion de requerimientos ecologicos para el diseno de regimenes ambientales de caudales fluviales

    National Research Council Canada - National Science Library

    Diez-Hernandez, Juan Manuel

    2008-01-01

    ... en el paradigma del Regimen Ambiental de Caudales (RAC). Este trabajo sugiere una metodologia generica para establecer RAC confiables, que posibiliten el aprovechamiento hidrico a un coste ecologico admisible...

  14. Plasma digoxin concentrations and urinary excretion during a 'simpler' regimen of infant digitalization.

    Science.gov (United States)

    Savage, M O; Hibble, A G; Pickering, D

    1975-01-01

    We have measured the plasma concentrations in sick neonates and infants being administered digoxin by a safer regimen. In the presence of normal renal function the plasma concentrations appear to be satisfactory. PMID:1103751

  15. Priority-Setting for Novel Drug Regimens to Treat Tuberculosis: An Epidemiologic Model

    Science.gov (United States)

    Cohen, Ted; Nuermberger, Eric; Dooley, Kelly E.; Gonzalez-Angulo, Lice; Churchyard, Gavin J.; Nahid, Payam; Rich, Michael L.; Bansbach, Cathy; Forissier, Thomas; Dowdy, David W.

    2017-01-01

    Background Novel drug regimens are needed for tuberculosis (TB) treatment. New regimens aim to improve on characteristics such as duration, efficacy, and safety profile, but no single regimen is likely to be ideal in all respects. By linking these regimen characteristics to a novel regimen’s ability to reduce TB incidence and mortality, we sought to prioritize regimen characteristics from a population-level perspective. Methods and Findings We developed a dynamic transmission model of multi-strain TB epidemics in hypothetical populations reflective of the epidemiological situations in India (primary analysis), South Africa, the Philippines, and Brazil. We modeled the introduction of various novel rifampicin-susceptible (RS) or rifampicin-resistant (RR) TB regimens that differed on six characteristics, identified in consultation with a team of global experts: (1) efficacy, (2) duration, (3) ease of adherence, (4) medical contraindications, (5) barrier to resistance, and (6) baseline prevalence of resistance to the novel regimen. We compared scale-up of these regimens to a baseline reflective of continued standard of care. For our primary analysis situated in India, our model generated baseline TB incidence and mortality of 157 (95% uncertainty range [UR]: 113–187) and 16 (95% UR: 9–23) per 100,000 per year at the time of novel regimen introduction and RR TB incidence and mortality of 6 (95% UR: 4–10) and 0.6 (95% UR: 0.3–1.1) per 100,000 per year. An optimal RS TB regimen was projected to reduce 10-y TB incidence and mortality in the India-like scenario by 12% (95% UR: 6%–20%) and 11% (95% UR: 6%–20%), respectively, compared to current-care projections. An optimal RR TB regimen reduced RR TB incidence by an estimated 32% (95% UR: 18%–46%) and RR TB mortality by 30% (95% UR: 18%–44%). Efficacy was the greatest determinant of impact; compared to a novel regimen meeting all minimal targets only, increasing RS TB treatment efficacy from 94% to 99

  16. ANALYSIS OF TOTAL COSTS OF BREAST CANCER CEMOTHERAPY PATIENTS BASED ON USE OF CHEMOTHERAPY REGIMEN ON JKN PATIENTS IN SANGLAH RSUP

    Directory of Open Access Journals (Sweden)

    Ni Putu Wintariani

    2017-10-01

    Full Text Available Breast cancer is the first sequence of most attacking women in Indonesia. The high cost of care and old services is a major problem in the prevention of breast cancer. This study aims to determine the relationship between the total cost of the Sanglah Denpasar hospital with the chemotherapy regimen of breast cancer of JKN patients at Sanglah Hospital Denpasar. Test homogeneity using Levene test method. Test normality using Kolmogorov-Smirnov. One way ANOVA test results showed a significant relationship between chemotherapy therapy regimen (FAC, FAC + PAXUS, FEC, AC, AC + PAXUS with total real cost in breast cancer chemotherapy patients (p = 0.001. The total rill cost was greater in the group receiving FAC + PAXUS, FEC, and AC + PAXUS regimens than the group receiving FAC and AC therapy regimens. This can be caused by a large pharmaceutical cost component in the FAC + PAXUS, FEC, and AC + PAXUS groups. Pharmaceutical costs account for 76.84-85.80% of the total real cost of breast cancer patients receiving chemotherapy. More drug combination factors can lead to higher total rill costs in patients receiving FAC + PAXUS, FEC, and AC + PAXUS.

  17. Dose Response for Radiation Cataractogenesis: A Meta-Regression of Hematopoietic Stem Cell Transplantation Regimens

    Energy Technology Data Exchange (ETDEWEB)

    Hall, Matthew D. [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States); Schultheiss, Timothy E., E-mail: schultheiss@coh.org [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States); Smith, David D. [Division of Biostatistics, City of Hope National Medical Center, Duarte, California (United States); Nguyen, Khanh H. [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States); Department of Radiation Oncology, Bayhealth Cancer Center, Dover, Delaware (United States); Wong, Jeffrey Y.C. [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States)

    2015-01-01

    Purpose/Objective(s): To perform a meta-regression on published data and to model the 5-year probability of cataract development after hematopoietic stem cell transplantation (HSCT) with and without total body irradiation (TBI). Methods and Materials: Eligible studies reporting cataract incidence after HSCT with TBI were identified by a PubMed search. Seventeen publications provided complete information on radiation dose schedule, fractionation, dose rate, and actuarial cataract incidence. Chemotherapy-only regimens were included as zero radiation dose regimens. Multivariate meta-regression with a weighted generalized linear model was used to model the 5-year cataract incidence and contributory factors. Results: Data from 1386 patients in 21 series were included for analysis. TBI was administered to a total dose of 0 to 15.75 Gy with single or fractionated schedules with a dose rate of 0.04 to 0.16 Gy/min. Factors significantly associated with 5-year cataract incidence were dose, dose times dose per fraction (D•dpf), pediatric versus adult status, and the absence of an ophthalmologist as an author. Dose rate, graft versus host disease, steroid use, hyperfractionation, and number of fractions were not significant. Five-fold internal cross-validation showed a model validity of 83% ± 8%. Regression diagnostics showed no evidence of lack-of-fit and no patterns in the studentized residuals. The α/β ratio from the linear quadratic model, estimated as the ratio of the coefficients for dose and D•dpf, was 0.76 Gy (95% confidence interval [CI], 0.05-1.55). The odds ratio for pediatric patients was 2.8 (95% CI, 1.7-4.6) relative to adults. Conclusions: Dose, D•dpf, pediatric status, and regimented follow-up care by an ophthalmologist were predictive of 5-year cataract incidence after HSCT. The low α/β ratio indicates the importance of fractionation in reducing cataracts. Dose rate effects have been observed in single institution studies but not in the

  18. Acute lymphoblastic leukaemia: cyclical chemotherapy with three combinations of four drugs (COAP-POMP-CART regimen).

    Science.gov (United States)

    Spiers, A S; Roberts, P D; Marsh, G W; Parekh, S J; Franklin, A J; Galton, D A; Szur, Z L; Paul, E A; Husband, P; Wiltshaw, E

    1975-12-13

    Forty-two adults and children with previously untreated acute lymphoblastic leukaemia (ALL) were entered into a programme of chemotherapy in which three combinations, each of four drugs were administered in a predetermined cyclical rotation together with cranial irradiation and intrathecal injections of methotrexate. Forty-one patients (98%) entered remission and no patient developed neuroleukaemia. Relapse of ALL occurred in 10 patients, and three patients died during remission, while eight patients stopped treatment after two and a half years and have remained in remission for two to 26 months. Comparison of remission and survival experience in this mixed group of children and adults with the experience of children treated at Memphis and in the Medical Research Council's UKALL-I trial showed no significant differences. On the other hand, analysis by prognostic factors showed that neither age nor blast cell count at presentation had any adverse effect in patients treated in this study. No relapses occurred in nine patients with blast cell counts greater than 20 x 109/1 at presentation. This regimen is effective treatment for ALL and may be of special value in patients with poor prognoses. The regiment has not as yet proved superior for the treatment of children with ALL who do not have adverse prognostic features.

  19. Effect of Four Bleaching Regimens on Color Changes and Microhardness of Dental Nanofilled Composite

    Science.gov (United States)

    Silva Costa, Simone Xavier; Becker, Anne Buss; de Souza Rastelli, Alessandra Nara; Monteiro Loffredo, Leonor de Castro; de Andrade, Marcelo Ferrarezi; Bagnato, Vanderlei Salvador

    2009-01-01

    Objective. The purpose of this study was to compare the color changes and microhardness of a nanocomposite after four bleaching regimens. Materials. Twenty-five specimens (n = 25) were made with a nanocomposite resin (Filtek Supreme XT). The specimens were divided into five groups equally (n = 5): bleaching groups and control group, as follows: G1: artificial saliva at 37°C; (control) G2: hydrogen peroxide (HP) at 7%; G3: hydrogen peroxide (HP) at 35%; G4: carbamide peroxide (CP) at 10%; G5: carbamide peroxide (CP) 35%. Color measurements were made with spectrophotometer using CIELAB color scale. The Vickers hardness (VHN) measurements were performed at the top surface. The data were analyzed with two-way Analysis of Variance. Results. ΔE and VHN mean values into the groups were not statistically different, however, the VHN mean values before and after storage and bleaching showed statistically significant differences. Conclusion. Nanocomposite samples showed no significant alteration (color and microhardness) after bleaching. Thus, no replacement of restorations is required after bleaching. PMID:20339576

  20. Ex vivo microbial leakage after using different final irrigation regimens with chlorhexidine

    Directory of Open Access Journals (Sweden)

    Esther NAVARRO-ESCOBAR

    2013-01-01

    Full Text Available Objective To assess the influence of final irrigation protocols with chlorhexidine in the coronal leakage of Enterococcus faecalis in filled root canals. Material and Methods Seventy single-root canals from extracted teeth were prepared using ProTaper instruments. The irrigation protocol accomplished an alternating irrigation with 5 mL of 2.5% sodium hypochlorite (NaOCI and 17% EDTA between each file. The teeth were randomly divided into four experimental groups (n=15 according to the final irrigation regimen: group 1, without final irrigation; group 2, irrigation with 10 mL 2.0% chlorhexidine (CHX; group 3, with a final application of EC40™; and group 4, irrigation with the combination (1:1 of 0.2% CHX + 0.1% cetrimide (CTR. All the teeth were mounted in a two-chamber apparatus and the coronal access was exposed to E. faecalis. The presence of turbidity in the BHI broth over a period of 180 days was observed. The Friedman test was used for statistical analysis. Results EC40™ varnish showed the least leakage at 180 days, and was statistically similar to 2% CHX. No significant differences were observed between the group without final irrigation and the 2% CHX group or 0.2% CHX + 0.1% CTR. Conclusions In this ex vivo study, EC40™ showed the longest delayed coronal leakage of E. faecalis, although without significant differences from 2% CHX.

  1. Ex vivo microbial leakage after using different final irrigation regimens with chlorhexidine

    Science.gov (United States)

    NAVARRO-ESCOBAR, Esther; BACA, Pilar; GONZÁLEZ-RODRÍGUEZ, María Paloma; ARIAS-MOLIZ, María Teresa; RUIZ, Matilde; FERRER-LUQUE, Carmen María

    2013-01-01

    Objective: To assess the influence of final irrigation protocols with chlorhexidine in the coronal leakage of Enterococcus faecalis in filled root canals. Material and Methods: Seventy single-root canals from extracted teeth were prepared using ProTaper instruments. The irrigation protocol accomplished an alternating irrigation with 5 mL of 2.5% sodium hypochlorite (NaOCl) and 17% EDTA between each file. The teeth were randomly divided into four experimental groups (n=15) according to the final irrigation regimen: group 1, without final irrigation; group 2, irrigation with 10 mL 2.0% chlorhexidine (CHX); group 3, with a final application of EC40TM; and group 4, irrigation with the combination (1:1) of 0.2% CHX + 0.1% cetrimide (CTR). All the teeth were mounted in a two-chamber apparatus and the coronal access was exposed to E. faecalis. The presence of turbidity in the BHI broth over a period of 180 days was observed. The Friedman test was used for statistical analysis. Results: EC40TM varnish showed the least leakage at 180 days, and was statistically similar to 2% CHX. No significant differences were observed between the group without final irrigation and the 2% CHX group or 0.2% CHX + 0.1% CTR. Conclusions: In this ex vivo study, EC40TM showed the longest delayed coronal leakage of E. faecalis, although without significant differences from 2% CHX. PMID:23559116

  2. Pharmacokinetic properties of single-dose primaquine in Papua New Guinean children: feasibility of abbreviated high-dose regimens for radical cure of vivax malaria.

    Science.gov (United States)

    Moore, Brioni R; Salman, Sam; Benjamin, John; Page-Sharp, Madhu; Robinson, Leanne J; Waita, Elizabeth; Batty, Kevin T; Siba, Peter; Mueller, Ivo; Davis, Timothy M E; Betuela, Inoni

    2014-01-01

    Since conventional 14-day primaquine (PMQ) radical cure of vivax malaria is associated with poor compliance, and as total dose, not therapy duration, determines efficacy, a preliminary pharmacokinetic study of two doses (0.5 and 1.0 mg/kg of body weight) was conducted in 28 healthy glucose-6-phosphate dehydrogenase-normal Papua New Guinean children, aged 5 to 12 years, to facilitate development of abbreviated high-dose regimens. Dosing was with food and was directly observed, and venous blood samples were drawn during a 168-h postdose period. Detailed safety monitoring was performed for hepatorenal function and hemoglobin and methemoglobin concentrations. Plasma concentrations of PMQ and its metabolite carboxyprimaquine (CPMQ) were determined by liquid chromatography-mass spectrometry and analyzed using population pharmacokinetic methods. The derived models were used in simulations. Both single-dose regimens were well tolerated with no changes in safety parameters. The mean PMQ central volume of distribution and clearance relative to bioavailability (200 liters/70 kg and 24.6 liters/h/70 kg) were within published ranges for adults. The median predicted maximal concentrations (Cmax) for both PMQ and CPMQ after the last dose of a 1.0 mg/kg 7-day PMQ regimen were approximately double those at the end of 14 days of 0.5 mg/kg daily, while a regimen of 1.0 mg/kg twice daily resulted in a 2.38 and 3.33 times higher Cmax for PMQ and CPMQ, respectively. All predicted median Cmax concentrations were within ranges for adult high-dose studies that also showed acceptable safety and tolerability. The present pharmacokinetic data, the first for PMQ in children, show that further studies of abbreviated high-dose regimens are feasible in this age group.

  3. Toxicities of different first-line chemotherapy regimens in the treatment of advanced ovarian cancer

    OpenAIRE

    Qu, Chang-Ping; Sun, Gui-Xia; Yang, Shao-Qin; Tian, Jun; Si, Jin-Ge; Wang, Yi-Feng

    2017-01-01

    Abstract Background: Ovarian cancer (OC) is the 5th leading cause of cancer-related deaths around the world, and several chemotherapy regimens have been applied in the treatment of OC. We aim to compare toxicities of different chemotherapy regimens in the treatment of advanced ovarian cancer (AOC) using network meta-analysis. Methods: Literature research in Cochrane Library, PubMed, and EMBASE was performed up to November 2015. Eligible randomized controlled trials (RCTs) of different chemoth...

  4. Survival benefit of taxane plus platinum in recurrent ovarian cancer with non-clear cell, non-mucinous histology.

    Science.gov (United States)

    Kajiyama, Hiroaki; Shibata, Kiyosumi; Mizuno, Mika; Umezu, Tomokazu; Suzuki, Shiro; Sekiya, Ryuichiro; Niimi, Kaoru; Mitsui, Hiroko; Yamamoto, Eiko; Kawai, Michiyasu; Nagasaka, Tetsuro; Kikkawa, Fumitaka

    2014-01-01

    This study was conducted to examine the effects of front-line chemotherapy on overall survival (OS) and postrecurrence survival (PRS) of patients with recurrent ovarian cancer, when stratifying the histologic type. Five hundred and seventy-four patients with recurrent ovarian cancer with sufficient clinical information, including front-line chemotherapy, were analyzed. The pathologic slides were evaluated by central pathologic review. The patients were divided into two groups: group A (n=261), who underwent taxane plus platinum, and group B (n=313), who underwent conventional platinum-based chemotherapy without taxanes. The median age was 54 years (range, 14 to 89 years). Group A had significantly better median OS (45.0 months vs. 30.3 months, phistology. In contrast, among patients with non-clear cell, non-mucinous histologies, the OS and PRS of group A were significantly better than those of group B (OS, phistologies, chemotherapy including taxane and platinum was an independent predictor of favorable survival outcomes. Conversely, in patients with clear cell or mucinous histology, taxane-including platinum-based combination chemotherapy did not improve the OS and PRS compared to a conventional platinum-based regimen which did not include taxanes. Since the emergence of taxane plus platinum, the prognosis of patients with recurrent ovarian cancer has improved. However, we here demonstrate that this improvement is limited to patients with non-clear cell, non-mucinous histologies.

  5. Diagnosis of clear sky ultraviolet radiation for Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Lemus Deschamps, L. [Bureau of Meteorology Research Centre (Australia); Galindo, I.; Solano, R.; Elizalde, A.T.; Fonseca, J. [Centro Universitario de Investigaciones en Ciencias del Ambiente, University of Colima (Mexico)

    2002-07-01

    A discrete-ordinate radiative transfer model is employed to develop a regional clear sky ultraviolet (UV) diagnosis system. The clear sky UV radiation, weighted by the spectral sensitivity of human skin is calculated using the Total Ozone Mapping Spectrometer (TOMS) data sets. Examples of the geographical clear sky UV Index distributions are presented and the model results are compared with surface UV measurements from University of Colima for 1999. [Spanish] Utilizando un modelo de transferencia de radiacion de ordenadas discretas se desarrolla un sistema para el diagnostico de la distribucion de radiacion ultravioleta para cielo despejado en la Republica Mexicana. La radiacion para cielo despejado se obtiene utilizando la respuesta espectral de la piel humana y los datos de satelite de ozono total registrados por el espectrometro TOMS. Se presentan ejemplos del Indice de radiacion ultravioleta (UV Index) calculados con el modelo y se comparan con las mediciones en superficie obtenidas en la Universidad de Colima durante 1999.

  6. Advanced ThioClear process testing. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Lani, B.

    1998-03-01

    Wet scrubbing is the leading proven commercial post-combustion FGD technology available to meet the sulfur dioxide reductions required by the Clean Air Act Amendments. To reduce costs associated with wet FGD, Dravo Lime Company has developed the ThioClear process. ThioClear is an ex-situ forced oxidation magnesium-enhanced lime FGD process. ThioClear process differs from the conventional magnesium-enhanced lime process in that the recycle liquor has minimal suspended solids and the by-products are wallboard quality gypsum and magnesium hydroxide, an excellent reagent for water treatment. The process has demonstrated sulfur dioxide removal efficiencies of +95% in both a vertical spray scrubber tower and a horizontal absorber operating at gas velocities of 16 fps, respectively. This report details the optimization studies and associated economics from testing conducted at Dravo Lime Company`s pilot plant located at the Miami Fort Station of the Cincinnati Gas and Electric Company.

  7. Effects of Mixing on Hopper Sedimentation in Clearing Mixtures

    DEFF Research Database (Denmark)

    Hjelmager Jensen, Jacob; Saremi, Sina

    2015-01-01

    Hopper sedimentation is the result of precipitation of typically fine sediment from a homogenous, high-concentration mixture, which is not completely deficient of turbulence. If hopper sedimentation or loading is accomplished through a single-inflow system, or if the irregularity of the inflow...... concentrations is pronounced or simply terminated, then the hopper mixture will clear. Whereas turbulent mixing is redundant, when the mixture is homogeneous, it may take an active role when the mixture is clearing. The role of turbulence on hopper sedimentation has been the focus of several studies......, and a common perception of turbulence (or at least of mixing) is that it delays sedimentation. Existing measurements of sedimentation rates in a closed-flume experiment, engineered to provide input to a hopper sedimentation model, revealed that turbulence in a clearing mixture is not necessarily associated...

  8. Effects of a Month-Long Napping Regimen in Older Individuals

    Science.gov (United States)

    Campbell, Scott S.; Stanchina, Michele D.; Schlang, Joelle R.; Murphy, Patricia J.

    2010-01-01

    OBJECTIVES 1) To examine the effects of a month-long nap regimen using one of two durations (45 min, or 2 hr) on nighttime sleep and waking function in a group of healthy older subjects. 2) To assess the degree to which healthy older individuals are willing/able to adhere to such napping regimens. DESIGN Three laboratory sessions, with 2-week at-home recording interspersed, using a between-subjects approach. SETTING The study was conducted in the Laboratory of Human Chronobiology at Weill Cornell Medical College and in subjects’ homes. PARTICIPANTS Twenty-two healthy men and women aged 50–88 years (mean = 70y). MEASUREMENTS Polysomnography (sleep EEG), actigraphy, sleep diaries, neurobehavioral performance, sleep latency tests. RESULTS With the exception of compliance to the protocol, there were few differences between Short and Long nap conditions. Napping had no negative impact on subsequent nighttime sleep quality or duration, resulting in a significant increase in 24-hour sleep amounts. Such increased sleep was associated with enhanced cognitive performance, but had no impact on simple reaction time. Subjects were generally able to comply better with the 45-minute than the 2-hour nap regimen. CONCLUSION A month-long, daily nap regimen may enhance waking function without negatively impacting nighttime sleep. Using 2-hour naps in such a regimen is unlikely to meet with acceptable compliance; a regimen of daily 1-hour naps may be more desireable for both effectiveness and compliance. PMID:21314644

  9. A preliminary evaluation of comparative effectiveness of riluzole in therapeutic regimen for irritable bowel syndrome

    Science.gov (United States)

    Mishra, Surya Prakash; Shukla, Sunit Kumar; Pandey, Bajrang Lal

    2014-01-01

    Objective To develop agents that are specifically effective in controlling the key disturbance of visceral hyperalgesia besides abating of associated multiple symptoms, and evaluate comparative effectiveness for IBS symptom relief for standard regimen (antispasmodic and probiotic) and add-on amitriptyine or riluzole regimens following two weeks administration. Methods 108 patients with visceral hypersensitivity accompanying IBS, divided into three groups were studied. First group received standard treatment (mebeverine 200 mg twice daily and probiotic 200 mg twice daily). Second group received add-on amitriptyline 25 mg before bedtime, while the third group got add-on riluzole 50 mg twice daily. Overall gastrointestinal symptom rating scale improving symptoms and hospital anxiety depression scale improving associated psychological morbidity were employed as measures at induction and at two-week follow-up period. Individual symptom scores were also examined to define the outcome profiles. Results Riluzole regimen resulted in significant reduction of overall gastrointestinal symptom rating scale score, not the other two regimens. Pain relief was seen with both riluzole and amitriptyline regimens significantly superior to standard treatment regimen, but riluzole effect appeared specific and independent anxiolytic effect. Amitriptyline caused relief in diarrhea and did not benefit in constipation point to non-specific remedial role in IBS. Conclusions Riluzole specifically relieves visceral hypersensitivity and is proved to be superior to current treatments in IBS patients. It appears a lead remedy based on glutamate transporter mechanisms in visceral hypersensititvity. PMID:25183107

  10. Effects of a month-long napping regimen in older individuals.

    Science.gov (United States)

    Campbell, Scott S; Stanchina, Michele D; Schlang, Joelle R; Murphy, Patricia J

    2011-02-01

    To examine the effects of a month-long nap regimen using one of two durations (45 minutes or 2 hours) on nighttime sleep and waking function in a group of healthy older participants and to assess the degree to which healthy older individuals are willing and able to adhere to such napping regimens. Three laboratory sessions, with 2-week at-home recording interspersed, using a between-participants approach. Laboratory of Human Chronobiology at Weill Cornell Medical College and participants' homes. Twenty-two healthy men and women aged 50 to 88 (mean 70). Polysomnography (sleep electroencephalography), actigraphy, sleep diaries, neurobehavioral performance, sleep latency tests. With the exception of adherence to the protocol, there were few differences between short and long nap conditions. Napping had no negative effect on subsequent nighttime sleep quality or duration, resulting in a significant increase in 24-hour sleep amounts. Such increased sleep was associated with enhanced cognitive performance but had no effect on simple reaction time. Participants were generally able to adhere better to the 45-minute than the 2-hour nap regimen. A month-long, daily nap regimen may enhance waking function without negatively affecting nighttime sleep. Using 2-hour naps in such a regimen is unlikely to meet with acceptable adherence; a regimen of daily 1-hour naps may be more desirable for effectiveness and adherence. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

  11. A comparative study of fissure sealants Helioseal Clear Chroma and Delton FS(+): 3 year results.

    Science.gov (United States)

    Kargul, B; Tanboga, I; Gulman, N

    2009-12-01

    To evaluate the retention rates of a resin based colour changing fissure sealant (Helioseal Clear Chroma; Ivoclar Vivadent AG Schaan, Liechtenstein) compared with a coloured resin based fluoride fissure sealant (Delton FS(+); Dentsply De Trey GmbH,Konstanz,Germany). The fissure sealants (FS) were placed on all 4 caries-free first permanent molars of 31 children aged 6-9 years, using a half mouth experimental design by a paediatric dentist according to the manufacturers' instructions. A total of 121 FS were placed at baseline. Teeth were evaluated at 3 month intervals for 36 months where a preventive program including topical fluoride application was applied. Retention rates for 36 months showed a differences between Delton FS(+) and Helioseal Clear Chroma that were statistically significant (pretention rate of 30.4% for 36 months compared with Helioseal Clear Chroma at 10.8% for the same evaluation period. Although Delton FS(+) showed significantly better results than Helioseal Clear Chroma for the evaluation periods, there were no statistically significant differences between Delton FS(+) (90.7%) and Helioseal Clear Chroma (80.4%) with respect to caries incidence at 36 months(p>0.05). Delton FS(+) showed a better complete retention rate for occlusal FS at one year. Both FS were aesthetically acceptable and easy to see during application and follow-up periods and gave significant protection from occlusal decay.

  12. Show Me My Health Plans

    Directory of Open Access Journals (Sweden)

    Mary C. Politi PhD

    2016-11-01

    Full Text Available Introduction: Since the Affordable Care Act was passed, more than 12 million individuals have enrolled in the health insurance marketplace. Without support, many struggle to make an informed plan choice that meets their health and financial needs. Methods: We designed and evaluated a decision aid, Show Me My Health Plans (SMHP, that provides education, preference assessment, and an annual out-of-pocket cost calculator with plan recommendations produced by a tailored, risk-adjusted algorithm incorporating age, gender, and health status. We evaluated whether SMHP compared to HealthCare.gov improved health insurance decision quality and the match between plan choice, needs, and preferences among 328 Missourians enrolling in the marketplace. Results: Participants who used SMHP had higher health insurance knowledge (LS-Mean = 78 vs. 62; P < 0.001, decision self-efficacy (LS-Mean = 83 vs. 75; P < 0.002, confidence in their choice (LS-Mean = 3.5 vs. 2.9; P < 0.001, and improved health insurance literacy (odds ratio = 2.52, P < 0.001 compared to participants using HealthCare.gov . Those using SMHP were 10.3 times more likely to select a silver- or gold-tier plan (P < 0.0001. Discussion: SMHP can improve health insurance decision quality and the odds that consumers select an insurance plan with coverage likely needed to meet their health needs. This study represents a unique context through which to apply principles of decision support to improve health insurance choices.

  13. Clear Plaque Mutants of Lactococcal Phage TP901-1

    DEFF Research Database (Denmark)

    Kot, Witold; Kilstrup, Mogens; Vogensen, Finn K.

    2016-01-01

    We report a method for obtaining turbid plaques of the lactococcal bacteriophage TP901-1 and its derivative TP901-BC1034. We have further used the method to isolate clear plaque mutants of this phage. Analysis of 8 such mutants that were unable to lysogenize the host included whole genome...... protein involved in the DNA binding. The conclusion is that cI is the only gene involved in clear plaque formation i.e. the CI protein is the determining factor for the lysogenic pathway and its maintenance in the lactococcal phage TP901-1....

  14. Advances and perspectives in tissue clearing using CLARITY.

    Science.gov (United States)

    Jensen, Kristian H Reveles; Berg, Rune W

    2017-12-01

    CLARITY is a tissue clearing method, which enables immunostaining and imaging of large volumes for 3D-reconstruction. The method was initially time-consuming, expensive and relied on electrophoresis to remove lipids to make the tissue transparent. Since then several improvements and simplifications have emerged, such as passive clearing (PACT) and methods to improve tissue staining. Here, we review advances and compare current applications with the aim of highlighting needed improvements as well as aiding selection of the specific protocol for use in future investigations. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Prospective comparison of three bowel preparation regimens: fleet phosphosoda, two-liter and four-liter electrolyte lavage solutions.

    Science.gov (United States)

    Ker, Tim S

    2008-10-01

    In an attempt to improve patients' tolerance for colon cleaning, three bowel preparation regimens: 90-mL Fleet phosphosoda (FPS), 2-L electrolyte lavage solution plus 20 mg oral bisacodyl, and 4-L lavage, were compared for efficacy and safety. A total of 912 patients were prospectively nonrandomized into three study groups. In Group A, 304 patients were given 45-mL Fleet phosphosoda at 9 AM and 6 PM the day before colonoscopy. In Group B, 304 patients were given four tablets of 5 mg bisacodyl at 12 PM the day before colonoscopy followed by 2 L electrolyte lavage by mouth at 6:00 PM the evening before colonoscopy. In Group C, 304 patients were given 4 L electrolyte lavage at 6:00 PM the evening before colonoscopy. All patients were kept on a clear liquid diet the day before colonoscopy. The bowel cleanliness was accessed by one colonoscopist. One registered nurse accessed the ease of the patient. In Group A (FPS), every patient finished the 90-mL Fleet phosphosoda. Colon cleanliness was 95.1 per cent. In Group B (2 L), three patients (0.6%) could not finish the laxative. Colon cleanliness was 95.9 per cent. In Group C (4 L), 22 patients (7.3%) could not finish the laxative preparation. Colon cleanliness was 95.3 per cent. The study found these three regimens can achieve equally good results of bowel preparation; however, the small volume laxative (FPS) has been accepted favorably by patients.

  16. Evaluation of a directly observed six months fully intermittent treatment regimen for tuberculosis in patients suspected of poor compliance.

    Science.gov (United States)

    Caminero, J A; Pavón, J M; Rodríguez de Castro, F; Díaz, F; Julià, G; Caylá, J A; Cabrera, P

    1996-11-01

    Although a priority for tuberculosis control is to achieve the maximum cure rate, compliance with chemotherapy in specific high risk groups (homeless, intravenous drug abusers, chronic alcoholics) is usually poor. From January 1990 to December 1994 102 patients with tuberculosis (96 pulmonary, six extrapulmonary) who were poorly compliant with treatment were treated with a six month fully intermittent (twice weekly) directly observed regimen. They comprised 71 homeless subjects, 50 chronic alcoholics, 23 intravenous drug abusers, nine infected with HIV, and 11 who had previously abandoned a daily antituberculosis regimen; 53 had more than one of these risk factors. Treatment included isoniazid and rifampicin for six months and pyrazinamide during the first two months. Patients who failed to take their medication on two consecutive occasions were actively sought by telephone or by personal search. After two months of treatment 95 of the 102 patients had taken their medication regularly and 90 of them had negative cultures. Four of the remaining patients had negative cultures after three months. At the end of the six months 87 patients had completed treatment and were considered cured. Only 15 patients abandoned the treatment (13 of whom had more than one risk factor). Only three relapses occurred in the 102 patients at one year follow up and in the 88 patients followed for two years. Two patients required a change of treatment due to major side effects. Although intravenous drug abuse was the only predictor of non-compliance in the multivariate analysis, if the available variables in the second month of treatment were analysed, current poor compliance and abandonment of treatment in the past were found to be significantly associated with non-compliance. This study shows the efficacy of this intermittent regimen and the effectiveness of a directly observed treatment programme.

  17. Efficacy and economic analysis of two treatment regimens using toltrazuril in lambs naturally infected with Eimeria spp. on pasture.

    Science.gov (United States)

    de Souza Rodrigues, Fernando; Cezar, Alfredo Skrebsky; de Menezes, Fernanda Rezer; Sangioni, Luis Antônio; Vogel, Fernanda Silveira Flores; de Avila Botton, Sônia

    2017-11-01

    This study evaluated the efficacy and the economic viability of two anticoccidial treatment regimens tested in lambs naturally exposed to Eimeria spp. re-infections in a grazing system during a 140-day period. Twenty-four suckling lambs were distributed into three groups based on the individual count of oocysts per gram of feces (OPG) and body weight. Animals were treated with toltrazuril 5% (20 mg/kg) at 14- (GI) or 21-day (GII) intervals, and GIII was kept as untreated control. A cost-benefit analysis of each treatment regimen was calculated. Additionally, economic analysis was performed on four hypothetical scenarios, in which lambs could be having 10, 25, 50, or 85% decrease in their expected body weight gain due to clinical. Efficacy of toltrazuril against Eimeria spp. was 96.9-99.9% (GI) and 74.2-99.9% (GII). E. ovinoidalis was most frequently identified, but no clinical signs of coccidiosis were observed in lambs. There were no differences in weight gain among the groups. The cost of treatment per lamb was $13.09 (GI) and $7.83 (GII). The estimation model showed that the cost-benefit ratio favored treatment with toltrazuril when lambs fail to gain weight. In the studied flock, the break-even point for toltrazuril administered at 14-day intervals was reached with 85% decrease in mean weight gain. In conclusion, toltrazuril can be used at 14-day intervals to control Eimeria spp. (re)-infection in lambs raised on pasture. This treatment regimen was not economically feasible for subclinical coccidiosis; however, it may be feasible when used to prevent weight loss caused by clinical coccidiosis.

  18. CMV and BKPyV Infections in Renal Transplant Recipients Receiving an mTOR Inhibitor-Based Regimen Versus a CNI-Based Regimen: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials.

    Science.gov (United States)

    Mallat, Samir G; Tanios, Bassem Y; Itani, Houssam S; Lotfi, Tamara; McMullan, Ciaran; Gabardi, Steven; Akl, Elie A; Azzi, Jamil R

    2017-08-07

    The objective of this meta-analysis is to compare the incidences of cytomegalovirus and BK polyoma virus infections in renal transplant recipients receiving a mammalian target of rapamycin inhibitor (mTOR)-based regimen compared with a calcineurin inhibitor-based regimen. We conducted a comprehensive search for randomized, controlled trials up to January of 2016 addressing our objective. Other outcomes included acute rejection, graft loss, serious adverse events, proteinuria, wound-healing complications, and eGFR. Two review authors selected eligible studies, abstracted data, and assessed risk of bias. We assessed quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation methodology. We included 28 randomized, controlled trials with 6211 participants classified into comparison 1: mTOR inhibitor versus calcineurin inhibitor and comparison 2: mTOR inhibitor plus reduced dose of calcineurin inhibitor versus regular dose of calcineurin inhibitor. Results showed decreased incidence of cytomegalovirus infection in mTOR inhibitor-based group in both comparison 1 (risk ratio, 0.54; 95% confidence interval, 0.41 to 0.72), with high quality of evidence, and comparison 2 (risk ratio, 0.43; 95% confidence interval, 0.24 to 0.80), with moderate quality of evidence. The available evidence neither confirmed nor ruled out a reduction of BK polyoma virus infection in mTOR inhibitor-based group in both comparisons. Secondary outcomes revealed more serious adverse events and acute rejections in mTOR inhibitor-based group in comparison 1 and no difference in comparison 2. There was no difference in graft loss in both comparisons. eGFR was higher in the mTOR inhibitor-based group in comparison 1 (mean difference =4.07 ml/min per 1.73 m(2); 95% confidence interval, 1.34 to 6.80) and similar to the calcineurin inhibitor-based group in comparison 2. More proteinuria and wound-healing complications occurred in the mTOR inhibitor-based groups. We found

  19. Treatment of Maxillary Midline Diastema Using Removable Clear Trays and Elastics: A Case Report

    Directory of Open Access Journals (Sweden)

    Sümeyya Şin

    2017-04-01

    Full Text Available Maxillary midline diastema is a common esthetic problem requiring treatment. This case presentation shows the treatment of a patient with a minor midline diastema using removable clear trays and elastics. A 20-year-old female patient, whose chief complaint was a small diastema between upper central incisors, had a symmetric face and competent lips. Intraoral examination showed class 1 buccal segments relationship with normal overjet and overbite. For the closure of midline diastema, an upper clear tray was fabricated and it was sectioned at the mesial third of each central incisor to create separate left and right trays with attachments for the elastic wear. Two months later, maxillary midline diastema was totally closed and a bonded maxillary 3-3 retainer was placed for retention. The esthetic problem was resolved. Clear appliance is aesthetic, and sufficient to close maxillary midline diastema.

  20. Histological spectrum of pulmonary manifestations in kidney transplant recipients on sirolimus inclusive immunosuppressive regimens

    Directory of Open Access Journals (Sweden)

    Kirby Sean

    2012-03-01

    Full Text Available Abstract Background After the introduction of novel effective immunosuppressive therapies, kidney transplantation became the treatment of choice for end stage renal disease. While these new therapies lead to better graft survival, they can also cause a variety of complications. Only small series or case reports describe pulmonary pathology in renal allograft recipients on mTOR inhibitor inclusive therapies. The goal of this study was to provide a systematic review of thoracic biopsies in kidney transplant recipients for possible association between a type of immunosuppressive regimen and pulmonary complications. Methods A laboratory database search revealed 28 of 2140 renal allograft recipients (18 males and 10 females, 25 to 77 years old, mean age 53 years who required a biopsy for respiratory symptoms. The histological features were correlated with clinical findings including immunosuppressive medications. Results The incidence of neoplasia on lung biopsy was 0.4% (9 cases, which included 3 squamous cell carcinomas, 2 adenocarcinomas, 1 diffuse large B-cell lymphoma, 1 lymphomatoid granulomatosis, and 2 post transplant B-cell lymphoproliferative disorders. Diffuse parenchymal lung disease was identified in 0.4% (9 cases, and included 5 cases of pulmonary hemorrhage, 3 cases of organizing pneumonia and 1 case of pulmonary alveolar proteinosis. Five (0.2% cases showed histological features indicative of a localized infectious process. Patients on sirolimus had neoplasia less frequently than patients on other immunosuppressive combinations (12.5% vs. 58.3%, p = 0.03. Lung biopsies in 4 of 5 patients with clinically suspected sirolimus toxicity revealed pulmonary hemorrhage as the sole histological finding or in combination with other patterns. Conclusions Our study documents a spectrum of neoplastic and non-neoplastic lesions in renal allograft recipients on current immunosuppressive therapies. Sirolimus inclusive regimens are associated with

  1. 75 FR 77576 - General Regulations and Derivatives Clearing Organizations

    Science.gov (United States)

    2010-12-13

    ... amendments would establish the regulatory standards for compliance with derivatives clearing organization... Risk), as well as DCO chief compliance officer (CCO) requirements set forth in Section 5b of the.... Legal Risk Requirements III. Technical Amendments IV. Effective Date V. Related Matters A. Regulatory...

  2. 76 FR 3697 - Risk Management Requirements for Derivatives Clearing Organizations

    Science.gov (United States)

    2011-01-20

    ... Trading Commission 17 CFR Part 39 Risk Management Requirements for Derivatives Clearing Organizations...; ] COMMODITY FUTURES TRADING COMMISSION 17 CFR Part 39 RIN 3038-AC98 Risk Management Requirements for...) Monitoring, reporting, and enforcement (b) Product eligibility 2. Risk management (a) General (b) Risk...

  3. 76 FR 16587 - Risk Management Requirements for Derivatives Clearing Organizations

    Science.gov (United States)

    2011-03-24

    ... COMMISSION 17 CFR Part 39 RIN 3038-AC98 Risk Management Requirements for Derivatives Clearing Organizations... Principle D (Risk Management) and would establish a related reporting requirement under Core Principle J... Exchange Act (CEA) \\4\\ to establish a comprehensive regulatory framework to reduce risk, increase...

  4. Skin optical clearing for improvement of laser tattoo removal

    Science.gov (United States)

    Genina, Elina A.; Bashkatov, Alexey N.; Gavrilova, Anna A.; Pravdin, Alexander B.; Tuchin, Valery V.; Yaroslavsky, Ilya V.; Altshuler, Gregory B.

    2007-06-01

    The removal of tattoo pigments by laser energy is effected through a process of selective photothermolysis. Dehydration and optical immersion based on refractive index matching of scattering centers with that of surrounding matter through introduction of an exogenous index-matching agent can improve laser tattoo removal by providing increased efficiency of laser delivery to embedded ink particles and enabling the use of shorter wavelength visible lasers more effective on certain inks. Effectiveness of a method of accelerating penetration of the index-matching compounds by enhancing skin permeability through creating a lattice of micro-zones of limited thermal damage in the stratum corneum was studied. As optical clearing agents 100% and 88%-aqueous glycerol solutions were used. The effect of stratum corneum perforation on the rate of the immersion clearing of skin was studied. Dynamics of refractive index alteration of glycerol solution during its interaction with skin samples was monitored. Improvement of tattoo visualization was observed. The results of the experiments have shown that the lattice of island damage method the is effective for transepidermal delivery of optical clearing agents and could be used successfully in in vivo conditions for the enhancement of optical clearing of treated skin area and as enabling improvement of laser tattoo removal.

  5. Clear cell colorectal carcinoma: Time to clarify diagnosis.

    Science.gov (United States)

    Remo, Andrea; Grillo, Federica; Mastracci, Luca; Fassan, Matteo; Sina, Sokol; Zanella, Caterina; Parcesepe, Pietro; Damiano Urso, Emanuele; Pancione, Massimo; Bortuzzo, Germana; Scarpa, Aldo; Manfrin, Erminia

    2017-05-01

    Primary clear cell colorectal carcinoma (CCC) is a very rare entity accounting for only 35 cases reported in the Literature. CCC is neither classified as a distinct entity nor is it defined as a CRC variant because its ontogeny remains unclear. Most of the reported CCC were found in the distal colon in patients with a mean age of 56 years. Histologically, clear cell change is the main morphologic feature and may present in a "pure" form, composed exclusively of clear cells, or in a "composite" form, admixed with other morphologically different components. It is possible to distinguish two biologically different types of CCC, with different clinical-pathologic features, therapeutic management and diagnostic criteria: a) Intestinal CCC consisting of an aggressive neoplasm, affecting mainly adult men, characterized by an intestinal-type immunoprofile (CK20+, CK7-, CEA+, CDX-2+) and b) Müllerian CCC consisting of an indolent carcinoma of the sigmoid-rectum, affecting young women, characterized by a different (CK7+, CK20-, CEA-, CA125 +) immunoprofile. Considerable diagnostic difficulties can arise in distinguishing CCC and primary or secondary clear cell neoplasms, such as metastases from renal carcinoma, lower urinary tract, female genital tract, adrenal gland, mesothelioma, melanoma and primary intestinal PEComa. In this paper we review the Literature with two additional cases in order to define the diagnostic criteria of CCC. Copyright © 2017 Elsevier GmbH. All rights reserved.

  6. Marketing Strategies of United Kingdom Universities during Clearing and Adjustment

    Science.gov (United States)

    Mogaji, Emmanuel

    2016-01-01

    Purpose: The clearing system in the UK enables students without a university place after exam results have been announced to find suitable vacancies, as it is important for universities to fill their vacancies as any shortfall loses them a lot of money. The purpose of this paper is to examine marketing strategies adopted by UK universities on…

  7. Distribution of hourly variability index of sky clearness | Madhlopa ...

    African Journals Online (AJOL)

    Clouds affect the values of insolation for solar technology and other applications. To detect the presence of variability in the sky clearness, an hourly variability index ( 3) is calculated. The present study examined the frequency distribution of this variable as a tool for assessing the utilizability of solar radiation at a site.

  8. Clear cell variant of syringoma as a rare case

    Directory of Open Access Journals (Sweden)

    Özben Yalçın

    2014-12-01

    Full Text Available Syringoma is a benign skin tumor derived from eccrine glands characterized by yellowish-pink color and firm papular lesions of the skin especially on the lower eyelid. Typical histopathological features of syringoma are dilated cystic eccrine sweat gland ducts. In this paper, we report a case of clear cell variant syringoma with neck and trunk lesions.

  9. Clear Speech Variants: An Acoustic Study in Parkinson's Disease

    Science.gov (United States)

    Lam, Jennifer; Tjaden, Kris

    2016-01-01

    Purpose: The authors investigated how different variants of clear speech affect segmental and suprasegmental acoustic measures of speech in speakers with Parkinson's disease and a healthy control group. Method: A total of 14 participants with Parkinson's disease and 14 control participants served as speakers. Each speaker produced 18 different…

  10. Seeing Clearly (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2014-05-08

    If you’re not seeing the world as clearly as you used to, you might be among the millions of people suffering from vision impairment. In this podcast, Dr. John Crews discusses ways to take care of your eyes.  Created: 5/8/2014 by MMWR.   Date Released: 5/8/2014.

  11. Advances and perspectives in tissue clearing using CLARITY

    DEFF Research Database (Denmark)

    Reveles Jensen, Kristian; Berg, Rune W.

    2017-01-01

    CLARITY is a tissue clearing method, which enables immunostaining and imaging of large volumes for 3D-reconstruction. The method was initially time-consuming, expensive and relied on electrophoresis to remove lipids to make the tissue transparent. Since then several improvements and simplifications...

  12. The Search for Durable Exterior Clear Coatings for Wood

    Directory of Open Access Journals (Sweden)

    Philip D. Evans

    2015-11-01

    Full Text Available The goal of a durable exterior clear coating has eluded generations of coatings technologists, despite long-standing desire amongst the public for such a coating. The journey towards this goal initially focused on modifications to coating formulation, but took a completely different direction when it was found that a UV-transparent silicone clear coating on wood modified with chromic acid met consumer expectations of coating durability. This finding sparked world-wide interest in wood pre-treatments as a way of enhancing the durability of clear coatings. This interest initially focused on transition metal compounds, but has now shifted in the direction of organic and inorganic photostabilizers or even more drastic pre-treatments. Pre-treatments that dimensionally stabilize wood, protect it from microbial degradation and photostabilize lignin, when combined with flexible, photostable, coatings provide the next way-stop on the journey towards achieving the goal of durable exterior clear coatings for wood. This paper reviews this journey, drawing upon our research and that of other groups who have focused on this elusive goal.

  13. Does gently clearing the nasal passage affect odor identification?

    Directory of Open Access Journals (Sweden)

    Mitchell G. Spring

    2014-12-01

    Full Text Available Identifying scents in a wine’s bouquet is considered one of the most important steps in the process of wine tasting. An individual’s ability to successfully do this is dependent on the sense of smell; thus, altering the nasal microenvironment could have a powerful effect on the wine tasting experience. In the present study, we examined olfactory performance in healthy participants who cleared their nasal cavity before odorant presentations. Fifty undergraduate participants were assessed with a standardized test of olfaction requiring the recognition of a battery of odors. Half of these participants cleared mucus from their nasal cavities (by gently blowing their noses prior to the assessment. No difference was found in performance between those who cleared their nasal passages and those who did not. Further, data were not different than known population data from the test. These data suggest that gently clearing the nasal cavity before presentation of odorants bears no effect on the ability to perceive those odor qualities.

  14. 18 CFR 367.1840 - Account 184, Clearing accounts.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Account 184, Clearing accounts. 367.1840 Section 367.1840 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... POWER ACT AND NATURAL GAS ACT UNIFORM SYSTEM OF ACCOUNTS FOR CENTRALIZED SERVICE COMPANIES SUBJECT TO...

  15. A case of clear cell sarcoma-A rare malignancy

    DEFF Research Database (Denmark)

    Juel, Jacob; Ibrahim, Rami Mossad

    2017-01-01

    INTRODUCTION: Clear cell sarcoma (CCS) is a rare tumour of the soft tissue often misdiagnosed, as it shares characteristics with malignant melanoma (MM). Previously, CCS has been characterised, as malignant melanoma of the soft tissue, contemporary immunohistochemical techniques, however, have made...

  16. Treatment results and prognostic factors of clear cell ovarian carcinomas and ovarian carcinomas with clear cell component

    Directory of Open Access Journals (Sweden)

    M. D. Ahmedova

    2012-01-01

    Full Text Available The most important prognostic factors for clear cell carcinoma (CCC are clinical and morphological signs and clinical stage of the disease. Analyses of 5-year survival in patients with I stage of CCC is 69 %, in II stage – 55 %, in III stage – 14 % and in IV stage – 4 % patients. We analyzed distant results of treatment of 71 patients with CCC and of 25 patients with mixed malignant ovaries neoplasm with obligatory clear cell component taking into consideration main clinical and morphological sings of disease. On the base of performed reseal we revealed that morphological structure of the tumors and stage of the disease exerted heist influence on the exponent of survival of the patients with clear CCC ovaries neoplasm. Besides, there is a correlation between exponent of patients’ survival and radicalized of surgery, character of tumor growth, differentiation degree, cell anaplasia and mitotic activity of tumor cells.

  17. Treat-and-Extend versus Monthly Regimen in Neovascular Age-Related Macular Degeneration: Results with Ranibizumab from the TREND Study.

    Science.gov (United States)

    Silva, Rufino; Berta, András; Larsen, Michael; Macfadden, Wayne; Feller, Chrystel; Monés, Jordi

    2018-01-01

    To evaluate the efficacy and safety of ranibizumab 0.5 mg treat-and-extend (T&E) versus monthly regimens in patients with neovascular age-related macular degeneration (nAMD) from the TReat and extEND (TREND) study. A 12-month phase 3b visual acuity (VA) assessor-masked, multicenter, randomized, interventional study. Six hundred fifty patients. Treatment-naïve nAMD patients (age, ≥50 years) were randomized 1:1 to receive either a ranibizumab 0.5 mg T&E (n = 323) or monthly (n = 327) regimen. The primary objective was to show noninferiority of ranibizumab 0.5 mg T&E versus monthly regimen, as assessed by the change in best-corrected VA (BCVA) from baseline to the end of the study. Secondary objectives included change in retinal central subfield thickness (CSFT) from baseline to the end of study, treatment exposure, and safety. Overall, 89.8% (T&E) and 90.2% (monthly) of patients completed the study. Patient demographic and baseline characteristics were well balanced between the 2 treatment groups. The T&E regimen was noninferior (P study, respectively. In both treatment groups, most BCVA improvements occurred during the first 6 months and were maintained until the end of the study. The mean change in CSFT from baseline to the end of study was -169.2 μm and -173.3 μm in the T&E and monthly groups, respectively. Fewer injections were required in patients receiving the T&E (8.7) versus monthly (11.1) regimen, with mean number of postbaseline visits of 8.9 and 11.2, respectively. Types and rates of adverse events were comparable between the treatment groups. Ranibizumab 0.5 mg administered according to a T&E regimen was statistically noninferior and clinically comparable with a monthly regimen in improving VA from baseline to the end of study. No new safety signals for ranibizumab were identified. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  18. Study of the epidermis ablation effect on the efficiency of optical clearing of skin in vivo

    Science.gov (United States)

    Genina, E. A.; Ksenofontova, N. S.; Bashkatov, A. N.; Terentyuk, G. S.; Tuchin, V. V.

    2017-06-01

    We present the results of a comparative analysis of optical immersion clearing of skin in laboratory animals in vivo with and without preliminary ablation of epidermis. Laser ablation is implemented using a setup based on a pulsed erbium laser (λ = 2940 nm). The size of the damaged region amounted to 6 × 6 mm, the depth being smaller than 50 μm. As an optical clearing agent (OCA), use is made of polyethylene glycol (PEG-300). Based on optical coherence tomography, we use the single scattering model to estimate the scattering coefficient in the process of optical clearing in 2 regions at depths of 50-170 μm and 150-400 μm. The results show that skin surface ablation leads to the local oedema of the affected region that increases the scattering coefficient. However, the intense evaporation of water from the ablation zone facilitates the optical clearing at the expense of tissue dehydration, particularly in the upper layers. The assessment of the optical clearing efficiency shows that the efficiency exceeding 30% can be achieved at a depth from 50 to 170 μm in 120 min after ablation, as well as after the same ablation with subsequent application of PEG-300, which increases the efficiency of the immersion method by almost 1.8 times. At a depth from 150 to 400 μm, dehydration of upper layers cannot completely compensate for an increase in light scattering by dermis after epidermis ablation. The additional effect of OCA enhances the optical clearing of skin at the expense of improving the refractive index matching between dermis components, but the maximal efficiency of optical clearing in 120 min does not exceed 6%.

  19. One-week quadruple therapy is an effective salvage regimen for Helicobacter pylori infection in patients after failure of standard triple therapy.

    Science.gov (United States)

    Lin, Chiun-Ku; Hsu, Ping-I; Lai, Kwok-Hung; Lo, Gin-Ho; Tseng, Hui-Hwa; Lo, Ching-Chu; Peng, Nan-Jing; Chen, Hui-Chun; Jou, Huei-Shu; Huang, Wen-Keui; Chen, Jin-Liang; Hsu, Ping-Ning

    2002-01-01

    Standard triple therapy remains an important option for eradicating Helicobacter pylori (Hp) in developing countries because of its relatively low cost. However, salvage therapies after failure of this regimen remain undefined. The authors therefore investigate the efficacy of 1-week quadruple therapy as a second-line treatment of Hp infection after failure of standard triple therapy. Seventy-eight patients who failed Hp eradication using a 2-week bismuth-based triple therapy were enrolled and received a course of 1-week quadruple therapy (lansoprazole, 30 mg twice daily; bismuth subcitrate, 120 mg four times daily; clarithromycin, 500 mg twice daily; and amoxicillin, 1,000 mg twice daily) as a salvage regimen. The Hp status was reassessed 7 weeks after cessation of therapy. Among the 78 patients, Hp eradication was achieved in 65 (83%, 95% confidence interval = 75-91%) by intention-to-treat analysis. Only five (6%) patients had side effects, and all (100%) showed good drug compliance. Multivariate analysis disclosed that coffee drinking was an independent factor for treatment failure (odds ratio = 5.3, 95% confidence interval = 1.2-23.6, p = 0.028). The authors therefore conclude that their 1-week quadruple therapy is an effective salvage regimen for Hp infection after failure of standard triple therapy in the population examined. The benefits of this regimen include the high eradication rate, the short duration of treatment, fewer side effects, and good drug compliance. Coffee consumption possibly is an important factor in failure of the rescue regimen. The mechanisms underlying the association between coffee drinking and eradication failure require further research.

  20. Efavirenz-Based Regimens in Antiretroviral-Naive HIV-Infected Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Kryst, Joanna; Kawalec, Paweł; Pilc, Andrzej

    2015-01-01

    Efavirenz, a non-nucleoside reverse-transcriptase inhibitor (NNRTI) is one of the most commonly prescribed antiretroviral drugs. The present article provides a systematic overview and meta-analysis of clinical trials comparing efavirenz and other active drugs currently recommended for treatment of HIV-infected, antiretroviral-naive patients. Electronic databases (Pubmed, Embase, the Cochrane Library, Trip Database) were searched up till 23 December 2013 for randomized controlled clinical trials published as a peer-reviewed papers, and concerning efavirenz-based regimens used as initial treatment for HIV infection. Thirty-four studies were included in the systematic review, while twenty-six trials were suitable for the meta-analysis. Efavirenz was compared with drugs from four different classes: NNRTIs other than efavirenz (nevirapine or rilpivirine), integrase strand transfer inhibitors (InSTIs), ritonavir-boosted protease inhibitors (bPI) and chemokine (C-C motif) receptor 5 (CCR5) antagonists (maraviroc), all of them were added to the background regimen. Results of the current meta-analysis showed that efavirenz-based regimens were equally effective as other recommended regimens based on NNRTI, ritonavir-boosted PI or CCR5 antagonist in terms of efficacy outcomes (disease progression and/or death, plasma viral HIV RNA meta-analysis support the present clinical guidelines for antiretroviral-naive, HIV-infected patients, in which efavirenz is one of the most preferred regimens in the analyzed population. Beneficial safety profile of InSTI-based and CCR5-based therapy over efavirenz-based treatment needs further studies.

  1. No impact of HIV-1 protease minority resistant variants on the virological response to a first-line PI-based regimen containing darunavir or atazanavir.

    Science.gov (United States)

    Perrier, Marine; Visseaux, Benoit; Landman, Roland; Joly, Véronique; Todesco, Eve; Yazdanpanah, Yazdan; Calvez, Vincent; Marcelin, Anne-Geneviève; Descamps, Diane; Charpentier, Charlotte

    2018-01-01

    To evaluate, in a clinical cohort of HIV-1-infected patients, the prevalence of PI minority resistant variants (MRV) at ART baseline and their impact on the virological response to a first-line PI-based regimen. In an observational single-centre cohort, we assessed all ART-naive patients initiating a first-line regimen including two NRTI and one boosted PI, darunavir/ritonavir or atazanavir/ritonavir, between January 2012 and March 2015. Ultra-deep sequencing of the pol gene was performed using Illumina® technology. Protease mutations were identified using the WHO transmitted drug resistance list and major PI resistance mutations (IAS-USA drug resistance mutations list). Ninety-four and 16 patients initiating a darunavir/ritonavir-based regimen and an atazanavir/ritonavir-based regimen, respectively, were assessed. Twenty-eight percent of the patients were HIV-1 subtype B, 39% CRF02_AG and 33% other non-B subtypes. Thirteen patients (13.8%) in the darunavir group and three patients (18.8%) in the atazanavir group experienced a virological failure (VF). Overall, 13 (11.8%) subjects had PI MRV at baseline in the median proportion of 1.3% (IQR = 1.1-1.7). The most prevalent PI MRV were G73C (n = 5) and M46I (n = 3). The proportion of patients harbouring baseline PI MRV was similar between those with virological success (10.6%) and those experiencing VF (18.8%) (P = 0.40). No difference was observed in the rate of PI MRV by viral subtype (P = 0.51) or by PI drug (P = 0.40). This study showed a prevalence of 11.8% of PI MRV among 110 ART-naive subjects, without significant impact on the virological response to a first-line PI-based regimen containing darunavir or atazanavir.

  2. Phase I and pharmacokinetic evaluation of floxuridine/leucovorin given on the Roswell Park weekly regimen.

    Science.gov (United States)

    Creaven, P J; Rustum, Y M; Petrelli, N J; Meropol, N J; Raghavan, D; Rodriguez-Bigas, M; Levine, E G; Frank, C; Udvary-Nagy, S; Proefrock, A

    1994-01-01

    A phase I and pharmacokinetics study was carried out of floxuridine (FdUrd) modulated by leucovorin (LV) given on the Roswell Park regimen (LV given at 500 mg/m2 by 2-h infusion and FdUrd given by i.v. push at 1 h after the start of LV infusion, treatment being given weekly x 6). The dose-limiting toxicity was diarrhea; the MTD and recommended dose for phase II studies was 1,650 mg/m2 per week of FdUrd. The dose-response curve was steep, with 3/3 patients treated at a dose of 1,750 mg/m2 developing grade IV diarrhea. With this schedule there was no significant mucositis. Pharmacokinetic parameters showed very wide interpatient variability. Plasma decay was biphasic with a t1/2 beta of approximately 2 h. Plasma clearance was high (> 200 1 h-1). No correlation between pharmacokinetic parameters and toxicity could be identified.

  3. Pharmacokinetics and Safety of Voriconazole Intravenous-to-Oral Switch Regimens in Immunocompromised Japanese Pediatric Patients

    Science.gov (United States)

    Kobayashi, Ryoji; Kato, Koji; Maeda, Naoko; Fukushima, Keitaro; Goto, Hiroaki; Inoue, Masami; Muto, Chieko; Okayama, Akifumi; Watanabe, Kenichi; Liu, Ping

    2014-01-01

    The aim of this study was to investigate the pharmacokinetics, safety, and tolerability of voriconazole following intravenous-to-oral switch regimens used with immunocompromised Japanese pediatric subjects (age 2 to voriconazole every 12 h (q12h), and 9 mg/kg (maximum, 350 mg) of oral voriconazole q12h (for patients age 2 to voriconazole q12h and 200 mg of oral voriconazole q12h (for patients age 12 to voriconazole exposures were comparable between these two groups due to large interindividual variability. The exposures in the 2 cytochrome P450 2C19 poor metabolizers were among the highest. Voriconazole was well tolerated. The most common treatment-related adverse events were photophobia and abnormal hepatic function. These recommended doses derived from the modeling appear to be appropriate for Japanese pediatric patients, showing no additional safety risks compared to those with adult patients. (This study has been registered at ClinicalTrials.gov under registration no. NCT01383993.) PMID:25451051

  4. Influence of feeding regimen and postnatal developmental stages on antibacterial activity of pancreatic juice.

    Science.gov (United States)

    Pierzynowski, S; Sharma, P; Sobczyk, J; Garwacki, S; Barej, W

    1992-10-01

    Antibacterial activity of pancreatic juice in the pig (n = 8) was investigated during early postnatal development and in cattle (n = 6) receiving a different feeding regimen. For pancreatic juice collection, a catheter was surgically implanted in the pancreatic duct. Reintroduction of pancreatic juice was achieved through a T-shaped cannula in the duodenum. Pancreatic juice was collected for 30 min in all cases. In piglets, collections were carried out at 2, 5-6, and 7-10 wk of age, and in cattle, after a standard meal, 48 h starvation, and following 24 h intraduodenal glucose infusion. Antibacterial activity was tested on Micrococcus Pyogenes strain ATTC 6538P by disc agar diffusion technique using nonactivated pancreatic juice, before and after heat treatment for 15 min at 65 and 100 degrees C, respectively. Piglets showed a significant rise in antibacterial activity of pancreatic juice after weaning. In cattle, 48 h of starvation resulted in a marked suppression of antibacterial activity. This activity was found to be normal after a standard meal and comparable to that after 24-h intraduodenal glucose infusion. Heating of pancreatic juice to 65 degrees C caused a 35% increase in the antibacterial potency, whereas heating to 100 degrees C completely abolished it. Additionally, dilution of pancreatic juice to 1:10 did not affect antibacterial potency.

  5. Induction of Specific Immunotherapy with Hymenoptera Venoms Using Ultrarush Regimen in Children: Safety and Tolerance

    Directory of Open Access Journals (Sweden)

    Alice Köhli-Wiesner

    2012-01-01

    Full Text Available Background & Objective. Ultrarush induction for specific venom immunotherapy has been shown to be reliable and efficacious in adults. In this study its safety and tolerance in children was evaluated. Methods. Retrospective analysis of 102 ultrarush desensitizations carried out between 1997 and 2005 in 94 children, aged 4 to 15 years. Diagnosis and selection for immunotherapy were according to recommendations of the European Academy of Allergy and Clinical Immunology. Systemic adverse reactions (SARs were described using the classification of H. L. Mueller. Results. All patients reached the cumulative dose of 111.1 μg hymenoptera venom within 210 minutes. Six patients (6% had allergic reactions grade I; 2 patients (2% grade II and 5 patients (5% grade III. Three patients (3% showed unclassified reactions. SARs did not occur in the 15 patients aged 4 to 8 years and they were significantly more frequent in girls (29% compared with boys (12% (=0.034, multivariant analysis and in bee venom extract treated patients (20% compared to those treated with wasp venom extract (8% (OR 0.33, 95% Cl 0.07–1.25. Conclusion. Initiation of specific immunotherapy by ultrarush regimen is safe and well tolerated in children and should be considered for treating children with allergy to hymenoptera venom.

  6. STRike - characteristics of HIV-1-infected patients treated with a single-tablet regimen in daily clinical practice

    Directory of Open Access Journals (Sweden)

    S Esser

    2012-11-01

    Full Text Available The life-long antiretroviral treatment of HIV-1 infection requires effective and well tolerated medications complemented by high rates of adherence in order to achieve viral suppression, immunologic reconstitution and to prevent the development of resistance. Single-tablet regimens (STRs, combining a full antiretroviral regimen in one tablet taken once daily, have been designed to achieve high adherence and better long-term outcomes. “STRike” is the first cohort study, describing the use of various STRs in routine clinical practice in Germany. In this observational cohort study 800 participants will be included in 4 treatment arms, treated with the STRs of TDF/FTC/EFV (a retrospective and prospective arm, TDF/FTC/RPV or TDF/FTC/COBI/EVG after regulatory approval. Patients are followed for at least two years, and reasons for choice of medications and treatment satisfaction will be collected, in addition to safety, demographic, effectiveness data. To date 344 patients on TDF/FTC/EFV and 123 patients on TDF/FTC/RPV are being followed. In general, the spectrum of patients in the study reflects the German HIV-1 infected population with regards to gender (88%/89% male, age (median 40/38 years of age and mode of infection (71%/63% MSM. However, patients starting TDF/FTC/RPV are less progressed in their disease according to their CDC stage compared with patients on TDF/FTC/EFV (74.5% stage “A” vs. 53.2%. Patients starting TDF/FTC/RPV show less comorbidities (54% vs. 82% with a spectrum different from patients on TDF/FTC/EFV. Pre-existing neuropsychiatric comorbidities are relatively more common (10% more among patients starting TDF/FTC/RPV than TDF/FTC/EFV. The decision to use an STR is mostly driven by patient preference to start with a more convenient ART regimen (56% or to simplify their current ART regimen (75%. STRs aim to make treatment of HIV more convenient, more efficacious and more durable and by that allowing for earlier initiation of

  7. Hematopoietic stem cell transplantation with conditioning regimens containing melphalan in pediatric patients with acute lymphoblastic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Matsuyama, Takaharu; Kato, Koji [Nagoya First Red Cross Hospital (Japan). Children' s Medical Center; Hanada, Ryoji [Saitama Children' s Medical Center, Iwatsuki (Japan)] [and others

    2002-07-01

    A multicenter comparative study was carried out to investigate the efficacy and safety of hematopoietic stem cell transplantation with conditioning regimens containing melphalan in pediatric patients with acute lymphoblastic leukemia. One hundred twenty three patients at a variety of remission stages were eligible for study participation. Eighty-nine were transplanted with allogeneic grafts and 34 patients with autologous grafts (23 cases with bone marrow and 11 cases with peripheral blood stem cells). Conditioning regimens used were as follows: melphalan and busulfan for 40 patients, melphalan, busulfan and TBI for 44 patients, other regimens for 39 patients. To accelerate engraftment G-CSF (lenograstim) was administered as a 1-hour or 24-hour drip infusion daily at 5 {mu}g/kg from day 5 until hematological recovery. The five year disease free survival (DFS) was 63% for 42 patients at CR1, 41% for 41 patients at CR2 and 33% for 40 patients at other stages. There was no significant difference in the DFS between allogeneic-transplantation and autologous-transplantation in all disease stages. In patients at remission stage for CR1 and CR2, the 5-year DFS by conditioning regimen was 63% for regimen with melphalan and busulfan, 54% for regimen with melphalan, busulfan and TBI and 54% for regimens with melphalan and TBI. There was no significant difference in the DFS between the groups. Serious complications such as renal failure were observed in 11%, veno-occlusive disease in 9%, and interstitial pneumonia in 9%. The most dominating cause of death was relapse in the disease (48% of deaths) which was most commonly observed in autologous transplantation. Contrary to that, treatment related toxic death was the most frequent cause of deaths in allogeneic-transplantation. (author)

  8. Fish oil provides robust and sustained memory recovery after cerebral ischemia: influence of treatment regimen.

    Science.gov (United States)

    Correia Bacarin, Cristiano; Mori, Marco Aurélio; Dias Fiuza Ferreira, Emilene; Valério Romanini, Cássia; Weffort de Oliveira, Rúbia Maria; Milani, Humberto

    2013-07-02

    We previously reported that long-term treatment with fish oil (FO) facilitates memory recovery after transient, global cerebral ischemia (TGCI), despite the presence of severe hippocampal damage. The present study tested whether this antiamnesic effect resulted from an action of FO on behavioral performance itself, or whether it resulted from an anti-ischemic action. Different treatment regimens were used that were distinguished from each other by their initiation or duration with regard to the onset of TGCI and memory assessment. Naive rats were trained in an eight-arm radial maze, subjected to TGCI (4-VO model, 15 min), and tested for memory performance up to 6 weeks after TGCI. Fish oil (docosahexaenoic acid, 300 mg/kg/day) was given orally according to one of the following regimens: regimen 1 (from 3 days prior to ischemia until 4 weeks post-ischemia), regimen 2 (from 3 days prior to ischemia until 1 week post-ischemia), and regimen 3 (from week 2 to week 5 post-ischemia). When administered according to regimens 1 and 2, FO abolished amnesia completely. This effect persisted for at least 5 weeks after discontinuing the treatment. Such an effect did not occur, however, in the group treated according to regimen 3. Hippocampal and cortical damage was not alleviated by FO. The present results demonstrate that FO-mediated memory recovery (or preservation) following TGCI is a reproducible, robust, and long-lasting effect. Moreover, such an effect was found with a relatively short period of treatment, provided it covered the first days prior to and after ischemia. This suggests that FO prevented amnesia by changing some acute, ischemia/reperfusion-triggered process and not by stimulating memory performance on its own. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Aggressive Regimens Reduce Risk of Recurrence After Successful Treatment of MDR-TB.

    Science.gov (United States)

    Ahmad Khan, Faiz; Gelmanova, Irina Y; Franke, Molly F; Atwood, Sidney; Zemlyanaya, Nataliya A; Unakova, Irina A; Andreev, Yevgeniy G; Berezina, Valentina I; Pavlova, Vera E; Shin, Sonya S; Yedilbayev, Askar B; Becerra, Mercedes C; Keshavjee, Salmaan

    2016-07-15

    We sought to determine whether treatment with a "long aggressive regimen" was associated with lower rates of relapse among patients successfully treated for pulmonary multidrug-resistant tuberculosis (MDR-TB) in Tomsk, Russia. We conducted a retrospective cohort study of adult patients that initiated MDR-TB treatment with individualized regimens between September 2000 and November 2004, and were successfully treated. Patients were classified as having received "aggressive regimens" if their intensive phase consisted of at least 5 likely effective drugs (including a second-line injectable and a fluoroquinolone) used for at least 6 months post culture conversion, and their continuation phase included at least 4 likely effective drugs. Patients that were treated with aggressive regimens for a minimum duration of 18 months post culture conversion were classified as having received "long aggressive regimens." We used recurrence as a proxy for relapse because genotyping was not performed. After treatment, patients were classified as having disease recurrence if cultures grew MDR-TB or they re-initiated MDR-TB therapy. Data were analyzed using Cox proportional hazard regression. Of 408 successfully treated patients, 399 (97.5%) with at least 1 follow-up visit were included. Median duration of follow-up was 42.4 months (interquartile range: 20.5-59.5), and there were 27 recurrence episodes. In a multivariable complete case analysis (n = 371 [92.9%]) adjusting for potential confounders, long aggressive regimens were associated with a lower rate of recurrence (adjusted hazard ratio: 0.22, 95% confidence interval, .05-.92). Long aggressive regimens for MDR-TB treatment are associated with lower risk of disease recurrence. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  10. 78 FR 54507 - Clearing Agency; the Options Clearing Corporation; Notice of Filing of Proposed Rule Change To...

    Science.gov (United States)

    2013-09-04

    ... measures the sensitivity of an options or futures contract price to changes in the price of the underlying... VIII of the Dodd-Frank Wall Street Reform and Consumer Protection Act entitled the Payment, Clearing... market price ofconcentrated security positions by identifying the two individual securities whose adverse...

  11. Tropospheric haze and colors of the clear twilight sky.

    Science.gov (United States)

    Lee, Raymond L; Mollner, Duncan C

    2017-07-01

    At the earth's surface, clear-sky colors during civil twilights depend on the combined spectral effects of molecular scattering, extinction by tropospheric aerosols, and absorption by ozone. Molecular scattering alone cannot produce the most vivid twilight colors near the solar horizon, for which aerosol scattering and absorption are also required. However, less well known are haze aerosols' effects on twilight sky colors at larger scattering angles, including near the antisolar horizon. To analyze this range of colors, we compare 3D Monte Carlo simulations of skylight spectra with hyperspectral measurements of clear twilight skies over a wide range of aerosol optical depths. Our combined measurements and simulations indicate that (a) the purest antisolar twilight colors would occur in a purely molecular, multiple-scattering atmosphere, whereas (b) the most vivid solar-sky colors require at least some turbidity. Taken together, these results suggest that multiple scattering plays an important role in determining the redness of the antitwilight arch.

  12. Estimation of global illuminance for clear skies at Madrid

    Energy Technology Data Exchange (ETDEWEB)

    Robledo, L. [Departamento de Sistemas Inteligentes Aplicados, E.U. Informatica, Universidad Politecnica de Madrid, Madrid (Spain); Soler, A. [Departamento de Fisica e Instalaciones, ETSAM, Madrid (Spain)

    2000-07-01

    Two elementary empirical models for the dependence of global illuminance on solar elevation for clear skies are provided. The models are developed from hourly data obtained from 1 year data collected at the International Daylight Measurement Programme (IDMP) general class station at the Escuela Tecnica Superior de Arquitectura in Madrid (ETSAM), and are statistically assessed with data obtained during another period of 6 months. Values of the mean bias deviation (MBD) and root mean square deviation (RMSD) of respectively less than 5% and 7% of the average illuminance measured were obtained. The qualitative dependence of global illuminance on solar elevation, common to that found by other researchers for other locations is justified, and found to be different to that given by Vazquez and Bernabeu [D. Vazquez, E. Bernabeu, Quantitative estimation of clear sky light in Madrid, Energy and Buildings, 26 (1997) 331] using data obtained at a site which is in close proximity to our station. (author)

  13. Impacts of roads and linear clearings on tropical forests.

    Science.gov (United States)

    Laurance, William F; Goosem, Miriam; Laurance, Susan G W

    2009-12-01

    Linear infrastructure such as roads, highways, power lines and gas lines are omnipresent features of human activity and are rapidly expanding in the tropics. Tropical species are especially vulnerable to such infrastructure because they include many ecological specialists that avoid even narrow (<30-m wide) clearings and forest edges, as well as other species that are susceptible to road kill, predation or hunting by humans near roads. In addition, roads have a major role in opening up forested tropical regions to destructive colonization and exploitation. Here, we synthesize existing research on the impacts of roads and other linear clearings on tropical rainforests, and assert that such impacts are often qualitatively and quantitatively different in tropical forests than in other ecosystems. We also highlight practical measures to reduce the negative impacts of roads and other linear infrastructure on tropical species.

  14. Bathymetry of Clear Creek Reservoir, Chaffee County, Colorado, 2016

    Science.gov (United States)

    Kohn, Michael S.; Kinzel, Paul J.; Mohrmann, Jacob S.

    2017-03-06

    To better characterize the water supply capacity of Clear Creek Reservoir, Chaffee County, Colorado, the U.S. Geological Survey, in cooperation with the Pueblo Board of Water Works and Colorado Mountain College, carried out a bathymetry survey of Clear Creek Reservoir. A bathymetry map of the reservoir is presented here with the elevation-surface area and the elevation-volume relations. The bathymetry survey was carried out June 6–9, 2016, using a man-operated boat-mounted, multibeam echo sounder integrated with a Global Positioning System and a terrestrial survey using real-time kinematic Global Navigation Satellite Systems. The two collected datasets were merged and imported into geographic information system software. The equipment and methods used in this study allowed water-resource managers to maintain typical reservoir operations, eliminating the need to empty the reservoir to carry out the survey.

  15. ClearFuels-Rentech Integrated Biorefinery Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Pearson, Joshua [Project Director

    2014-02-26

    The project Final Report describes the validation of the performance of the integration of two technologies that were proven individually on a pilot scale and were demonstrated as a pilot scale integrated biorefinery. The integrated technologies were a larger scale ClearFuels’ (CF) advanced flexible biomass to syngas thermochemical high efficiency hydrothermal reformer (HEHTR) technology with Rentech’s (RTK) existing synthetic gas to liquids (GTL) technology.

  16. Clear turbulence forecasting - Towards a union of art and science

    Science.gov (United States)

    Keller, J. L.

    1985-01-01

    The development of clear air turbulence (CAT) forecasting over the last several decades is reviewed in the context of empirical and theoretical research into the nature of nonconvective turbulence in the free atmosphere, particularly at jet stream levels. Various qualitative CAT forecasting techniques are examined, and prospects for an effective quantitative index to aid aviation meteorologists in jet stream level turbulence monitoring and forecasting are examined. Finally, the use of on-board sensors for short-term warning is discussed.

  17. PSO con operador de clearing adaptativo para fomentar la diversidad

    Directory of Open Access Journals (Sweden)

    Eduardo Samaniego

    2016-12-01

    Full Text Available En el presente trabajo se aplica una variante adaptativa del operador de Clearing para fomentar la diversidad de la Meta-heurística Optimización basada en Enjambre de Partículas (PSO. El objetivo consiste en determinar si la utilización de dicho operador mejora los niveles de exploración del algoritmo PSO incrementando la diversidad de la población y por consiguiente obteniendo mejores soluciones. Para ello, se propone una forma adaptativa para controlar la distancia permitida entre soluciones y de esta forma perturbar soluciones que se encuentren muy cercanas a otra con mejor calidad. Esta idea permite estudiar diferentes alternativas de como perturbar las soluciones seleccionadas, presentando en el trabajo dos enfoques diferentes: basado en la posición actual y en la mejor posición histórica. Además, se detalla un estudio para determinar cuando se aplicará el operador de Clearing para obtener la máxima contribución al proceso de búsqueda aplicado por PSO. La propuesta fue probada en un conjunto de 20 funciones multimodales, donde los resultados mostraron que el operador de clearing mejora la exploración de la Meta-heurística PSO, obteniéndose resultados significativamente superiores en cuanto a calidad que el modelo PSO original.

  18. STANDARD TREATMENT REGIMENS FOR MULTIDRUG-RESISTANT TUBERCULOSIS – ANALYSIS OF EFFECTIVENESS

    Directory of Open Access Journals (Sweden)

    Ovcharenko IA

    2017-03-01

    nd month of treatment there was positive X-ray dynamics in more by 10.9% patients in group II than in group Ib (84.2% and 73.3%, respectively. Also, after 2 months of treatment, there were less patients with bacterial excision (detected both microscopically (26.3% and 30%, respectively, and culturally (42.1% and 60%, respectively in group II than in group Ib. Effectiveness of treatment of such patients was almost the same (70% and 68,4%, respectively, in groups II and Ib, but the number of deaths was higher in group Ib than in group II (23.3% and 10.5%, respectively. Also in group II there were no treatment failures. Conclusions. Analysis of treatment efficiency criteria for patients with MDR-TB in various standard schemes showed that in group II the schemes were most effective. It should be noted that expressed positive effect of therapy has been already was achieved at the 6th month of treatment, despite the fact that according to the protocol, duration of intensive phase was not less than 8 months. But the additional use of isoniazid had no positive effects, and in general, when comparing the effectiveness of treatment with regimens with its use, patients from this group showed the worst positive dynamics from therapy.

  19. A randomized clinical trial of two emergency contraceptive pill regimens in a Ugandan population.

    Science.gov (United States)

    Byamugisha, Josaphat K; Mirembe, Florence M; Faxelid, Elisabeth; Tumwesigye, Nazarius M; Gemzell-Danielsson, Kristina

    2010-05-01

    Recent trials on emergency contraception (EC) have indicated that levonorgestrel (LNG) used alone has fewer side-effects and is more efficacious than the Yuzpe regimen (high dose combined oral contraceptive pills). However, the experienced side-effects and acceptability may vary between different groups or societies. The primary objective of this study was to determine side-effects and acceptability of two emergency contraceptive pill (ECP) regimens among users in Kampala, Uganda. Randomized clinical trial. A total of 337 women were enrolled in a double blind randomized clinical trial. Women requesting ECPs within 72 hours after unprotected sexual intercourse received either LNG or the Yuzpe regimen. The women returned for follow-up after three days and a follow-up interview was performed after one year. Levonorgestrel had significantly fewer side-effects than the Yuzpe regimen (p < 0.001). There was a significant association between having worries about the method and experiencing side-effects (p < 0.001). Most women (81%) were prime users of EC. The majority would recommend ECP to other clients. Levonorgestrel is a superior option to the Yuzpe regimen and should be promoted as the recommended ECP. Having worries about ECP may influence experience of the side-effects. Correct information is critical in promotion of ECP use.

  20. Efavirenz Conceptions and Regimen Management in a Prospective Cohort of Women on Antiretroviral Therapy

    Directory of Open Access Journals (Sweden)

    Sheree Schwartz

    2012-01-01

    Full Text Available Use of the antiretroviral drug efavirenz (EFV is not recommended by the WHO or South African HIV treatment guidelines during the first trimester of pregnancy due to potential fetal teratogenicity; there is little evidence of how clinicians manage EFV-related fertility concerns. Women on antiretroviral therapy (ART were enrolled into a prospective cohort in four public clinics in Johannesburg, South Africa. Fertility intentions, ART regimens, and pregnancy testing were routinely assessed during visits. Women reporting that they were trying to conceive while on EFV were referred for regimen changes. Kaplan-Meier estimators were used to assess incidence across ART regimens. From the 822 women with followup visits between August 2009–March 2011, 170 pregnancies were detected during study followup, including 56 EFV conceptions. Pregnancy incidence rates were comparable across EFV, nevirapine, and lopinavir/ritonavir person-years (95% 100/users (P=0.25; incidence rates on EFV were 18.6 Confidence Interval: 14.2–24.2. Treatment substitution from EFV was made for 57 women, due to pregnancy intentions or actual pregnancy; however, regimen changes were not systematically applied across women. High rates of pregnancy on EFV and inconsistencies in treatment management suggest that clearer guidelines are needed regarding how to manage fertility-related issues in. women on EFV-based regimens.

  1. Dealing with large-scale supply lines when introducing new regimens.

    Science.gov (United States)

    Malati, Christine; Rosenfeld, Joshua; Mowafy, Sherif; Rittmiller, Trevor; Kuritsky, Joel; Crowley, John

    2017-07-01

    As programs plan the introduction of a new antiretroviral as part of a regimen for HIV treatment, supply chain considerations need to be taken into account. The key to success is balancing the introduction of a new regimen with the phasing out of an old regimen in a manner that does not result in either a shortage or an excess supply of either product while ensuring that patients continue receiving their medications. This necessitates that country programs, donors, and procurement entities possess an appreciation of the global antiretroviral market and understand the dynamics that the manufacturing of new antiretrovirals will have on the transition. Supply, demand, and financial considerations affect the capacity of the supply chain to facilitate a successful antiretroviral transition. Although this commentary draws on United States Agency for International Development experiences under the President's Emergency Plan for AIDS Relief from earlier antiretroviral treatment shifts, the approaches are applicable to other institutions and to future transitions. Three approaches were employed: ensuring the engagement of all key stakeholders in transition planning and execution, including clinicians, advocacy groups, supply chain professionals, ministry, and donors; conducting and updating regularly the national quantification and supply plans for all regimens; and introducing antiretroviral products into programs from regional warehouses based on firm orders. Extensive planning and accounting for supply chain factors is essential to ensuring a smooth transition to a new regimen and to enable the global antiretroviral market to respond adequately.

  2. Comparing interval and continuous exercise training regimens on neurotrophic factors in rat brain.

    Science.gov (United States)

    Afzalpour, Mohammad Esmaiel; Chadorneshin, Hossein Taheri; Foadoddini, Mohsen; Eivari, Hossein Abtahi

    2015-08-01

    The research literature suggests that oxidative stress and pro-inflammatory factors influence neurotrophins in vitro. However, there is insufficient information about their effects on exercise training conditions, especially during high intensity trainings. This study aimed to compare the effects of 6weeks of high intensity interval and continuous training regimens on brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), hydrogen peroxide (H2O2), and tumor necrosis factor alpha (TNF-α) in the rat brain. For this purpose, twenty-four Albino Wistar rats were divided into sedentary control (SC), high intensity interval training (HIIT), and continuous training (CT) groups. Both HIIT and CT regimens increased H2O2 level and TNF-α concentration in the brain, and the alterations made were greater following HIIT than CT. In addition, both HIIT and CT regimens increased BDNF and GDNF concentrations significantly, with a higher elevation following HIIT than CT. Furthermore, H2O2 level and TNF-α concentration correlated positively with both BDNF and GDNF concentrations. Generally, high intensity interval training regimen, rather than continuous training regimen, is highly potential to improve BDNF and GDNF through a greater increase in H2O2 and TNF-α as oxidative stress and pro-inflammatory factors. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Outcome of treatment of MDR-TB patients with standardised regimens, Iran, 2002-2006.

    Science.gov (United States)

    Masjedi, M R; Tabarsi, P; Chitsaz, E; Baghaei, P; Mirsaeidi, M; Amiri, M V; Farnia, P; Javanmard, P; Mansouri, D; Velayati, A A

    2008-07-01

    Multidrug-resistant tuberculosis (MDR-TB) imposes a formidable burden on national health systems. There is still no consensus on the subject, with controversies regarding treatment protocols, treatment outcomes and the various treatment regimens. The present study describes Iran's second national cohort for treatment of MDR-TB. The study comprised all documented MDR-TB cases in Iran referred to our centre during the period 2002-2006. All patients received a standardised second-line regimen consisting of ofloxacin, cycloserine, prothionamide and amikacin. Based on drug susceptibility testing results, ethambutol and pyrazinamide were added to the regimen. Forty-three patients diagnosed with MDR-TB, with a mean age of 44.38 +/- 19.05 years, received treatment; of these, 27 (62.8%) were male. Twenty-three were (53.5%) Iranians and the remainder were Afghans. All patients were acquired MDR-TB cases. Of the 43 cases, 25 (58.1%) experienced severe clinically significant adverse effects; 29 (67.5%) had a successful outcome and 14 (32.5%) had a poor outcome (treatment failure in six [14%] and death in eight [18.6%]). Mortality was higher in Iranians (P = 0.039) and in patients whose initial regimen was changed due to adverse drug reactions (P = 0.01). Compared with previous studies, our study was able to obtain more favourable outcomes of MDR-TB treatment using a standardised regimen.

  4. Dietary regimens of athletes competing at the Delhi 2010 Commonwealth Games.

    Science.gov (United States)

    Pelly, Fiona E; Burkhart, Sarah J

    2014-02-01

    The aim of this study was to investigate the dietary regimens reported by athletes competing at a major international competition and report whether these were based on nutrient composition, religious beliefs, cultural eating style, food intolerance or avoidance of certain ingredients. A questionnaire was randomly distributed to 351 athletes in the main dining hall of the athletes' village over the three main meal periods during the Delhi 2010 Commonwealth Games (23rd Sept-14th Oct, 2010). The majority (n = 218, 62%) of athletes reported following one or more dietary regimens, with 50% (n = 174) following a diet based on the nutrient composition of the food. Significantly more athletes from weight category and aesthetic sports (28%, p = .005) and from power/sprint sports (41%, p = .004) followed low fat and high protein regimens respectively. Other specialized dietary regimens were followed by 33% of participants, with avoidance of red meat (13%), vegetarian (7%), Halal (6%), and low lactose regimens (5%) reported most frequently. Significantly more athletes from non-Western regions followed a vegetarian diet (p nutrition support and food items are available at similar events.

  5. Niacin Alternatives for Dyslipidemia: Fool's Gold or Gold Mine? Part I: Alternative Niacin Regimens.

    Science.gov (United States)

    Dunbar, Richard L; Goel, Harsh

    2016-02-01

    Niacin was the first drug demonstrating lowered cholesterol prevents coronary heart disease (CHD) events, with two clinical CHD outcome studies establishing a cardioprotective niacin regimen: 1 g thrice daily with meals. Though cardioprotective, skin toxicity limits niacin's use, fostering several variations to improve tolerability. One of these, an extended-release (ER) alternative, proved immensely successful commercially, dominating clinical practice despite departing from the established regimen in several critical ways. Hence, improved tolerability may have come at the cost of diminished efficacy, posing a conundrum: Does it still help the population at risk for CHD to broaden a drug's acceptance by "watering it down"? This question is crucial at this stage now that the ER alternative failed to recapitulate the benefits of the established cardioprotective niacin regimen in two trials of the alternative approach: AIM-HIGH and HPS2-THRIVE. Part I of this review discusses how vastly the ER alternative departs from the established cardioprotective regimen, why that is important physiologically, and how it may explain the findings of AIM-HIGH and HPS2-THRIVE. Given important gaps left by statin therapy, the established cardioprotective niacin regimen remains an important evidence-based therapy for the statin intolerant or statin averse.

  6. An in silico evaluation of treatment regimens for recurrent Clostridium difficile infection

    Science.gov (United States)

    Blanco, Natalia; Foxman, Betsy; Malani, Anurag N.; Zhang, Min; Walk, Seth; Rickard, Alexander H.

    2017-01-01

    Background Clostridium difficile infection (CDI) is a significant nosocomial infection worldwide, that recurs in as many as 35% of infections. Risk of CDI recurrence varies by ribotype, which also vary in sporulation and germination rates. Whether sporulation/germination mediate risk of recurrence and effectiveness of treatment of recurring CDI remains unclear. We aim to assess the role of sporulation/germination patterns on risk of recurrence, and the relative effectiveness of the recommended tapered/pulsing regimens using an in silico model. Methods We created a compartmental in-host mathematical model of CDI, composed of vegetative cells, toxins, and spores, to explore whether sporulation and germination have an impact on recurrence rates. We also simulated the effectiveness of three tapered/pulsed vancomycin regimens by ribotype. Results Simulations underscored the importance of sporulation/germination patterns in determining pathogenicity and transmission. All recommended regimens for recurring CDI tested were effective in reducing risk of an additional recurrence. Most modified regimens were still effective even after reducing the duration or dosage of vancomycin. However, the effectiveness of treatment varied by ribotype. Conclusion Current CDI vancomycin regimen for treating recurrent cases should be studied further to better balance associated risks and benefits. PMID:28800598

  7. Different magnesium sulphate regimens for neuroprotection of the fetus for women at risk of preterm birth.

    Science.gov (United States)

    Bain, Emily; Middleton, Philippa; Crowther, Caroline A

    2012-02-15

    The effectiveness of antenatal magnesium sulphate for neuroprotection of the fetus, infant, and child prior to very preterm birth, when given to women considered at risk of preterm birth, has been established. There is currently no consensus as to the regimen to use in terms of the dose, duration, the use of repeat dosing and timing. To assess the comparative effectiveness and adverse effects of different magnesium sulphate regimens for neuroprotection of the fetus in women considered at risk of preterm birth. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2011). Randomised trials comparing different magnesium sulphate regimens when used for neuroprotection of the fetus in women considered at risk of preterm birth. We planned to include cluster trials. We planned to exclude quasi-randomised trials and those with a crossover design. We planned to include trials published as full-text papers, along with those published in abstract form only. We planned that at least two review authors would assess trial eligibility. No eligible completed trials were identified. Although strong evidence supports the use of antenatal magnesium sulphate for neuroprotection of the fetus prior to very preterm birth, no trials comparing different treatment regimens have been completed. Research should be directed towards comparisons of different dosages and other variations in regimens, evaluating both maternal and infant outcomes.

  8. Optical clearing of porcine skin tissue in vitro studied by Raman microspectroscopy

    Science.gov (United States)

    Huang, Deqiu; Zhang, Wen; Zhong, Huiqing; Xiong, Honglian; Guo, Xi; Guo, Zhouyi

    2012-01-01

    In present work, we studied the effect of optical clearing on porcine skin in vitro with glycerol by Raman microspectroscopy, denoted as RM, at various time intervals of 0, 15, 30, 45, 60, and 75 min respectively. The results showed that the addition of glycerol significantly improved the depth of RM measurement, and enhanced the recovery of skin tissue Raman spectra that were not overlapped with the glycerol Raman spectra over time. Moreover, it was found that the Raman signals resembled the native spectrum of the molecules in porcine skin with a negligible frequency shift. Furthermore, we evaluated the extent of optical clearing in porcine skin by utilizing various concentrations of 40%, 60%, and 80% glycerol solution. The results demonstrated that with the increase of concentration of glycerol, the optical clearing of porcine skin was much improved.

  9. Treatment of Maxillary Midline Diastema Using Removable Clear Trays and Elastics: A Case Report

    OpenAIRE

    Sümeyya Şin; Kadir Beycan; Yazgı Ay

    2017-01-01

    Maxillary midline diastema is a common esthetic problem requiring treatment. This case presentation shows the treatment of a patient with a minor midline diastema using removable clear trays and elastics. A 20-year-old female patient, whose chief complaint was a small diastema between upper central incisors, had a symmetric face and competent lips. Intraoral examination showed class 1 buccal segments relationship with normal overjet and overbite. For the closure of midline diastema, an upper ...

  10. Aerosol optical depth under "clear" sky conditions derived from sea surface reflection of lidar signals.

    Science.gov (United States)

    He, Min; Hu, Yongxiang; Huang, Jian Ping; Stamnes, Knut

    2016-12-26

    There are considerable demands for accurate atmospheric correction of satellite observations of the sea surface or subsurface signal. Surface and sub-surface reflection under "clear" atmospheric conditions can be used to study atmospheric correction for the simplest possible situation. Here "clear" sky means a cloud-free atmosphere with sufficiently small aerosol particles. The "clear" aerosol concept is defined according to the spectral dependence of the scattering cross section on particle size. A 5-year combined CALIPSO and AMSR-E data set was used to derive the aerosol optical depth (AOD) from the lidar signal reflected from the sea surface. Compared with the traditional lidar-retrieved AOD, which relies on lidar backscattering measurements and an assumed lidar ratio, the AOD retrieved through the surface reflectance method depends on both scattering and absorption because it is based on two-way attenuation of the lidar signal transmitted to and then reflected from the surface. The results show that the clear sky AOD derived from the surface signal agrees with the clear sky AOD available in the CALIPSO level 2 database in the westerly wind belt located in the southern hemisphere, but yields significantly higher aerosol loadings in the tropics and in the northern hemisphere.

  11. Assessment of serum magnesium levels and its outcome in neonates of eclamptic mothers treated with low-dose magnesium sulfate regimen

    Science.gov (United States)

    Das, Monalisa; Chaudhuri, Patralekha Ray; Mondal, Badal C.; Mitra, Sukumar; Bandyopadhyay, Debasmita; Pramanik, Sushobhan

    2015-01-01

    Objectives: Magnesium historically has been used for treatment and/or prevention of eclampsia. Considering the low body mass index of Indian women, a low-dose magnesium sulfate regime has been introduced by some authors. Increased blood levels of magnesium in neonates is associated with increased still birth, early neonatal death, birth asphyxia, bradycardia, hypotonia, gastrointestinal hypomotility. The objective of this study was to assess safety of low-dose magnesium sulfate regimen in neonates of eclamptic mothers treated with this regimen. Materials and Methods: This was a cross-sectional observational study of 100 eclampsia patients and their neonates. Loading dose and maintenance doses of magnesium sulfate were administered to patients by combination of intravenous and intramuscular routes. Maternal serum and cord blood magnesium levels were estimated. Neonatal outcome was assessed. Results: Bradycardia was observed in 18 (19.15%) of the neonates, 16 (17.02%) of the neonates were diagnosed with hypotonia. Pearson Correlation Coefficient showed Apgar scores decreased with increase in cord blood magnesium levels. Unpaired t-test showed lower Apgar scores with increasing dose of magnesium sulfate. The Chi-square/Fisher's exact test showed significant increase in hypotonia, birth asphyxia, intubation in delivery room, Neonatal Intensive Care Unit (NICU) care requirement, with increasing dose of magnesium sulfate. (P ≤ 0.05). Conclusion: Several neonatal complications are significantly related to increasing serum magnesium levels. Overall, the low-dose magnesium sulfate regimen was safe in the management of eclamptic mothers, without toxicity to their neonates. PMID:26600638

  12. induction of labour using low and high dose regimens

    African Journals Online (AJOL)

    hi-tech

    2003-01-01

    Jan 1, 2003 ... Logistic regression analysis showed that the success rate of induction of labour was dependent only on maternal age ... membranes, a living fetus and no contraindication to vaginal delivery or prostaglandin .... 30 (17.9). 36 (14.9). *poor obstetric history, non-assuring biophysical profile, Rh isoimmunization ...

  13. A Phase III Randomized Study Comparing a Chemotherapy with Cisplatin and Etoposide to a Etoposide Regimen without Cisplatin for Patients with Extensive Small-Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Thierry Berghmans

    2017-09-01

    Full Text Available IntroductionIn a literature meta-analysis, we showed survival benefits for regimens including cisplatin [hazard ratio (HR 0.61; 95% confidence interval (CI, 0.57–0.66] and for those including etoposide (HR 0.65; 0.61–0.69. That benefit was mainly observed when etoposide alone or in combination with cisplatin was included in the chemotherapy regimens. Our objective was to determine if chemotherapy with both drugs improves survival in comparison to a non-platinum regimen with etoposide.MethodsExtensive small-cell lung cancer patients were randomized between cisplatin–etoposide (CE and ifosfamide + etoposide + epirubicin regimen (IVE between 2000 and 2013.Results176 and 170 eligible patients were allocated to CE and IVE (315 deaths were required before analysis, respectively. Objective response rates were not significantly different: 60% with CE and 59% with IVE. No statistically significant difference in median survival and 1-year and 2-year was observed with rates of 9.6 months, 31 and 5% for CE and 10 months, 39 and 9% for IVE, respectively. HR was 0.84 (95% CI 0.68–1.05, p = 0.16. Only two prognostic factors for survival were retained in multivariate analysis: sex with HR = 0.69 (95% CI 0.49–0.97, p = 0.03 and performance status with HR = 0.53 (95% CI 0.49–0.97, p < 0.0001. After adjustment for these prognostic factors, HR for survival was 0.83 (95% CI 0.65–1.08, p = 0.17. There was more thrombopenia in the CE regimen and more leukopenia with IVE.ConclusionCombination of CE failed to improve survival in comparison to an etoposide-containing regimen without cisplatin.Clinical Trial Registrationhttps://clinicaltrials.gov/ct2/show/NCT00658580?term=ELCWP+01994&rank=1, identifier NCT00658580.

  14. ACCELERATED REGIMENS OF ADJUVANT RADIOTHERAPY IN THE TREATMENT OF BREAST CANCER

    Directory of Open Access Journals (Sweden)

    G. V. Afonin

    2017-01-01

    Full Text Available Treatment of breast cancer (BC is a complex multidisciplinary problem. Often, radiation therapy is an obligatory component of treatment of breast cancer patients. Numerous large randomized trials have proved the efficacy of adjuvant radiotherapy in both the standard fractionation regimen in a single focal dose of 2 Gy to a total focal dose of 50 Gy for 25 fractions and in modes of hypofractionation using radiation exposure at a larger daily dose with a reduction in the total treatment time. The presented review summarizes the data of the largest studies on the modes of hypofractionation of postoperative radiotherapy for breast cancer. Most of the studies comparing the standard mode of fractionation of postoperative radiotherapy with the modes of hypofractionation showed comparable results for the main oncological parameters with similar tolerability, frequency of complications and good cosmetic results. It also shows the economic feasibility of applying accelerated regimes in everyday practice. Despite the fact that radiotherapy in the mode of hypofractionation has already become the standard of treatment and is recommended for use by the largest European and American cancer associations, indications for its conduct, the criteria for selection in the studies and the range of recommended single focal doses differ. The obtained results do not give an opportunity to confidently judge the advantage of one or another regime. It is necessary to determine the factors of a favorable and unfavorable prognosis, to clarify the indications for the use of various radiotherapy techniques. Therefore, questions about the optimal mode of hypo-fractionation of adjuvant radiotherapy, the timing of its initiation and the criteria for selecting patients for this type of therapy as part of the comprehensive treatment of breast cancer have not yet been fully resolved. Also open is the choice of optimal single and total doses of radiation, its combination with drug

  15. Treatment burden, clinical outcomes, and comorbidities in COPD: an examination of the utility of medication regimen complexity index in COPD

    Directory of Open Access Journals (Sweden)

    Negewo NA

    2017-10-01

    .5 compared to those in quadrants A (13.5; P=0.0001 and B (12.5; P<0.0001. Increased complexity of COPD-specific treatments showed significant but weak correlations with lower lung function and 6-minute walk distance, higher St George’s Respiratory Questionnaire and COPD assessment test scores, and higher number of prior year COPD exacerbations and hospitalizations. Comorbid cardiovascular, gastrointestinal, or metabolic diseases individually contributed to higher total MRCI scores and/or medication counts for all medications. Charlson Comorbidity Index and COPD-specific comorbidity test showed the highest degree of correlation with total MRCI score (ρ=0.289 and ρ=0.326; P<0.0001, respectively.Conclusion: In COPD patients, complex medication regimens are associated with disease severity and specific class of comorbidities. Keywords: medication burden, medication counts, complex pharmacotherapy, clinical scores 

  16. Characterization of HIV-1 from patients with virological failure to a boosted protease inhibitor regimen

    DEFF Research Database (Denmark)

    Lillemark, Marie Rathcke; Gerstoft, Jan; Obel, Niels

    2011-01-01

    The use of highly active antiretroviral treatment (HAART) regimens with unboosted protease inhibitors (PIs) has resulted in a high level of virological failure primarily due to the development of resistant virus. Current boosted PI regimens combine successfully low-dose ritonavir (r) with a second...... PI. The aim of the study was to estimate the proportion of patients, in a population based setting, who develop virological failure on a PI/r regimen. Through The Danish HIV Cohort Study 1,007 patients who received PI/r based treatment between 1995 and 2008 were identified. Twenty-three (2.......3%) experienced virological failure, of whom 19 (83%) started PI/r treatment before 2001. Patients from Copenhagen (n=19) were selected to study the development of protease (PR) and gag cleavage site (CS) mutations during PI/r treatment and PI plasma levels at the time of virological failure. Three patients (16...

  17. The relationship among registered nurses' weight status, weight loss regimens, and successful or unsuccessful weight loss.

    Science.gov (United States)

    Zitkus, Bruce S

    2011-02-01

    To investigate relationships between body mass index (BMI), personality type, weight loss regimens, and successful or unsuccessful weight loss. Seven hundred and twenty-one registered nurses (RNs) were recruited from the American Academy of Nurse Practitioners, the membership of a nursing honor society, and RNs at a large state university. Participants completed the Myers-Briggs Type Indicator (MBTI), a demographic survey (age, gender, height, weight, ethnicity, education status, disability, shift work hours, and prescription medication use), and questions related to their weight status, weight loss attempts, and motivation. RNs who had a lower BMI were more successful in losing weight than RNs who had a higher BMI. They were also more successful in their weight loss attempts if they did not use a diet regimen. RNs who were successful in losing weight did not use a specified dietary regimen. ©2011 The Author Journal compilation ©2011 American Academy of Nurse Practitioners.

  18. Cancer Chemotherapy Update: Bevacizumab, Etoposide, and Cisplatin Regimen for Refractory Brain Metastases.

    Science.gov (United States)

    Mayer, Seth A; Solimando, Dominic A; Waddell, J Aubrey

    2017-06-01

    The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr, President, Oncology Pharmacy Services, Inc, 4201 Wilson Blvd #110-545, Arlington, VA 22203, email: OncRxSvc@comcast.net; or J. Aubrey Waddell, Professor, University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804, email: waddfour@charter.net. Regimen Name: Bevacizumab, etoposide, and cisplatin (BEEP) Origin of Name: The regimen is named for the medications it contains: be vacizumab, e toposide, and cis p latin.

  19. Poor response to tuberculosis treatment with regimens without rifampicin in immunosuppressed AIDS patients

    Directory of Open Access Journals (Sweden)

    O'Donnel M.M.

    2002-01-01

    Full Text Available A prospective study was conducted on 79 advanced immunosuppressed AIDS patients from 1997 to 1999, during which nine cases of tuberculosis (TB were diagnosed. The main clinical and laboratory characteristics and the response to TB treatment were reviewed. The clinical manifestations of TB were: pulmonary (six cases, extrapulmonary (two cases and disseminated (one case. These patients were being treated with highly active antiretroviral treatment (HAART and were not responding. In three cases an optional regimen without rifampicin (RMP was indicated to maintain HAART during TB treatment. A clinical response to TB treatment (disappearance of fever was observed in 6/9 patients during a mean of 73 days (SD = 96. The three unresponsive patients were those treated without RMP. A switch to TB regimens containing RMP was proposed and successful. In our study, though it was limited by a small sample size, the response to TB regimens without rifampin was poor in immunossupressed patients failing HAART.

  20. Poor response to tuberculosis treatment with regimens without rifampicin in immunosuppressed AIDS patients

    Directory of Open Access Journals (Sweden)

    M.M. O'Donnel

    Full Text Available A prospective study was conducted on 79 advanced immunosuppressed AIDS patients from 1997 to 1999, during which nine cases of tuberculosis (TB were diagnosed. The main clinical and laboratory characteristics and the response to TB treatment were reviewed. The clinical manifestations of TB were: pulmonary (six cases, extrapulmonary (two cases and disseminated (one case. These patients were being treated with highly active antiretroviral treatment (HAART and were not responding. In three cases an optional regimen without rifampicin (RMP was indicated to maintain HAART during TB treatment. A clinical response to TB treatment (disappearance of fever was observed in 6/9 patients during a mean of 73 days (SD = 96. The three unresponsive patients were those treated without RMP. A switch to TB regimens containing RMP was proposed and successful. In our study, though it was limited by a small sample size, the response to TB regimens without rifampin was poor in immunossupressed patients failing HAART.

  1. Tradução e validação para o português do Medication Regimen Complexity Index Translation and validation into portuguese Language of the Medication Regimen Complexity Index

    Directory of Open Access Journals (Sweden)

    Ana Carolina Melchiors

    2007-10-01

    Portuguese, back-translation and pre-test of the tool, creating a new version called the Pharmacotherapy Complexity Index (PCI. The psychometric parameters were assessed, including convergent validity, discriminant validity and reliability (interclass and test-retest correlation. RESULTS: The complexity of pharmacotherapy measured by the MRCI-Brazil had an average score of 15.7 points (SD=8.36. MRCI-Brazil showed significant correlation with the number of medications (r=0.86; p<0.001 and age of patients (r=0.28, p=0.005. Interrater reliability analysis found an intra-class correlation (ICC of 0.99 (p<0.001 and test-retest correlation was of 0.997 (p<0.001. CONCLUSION: The results have shown that the Brazilian version of the MRCI presents adequate validity and reliability, and may be useful in clinical practice and research involving the analysis of the drug regimen complexity.

  2. Some indicators of welfare of crated veal calves on three dietary iron regimens.

    Science.gov (United States)

    McFarlane, J M; Morris, G L; Curtis, S E; Simon, J; McGlone, J J

    1988-02-01

    Holstein calves were managed from less than 1 wk of age as in the special-fed veal industry but subjected to three dietary regimens (n = 10/group): low dietary iron (LI = approximately 5 mg iron/kg dry milk replacer) throughout 16 wk; 2) high then low dietary iron (H-LI = 140 mg/kg through d 18, then approximately 5 mg/kg through wk 16; a typical industrial scheme) or 3) high dietary iron (HI = approximately 105 mg/kg throughout the study). Several physiologic, behavioral and health indicators of welfare were monitored at various times. From wk 7 on, blood hemoglobin concentration was higher in HI calves than in LI, whereas that in H-LI calves was intermediate. Blood red cell count was higher in HI calves than in LI from wk 11 to 16, and was higher in HI than in H-LI from wk 14 to 16. Ratio of blood segmented neutrophils to lymphocytes (an indicator of stress) did not differ due to dietary regimen. Between wk 2 and 16, lying time increased from 69.5 to 76.6% of total time. Oral behaviors (e.g., licking and gnawing) occupied less than 15% of total time. Dietary regimen did not affect time spent either lying or engaging in oral behaviors. Calves in all dietary-regimen and slaughter-age groups experienced high frequencies of pneumonia, digestive-tract maladies and trichobezoars, but neither disease nor medical-treatment frequency was related to dietary regimen. Live, hot-dressed carcass and liver weights of the five calves/group slaughtered at 16 wk were not affected by dietary regimens, but carcass grade was highest for LI calves and lowest for HI.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Dose-finding study of a once-daily indinavir/ritonavir regimen.

    Science.gov (United States)

    Hugen, P W; Burger, D M; ter Hofstede, H J; Koopmans, P P; Stek, M; Hekster, Y A; Reiss, P; Lange, J M

    2000-11-01

    In antiretroviral therapy, to improve compliance the need is increasing to develop regimens that combine potency and safety with convenient dosing. The objective of our study was to find a once-daily dosing regimen of a HIV-protease inhibitor, indinavir (IDV), by combining it with ritonavir (RTV). In the study, 12 healthy volunteers took a single IDV dose of 800 mg on day 1. Plasma and urine sampling was done for 12 hours. From day 2 to day 21, participants took RTV liquid 200 mg (group A) or 400 mg (group B) once daily. Repeated pharmacokinetic sampling was performed over the course of 24 hours, after single doses of indinavir 400 mg (day 15), 800 mg (day 18), and 1200 mg (day 21). The best dosage regimen in this pharmacokinetic study was selected based on efficacy and tolerability criteria. The study comprised 10 male and 2 female healthy volunteers, mean age, 25 years (range, 18-50 years), mean weight, 70 kg (range, 52-83 kg). One male participant discontinued on day 8 due to influenza. All other participants completed the study without the occurrence of serious adverse events. RTV inhibited indinavir plasma clearance by 51% to 70%, leading to increased and prolonged IDV exposure. Renal clearance was influenced by the addition of RTV and dosage increments of IDV. The efficacy criterion was best fulfilled by 1200 mg IDV/400 mg RTV, whereas this combination performed most poorly on tolerability criteria. Based on the single dose data, a once-daily regimen of IDV with a low dose of RTV is possible. The best dosage regimen to start with among those studied here appears to be 1200 mg IDV/400 mg RTV, which could be decreased at steady state to 800 IDV/400 RTV or 1200 IDV/200 RTV if toxicity occurs. Steady-state pharmacokinetic data of once-daily IDV/RTV regimens in HIV-infected patients are warranted.

  4. Helicobacter pylori-positive duodenal ulcer: three-day antibiotic eradication regimen.

    Science.gov (United States)

    Catalano, F; Branciforte, G; Catanzaro, R; Cipolla, R; Bentivegna, C; Brogna, A

    2000-10-01

    The most widely used treatments for ulcer healing and Helicobacter pylori eradication consist of a 1-2 week regimen of a proton pump inhibitor plus two or three antimicrobials. To evaluate the efficacy, safety, cost, and tolerance of a three-day regimen with three antibiotics vs. a 10-day treatment with a proton pump inhibitor or vs. a ranitidine bismuth citrate triple therapy. Two hundred and twenty-one patients with endoscopically-proven H. pylori-positive duodenal ulcers were recruited to the study. Recruited patients were assigned to one of the following four regimens: (I) omeprazole 40 mg o.m. plus amoxycillin 1 g b.d. and clarithromycin 500 mg b.d. for 10 days (OAC: 55 patients); (ii) omeprazole 40 mg o.m. on days 1-5, plus amoxycillin 1 g b.d., clarithromycin 500 mg b.d. and metronidazole 500 mg b.d. on days 3-5 (OACM: 56 patients); (iii) ranitidine bismuth citrate 400 mg b.d. plus amoxycillin 1 g b.d. and clarithromycin 500 mg b.d. for 10 days (RAC: 54 patients); (iv) ranitidine bismuth citrate 400 mg b.d. on days 1-5, plus amoxycillin 1 g b.d., clarithromycin 500 mg b.d. and metronidazole 500 mg b.d. on days 3-5 (RACM: 56 patients). Fisher's exact test was used to compare data regarding healing and eradication in the four groups. The intention-to-treat eradication and ulcer healing rates for the RACM regimen were 95% and 98%, respectively. Statistically significant differences were observed, relating to the eradication and healing of ulcers, between RACM and either the RAC or OAC regimens. The three-day antibiotic therapy with amoxycillin, clarithromycin and metronidazole in addition to ranitidine bismuth citrate is a very effective anti-H. pylori regimen.

  5. Identifying fly puparia by clearing technique: application to forensic entomology.

    Science.gov (United States)

    Sukontason, Kabkaew L; Ngern-Klun, Radchadawan; Sripakdee, Duanghatai; Sukontason, Kom

    2007-10-01

    In forensic investigations, immature stages of the fly (egg, larva, or puparia) can be used as entomological evidence at death scenes, not only to estimate the postmortem interval (PMI), analyze toxic substances, and to determine the manner of death but also to indicate the movement of a corpse in homicide cases. Of these immature stages, puparia represent the longest developmental time, which makes them of useful. However, in order for forensic entomologists to use puparia effectively, it is crucial that they are able to accurately identify the species of fly found in a corpse. Typically, these puparia are similar in general appearance, being coarctate and light brown to dark brown in color, which makes identification difficult. In this study, we report on the clearing technique used to pale the integument of fly puparia, thereby allowing observation of the anterior end (second to fourth segments) and the profile of the posterior spiracle, which are important clues for identification. We used puparia of the blowfly, Chrysomya megacephala (F.), as the model species in this experiment. With placement in a 20% potassium hydroxide solution daily and mounting on a clearing medium (Permount(R), New Jersey), the profile of the posterior spiracle could be clearly examined under a light microscope beginning on the fifth day after pupation, and the number of papillae in the anterior spiracle could be counted easily starting from the ninth day. Comparison of morphological features of C. megacephala puparia with those of other blowflies (Chrysomya nigripes [Aubertin], Chrysomya rufifacies [Macquart], Chrysomya villeneuvi [Patton], Lucilia cuprina [Wiedemann], and Hemipyrellia ligurriens [Wiedemann]) and a housefly (Musca domestica L.) revealed that the anterior ends and the profiles of the posterior spiracles had markedly distinguishing characteristics. Morphometric analysis of the length and width of puparia, along with the length of the gaps between the posterior spiracles

  6. The Clear Creek Envirohydrologic Observatory: From Vision Toward Reality

    Science.gov (United States)

    Just, C.; Muste, M.; Kruger, A.

    2007-12-01

    As the vision of a fully-functional Clear Creek Envirohydrologic Observatory comes closer to reality, the opportunities for significant watershed science advances in the near future become more apparent. As a starting point to approaching this vision, we focused on creating a working example of cyberinfrastructure in the hydrologic and environmental sciences. The system will integrate a broad range of technologies and ideas: wired and wireless sensors, low power wireless communication, embedded microcontrollers, commodity cellular networks, the internet, unattended quality assurance, metadata, relational databases, machine-to-machine communication, interfaces to hydrologic and environmental models, feedback, and external inputs. Hardware: An accomplishment to date is "in-house" developed sensor networking electronics to compliment commercially available communications. The first of these networkable sensors are dielectric soil moisture probes that are arrayed and equipped with wireless connectivity for communications. Commercially available data logging and telemetry-enabled systems deployed at the Clear Creek testbed include a Campbell Scientific CR1000 datalogger, a Redwing 100 cellular modem, a YA Series yagi antenna, a NP12 rechargeable battery, and a BP SX20U solar panel. This networking equipment has been coupled with Hach DS5X water quality sondes, DTS-12 turbidity probes and MicroLAB nutrient analyzers. Software: Our existing data model is an Arc Hydro-based geodatabase customized with applications for extraction and population of the database with third party data. The following third party data are acquired automatically and in real time into the Arc Hydro customized database: 1) geophysical data: 10m DEM and soil grids, soils; 2) land use/land cover data; and 3) eco-hydrological: radar-based rainfall estimates, stream gage, streamlines, and water quality data. A new processing software for data analysis of Acoustic Doppler Current Profilers (ADCP

  7. The Appropriate DOTS Regimen Greatly Reduces the Disabilities in Polyarticular EPTB.

    Science.gov (United States)

    Pandey, Arvnd S; Surana, Ashish

    2013-03-01

    The placement of cases of Extrapulmonary Tuberculosis (EPTB) on the appropriate Directly Observed Treatment Short Course (DOTS) regimen remains a problematic issue in India and often, consultants delay this, leading to significant avoidable pain, discomfort and reduction in the quality of life of the patients. In contrast, a prompt institution of the DOTS regimen can regress such problems, even at a delayed stage. The following case report on polyarticular tuberculosis which involved the bilateral knee and ankle joints without a pulmonary or disseminated form of tuberculosis, amply highlights these facts.

  8. A randomized trial evaluating a block-replacement regimen during radioiodine therapy

    DEFF Research Database (Denmark)

    Bonnema, Steen J; Grupe, Peter; Boel-Jørgensen, Henrik

    2011-01-01

    Eur J Clin Invest 2010 ABSTRACT: Background  Lack of consensus regarding the antithyroid drug regimen in relation to radioiodine ((131) I) therapy of hyperthyroidism prompted this randomized trial comparing two strategies. Design  Patients with Graves' disease (GD, n = 51) or toxic nodular goitre...... (TNG, n = 49) were randomized to (131) I either 8 days following discontinuation of methimazole (-BRT, n = 52, median dose: 5 mg) or while on a continuous block-replacement regimen (+BRT, n = 48, median dose 15 mg methimazole and 100 μg levothyroxine). Results  Patients in the +BRT group required more...

  9. Combined Approach to Lysis Utilizing Eptifibatide and Recombinant Tissue-Type Plasminogen Activator in Acute Ischemic Stroke-Full Dose Regimen Stroke Trial.

    Science.gov (United States)

    Adeoye, Opeolu; Sucharew, Heidi; Khoury, Jane; Vagal, Achala; Schmit, Pamela A; Ewing, Irene; Levine, Steven R; Demel, Stacie; Eckerle, Bryan; Katz, Brian; Kleindorfer, Dawn; Stettler, Brian; Woo, Daniel; Khatri, Pooja; Broderick, Joseph P; Pancioli, Arthur M

    2015-09-01

    The Combined Approach to Lysis Utilizing Eptifibatide and Recombinant Tissue-Type Plasminogen Activator (r-tPA; CLEAR) in Acute Ischemic Stroke (AIS) and CLEAR-Enhanced Regimen (CLEAR-ER) trials demonstrated safety of reduced dose r-tPA plus the glycoprotein 2b/3a inhibitor, eptifibatide, in AIS compared with r-tPA alone. The objective of the CLEAR-Full Dose Regimen (CLEAR-FDR) trial was to estimate the rate of symptomatic intracerebral hemorrhage (sICH) in AIS patients treated with the combination of full-dose r-tPA plus eptifibatide. CLEAR-FDR was a single-arm, prospective, open-label, multisite study. Patients aged 18 to 85 years treated with 0.9 mg/kg IV r-tPA within 3 hours of symptom onset were enrolled. After obtaining consent, eptifibatide (135 μg/kg bolus and 2-hour infusion at 0.75 μg/kg per minute) was administered. The primary end point was the proportion of patients who experienced sICH within 36 hours. An independent clinical monitor adjudicated if an sICH had occurred and an independent neuroradiologist reviewed all images. The stopping rule was 3 sICHs within the first 19 patients or 4 sICHs within 29 patients. From October 2013 to December 2014, 27 patients with AIS were enrolled. Median age was 73 years (range, 34-85; interquartile range, 65-80) and median National Institute of Health stroke scale score was 12 (range, 6-26; interquartile range, 9-16). One sICH (3.7%; 95% confidence interval, 0.7%-18%) was observed. These results demonstrate comparable safety of full-dose r-tPA plus eptifibatide with historical rates of sICH with r-tPA alone and support proceeding with a phase 3 trial evaluating full-dose r-tPA combined with eptifibatide to improve outcomes after AIS. © 2015 American Heart Association, Inc.

  10. Safety analysis of raltegravir/truvada regimen in HIV/HCV co-infected patients without switchback after HCV treatment

    Directory of Open Access Journals (Sweden)

    Robert Ehret

    2014-11-01

    Full Text Available Introduction: Due to drug-drug interactions of HIV- and HCV-specific antivirals when initiating an HCV-therapy, the antiretroviral therapy (ART often has to be changed. The spectrum of applicable antiretrovirals is small, therefore many patients were switched to raltegravir/truvada (RAL/TVD in our cohort. Due to the relatively low genetic barrier of RAL, this regimen may be endangered to fail, if the NRTI backbone is not fully active because of pre-existing NRTI resistance. We investigated the long-term follow-up and safety of RAL/TVD in co-infected patients after hepatitis C virus (HCV therapy was stopped and the protective antiretroviral effect of interferon ended. Materials and Methods: Twenty patients initiated a direct-acting antiviral (DAA containing HCV therapy (8x faldaprevir, 6x telaprevir, 2x daclatasvir and 4x simeprevir between 11/2011 and 01/2013. Seventeen were switched to RAL/TVD, three patients were not treated before, but started with the regimen. Diagnosis of HIV infection was dated between 1985 and 2010. The HI-viral suppression was monitored retrospectively to date. Results: Thirteen of the twenty patients (65% remained on RAL/TVD after finishing HCV treatment, for seven patients, no data about their ART continuation was available, after HCV therapy had stopped. All remaining thirteen patients showed an HI-viral load below detection limit up to date (for 15 to 22 months, median 20 months. Only for four patients, historic resistance data were available but none showed NRTI mutations. Conclusions: Switch to RAL/TVD as HIV ART due to initiating HCV therapy was safe for the observed small cohort even in long-term follow-up without switchback or a second ART switch. However, resistance data for the cohort was little, showing no NRTI mutations, indicating a relatively safe setting. Since no further data is available, physicians should keep in mind ART history, historical therapy failure and HIV-resistance while switching ART to

  11. Comparison of a 4-Day versus 2-Day Low Fiber Diet Regimen in Barium Tagging CT Colonography in Incomplete Colonoscopy Patients

    Directory of Open Access Journals (Sweden)

    Kaan Meric

    2015-01-01

    Full Text Available Our aim was to compare the amount of residual feces, residual fluid, the tagging quality, and patient compliance using 4-day versus 2-day low fiber diet regimen in barium tagging CT colonography in incomplete colonoscopy patients. Methods. A total of 101 patients who underwent CT colonography were assigned to 2-day diet group (n=56 and 4-day diet group (n=45. Fecal tagging was achieved with barium sulphate while bisacodyl and sennoside B were used for bowel preparation. Residual solid stool was divided into two groups measuring 0.05. The prevalence of moderate discomfort was significantly higher in 4-day group (P<0.001. Conclusion. Our study shows that 2-day limited bowel preparation regimen for fecal tag CT colonography is a safe and reasonable technique to evaluate the entire colon, particularly in incomplete conventional colonoscopy patients.

  12. Primary clear cell ductal adenocarcinoma of the pancreas: A case report and clinicopathologic literature review

    Directory of Open Access Journals (Sweden)

    Yashpal Modi

    2014-01-01

    Full Text Available We present a very rare, interesting case of a carcinoma of the pancreas with predominantly abundant clear cell morphology. According to the WHO classification, primary clear cell carcinoma of the pancreas is classified as a rare "miscellaneous" carcinoma. The tumor was observed in the distal body and tail of the pancreas of a 74-year-old woman. The histopathology of tumor cells showed well-defined cell membranes, clear cytoplasm, and prominent cell boundaries. Immunohistochemical (IHC staining showed positive reactions to antibodies against vimentin, cytokeratin 7 (CK-7, mucicarmine (MUC-1, periodic acid-Schiff (PAS, periodic acid-Schiff with diastase (PASD, carcinoembryonic antigen (CEA, and Carbohydrate Antigen 19-9 (CA 19-9. On the other hand, IHC staining was negative for alpha-fetoprotein (AFP, cytokeratin 20 (CK-20, HMB45, chromogranin, and synaptophysin. The patient was subsequently diagnosed with a primary solid-type pancreatic clear cell carcinoma with hepatic metastasis. Herein, we report this rare case and include a review of the current literature of this tumor.

  13. Fluorescent-protein stabilization and high-resolution imaging of cleared, intact mouse brains.

    Directory of Open Access Journals (Sweden)

    Martin K Schwarz

    Full Text Available In order to observe and quantify long-range neuronal connections in intact mouse brain by light microscopy, it is first necessary to clear the brain, thus suppressing refractive-index variations. Here we describe a method that clears the brain and preserves the signal from proteinaceous fluorophores using a pH-adjusted non-aqueous index-matching medium. Successful clearing is enabled through the use of either 1-propanol or tert-butanol during dehydration whilst maintaining a basic pH. We show that high-resolution fluorescence imaging of entire, structurally intact juvenile and adult mouse brains is possible at subcellular resolution, even following many months in clearing solution. We also show that axonal long-range projections that are EGFP-labelled by modified Rabies virus can be imaged throughout the brain using a purpose-built light-sheet fluorescence microscope. To demonstrate the viability of the technique, we determined a detailed map of the monosynaptic projections onto a target cell population in the lateral entorhinal cortex. This example demonstrates that our method permits the quantification of whole-brain connectivity patterns at the subcellular level in the uncut brain.

  14. A dual drug regimen synergistically blocks human parainfluenza virus infection

    Science.gov (United States)

    Bailly, Benjamin; Dirr, Larissa; El-Deeb, Ibrahim M.; Altmeyer, Ralf; Guillon, Patrice; von Itzstein, Mark

    2016-04-01

    Human parainfluenza type-3 virus (hPIV-3) is one of the principal aetiological agents of acute respiratory illness in infants worldwide and also shows high disease severity in the elderly and immunocompromised, but neither therapies nor vaccines are available to treat or prevent infection, respectively. Using a multidisciplinary approach we report herein that the approved drug suramin acts as a non-competitive in vitro inhibitor of the hPIV-3 haemagglutinin-neuraminidase (HN). Furthermore, the drug inhibits viral replication in mammalian epithelial cells with an IC50 of 30 μM, when applied post-adsorption. Significantly, we show in cell-based drug-combination studies using virus infection blockade assays, that suramin acts synergistically with the anti-influenza virus drug zanamivir. Our data suggests that lower concentrations of both drugs can be used to yield high levels of inhibition. Finally, using NMR spectroscopy and in silico docking simulations we confirmed that suramin binds HN simultaneously with zanamivir. This binding event occurs most likely in the vicinity of the protein primary binding site, resulting in an enhancement of the inhibitory potential of the N-acetylneuraminic acid-based inhibitor. This study offers a potentially exciting avenue for the treatment of parainfluenza infection by a combinatorial repurposing approach of well-established approved drugs.

  15. Menstrual blood closely resembles the uterine immune micro-environment and is clearly distinct from peripheral blood

    NARCIS (Netherlands)

    Molen, R.G. van der; Schutten, J.H.; Cranenbroek, B. van; Meer, M. ter; Donckers, J.; Scholten, R.R.; Heijden, O.W.H. van der; Spaanderman, M.E.A.; Joosten, I.

    2014-01-01

    STUDY QUESTION: Is menstrual blood a suitable source of endometrial derived lymphocytes? SUMMARY ANSWER: Mononuclear cells isolated from menstrual samples (menstrual blood mononuclear cells (MMC)) are clearly distinct from peripheral blood mononuclear cells (PBMC) and show a strong resemblance with

  16. Comparison of Thromboemboli Prophylactic Effect of Aspirin and Low Dose Warfarin in Standard Risk Multiple Myeloma Patients that Treated with Regimens Containing Thalidomide

    Directory of Open Access Journals (Sweden)

    Seyed Amir Dadkhahi

    2017-05-01

    Full Text Available Abstract Background: Most of the current regimens in the treatment of multiple myeloma include thalidomide. Thalidomide is a modulator of the immune system and according to several studies, its main complication is thromboembolism. The aim of this study is to compare the thromboemboli prophylactic effect of aspirin and low dose warfarin in standard risk multiple myeloma patients that treated with regimens containing thalidomide. Materials and Methods: In this double- blind clinical trial study, sixty-six patients with multiple myeloma under treatment with thalidomide-containing regimens with standard risk for thromboembolism who were admitted to Khansari hospital, entered the study according to inclusion and exclusion criteria. The incidence of thromboembolism in these patients was evaluated. Results: Five patients in the warfarin group and 2 patients in the aspirin group had thromboemboli. Chi square analyses showed no significant difference between groups (p=0.635. Conclusion: The results showed that both drugs are effective in preventing thromboembolism and can be used as a prophylactic treatment.

  17. Clear goals, solid evidence, integrated systems, realistic roles.

    Science.gov (United States)

    Thompson, L G

    2000-01-01

    To maximize the effectiveness of home care in improving or maintaining the health of Canadians, home-care programs must have clear goals, be founded firmly on evidence of effectiveness, form part of an integrated healthcare system and be grounded in constitutional and political reality. Goals should be client-centred and distinguish between curative, supportive and preventive care. Curative and supportive home care can be cost-effective if substitution for more costly institutional services can be achieved, but the cost-effectiveness of preventive home care and comprehensive care for the elderly has not been clearly demonstrated. Integrated delivery systems are a prerequisite for effective substitution of care at home for institutional care. Federal financing dedicated to a home-care program is unnecessary and is a political and constitutional non-starter. Federal leadership for a national home-care approach would be welcome. Canada Health Act protection for access to medically necessary home care is attractive, but such protection for pharmaceuticals is a higher need. Federal support for research and demonstration of new models of care is valuable.

  18. Statistical functions and relevant correlation coefficients of clearness index

    Science.gov (United States)

    Pavanello, Diego; Zaaiman, Willem; Colli, Alessandra; Heiser, John; Smith, Scott

    2015-08-01

    This article presents a statistical analysis of the sky conditions, during years from 2010 to 2012, for three different locations: the Joint Research Centre site in Ispra (Italy, European Solar Test Installation - ESTI laboratories), the site of National Renewable Energy Laboratory in Golden (Colorado, USA) and the site of Brookhaven National Laboratories in Upton (New York, USA). The key parameter is the clearness index kT, a dimensionless expression of the global irradiance impinging upon a horizontal surface at a given instant of time. In the first part, the sky conditions are characterized using daily averages, giving a general overview of the three sites. In the second part the analysis is performed using data sets with a short-term resolution of 1 sample per minute, demonstrating remarkable properties of the statistical distributions of the clearness index, reinforced by a proof using fuzzy logic methods. Successively some time-dependent correlations between different meteorological variables are presented in terms of Pearson and Spearman correlation coefficients, and introducing a new one.

  19. Glycogen-rich clear cell carcinoma of the breast

    Directory of Open Access Journals (Sweden)

    Hatzinikolaou ML

    2008-04-01

    Full Text Available Abstract Background Glycogen-rich carcinoma of the breast is a rare histological subtype of breast cancer, usually reported to have poor prognosis. Case presentation We present the case of a 59-year-old woman who underwent a mastectomy for a 3.5 cm clinically palpable left breast carcinoma, originally diagnosed as fibroadenoma on a screening mammogram four years before presentation. Diagnosis of clear cell carcinoma was based on certain histological characteristics of the tumour and immunohistochemical analysis (PAS staining, keratins AE1/AE3, EMA, cytokeratin 7, cytokeratin 20, melanosomes, vimentin, Chromogranin, Synaptophysin, S-100, SMA. No lymph node metastasis was found and as the tumour was ER positive and PgR negative, patient was treated only with an aromatase inhibitor upfront and remains free of disease 48 months now since operation. Conclusion Glycogen-rich clear cell carcinoma of the breast is a rare tumor, its clinical behavior reported to be rather aggressive so far, might varies depending on special characteristics such as low grade and strongly positive ER expression

  20. Clear Cell Adenocarcinoma of the Urethra: Review of the Literature

    Directory of Open Access Journals (Sweden)

    Anthony Kodzo-Grey Venyo

    2015-01-01

    Full Text Available Background. Clear cell adenocarcinoma of the urethra (CCAU is extremely rare and a number of clinicians may be unfamiliar with its diagnosis and biological behaviour. Aims. To review the literature on CCAU. Methods. Various internet databases were used. Results/Literature Review. (i CCAU occurs in adults and in women in the great majority of cases. (ii It has a particular association with urethral diverticulum, which has been present in 56% of the patients; is indistinguishable from clear cell adenocarcinoma of the female genital tract but is not associated with endometriosis; and probably does not arise by malignant transformation of nephrogenic adenoma. (iii It is usually, readily distinguished from nephrogenic adenoma because of greater cytological a-typicality and mitotic activity and does not stain for prostate-specific antigen or prostatic acid phosphatase. (iv It has been treated by anterior exenteration in women and cystoprostatectomy in men and at times by radiotherapy; chemotherapy has rarely been given. (v CCAU is aggressive with low 5-year survival rates. (vi There is no consensus opinion of treatment options that would improve the prognosis. Conclusions. Few cases of CCAU have been reported. Urologists, gynaecologists, pathologists, and oncologists should report cases of CCAU they encounter and enter them into a multicentric trial to determine the best treatment options that would improve the prognosis.

  1. Near Real-Time Sensing of Clear Creek Water Quality

    Science.gov (United States)

    Loperfido, J. V.; Just, C. L.; Papanicolaou, A.; Schnoor, J. L.

    2007-12-01

    The transport of sediments, nutrients, and fecal bacteria from agricultural runoff through a watershed can have deleterious effects on receiving streams. It can impair aquatic ecosystems and cause excessive export of nutrients downstream, which can contribute to hypoxia. The ability to sense sediment and nutrient concentrations with high temporal resolution in near real-time could greatly improve our ability to understand processes which affect downstream water quality. Observations by sensors placed in streams can relay measurements to databases, and data mining can be used to glean information from streaming data for statistical and mathematical assimilation. Results from models can be used to provide advanced warning of harmful events and/or implement remedial measures. The goal of this research is to use the initial station of the Environmental Field Facility located in Clear Creek, Iowa to study processes and relationships which are essential to modeling water quality throughout the entire watershed. This station consists of several components including data loggers, telemetry hardware, and water quality sensors. Measurements collected at this field facility include conductivity, dissolved oxygen, pH, temperature, and turbidity. The measurements can be used as inputs to water quality models at the hillslope scale. This data will also provide estimates of other parameters that cannot be obtained in near real-time, and will improve our understanding of fundamental biogeochemical processes which dictate water quality in Clear Creek.

  2. Genetic characteristics of the non-clear cell renal cancer

    Directory of Open Access Journals (Sweden)

    D. S. Mikhaylenko

    2016-01-01

    Full Text Available Renal cancer (RC is one of the most frequent diseases in oncological urology; the most common form of RC is the clear cell carcinoma. However, percentage of less-studied non-clear cell RC (nccRC reaches up to 25 % of cases suggesting further studying, improvement of diagnosis and treatment of these tumors. The key events of carcinogenesis are genetic alterations including chromosomal aberrations and point mutations in proto-oncogenes and tumor suppressor genes. This review describes cytogenetic aberrations in the context of nccRC diversity according to the current ISUP classification. Translocation variants of nccRC (MiT-RC were characterized separately as particular cases of the chromosome rearrangements involving MiT gene family (TFE3, TFEB, MITF. In addition, the main nccRC hereditary forms caused by germinal mutations in the genes FLCN, FH, and MET, as well as recent studies of sporadic tumors with using the next generation sequencing techniques were reviewed. These experiments were designed to search for somatic mutations throughout the tumor genome or exom and revealed the different mutational profiles of I/II papillary RC subtypes, chromophobe carcinoma versus oncocytoma. The review may be informative for oncologists, urologists, geneticists and specialists in related sciences. 

  3. Changes in corneal hysteresis after clear corneal cataract surgery.

    Science.gov (United States)

    Hager, Annette; Loge, Kristina; Füllhas, Marc-Oliver; Schroeder, Bernd; Grossherr, Martin; Wiegand, Wolfgang

    2007-09-01

    To assess the changes in corneal hysteresis (CH) as measured by the Ocular Response Analyzer (ORA; Reichert Ophthalmic Instruments, Buffalo, New York, USA) to describe the influence of clear corneal cataract surgery on corneal viscoelastic properties and intraocular pressure (IOP) measured by noncontact tonometry (NCT) and Goldmann applanation tonometry (GAT). Retrospective, interventional, comparative study. One hundred and one eyes of 101 consecutive patients who underwent routine clear corneal cataract surgery were evaluated. CH, NCT, and central corneal thickness (CCT) were measured by ORA before surgery and at postoperative day 1. A control group of 48 pseudophakic eyes (surgery >3 months previously) was included. CCT increased from 556.82 +/- 32.5 microm before surgery to 580.26 +/- 45.5 microm after surgery (P corneal cataract surgery, CH is diminished, whereas CCT is increased significantly. Postoperative corneal edema leads to a change of corneal viscoelastic properties, resulting in a lower damping capacity of the cornea. It is supposed that GAT and NCT measurements are significantly different because of postoperative changes in viscoelastic properties of the cornea.

  4. APLIKASI SIX SIGMA PADA PRODUK CLEAR FILE DI PERUSAHAAN STATIONARY

    Directory of Open Access Journals (Sweden)

    Desy Emilasari

    2007-01-01

    Full Text Available This paper describes the application of the Six Sigma methods is used in order to improve quality in manufacturing company that produce stationary product. DMAIC approach is utilized to analyze and improve 'Pocket Clear File' product since this product has more variability and defects. Quality improvement also monitor the process that influenced pocket defect in Bag Making, Kami-ire, Karidome, and Pocket after Karidome Inspections section. Determining of Six Sigma project is based in process and defect type in each section. FMEA also gave the recommendation for quality improvement we need to evaluate the final result of the improvement since some of them were not working properly. Abstract in Bahasa Indonesia : Paper ini menggambarkan bagaimana aplikasi metode Six Sigma digunakan untuk melakukan perbaikan kualitas pada perusahaan manufaktur yang memproduksi produk stationary. Pendekatan DMAIC dipakai untuk menganalisa dan melakukan perbaikan produk 'Pocket Clear File' karena tingginya variabilitas dan cacat dibanding produk lain. Perbaikan kualitas juga memperhatikan proses yang mempengaruhi terjadinya cacat pocket pada section Bag Making, Kami-ire, Karidome, dan Pocket after Karidome Inspection. Penentuan proyek Six Sigma didasarkan atas proses dan jenis cacat pada setiap section. Pendekatan FMEA mampu memberi rekomendasi perbaikan kualitas. Evaluasi dari hasil perbaikan penting untuk dilakukan karena beberapa implementasi perbaikan kualitas tidak berjalan sesuai dengan rencana. kata kunci: six sigma, DMAIC, perusahaan stationary.

  5. DAΦNE operation with electron-cloud-clearing electrodes.

    Science.gov (United States)

    Alesini, D; Drago, A; Gallo, A; Guiducci, S; Milardi, C; Stella, A; Zobov, M; De Santis, S; Demma, T; Raimondi, P

    2013-03-22

    The effects of an electron cloud (e-cloud) on beam dynamics are one of the major factors limiting performances of high intensity positron, proton, and ion storage rings. In the electron-positron collider DAΦNE, namely, a horizontal beam instability due to the electron-cloud effect has been identified as one of the main limitations on the maximum stored positron beam current and as a source of beam quality deterioration. During the last machine shutdown in order to mitigate such instability, special electrodes have been inserted in all dipole and wiggler magnets of the positron ring. It has been the first installation all over the world of this type since long metallic electrodes have been installed in all arcs of the collider positron ring and are currently used during the machine operation in collision. This has allowed a number of unprecedented measurements (e-cloud instabilities growth rate, transverse beam size variation, tune shifts along the bunch train) where the e-cloud contribution is clearly evidenced by turning the electrodes on and off. In this Letter we briefly describe a novel design of the electrodes, while the main focus is on experimental measurements. Here we report all results that clearly indicate the effectiveness of the electrodes for e-cloud suppression.

  6. EXPRESSION PROFILES AND METHYLATION GENES IN CLEAR CELL RENAL CARCINOMA

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    E. A. Braga

    2016-01-01

    Full Text Available Renal cancer (RC is a common malignancy of the genitourinary system. Clear cell renal cell carcinoma is the most common histological type of RC. In most cases diagnosis and prognosis of clear cell renal cell carcinoma are based on the results of instrumental tests, while search for novel molecular RC markers and their characterization remain relevant. Molecular genetic abnormalities accompanied with changes in gene expression underly the RC carcinogenesis; however, diagnostic panels of the expression markers of RC are still not widely used. This review represents the results of recent research in the area of gene expression markers of RC aimed to elaborate prognostic test systems. Application of the NotI-microarray methodology allowed for identification of many novel genes associated with RC pathogenesis. The relationship of alterations of expression level and methylation of chromosome 3 genes with RC progression and metastasis has been shown. Based on this data, a  diagnostic marker system for RC have been proposed with identification of expression and methylation profiles and novel markers, that is an urgent problem in modern urologic oncology.

  7. MODIS Observations of Enhanced Clear Sky Reflectance Near Clouds

    Science.gov (United States)

    Varnai, Tamas; Marshak, Alexander

    2009-01-01

    Several recent studies have found that the brightness of clear sky systematically increases near clouds. Understanding this increase is important both for a correct interpretation of observations and for improving our knowledge of aerosol-cloud interactions. However, while the studies suggested several processes to explain the increase, the significance of each process is yet to be determined. This study examines one of the suggested processes three-dimensional (3-D) radiative interactions between clouds and their surroundings by analyzing a large dataset of MODIS (Moderate Resolution Imaging Spectroradiometer) observations over the Northeast Atlantic Ocean. The results indicate that 3-D effects are responsible for a large portion of the observed increase, which extends to about 15 km away from clouds and is stronger (i) at shorter wavelengths (ii) near optically thicker clouds and (iii) near illuminated cloud sides. This implies that it is important to account for 3-D radiative effects in the interpretation of solar reflectance measurements over clear regions in the vicinity of clouds.

  8. Effectiveness of efavirenz-based regimens in young HIV-infected children treated for tuberculosis: a treatment option for resource-limited settings.

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    Janneke H van Dijk

    Full Text Available Antiretroviral treatment (ART options for young children co-infected with HIV and tuberculosis are limited in resource-poor settings due to limited data on the use of efavirenz (EFV. Using available pharmacokinetic data, an EFV dosing schedule was developed for young co-infected children and implemented as the standard of care at Macha Hospital in Southern Province, Zambia. Treatment outcomes in children younger than 3 years of age or weighing less than 10 kg receiving either EFV-based ART plus anti-tuberculous treatment or nevirapine-based (NVP ART were compared.Treatment outcomes were measured in a cohort of HIV-infected children seeking care at Macha Hospital in rural Zambia from 2007 to 2010. Information on the diagnosis and treatment of tuberculosis was abstracted from medical records.Forty-five children treated for tuberculosis initiated an EFV-based regimen and 69 children initiated a NVP-based regimen, 7 of whom also were treated for tuberculosis. Children receiving both regimens were comparable in age, but children receiving EFV started ART with a lower CD4(+ T-cell percentage and weight-for-age z-score. Children receiving EFV experienced increases in both CD4(+ T-cell percentage and weight-for-age z-score during follow-up, such that levels were comparable to children receiving NVP after two years of ART. Cumulative survival after 12 months of ART did not differ between groups (NVP:87%;EFV:80%;p = 0.25. Eleven children experienced virologic failure during follow-up.The adjusted hazard ratio of virologic failure comparing EFV to NVP was 0.25 (95% CI:0.05,1.24 and 0.13 (95% CI:0.03,0.62 using thresholds of 5000 and 400 copies/mL, respectively.Five children receiving EFV were reported to have had convulsions after ART initiation compared to only one child receiving NVP (p = 0.04.Despite poorer health at ART initiation, children treated for tuberculosis and receiving EFV-based regimens showed significant improvements comparable to children

  9. Therapeutic Assessment of Chloroquine-Primaquine Combined Regimen in Adult Cohort of Plasmodium vivax Malaria from Primary Care Centres in Southwestern India.

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    Kavitha Saravu

    Full Text Available Several reports of chloroquine treatment failure and resistance in Plasmodium vivax malaria from Southeast Asian countries have been published. Present study was undertaken to assess the efficacy of chloroquine-primaquine (CQ-PQ combined regimen for the treatment of P. vivax malaria patients who were catered by the selected primary health centres (PHCs of Udupi taluk, Udupi district, Karnataka, India.Five PHCs were selected within Udupi taluk based on probability proportional to size. In-vivo therapeutic efficacy assessment of CQ (1500 mg over three days plus PQ (210 mg over 14 days regimen was carried out in accordance with the World Health Organization's protocol of 28 days follow-up among microscopically diagnosed monoinfection P. vivax cohort.In total, 161 participants were recruited in the study of which, 155 (96.3% participants completed till day 28 follow-up, fully complied with the treatment regimen and showed adequate clinical and parasitological response. Loss to follow up was noted with 5 (3.1% participants and non-compliance with treatment regimen occurred with one participant (0.6%. Glucose-6-phosphate dehydrogenase deficiency (G6PDd, <30% of normal mean activity was noted among 5 (3.1% participants and one of them did develop PQ induced dark-brown urination which subsided after PQ discontinuation. G6PDd patients were treated with PQ 45 mg/week for eight weeks while PQ was discontinued in one case with G6PD 1.4 U/g Hb due to complaint of reddish-brown coloured urine by 48 hours of PQ initiation. Nested polymerase chain reaction test revealed 45 (28% cases as mixed (vivax and falciparum malaria.The CQ-PQ combined regimen remains outstandingly effective to treat uncomplicated P. vivax malaria in Udupi taluk and thus it should continue as first line regimen. For all P. vivax cases, G6PD screening before PQ administration must be mandatory and made available in all PHCs.

  10. Antiretroviral therapy in HIV-infected patients: a proposal to assess the economic value of the single-tablet regimen

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    Colombo GL

    2013-02-01

    Full Text Available Giorgio L Colombo,1,2 Sergio Di Matteo,2 Franco Maggiolo31University of Pavia, Department of Drug Sciences, School of Pharmacy, Pavia, Italy, 2Studi Analisi Valutazioni Economiche, Milan, Italy, 3Division of Infectious Diseases, Ospedali Riuniti, Bergamo, ItalyBackground: The aim of this study was to assess the economic value of a reduced number of pills in patients infected with the immunodeficiency virus (HIV and on highly active antiretroviral therapy by a cost-effectiveness model.Methods: An incremental cost-effectiveness analysis of efavirenz, tenofovir, and emtricitabine (TDF-FTC-EFV as a single-tablet regimen versus a multipill regimen, with reference to untreated HIV-infected patients, was carried out from the perspective of the Italian National Health Service. The comparisons were performed with the help of a Markov decision model over a 10-year time horizon. Based on the ADONE (ADherence to ONE pill study, it was then possible to identify the utility score increment in patients switching from a multipill regimen of TDF-FTC + EFV therapy to a single-tablet regimen.Results: The single-tablet regimen (0.755 quality-adjusted life-years [QALYs]/year resulted in better patient quality of life, with a higher number of QALYs than for the TDF-FTC + EFV multipill regimen (0.716 QALYs/year. The single-tablet regimen was the most cost-effective treatment strategy, with an incremental cost-effectiveness ratio of €22,017.00 versus €26,558.00 for the multipill regimen. A 24% decrease in cost of the multipill regimen determined equivalence with the single-tablet regimen in terms of the incremental cost-effectiveness ratio. Univariate sensitivity and probabilistic analysis carried out on the main variables did not highlight significant variations with respect to the base case scenario.Conclusion: The single-tablet regimen resulted in better adherence, and therefore better quality of life as perceived by patients, corresponding to a €4541.00 lower

  11. Relative safety profiles of high dose statin regimens

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    Carlos Escobar

    2008-06-01

    Full Text Available Carlos Escobar, Rocio Echarri, Vivencio BarriosDepartment of Cardiology, Hospital Ramón y Cajal, Madrid, SpainAbstract: Recent clinical trials recommend achieving a low-density lipoprotein cholesterol level of <100 mg/dl in high-risk and <70 mg/dl in very high risk patients. To attain these goals, however, many patients will need statins at high doses. The most frequent side effects related to the use of statins, myopathy, rhabdomyolysis, and increased levels of transaminases, are unusual. Although low and moderate doses show a favourable profile, there is concern about the tolerability of higher doses. During recent years, numerous trials to analyze the efficacy and tolerability of high doses of statins have been published. This paper updates the published data on the safety of statins at high doses.Keywords: statins, high doses, tolerability, liver, muscle

  12. Adult Heart Transplantation Under Tacrolimus (FK506) Immunosuppression: Histopathologic Observations and Comparison to a Cyclosporine-based Regimen with Lympholytic (ATG) Induction

    Science.gov (United States)

    Tsamandas, Athanassios C.; Pham, Si M.; Seaberg, Eric C.; Pappo, Orit; Kormos, Robert L.; Kawai, Akihiko; Griffith, Bartley P.; Zeevi, Adriana; Duquesnoy, Rene; Fung, John J.; Starzl, Thomas E.; Demetris, Anthony J.

    2011-01-01

    Background Tacrolimus (FK506) is an effective immunosuppressant for human heart transplantation, but information about its effects on cardiac allograft and nonallograft kidney and liver histopathologic study is limited. Methods We therefore reviewed 1145 endomyocardial biopsy specimens and eight autopsy results from 80 heart transplant recipients who received tacrolimus as baseline immunosuppression. These were compared with 619 endomyocardial biopsy specimens and four autopsy results from 51 patients treated with cyclosporine-based immunosuppression with lympholytic induction (CLI) by use of rabbit anti-thymocyte globulin. Twenty-one histologic features including the International Society for Heart and Lung Transplantation histopathologic grade were retrospectively assessed without knowledge of the treatment regimen. The lymphocyte growth index on biopsy specimens obtained from these patients was also compared. Results In general, there were no qualitative differences in the histopathologic appearance of various allograft syndromes between tacrolimus- and CLI-treated patients. Thus histopathologic criteria used to diagnose various graft syndromes are applicable under tacrolimus immunosuppression. However, early (between 10 and 30 days) after transplantation, biopsy specimens from patients treated with tacrolimus showed a significantly higher percentage of inflamed fragments (p = 0.02), the inflammation tended to be more severe (p = 0.09), and the rejection grade tended to be slightly higher (p = 0.08). In contrast, during the late transplantation period (275 to 548 days), biopsy specimens from patients treated with CLI showed a significantly higher percentage of inflamed fragments (p = 0.03), more severe inflammation (p = 0.03), higher rejection grades (p = 0.01), and a higher frequency of Quilty lesions (p = 0.05). Although overall freedom from any grade 3A or higher rejection was greater in the CLI-treated arm, tacrolimus was successfully used to treat

  13. Efficacy of a combined contraceptive regimen consisting of condoms and emergency contraception pills.

    Science.gov (United States)

    Zhao, Rui; Wu, Jun-Qing; Li, Yu-Yan; Zhou, Ying; Ji, Hong-Lei; Li, Yi-Ran

    2014-04-14

    To evaluate and compare the effectiveness of the combined regimen (consisting of condoms and emergency contraception pills (ECP)) and using condoms only for the purpose of preventing pregnancy. One-thousand-five-hundred-and-sixty-two (1,562) couples as volunteers enrolled at nine centers in Shanghai. Eight-hundred-and-twelve (812) were randomized to use male condoms and ECP (i.e., Levonorgestrel) as a back-up to condoms (the intervention group) and 750 to use male condoms only(the control group), according to their working unit. Participants were visited at admission and at the end of 1, 3, 6, 9, and 12 months. The cumulative life table rates were calculated for pregnancy and other reasons for discontinuation. The gross cumulative life table rates showed that the cumulative discontinuation rates for all reasons during the year of follow-up in the condoms plus emergency contraception group and the condoms only group were 7.76 ± 0.94 and 6.61 ± 0.91, respectively, per 100 women (χ2 = 0.41, p = 0.5227). The cumulative gross pregnancy rate of the condoms plus emergency contraception group and the condoms only group were 2.17 ± 0.52 and 1.25 ± 0.41, respectively, per 100 women (χ2 = 1.93, p = 0.1645). The Pearl Index in the condoms plus emergency contraception group and the condoms only group were 2.21% and 1.26%, respectively. Male condoms remain a highly effective contraceptive method for a period of one year while consistently and correctly used. In addition, the lowest pregnancy rate followed from perfect use condom.

  14. Dietary regimens modify early onset of obesity in mice haploinsufficient for Rai1.

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    Joseph T Alaimo

    Full Text Available Smith-Magenis syndrome is a complex genomic disorder in which a majority of individuals are obese by adolescence. While an interstitial deletion of chromosome 17p11.2 is the leading cause, mutation or deletion of the RAI1 gene alone results in most features of the disorder. Previous studies have shown that heterozygous knockout of Rai1 results in an obese phenotype in mice and that Smith-Magenis syndrome mouse models have a significantly reduced fecundity and an altered transmission pattern of the mutant Rai1 allele, complicating large, extended studies in these models. In this study, we show that breeding C57Bl/6J Rai1+/- mice with FVB/NJ to create F1 Rai1+/- offspring in a mixed genetic background ameliorates both fecundity and Rai1 allele transmission phenotypes. These findings suggest that the mixed background provides a more robust platform for breeding and larger phenotypic studies. We also characterized the effect of dietary intake on Rai1+/- mouse growth during adolescent and early adulthood developmental stages. Animals fed a high carbohydrate or a high fat diet gained weight at a significantly faster rate than their wild type littermates. Both high fat and high carbohydrate fed Rai1+/- mice also had an increase in body fat and altered fat distribution patterns. Interestingly, Rai1+/- mice fed different diets did not display altered fasting blood glucose levels. These results suggest that dietary regimens are extremely important for individuals with Smith-Magenis syndrome and that food high in fat and carbohydrates may exacerbate obesity outcomes.

  15. Renexin as a rescue regimen for noise-induced hearing loss

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    So Young Park

    2014-01-01

    Full Text Available Renexin, a compound of cilostazol and ginkgo biloba extract, has been reported to produce neuroprotective effects through antioxidant, antiplatelet, and vasodilatory mechanisms. This study was designed to investigate the protective effects of renexin on hearing, the organ of Corti (OC, and medial olivocochlear efferents against noise-induced damage. C57BL/6 mice were exposed to 110 dB SPL white noise for 60 min and then randomly divided into three groups: high- and low-dose renexin-treated groups and noise only group. Renexin were administered for 7 days: 90 mg/kg to the low-dose, and 180 mg/kg to the high-dose groups. All mice, including the controls underwent hearing tests on postnoise day 8 and were killed for cochlear harvest. We compared the hearing thresholds and morphology of the OC and cochlear efferents across the groups. The renexin-treated groups recovered from the immediate threshold shifts in a dose-dependent manner, while the noise group showed a permanent hearing loss. The renexin-treated ears demonstrated less degeneration of the OC. The diameters of the efferent terminals labeled with α-synuclein were preserved in the high-dose renexin-treated group. In the western blot assay of the cochlear homogenates, the treated groups displayed stronger expressions of α-synuclein than the noise and control groups, which may indicate that noise-induced enhanced activity of the cochlear efferent system was protected by renexin. Our results suggest that pharmacologic treatment with renexin is hopeful to reduce or prevent noise-induced hearing loss as a rescue regimen after noise exposure.

  16. Engraftment kinetics and graft failure after single umbilical cord blood transplantation using a myeloablative conditioning regimen

    Science.gov (United States)

    Ruggeri, Annalisa; Labopin, Myriam; Sormani, Maria Pia; Sanz, Guillermo; Sanz, Jaime; Volt, Fernanda; Michel, Gerard; Locatelli, Franco; De Heredia, Cristina Diaz; O’Brien, Tracey; Arcese, William; Iori, Anna Paola; Querol, Sergi; Kogler, Gesine; Lecchi, Lucilla; Pouthier, Fabienne; Garnier, Federico; Navarrete, Cristina; Baudoux, Etienne; Fernandes, Juliana; Kenzey, Chantal; Eapen, Mary; Gluckman, Eliane; Rocha, Vanderson; Saccardi, Riccardo

    2014-01-01

    Umbilical cord blood transplant recipients are exposed to an increased risk of graft failure, a complication leading to a higher rate of transplant-related mortality. The decision and timing to offer a second transplant after graft failure is challenging. With the aim of addressing this issue, we analyzed engraftment kinetics and outcomes of 1268 patients (73% children) with acute leukemia (64% acute lymphoblastic leukemia, 36% acute myeloid leukemia) in remission who underwent single-unit umbilical cord blood transplantation after a myeloablative conditioning regimen. The median follow-up was 31 months. The overall survival rate at 3 years was 47%; the 100-day cumulative incidence of transplant-related mortality was 16%. Longer time to engraftment was associated with increased transplant-related mortality and shorter overall survival. The cumulative incidence of neutrophil engraftment at day 60 was 86%, while the median time to achieve engraftment was 24 days. Probability density analysis showed that the likelihood of engraftment after umbilical cord blood transplantation increased after day 10, peaked on day 21 and slowly decreased to 21% by day 31. Beyond day 31, the probability of engraftment dropped rapidly, and the residual probability of engrafting after day 42 was 5%. Graft failure was reported in 166 patients, and 66 of them received a second graft (allogeneic, n=45). Rescue actions, such as the search for another graft, should be considered starting after day 21. A diagnosis of graft failure can be established in patients who have not achieved neutrophil recovery by day 42. Moreover, subsequent transplants should not be postponed after day 42. PMID:24972767

  17. Efficacy of different therapeutic regimens for acute foot rot in adult sheep

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    Mohammad Moin Ansari

    2014-09-01

    Full Text Available In this study, efficacies of different therapeutic regimens along with 10% zinc-sulfate footbath for the treatment of acute foot rot in adult sheep were evaluated. The research work conducted on the adult sheep (n=104 of both sexes which were presented to the Teaching Veterinary Clinical Complex during April 2013 to May 2014. Foot rot was confirmed based on clinical and physical examinations. The sheep were divided into four equal groups; G-I, G-II, G-III, and G-IV. The animals of the G-I, II and IV were treated with a mixture of amoxicillin and cloxacillin at 15 mg/kg body weight (b.wt. through intramuscular (IM route, oxytetracycline at 20 mg/kg b.wt., IM, and enrofloxacin at 5 mg/kg b.wt., IM, respectively. The animals of G-III were treated with gamma benzene hexachloride cream. Along with the above treatments, all four groups were given footbath with 10% zinc-sulfate. Mean recovery time (days was recorded as lowest in G-II (3.83±0.64 followed by G-I (4.17±0.31, G-IV (4.38±0.0.79 and G-III (5.67±0.98, respectively. The mean±SE values of rectal temperature and ruminal motility that were recorded before and after the treatment showed significant (p<0.05 differences. In conclusion, administration of parenteral antibiotics in combination with footbath was highly effective to treat combination with footbath was highly effective to treat the acute foot rot in sheep.

  18. Comparing efficacy of BCG/lactoferrin primary vaccination versus booster regimen

    Science.gov (United States)

    Hwang, Shen-An; Welsh, Kerry J.; Boyd, Sydney; Kruzel, Marian L.; Actor, Jeffrey K.

    2011-01-01

    Summary Lactoferrin is an iron binding glycoprotein possessing multiple immune modulatory activities, including ability to affect macrophage cytokine production, mature T- and B- lymphocytes and immature dendritic cells, and enhance the ability of macrophages and dendritic cells to stimulate antigen-specific T-cells, and. These characteristics of lactoferrin suggested that it could function as an effective adjuvant enhance efficacy of the BCG, the current vaccine for tuberculosis disease. Admix of lactoferrin to the BCG vaccine promoted host protective responses that surpasses activity of the BCG vaccine alone as determined by decreasing pulmonary pathology upon challenge with virulent Mycobacterium tuberculosis (MTB). This study builds on previous reports by examining the effectiveness of the lactoferrin adjuvant comparing primary vaccination versus an immunization schedule with a booster administered at 8 weeks. BCG/lactoferrin vaccinating, given once or twice, demonstrated an improvement in pulmonary disease compared to both the BCG vaccinated and non-immunized groups. The splenic recall profiles showed a difference in cytokine production induced by mycobacterial antigen from splenocytes isolated from mice immunized with BCG/lactoferrin once or twice. Production of IL-17 is increased in the BCG/lactoferrin 2x group compared to the primary vaccinated group. Both BCG/lactoferrin vaccinated group exhibited increase production of IFN-γ compared to the non-immunized group and decreased production of IL-10 compared to the group vaccinated with only BCG. This study illustrates that the adjuvant activity of lactoferrin to enhance BCG efficacy occurs whether the vaccination regimen is a single delivery or combined with a booster, leading to enhanced host protection and decreased disease manifestation. PMID:22088320

  19. Efficacy of a quadruple therapy regimen for Helicobacter pylori eradication after partial gastrectomy

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    F. Zhang

    2016-01-01

    Full Text Available We aimed to evaluate the effectiveness and safety of bismuth-containing quadruple therapy plus postural change after dosing for Helicobacter pylori eradication in gastrectomized patients. We compared 76 gastric stump patients with H. pylori infection (GS group with 50 non-gastrectomized H. pylori-positive patients who met the treatment indication (controls. The GS group was divided into GS group 1 and GS group 2. All groups were administered bismuth potassium citrate (220 mg, esomeprazole (20 mg, amoxicillin (1.0 g, and furazolidone (100 mg twice daily for 14 days. GS group 1 maintained a left lateral horizontal position for 30 min after dosing. H. pylori was detected using rapid urease testing and histologic examination of gastric mucosa before and 3 months after therapy. Mucosal histologic manifestations were evaluated using visual analog scales of the updated Sydney System. GS group 1 had a higher prevalence of eradication than the GS group 2 (intention-to-treat [ITT]: P=0.025; per-protocol [PP]: P=0.030, and the control group had a similar prevalence. GS group 2 had a lower prevalence of eradication than controls (ITT: P=0.006; PP: P=0.626. Scores for chronic inflammation and activity declined significantly (P<0.001 3 months after treatment, whereas those for atrophy and intestinal metaplasia showed no significant change. Prevalence of adverse reactions was similar among groups during therapy (P=0.939. A bismuth-containing quadruple therapy regimen plus postural change after dosing appears to be a relatively safe, effective, economical, and practical method for H. pylori eradication in gastrectomized patients.

  20. Superior rejection profile during the first 24 months after heart transplantation under tacrolimus as baseline immunosuppressive regimen

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    Helmschrott M

    2014-09-01

    Full Text Available Matthias Helmschrott,1 Jan Beckendorf,1 Ceylan Akyol,1 Arjang Ruhparwar,2 Bastian Schmack,2 Christian Erbel,1 Christian A Gleissner,1 Mohammadreza Akhavanpoor,1 Philipp Ehlermann,1 Tom Bruckner,3 Hugo A Katus,1 Andreas O Doesch1 1Department of Cardiology, Angiology, Pneumology, University of Heidelberg, Heidelberg, Germany; 2Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany; 3Institute for Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany Background: The use of tacrolimus (TAC in patients after heart transplantation (HTX has increased over the last few years. Aim: In this retrospective study, we evaluated the effects of a TAC (conventional and extended-release TAC-based immunosuppressive therapy regarding rejection profile in comparison to a cyclosporine A (CSA-based regimen in patients after HTX.Methods: The data of 233 patients who underwent HTX at the Heidelberg Heart Transplantation Center from May 1998 until November 2010 were retrospectively analyzed. Primary immunosuppressive therapy was changed from a CSA (n=114 to a TAC (n=119-based regimen in February 2006 according to center routine. Follow-up period was 2 years post-HTX. Primary endpoint was time to first biopsy-proven rejection requiring therapy. In all patients, routine follow-up at the Heidelberg Heart Transplantation Center was mandatory. Results: Multivariate risk factor analysis regarding time to first rejection episode showed no statistically significant differences regarding recipient age, donor age, recipient sex, donor sex, sex mismatch, ischemic time, and diagnosis leading to HTX between the two groups (all P= not statistically significant. Time to first biopsy-proven rejection was significantly longer in the TAC group (intention-to-treat analysis, n=233, log-rank test P<0.0001; per-protocol analysis, n=150, log-rank test P=0.0003. In patients who underwent a change of primary immunosuppression (n=49, a

  1. Effective treatment of a highly active antiretroviral regimen through jejunostomy.

    Science.gov (United States)

    Florit-Sureda, Marta; Giner-Soriano, Maria; Antonio, Javier Mateu-de; Carmona-Yelo, Alexia

    2014-06-01

    A 49-year-old woman voluntarily not receiving HIV treatment was admitted to the emergency department showing sepsis and peritonism. She required several surgical procedures for intestinal perforations. Finally, a proximal-terminal jejunostomy and a distal mucous jejunostomy were performed. At this time, her HIV viral load was 531 388 copies/ml and CD4 count was 193 cells/μl. Then, HAART was restarted with lopinavir/ritonavir 400/100 mg plus lamivudine 150 mg/12 hours, and etravirine 400 mg/24 hours. Each drug was dissolved in 20 ml of water and administered through the distal jejunostomy. In 2 months, her HIV viral load decreased in 3·9 log and CD4 count increased in 70 cells/μl. On day 250, an intestinal tract reconstruction was performed and short after highly active antiretroviral therapy (HAART) was restarted orally. Lopinavir/ritonavir, etravirine, and lamivudine administered through a jejunostomy resulted effective in decreasing HIV viral load and increasing CD4 lymphocyte count in a HIV patient who could not receive treatment orally.

  2. Use of Digital Image Technology to 'Clearly' Depict Global Change

    Science.gov (United States)

    Molnia, B. F.; Carbo, C. L.

    2014-12-01

    Earth is dynamic and beautiful. Understanding why, when, how, and how fast its surface changes yields information and serves as a source of inspiration. The artistic use of geoscience information can inform the public about what is happening to their planet in a non-confrontational and apolitical way. While individual images may clearly depict a landscape, photographic comparisons are necessary to clearly capture and display annual, decadal, or century-scale impacts of climate and environmental change on Earth's landscapes. After years of effort to artistically communicate geoscience concepts with unenhanced individual photographs or pairs of images, the authors have partnered to maximize this process by using digital image enhancement technology. This is done, not to manipulate the inherent artistic content or information content of the photographs, but to insure that the comparative photo pairs produced are geometrically correct and unambiguous. For comparative photography, information-rich historical photographs are selected from archives, websites, and other sources. After determining the geographic location from which the historical photograph was made, the original site is identified and eventually revisited. There, the historical photos field of view is again photographed, ideally from the original location. From nearly 250 locations revisited, about 175 pairs have been produced. Every effort is made to reoccupy the original historical site. However, vegetation growth, visibility reduction, and co-seismic level change may make this impossible. Also, inherent differences in lens optics, camera construction, and image format may result in differences in the geometry of the new photograph when compared to the old. Upon selection, historical photos are cleaned, contrast stretched, brightness adjusted, and sharpened to maximize site identification and information extraction. To facilitate matching historical and new images, digital files of each are overlain in

  3. A Phase 1 Human Immunodeficiency Virus Vaccine Trial for Cross-Profiling the Kinetics of Serum and Mucosal Antibody Responses to CN54gp140 Modulated by Two Homologous Prime-Boost Vaccine Regimens

    Directory of Open Access Journals (Sweden)

    Sven Kratochvil

    2017-05-01

    Full Text Available A key aspect to finding an efficacious human immunodeficiency virus (HIV vaccine is the optimization of vaccine schedules that can mediate the efficient maturation of protective immune responses. In the present study, we investigated the effect of alternate booster regimens on the immune responses to a candidate HIV-1 clade C CN54gp140 envelope protein, which was coadministered with the TLR4-agonist glucopyranosyl lipid A-aqueous formulation. Twelve study participants received a common three-dose intramuscular priming series followed by a final booster at either 6 or 12 months. The two homologous prime-boost regimens were well tolerated and induced CN54gp140-specific responses that were observed in both the systemic and mucosal compartments. Levels of vaccine-induced IgG-subclass antibodies correlated significantly with FcγR engagement, and both vaccine regimens were associated with strikingly similar patterns in antibody titer and FcγR-binding profiles. In both groups, identical changes in the antigen (Ag-specific IgG-subclass fingerprint, leading to a decrease in IgG1 and an increase in IgG4 levels, were modulated by booster injections. Here, the dissection of immune profiles further supports the notion that prime-boost strategies are essential for the induction of diverse Ag-specific HIV-1 responses. The results reported here clearly demonstrate that identical responses were effectively and safely induced by both vaccine regimens, indicating that an accelerated 6-month regimen could be employed for the rapid induction of immune responses against CN54gp140 with no apparent impact on the overall quality of the induced immune response. (This study has been registered at http://ClinicalTrials.gov under registration no. NCT01966900.

  4. Efficacy and tolerance of artemisinin in short combination regimens for the treatment of uncomplicated falciparum malaria

    NARCIS (Netherlands)

    Bich, N. N.; de Vries, P. J.; van Thien, H.; Phong, T. H.; Hung, L. N.; Eggelte, T. A.; Anh, T. K.; Kager, P. A.

    1996-01-01

    Two oral regimens comprising a single dose of 20 mg/kg of artemisinin followed by three days of quinine, 10 mg/kg three times a day (AQ), or doxycycline, 4 mg/kg once a day (AD), were compared with a standard seven-day course of oral quinine, 10 mg/kg three times a day (Q), in the treatment of

  5. The Role of Feeding Regimens in Regulating Metabolism of Sexually Mature Broiler Breeders

    Science.gov (United States)

    A trial was conducted to determine the effects of different rearing feed regimens on plasma hormone and metabolite levels and hepatic lipid metabolism and gene expression on sexually mature broiler breeders. Cobb 500 birds were divided into two groups at 4 weeks of age and fed either everyday (ED) ...

  6. The phenotypic profile of CD34-positive peripheral blood stem cells in different mobilization regimens

    NARCIS (Netherlands)

    Boer, F. de; Dräger, A.M.; Haperen, M.J.A.M van; Wall, E. van der; Kessler, F.; Huijgens, P.C.; Pinedo, H. M.; Schuurhuis, G.J.

    2000-01-01

    The type of regimen used might result in mobilization of phenotypically and functionally different CD34+ cells. We compared the phenotype of CD34+ cells in leukapheresis products of three homogeneous groups: I, healthy individuals treated with granulocyte colony-stimulating factor (G-CSF) alone (n

  7. Outcomes of Patients With Burkitt Lymphoma Older Than Age 40 Treated With Intensive Chemotherapeutic Regimens

    NARCIS (Netherlands)

    Kelly, Jennifer L.; Toothaker, Stephen R.; Ciminello, Lauren; Hoelzer, Dieter; Holte, Harald; LaCasce, Ann S.; Mead, Graham; Thomas, Deborah; Van Imhoff, Gustaaf W.; Kahl, Brad S.; Cheson, Bruce D.; Magrath, Ian T.; Fisher, Richard I.; Friedberg, Jonathan W.

    Burkitt lymphoma is a highly curable disorder when treated with modern intensive chemotherapy regimens. The majority of adult patients with Burkitt lymphoma in the United States are over age 40 years. Older patients have historically been underrepresented in published clinical trials of modern

  8. Efficacy of combination of glycolic acid peeling with topical regimen in treatment of melasma.

    Science.gov (United States)

    Chaudhary, Savita; Dayal, Surabhi

    2013-10-01

    Various treatment modalities are available for management of melasma, ranging from topical and oral to chemical peeling, but none is promising alone. Very few studies are available regarding efficacy of combination of topical treatment with chemical peeling. Combination of chemical peeling and topical regimen can be a good treatment modality in the management of this recalcitrant disorder. To assess the efficacy of combination of topical regimen (2% hydroquinone, 1% hydrocortisone and 0.05% tretinoin) with serial glycolic acid peeling in the treatment of melasma in Indian patients. Forty Indian patients of moderate to severe epidermal variety melasma were divided into two groups of 20 each. One Group i.e. peel group received topical regimen (2% hydroquinone, 1% hydrocortisone and 0.05% tretinoin) with serial glycolic acid peeling and other group i.e. control group received topical regimen (2% hydroquinone, 1% hydrocortisone, 0.05% tretinoin). There was an overall decrease in MASI from baseline in 24 weeks of therapy in both the groups (P value melasma.

  9. Biohydrogenation of Fatty Acids Is Dependent on Plant Species and Feeding Regimen of Dairy Cows

    DEFF Research Database (Denmark)

    Petersen, Majbritt Bonefeld; Jensen, Søren Krogh

    2014-01-01

    and LA between single plant species and feeding regimens. Rumen fluid was collected from cows fed either total mixed ration (TMR), species-rich silage (HERB), or grass silage (GRASS). Five single species (alfalfa, birdsfoot trefoil, chicory, English plantain, and salad burnet) and a grass–clover mixture...

  10. Dyslipidemia in an Asian population after treatment for two years with protease inhibitor-containing regimens

    NARCIS (Netherlands)

    Kerr, Stephen J.; Duncombe, Chris; Avihingsanon, Anchalee; Ananworanich, Jintanat; Boyd, Mark; Sopa, Bunruan; Medtech, B.; Chuenyam, Theshinee; Cooper, David A.; Lange, Joep M. A.; Phanuphak, Praphan; Ruxrungtham, Kiat

    2007-01-01

    There are limited data about dyslipidemia in Asian patients treated with combination antiretroviral therapy. To assess the relative association of different protease-inhibitor-containing regimens with the degree of dyslipidemia, fasting lipid levels were compared during 110 weeks in 250

  11. Individualized Ranibizumab Regimen Driven by Stabilization Criteria for Central Retinal Vein Occlusion

    DEFF Research Database (Denmark)

    Larsen, Michael; Waldstein, Sebastian M; Boscia, Francesco

    2016-01-01

    PURPOSE: To assess the 12-month efficacy and safety profile of an individualized regimen of ranibizumab 0.5 mg driven by stabilization criteria in patients with macular edema secondary to central retinal vein occlusion (CRVO). DESIGN: A 24-month, prospective, open-label, single-arm, multicenter s...

  12. Comparative Study on the Efficacy of Two Regimens of Single-Shot ...

    African Journals Online (AJOL)

    Comparative Study on the Efficacy of Two Regimens of Single-Shot Spinal Block for Pain Relief in Women Presenting in Established Labour. ... difference in neonatal outcome had no clinical significance, and there were no significant differences in adverse effects, sensory levels, and motor power between the two groups.:

  13. The Diabetes Regimen Responsibility Scale: Information on Internal Consistency and Validity in a Pediatric Sample.

    Science.gov (United States)

    Carey, Tracy; Reid, Graham; Ruggiero, Laurie; Horner, James; Dubow, Eric

    1997-01-01

    The internal consistency and validity of the Diabetes Regimen Responsibility Scale (DRRS) (L. Ruggiero and others, 1991) were examined in a sample of 49 youths. The DRRS demonstrated adequate internal consistency, and most subscales correlated significantly with diabetes knowledge (health education issue). Only two reports correlated with…

  14. Metabolic drug interactions - the impact of prescribed drug regimens on the medication safety.

    NARCIS (Netherlands)

    Fialova, D.; Vrbensky, K.; Topinkova, E.; Vlcek, J.; Soerbye, L.W.; Wagner, C.; Bernabei, R.

    2005-01-01

    Background and objective: Risk/benefit profile of prescribed drug regimens is unkown. Over 60% of commonly used medications interact on metabolic pathways (cytochrom P450 (CYP450), uridyl-glucuronyl tranferasis (UGT I, II) and P-glycoprotein (PGP) transport). Using an up-to-date knowledge on

  15. Patient non-compliance with drug regimens for chronic diseases in ...

    African Journals Online (AJOL)

    Patient non-compliance with drug regimens for chronic diseases in northwest Ethiopia. Teferra Abulal, Alemayehu Worku2. Abstract. Background: Poor compliance with prescribed medication is a major problem in chronic disease states and is often responsible for the therapeutic failure. It also unnecessarily increases the ...

  16. Pharmacokinetics of a once-daily regimen of lopinavir/ritonavir in HIV-1-infected children.

    NARCIS (Netherlands)

    Lee, M. van der; Verweel, G.; Groot, R. de; Burger, D.M.

    2006-01-01

    INTRODUCTION: Lopinavir is an HIV protease inhibitor that is co-formulated with ritonavir. The approved paediatric dose is 230/57.5 mg/m2 twice daily. Once-daily dosing may offer an advantage to adherence. We studied the pharmacokinetics of lopinavir/ritonavir in a once-daily regimen in

  17. Effectiveness of a triple-drug regimen for global elimination of lymphatic filariasis: A modelling study

    NARCIS (Netherlands)

    M.A. Irvine (Michael A.); W.A. Stolk (Wilma); Smith, M.E. (Morgan E); S.V. Subramanian; B.K. Singh (Brajendra K.); G.J. Weil (Gary); E. Michael (Edwin); T.D. Hollingsworth (T. Déirdre)

    2017-01-01

    textabstractBackground: Lymphatic filariasis is targeted for elimination as a public health problem by 2020. The principal approach used by current programmes is annual mass drug administration with two pairs of drugs with a good safety profile. However, one dose of a triple-drug regimen

  18. Effectiveness of a standardised oral Vitamin D dosing regimen for somatic and psychogeriatric nursing home residents

    NARCIS (Netherlands)

    Toren-Wielema, M.L.; Veenhuizen, R.B.; Kappelle, J.W.; Veeger, N.J.G.M.; Van Roon, E.N.

    2017-01-01

    BACKGROUND The prevalence of Vitamin D deficiency in nursing home residents (NHR) ranges from 79 to 98%. OBJECTIVE To determine the efficacy of a standardised oral Vitamin D dosing regimen (VDDRI consisting of a loading dose (ID) of 200,000 IU followed by a maintenance dose (MD) of 100.000 IU every

  19. Efficacy of homecare regimens for mechanical plaque removal in managing gingivitis: a meta review

    NARCIS (Netherlands)

    van der Weijden, F.A.; Slot, D.E.

    2015-01-01

    Focused question Based on evidence as presented in systematic reviews what is the efficacy and safety of available homecare toothbrush regimens for mechanical plaque removal on plaque and gingivitis in adults? Material & Methods Three Internet sources were used (up to and including August 2014) to

  20. Comparison of Short and Continuous Hydration Regimen in Chemotherapy Containing Intermediate- to High-Dose Cisplatin

    Directory of Open Access Journals (Sweden)

    Akira Ouchi

    2014-01-01

    Full Text Available Aim. The efficacy of the short hydration regimen was reported in chemotherapy containing intermediate- to high-dose cisplatin, and the use of outpatient chemotherapy containing cisplatin with short hydration has been widespread in recent years. Methods. We compared patients with gastric cancer, lung cancer, and urothelial cancer who received outpatient chemotherapy containing cisplatin (≥60 mg/m2/cycle with the short hydration regimen since April 2012 (n=13 with those who received hospital chemotherapy with continuous hydration between April 2011 and March 2013 (n=17 in our hospital. Results. Grade 2 or higher acute kidney injury occurred in 2 patients in the continuous hydration group and in no patient in the short hydration group; 1 patient discontinued treatment on account of nephrotoxicity. There was no difference between the 2 groups in maximum creatinine increment and maximum clearance decrement. Relative dose intensity in the short hydration group was higher than that in the continuous hydration group (89.5% versus 80.3%; P<0.01. Conclusions. The short hydration regimen in outpatient chemotherapy containing intermediate- to high-dose cisplatin is as safe as the continuous hydration regimen and increased the efficacy of chemotherapy.

  1. PROPOSAL OF ANTI-TUBERCULOSIS REGIMENS BASED ON SUSCEPTIBILITY TO ISONIAZID AND RIFAMPICIN

    Science.gov (United States)

    Mendoza-Ticona, Alberto; Moore, David AJ; Alarcón, Valentina; Samalvides, Frine; Seas, Carlos

    2014-01-01

    Objective To elaborate optimal anti-tuberculosis regimens following drug susceptibility testing (DST) to isoniazid (H) and rifampicin (R). Design 12 311 M. tuberculosis strains (National Health Institute of Peru 2007-2009) were classified in four groups according H and R resistance. In each group the sensitivity to ethambutol (E), pirazinamide (Z), streptomycin (S), kanamycin (Km), capreomycin (Cm), ciprofloxacin (Cfx), ethionamide (Eto), cicloserine (Cs) and p-amino salicilic acid (PAS) was determined. Based on resistance profiles, domestic costs, and following WHO guidelines, we elaborated and selected optimal putative regimens for each group. The potential efficacy (PE) variable was defined as the proportion of strains sensitive to at least three or four drugs for each regimen evaluated. Results Selected regimes with the lowest cost, and highest PE of containing 3 and 4 effective drugs for TB sensitive to H and R were: HRZ (99,5%) and HREZ (99,1%), respectively; RZECfx (PE=98,9%) and RZECfxKm (PE=97,7%) for TB resistant to H; HZECfx (96,8%) and HZECfxKm (95,4%) for TB resistant to R; and EZCfxKmEtoCs (82.9%) for MDR-TB. Conclusion Based on resistance to H and R it was possible to select anti-tuberculosis regimens with high probability of success. This proposal is a feasible alternative to tackle tuberculosis in Peru where the access to rapid DST to H and R is improving progressively. PMID:23949502

  2. Effects of an Aerobic Rowing Training Regimen in Young Adults with Down Syndrome.

    Science.gov (United States)

    Varela, Ana Maria; Sardinha, Luis Bettencount; Pitetti, Kenneth H.

    2001-01-01

    Eight young adult males with Down syndrome received a 16-week rowing ergometry training regimen. Following training, no changes in cardiovascular fitness were found but participants did achieve significantly higher levels of work performance on both treadmill and rowing ergometer tests than did a control group. (Contains references.) (Author/DB)

  3. Estimation of clear sky hourly global solar radiation in Iraq

    Energy Technology Data Exchange (ETDEWEB)

    Al-Jumaily, Kais J.; Al-Zuhairi, Munya F.; Mahdi, Zahraa S. [Department of Atmospheric Sciences, College of Science, Al-Mustansiriyah University, Baghdad (Iraq)

    2012-07-01

    The availability of hourly solar radiation data is very important for applications utilizing solar energy and for climate and environmental aspects. The aim of this work is to use a simple model for estimating hourly global solar radiation under clear sky condition in Iraq. Calculations were compared with measurements obtained from local station in Baghdad city and from Meteosat satellite data for different locations in Iraq. The statistical test methods of the mean bias error (MBE), root mean square error (RMSE) and t-test were used to evaluate the performance of the model. Results indicated that a fairly good agreement exists between calculated and measured values for all locations in Iraq. Since the model is independent of any meteorological variable, it would be of a practical use for rural areas where no meteorological data are available.

  4. Interpretation of MST radar returns from clear air

    Science.gov (United States)

    Liu, C. H.

    1983-01-01

    The nature of the scattering and reflection mechanisms that give rise to the MST radar echoes from the clear air is essential in the correct interpretation of the data about winds, waves, turbulence and stability in the atmosphere. There are two main aspects: the nature of the targets the radar sees and their generation mechanisms; and the signatures of the radar signals returned from the different targets. Volume scatterings from isotropic or anisotropic turbulence, and partial reflections from horizontally stratified, sharp refractive index gradients are believed the main contributors to radar echoes. Combined effects from all the mechanisms probably produce the observed data. The signature of the echo signals for these different scatterers under realistic experimental conditions should be studied. It is hoped from these studies, the nature of the targets can be better understood, and related to atmospheric dynamic processes.

  5. Global Response of Clear-Air Turbulence to Climate Change

    Science.gov (United States)

    Storer, Luke N.; Williams, Paul D.; Joshi, Manoj M.

    2017-10-01

    Clear-air turbulence (CAT) is one of the largest causes of weather-related aviation incidents. Here we use climate model simulations to study the impact that climate change could have on global CAT by the period 2050-2080. We extend previous work by analyzing eight geographic regions, two flight levels, five turbulence strength categories, and four seasons. We find large relative increases in CAT, especially in the midlatitudes in both hemispheres, with some regions experiencing several hundred per cent more turbulence. The busiest international airspace experiences the largest increases, with the volume of severe CAT approximately doubling over North America, the North Pacific, and Europe. Over the North Atlantic, severe CAT in future becomes as common as moderate CAT historically. These results highlight the increasing need to improve operational CAT forecasts and to use them effectively in flight planning, to limit discomfort and injuries among passengers and crew.

  6. The palm oil supply chain, deforestation and peat clearing

    Science.gov (United States)

    Boucher, D. H.

    2013-12-01

    The palm oil industry has expanded rapidly in the last two decades, particularly in Indonesia. A considerable amount of this expansion has been at the expense of forests and peatlands, resulting in considerable greenhouse gas emissions. Now the industry is faced with two new challenges. There is a possible oversupply on the global market due to recent expansion and the time lag between clearing and new production coming on line, which may depress prices considerably. Furthermore, there is increasing pressure to reduce the industry's impact on climate and biodiversity, exemplified by the commitment by the businesses of the Consumer Goods Forum to eliminate deforestation from their supply chains by 2020. This presentation will examine the interaction between these two challenges and its implications for the industry, in both southeast Asia and new regions of expansion, and how this interaction could transform the industry's mode of expansion in the coming decade.

  7. Proposal for a project agreement with ISTC - Crystal Clear Collaboration

    CERN Document Server

    2001-01-01

    This document concerns a project agreement with the ISTC entitled "Development of the Detector Production Technology for a New Generation of Positron Emission Tomographs to be used in Medecine and Pharmacology" to be executed in co-operation with the Crystal Clear Collaboration. For the reasons set out in this document, the Finance Committee is invited to agree to the negotiation of a project agreement with ISTC for a total amount of 775 000 US dollars. The European Union party in ISTC will co-fund the project up to a total of 525 000 US dollars. CERN's contribution will not exceed 250 000 US dollars. At the present rate of exchange this is equivalent to approximately 430 000 Swiss francs

  8. A Supplementary Clear-Sky Snow and Ice Recognition Technique for CERES Level 2 Products

    Science.gov (United States)

    Radkevich, Alexander; Khlopenkov, Konstantin; Rutan, David; Kato, Seiji

    2013-01-01

    Identification of clear-sky snow and ice is an important step in the production of cryosphere radiation budget products, which are used in the derivation of long-term data series for climate research. In this paper, a new method of clear-sky snow/ice identification for Moderate Resolution Imaging Spectroradiometer (MODIS) is presented. The algorithm's goal is to enhance the identification of snow and ice within the Clouds and the Earth's Radiant Energy System (CERES) data after application of the standard CERES scene identification scheme. The input of the algorithm uses spectral radiances from five MODIS bands and surface skin temperature available in the CERES Single Scanner Footprint (SSF) product. The algorithm produces a cryosphere rating from an aggregated test: a higher rating corresponds to a more certain identification of the clear-sky snow/ice-covered scene. Empirical analysis of regions of interest representing distinctive targets such as snow, ice, ice and water clouds, open waters, and snow-free land selected from a number of MODIS images shows that the cryosphere rating of snow/ice targets falls into 95% confidence intervals lying above the same confidence intervals of all other targets. This enables recognition of clear-sky cryosphere by using a single threshold applied to the rating, which makes this technique different from traditional branching techniques based on multiple thresholds. Limited tests show that the established threshold clearly separates the cryosphere rating values computed for the cryosphere from those computed for noncryosphere scenes, whereas individual tests applied consequently cannot reliably identify the cryosphere for complex scenes.

  9. Effect of various dietary regimens on oral challenge with Mycobacterium avium subsp. paratuberculosis in a rabbit model.

    Science.gov (United States)

    Arrazuria, Rakel; Molina, Elena; Mateo-Abad, Maider; Arostegui, Inmaculada; Garrido, Joseba M; Juste, Ramón A; Elguezabal, Natalia

    2015-08-01

    Rabbits are susceptible to infection by Mycobacterium avium subspecies paratuberculosis (MAP) in both wildlife and experimental conditions. Under the hypotheses that nutrient balance might influence the establishment of infection, we designed an experiment where MAP intestinal colonization was assessed under three dietary regimens: high fiber, high protein, and regular diet in New Zealand white rabbits submitted to oral challenge with MAP. Lowest weight gain (F=5.17, p=0.024), higher tissue culture positivity rates (X(2)=7.43, p=0.024) and especially extended MAP-compatible lesions (F=5.78, p=0.017) were detected in the regular diet. Taken altogether, results indicate that paratuberculosis infection was achieved affecting mostly regular diet animals and showing that dietary changes may modulate the course of the infection. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Randomised study to assess the efficacy and safety of once-daily etravirine-based regimen as a switching strategy in HIV-infected patients receiving a protease inhibitor-containing regimen. Etraswitch study.

    Directory of Open Access Journals (Sweden)

    Patricia Echeverría

    Full Text Available Etravirine (ETR was approved for patients with virological failure and antiretroviral resistance mutations. It has also shown antiviral efficacy in antiretroviral-naïve patients. However, data on the switching from protease inhibitors (PI to ETR are lacking.HIV-1-infected patients with suppressed viral load (VL during a PI-containing regimen (>12 months and no previous virological failure were randomized to switch from the PI to ETR (400 mg/day, dissolved in water (ETR group, n = 22 or to continue with the same regimen (control group, n = 21. Percentage of patients with VL ≤ 50 copies/mL were assessed at week 48, as well as changes in CD4 T-cell counts and metabolic profile.We included 43 patients [72.9% male, 46.3 (42.2; 50.6 years]. Two patients receiving ETR (grade-1 diarrhea and voluntary discontinuation and another in the control group (simplification discontinued therapy early. No patients presented virological failure (two consecutive VL>50 copies/mL; treatment was successful in 95.2% of the control group and 90.9% of the ETR group (intention-to-treat analysis, missing = failure (p = 0.58. CD4+ T-cell counts did not significantly vary [+49 cells/µL in the ETR group (p = 0.25 and -4 cells/µL in the control group (p = 0.71]. The ETR group showed significant reductions in cholesterol (p<0.001, triglycerides (p = <0.001, and glycemia (p = 0.03 and higher satisfaction (0-10 scale (p = 0.04. Trough plasma concentrations of ETR were similar to observed in studies using ETR twice daily.Switch from a PI-based regimen to a once-daily combination based on ETR maintained undetectable VL during 48 weeks in virologically suppressed HIV-infected patients while lipid profile and patient satisfaction improved significantly.ClinicalTrials.gov NCT01034917.

  11. Clear cell chondrosarcoma of the pelvis in a skeletally immature patient

    Energy Technology Data Exchange (ETDEWEB)

    Ishida, Tsuyoshi; Yamamoto, Motoi; Machinami, Rikuo [Department of Pathology, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655 (Japan); Goto, Takahiro; Kawano, Hirotaka; Yamamoto, Aiichiro [Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo (Japan)

    1999-05-01

    We report on a case of clear cell chondrosarcoma (CCCS) of the left iliac bone in a 12-year-old skeletally immature boy. Radiographic examination revealed an aggressive osteolytic lesion with areas of mineralization. Fluid-fluid levels were seen on T2-weighted MR images. Laboratory data showed slight elevation of serum alkaline phosphatase. The biopsy specimen showed histological features of CCCS with some resemblance to osteosarcoma, such as prominent irregular osteoid formation among clear tumor cells. Surgical treatment was accomplished without pre- or post-operative chemotherapy. Because of the patient`s age, elevated serum alkaline phosphatase, and histopathology with prominent osteoid production, this case could be confused with osteosarcoma. Although CCCS is an extremely rare bone tumor in children, it is important to be aware that it may arise in a skeletally immature patient. CCCS, unlike osteosarcoma, is not treated with neo-adjuvant chemotherapy. (orig.) With 6 figs., 14 refs.

  12. Novel Kivexa-based regimens in early courses of treatment for HIV infection

    Directory of Open Access Journals (Sweden)

    B Conway

    2012-11-01

    Full Text Available Background: As the long-term efficacy of antiretroviral therapy regimens is confirmed, we need to identify additional combinations with long-term safety and potency, while also favoring simplicity of administration. In this light, we have undertaken a review of the use of abacavir/lamivudine (Kivexa, KVX-based regimens using integrase or CCR5 inhibitors as the third agent. Methods: A retrospective chart review was undertaken, with informed patient consent. We identified all the patients in whom KVX was prescribed (following appropriate HLA-B5701 screening with either raltegravir (RGV or maraviroc (MVC as initial therapy or as a switch from another regimen for reasons other than virologic failure. Virologic efficacy over 48 weeks was evaluated, along with specific drug-associated toxicity, adherence, and regimen modifications. Results: A total of 38 patients (5 women were evaluated, 24 on KVX/RGV, 13 on KVX/MVC, 1 on KVX/RGV/MVC. This was used as initial therapy in drug-naïve subjects in three cases, and was selected as a modification of previous (current or not therapy in 35 cases. Switches included replacement of the third agent with RGV or MVC (n=13, replacement of the NRTI backbone with KVX (n=13 or both. In all cases, the change was implemented to address a current or previous medication-associated toxicity, most commonly to address jaundice (n=8, diarrhea (n=5 or reduced renal function (n=5. Patients were predominantly MSMs (n=17 or IDUs (n=13 with a mean baseline CD4 cell count of 363 cells/mm3, and plasma viral load of 46407 copies/mL (20 with full suppression at time of study entry. At 48 weeks, 34/38 (89% achieved or maintained full suppression, with a mean CD4 count of 553 cells/mm3. Virologic failure with the development of the M184V mutation was observed in 3/4 non-suppressed patients, and a loss of CCR5 tropism and RGV resistance were observed in one case each, all in the context of reduced adherence. There were no treatment

  13. Impact of adverse events of antiretroviral treatment on regimen change and mortality in Ugandan children

    Directory of Open Access Journals (Sweden)

    Ntambwe Malangu

    2010-03-01

    Full Text Available Background: Outcomes of antiretroviral treatment have been documented in both developed and developing countries. It has been reported consistently that the treatment is associated with many adverse events. However, little is known about their impact on the quality of life, clinical management, and survival in children aged less than 6 years in Uganda.Objectives: The purpose of this study was to determine the prevalence of the adverse events of antiretroviral treatment, their impact on mortality and the change in regimens prescribed to children treated at Mildway Centre in Uganda.Method: A retrospective chart review was performed for children younger than 6 years, treated since the Mildway Centre was opened in 1999. In order to achieve a larger sample, the records of children treated from January 2000 to July 2005 were included in the study. A pre-tested data collection form was used to collate socio-demographic and clinical data of the patients. These included the documented adverse events, causes of death, stage of infection, duration of treatment, regimen prescribed, year of enrolment into the treatment program, as well as whether or not they were still alive. Descriptive statistics were used in the analysis of data.Results: Of the 179 children, the majority were males and had a median age of 4 years. The majority (58.8% of children had suffered from severe immune depression since they met the WHO clinical stage III and IV, 73.8% had a baseline CD4T of less than 15%. Four regimens were prescribed to the children. The most common was a regimen containing zidovudine, lamivudine, and nevirapine (34.6%, followed by a regimen containing stavudine, lamivudine, and nevirapine (27.9%. Eleven children (6.1% had their regimen changed, of which six (54.5% were due to adverse events. The prevalence of adverse events was 8%; of the 14 documented adverse events, the most common were severe anaemia (3, vomiting (3, and skin rashes (3. After 12 months on

  14. Comparison of three dose regimens of aprotinin in infants undergoing the arterial switch operation

    Directory of Open Access Journals (Sweden)

    Verma Yashwant

    2010-01-01

    III (8.14 ± 3.17, whereas in group II, it was 16.45 ± 6.33 (P = 0.019 group I versus group III; (P = 0.036 group II versus group III. Postoperative PRBC requirements were significantly less in high dose group III (P = 0.008, group I versus III; p = 0.116, group II versus group III . Tests for coagulation performed at four hours postoperatively, viz. ACT, PT, INR, FDP, and platelets were comparable in the three groups. Urine output on CPB was comparable in all the groups. Serum urea and creatinine showed no significant difference between the three groups twenty four hours postoperatively. Aprotinin dosage regimen of 40,000 KIU/kg at induction, in CPB prime and postoperatively for three hours was most effective in reducing postoperative blood loss and PRBC transfusion requirements. Aprotinin does not have any adverse effect on renal function.

  15. A case of clear cell adenocarcinoma arising from the urethral diverticulum: Utility of urinary cytology and immunohistochemistry

    Directory of Open Access Journals (Sweden)

    Shin-ichi Nakatsuka

    2012-01-01

    Full Text Available Carcinomas rarely arise from the urethral diverticulum. In this report, we present a case of clear cell adenocarcinoma arising from the urethral diverticulum. A 42-year-old woman complained of bloody discharge and lower back pain. Imaging studies showed a tumor involving the region surrounding the urethra and cystourethroscopy showed papillary and villous tumors in the urethral diverticula. Cytology of the urine sediment showed papillary or spherical clusters of atypical cells, some of which had clear abundant cytoplasm and formed mirror ball-like clusters, suggesting adenocarcinoma. Although histological diagnosis was indeterminate by biopsy and transurethral resection (TUR because of absence of stromal invasion, surgically resected specimen via cysturethrectomy revealed that the tumor was clear cell carcinoma. Urinary cytological findings and immunohistochemical analysis for CD15, Ki-67, and p53 might be useful for accurate diagnosis of clear cell adenocarcinoma that arises from the urethral diverticulum when sufficient materials are not available by biopsy and TUR.

  16. Comparison of different glucocorticoid regimens in the management of classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency

    Directory of Open Access Journals (Sweden)

    T P Ajish

    2014-01-01

    Full Text Available Background: There are recommendations regarding the total dose of hydrocortisone to be administered in the treatment of classical congenital adrenal hyperplasia (CAH to achieve the twin objectives of glucocorticoid replacement and control of hyperandrogenism. However, there is evidence gap regarding the breakup, timing and type of the steroid regimen. Objectives: Efficacy of three different glucocorticoid regimens having the same total dose of steroid, differing in either the timing or type of evening steroid administered, in achieving biochemical control of the disease was assessed. Materials and Methods: The study was done in 13 prepubertal children with classical CAH over a 6-month period with 2 months devoted to each regimen. We used a prospective cross-over design using 10-15 mg/m 2 total dose of hydrocortisone. Two-fifths of the total dose of hydrocortisone was administered in the morning and one-fifth of the total dose was administered at noon in all the regimens. The regimens differed in the timing of the evening dose of hydrocortisone, 06.00-07.00 pm in regimen 1 and 09.00-10.00 pm in regimen 2. The third regimen had the evening dose of hydrocortisone replaced by an equivalent dose of prednisolone suspension which was administered at 10.00 pm. Serum 17-hydroxyprogesterone and testosterone levels were compared to assess the efficacy of treatment regimens. Results: The three different regimens were found to be similar in their ability to control 17-hydroxyprogesterone and testosterone levels. The percentage of patients with predefined criteria for biochemically controlled disease was similar in all the three regimens. However, there was a trend toward better control of 17-hydroxyprogesterone levels in patients receiving evening dose of prednisolone. Conclusions: There is no significant advantage in administering the hydrocortisone dose late at night in patients with classical CAH.

  17. Tretinoin gel microsphere pump 0.04% plus 5% benzoyl peroxide wash for treatment of acne vulgaris: morning/morning regimen is as effective and safe as morning/evening regimen.

    Science.gov (United States)

    Pariser, David; Bucko, Alicia; Fried, Richard; Jarratt, Michael T; Kempers, Steven; Kircik, Leon; Lucky, Anne W; Rafal, Elyse; Rendon, Marta; Weiss, Jonathan; Wilson, David C; Rossi, Ana Beatris; Ramaswamy, Ratna; Nighland, Marge

    2010-07-01

    Topical tretinoin and benzoyl peroxide (BPO) are often prescribed in combination for the treatment of acne vulgaris; however, these products have not traditionally been administered simultaneously because of the potential for tretinoin degradation by BPO as well as the instability of tretinoin in daylight. The primary objective of this randomized, investigator-blinded, 12-week, phase 4 trial was to determine non-inferiority of a once-daily morning combination regimen of 5% BPO wash + tretinoin gel microsphere (TGM) 0.04% pump versus a sequential regimen (BPO in the morning/TGM in the evening) in patients > or = 12 years old with moderate facial acne vulgaris. The primary efficacy endpoint was the change from baseline in total acne lesions; the primary safety endpoint was the change in cutaneous irritation scores. The 247 participants (mean age: 18.5 years) were randomized to either the morning/morning regimen (n = 123) or the morning/evening regimen (n = 124). The morning/morning regimen was determined to be non-inferior to the morning/evening regimen in reduction of total acne lesions. The tolerability of both regimens was comparable. The morning/morning regimen is a safe and effective treatment option for patients with moderate acne vulgaris.

  18. Adherence to Antiretroviral Therapy (ART) in Yaoundé-Cameroon: Association with Opportunistic Infections, Depression, ART Regimen and Side Effects.

    Science.gov (United States)

    Fonsah, Julius Y; Njamnshi, Alfred K; Kouanfack, Charles; Qiu, Fang; Njamnshi, Dora M; Tagny, Claude T; Nchindap, Emilienne; Kenmogne, Léopoldine; Mbanya, Dora; Heaton, Robert; Kanmogne, Georgette D

    2017-01-01

    Following global efforts to increase antiretroviral therapy (ART) access in Sub-Saharan Africa, ART coverage among HIV-infected Cameroonians increased from 0% in 2003 to 22% in 2014. However, the success of current HIV treatment programs depends not only on access to ART, but also on retention in care and good treatment adherence. This is necessary to achieve viral suppression, prevent virologic failure, and reduce viral transmission and HIV/AIDS-related deaths. Previous studies in Cameroon showed poor adherence, treatment interruption, and loss to follow-up among HIV+ subjects on ART, but the factors that influence ART adherence are not well known. In the current cross-sectional study, patient/self-reported questionnaires and pharmacy medication refill data were used to quantify ART adherence and determine the factors associated with increased risk of non-adherence among HIV-infected Cameroonians. We demonstrated that drug side-effects, low CD4 cell counts and higher viral loads are associated with increased risk of non-adherence, and compared to females, males were more likely to forego ART because of side effects (pART regimen, age, gender, and education showed that subjects with opportunistic infections had 3.1-times higher odds of having been non-adherent (p40 years) were less likely to be non-adherent (pART during antibiotic treatment (r = 0.53, p = 0.04), and was associated with lower CD4 cell counts (p = 0.04) and longer non-adherent periods (p = 0.04). Change in ART regimen was significantly associated with increased likelihood of non-adherence and increased duration of the non-adherence period. Addressing these underlying risk factors could improve ART adherence, retention in care and treatment outcomes for HIV/AIDS patients in Cameroon.

  19. Adherence to Antiretroviral Therapy (ART) in Yaoundé-Cameroon: Association with Opportunistic Infections, Depression, ART Regimen and Side Effects

    Science.gov (United States)

    Fonsah, Julius Y.; Njamnshi, Alfred K.; Kouanfack, Charles; Qiu, Fang; Njamnshi, Dora M.; Tagny, Claude T.; Nchindap, Emilienne; Kenmogne, Léopoldine; Mbanya, Dora; Heaton, Robert; Kanmogne, Georgette D.

    2017-01-01

    Following global efforts to increase antiretroviral therapy (ART) access in Sub-Saharan Africa, ART coverage among HIV-infected Cameroonians increased from 0% in 2003 to 22% in 2014. However, the success of current HIV treatment programs depends not only on access to ART, but also on retention in care and good treatment adherence. This is necessary to achieve viral suppression, prevent virologic failure, and reduce viral transmission and HIV/AIDS-related deaths. Previous studies in Cameroon showed poor adherence, treatment interruption, and loss to follow-up among HIV+ subjects on ART, but the factors that influence ART adherence are not well known. In the current cross-sectional study, patient/self-reported questionnaires and pharmacy medication refill data were used to quantify ART adherence and determine the factors associated with increased risk of non-adherence among HIV-infected Cameroonians. We demonstrated that drug side-effects, low CD4 cell counts and higher viral loads are associated with increased risk of non-adherence, and compared to females, males were more likely to forego ART because of side effects (pART regimen, age, gender, and education showed that subjects with opportunistic infections had 3.1-times higher odds of having been non-adherent (p40 years) were less likely to be non-adherent (pART during antibiotic treatment (r = 0.53, p = 0.04), and was associated with lower CD4 cell counts (p = 0.04) and longer non-adherent periods (p = 0.04). Change in ART regimen was significantly associated with increased likelihood of non-adherence and increased duration of the non-adherence period. Addressing these underlying risk factors could improve ART adherence, retention in care and treatment outcomes for HIV/AIDS patients in Cameroon. PMID:28141867

  20. Reconstructing daily clear-sky land surface temperature for cloudy regions from MODIS data

    Science.gov (United States)

    Sun, Liang; Chen, Zhongxin; Gao, Feng; Anderson, Martha; Song, Lisheng; Wang, Limin; Hu, Bo; Yang, Yun

    2017-08-01

    Land surface temperature (LST) is a critical parameter in environmental studies and resource management. The MODIS LST data product has been widely used in various studies, such as drought monitoring, evapotranspiration mapping, soil moisture estimation and forest fire detection. However, cloud contamination affects thermal band observations and will lead to inconsistent LST results. In this study, we present a new Remotely Sensed DAily land Surface Temperature reconstruction (RSDAST) model that recovers clear sky LST for pixels covered by cloud using only clear-sky neighboring pixels from nearby dates. The reconstructed LST was validated using the original LST pixels. Model shows high accuracy for reconstructing one masked pixel with R2 of 0.995, bias of -0.02 K and RMSE of 0.51 K. Extended spatial reconstruction results show a better accuracy for flat areas with R2 of 0.72‒0.89, bias of -0.02-0.21 K, and RMSE of 0.92-1.16 K, and for mountain areas with R2 of 0.81-0.89, bias of -0.35-1.52 K, and RMSE of 1.42‒2.24 K. The reconstructed areas show spatial and temporal patterns that are consistent with the clear neighbor areas. In the reconstructed LST and NDVI triangle feature space which is controlled by soil moisture, LST values distributed reasonably and correspond well to the real soil moisture conditions. Our approach shows great potential for reconstructing clear sky LST under cloudy conditions and provides consistent daily LST which are critical for daily drought monitoring.