Title
 Spectrum of fibrosing diffuse parenchymal lung disease .

 ABSTRACT GENERAL
 The interstitial lung diseases are a heterogeneous group of disorders characterized by inflammation and/or fibrosis of the pulmonary interstitium . In 2002 , the American Thoracic Society and the European Respiratory Society revised the classification of interstitial lung diseases and introduced the term diffuse parenchymal lung disease . The idiopathic interstitial pneumonias are a subtype of diffuse parenchymal lung disease . The idiopathic interstitial pneumonias are subdivided into usual interstitial pneumonia ( with its clinical counterpart idiopathic interstitial pneumonia ) , nonspecific interstitial pneumonia , cryptogenic organizing pneumonia , acute interstitial pneumonia , desquamative interstitial pneumonia , respiratory bronchiolitis interstitial lung disease , and lymphocytic pneumonia . Sarcoidosis and hypersensitivity pneumonitis are the 2 most common granulomatous diffuse parenchymal lung diseases . Rheumatoid arthritis , systemic sclerosis , and dermatomyositis/polymyositis ( causing antisynthetase syndrome ) are diffuse parenchymal lung diseases of known association because these conditions are associated with connective tissue disease . Hermansky-Pudlak syndrome is a rare genetic diffuse parenchymal lung disease characterized by the clinical triad of pulmonary disease , oculocutaneous albinism , and bleeding diathesis . This review provides an overview of the chronic fibrosing diffuse parenchymal lung diseases . Its primary objective is to illuminate the clinical challenges encountered by clinicians who manage the diffuse parenchymal lung diseases regularly and to offer potential solutions to those challenges . Treatment for the diffuse parenchymal lung diseases is limited , and for many patients with end-stage disease , lung transplantation remains the best option . Although much has been learned about the diffuse parenchymal lung diseases during the past decade , research in these diseases is urgently needed .

Title

Spectrum

of

fibrosing

diffuse

parenchymal

lung

disease

ABSTRACT GENERAL

The

interstitial

lung

diseases

are

a

heterogeneous

group

of

disorders

characterized

by

inflammation

and/or

fibrosis

of

the

pulmonary

interstitium

In

the

American

Thoracic

Society

and

the

European

Respiratory

Society

revised

the

classification

of

interstitial

lung

diseases

and

introduced

the

term

diffuse

parenchymal

lung

disease

The

idiopathic

interstitial

pneumonias

are

a

subtype

of

diffuse

parenchymal

lung

disease

The

idiopathic

interstitial

pneumonias

are

subdivided

into

usual

interstitial

pneumonia

with

its

clinical

counterpart

idiopathic

interstitial

pneumonia

nonspecific

interstitial

pneumonia

cryptogenic

organizing

pneumonia

acute

interstitial

pneumonia

desquamative

interstitial

pneumonia

respiratory

bronchiolitis

interstitial

lung

disease

and

lymphocytic

pneumonia

Sarcoidosis

and

hypersensitivity

pneumonitis

are

the

most

common

granulomatous

diffuse

parenchymal

lung

diseases

Rheumatoid

arthritis

systemic

sclerosis

and

dermatomyositis/polymyositis

causing

antisynthetase

syndrome

are

diffuse

parenchymal

lung

diseases

of

known

association

because

these

conditions

are

associated

with

connective

tissue

disease

Hermansky-Pudlak

syndrome

is

a

rare

genetic

diffuse

parenchymal

lung

disease

characterized

by

the

clinical

triad

of

pulmonary

disease

oculocutaneous

albinism

and

bleeding

diathesis

This

review

provides

an

overview

of

the

chronic

fibrosing

diffuse

parenchymal

lung

diseases

Its

primary

objective

is

to

illuminate

the

clinical

challenges

encountered

by

clinicians

who

manage

the

diffuse

parenchymal

lung

diseases

regularly

and

to

offer

potential

solutions

to

those

challenges

Treatment

for

the

diffuse

parenchymal

lung

diseases

is

limited

and

for

many

patients

with

end-stage

disease

lung

transplantation

remains

the

best

option

Although

much

has

been

learned

about

the

diffuse

parenchymal

lung

diseases

during

the

past

decade

research

in

these

diseases

is

urgently

needed


Title
 Superiority of 10 % air-10 % blood-saline mixture for measuring the velocity of tricuspid regurgitation in patients with severe emphysema .

 ABSTRACT BACKGROUND
 Severe emphysema frequently is associated with elevated pulmonary artery systolic pressure . However , it is often difficult to obtain adequate tricuspid regurgitation ( TR ) signals for measurement of pulmonary artery systolic pressure in patients with severe emphysema .

 ABSTRACT OBJECTIVE
 This study was conducted to evaluate the usefulness of air-blood-saline mixture in measuring TR velocity in severe emphysema .

 ABSTRACT METHODS
 We studied 82 patients with severe emphysema ( 67.7 + / - 9.2 years , 57 males ) who had no or mild TR on color Doppler . Contrast echocardiography studies were performed with agitated 10 % air-90 % saline and 10 % air-10 % blood-80 % saline mixtures . Tracing quality and peak velocity were assessed on baseline continuous wave signals and contrast continuous wave signals with the 2 mixtures .

 ABSTRACT RESULTS
 With the injection of an air-saline mixture , the quality of TR tracing improved in 45 patients ( P < .0001 ) and a higher peak TR velocity was obtained ( 2.46 + / - 0.37 m/s vs 2.95 + / - 0.40 m/s , P < .0001 ) compared with baseline echocardiography . Compared with air-saline mixture , the air-blood-saline mixture further enhanced TR tracing quality in 17 patients ( P < .0001 ) and the peak TR velocity increased to 3.13 + / - 0.42 m/s ( P < .0001 ) .

 ABSTRACT CONCLUSIONS
 In patients with severe emphysema , an air-blood-saline mixture improves the quantifiable TR signals for more accurate estimation of pulmonary artery systolic pressure , even when there is minimal valve TR .

Title

Superiority

of

blood-saline

mixture

for

measuring

the

velocity

of

tricuspid

regurgitation

in

patients

with

severe

emphysema

ABSTRACT BACKGROUND

Severe

emphysema

frequently

is

associated

with

elevated

pulmonary

artery

systolic

pressure

However

it

is

often

difficult

to

obtain

adequate

tricuspid

regurgitation

TR

signals

for

measurement

of

pulmonary

artery

systolic

pressure

in

patients

with

severe

emphysema

ABSTRACT OBJECTIVE

This

study

was

conducted

to

evaluate

the

usefulness

of

air-blood-saline

mixture

in

measuring

TR

velocity

in

severe

emphysema

ABSTRACT METHODS

We

studied

patients

with

severe

emphysema

years

males

who

had

no

or

mild

TR

on

color

Doppler

Contrast

echocardiography

studies

were

performed

with

agitated

saline

and

saline

mixtures

Tracing

quality

and

peak

velocity

were

assessed

on

baseline

continuous

wave

signals

and

contrast

continuous

wave

signals

with

the

mixtures

ABSTRACT RESULTS

With

the

injection

of

an

air-saline

mixture

the

quality

of

TR

tracing

improved

in

patients

P

and

a

higher

peak

TR

velocity

was

obtained

m/s

vs

m/s

P

compared

with

baseline

echocardiography

Compared

with

air-saline

mixture

the

air-blood-saline

mixture

further

enhanced

TR

tracing

quality

in

patients

P

and

the

peak

TR

velocity

increased

to

m/s

P

ABSTRACT CONCLUSIONS

In

patients

with

severe

emphysema

an

air-blood-saline

mixture

improves

the

quantifiable

TR

signals

for

more

accurate

estimation

of

pulmonary

artery

systolic

pressure

even

when

there

is

minimal

valve

TR


Title
 Dose-ranging study of mometasone furoate dry powder inhaler in the treatment of moderate persistent asthma using fluticasone propionate as an active comparator .

 ABSTRACT BACKGROUND
 Mometasone furoate ( MF ; Schering-Plough , Madison , NJ ) , is a glucocorticoid with high local potency and low potential systemic availability .

 ABSTRACT OBJECTIVE
 To compare the relative efficacy and safety of a new formulation of MF , coupled with a recently designed dry powder inhaler ( DPI ) , in the treatment of patients with moderate persistent asthma . Fluticasone propionate administered by Diskhaler ( FP Diskhaler , 250 microg twice a day ; Glaxo Wellcome , Research Triangle Park , NC ) was used as an active control .

 ABSTRACT METHODS
 A randomized , parallel group , double-blind ( for MF-DPI dosage ) , evaluator-blind ( for MF-DPI vs FP ) trial .

 ABSTRACT METHODS
 Sixty centers in 20 countries .

 ABSTRACT METHODS
 Seven hundred thirty-three patients with moderate persistent asthma on inhaled corticosteroid treatment .

 ABSTRACT METHODS
 Discontinuation of previous inhaled corticosteroid and initiation of one of four study treatments : three doses of MF-DPI ( 100 , 200 , and 400 microg twice daily ) and one of FP ( 250 microg twice daily > 12 weeks ) .

 ABSTRACT RESULTS
 FEV1 ( primary efficacy variable ) was evaluated as the mean change from baseline to endpoint ( last evaluable visit ) . All dosage groups showed improvement at endpoint . Only 400 microg twice daily of MF-DPI ( +0.19 L ) was statistically different from 100 microg twice daily of MF-DPI ( +0.07 L ; P = 0.02 ) . MF-DPI ( 200 microg twice daily ) and FP Diskhaler groups showed similar improvement ( +0.16 L ) . Greater improvement in most secondary variables ( forced expiratory flow between 25 % and 75 % of vital capacity , and morning and evening peak expiratory flows ) also resulted from treatment with 200 or 400 microg twice daily of MF-DPI or with FP Diskhaler , compared with 100 microg twice daily of MF-DPI . Overall , a total daily 800-microg dose of MF-DPI conferred no significant additional benefit > 400 microg of MF-DPI . The incidence of oral candidiasis was 1 % , 7 % , 10 % , and 10 % in the 100 , 200 , and 400 microg twice daily of MF-DPI and FP groups , respectively .

 ABSTRACT CONCLUSIONS
 A total daily dose of 400 microg of MF-DPI provides clinical benefit comparable to that observed with a total daily dose of 500 microg of FP Diskhaler .

Title

Dose-ranging

study

of

mometasone

furoate

dry

powder

inhaler

in

the

treatment

of

moderate

persistent

asthma

using

fluticasone

propionate

as

an

active

comparator

ABSTRACT BACKGROUND

Mometasone

furoate

MF

Schering-Plough

Madison

NJ

is

a

glucocorticoid

with

high

local

potency

and

low

potential

systemic

availability

ABSTRACT OBJECTIVE

To

compare

the

relative

efficacy

and

safety

of

a

new

formulation

of

MF

coupled

with

a

recently

designed

dry

powder

inhaler

DPI

in

the

treatment

of

patients

with

moderate

persistent

asthma

Fluticasone

propionate

administered

by

Diskhaler

FP

Diskhaler

microg

twice

a

day

Glaxo

Wellcome

Research

Triangle

Park

NC

was

used

as

an

active

control

ABSTRACT METHODS

A

randomized

parallel

group

double-blind

for

MF-DPI

dosage

evaluator-blind

for

MF-DPI

vs

FP

trial

ABSTRACT METHODS

Sixty

centers

in

countries

ABSTRACT METHODS

Seven

hundred

thirty-three

patients

with

moderate

persistent

asthma

on

inhaled

corticosteroid

treatment

ABSTRACT METHODS

Discontinuation

of

previous

inhaled

corticosteroid

and

initiation

of

one

of

four

study

treatments

three

doses

of

MF-DPI

and

microg

twice

daily

and

one

of

FP

microg

twice

daily

weeks

ABSTRACT RESULTS

primary

efficacy

variable

was

evaluated

as

the

mean

change

from

baseline

to

endpoint

last

evaluable

visit

All

dosage

groups

showed

improvement

at

endpoint

Only

microg

twice

daily

of

MF-DPI

L

was

statistically

different

from

microg

twice

daily

of

MF-DPI

L

P

MF-DPI

microg

twice

daily

and

FP

Diskhaler

groups

showed

similar

improvement

L

Greater

improvement

in

most

secondary

variables

forced

expiratory

flow

between

and

of

vital

capacity

and

morning

and

evening

peak

expiratory

flows

also

resulted

from

treatment

with

or

microg

twice

daily

of

MF-DPI

or

with

FP

Diskhaler

compared

with

microg

twice

daily

of

MF-DPI

Overall

a

total

daily

dose

of

MF-DPI

conferred

no

significant

additional

benefit

microg

of

MF-DPI

The

incidence

of

oral

candidiasis

was

and

in

the

and

microg

twice

daily

of

MF-DPI

and

FP

groups

respectively

ABSTRACT CONCLUSIONS

A

total

daily

dose

of

microg

of

MF-DPI

provides

clinical

benefit

comparable

to

that

observed

with

a

total

daily

dose

of

microg

of

FP

Diskhaler


Title
 Trazodone for erectile dysfunction : a systematic review and meta-analysis .

 ABSTRACT OBJECTIVE
 To determine the efficacy and safety of trazodone in the treatment of erectile dysfunction ( ED ) in a meta-analysis .

 ABSTRACT METHODS
 The data sources used were Medline and the Cochrane Library databases ( January 1966 to May 2002 ) , bibliographies of retrieved articles and review articles , and conference proceedings and abstracts . Trials were eligible for inclusion in the review if they included men with ED , compared trazodone with a control , were randomized , of > or = 7 days ' duration and assessed clinically relevant outcomes . Two reviewers independently evaluated study quality and extracted data in a standardized fashion .

 ABSTRACT RESULTS
 Six trials ( comprising 396 men ) met the inclusion criteria ; they consisted of heterogeneous populations , were small , brief and in some cases methodologically weak . Three of the six trials showed an apparently clinically meaningful benefit of trazodone for ED compared with placebo , the differences being statistically significant in two . In pooled results , trazodone monotherapy appeared more likely than placebo to lead to a ' positive treatment response ' , although this difference was not statistically significant ( 37 % vs 20 % ; relative benefit increase , 1.6 ; 95 % confidence interval , CI , 0.8-3.3 ) . Subgroup analyses suggested that men with psychogenic ED might be more likely to benefit from trazodone than those with mixed or physiological ED . The efficacy of trazodone also appeared greater at higher doses ( 150-200 vs 50 mg/day ) . Men randomized to trazodone were not significantly more likely than those receiving placebo to withdraw for any reason or for an adverse event , or to have specific adverse events , but wide CIs could not exclude a greater risk of these adverse outcomes with trazodone . Specific adverse events with trazodone included dry mouth ( 19 % ) , sedation ( 16 % ) , dizziness ( 16 % ) and fatigue ( 15 % ) .

 ABSTRACT CONCLUSIONS
 Trazodone may be helpful in men with ED , possibly more so at higher doses , and in men with psychogenic ED . Future high-quality trials should compare trazodone with placebo and other therapies in men with depression and psychogenic ED .

Title

Trazodone

for

erectile

dysfunction

a

systematic

review

and

meta-analysis

ABSTRACT OBJECTIVE

To

determine

the

efficacy

and

safety

of

trazodone

in

the

treatment

of

erectile

dysfunction

ED

in

a

meta-analysis

ABSTRACT METHODS

The

data

sources

used

were

Medline

and

the

Cochrane

Library

databases

January

to

May

bibliographies

of

retrieved

articles

and

review

articles

and

conference

proceedings

and

abstracts

Trials

were

eligible

for

inclusion

in

the

review

if

they

included

men

with

ED

compared

trazodone

with

a

control

were

randomized

of

or

days

duration

and

assessed

clinically

relevant

outcomes

Two

reviewers

independently

evaluated

study

quality

and

extracted

data

in

a

standardized

fashion

ABSTRACT RESULTS

Six

trials

comprising

men

met

the

inclusion

criteria

they

consisted

of

heterogeneous

populations

were

small

brief

and

in

some

cases

methodologically

weak

Three

of

the

six

trials

showed

an

apparently

clinically

meaningful

benefit

of

trazodone

for

ED

compared

with

placebo

the

differences

being

statistically

significant

in

two

In

pooled

results

trazodone

monotherapy

appeared

more

likely

than

placebo

to

lead

to

a

positive

treatment

response

although

this

difference

was

not

statistically

significant

vs

relative

benefit

increase

confidence

interval

CI

Subgroup

analyses

suggested

that

men

with

psychogenic

ED

might

be

more

likely

to

benefit

from

trazodone

than

those

with

mixed

or

physiological

ED

The

efficacy

of

trazodone

also

appeared

greater

at

higher

doses

vs

mg/day

Men

randomized

to

trazodone

were

not

significantly

more

likely

than

those

receiving

placebo

to

withdraw

for

any

reason

or

for

an

adverse

event

or

to

have

specific

adverse

events

but

wide

CIs

could

not

exclude

a

greater

risk

of

these

adverse

outcomes

with

trazodone

Specific

adverse

events

with

trazodone

included

dry

mouth

sedation

dizziness

and

fatigue

ABSTRACT CONCLUSIONS

Trazodone

may

be

helpful

in

men

with

ED

possibly

more

so

at

higher

doses

and

in

men

with

psychogenic

ED

Future

high-quality

trials

should

compare

trazodone

with

placebo

and

other

therapies

in

men

with

depression

and

psychogenic

ED


Title
 Immunotherapy with live BCG plus heat killed Leishmania induces a T helper 1-like response in American cutaneous leishmaniasis patients .

 ABSTRACT GENERAL
 Previous work has shown that American cutaneous leishmaniasis ( ACL ) patients treated with viable BCG plus heat killed promastigotes of Leishmania amazonensis show the same rate of cure as patients receiving conventional chemotherapy . The treatment is safe and economical , but the immunological correlates of cure have not been examined . In the present study , T cell responses have been analysed in 43 ACL patients , including patient groups sampled before and after therapy , and in 10 endemic controls . Lymphocyte proliferation , interferon ( IFN ) - gamma and interleukin ( IL ) -5 responses to crude antigen ( L. amazonensis , MEL ; Mycobacterium tuberculosis PPD ; M. bovis BCG ) stimulation , and serum IL-5 levels , were analysed . In endemic volunteers , proliferative responses to BCG were high and IFN-gamma responses low . In contrast , localized cutaneous ( LCL ) and mucocutaneous ( MCL ) patients showed low proliferative and high IFN-gamma responses to BCG . Treatment enhanced the IFN-gamma response and further decreased the proliferative response to BCG , especially in MCL patients . LCL and MCL patients showed an increase in proliferative and IFN-gamma responses to MEL with treatment , but the response was not exaggerated in MCL patients , either before or after treatment , compared to LCL patients . IL-5 production was low in T cell assays , and > 62 % of untreated patients had very low serum IL-5 levels . There were no significant changes in serum IL-5 with treatment . Overall results show enhanced antigen-specific IFN-gamma responses to the two components of the immunotherapy , live M. bovis BCG and heat killed L. amazonensis , which is consistent with a shift in balance of T cell response towards a T helper 1 response and clinical cure mediated by IFN-gamma .

Title

Immunotherapy

with

live

BCG

plus

heat

killed

Leishmania

induces

a

T

helper

response

in

American

cutaneous

leishmaniasis

patients

ABSTRACT GENERAL

Previous

work

has

shown

that

American

cutaneous

leishmaniasis

ACL

patients

treated

with

viable

BCG

plus

heat

killed

promastigotes

of

Leishmania

amazonensis

show

the

same

rate

of

cure

as

patients

receiving

conventional

chemotherapy

The

treatment

is

safe

and

economical

but

the

immunological

correlates

of

cure

have

not

been

examined

In

the

present

study

T

cell

responses

have

been

analysed

in

ACL

patients

including

patient

groups

sampled

before

and

after

therapy

and

in

endemic

controls

Lymphocyte

proliferation

interferon

IFN

gamma

and

interleukin

IL

responses

to

crude

antigen

L.

amazonensis

MEL

Mycobacterium

tuberculosis

PPD

M.

bovis

BCG

stimulation

and

serum

levels

were

analysed

In

endemic

volunteers

proliferative

responses

to

BCG

were

high

and

IFN-gamma

responses

low

In

contrast

localized

cutaneous

LCL

and

mucocutaneous

MCL

patients

showed

low

proliferative

and

high

IFN-gamma

responses

to

BCG

Treatment

enhanced

the

IFN-gamma

response

and

further

decreased

the

proliferative

response

to

BCG

especially

in

MCL

patients

LCL

and

MCL

patients

showed

an

increase

in

proliferative

and

IFN-gamma

responses

to

MEL

with

treatment

but

the

response

was

not

exaggerated

in

MCL

patients

either

before

or

after

treatment

compared

to

LCL

patients

production

was

low

in

T

cell

assays

and

of

untreated

patients

had

very

low

serum

levels

There

were

no

significant

changes

in

serum

with

treatment

Overall

results

show

enhanced

antigen-specific

IFN-gamma

responses

to

the

two

components

of

the

immunotherapy

live

M.

bovis

BCG

and

heat

killed

L.

amazonensis

which

is

consistent

with

a

shift

in

balance

of

T

cell

response

towards

a

T

helper

response

and

clinical

cure

mediated

by

IFN-gamma


Title
 Prospective , multicenter study of managing lower extremity venous ulcers .

 ABSTRACT GENERAL
 Seventy patients with 90 venous ulcers were randomly assigned to hydrocolloid or conventional dressing and compression therapy at four study centers . The ulcers had been present for a mean of 47.8 in the control and 46.2 weeks in the treatment group and 42 % of all patients had recurrent ulcers . Ulcers treated with hydrocolloid dressings reduced 71 % and control treated wounds reduced 43 % in area after 7.2 weeks of treatment . Thirty-four percent of all ulcers healed . Mean time to healing was 7 weeks for the hydrocolloid dressing group and 8 weeks for the control group . Most ulcers were less painful at final evaluation , but reduction in pain was more pronounced in hydrocolloid-dressed ulcers ( p = 0.03 ) . At baseline as well as during follow-up , significant differences between study centers were observed . Ulcers in patients in the United Kingdom were larger and less likely to heal ( p = 0.001 ) . Size of the ulcer at baseline was associated with treatment response and time to healing ( p = 0.002 ) . Percent reduction in ulcer area after 2 weeks was also correlated with treatment outcome ( p = 0.004 ) and time to healing ( p = 0.002 ) . When all treatment outcome predictors were analyzed together , only percent reduction in area after 2 weeks remained statistically significant ( p = 0.002 ) , with percent reduction during the first 2 weeks of treatment > 30 % predicting healing .

Title

Prospective

multicenter

study

of

managing

lower

extremity

venous

ulcers

ABSTRACT GENERAL

Seventy

patients

with

venous

ulcers

were

randomly

assigned

to

hydrocolloid

or

conventional

dressing

and

compression

therapy

at

four

study

centers

The

ulcers

had

been

present

for

a

mean

of

in

the

control

and

weeks

in

the

treatment

group

and

of

all

patients

had

recurrent

ulcers

Ulcers

treated

with

hydrocolloid

dressings

reduced

and

control

treated

wounds

reduced

in

area

after

weeks

of

treatment

Thirty-four

percent

of

all

ulcers

healed

Mean

time

to

healing

was

weeks

for

the

hydrocolloid

dressing

group

and

weeks

for

the

control

group

Most

ulcers

were

less

painful

at

final

evaluation

but

reduction

in

pain

was

more

pronounced

in

hydrocolloid-dressed

ulcers

p

At

baseline

as

well

as

during

follow-up

significant

differences

between

study

centers

were

observed

Ulcers

in

patients

in

the

United

Kingdom

were

larger

and

less

likely

to

heal

p

Size

of

the

ulcer

at

baseline

was

associated

with

treatment

response

and

time

to

healing

p

Percent

reduction

in

ulcer

area

after

weeks

was

also

correlated

with

treatment

outcome

p

and

time

to

healing

p

When

all

treatment

outcome

predictors

were

analyzed

together

only

percent

reduction

in

area

after

weeks

remained

statistically

significant

p

with

percent

reduction

during

the

first

weeks

of

treatment

predicting

healing


Title
 Management and efficacy of intensified insulin therapy -- starting in outpatients .

 ABSTRACT GENERAL
 Diabetic patients under multiple injection insulin therapy ( i.e. , intensified insulin therapy , IIT ) usually start this treatment during hospitalization . We report here on the logistics , efficacy , and safety of IIT , started in outpatients . Over 8 months , 52 type I and type II diabetics were followed up whose insulin regimens consecutively had been changed from conventional therapy to IIT . Two different IIT strategies were compared : free mixtures of regular and intermediate ( 12 hrs ) - acting insulin versus the basal and prandial insulin treatment with preprandial injections of regular insulin , and ultralente ( 24 hrs-acting ) or intermediate insulin for the basal demand . After 8 months HbA1 levels had decreased from 10.6 % + / - 2.4 % to 8.0 % + / - 1.3 % ( mean + / - SD ) . There was no difference between the two regimens with respect to metabolic control ; but type II patients maintained the lowered HbA1 levels better than type I patients . Only two patients were hospitalized during the follow-up time because of severe hypoglycemia . An increase of body weight due to the diet liberalization during IIT became a problem in one-third of the patients . Our results suggest that outpatient initiation of IIT is safe and efficacious with respect to near-normoglycemic control . Weight control may become a problem in IIT patients .

Title

Management

and

efficacy

of

intensified

insulin

therapy

starting

in

outpatients

ABSTRACT GENERAL

Diabetic

patients

under

multiple

injection

insulin

therapy

i.e.

intensified

insulin

therapy

IIT

usually

start

this

treatment

during

hospitalization

We

report

here

on

the

logistics

efficacy

and

safety

of

IIT

started

in

outpatients

Over

months

type

I

and

type

II

diabetics

were

followed

up

whose

insulin

regimens

consecutively

had

been

changed

from

conventional

therapy

to

IIT

Two

different

IIT

strategies

were

compared

free

mixtures

of

regular

and

intermediate

hrs

acting

insulin

versus

the

basal

and

prandial

insulin

treatment

with

preprandial

injections

of

regular

insulin

and

ultralente

hrs-acting

or

intermediate

insulin

for

the

basal

demand

After

months

levels

had

decreased

from

to

mean

SD

There

was

no

difference

between

the

two

regimens

with

respect

to

metabolic

control

but

type

II

patients

maintained

the

lowered

levels

better

than

type

I

patients

Only

two

patients

were

hospitalized

during

the

follow-up

time

because

of

severe

hypoglycemia

An

increase

of

body

weight

due

to

the

diet

liberalization

during

IIT

became

a

problem

in

one-third

of

the

patients

Our

results

suggest

that

outpatient

initiation

of

IIT

is

safe

and

efficacious

with

respect

to

near-normoglycemic

control

Weight

control

may

become

a

problem

in

IIT

patients


Title
 Working memory differences in illusory recollection of critical lures .

 ABSTRACT GENERAL
 In the present experiments , we explored the relationship between individual differences in working memory ( WM ) capacity and susceptibility to false recognitions and their accompanying subjective experiences . Deese/Roediger-McDermott ( DRM ) associative lists were used to elicit false memories , and remember/know judgments were used to measure the recollective experiences accompanying recognition decisions . We found that WM capacity was related to false recognitions of nonpresented critical lures and to the proportion of remember responses given to critical lures , such that higher WM capacity was associated with lower false-recognition rates and with lower proportions of remember responses . Importantly , these WM differences were only found when participants were forewarned about the nature of the DRM task prior to encoding ( Exp . 1 ) . When the forewarning was absent , WM capacity was not related to false recognitions or to the proportion of remember responses given to critical lures ( Exp . 2 ) . These results support the controlled-attention view of WM and suggest that subjective experiences of falsely recognized lures fluctuate as a function of WM capacity .

Title

Working

memory

differences

in

illusory

recollection

of

critical

lures

ABSTRACT GENERAL

In

the

present

experiments

we

explored

the

relationship

between

individual

differences

in

working

memory

WM

capacity

and

susceptibility

to

false

recognitions

and

their

accompanying

subjective

experiences

Deese/Roediger-McDermott

DRM

associative

lists

were

used

to

elicit

false

memories

and

remember/know

judgments

were

used

to

measure

the

recollective

experiences

accompanying

recognition

decisions

We

found

that

WM

capacity

was

related

to

false

recognitions

of

nonpresented

critical

lures

and

to

the

proportion

of

remember

responses

given

to

critical

lures

such

that

higher

WM

capacity

was

associated

with

lower

false-recognition

rates

and

with

lower

proportions

of

remember

responses

Importantly

these

WM

differences

were

only

found

when

participants

were

forewarned

about

the

nature

of

the

DRM

task

prior

to

encoding

Exp

When

the

forewarning

was

absent

WM

capacity

was

not

related

to

false

recognitions

or

to

the

proportion

of

remember

responses

given

to

critical

lures

Exp

These

results

support

the

controlled-attention

view

of

WM

and

suggest

that

subjective

experiences

of

falsely

recognized

lures

fluctuate

as

a

function

of

WM

capacity


Title
 [ The principles of designing stump pin inserts in pathological tooth abrasion ] .

 ABSTRACT GENERAL
 A total of 278 patients aged 40 to 67 with pathological abrasion of hard dental tissues were treated . Decreased occlusion height was diagnosed in 152 ( 54.67 % ) of these . In 146 patients abutment teeth under permanent dentures were fixed with cast stump pin insertions . Complications occurred in 9.6 % cases : perforation of the wall of the root canal ( 1.14 % ) , failure of cementing ( 3.98 % ) , fracture of the root ( 1.14 % ) , breaking of a fragment of the root at the neck of the tooth ( 2.84 % ) , and inflammations of the marginal periodontium ( 0.57 % ) . In order to prevent these complications and improve the fixation of cast stump pin insertion , we used our modifications of cast stump pin insertions ( n = 394 ) for anterior and lateral teeth . The incidence of complications decreased more than 5 times . Follow-up of 2 to 8 years showed 1.78 % of complications .

Title

The

principles

of

designing

stump

pin

inserts

in

pathological

tooth

abrasion

ABSTRACT GENERAL

A

total

of

patients

aged

to

with

pathological

abrasion

of

hard

dental

tissues

were

treated

Decreased

occlusion

height

was

diagnosed

in

of

these

In

patients

abutment

teeth

under

permanent

dentures

were

fixed

with

cast

stump

pin

insertions

Complications

occurred

in

cases

perforation

of

the

wall

of

the

root

canal

failure

of

cementing

fracture

of

the

root

breaking

of

a

fragment

of

the

root

at

the

neck

of

the

tooth

and

inflammations

of

the

marginal

periodontium

In

order

to

prevent

these

complications

and

improve

the

fixation

of

cast

stump

pin

insertion

we

used

our

modifications

of

cast

stump

pin

insertions

n

for

anterior

and

lateral

teeth

The

incidence

of

complications

decreased

more

than

times

Follow-up

of

to

years

showed

of

complications


Title
 [ Pathophysiology and treatment of congestive heart failure -- recently advanced strategy for heart failure ] .

 ABSTRACT GENERAL
 The principle functions of the heart are to accept blood from the systemic and the pulmonary circulatory system , pump and deliver it to the whole body tissues and lungs . The term " heart failure " is used to describe the pathophysiological state in which an abnormality of cardiac function is responsible for failure of the heart to pump blood at a rate commensurate with the requirements of the metabolizing tissues , or to do so only from an elevated filling pressure . Thus , for a long period , heart failure has been thought of as a mechanical disorder of the heart and vessels , and its treatment has been based on improving impaired cardiac function and hemodynamic disorder . Recently multi-center , randomized placebo-controlled survival trials revealed that pure inotropic agents such as phosphodiesterase inhibitors succeeded in mechanical improvement , yet not only failed to prolong the patient 's life , but also increased mortality . A number of neurohumoral mechanisms , which are activated in heart failure , were thought to be compensatory ones . However , survival trials demonstrated that two types of drug interfering with the renin-angiotensin system and the sympathetic nervous system reduced mortality . Those drugs are angiotensin-converting enzyme ( ACE ) inhibitors and beta blockers . ACE inhibitors reduce the direct effects of angiotensin II on myocardial cells , which may lead to cell necrosis , imbalanced remodeling through fibrosis , and attenuate the progressive ventricular dilatation . Local tissue renin-angiotensin system may be potentially important in regulating the angiotensin II production in both heart and vessels . ( ABSTRACT TRUNCATED AT 250 WORDS )

Title

Pathophysiology

and

treatment

of

congestive

heart

failure

recently

advanced

strategy

for

heart

failure

ABSTRACT GENERAL

The

principle

functions

of

the

heart

are

to

accept

blood

from

the

systemic

and

the

pulmonary

circulatory

system

pump

and

deliver

it

to

the

whole

body

tissues

and

lungs

The

term

heart

failure

is

used

to

describe

the

pathophysiological

state

in

which

an

abnormality

of

cardiac

function

is

responsible

for

failure

of

the

heart

to

pump

blood

at

a

rate

commensurate

with

the

requirements

of

the

metabolizing

tissues

or

to

do

so

only

from

an

elevated

filling

pressure

Thus

for

a

long

period

heart

failure

has

been

thought

of

as

a

mechanical

disorder

of

the

heart

and

vessels

and

its

treatment

has

been

based

on

improving

impaired

cardiac

function

and

hemodynamic

disorder

Recently

multi-center

randomized

placebo-controlled

survival

trials

revealed

that

pure

inotropic

agents

such

as

phosphodiesterase

inhibitors

succeeded

in

mechanical

improvement

yet

not

only

failed

to

prolong

the

patient

's

life

but

also

increased

mortality

A

number

of

neurohumoral

mechanisms

which

are

activated

in

heart

failure

were

thought

to

be

compensatory

ones

However

survival

trials

demonstrated

that

two

types

of

drug

interfering

with

the

renin-angiotensin

system

and

the

sympathetic

nervous

system

reduced

mortality

Those

drugs

are

angiotensin-converting

enzyme

ACE

inhibitors

and

beta

blockers

ACE

inhibitors

reduce

the

direct

effects

of

angiotensin

II

on

myocardial

cells

which

may

lead

to

cell

necrosis

imbalanced

remodeling

through

fibrosis

and

attenuate

the

progressive

ventricular

dilatation

Local

tissue

renin-angiotensin

system

may

be

potentially

important

in

regulating

the

angiotensin

II

production

in

both

heart

and

vessels

ABSTRACT

TRUNCATED

AT

WORDS


Title
 [ Comparison of the hemodynamic effects induced by dobutamine , isoproterenol and dopamine in patients with coronary artery disease ( author 's transl ) ] .

 ABSTRACT GENERAL
 The haemodynamic affects of dobutamine ( DB ) ( 5 microgram/kg/min ) , isoproterenol ( I ) ( 0.02 microgram/kg/min ) , dopamine ( DP ) ( 5 microgram/kg/min ) , were studied in 12 patients with coronary artery disease randomly divided in two groups of 6 patients . In one group each patient received DB and I , in the other group each patient received DB and DP . The following parameters were measured : heart rate , aortic blood pressure , left ventricular pressure , left ventricular dp/dt , pulmonary arterial and wedge pressure , cardiac output , stroke volume , peripheral and pulmonary vascular resistances . In both groups either I and DP increased significantly heart rate whereas DB did not modifie it . DB caused a larger increase of dp/dt max and of stroke volume as compared to I and DP . These data confirm that DB possesses an inotropic effect greater than I and DP without any significant positive chronotropic effect in patients with coronary artery disease .

Title

Comparison

of

the

hemodynamic

effects

induced

by

dobutamine

isoproterenol

and

dopamine

in

patients

with

coronary

artery

disease

author

's

transl

ABSTRACT GENERAL

The

haemodynamic

affects

of

dobutamine

DB

microgram/kg/min

isoproterenol

I

microgram/kg/min

dopamine

DP

microgram/kg/min

were

studied

in

patients

with

coronary

artery

disease

randomly

divided

in

two

groups

of

patients

In

one

group

each

patient

received

DB

and

I

in

the

other

group

each

patient

received

DB

and

DP

The

following

parameters

were

measured

heart

rate

aortic

blood

pressure

left

ventricular

pressure

left

ventricular

dp/dt

pulmonary

arterial

and

wedge

pressure

cardiac

output

stroke

volume

peripheral

and

pulmonary

vascular

resistances

In

both

groups

either

I

and

DP

increased

significantly

heart

rate

whereas

DB

did

not

modifie

it

DB

caused

a

larger

increase

of

dp/dt

max

and

of

stroke

volume

as

compared

to

I

and

DP

These

data

confirm

that

DB

possesses

an

inotropic

effect

greater

than

I

and

DP

without

any

significant

positive

chronotropic

effect

in

patients

with

coronary

artery

disease


Title
 Biweekly docetaxel as second-line chemotherapy of patients with advanced non-small cell lung cancer : a phase II study of the Galician Lung Cancer Group ( GGCP 006-00 ) .

 ABSTRACT GENERAL
 This phase II trial assessed the antitumoral activity and toxicity of docetaxel 50 mg/m ( 1-h i.v. infusion ) administered every 2 weeks as second-line treatment in 45 patients with advanced non-small cell lung cancer ( NSCLC ) . A total of 251 infusions ( median 4 per patient ) were administered . The actual and relative median dose intensity values were 24.2 mg/m/week and 0.97 , respectively . Thirty-seven patients were evaluable for tumor response . The overall response rate was 20 % [ 95 % confidence interval ( CI ) 8-32 % ] and included one complete response ( 2 % ) and eight partial responses ( 18 % ) . Stable disease was found in seven patients ( 16 % ) . With a median follow-up of 4 months , the median time to disease progression was 2.8 months ( 95 % CI 1.9-3.7 ) , the median overall survival was 4.0 months ( 95 % CI 3.4-4.6 ) and the 1-year survival rate was 23 % ( 95 % CI 9-37 ) . The every-2-weeks docetaxel schedule was well tolerated . Grade 3/4 non-hematological toxicities showed rates of 5 % or less of patients and 2 % or less of cycles . The main grade 3/4 hematological toxicity was neutropenia ( 16 % of patients and 8 % of cycles ) . No febrile neutropenia was found . Nevertheless , one toxic death was reported . We conclude that the biweekly docetaxel schedule showed an antitumoral activity similar to that found with the every-3-weeks or weekly docetaxel schedule in a second-line setting for advanced NSCLC . This antitumoral effect was associated with a marked reduction in hematological toxicity , therefore suggesting that this new docetaxel schedule might be useful in the design of combined second-line schedules for treating NSCLC .

Title

Biweekly

docetaxel

as

second-line

chemotherapy

of

patients

with

advanced

non-small

cell

lung

cancer

a

phase

II

study

of

the

Galician

Lung

Cancer

Group

GGCP

ABSTRACT GENERAL

This

phase

II

trial

assessed

the

antitumoral

activity

and

toxicity

of

docetaxel

mg/m

i.v.

infusion

administered

every

weeks

as

second-line

treatment

in

patients

with

advanced

non-small

cell

lung

cancer

NSCLC

A

total

of

infusions

median

per

patient

were

administered

The

actual

and

relative

median

dose

intensity

values

were

mg/m/week

and

respectively

Thirty-seven

patients

were

evaluable

for

tumor

response

The

overall

response

rate

was

confidence

interval

CI

and

included

one

complete

response

and

eight

partial

responses

Stable

disease

was

found

in

seven

patients

With

a

median

follow-up

of

months

the

median

time

to

disease

progression

was

months

CI

the

median

overall

survival

was

months

CI

and

the

survival

rate

was

CI

The

docetaxel

schedule

was

well

tolerated

Grade

non-hematological

toxicities

showed

rates

of

or

less

of

patients

and

or

less

of

cycles

The

main

grade

hematological

toxicity

was

neutropenia

of

patients

and

of

cycles

No

febrile

neutropenia

was

found

Nevertheless

one

toxic

death

was

reported

We

conclude

that

the

biweekly

docetaxel

schedule

showed

an

antitumoral

activity

similar

to

that

found

with

the

or

weekly

docetaxel

schedule

in

a

second-line

setting

for

advanced

NSCLC

This

antitumoral

effect

was

associated

with

a

marked

reduction

in

hematological

toxicity

therefore

suggesting

that

this

new

docetaxel

schedule

might

be

useful

in

the

design

of

combined

second-line

schedules

for

treating

NSCLC


Title
 Improving healthy dietary behaviors , nutrition knowledge , and self-efficacy among underserved school children with parent and community involvement .

 ABSTRACT BACKGROUND
 University – community partnerships through coordinated school health programs ( CSHP ) can play a key role in decreasing child obesity . The main objective of this study was to measure over a 1-year period whether a CSHP with parental , school , and home-based components to promote optimal nutrition will reduce BMI percentiles and z-scores and improve dietary behaviors in a sample of low-income , school-aged children .

 ABSTRACT METHODS
 The intervention included , Kids Nutrition and Fitness , a 6-week nutrition , physical activity educational after-school program , and school activities , including creation of an Advisory Committee that made wellness policies . A randomized controlled pilot study evaluated the effectiveness of the intervention that contrasts 251 ( n = 251 ) predominantly Mexican-American 8 to 12 year olds from low-income Los Angeles – based schools . A mixed model of repeated measures analysis assessed changes in BMI percentiles and z-scores , dietary behaviors , food preferences , knowledge , and self-efficacy measured by a reliable/valid questionnaire . These data were collected at baseline and at 4 and 12 months postintervention . Process measures , collected via focus groups with parents , evaluated parent/community involvement .

 ABSTRACT RESULTS
 At the 12-month follow-up , children in the intervention group decreased their BMI on average by 2.80 ( p = 0.04 ) and BMI z-scores on average by 0.48 ( p = 0.03 ) and they increased their daily dietary intake of vegetables on average by 1.51 ( p = 0.03 ) , fruit on average by 2.00 ( P = 0.001 ) , and 100 % fruit juice by 1.12 ( p = 0.05 ) . An increase of 1.02 ( p = 0.03 ) was seen in self-efficacy of healthy food choices ( p = 0.03 ) . Parent ( P = 0.04 ) and community ( p = 0.001 ) involvement significantly increased to 100 % participation by the 12-month follow-up .

 ABSTRACT CONCLUSIONS
 A CSHP using parent and community involvement was effective in reducing the risk of obesity in school-aged Mexican - American children attending low-income schools . The findings need to be examined in a larger , more diverse sample of children .

Title

Improving

healthy

dietary

behaviors

nutrition

knowledge

and

self-efficacy

among

underserved

school

children

with

parent

and

community

involvement

ABSTRACT BACKGROUND

University

community

partnerships

through

coordinated

school

health

programs

CSHP

can

play

a

key

role

in

decreasing

child

obesity

The

main

objective

of

this

study

was

to

measure

over

a

period

whether

a

CSHP

with

parental

school

and

home-based

components

to

promote

optimal

nutrition

will

reduce

BMI

percentiles

and

z-scores

and

improve

dietary

behaviors

in

a

sample

of

low-income

school-aged

children

ABSTRACT METHODS

The

intervention

included

Kids

Nutrition

and

Fitness

a

nutrition

physical

activity

educational

after-school

program

and

school

activities

including

creation

of

an

Advisory

Committee

that

made

wellness

policies

A

randomized

controlled

pilot

study

evaluated

the

effectiveness

of

the

intervention

that

contrasts

n

predominantly

Mexican-American

to

year

olds

from

low-income

Los

Angeles

based

schools

A

mixed

model

of

repeated

measures

analysis

assessed

changes

in

BMI

percentiles

and

z-scores

dietary

behaviors

food

preferences

knowledge

and

self-efficacy

measured

by

a

reliable/valid

questionnaire

These

data

were

collected

at

baseline

and

at

and

months

postintervention

Process

measures

collected

via

focus

groups

with

parents

evaluated

parent/community

involvement

ABSTRACT RESULTS

At

the

follow-up

children

in

the

intervention

group

decreased

their

BMI

on

average

by

p

and

BMI

z-scores

on

average

by

p

and

they

increased

their

daily

dietary

intake

of

vegetables

on

average

by

p

fruit

on

average

by

P

and

fruit

juice

by

p

An

increase

of

p

was

seen

in

self-efficacy

of

healthy

food

choices

p

Parent

P

and

community

p

involvement

significantly

increased

to

participation

by

the

follow-up

ABSTRACT CONCLUSIONS

A

CSHP

using

parent

and

community

involvement

was

effective

in

reducing

the

risk

of

obesity

in

school-aged

Mexican

American

children

attending

low-income

schools

The

findings

need

to

be

examined

in

a

larger

more

diverse

sample

of

children


Title
 Metastatic renal cell carcinoma treated with purified leukocyte interferon . Clinical response in relation to tumor DNA content .

 ABSTRACT GENERAL
 Twenty-eight patients with renal cell carcinoma and evaluable metastases were treated with a purified leukocyte interferon 2-7 x 10 ( 6 ) IU daily . DNA content was analyzed by flow cytometry . Nine patients had lung metastases only , 12 had dissemination to lungs and to other sites as well , and 7 had metastases in other sites only . Two patients had complete response and one had minor response of lung metastases . Another 3 patients had mixed responses : 2 of them complete disappearance and one minor response of lung metastases but concomitant progression of skeletal and abdominal metastases . The overall response rate restricted to lung metastases only was 21 % ( 6 of 28 patients ) including the 3 patients with mixed response . The 6 patients with any kind of response were found among 19 patients with aneuploid primary tumors while no response was noted in 8 patients with diploid tumors .

Title

Metastatic

renal

cell

carcinoma

treated

with

purified

leukocyte

interferon

Clinical

response

in

relation

to

tumor

DNA

content

ABSTRACT GENERAL

Twenty-eight

patients

with

renal

cell

carcinoma

and

evaluable

metastases

were

treated

with

a

purified

leukocyte

interferon

x

IU

daily

DNA

content

was

analyzed

by

flow

cytometry

Nine

patients

had

lung

metastases

only

had

dissemination

to

lungs

and

to

other

sites

as

well

and

had

metastases

in

other

sites

only

Two

patients

had

complete

response

and

one

had

minor

response

of

lung

metastases

Another

patients

had

mixed

responses

of

them

complete

disappearance

and

one

minor

response

of

lung

metastases

but

concomitant

progression

of

skeletal

and

abdominal

metastases

The

overall

response

rate

restricted

to

lung

metastases

only

was

of

patients

including

the

patients

with

mixed

response

The

patients

with

any

kind

of

response

were

found

among

patients

with

aneuploid

primary

tumors

while

no

response

was

noted

in

patients

with

diploid

tumors


Title
 Profile changes of bone and soft tissues following vestibular sulcus extension by the operation of Edlan and Mejchar . A 2-year follow-up study-II .

 ABSTRACT GENERAL
 The progression of alveolar resorption and the alteration of the soft tissue profile of the chin were studied in 15 patients operated on by the vestibular sulcus extension technique of EDLAN & MEJCHAR . Lateral cephalograms and tracings exhibited an apparently accelerated bone resorption of the alveolar crest . Furthermore , a significant reduction of lower lip height and increase of mental soft tissue protrusion have been recorded .

Title

Profile

changes

of

bone

and

soft

tissues

following

vestibular

sulcus

extension

by

the

operation

of

Edlan

and

Mejchar

A

follow-up

study-II

ABSTRACT GENERAL

The

progression

of

alveolar

resorption

and

the

alteration

of

the

soft

tissue

profile

of

the

chin

were

studied

in

patients

operated

on

by

the

vestibular

sulcus

extension

technique

of

EDLAN

MEJCHAR

Lateral

cephalograms

and

tracings

exhibited

an

apparently

accelerated

bone

resorption

of

the

alveolar

crest

Furthermore

a

significant

reduction

of

lower

lip

height

and

increase

of

mental

soft

tissue

protrusion

have

been

recorded


Title
 Erythropoietin treatment is associated with an augmented immune response to the influenza vaccine in hematologic patients .

 ABSTRACT GENERAL
 The objective of this study was to examine whether treatment with recombinant human erythropoietin ( rHuEPO ) , previously found to be associated with a positive effect on cell-mediated immunity and humoral immunity ( hepatitis B vaccine ) , is associated with an improved response to the seasonal influenza ( flu ) vaccine . Three groups received flu vaccine : healthy controls , hematologic patients not treated with rHuEPO ( " No EPO " group ) , and hematologic patients receiving rHuEPO for their anemia ( " EPO " group ) . Anti-flu Ab titer was measured ( complement fixation test ) from blood samples drawn before and approximately 3-4 weeks , 7-8 weeks and 4 months after vaccination . Nineteen healthy subjects were compared with 17 No EPO and 17 EPO patients . Mean ages were 59.5 , 61.3 , and 73.1 years , respectively ( EPO patients were older ; p = 0.005 ) . In the healthy group , the percentage of those sustaining only a partial ( twofold ) response , a strong ( fourfold or greater ) response , and an overall response ( combined partial and strong responses ) were 31.6 % , 57.9 % , and 89.5 % , respectively . In the No EPO group , values were 35.3 % , 17.6 % , and 52.9 % , respectively . EPO group results were similar to those of the healthy controls : 23.5 % , 58.8 % , and 82.4 % ( p = 0.016 , EPO vs. No EPO ) . In conclusion , hematologic patients ( NoEPO group ) respond poorly to the flu vaccine , compared with healthy subjects , and rHuEPO treatment is associated with an improved immune response to the flu vaccine in hematologic patients , with titers similar to those of healthy subjects .

Title

Erythropoietin

treatment

is

associated

with

an

augmented

immune

response

to

the

influenza

vaccine

in

hematologic

patients

ABSTRACT GENERAL

The

objective

of

this

study

was

to

examine

whether

treatment

with

recombinant

human

erythropoietin

rHuEPO

previously

found

to

be

associated

with

a

positive

effect

on

cell-mediated

immunity

and

humoral

immunity

hepatitis

B

vaccine

is

associated

with

an

improved

response

to

the

seasonal

influenza

flu

vaccine

Three

groups

received

flu

vaccine

healthy

controls

hematologic

patients

not

treated

with

rHuEPO

No

EPO

group

and

hematologic

patients

receiving

rHuEPO

for

their

anemia

EPO

group

Anti-flu

Ab

titer

was

measured

complement

fixation

test

from

blood

samples

drawn

before

and

approximately

weeks

weeks

and

months

after

vaccination

Nineteen

healthy

subjects

were

compared

with

No

EPO

and

EPO

patients

Mean

ages

were

and

years

respectively

EPO

patients

were

older

p

In

the

healthy

group

the

percentage

of

those

sustaining

only

a

partial

twofold

response

a

strong

fourfold

or

greater

response

and

an

overall

response

combined

partial

and

strong

responses

were

and

respectively

In

the

No

EPO

group

values

were

and

respectively

EPO

group

results

were

similar

to

those

of

the

healthy

controls

and

p

EPO

vs.

No

EPO

In

conclusion

hematologic

patients

NoEPO

group

respond

poorly

to

the

flu

vaccine

compared

with

healthy

subjects

and

rHuEPO

treatment

is

associated

with

an

improved

immune

response

to

the

flu

vaccine

in

hematologic

patients

with

titers

similar

to

those

of

healthy

subjects


Title
 Closed system endotracheal suctioning maintains lung volume during volume-controlled mechanical ventilation .

 ABSTRACT OBJECTIVE
 A closed suction system ( CS ) maintains connection with the mechanical ventilator during tracheal suctioning and is claimed to limit loss in lung volume and oxygenation . We compared changes in lung volume , oxygenation , airway pressure and hemodynamics during endotracheal suctioning performed with CS and with an open suction system ( OS ) .

 ABSTRACT METHODS
 Prospective , randomized study .

 ABSTRACT METHODS
 Intensive care unit in a university hospital .

 ABSTRACT METHODS
 We enrolled ten patients , volume-controlled ( VC ) ventilated with a Siemens Servo 900 ventilator ( PaO2/FIO2 192 + / - 70 , PEEP 10.7 + / - 3.9 cmH2O ) .

 ABSTRACT METHODS
 We performed four consecutive tracheal suction maneuvers , two with CS and two with OS , at 20-min intervals . During the suction maneuvers continuous suction was applied for 20 s.

 ABSTRACT RESULTS
 We measured end-expiratory lung volume changes ( delta VL ) , tidal volume ( VTrt ) , respiratory rate ( RR ) and minute volume ( VErt ) by respiratory inductive plethysmography ; arterial oxygen saturation ( SpO2 ) , airway pressure and arterial pressure ( PA ) . Loss in lung volume during OS ( delta VL 1.2 + / - 0.7 l ) was significantly higher than during CS ( delta VL 0.14 + / - 0.1 l ) . During OS we observed a marked drop in SpO2 , while during CS the change was only minor . During CS ventilation was not interrupted and we observed an immediate increase in RR ( due to the activation of the ventilator 's trigger ) , while VTrt decreased , VErt was maintained .

 ABSTRACT CONCLUSIONS
 Avoiding suction-related lung volume loss can be helpful in patients with an increased tendency to alveolar collapse ; CS allows suctioning while avoiding dramatic drops in lung volumes and seems to be safe during the VC ventilation setting that we used .

Title

Closed

system

endotracheal

suctioning

maintains

lung

volume

during

volume-controlled

mechanical

ventilation

ABSTRACT OBJECTIVE

A

closed

suction

system

CS

maintains

connection

with

the

mechanical

ventilator

during

tracheal

suctioning

and

is

claimed

to

limit

loss

in

lung

volume

and

oxygenation

We

compared

changes

in

lung

volume

oxygenation

airway

pressure

and

hemodynamics

during

endotracheal

suctioning

performed

with

CS

and

with

an

open

suction

system

OS

ABSTRACT METHODS

Prospective

randomized

study

ABSTRACT METHODS

Intensive

care

unit

in

a

university

hospital

ABSTRACT METHODS

We

enrolled

ten

patients

volume-controlled

VC

ventilated

with

a

Siemens

Servo

ventilator

PEEP

ABSTRACT METHODS

We

performed

four

consecutive

tracheal

suction

maneuvers

two

with

CS

and

two

with

OS

at

intervals

During

the

suction

maneuvers

continuous

suction

was

applied

for

s.

ABSTRACT RESULTS

We

measured

end-expiratory

lung

volume

changes

delta

VL

tidal

volume

VTrt

respiratory

rate

RR

and

minute

volume

VErt

by

respiratory

inductive

plethysmography

arterial

oxygen

saturation

airway

pressure

and

arterial

pressure

PA

Loss

in

lung

volume

during

OS

delta

VL

l

was

significantly

higher

than

during

CS

delta

VL

l

During

OS

we

observed

a

marked

drop

in

while

during

CS

the

change

was

only

minor

During

CS

ventilation

was

not

interrupted

and

we

observed

an

immediate

increase

in

RR

due

to

the

activation

of

the

ventilator

's

trigger

while

VTrt

decreased

VErt

was

maintained

ABSTRACT CONCLUSIONS

Avoiding

suction-related

lung

volume

loss

can

be

helpful

in

patients

with

an

increased

tendency

to

alveolar

collapse

CS

allows

suctioning

while

avoiding

dramatic

drops

in

lung

volumes

and

seems

to

be

safe

during

the

VC

ventilation

setting

that

we

used


Title
 [ Analysis of genetic expression of FMR-1 gene in male patients with fragile X syndrome using RT-PCR method ] .

Title

Analysis

of

genetic

expression

of

gene

in

male

patients

with

fragile

X

syndrome

using

RT-PCR

method


Title
 Estimation of the area under the concentration-versus-time curve of carboplatin following irinotecan using a limited sampling model .

 ABSTRACT OBJECTIVE
 The aim of this study was to develop limited sampling models for estimating the area under the concentration-versus-time curve ( AUC ) of carboplatin .

 ABSTRACT METHODS
 Based on pharmacokinetic analyses of 14 patients who received 300 mg x m2 of carboplatin over a 90-min infusion following irinotecan , we developed limited sampling models with stepwise multiple linear regression analysis . We validated these models to be unbiased and precise using pharmacokinetic data of a second group of 14 patients . We also compared the observed and the predicted AUC in the patients using Calvert 's formula with the patients ' renal function .

 ABSTRACT RESULTS
 We developed the following models : AUC ( mg x ml ( -1 ) x min ) = 0.784 x C4 + 1.30 ( r2 = 0.930 ) and AUC = 0.100 x C0 .25 + 0.597 x C4 + 0.140 ( r = 0.992 ) , where C0 .25 and C4 denote unbound plasma concentrations ( microg x ml ( -1 ) ) of carboplatin at 0.25 h and 4 h after the end of infusion , respectively . These models were validated to be unbiased and precise : a mean prediction error ( MPE ) with standard deviation ( SD ) = 2.41 ( 9.45 ) % and a root mean squared error ( RMSE ) = 9.42 % for the one-sample model , and MPE with ( SD ) = 1.22 ( 5.56 ) % and RMSE = 5.49 % for the two-sample model . We also calculated predicted AUC in the patients using Calvert 's formula : MPE with ( SD ) = -5.87 ( 21.5 ) % and RMSE = 21.5 % .

 ABSTRACT CONCLUSIONS
 These estimations were , as expected , more accurate than the prediction using Calvert 's formula based on patients ' renal function . The result of this study confirmed the idea that the pharmacokinetic parameters derived from limited sampling models would be more suitable for pharmacokinetic analysis of carboplatin than those obtained using Calvert 's formula .

Title

Estimation

of

the

area

under

the

concentration-versus-time

curve

of

carboplatin

following

irinotecan

using

a

limited

sampling

model

ABSTRACT OBJECTIVE

The

aim

of

this

study

was

to

develop

limited

sampling

models

for

estimating

the

area

under

the

concentration-versus-time

curve

AUC

of

carboplatin

ABSTRACT METHODS

Based

on

pharmacokinetic

analyses

of

patients

who

received

mg

x

of

carboplatin

over

a

infusion

following

irinotecan

we

developed

limited

sampling

models

with

stepwise

multiple

linear

regression

analysis

We

validated

these

models

to

be

unbiased

and

precise

using

pharmacokinetic

data

of

a

second

group

of

patients

We

also

compared

the

observed

and

the

predicted

AUC

in

the

patients

using

Calvert

's

formula

with

the

patients

renal

function

ABSTRACT RESULTS

We

developed

the

following

models

AUC

mg

x

ml

x

min

x

and

AUC

x

x

r

where

and

denote

unbound

plasma

concentrations

microg

x

ml

of

carboplatin

at

h

and

h

after

the

end

of

infusion

respectively

These

models

were

validated

to

be

unbiased

and

precise

a

mean

prediction

error

MPE

with

standard

deviation

SD

and

a

root

mean

squared

error

RMSE

for

the

one-sample

model

and

MPE

with

SD

and

RMSE

for

the

two-sample

model

We

also

calculated

predicted

AUC

in

the

patients

using

Calvert

's

formula

MPE

with

SD

and

RMSE

ABSTRACT CONCLUSIONS

These

estimations

were

as

expected

more

accurate

than

the

prediction

using

Calvert

's

formula

based

on

patients

renal

function

The

result

of

this

study

confirmed

the

idea

that

the

pharmacokinetic

parameters

derived

from

limited

sampling

models

would

be

more

suitable

for

pharmacokinetic

analysis

of

carboplatin

than

those

obtained

using

Calvert

's

formula


Title
 Randomized study of adjusted versus fixed low dose heparin prophylaxis of deep vein thrombosis in hip surgery .

 ABSTRACT GENERAL
 A randomized study of adjusted versus fixed low dose heparin prophylaxis has been conducted in 100 patients undergoing surgery for hip replacement or fractured neck of femur . The two types of patients were randomized independently into the adjusted and fixed dose regimens . Patients in the adjusted group were controlled by an activated partial thromboplastin time method particularly responsive to the anticoagulant effect of heparin . The aim was to maintain the peak value just above the upper limit of the normal range . Adjustment of dosage began 24 h after surgery in the replacement group and 24 h after admission in the fracture group . Significant improvement in protection against postoperative deep vein thrombosis , assessed by venography , was observed in the adjusted group undergoing hip replacement ( P = 0.013 ) and overall in both groups ( P = 0.017 ) compared with a conventional fixed dose subcutaneous regimen ( calcium heparin 5000 units , 8-hourly ) . In most instances , adjustment resulted in increased heparin dosage but this was not associated with any evidence of excessive bleeding .

Title

Randomized

study

of

adjusted

versus

fixed

low

dose

heparin

prophylaxis

of

deep

vein

thrombosis

in

hip

surgery

ABSTRACT GENERAL

A

randomized

study

of

adjusted

versus

fixed

low

dose

heparin

prophylaxis

has

been

conducted

in

patients

undergoing

surgery

for

hip

replacement

or

fractured

neck

of

femur

The

two

types

of

patients

were

randomized

independently

into

the

adjusted

and

fixed

dose

regimens

Patients

in

the

adjusted

group

were

controlled

by

an

activated

partial

thromboplastin

time

method

particularly

responsive

to

the

anticoagulant

effect

of

heparin

The

aim

was

to

maintain

the

peak

value

just

above

the

upper

limit

of

the

normal

range

Adjustment

of

dosage

began

h

after

surgery

in

the

replacement

group

and

h

after

admission

in

the

fracture

group

Significant

improvement

in

protection

against

postoperative

deep

vein

thrombosis

assessed

by

venography

was

observed

in

the

adjusted

group

undergoing

hip

replacement

P

and

overall

in

both

groups

P

compared

with

a

conventional

fixed

dose

subcutaneous

regimen

calcium

heparin

units

In

most

instances

adjustment

resulted

in

increased

heparin

dosage

but

this

was

not

associated

with

any

evidence

of

excessive

bleeding


Title
 An experiment of prophylactic medication for those with mild hypertension in population .

Title

An

experiment

of

prophylactic

medication

for

those

with

mild

hypertension

in

population


Title
 Phosphodiesterase 5 inhibitors for lower urinary tract symptoms secondary to benign prostatic hyperplasia : a systematic review .

 ABSTRACT OBJECTIVE
 • To review the evidence in support of the effectiveness of phosphodiesterase 5 inhibitors in lower urinary tract symptoms ( LUTS ) caused by benign prostatic hyperplasia ( BPH ) .

 ABSTRACT METHODS
 • Relevant studies were identified by performing a literature search using MEDLINE ® and The Cochrane Library ® . The criteria used during the search included randomized , placebo-controlled trials of treatment for LUTS secondary to BPH using the International Prostate Symptom Score as an outcome measure .

 ABSTRACT RESULTS
 • Four trials that included a total of 1928 patients met the inclusion criteria . All four studies showed a statistically significant difference in the International Prostate Symptom Score , quality of life and erectile function in favour of phosphodiesterase 5 inhibitors . • No study showed a statistically significant improvement of the maximum urinary flow . • Meta-analysis of the results was not possible because of heterogeneity across the studies .

 ABSTRACT CONCLUSIONS
 • Phosphodiesterase 5 inhibitors used in the clinical setting can significantly improve LUTS secondary to BPH , erectile function and quality of life . Maximum urinary flow improvement is not statistically significant . • Future research should focus on pathophysiological principles and cost analysis .

Title

Phosphodiesterase

inhibitors

for

lower

urinary

tract

symptoms

secondary

to

benign

prostatic

hyperplasia

a

systematic

review

ABSTRACT OBJECTIVE

To

review

the

evidence

in

support

of

the

effectiveness

of

phosphodiesterase

inhibitors

in

lower

urinary

tract

symptoms

LUTS

caused

by

benign

prostatic

hyperplasia

BPH

ABSTRACT METHODS

Relevant

studies

were

identified

by

performing

a

literature

search

using

MEDLINE

and

The

Cochrane

Library

The

criteria

used

during

the

search

included

randomized

placebo-controlled

trials

of

treatment

for

LUTS

secondary

to

BPH

using

the

International

Prostate

Symptom

Score

as

an

outcome

measure

ABSTRACT RESULTS

Four

trials

that

included

a

total

of

patients

met

the

inclusion

criteria

All

four

studies

showed

a

statistically

significant

difference

in

the

International

Prostate

Symptom

Score

quality

of

life

and

erectile

function

in

favour

of

phosphodiesterase

inhibitors

No

study

showed

a

statistically

significant

improvement

of

the

maximum

urinary

flow

Meta-analysis

of

the

results

was

not

possible

because

of

heterogeneity

across

the

studies

ABSTRACT CONCLUSIONS

Phosphodiesterase

inhibitors

used

in

the

clinical

setting

can

significantly

improve

LUTS

secondary

to

BPH

erectile

function

and

quality

of

life

Maximum

urinary

flow

improvement

is

not

statistically

significant

Future

research

should

focus

on

pathophysiological

principles

and

cost

analysis


Title
 Echography ( Ultrasound ) Procedures for the Collaborative Ocular Melanoma Study ( COMS ) , Report no. 12 , Part II .

Title

Echography

Ultrasound

Procedures

for

the

Collaborative

Ocular

Melanoma

Study

COMS

Report

no.

Part

II


Title
 Using a belly board device to reduce the small bowel volume within pelvic radiation fields in women with postoperatively treated cervical carcinoma .

 ABSTRACT OBJECTIVE
 The purpose of this study was to attempt to reduce the small bowel volume in cervical cancer patients undergoing radiation therapy using the belly board device and a four-field technique .

 ABSTRACT METHODS
 From 1994 through 1997 , twenty-one patients with cervical cancer were referred to the University of Minnesota Medical Center and underwent surgical staging with or without radical hysterectomy followed by postoperative external beam radiotherapy for various indications including positive nodal disease ( n = 11 ) , lymph-vascular space invasion ( n = 2 ) , poor histology ( n = 3 ) , parametrial disease ( n = 4 ) , and positive vaginal margin ( n = 1 ) .

 ABSTRACT RESULTS
 The median age of the 21 patients was 42 years ( 25-54 years ) and a median external beam pelvic radiation dose of 4775 cGy ( range , 4200-5075 cGy ) was administered . All patients were evaluated for amount of small bowel in the field in both the supine and prone positions , with and without the belly board device ( BBD ) , using a four-field technique . With a full bladder , abdominal radiographs with contrast were obtained to evaluate the volume of small bowel within the radiation fields . In most patients , the BBD was effective at minimizing the amount of small bowel in the lateral fields , whereas a prone position on the treatment table ( without the BBD ) spared the most small bowel with the AP/PA fields . Therefore over a 2-day cycle , the most small bowel sparing was obtained with the patients treated prone on the BBD for the lateral fields on Day 1 and prone on the table for the AP/PA fields on Day 2 . Patients had FIGO stage IB ( n = 18 ) , IA2 ( n = 1 ) , and IIA ( n = 2 ) . The median follow-up was 37 months ( 24-65 months ) . No significant acute gastrointestinal or genitourinary toxicity was experienced and no patients have experienced a bowel obstruction to date .

 ABSTRACT CONCLUSIONS
 The BBD may offer a means for positioning the mobile small intestine out of the radiation field and improving the tolerance of radiotherapy . The BBD provides a noninvasive technique for reduction of acute and chronic gastrointestinal morbidity .

Title

Using

a

belly

board

device

to

reduce

the

small

bowel

volume

within

pelvic

radiation

fields

in

women

with

postoperatively

treated

cervical

carcinoma

ABSTRACT OBJECTIVE

The

purpose

of

this

study

was

to

attempt

to

reduce

the

small

bowel

volume

in

cervical

cancer

patients

undergoing

radiation

therapy

using

the

belly

board

device

and

a

four-field

technique

ABSTRACT METHODS

From

through

twenty-one

patients

with

cervical

cancer

were

referred

to

the

University

of

Minnesota

Medical

Center

and

underwent

surgical

staging

with

or

without

radical

hysterectomy

followed

by

postoperative

external

beam

radiotherapy

for

various

indications

including

positive

nodal

disease

n

lymph-vascular

space

invasion

n

poor

histology

n

parametrial

disease

n

and

positive

vaginal

margin

n

ABSTRACT RESULTS

The

median

age

of

the

patients

was

years

years

and

a

median

external

beam

pelvic

radiation

dose

of

cGy

range

cGy

was

administered

All

patients

were

evaluated

for

amount

of

small

bowel

in

the

field

in

both

the

supine

and

prone

positions

with

and

without

the

belly

board

device

BBD

using

a

four-field

technique

With

a

full

bladder

abdominal

radiographs

with

contrast

were

obtained

to

evaluate

the

volume

of

small

bowel

within

the

radiation

fields

In

most

patients

the

BBD

was

effective

at

minimizing

the

amount

of

small

bowel

in

the

lateral

fields

whereas

a

prone

position

on

the

treatment

table

without

the

BBD

spared

the

most

small

bowel

with

the

AP/PA

fields

Therefore

over

a

cycle

the

most

small

bowel

sparing

was

obtained

with

the

patients

treated

prone

on

the

BBD

for

the

lateral

fields

on

Day

and

prone

on

the

table

for

the

AP/PA

fields

on

Day

Patients

had

FIGO

stage

IB

n

n

and

IIA

n

The

median

follow-up

was

months

months

No

significant

acute

gastrointestinal

or

genitourinary

toxicity

was

experienced

and

no

patients

have

experienced

a

bowel

obstruction

to

date

ABSTRACT CONCLUSIONS

The

BBD

may

offer

a

means

for

positioning

the

mobile

small

intestine

out

of

the

radiation

field

and

improving

the

tolerance

of

radiotherapy

The

BBD

provides

a

noninvasive

technique

for

reduction

of

acute

and

chronic

gastrointestinal

morbidity


Title
 Double-blind placebo-controlled study of the hyperventilation provocation test and the validity of the hyperventilation syndrome .

 ABSTRACT BACKGROUND
 Hyperventilation syndrome ( HVS ) describes a set of somatic and psychological symptoms thought to result from episodic or chronic hyperventilation . Recognition of symptoms during the hyperventilation provocation test ( HVPT ) is the most widely used criterion for diagnosis of HVS . We have investigated the validity of the HVPT and of the concept of HVS .

 ABSTRACT METHODS
 In a randomised , double-blind , crossover design , the ability of 115 patients with suspected HVS to recognise symptoms during the HVPT was compared with the ability to recognise symptoms during a placebo test ( isocapnic overbreathing , with carbon dioxide levels maintained by manual titration ) . 30 patients who had positive results on the HVPT underwent ambulatory transcutaneous monitoring of pCO2 to ascertain whether they hyperventilated during spontaneous symptom attacks .

 ABSTRACT RESULTS
 Of the 115 patients who underwent the HVPT and the placebo test , 85 ( 74 % ) reported symptom recognition during the HVPT ( positive diagnosis HVS ) . Of that subset , 56 were also positive on the placebo test ( false-positive ) , and 29 were negative on the placebo test ( true-positive ) . False-positive and true-positive patients did not differ in symptom profile or in physiological variables . During ambulatory monitoring ( 15 true-positive , 15 false-positive ) 22 attacks were registered . Transcutaneous end-tidal , pCO2 decreased during only seven . The decreases were slight and apparently followed the onset of the attack , which suggests that hyperventilation is a consequence rather than a cause of the attack . There were no apparent differences between false-positive and true-positive patients .

 ABSTRACT CONCLUSIONS
 The HVPT is invalid as a diagnostic test for HVS . Hyperventilation seems a negligible factor in the experience of spontaneous symptoms . The term HVS should be avoided .

Title

Double-blind

placebo-controlled

study

of

the

hyperventilation

provocation

test

and

the

validity

of

the

hyperventilation

syndrome

ABSTRACT BACKGROUND

Hyperventilation

syndrome

HVS

describes

a

set

of

somatic

and

psychological

symptoms

thought

to

result

from

episodic

or

chronic

hyperventilation

Recognition

of

symptoms

during

the

hyperventilation

provocation

test

HVPT

is

the

most

widely

used

criterion

for

diagnosis

of

HVS

We

have

investigated

the

validity

of

the

HVPT

and

of

the

concept

of

HVS

ABSTRACT METHODS

In

a

randomised

double-blind

crossover

design

the

ability

of

patients

with

suspected

HVS

to

recognise

symptoms

during

the

HVPT

was

compared

with

the

ability

to

recognise

symptoms

during

a

placebo

test

isocapnic

overbreathing

with

carbon

dioxide

levels

maintained

by

manual

titration

patients

who

had

positive

results

on

the

HVPT

underwent

ambulatory

transcutaneous

monitoring

of

to

ascertain

whether

they

hyperventilated

during

spontaneous

symptom

attacks

ABSTRACT RESULTS

Of

the

patients

who

underwent

the

HVPT

and

the

placebo

test

reported

symptom

recognition

during

the

HVPT

positive

diagnosis

HVS

Of

that

subset

were

also

positive

on

the

placebo

test

false-positive

and

were

negative

on

the

placebo

test

true-positive

False-positive

and

true-positive

patients

did

not

differ

in

symptom

profile

or

in

physiological

variables

During

ambulatory

monitoring

true-positive

false-positive

attacks

were

registered

Transcutaneous

end-tidal

decreased

during

only

seven

The

decreases

were

slight

and

apparently

followed

the

onset

of

the

attack

which

suggests

that

hyperventilation

is

a

consequence

rather

than

a

cause

of

the

attack

There

were

no

apparent

differences

between

false-positive

and

true-positive

patients

ABSTRACT CONCLUSIONS

The

HVPT

is

invalid

as

a

diagnostic

test

for

HVS

Hyperventilation

seems

a

negligible

factor

in

the

experience

of

spontaneous

symptoms

The

term

HVS

should

be

avoided


Title
 Comparison of Treatments for Superior Labrum-Biceps Complex Lesions With Concomitant Rotator Cuff Repair : A Prospective , Randomized , Comparative Analysis of Debridement , Biceps Tenotomy , and Biceps Tenodesis .

 ABSTRACT GENERAL
 To compare the clinical outcomes in patients with concomitant superior labrum-biceps complex ( SLBC ) lesions and rotator cuff tears who underwent arthroscopic rotator cuff repair , according to 3 different treatment methods ( simple debridement , biceps tenotomy , or biceps tenodesis ) for the SLBC lesions .

 ABSTRACT GENERAL
 One hundred twenty patients who underwent arthroscopic rotator cuff repair with SLBC lesions ( biceps partial tears < 50 % , partial pulley lesions , and type II SLAP lesions ) were enrolled in this prospective comparative study and randomly assigned to 1 of 3 treatment groups ( simple debridement [ Deb ] , biceps tenotomy only [ BTo ] , or biceps tenodesis with one suture anchor [ BTd ] ) . Patients with isolated subscapularis tears or osteoarthritis were excluded . Finally , 86 patients ( Deb in 28 , BTo in 27 , and BTd in 31 ) were analyzed ( mean follow-up , 22.1 ± 7.72 months ; mean age , 58.98 ± 7.8 years ) . Pain ; functional , clinical , and radiologic outcomes ; and the strength index of elbow flexion and forearm supination were analyzed .

 ABSTRACT GENERAL
 Pain , range of motion , and functional scores significantly improved postoperatively in all 3 groups , with no significant differences across groups . At the 6-month follow-up , 8 patients reported cramping pain ( 5 Deb patients , 2 BTo patients , and 1 BTd patient ) , but the pain improved in most patients over time ( with cramping pain reported by zero Deb patients , 1 BTo patient , and 1 BTd patient at final follow-up ) . Bicipital groove tenderness significantly improved in the BTo group postoperatively ( P = .006 ) . The Popeye deformity was noted in 10 patients ( 37.0 % ) in the BTo group , 8 ( 25.8 % ) in the BTd group , and only 2 ( 7.1 % ) in the Deb group ( P = .029 ) . On radiologic examination , the presence of tenodesis of the biceps tendons on the bicipital groove showed low agreement with the presence of the Popeye deformity ( observed in 13 of 20 patients with the deformity , 65 % ) . On strength index analysis , the BTo group showed lower forearm supination strength ( 0.877 ± 0.44 ) compared with that in the other groups ( 1.29 ± 0.525 in the Deb group and 1.12 ± 0.451 in the BTd group , P = .049 ) .

 ABSTRACT GENERAL
 All 3 treatments improved pain and function . Simple debridement showed the lowest risk of the Popeye deformity and preserved forearm supination strength . Biceps tenotomy and tenodesis may be preferable for selected patients : biceps tenotomy for patients with definite bicipital groove tenderness and biceps tenodesis for patients , especially male patients , with bicipital groove tenderness who want to preserve supination strength .

 ABSTRACT GENERAL
 Level II , prospective comparative study .

Title

Comparison

of

Treatments

for

Superior

Labrum-Biceps

Complex

Lesions

With

Concomitant

Rotator

Cuff

Repair

A

Prospective

Randomized

Comparative

Analysis

of

Debridement

Biceps

Tenotomy

and

Biceps

Tenodesis

ABSTRACT GENERAL

To

compare

the

clinical

outcomes

in

patients

with

concomitant

superior

labrum-biceps

complex

SLBC

lesions

and

rotator

cuff

tears

who

underwent

arthroscopic

rotator

cuff

repair

according

to

different

treatment

methods

simple

debridement

biceps

tenotomy

or

biceps

tenodesis

for

the

SLBC

lesions

ABSTRACT GENERAL

One

hundred

twenty

patients

who

underwent

arthroscopic

rotator

cuff

repair

with

SLBC

lesions

biceps

partial

tears

partial

pulley

lesions

and

type

II

SLAP

lesions

were

enrolled

in

this

prospective

comparative

study

and

randomly

assigned

to

of

treatment

groups

simple

debridement

Deb

biceps

tenotomy

only

BTo

or

biceps

tenodesis

with

one

suture

anchor

BTd

Patients

with

isolated

subscapularis

tears

or

osteoarthritis

were

excluded

Finally

patients

Deb

in

BTo

in

and

BTd

in

were

analyzed

mean

follow-up

months

mean

age

years

Pain

functional

clinical

and

radiologic

outcomes

and

the

strength

index

of

elbow

flexion

and

forearm

supination

were

analyzed

ABSTRACT GENERAL

Pain

range

of

motion

and

functional

scores

significantly

improved

postoperatively

in

all

groups

with

no

significant

differences

across

groups

At

the

follow-up

patients

reported

cramping

pain

Deb

patients

BTo

patients

and

BTd

patient

but

the

pain

improved

in

most

patients

over

time

with

cramping

pain

reported

by

zero

Deb

patients

BTo

patient

and

BTd

patient

at

final

follow-up

Bicipital

groove

tenderness

significantly

improved

in

the

BTo

group

postoperatively

P

The

Popeye

deformity

was

noted

in

patients

in

the

BTo

group

in

the

BTd

group

and

only

in

the

Deb

group

P

On

radiologic

examination

the

presence

of

tenodesis

of

the

biceps

tendons

on

the

bicipital

groove

showed

low

agreement

with

the

presence

of

the

Popeye

deformity

observed

in

of

patients

with

the

deformity

On

strength

index

analysis

the

BTo

group

showed

lower

forearm

supination

strength

compared

with

that

in

the

other

groups

in

the

Deb

group

and

in

the

BTd

group

P

ABSTRACT GENERAL

All

treatments

improved

pain

and

function

Simple

debridement

showed

the

lowest

risk

of

the

Popeye

deformity

and

preserved

forearm

supination

strength

Biceps

tenotomy

and

tenodesis

may

be

preferable

for

selected

patients

biceps

tenotomy

for

patients

with

definite

bicipital

groove

tenderness

and

biceps

tenodesis

for

patients

especially

male

patients

with

bicipital

groove

tenderness

who

want

to

preserve

supination

strength

ABSTRACT GENERAL

Level

II

prospective

comparative

study


Title
 Effect of morphine on breathlessness and exercise endurance in advanced COPD : a randomised crossover trial .

 ABSTRACT GENERAL
 The objective of the present study was to evaluate the effect of morphine on exertional breathlessness and exercise endurance in advanced chronic obstructive pulmonary disease ( COPD ) . In a randomised crossover trial , we compared the acute effect of immediate-release oral morphine versus placebo on physiological and perceptual responses during constant-load cardiopulmonary cycle exercise testing ( CPET ) in 20 adults with advanced COPD and chronic breathlessness syndrome.Compared with placebo , morphine reduced exertional breathlessness at isotime by 1.2 ± 0.4 Borg units and increased exercise endurance time by 2.5 ± 0.9 min ( both p ≤ 0.014 ) . During exercise at isotime , morphine decreased ventilation by 1.3 ± 0.5 L · min-1 and breathing frequency by 2.0 ± 0.9 breaths · min-1 ( both p ≤ 0.041 ) . Compared with placebo , morphine decreased exertional breathlessness at isotime by ≥ 1 Borg unit in 11 participants ( responders ) and by < 1 Borg unit in nine participants ( non-responders ) . Baseline participant characteristics , including pulmonary function and cardiorespiratory fitness , were similar between responders and non-responders . A higher percentage of responders versus non-responders stopped incremental CPET due to intolerable breathlessness : 82 versus 33 % ( p = 0.028 ) . Immediate-release oral morphine improved exertional breathlessness and exercise endurance in some , but not all , adults with advanced COPD . The locus of symptom-limitation on laboratory-based CPET may help to identify patients most likely to benefit from morphine .

Title

Effect

of

morphine

on

breathlessness

and

exercise

endurance

in

advanced

COPD

a

randomised

crossover

trial

ABSTRACT GENERAL

The

objective

of

the

present

study

was

to

evaluate

the

effect

of

morphine

on

exertional

breathlessness

and

exercise

endurance

in

advanced

chronic

obstructive

pulmonary

disease

COPD

In

a

randomised

crossover

trial

we

compared

the

acute

effect

of

immediate-release

oral

morphine

versus

placebo

on

physiological

and

perceptual

responses

during

constant-load

cardiopulmonary

cycle

exercise

testing

CPET

in

adults

with

advanced

COPD

and

chronic

breathlessness

syndrome.Compared

with

placebo

morphine

reduced

exertional

breathlessness

at

isotime

by

Borg

units

and

increased

exercise

endurance

time

by

min

both

p

During

exercise

at

isotime

morphine

decreased

ventilation

by

L

and

breathing

frequency

by

breaths

both

p

Compared

with

placebo

morphine

decreased

exertional

breathlessness

at

isotime

by

Borg

unit

in

participants

responders

and

by

Borg

unit

in

nine

participants

non-responders

Baseline

participant

characteristics

including

pulmonary

function

and

cardiorespiratory

fitness

were

similar

between

responders

and

non-responders

A

higher

percentage

of

responders

versus

non-responders

stopped

incremental

CPET

due

to

intolerable

breathlessness

versus

p

Immediate-release

oral

morphine

improved

exertional

breathlessness

and

exercise

endurance

in

some

but

not

all

adults

with

advanced

COPD

The

locus

of

symptom-limitation

on

laboratory-based

CPET

may

help

to

identify

patients

most

likely

to

benefit

from

morphine


Title
 Propranolol and other anti-anginal drugs .

Title

Propranolol

and

other

anti-anginal

drugs


Title
 Nonsteroidal treatment of autoimmune skin diseases .

 ABSTRACT GENERAL
 This brief survey has , it is hoped , helped to ease some of the anxiety associated with the management of complex autoimmune skin disorders . The main points to remember are that there are numerous therapeutic options for each disease . I like to think of this method of therapeutics as ' informed trial and error . ' One does not need to master the monitoring , side-effect profile , or dosing regimen for each of the drugs in Table 1 ; only a working knowledge of a few is sufficient . I hope that the readers take advantage of the many tables and caveats I have included so this article can be a ready reference for many future uses .

Title

Nonsteroidal

treatment

of

autoimmune

skin

diseases

ABSTRACT GENERAL

This

brief

survey

has

it

is

hoped

helped

to

ease

some

of

the

anxiety

associated

with

the

management

of

complex

autoimmune

skin

disorders

The

main

points

to

remember

are

that

there

are

numerous

therapeutic

options

for

each

disease

I

like

to

think

of

this

method

of

therapeutics

as

informed

trial

and

error

One

does

not

need

to

master

the

monitoring

side-effect

profile

or

dosing

regimen

for

each

of

the

drugs

in

Table

only

a

working

knowledge

of

a

few

is

sufficient

I

hope

that

the

readers

take

advantage

of

the

many

tables

and

caveats

I

have

included

so

this

article

can

be

a

ready

reference

for

many

future

uses


Title
 Interaction between baseline and early worsening of renal function and efficacy of renin-angiotensin-aldosterone system blockade in patients with heart failure : insights from the Val-HeFT study .

 ABSTRACT OBJECTIVE
 We evaluated the effect of ( dual ) renin-angiotensin-aldosterone system ( RAAS ) blockade with valsartan and an ACE inhibitor [ 92.7 % of patients were treated with an ACE inhibitor in the Valsartan in Heart Failure Trial ( Val-HeFT ) ] in patients with NYHA class II-IV heart failure ( HF ) and reduced EF on cardiovascular ( CV ) death and HF hospitalization by subgroups and by presence of early worsening of renal function ( EWRF ) and according to baseline estimated glomerular filtration rate ( eGFR ) .

 ABSTRACT RESULTS
 We analysed the data from 5010 patients enrolled in the Val-HeFT study . A total of 2346 ( 46.8 % ) patients had baseline renal impairment ( i.e. baseline eGFR < 60 mL/min/1 .73 m ( 2 ) ) . Further , 425 patients ( 8.6 % ) had EWRF ( i.e. eGFR decrease > 20 % within 1 month after randomization ) , whereas 4503 patients ( 91.4 % ) had ≤ 20 % decline in eGFR . Overall , the difference between valsartan and placebo on the composite endpoint of CV death and HF hospitalization was significant [ P = 0.0005 ; hazard ratio ( HR ) 0.83 , 95 % confidence interval ( CI ) 0.75-0.92 ) ] . In patients with baseline renal impairment , the difference between the treatment groups was also significant ( P = 0.0002 ; HR 0.76 , 95 % CI 0.66-0.88 ) . Patients with EWRF had higher risk of CV death and HF hospitalization vs. those without ERWF ( P < 0.0001 ; HR 1.44 , 95 % CI 1.21-1.71 ) , and within the EWRF group a significant difference was also observed between valsartan and placebo ( P = 0.0086 ; HR 0.63 , 95 % CI 0.45-0.89 ) . However , the interaction between treatment and eGFR at Month 1 was not significant ( P = 0.1160 ) .

 ABSTRACT CONCLUSIONS
 Benefits were maintained in patients with renal dysfunction at baseline and those who experienced EWRF .

Title

Interaction

between

baseline

and

early

worsening

of

renal

function

and

efficacy

of

renin-angiotensin-aldosterone

system

blockade

in

patients

with

heart

failure

insights

from

the

Val-HeFT

study

ABSTRACT OBJECTIVE

We

evaluated

the

effect

of

dual

renin-angiotensin-aldosterone

system

RAAS

blockade

with

valsartan

and

an

ACE

inhibitor

of

patients

were

treated

with

an

ACE

inhibitor

in

the

Valsartan

in

Heart

Failure

Trial

Val-HeFT

in

patients

with

NYHA

class

II-IV

heart

failure

HF

and

reduced

EF

on

cardiovascular

CV

death

and

HF

hospitalization

by

subgroups

and

by

presence

of

early

worsening

of

renal

function

EWRF

and

according

to

baseline

estimated

glomerular

filtration

rate

eGFR

ABSTRACT RESULTS

We

analysed

the

data

from

patients

enrolled

in

the

Val-HeFT

study

A

total

of

patients

had

baseline

renal

impairment

i.e.

baseline

eGFR

m

Further

patients

had

EWRF

i.e.

eGFR

decrease

within

month

after

randomization

whereas

patients

had

decline

in

eGFR

Overall

the

difference

between

valsartan

and

placebo

on

the

composite

endpoint

of

CV

death

and

HF

hospitalization

was

significant

P

hazard

ratio

HR

confidence

interval

CI

In

patients

with

baseline

renal

impairment

the

difference

between

the

treatment

groups

was

also

significant

P

HR

CI

Patients

with

EWRF

had

higher

risk

of

CV

death

and

HF

hospitalization

vs.

those

without

ERWF

P

HR

CI

and

within

the

EWRF

group

a

significant

difference

was

also

observed

between

valsartan

and

placebo

P

HR

CI

However

the

interaction

between

treatment

and

eGFR

at

Month

was

not

significant

P

ABSTRACT CONCLUSIONS

Benefits

were

maintained

in

patients

with

renal

dysfunction

at

baseline

and

those

who

experienced

EWRF


Title
 Outcome of first line systemic treatment in elderly compared to younger patients with metastatic colorectal cancer : a retrospective analysis of the CAIRO and CAIRO2 studies of the Dutch Colorectal Cancer Group ( DCCG ) .

 ABSTRACT BACKGROUND
 Metastatic colorectal cancer ( CRC ) is predominantly a disease of the elderly , therefore the current standards should be evaluated in this population .

 ABSTRACT METHODS
 We evaluated in different age groups the outcome in terms of median overall and progression-free survival , response rate , disease control rate , relative dose intensity ( RDI ) , tolerability , and global quality of life ( QoL ) of first-line capecitabine monotherapy ( CAP ) versus capecitabine + irinotecan ( CAPIRI ) and capecitabine + oxaliplatin + bevacizumab ( CAPOX + BEV ) in the CAIRO and CAIRO2 study , respectively . Patients were categorized into three age groups : age > 75 , 70-75 and < 70 years .

 ABSTRACT RESULTS
 Clinical outcomes were not significantly different among age groups , with the exception of a higher response rate from CAP treatment in the elderly . Elderly patients treated with CAPOX + BEV showed a trend towards a worse median overall survival compared to younger patients . Only treatment with CAP resulted in a higher incidence of grade 3-4 toxicity and a lower RDI in elderly versus younger patients . Treatment with CAP and CAPOX + BEV in elderly patients was significantly more often discontinued due to toxicity instead of progression to disease compared to younger patients . The increase in global QoL was comparable for the three age groups for each treatment regimen .

 ABSTRACT CONCLUSIONS
 We did not observe significant differences in survival outcomes between elderly and younger metastatic CRC patients with three different first-line systemic treatment regimens . Our data suggest that initial dose reduction of CAP monotherapy may be indicated in elderly patients .

Title

Outcome

of

first

line

systemic

treatment

in

elderly

compared

to

younger

patients

with

metastatic

colorectal

cancer

a

retrospective

analysis

of

the

CAIRO

and

studies

of

the

Dutch

Colorectal

Cancer

Group

DCCG

ABSTRACT BACKGROUND

Metastatic

colorectal

cancer

CRC

is

predominantly

a

disease

of

the

elderly

therefore

the

current

standards

should

be

evaluated

in

this

population

ABSTRACT METHODS

We

evaluated

in

different

age

groups

the

outcome

in

terms

of

median

overall

and

progression-free

survival

response

rate

disease

control

rate

relative

dose

intensity

RDI

tolerability

and

global

quality

of

life

QoL

of

first-line

capecitabine

monotherapy

CAP

versus

capecitabine

irinotecan

CAPIRI

and

capecitabine

oxaliplatin

bevacizumab

CAPOX

BEV

in

the

CAIRO

and

study

respectively

Patients

were

categorized

into

three

age

groups

age

and

years

ABSTRACT RESULTS

Clinical

outcomes

were

not

significantly

different

among

age

groups

with

the

exception

of

a

higher

response

rate

from

CAP

treatment

in

the

elderly

Elderly

patients

treated

with

CAPOX

BEV

showed

a

trend

towards

a

worse

median

overall

survival

compared

to

younger

patients

Only

treatment

with

CAP

resulted

in

a

higher

incidence

of

grade

toxicity

and

a

lower

RDI

in

elderly

versus

younger

patients

Treatment

with

CAP

and

CAPOX

BEV

in

elderly

patients

was

significantly

more

often

discontinued

due

to

toxicity

instead

of

progression

to

disease

compared

to

younger

patients

The

increase

in

global

QoL

was

comparable

for

the

three

age

groups

for

each

treatment

regimen

ABSTRACT CONCLUSIONS

We

did

not

observe

significant

differences

in

survival

outcomes

between

elderly

and

younger

metastatic

CRC

patients

with

three

different

first-line

systemic

treatment

regimens

Our

data

suggest

that

initial

dose

reduction

of

CAP

monotherapy

may

be

indicated

in

elderly

patients