Increase In Number Of Days Research Articles

Validation of Treatment Escalation as a Definition of Atopic Eczema Flares

BackgroundAtopic eczema (AE) is a chronic disease with flares and remissions. Long-term control of AE flares has been identified as a core outcome domain for AE trials. However, it is unclear how flares should be defined and measured.ObjectiveTo validate two concepts of AE flares based on daily reports of topical medication use: (i) escalation of treatment and (ii) days of topical anti-inflammatory medication use (topical corticosteroids and/or calcineurin inhibitors).MethodsData from two published AE studies (studies A (n=336) and B (n=60)) were analysed separately. Validity and feasibility of flare definitions were assessed using daily global bother (scale 0 to 10) as the reference standard. Intra-class correlations were reported for continuous variables, and odds ratios and area under the receiver operator characteristic (ROC) curve for binary outcome measures.ResultsGood agreement was found between both AE flare definitions and change in global bother: area under the ROC curve for treatment escalation of 0.70 and 0.73 in studies A and B respectively, and area under the ROC curve of 0.69 for topical anti-inflammatory medication use (Study A only). Significant positive relationships were found between validated severity scales (POEM, SASSAD, TIS) and the duration of AE flares occurring in the previous week – POEM and SASSAD rose by half a point for each unit increase in number of days in flare. Smaller increases were observed on the TIS scale. Completeness of daily diaries was 95% for Study A and 60% for Study B over 16 weeks).ConclusionBoth definitions were good proxy indicators of AE flares. We found no evidence that ‘escalation of treatment’ was a better measure of AE flares than ‘use of topical anti-inflammatory medications’. Capturing disease flares in AE trials through daily recording of medication use is feasible and appears to be a good indicator of long-term control.Trial registrationCurrent Controlled Trials ISRCTN71423189 (Study A).

Assessment of different insecticides on whitefly population and consequent viral diseases incidence

Several insecticides namely Fipronil 200 SC, Triazophos 40 EC, Imidacloprid 30.5 SC, Malathion 50 EC and Dimethoate 30 EC, were tested at their recommended doses for efficacy against whiteflies (Bemisia tabacci Genn.) on three different mungbean varieties viz. ML-818, SML-668 and ML1165. Experiments were laid at Pulses Research Sub Station, SKUAST-J, Samba during two consecutive kharif seasons, in a factorial Randomized Block Design. Insecticidal sprays were given at 50 days after sowing when the pest populations were maximum. Observations were made 2, 5 and 7 days after spray. Whitefly/cage population was least in fipronil sprayed plants during both the seasons followed by triazophos and imidacloprid. All the three mungbean varieties carried almost similar pest load. With the increase in number of days after spray whitefly populations increased. There was an increase in diseases viz., yellow mosaic, leaf curl and leaf crinkle, all being transmitted by whiteflies in a persistent manner. However, the three different mungbean varieties showed different reactions to the disease. ML-1165 showed maximum susceptibility to all the three diseases, while ML-818 and SML-668 were at par. Yield losses due to these mungbean diseases transmitted by whiteflies can therefore be reduced by growing resistant varieties and by application of single spray of new insecticides, fipronil, triazophos or imidacloprid at the right crop growth stage.

Tendencies of climatic extremes occurrence in different Moravian regions and landscape types

In this study present frequency of several characteristic days as tropical, summer, arctic, frost and ice days and also length of heat waves was compared with modelled future occurrence of these climate extreme indices. Climate-diagrams were used for drought hazard assessment. The main objective of our research was to detect possible changes of frequency of the extreme events toward future. Data from four localities in the Czech Republic (Moravia) were chosen for the evaluation. Each locality represents different climatic, landscape and settlement conditions. Localities are represented by the closest grid points. Future trend was modelled for scenario data (scenario A1B) by regional model ALADIN-Climate/CZ in the Czech Hydrometeorological Institute. The results showed obvious rising tendency of tropical and summer days frequency on all localities, especially in lowland regions. Very strong decreasing trend seemed to be in occurrence of arctic days, which might be very scarce in the future. Frost days and ice days should also decrease. Increase in number of days in heat wave was considerable. Climate-diagrams showed possible rising drought hazard for all localities towards future periods.

Effect of Bio Field Treatment on the Physical and Thermal Characteristics of Vanadium Pentoxide Powders

Vanadium pentoxide powders are very useful in producing ferrous as well as aluminiumalloys, inremoving carbon and sulphur and as catalysts in synthesizing ammonia and sulphuric acid. It is also used as corrosion inhibitor petroleum and chemical processing. In the present investigation V2O5 powders are exposed to biofield. Both the exposed and unexposed powders are later characterized by various techniques. The average particle size is found to decrease with increase in number of days after treatment upto a maximum of 15.9% in 110 days indicating severe fracture at agglomerate/crystallite boundaries. The BET surface area showed a surprising decrease (it should increase as particle size is decreased) of 7.22% in 109 days indicating the surface densification/removal of sharp surface corners/formation of large particles. SEM photographs indeed showed that samples exposed to biofield after 20 days showed increase in size as well as rounded corners. Thermal analysis indicated an increase in melting temperature by 9.9% in samples treated after 57 days along with a much reduced change in weight. X-ray diffraction of the powder samples indicated both increase and decrease in crystallite size, unit cell volume and molecular weight of samples exposed to biofield after 28, 104, 124 and 139 days. These results indicate that the catalytic nature of vanadium pentoxide can be controlled by exposing to bio field and using after a specific number of days after exposure.

Long-term Yield of Horticultural Crops in Wisconsin in Relation to Seasonal Climate in Comparison with Southern Ontario, Canada

The relationship between long-term weather and yield of 11 horticultural crops and one field crop in Wisconsin was determined for a 55-year period (1950–2005). The relationships among weather parameters and yield in Wisconsin were also compared with associations between weather and yields in Ontario, Canada, from a previous study. The number of days in a growing season with maximum temperatures 30 °C or greater (hot days) was negatively correlated with yields of beet for canning (r2 = 0.15), green pea (r2 = 0.16), onion (r2 = 0.08), and sweet corn for processing (r2 = 0.16) in Wisconsin. Hot days were also negatively correlated with yield of green pea (r2 = 0.16) in Ontario, Canada. Growing season precipitation in Wisconsin was positively correlated with yields of beet for canning (r2 = 0.18) and green pea (r2 = 0.09). An increase in yields of beet for canning in Wisconsin and green pea from Ontario was also observed with an increase in number of days with rainfall during the growing season (r2 = 0.12 and 0.15, respectively). Monthly minimum and maximum temperatures and hot days had an effect on vegetable yields in Wisconsin. A high number of days with precipitation in May and July was associated with yields of most vegetables and grain corn in Wisconsin. These results indicated the importance of the total and frequency of seasonal precipitation and the negative effect of exposure of crops to extreme temperatures on yields of vegetable crops.

Effect of Bio Field Treatment on the Physical and Thermal Characteristics of Silicon, Tin and Lead Powders

Silicon, tin and lead powders belong to group IV in periodic table and exhibit decreasing semi conducting nature towards the bottom of the group. These are very useful in producing non ferrous powder metallurgy components. In the present investigation silicon, tin and lead powders are exposed to bio field. Both the exposed and unexposed powders are later characterized by various techniques. The average particle size, after an initial decrease is found to increase with increase in number of days after treatment although the size is lee than that exhibited by untreated powder, suggesting the operation of competing mechanisms fracture and sintering. The BET surface area increased slightly in silicon powder but did not change in tin and lead powders. SEM photographs showed that samples exposed to bio field after 20 days showed fracture paths and fractures at inter and intra particle boundaries in treated powders. Thermal analysis indicated a decrease in heat of reaction and decrease in mass in treated samples. X-ray diffraction of the powder samples indicated both increase and decrease in crystallite size, unit cell volume and molecular weight of samples exposed to bio field even after 179 days. These results indicate that the properties of the metallic powders can be controlled even up to atomic level by exposing to bio field.

Simple neck pain questions used in surveys, evaluated in relation to health outcomes: a cohort study

BackgroundThe high prevalence of pain reported in many epidemiological studies, and the degree to which this prevalence reflects severe pain is under discussion in the literature. The aim of the present study was to evaluate use of the simple neck pain questions commonly included in large epidemiological survey studies with respect to aspects of health. We investigated if and how an increase in number of days with pain is associated with reduction in health outcomes.MethodsA cohort of university students (baseline age 19–25 years) were recruited in 2002 and followed annually for 4 years. The baseline response rate was 69% which resulted in 1200 respondents (627 women, 573 men). Participants were asked about present and past pain and perceptions of their general health, sleep disturbance, stress and energy levels, and general performance. The data were analyzed using a mixed model for repeated measurements and a random intercept logistic model.ResultsWhen reporting present pain, participants also reported lower prevalence of very good health, higher stress and sleep disturbance scores and lower energy score. Among those with current neck pain, additional questions characterizing the pain such as duration (categorized), additional pain sites and decreased general performance were associated with lower probability of very good health and higher amounts of sleep disturbance. Knowing about the presence or not of pain explains more of the variation in health between individuals, than within individuals.ConclusionThis study of young university students has demonstrated that simple neck pain survey questions capture features of pain that affect aspects of health such as perceived general health, sleep disturbance, mood in terms of stress and energy. Simple pain questions are more useful for group descriptions than for describing or following pain in an individual.

Impacts of future climate scenarios on nitrous oxide emissions from pasture based dairy systems in south eastern Australia

Nitrous oxide emissions account for ∼10% of global greenhouse gas emissions, with the vast majority of them (∼90%) from agricultural practices. The dairy industry in south-eastern Australia is largely a pasture based grazing system relying on a combination of pasture legumes, N fertiliser, imported feeds and effluent spreading to ensure adequate N nutrition of pastures. Total N inputs to this pasture system can exceed 300kg N/ha/yr, with N surpluses often exceeding 200kg N/ha/yr, resulting in high emissions of N2O. Climate change scenarios for south-eastern Australia suggest increasing temperatures, declining rainfall and longer dry summer seasons, raising the question of potential impacts of future climate change scenarios on N2O emissions. EcoMod, a biophysical, mechanistic, daily time-step model, was used to model effects of 4 future climate change scenarios (measured baseline of 1971–2000, 2030 high emission scenario, 2070 mid emission scenario and 2070 high emission scenario) on N2O emissions for 4 different soil type, climate and system combinations. Annual N2O emissions increased in the future projected climates at all sites except Elliott, where N2O emissions remained low due to well drained soil. At the remaining sites, the model showed an increase in number of days with soil water filed pore space (WFPS) in the range of 0.6–0.8 during the wetter colder months and fewer days with WFPS 0.6–0.8 during the drier, warmer months. Warmer soil temperatures, coupled with wet but less saturated soils, resulted in an increased opportunity for N2O production during cooler months, while the potential for N2O production during warmer months remained low. Emission factors (i.e., proportion of N inputs lost as N2O) changed in the future climate scenarios, emphasising the need for a more dynamic and mechanistic modelling approach in development of national greenhouse gas inventories. The likelihood of increased N2O emissions from pasture based dairy systems with the progression of climate change emphasises the need for targeted N2O abatement options for intensive grazing systems.This article is part of the special issue entitled: Greenhouse Gases in Animal Agriculture – Finding a Balance between Food and Emissions, Guest Edited by T.A. McAllister, Section Guest Editors; K.A. Beauchemin, X. Hao, S. McGinn and Editor for Animal Feed Science and Technology, P.H. Robinson.

Effect of varying slopes on soil loss from newly planted tea in North Eastern India

Tea grows on different slopes in North Eastern India. Varying intensity and duration of rainfall result in considerable soil loss, which has not been documented so far. Experiments were conducted during 2009 at the Tocklai Experimental Station of Tea Research Association, Jorhat, Assam (India) to monitor the periodical changes in soil loss from a newly established tea area with different rainfall intensities, duration and amount under varying degrees of slope (0.1, 2, 3 and 6 percent). The study revealed that an increase in the rainfall intensity, amount and duration in general, increased the soil loss in all treatments. An increase in the soil loss was recorded with the increase in slope per cent. The comparative soil loss, however, decreased with the advancement of crop/ increase in number of days after planting. The average soil loss per mm of rainfall under 0, 1, 2, 3 and 6 per cent slopes was found to be 2.65, 17.14, 34.91, 39.89 and 47.26 kg ha-1. The estimated average annual soil loss from these slopes was 5.37, 34.71, 70.70, 80.79 and 95.73 t ha-1 year-1, respectively. The trend of soil loss was highly correlated with the soil slope having R2 value of 0.95

EFFECT OF FUROSEMIDE AND TORASEMIDE ON HEART RATE VARIABILITY AND VENTRICULAR RHYTHM DISORDERS IN PATIENTS WITH CHRONIC HEART FAILURE COMPLICATING ISCHEMIC HEART DISEASE: COMPARATIVE NONRANDOMIZED STUDY

Aim. To study effect of diuretic therapy with furosemide and torasemide on heart rate variability (HRV) and frequency of ventriclar rhythm disorders in patients with chronic heart failure (CHF) complicating ischemic heart disease (IHD). Material and methods. Patients (n=107) with CHF III-IV functional class (NYHA) complicating IHD were examined. The first group of patients received furosemide, 20-60 mg QD (n=52), the second group received torasemide, 5-20 mg QD (n=55). Analysis of heart rhythm disorders and the basic HRV indicators was performed by ECG 10-minute record￾ings initially and after 10 days of therapy. Results. Decrease in time and spectral HRV parameters and increase in daily number of ventricular extrasystoles was found in furosemide treated patients. Improvement of HRV parameters and reduction of daily number of ventricular rhythm disorders was found torasemide treated patients. Conclusion. Torasemide therapy improves an autonomic regulation of heart rhythm and leads to the reduction of ventricular heart rhythm disorders in patients with CHF complicating IHD.

Patient experience with the copper versus the levonorgesterol-releasing intrauterine device: a randomized controlled trial

OBJECTIVE: To evaluate bleeding patterns, endometrial thickness and patient satisfaction with a levonorgesterol intrauterine device (L-IUD) vs. a copper IUD (C-IUD). DESIGN: Single blind prospective randomized trial, patient survey, bleeding diaries and ultrasound MATERIALS AND METHODS: This is a preliminary sub-group analysis of patient experience in a trial designed to assess the effect of IUDs on coagulation. Women aged 18-52 were randomized to the L-IUD or the C-IUD. Bleeding diaries were completed for one cycle prior to IUD insertion and again 2-4 months post-IUD insertion. A patient satisfaction survey was conducted 4 months after insertion. Follicular phase endometrial thickness was assessed via transvaginal ultrasound prior to IUD insertion and 4 months post-insertion. RESULTS: Eleven patients were randomized to the C-IUD and 7 were randomized to the L-IUD. The most common reasons for choosing the IUD were desire for contraception that was long-term (94%), reversible (83%), effective (72%), didn't require remembering (72%), and avoided systemic hormones (50%). Patients randomized to the C-IUD had an increase in number of days of spotting (1.45 vs. 3.54, p=0.02) and heavy bleeding (0.91 vs. 1.82, p=0.04) compared while patients randomized to the L-IUD had a decrease in days of heavy bleeding (1.86 vs. 0.57, p=0.01) compared to pre-insertion. Comparing the two groups post-IUD insertion, patients randomized to the L-IUD had significantly fewer days of heavy bleeding compared to patients randomized to the C-IUD (p=0.0002). Other bleeding parameters (spotting, light, moderate, and heavy bleeding) were unchanged. Endometrial thickness was significantly reduced 4 months post-IUD insertion in the L-IUD group compared to the C-IUD group (4.74 vs. 3.17 mm, p=0.03). Patient satisfaction averaged 4.4 on a 5 point scale and was not different between groups. CONCLUSIONS: The C-IUD resulted in increased menstrual flow and the L-IUD resulted in decreased flow and endometrial thickness. Patient satisfaction was high for both groups.

EFFECT OF STORAGE METHODS AND PERIODS ON GERMINATION OF ONION SEED

Two laboratory experiments were conducted at Gemmeiza Agriculture Research Station (Gharbeia Governorate) to study the effect of both storage and methods of storage on viability of onion seed during the period from August 2006 to August 2008. Randomize Complete Blocks Design with three replications was used. The results clearly showed that : 1- There was a progressive decline in germination percentage with each increase in the storage period. The decline in germination percentage after 12 months was 10.36 % and 21.42 % after 24 months. Seed germination percentage was markedly affected by methods of storage. Utilizing of polyethylene bags under Frigidaire at 5-8 oC or freezing resulted in higher seed germination percentage. There was a significant interaction effect of period and method of storage. The higher percentage of germination was observed under the treatment of storage period for 4 months in paper bags without and additions under normal room conditions. 2- Germination rate (days) was markedly affected by storage period, but differences between treatments were not always significant. There are a progressive increase in number of days to complete germination with each increase in storage period. Germination rate was significantly affected by storage method. The fastest rates of germination were observed with storage of onion seed in polyethylene in normal room conditions. 3- Seedling length was markedly affected by storage period. Storage at 4 and 8 months were associated with highest length of seedlings i.e . 3.85 and 3.84 cm), respectively. Seedling length was markedly affected by storage method. The maximum seed length (3.84 cm) was observed with storage of seed in polyethylene bags without any additions under normal room conditions It can be concluded that storage onion seed for four months in paper bags in normal room conditions followed by burlap bags in normal room conditions gave the best results in germination percentage and other seedling parameters.

Accurate Assessment of Mother & Infant Sleep

The purpose of the study was to determine the number of days of diary data collection needed to reliably measure mother and infant sleep-wake pattern. Twenty healthy adult mothers and their healthy term gestation infants age 4 to 10 weeks postnatal participated in a single group, cross-sectional design. Mothers completed a paper and pencil sleep-wake diary divided into 15-minute time periods. Data were collected in the home environment over a 4-day period. Mother and infant sleep and wake as well as infant feeding and cry were summarized and compared using between 1 and 4 days of data. Reliability was evaluated by correlating results obtained using from 1 to 4 days of data. Mean values for mother and infant sleep and activity variables did not differ significantly by day. Correlation among values calculated using increases in number of days of data showed adequate reliability (r > or = 0.80) when 3 days of data were used. Clinical measures should be valid and reliable. Due to day-to-day changes in maternal and infant sleep-wake pattern, a diary collected over 1 day may not provide adequate sleep information. These study findings indicate that 3 days of diary data are sufficient to reliably measure mother and infant sleep patterns. When using a diary to assess maternal and infant sleep-wake pattern in clinical practice or in clinically-based research, a 3-day period is suggested.

Some Factors Affecting the Abortion Rate in Dairy Herds with High Incidence ofNeospora-Associated Abortions are Different in Cows and Heifers

The aim of this study was to determine if the factors affecting the abortion rate in dairy herds with high incidence of Neospora-associated abortions are different in pregnancies of cows and heifers chronically infected with Neospora caninum. In heifers (n = 229), an increase in the cumulative number of days with a mean relative humidity (RH) lower than 60% during the second trimester of gestation increases the risk of abortion. Yet, the likelihood of abortion was 7.6 times lower for pregnant heifers inseminated with Limousin bull semen, compared with those inseminated with Holstein-Friesian bull semen. In pregnancies of parous cows (n = 521), an increase in rainfall and in the cumulative number of days with a mean RH lower than 60% during the second trimester of gestation increased the abortion rate. However, in contrast, an increase in the lactation number produced a decrease in the abortion rate, with a likelihood of abortion 4.8 times lower for pregnant cows inseminated with Limousin bull semen, and three times lower for those inseminated with Belgian Blue bull semen, compared with dairy cows inseminated with Holstein-Friesian bull semen. Finally, the likelihood of abortion was 3.2 times lower for pregnancies of parous cows with low antibody titres against N. caninum (6-30 units) as compared to those with high antibody titres (>/=30 units), whereas in heifers this variable had no effect. The practical recommendations of the present study include the control of the cow environment during the second trimester of gestation, the priority of culling for parous cows with higher antibody titres against N. caninum and the insemination of Neospora-seropositive cows with semen from the Limousin breed.

Trends in use of opioids for non-cancer pain conditions 2000–2005 in Commercial and Medicaid insurance plans: The TROUP study

Opioids are widely prescribed for non-cancer pain conditions (NCPC), but there have been no large observational studies in actual clinical practice assessing patterns of opioid use over extended periods of time. The TROUP (Trends and Risks of Opioid Use for Pain) study reports on trends in opioid therapy for NCPC in two disparate populations, one national and commercially insured population (HealthCore plan data) and one state-based and publicly-insured (Arkansas Medicaid) population over a six year period (2000–2005). We track enrollees with the four most common NCPC conditions: arthritis/joint pain, back pain, neck pain, headaches, as well as HIV/AIDS. Rates of NCPC diagnosis and opioid use increased linearly during this period in both groups, with the Medicaid group starting at higher rates and the HealthCore group increasing more rapidly. The proportion of enrollees receiving NCPC diagnoses increased (HealthCore 33%, Medicaid 9%), as did the proportion of enrollees with NCPC diagnoses who received opioids (HealthCore 58%, Medicaid 29%). Cumulative yearly opioid dose (in mg. morphine equivalents) received by NCPC patients treated with opioids increased (HealthCore 38%, Medicaid 37%) due to increases in number of days supplied rather than dose per day supplied. Use of short-acting Drug Enforcement Administration Schedule II opioids increased most rapidly, both in proportion of NCPC patients treated (HealthCore 54%, Medicaid 38%) and in cumulative yearly dose (HealthCore 95%, Medicaid 191%). These trends have occurred without any significant change in the underlying population prevalence of NCPC or new evidence of the efficacy of long-term opioid therapy and thus likely represent a broad-based shift in opioid treatment philosophy.

Simulation Study of past Climate Change Effect on Chickpea Phenology at Different Sowing Dates in Gorgan, Iran

This simulation study was mainly aimed to find the probable difference between sowing dates for response of four chickpea cultivars to past climate change. Firstly, the model CYRUS was recoded in QBASIC programming. Then phenology of cultivars Jam, Hashem, Arman and Beauvanij, seeded at day of year 50, 70 and 90, was evaluated during years 1961 to 2003 in Gorgan, Iran. The changes in some climatic variables were also studied. Results revealed that the solar radiation has been decreased for month December. Although the value of maximum temperature appeared to be the same across years 1961 to 2003 for all months, that of minimum temperature tended to show increasing trend for May and August. The increase in number of days with temperature higher than 35 degrees C was considerable for April and October, but negligible for other months. The warming of night temperature was significant only for May and August. It found about 34 mm per 43 years decrease in monthly rainfall for March. The rate of increase in number of days with rainfall was 0.0737 day per year for December. Nearly similar situation was found for number of days with rainfall lower than and/or equal to 10 mm. The change in number of days with rainfall higher than 10 mm and lower and/or equal to 30 mm was in decreasing manner (March, October and December). The length of time from sowing to emergence appeared to be constant across past years. The advance in flowering (R1) was true only for cultivar Jam seeded at day of year 70. The length of period from R1 to pod initiation (R3) has been diminished for sowing at day of year 70 (Jam and Arman). Only cultivar Hashem seeded at day of year 90 tended to have decreasing trend for length of period between R3 and pod filling. It found one day (per 43 years) decreases from pod yellowing to maturity for cultivar Beauvanij seeded at day of year 70. Based on these findings and on the fact that future climate change is predicted using past changes, it seems that the adaptation strategies for future, including agronomy and/or breeding programs, may be not the same for different sowing dates of chickpea.

Effect of Restraint Stress Duration on Humoral Immune Response in Albino Rats: Modulation by Chlordiazepoxide

We evaluated the effect of restraint stress (1hr/day) for 6, 10, 14 and 21 days on antibody response against sheep RBC (SRBC) and modulation by chlordiazepoxide (CDP) pretreatment (10 mg/kg/day) in albino rats. Anti-SRBC titer was significantly decreased with increase in number of days of restraint stress exposure. CDP pretreatment significantly reversed the effects of 6, 10 and 14 (but not of 21) days of restraint stress. CDP treatment for 21 days per se suppressed immune response, but no additive effect was observed. CDP was not effective in chronic stress (i.e., 21 days of stress). Hence, the rationale behind benzodiazepines therapy in chronic stress needs to be evaluated.

Intermediate care at a community hospital as an alternative to prolonged general hospital care for elderly patients: a randomised controlled trial

BackgroundDemographic changes together with an increasing demand among older people for hospital beds and other health services make allocation of resources to the most efficient care level a vital issue. The aim of this trial was to study the efficacy of intermediate care at a community hospital compared to standard prolonged care at a general hospital.MethodsIn a randomised controlled trial 142 patients aged 60 or more admitted to a general hospital due to acute illness or exacerbation of a chronic disease 72 (intervention group) were randomised to intermediate care at a community hospital and 70 (general hospital group) to further general hospital care.ResultsIn the intervention group 14 patients (19.4%) were readmitted for the same disease compared to 25 patients (35.7%) in the general hospital group (p = 0.03). After 26 weeks 18 (25.0%) patients in the intervention group were independent of community care compared to seven (10.0%) in the general hospital group (p = 0.02). There were an insignificant reduction in the number of deaths and an insignificant increase in the number of days with inward care in the intervention group. The number of patients admitted to long-term nursing homes from the intervention group was insignificantly higher than from the general hospital group.ConclusionIntermediate care at a community hospital significantly decreased the number of readmissions for the same disease to general hospital, and a significantly higher number of patients were independent of community care after 26 weeks of follow-up, without any increase in mortality and number of days in institutions.

A controlled, mirror-image study of second-generation antipsychotics in the treatment of schizophrenia

Second-generation antipsychotics are now treatments of choice in many countries. In this study, we aimed to compare hospital stay and admissions to hospital in patients switching from first-generation (conventional) to second-generation (atypical) antipsychotics with patients switching from one first-generation drug to another. This was a retrospective, 6-year, controlled mirror-image study conducted in an acute general psychiatry services in an inner-city area. Subjects were consisted of patients diagnosed with schizophrenia or schizoaffective disorder receiving continuous prescription of antipsychotics over at least a 6-year period between 1994 and 2002. The main outcome measures were number of days spent in hospital and number of admissions to hospital. In 36 patients switched from first to second-generation antipsychotics, total number of days spent in hospital increased, from a mean of 90 days in the 3 years before switching, to a mean of 200 days in the 3 years after (P<0.001). Mean number of admissions did not change significantly (1.61 before vs. 1.44 after, P=0.360). In 36 matched control patients, switching between first-generation antipsychotic drugs, mean number of days in hospital fell from 64 to 50 (P=0.189) and number of admissions was virtually unchanged (1.42 before vs. 1.03 after, P=0.202). Mean days in hospital were significantly increased in the second-generation antipsychotic group compared with the first-generation antipsychotic (control) group (P<0.001). Switching from first to second-generation antipsychotics resulted in an important increase in number of days spent in hospital. Switching from one first-generation antipsychotic drug to another did not significantly affect number of days in hospital.

Probiotic treatment of collagenous colitis: A randomized, double-blind, placebo-controlled trial with Lactobacillus acidophilus and Bifidobacterium animalis subsp. Lactis

Probiotic treatment may be effective in diseases involving gut microflora and intestinal inflammation. In collagenous colitis (CC), a potential pathogenic role of the gut microflora has been proposed. The effect of probiotic treatment in CC is unknown. Our aim was to investigate the clinical effect of treatment with Lactobacillus acidophilus LA-5 and Bifidobacterium animalis subsp. lactis BB-12 (AB-Cap-10) in patients with CC. Patients with CC and diarrhea were in a double-blind placebo-controlled study randomized (2:1) to AB-Cap-10 or placebo for 12 weeks. The primary end point was reduction in bowel frequency per week of >or=50%. Secondary end points were changes in bowel frequencies, stool consistency, stool weight, histopathology, and abdominal bloating and pain. Twenty-nine patients were randomized: 21 to probiotics and 8 to placebo. Reduction in bowel frequency per week of >or=50% occurred in 6 of 21 (29%) and in 1 of 8 (13%) patients receiving probiotic and placebo, respectively (P = 0.635). No differences between treatments were observed regarding the secondary end points. Post hoc analysis showed a median reduction in bowel frequency per week from 32 (range 18-84) to 23 (range 11-56; P < 0.005), a reduction in number of days with liquid stools per week from 6 days (range 0-7 days) to 1 day (range 0-7 days; P < 0.005), and an increase in number of days with solid stools per week (P < 0.05) in the AB-Cap-10 group. AB-Cap-10 had no significant effect on the chosen end points. Post hoc analysis demonstrated amelioration of clinical symptoms in the AB-Cap-10 group, indicating that probiotic treatment may potentially influence the disease course of CC.