Difference In Mean Percentage Research Articles

The influence of HLA supertype on thymidine analogue associated with low peripheral fat in HIV

To examine the relationship between human leukocyte antigen (HLA) genotype and body composition changes induced by thymidine analogue nucleoside reverse transcriptase inhibitor (NtRTI) use in HIV-positive individuals. Data collected during the Simplification with Tenofovir-Emtricitabine (TDF-FTC) or Abacavir-Lamivudine (ABC-3TC) (STEAL) study were analysed to examine the potential association of HLA genotypes with changes in body composition in treatment-experienced HIV-positive individuals. Demographic, HIV-related, body composition and HLA genotyping data from the STEAL study were used in this analysis. The mean percentage peripheral fat at study baseline was compared in participants with and without prior NtRTI use. Analyses were also carried out for each HLA supertype strata, for five HLA genes, within the thymidine-exposed group. These comparisons were made using Mann-Whitney rank-sum tests. Participants with prior NtRTI use had a significantly lower baseline mean peripheral fat percentage compared to those without NtRTI use (31.9 vs. 34.7%; P = 0.0045). However, participants carrying one or more of the three particular HLA supertype alleles, A01, B08 and DQ2, showed no significant difference in mean peripheral fat percentage at baseline by NtRTI use. Among participants with prior NtRTI exposure, there were significant differences in mean peripheral fat by HLA A01, B08 and DQ2 allele expression compared to those without expression of these alleles (A01: 34.91% vs. no A01: 30.3%; P = 0.0087; B08: 36.2% vs. no B08: 31.1%; P = 0.0317; DQ2: 35.16% vs. no DQ2: 30.06%; P = 0.0081). This analysis suggests that HIV-infected individuals carrying HLA A01, B08 or DQ2 supertype alleles may be resistant to NtRTI-induced peripheral fat loss.

Comparison of Actical and activPAL measures of sedentary behaviour in preschool children

ObjectivesThe purpose of this study was to examine the convergent validity of the Actical and activPAL to measure sedentary behaviour (SB) and non-SB in preschoolers in a free-living environment. DesignA convenience sample of 49 preschoolers (22 boys; 4.0±0.5 years) from six early childhood centres in Auckland, New Zealand were included in data analysis. MethodsParticipants wore a hip-mounted Actical and a thigh-mounted activPAL accelerometer simultaneously during centre attendance for one day and data were collected in 15s epochs. Bland–Altman tests were used to assess differences in group mean minutes and percentage of time in (non-)SB between both monitors. Agreement between binary coded (SB vs. non-SB) 15s-by-15s Actical and activPAL data was evaluated by calculating percentage agreement and κ statistic. ResultsThe monitors were worn on average for 294.8±46.3min resulting in a total of 57,780 15s epochs. Bland–Altman tests suggested a small group mean difference in (non-)SB (1.3min; 0.1%) and a wide prediction interval (121.3min; 39.2%). No obvious systematic bias was observed in the Bland–Altman plot. Percentage agreement between the 15s-by-15s Actical and activPAL data of all participants was 73.0% (inter-child range: 36.8–93.8%). The κ statistic showed moderate agreement with a value of 0.46 (95% CI: 0.45–0.47). ConclusionsAlthough the group mean estimate of (non-)SB was similar between the Actical and activPAL, the output of both monitors cannot be considered convergent as meaningful random disagreement was found between both monitors.

Demographics and Faculty Time Allocation of Music Education Professors in the United States

The purpose of this study was to construct a demographic and time allocation profile of the typical music education faculty member in the United States. Participant institutions ( n = 220) were selected from a random sample of National Association of Schools of Music–accredited institutions offering music education degrees ( N = 517). The authors sent invitations to complete the online survey to 665 music education professors at the institutions in the sample. The completed response rate for the survey was 35% ( n = 236). Findings aided in the construction of a profile of the typical music education faculty member in the United States. The data demonstrate that the typical respondent has a doctorate, 9 to 12 years of K–12 teaching experience, and is 51.5 years old, but entered the professoriate around age 36. The typical respondent spends approximately 11 hours per week teaching undergraduate students and has only 10% of his or her workload devoted to research. The report explores numerous other variables as well. Certain characteristics of the profile varied according to the type of institution at which the respondent worked. For example, the data demonstrate a significant difference in mean percentage of workload devoted to teaching and research between various institution types but not in time devoted to service. The exploration of demographic and time allocation norms in the music education professoriate may be of interest to those who prepare music teacher education faculty. Such information may also be of value to current and future graduate students preparing for careers in the music education professoriate.

212 EFFECT OF CONSECUTIVE SUPERSTIMULATORY TREATMENT-INDUCED FOLLICULAR WAVE SYNCHRONIZATION TO OPTIMIZE OOCYTE RETRIEVAL AND EMBRYO PRODUCTION BY OVUM PICKUP AND IN VITRO FERTILIZATION IN COWS

We previously reported that superstimulatory (SS) treatment-induced follicular wave synchronization after ovum pickup (OPU) was effective in enhancing the quality of obtained oocytes and blastocysts derived from in vitro maturation (IVM) and fertilization (IVF; Imai et al. 2010 Reprod. Fertil. Dev. 22, 296). The present study was designed to examine the efficiency of embryo production by 4 sessions of OPU-IVF using a series of the SS treatment-induced follicular wave synchronizations. For the SS protocols, 3 consecutive SS (3CSS) and 2 separated SS (2SSS) were used. In the 3CSS group, the first OPU was performed on random days of the oestrous cycle (Day 0) and all follicles larger than 2 mm in diameter were aspirated. On Day 5, follicles larger than 8 mm in diameter were aspirated and a CIDR (InterAg, Hamilton, New Zealand) was inserted. The cows then received 20 armour units of FSH (Kawasaki-Seiyaku, Kawasaki, Japan) in twice-daily decreasing doses by IM injection from Day 7 to 10. Cloprostenol (PGF; 0.75 mg, Fujita-Pharm, Tokyo, Japan) was administered on the morning of Day 9. The second OPU was performed 48 h after PGF administration on Day 11; the CIDR was removed from the cows just before OPU. After the second OPU, donors were treated consecutively with the SS protocol mentioned above for the third and fourth OPU sessions. In the 2SSS group, donors received 2 sets of the SS treatment mentioned above, with an interval of 11 days between the second and the third OPU session. Four OPU sessions were performed every 11 days on all cows. In this study, 8 Japanese Black cows were divided into the 3CSS and 2SSS groups, and the treatment for each group was reversed after a 65-day interval as crossover trials. After OPU, Grade 1 and 2 oocytes were used for IVM and IVF, and putative zygotes were cultured as described by (Imai et al. 2006 J. Reprod. Dev. 52, S19–S29 suppl.). A part of the zygotes were cultured in a micro-well system. Data were analysed by Student’s t-test and chi-square test. There were differences (P < 0.05) in the mean (±SD) number of follicles, collected oocytes, and cultured oocytes in the 3CSS (35.0 ± 8.6 and 24.4 ± 11.2, respectively) and 2SSS (30.8 ± 10.5 and 20.2 ± 9.0, respectively) groups. There were no differences in mean percentage of blastocyst formation and Grade 1 blastocyst rates between the 3CSS (38.5 and 55.8%, respectively) and 2SSS (34.8 and 54.8%, respectively) groups. However, the mean number of blastocysts produced per OPU session was significantly (P < 0.05) higher in the 3CSS group (8.1 ± 6.3) compared with the 2SSS group (5.8 ± 4.4). These results indicate that a series of 3 consecutive SS treatments had greater efficiency in producing OPU-IVF embryos. This work was supported in part by the Research and Development Program for New Bio-industry Initiatives.

Randomized Trial of Intravitreal Clindamycin and Dexamethasone versus Pyrimethamine, Sulfadiazine, and Prednisolone in Treatment of Ocular Toxoplasmosis

To compare the efficacy of intravitreal injection of clindamycin and dexamethasone with classic treatment for ocular toxoplasmosis. Prospective, randomized single-masked clinical trial. A total of 68 patients with active ocular toxoplasmosis were assigned randomly to 2 treatment groups: 34 in the intravitreal clindamycin plus dexamethasone (IVCD) group and 34 in the classic treatment (CT) group. The IVCD group received 1 to 3 injection(s) of 1 mg intravitreal clindamycin and 400 μg dexamethasone, and the CT group received 6 weeks of treatment with pyrimethamine and sulfadiazine plus prednisolone. Antitoxoplasmosis antibodies (immunoglobulin [Ig] M and IgG) were measured using an enzyme-linked immunosorbent assay. Changes in retinochoroidal lesion size, measured by a computer program written in the MATLAB environment, 6 weeks after initiation of treatment. Visual acuity (VA) changes, vitreous inflammatory response, adverse drug reactions, and rate of recurrence were secondary outcome measures. The mean number of injections in the IVCD group was 1.6. The lesion size reduction was statistically significant after treatment in both IVCD and CT groups (P < 0.001 and P = 0.009, respectively). However, the difference in mean percentage of reduction at 6 weeks was not significant: 57.0 ± 27.8% in the IVCD group versus 58.4 ± 29.3% in the CT group (P = 0.569). In relation to the baseline, VA increased by 0.44 ± 0.24 and 0.29 ± 0.19 logarithm of the minimum angle of resolution units in the IVCD and CT groups, respectively (P < 0.001); however, the difference of VA improvement between the groups was not significant. The interaction effect of IgM and treatment group on lesion size reduction was significant (P = 0.002); this indicated that IgM-positive cases responded better to CT and IgM-negative cases responded better to IVCD treatment. Vitreous inflammation reduction was insignificant between the groups. Within 2 years, 4 eyes (2 in each group) had 1 episode of recurrence. Adverse drug reactions occurred in 2 patients in the CT group. No major injection-related complication was encountered in the IVCD group. Intravitreal injection of clindamycin and dexamethasone may be an acceptable alternative to the classic treatment in ocular toxoplasmosis. It may offer the patient more convenience, a safer systemic side effect profile, greater availability, and fewer follow-up visits and hematologic evaluations.

Comparative study of the effects of three semen preparation media on semen analysis, DNA damage and protamine deficiency, and the correlation between DNA integrity and sperm parameters

Semen samples collected from 28 male partners of infertile couples were divided into three equal aliquots and prepared with three selected media, such as PureSperm (Nidacon, Gothenburg, Sweden), Sil-Select Plus (Fertipro, Beernem, Belgium) and SpermGrad (Vitrolife, Gothenburg, Sweden). The differences in mean percentages of semen parameters were assessed by repeated measures analysis. Correlations of sperm DNA damage, as measured by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay, and of protamine deficiency, as measured by chromomycin A3 (CMA3) staining with sperm parameters, were determined by Pearson's correlation. After preparation with all three media, sperm concentrations decreased (P < 0.05) while percentages of sperm with normal morphology increased (P < 0.05). Percentages of sperm motility, rapid motility and progressive motile concentration (PMC) increased (P < 0.05) for each of these parameters, PureSperm preparation gave the best results (P < 0.05). The percentage of DNA damage decreased in the PureSperm and Sil-Select Plus preparations (17.9% and 31.3%, respectively, P < 0.05) and increased in the SpermGrad preparation (56.3%, P < 0.05). Protamine deficiency also decreased in all three kinds of media, 59.3%, 47.7% and 40.3% for PureSperm, Sil-Select Plus and SpermGrad preparations, respectively (P < 0.05). The percentage of DNA-damaged sperm was negatively correlated with the percentages of sperm motility, rapid motility and PMC, but was positively correlated with static motility (P < 0.05). This comparative study and correlation analysis revealed that PureSperm preparation yielded sperm with the best motility and the lowest percentage of protamine deficiency. The Sil-Select Plus preparation yielded sperm with the lowest amount of DNA damage. The SpermGrad preparation had a high percentage of sperm with normal morphology, but also had the highest percentage of sperm with DNA damage. Sperm DNA damage was correlated with percentages of sperm motility, rapid motility, static motility and PMC.

Regression of cervical intraepithelial neoplasia by zerumbone in female Balb/c mice prenatally exposed to diethylstilboestrol: Involvement of mitochondria-regulated apoptosis

Background Cervical cancer is the second most common cause of cancer death in women. We have demonstrated previously that zerumbone (ZER) has an anti-cancer effect towards human cervical cancer cells (HeLa). Methods Anti-cancer properties of ZER were investigated using female Balb/c mice exposed prenatally to diethylstilboestrol. Female offspring have been treated with ZER (4, 8 and 16 mg/kg), normal saline and cisplatin (10 mg/kg; positive control). The anti-cancer properties of ZER were evaluated using histopathology, TdT-mediated dUTP nick end labeling (TUNEL) Assay and immunhistochemical staining of Bcl-2-associated X protein (Bax), a key protein in mitochondrial pathway of apoptosis. In addition, laser capture microdissection microscopy isolated RNA was amplified using reverse transcriptase polymerase chain reaction (RT-PCR) based on the specific primer of B-cell lymphoma 2 (Bcl-2). Results Treatment with ZER resulted ( P<0.05, χ 2 statistics) in the regression of cervical intraepithelial neoplasia (CIN) resembling cisplatin effect (10 mg/kg). TUNEL micrographs showed the absence of apoptosis in cancerous tissues treated with normal saline compared to ZER and cisplatin where abundant apoptotic cells were noticed. A post hoc analysis showed a significant ( P<0.01) difference in mean percentage of apoptosis between normal saline treatment (0%), ZER (15.7%) and cisplatin (21.7%). Immunohistochemical staining of Bax protein revealed that ZER modulates the expression of this apoptosis marker. Administration of ZER has also modulated the expression of Bcl-2 gene. Conclusion These findings showed that ZER induces apoptosis efficiently in cervical tissues from female Balb/c mice treated prenatally with diethylstilboestrol. This suggested that ZER, a plant-derived compound, could be introduced as a new chemo-preventive agent for CIN in future.

A randomized trial of classical and medium‐chain triglyceride ketogenic diets in the treatment of childhood epilepsy

To conduct the first randomized trial on classical and medium-chain triglyceride (MCT) versions of the ketogenic diet, examining efficacy and tolerability after 3, 6, and 12 months. One hundred forty-five children with intractable epilepsy were randomized to receive a classical or an MCT diet. Seizure frequency was assessed after 3, 6, and 12 months. Treatment withdrawals were documented. Tolerability was assessed by questionnaire, and blood ketone levels were measured. Of the 61 children who started a classical diet and the 64 who started an MCT diet, data from 94 were available for analysis: 45 classical and 49 MCT. After 3, 6, and 12 months there were no statistically significant differences in mean percentage of baseline seizures between the two groups (3 months: classical 66.5%, MCT 68.9%; 6 months: classical 48.5%, MCT 67.6%; 12 months: classical 40.8%, MCT 53.2%; all p > 0.05). There were no significant differences between groups in numbers achieving greater than 50% or 90% seizure reduction. Serum acetoacetate and beta-hydroxybutyrate levels at 3 and 6 months were significantly higher in children on the classical diet (p < 0.01); this was the case at 12 months for acetoacetate. There were no significant differences in tolerability except increased reports in the classical group of lack of energy after 3 months and vomiting after 12 months. This study has shown classical and MCT ketogenic diet protocols to be comparable in efficacy and tolerability; both ways of implementing the diet have their place in the treatment of childhood epilepsy.

Food hypersensitivity among Caucasian and non‐Caucasian children

There are little data regarding the frequency of different foods that cause hypersensitivity in the UK. Furthermore, there are no data regarding food hypersensitivity related to ethnic variations. This prospective study involved 76 children with IgE-mediated food allergy presenting consecutively over 18 months to a Paediatric Allergy Clinic serving a well-defined population that is 21% non-Caucasian. A total of 52.6% of the paediatric allergy clinic population was non-Caucasian compared with 35.9% in General Paediatric Clinics giving a mean difference in percentage of 16.7 (5.6, 27.8), p < 0.01. The average number of food allergens per child in the non-Caucasian group was 2.05 vs. 1.22 in the Caucasian group, mean difference 0.83, which is significant (t = 4.15, d.f. = 74, p < 0.01). Analysis of other allergic conditions revealed no significant increase in the non-Caucasian group. The mean age of first reaction to any food was 2.6 yr (range 0.3-12 yr) in Caucasian, and 1.7 yr (range 0.3-8 yr) in non-Caucasian, children (p < 0.05). There were 125 reactions in the study population, with egg, peanut, tree nut, cow milk and cod being the commonest food allergens. Some novel foods, such as kiwi, lentil and sesame, were also represented in the top 10 food allergies, particularly in the non-Caucasian population. Ethnic minorities are over-represented in terms of the number of children with food allergy and number of food allergies per child, present at an earlier age with food allergy, and possibly have a greater variety of food allergies compared with Caucasians. This is important in terms of health education. Our findings need confirmation by a more detailed population based study, ideally using food challenges in addition to history and skin prick testing.

Genotypes A and B of Cadophora gregata Differ in Ability to Colonize Susceptible Soybean.

Growth chamber experiments were conducted to determine if extent of colonization of soybean stems by genotypes A and B of Cadophora gregata (Phialophora gregata), the causal agent of brown stem rot (BSR) of soybean, is similar in soybean plants resistant or susceptible to genotype A. Upon introduction of the two genotypes separately into the base of stems of 2-week-old seedlings, genotype A advanced with the growing tips of susceptible but not resistant genotypes. In contrast, genotype B did not advance with the growing tips of either resistant or susceptible soybean. In similar experiments, 5 weeks after introduction of genotype A, both mean percent stem length colonized by C. gregata and mean percentage of symptomatic trifoliate leaflets were significantly less for resistant than for susceptible genotypes. For genotype B, there was no or a slight difference between resistant and susceptible soybean genotypes in mean percent stem length colonized and no difference in mean percentage of symptomatic trifoliate leaflets 5 weeks after introduction of the pathogen. These results indicate that genotype A and genotype B differ not only in the severity of foliar symptoms they cause on genotype A-susceptible soybean plants, but also in how severely they colonize the stems of these soybean plants. In our experiments, genotype A and genotype B did not differ consistently in their ability to cause internal stem discoloration. The two genotypes of C. gregata can be distinguished based on how severely they colonize stems of genotype A-susceptible soybean. Thus, a BSR resistance screening method, which relies on assessment of stem colonization by C. gregata, works only for screening soybean lines resistance to genotype A. In light of these results, it is important to distinguish soybean resistance to genotype A versus genotype B of C. gregata. Whether genotype B causes yield loss and whether soybean plants can be distinguished as resistant or susceptible to genotype B needs to be investigated.

Histomorphometric Analysis of Bone Density in the Maxillary Tuberosity of Cadavers: A Pilot Study

Maxillary tuberosities have been widely used as a source of autogenous bone for a variety of oral surgical procedures. However, no previous studies have actually demonstrated the histologic and histomorphometric characteristics of this anatomical region in detail. The aim of this study was to evaluate maxillary tuberosities in cadavers histologically and histomorphometrically. A block section, including the overlying alveolar mucosa, was obtained from a randomly assigned maxillary tuberosity of 20 cadavers (nine females and 11 males). All cadavers were edentulous distal to the second bicuspid teeth, and 14 out of 20 were edentulous distal to the cuspids. A minimum of 35 serial sections were obtained from each cadaver. Description analysis was performed for the presence of either a fibrotic or fatty infiltration of the marrow spaces and thickness and continuity of alveolar bone. Computer-based histomorphometric image analysis of the percentage surface area of bone was also carried out in three sections of each cadaver. Statistical analysis was performed to establish possible differences between genders. The analysis did not control for nutritional status and/or possible systemic or skeletal diseases. Little variation existed between specimens, regardless of gender, with respect to thickness of oral mucosa overlying the tuberosity. Descriptive bone analysis revealed thin cortical bone and sparse cancellous bone patterns. In addition, the block specimens exhibited no evidence of osteoid or active bone formation, but large marrow spaces infiltrated with loosely organized fibrous connective tissue and/or lipid cells. Histomorphometric analysis demonstrated a mean percentage of vital bone of 24.23% +/- 5.2%. Stratification of the data revealed statistically significant differences in mean percentage of vital bone between genders (27.15% +/- 4.7% for males versus 20.66% +/- 3.4% for females; P = 0.003). Within the limitations of this study, maxillary tuberosities seem to mainly consist of marrow spaces, adipose tissue, and a low vital bone profile. Females demonstrated a statistically significant lower amount of vital bone than males. The results suggest that this specific area may not be an ideal source of autogenous bone for grafting purposes in older individuals. However, it is imperative to note that this investigation did not control for nutritional imbalances and skeletal disorders. Further studies are necessary to control all confounding factors.

Synovial Fluid Cell Counts and Total Protein Concentration in Clinically Normal Fetlock Joints of Young Dromedarian Camels

Twenty-seven 9-12 months old healthy male dromedarian camels were used to determine total nucleated leucocyte count (TNCC), absolute and percentages of polymorphonuclear (PMN) and mononuclear leucocytes, and total protein (TP) concentration in synovial fluid from grossly and radiographically normal fetlock joints. Arthrocentesis was performed bilaterally from the fetlock joints of the forelimbs and hindlimbs. Blood contaminated samples and samples obtained from grossly or radiographically abnormal joints were excluded. The mean +/- SD of TNCC in 108 samples of fetlock joint synovial fluids was 500 +/- 400 cells/microl. Monocytes/macrophages were the predominant cell type. There were no significant differences in mean TNCC, absolute numbers and percentages of various leucocytes and TP concentrations between the right and left fetlock joints of the forelimbs and hindlimbs or between the fetlock joints of the forelimbs and hindlimbs. The mean +/- SD of absolute numbers and percentages of various cell types were: PMN leucocytes 1 +/- 2 cells/microl (2%), lymphocytes 116 +/- 167 cells/microl (26%), and monocytes/macrophages 383 +/- 323 cells/microl (72%). The mean +/- SD of TP concentration was 2 +/- 1 g/dl.

Effects of single-dose injectable paracetamolversus propacetamol in pain management after minor gynecologic surgery: A multicenter, randomized, double-blind, active-controlled, two-parallel-group study

Background: Intravenous administration is the route of choice for drug therapy in the immediate postoperative period. Propacetamol (ProAPAP), an injectable prodrug of paracetamol requiring reconstitution, has demonstrated efficacy in managing acute pain and fever. However, it has been associated with pain at the injection site. A stable, ready-to-use formulation of paracetamol solution infused intravenously (IV-APAP) has been developed and might be associated with less pain at the injection site compared with ProAPAR Objective: The objective of this study was to assess the tolerability and efficacy of a single dose of IV APAP 1 g compared with those of a single dose of ProAPAP 2 g in patients with moderate to severe pain after minor gynecologic surgery. Methods: This single-dose, randomized, double-blind, active-controlled,2-parallel-group study was conducted at 23 hospitals and outpatient clinics in France. After minor gynecologic surgery, patients reporting moderate to severe pain were randomized to receive a single 15-minute infusion of IV-APAP 1 g or ProAPAP 2 g (bioeyuivalent doses). Tolerability was monitored using local and systemic adverse event (AE) reporting, clinical examination including vital sign measurement, and patients' ratings of acceptability of the infusion. Efficacy end points included pain intensity at 0, 1, 2, 4, and 6 hours; median time to rescue medication (defined as the time at which 50% of patients requested rescue medication); and percentage of patients requesting rescue medication. Patients' satisfaction with the study drugs was assessed using patient's global evaluation (PGE) and the percentage of patients willing to receive the treatment again. Results: Of the 163 women who were randomized, 161 received the studymedication. The IV-APAP group comprised 80 patients (mean [SD] age, 38.3 [12.8] years [range, 18.0-69.0 years]; mean [SD] weight, 61.1 [11.0] kg [range, 49.0–90.0 kg]), and the ProAPAP group comprised 81 patients (mean [SD] age, 33.9 [12.0] years [range, 18.0–67.0 years]; mean [SD] weight, 61.6 [10.2] kg [range, 42.0–95.5 kg]); the difference in mean age between the 2 groups was statistically significant ( P < 0.05). The incidence of local treatment-emergent AEs (TEAEs) was significantly lower in the IV-APAP group compared with that in the ProAPAP group (7.5% vs 38.3%; P < 0.001). No between-group differences in the incidence of systemic TEAEs was found. All patients in the IV-APAP group found the infusion tolerable, compared with 95% of patients in the ProAPAP group. The median time to rescue medication was not evaluated because <50% of the patients in each group requested it. No significant differences in mean pain intensity score or percentage of patients requesting rescue medication were found between the 2 groups at any time point. The percentages of patients in the IV-APAP and ProAPAP groups who rated the study medication as good or excellent on the PGE (83.6% vs 75.6%; P < 0.05) and who were willing to receive the same treatment again (96.0% vs 81.0%; P = 0.005) were significantly higher with IV-APAP compared with ProAPAP Conclusion: In these patients with moderate to severe pain after minor gynecologic surgery, a single dose of IV-APAP was associated with better local tolerability, similar analgesic efficacy, and greater patient satisfaction compared with a single bioequivalent dose of ProAPAP.

Cerebral Vasoreactivity: A Comparison of Color Velocity Imaging Quantification and Stable Xenon-Enhanced CT

Compromised cerebral vasoreactivity increases the risk of stroke. In this study, we sought to determine whether extracranial arterial blood flow volume measured on color velocity imaging quantification could be predictive of cerebral vasoreactivity after the administration of acetazolamide. Cerebral blood flow and extracranial arterial blood flow volume of 35 patients with symptomatic carotid occlusive disease were measured before and after the administration of acetazolamide on stable xenon CT and color velocity imaging quantification, respectively. The changes in unilateral extracranial arterial blood flow volume and respective hemispheric cerebral blood flow were compared. The mean difference in the percentage of change in flow volume, the 95% limit of agreement, and Cohen's kappa coefficient were calculated. A total of 64 unilateral extracranial arterial blood flow volume changes were successfully compared with the changes in the ipsilateral hemispheric cerebral blood flow. The mean difference in percentage of change in flow volume between the two techniques was 4.7%, with the 95% limit of agreement ranging from -90.2% to 99.7%. Cohen's kappa coefficient was 0.41 (95% confidence interval, 0.13-0.68; p = 0.001). The performance of color velocity imaging quantification for evaluating cerebral vasoreactivity is comparable to that of transcranial Doppler sonography. Because color velocity imaging quantification is not as limited as transcranial Doppler sonography, it could be an ideal complementary tool to transcranial Doppler sonography. More studies are required to define its clinical value.

Periodontal disease as a risk factor for pre‐eclampsia: A case control study

To investigate the association between periodontal disease and pre-eclampsia, while controlling known risk factors for pre-eclampsia. A matched case-control study was carried out on 41 pre-eclamptic women and 41 normotensive, healthy, pregnant, control women. The pre-eclamptic women and controls were individually matched for age, gravidity, parity, smoking and prenatal care. The number of teeth and the number of restorations and decay on all tooth surfaces, and clinical periodontal parameters, excluding third molars were determined within 48 h before delivery. The relation of independent variables to pre-eclampsia was assessed using conditional multiple logistic regression analysis on subject-based data. There were no statistically significant differences in mean percentages of sites with plaque between groups. The mean probing depth (PD) and mean clinical attachment level (CAL) for pre-eclamptic patients were significantly greater compared to those of normotensive patients (P < 0.01). The percentage of sites exhibiting bleeding on probing (BOP) (P < 0.05), the number of sites with PD >/= 4 mm and with CAL >/= 3 mm was significantly higher among pre-eclamptic patients than those with normotensive patients (P < 0.01). Conditional multiple logistic regression analysis indicated that periodontal disease and triglycerides level were significantly associated with pre-eclampsia. Other independent variables (maternal body weight and serum total cholesterol level) did not appear to be associated with pre-eclampsia. Conditional multiple logistic regression results showed that pre-eclamptic patients were 3.47 (95% CI = 1.07-11.95) times more likely to have periodontal disease than normotensive patients. The present study shows that maternal periodontal disease during pregnancy is associated with an increased risk for the development of pre-eclampsia. The higher incidence of periodontal disease parameters in pre-eclamptic group would suggest a possible role for periodontal disease in the development of pre-eclampsia. The nature both of periodontitis and pre-eclampsia is multifactorial, and caution should be exercised when implicating periodontal disease in causation of pre-eclampsia.

Mesenchymal Stem Cells: Potential Precursors for Tumor Stroma and Targeted-Delivery Vehicles for Anticancer Agents

High concentrations of interferon beta (IFN-beta) inhibit malignant cell growth in vitro. However, the therapeutic utility of IFN-beta in vivo is limited by its excessive toxicity when administered systemically at high doses. Mesenchymal stem cells (MSC) can be used to target delivery of agents to tumor cells. We tested whether MSC can deliver IFN-beta to tumors, reducing toxicity. Human MSC were transduced with an adenoviral expression vector carrying the human IFN-beta gene (MSC-IFN-beta cells). Flow cytometry was used to measure tumor cell proliferation among in vitro co-cultures of MSC-IFN-beta cells and human MDA 231 breast carcinoma cells or A375SM melanoma cells. We used a severe combined immunodeficiency mouse xenograft model (4-10 mice per group) to examine the effects of injected MSC-IFN-beta cells and human recombinant IFN-beta on the growth of MDA 231- and A375SM-derived pulmonary metastases in vivo and on survival. All statistical tests were two-sided. Co-culture of MSC-IFN-beta cells with A375SM cells or MDA 231 cells inhibited tumor cell growth as compared with growth of the tumor cells cultured alone (differences in mean percentage of control cell growth: -94.0% [95% confidence interval [CI] = -81.2% to -106.8%; P<.001] and -104.8% [95% CI = -82.1% to -127.5%; P<.001], respectively). Intravenous injection of MSC-IFN-beta cells into mice with established MDA 231 or A375SM pulmonary metastases led to incorporation of MSC in the tumor architecture and, compared with untreated control mice, to prolonged mouse survival (median survival for MDA 231-injected mice: 60 and 37 days for MSC-injected and control mice, respectively [difference = 23.0 days (95% CI = 14.5 to 34.0 days; P<.001]; median survival for A375SM-injected mice: 73.5 and 30.0 days for MSC-injected and control mice, respectively [difference = 43.5 days (95% CI = 37.0 to 57.5 days; P<.001]). By contrast, intravenous injection of recombinant IFN-beta did not prolong survival in the same models (median survival for MDA 231-injected mice: 41.0 and 37.0 days for IFN-beta-injected and control mice, respectively [difference = 4 days, 95% CI = -5 to 10 days; P = .308]; median survival for A375SM-injected mice: 32.0 and 30.0 days for IFN-beta-injected and control mice, respectively [difference = 2 days, 95% CI = 0 to 4.5 days; P = .059]). Injected MSC-IFN-beta cells suppressed the growth of pulmonary metastases, presumably through the local production of IFN-beta in the tumor microenvironment. MSC may be an effective platform for the targeted delivery of therapeutic proteins to cancer sites.

Improvement of hypothyroidism after laparoscopic Roux-en-Y gastric bypass for morbid obesity.

Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been very effective in managing a broad range of morbid obesity-related co-morbidities. We report a beneficial effect of LRYGBP that has not been previously observed. Between December 1999 and September 2002, 224 patients underwent LRYGBP. Preoperative assessment for hypothyroidism and follow-up data were prospectively collected in our database. Improved thyroid function (ITF) or unchanged thyroid function (UTF) was determined by comparison of preoperative and postoperative thyroxine requirements. 23 of 224 patients (10.3%) were treated preoperatively for hypothyroidism. During a median follow-up of 17 months, hypothyroidism was improved in 10/23 patients (43.5%). 2 patients had complete resolution, and the remaining 8 had reduction (14%-50%) of their thyroxine requirements. ITF occurred at a mean follow-up of 8.9 months and at a mean excess weight loss (EWL) of 57%. 6 of the 8 patients (75%) with ITF >or= 25% had EWL >90% at last follow-up, compared to 1 out of 15 patients (6.6%) with UTF or <25% improvement (P =0.001). Comparison of patients with ITF and UTF over time during a 20-month follow-up, showed no significant difference in mean body mass index (BMI) and mean percentage of EWL. Improvement of hypothyroidism may be an additional benefit of bariatric surgery that has not been previously reported. Reduction of thyroxine requirements is most likely the result of the decrease in the BMI.

Differential leukocyte counts in "dourado", Salminus maxillosus Valenciennes, 1840, from the Mogi-Guaçu River, Pirassununga, SP.

From August, 1996 to December, 1997, 293 of "dourado" specimens, Salminus maxillosus (Valencienes, 1840), of various sizes, were caught in Mogi-Guaçu River, Emas Falls, for hematologic studies. Total weight (Wt in g) and length (Lt in cm) were taken for each individual animal. Smears were prepared from blood samples and utilized for differential leukocyte counts (lymphocytes, neutrophils, monocytes, eosinophils, special granulocytic cell and immature cells). The mean percentages of leukocytes were determined according to sex and stage of gonadal maturation (immature, in maturation, mature, spent and resting). Significant differences between male and female occurred only for the special granulocytic cell. In analyzing the leukocyte profile during gonadal development, only female showed significant differences in mean percentages of lymphocytes, neutrophils, monocytes and eosinophils.

Prevention of Bone Loss With Tibolone in Postmenopausal Women: Results of Two Randomized, Double-Blind, Placebo-Controlled, Dose-Finding Studies

Tibolone is a synthetic agent with tissue-specific effects, including an antiresorptive effect on bone. Clinical trials have documented prevention of bone loss in postmenopausal women; a daily oral dose of 2.5 mg has generally been used. The present study evaluated tibolone therapy over 2 years with daily doses of 0.3, 0.625, 1.25, or 2.5 mg of tibolone as compared with placebo in 770 generally healthy women who were 1 to 4 years past menopause and who had normal bone density for their age. All of them took supplemental calcium carbonate as well in a daily dose of 500 mg. Bone mineral density (BMD) was measured in the lumbar spine and right proximal femur by dual-energy x-ray absorptiometry for up to 2 years. The patient population was drawn from two identically designed randomized, placebo-controlled, dose-finding studies. A total of 519 women completed the 2-year studies. Tibolone led to a progressive increase in spinal and total hip BMD over 2 years of treatment in all doses except 0.3 mg. Hip BMD was maintained by the 0.3-mg dose. Only doses of 1.25 or 2.5 mg daily progressively increased BMD at the femoral neck. Differences in mean percentage of change from baseline in spinal and total hip BMD were significant for all dose groups compared with placebo. The rise in BMD at the lumbar spine over baseline, with 1.25 or 2.5 mg daily, was 2.0 to 2.6% at 2 years, a statistically significant and clinically meaningful effect. Increasing BMD was not limited to the first year of tibolone therapy. All tibolone doses except the lowest were associated with decreased serum osteocalcin levels, whereas in placebo recipients osteocalcin increased over baseline. Comparable reductions in bone-specific alkaline phosphatase were noted in patients given 1.25 and 2.5 mg of tibolone. Total cholesterol levels decreased in all tibolone dose groups, but declines in high-density lipoprotein cholesterol, triglycerides, and apolipoprotein A-1 seemed to be dose-related. All doses of tibolone were generally well tolerated during the 2 years of administration. No deep venous thrombosis or pulmonary embolism was observed. Hot flashes were less frequent with tibolone therapy than with placebo and were at their lowest with the 2.5-mg dose. Average body weight changes were similar in the actively treated and placebo groups. Endometrial hyperplasia was comparably frequent in the two groups. Vaginal bleeding became less prevalent with continued tibolone treatment. A 1.25-mg daily dose of tibolone is recommended for preventing osteoporosis. The ability of this drug to dose-dependently increase BMD in the lumbar spine and total hip should allow individualized antiresorptive treatment for postmenopausal women according to their clinical response.

Evidence That Emotional Maladjustment Is Worse in Men Than in Women with Psychogenic Nonepileptic Seizures

The purpose of this study is to examine the effects of gender on adjustment and cognition in patients with psychogenic nonepileptic seizures (NES) and on patients with epilepsy. We compared 57 women and 27 men, all at least 16 years old, with only NES as documented by long-term EEG-video monitor studies, to equal numbers of randomly selected women and men with only epileptic seizures. Variables examined included age, age of onset, education, scales from the MMPI, the WAIS-R, and the number of tests outside normal limits from the Neuropsychological Battery for Epilepsy. We found no significant differences in mean age, intelligence, or percentage of neuropsychological tests outside normal limits across the four groups. Women and men with NES had significantly later age of onset of attacks compared with subjects of either gender with epilepsy (26 years vs 13 years, P < 0.001) and men with NES had greater educational achievement than women with NES or patients with epilepsy ( P < 0.02). However, the most important findings were seen on the MMPI. Men with NES exhibited significantly greater elevations on multiple scales (especially Hysteria, Depression, Hypochondriasis, Psychoasthenia, Schizophrenia) compared with men with epilepsy or women with either epilepsy or NES. We conclude that men with NES have significantly worse patterns of emotional adjustment, as measured by the MMPI, than women with NES or subjects of either gender with epilepsy.