Reduction In Mean Frequency Research Articles

P96: Efficacy of Brexpiprazole for the Treatment of Agitation in Alzheimer’s Dementia: Post Hoc Line Item Analysis of the Cohen-Mansfield Agitation Inventory

Objective:Agitation is a common neuropsychiatric symptom in Alzheimer’s dementia. The Cohen-Mansfield Agitation Inventory (CMAI) assesses the frequency of 29 agitation behaviors in elderly persons. The frequency of each behavior is rated from 1–7 (1=never, 2=less than once a week, 3=once or twice a week, 4=several times a week, 5=once or twice a day, 6=several times a day, 7=several times an hour), typically reported as a single total score. This post hoc analysis explored the efficacy of brexpiprazole on the frequency of individual agitation behaviors.Methods:Post hoc analyses were conducted for two 12-week, randomized, double- blind, placebo-controlled, parallel-arm, fixed-dose trials of brexpiprazole in patients with agitation in Alzheimer’s dementia (NCT01862640, NCT03548584). Data are reported using descriptive statistics for brexpiprazole (2 or 3 mg/day) and placebo, for patients who completed 12 weeks of treatment.Results:In the first fixed-dose trial (brexpiprazole 2 mg/day, n=120; placebo, n=118), baseline behavior frequency was similar between groups (range 1.12 to 4.92). At baseline, the most frequently observed behavior was “general restlessness” (brexpiprazole, 4.92; placebo, 4.82; approximately “once or twice a day”), and the least frequently observed behaviors were “biting” (brexpiprazole, 1.12) and “making physical sexual advances” (placebo, 1.14). At Week 12, the average reduction in mean frequency was -0.73 (brexpiprazole) and -0.60 (placebo), with a greater numerical reduction for 21/29 behaviors with brexpiprazole versus placebo. In the second fixed-dose trial (brexpiprazole 2 or 3 mg/day, n=192; placebo, n=103), baseline behavior frequency was similar between groups (range 1.12 to 5.22), and higher than in the first trial due to study inclusion criteria. At baseline, the most frequently observed behavior was “general restlessness” (brexpiprazole, 5.22; placebo, 5.09; approximately “once or twice a day”), and the least frequently observed behaviors were “making physical sexual advances” (brexpiprazole, 1.13) and “intentional falling” (placebo, 1.12). At Week 12, the average reduction in mean frequency was -0.78 (brexpiprazole) and -0.54 (placebo), with a greater numerical reduction for 26/29 behaviors with brexpiprazole versus placebo.Conclusion:In this post hoc analysis, brexpiprazole was associated with numerically greater reduction in the frequency of most individual agitation behaviors versus placebo.

Spatial resolution, noise properties, and detectability index of a deep learning reconstruction algorithm for dual-energy CT of the abdomen.

Iterative reconstruction (IR) has increasingly replaced traditional reconstruction methods in computed tomography (CT). The next paradigm shift in image reconstruction is likely to come from artificial intelligence, with deep learning reconstruction (DLR) solutions already entering the clinic. An enduring disadvantage to IR has been a change in noise texture, which can affect diagnostic confidence. DLR has demonstrated the potential to overcome this issue and has recently become available for dual-energy CT. To evaluate the spatial resolution, noise properties, and detectability index of a commercially available DLR algorithm for dual-energy CT of the abdomen and compare it to single-energy (SE) CT. An oval 25cmx35cm custom-made phantom was scanned on a GE Revolution CT scanner (GE Healthcare, Waukesha, WI) at two dose levels (13 and 5mGy) and two iodine concentrations (8 and 2mg/mL), using three typical abdominal scan protocols: dual-energy (DE), SE 80kV (SE-80kV) and SE 120kV (SE-120kV). Reconstructions were performed with three strengths of IR (ASiR-V: AR0%, AR50%, AR100%) and three strengths of DLR (TrueFidelity: low, medium, high). The DE acquisitions were reconstructed as mono-energetic images between 40 and 80keV. The noise power spectrum (NPS), task transfer function (TTF), and detectability index (d') were determined for the reconstructions following the recommendations of AAPM Task Group 233. Noise magnitude reductions (relative to AR0%) for the SE protocols were on average (-29%, -21%) for (AR50%, TF-M), while for DE-70keV were (-28%, -43%). There was less reduction in mean frequency (fav ) for DLR than for IR, with similar results for SE and DE imaging. There was, however, a substantial change in the NPS shape when using DE with DLR, quantifiable by a marked reduction in the peak frequency (fpeak ) that was absent in SE mode. All protocols and reconstructions (including AR0%) exhibited slight to moderate shifts towards lower spatial frequencies at the lower dose (<12% in fav ). Spatial resolution was consistently superior for DLR compared to IR for SE but not for DE. All protocols and reconstructions (including AR0%) showed decreased resolution with reduced dose and iodine concentration, with less decrease for DLR compared to IR. DLR displayed a higher d' than IR. The effect of energy was large: d' increased with lower keV, and SE-80kV had higher d' than SE-120kV. Using DE with DLR could provide higher d' than SE-80kV at the higher dose but not at lower dose. DE imaging with DLR maintained spatial resolution and reduced noise magnitude while displaying less change in noise texture than IR. The d' was also higher with DLR than IR, suggesting superiority in detectability of iodinated contrast. Despite these trends being consistent with those previously established for SE imaging, there were some noteworthy differences. For DE imaging there was no improvement in resolution compared to IR and a change in noise texture. DE imaging with low keV and DLR had superior detectability to SE DLR at the high dose but was not better than SE-80kV at low dose.

K.Vita: a feasibility study of a blend of medium chain triglycerides to manage drug-resistant epilepsy.

This prospective open-label feasibility study aimed to evaluate acceptability, tolerability and compliance with dietary intervention with K.Vita, a medical food containing a unique ratio of decanoic acid to octanoic acid, in individuals with drug-resistant epilepsy. Adults and children aged 3–18 years with drug-resistant epilepsy took K.Vita daily whilst limiting high-refined sugar food and beverages. K.Vita was introduced incrementally with the aim of achieving ≤35% energy requirements for children or 240 ml for adults. Primary outcome measures were assessed by study completion, participant diary, acceptability questionnaire and K.Vita intake. Reduction in seizures or paroxysmal events was a secondary outcome. 23/35 (66%) children and 18/26 (69%) adults completed the study; completion rates were higher when K.Vita was introduced more gradually. Gastrointestinal disturbances were the primary reason for discontinuation, but symptoms were similar to those reported from ketogenic diets and incidence decreased over time. At least three-quarters of participants/caregivers reported favourably on sensory attributes of K.Vita, such as taste, texture and appearance, and ease of use. Adults achieved a median intake of 240 ml K.Vita, and children 120 ml (19% daily energy). Three children and one adult had ß-hydroxybutyrate >1 mmol/l. There was 50% (95% CI 39–61%) reduction in mean frequency of seizures/events. Reduction in seizures or paroxysmal events correlated significantly with blood concentrations of medium chain fatty acids (C10 and C8) but not ß-hydroxybutyrate. K.Vita was well accepted and tolerated. Side effects were mild and resolved with dietetic support. Individuals who completed the study complied with K.Vita and additional dietary modifications. Dietary intervention had a beneficial effect on frequency of seizures or paroxysmal events, despite absent or very low levels of ketosis. We suggest that K.Vita may be valuable to those with drug-resistant epilepsy, particularly those who cannot tolerate or do not have access to ketogenic diets, and may allow for more liberal dietary intake compared to ketogenic diets, with mechanisms of action perhaps unrelated to ketosis. Further studies of effectiveness of K.Vita are warranted.

Short and Mid-Term Predictors of Response to OnabotulinumtoxinA: Real-Life Experience Observational Study.

To identify clinical predictors of excellent response to OnabotulinumtoxinA in patients with chronic migraine (CM) at 6 and 12months of follow-up. Clinical predictors of response to OnabotulinumtoxinA are scarce and have not been clearly reproduced and analyzed in detail. So far, predictors of response to OnabotulinumtoxinA assess response in general or good response, but not an excellent response. Cohort study of patients attended in a specialized Headache Clinic in treatment with OnabotulinumtoxinA were classified according to their improvement in frequency: no-response (<25%) and excellent response (≥75%). A comparative analysis was carried out at 6 and 12months identifying clinical predictors of excellent response to OnabotulinumtoxinA at each timepoint. Data were collected from 221 patients. After 6 and also 12months, we observed a statistically significant mean reduction in frequency and analgesic intake. At month 6, independent variables associated with excellent response (OR[95%CI]) were daily headache frequency (0.32[0.14-0.74]; P=.005), medication overuse (MO) (2.28[1.19-4.37]; P=.013), and a higher ratio of migraine days/month (MDM) (1.20[1.10-1.45]; P=.018) at baseline. At month 12, independent predictors of excellent response were patients with less than 30years of migraine evolution (0.43[0.23-0.82]; P=.011), presence of anxiety (0.44[0.23-0.85]; P=.018), and aura (0.48[0.25-0.92]; P=.037). Excellent responders showed a higher improvement rate in pain intensity at 6 and 12months. Patients with daily frequency and MO show a clinical improvement in short-term. Patients with comorbidities who start treatment earlier in the course of the disease need a longer duration of treatment. The profile of response to treatment with OnabotulinumtoxinA determines its minimum treatment duration and the timepoint of a meaningful response.

Fatiguing effects of indirect vibration stimulation in upper limb muscles: pre, post and during isometric contractions superimposed on upper limb vibration.

Whole-body vibration and upper limb vibration (ULV) continue to gain popularity as exercise intervention for rehabilitation and sports applications. However, the fatiguing effects of indirect vibration stimulation are not yet fully understood. We investigated the effects of ULV stimulation superimposed on fatiguing isometric contractions using a purpose developed upper limb stimulation device. Thirteen healthy volunteers were exposed to both ULV superimposed to fatiguing isometric contractions (V) and isometric contractions alone Control (C). Both Vibration (V) and Control (C) exercises were performed at 80% of the maximum voluntary contractions. The stimulation used was 30 Hz frequency of 0.4 mm amplitude. Surface-electromyographic (EMG) activity of the Biceps Brachii, Triceps Brachii and Flexor Carpi Radialis were measured. EMG amplitude (EMGrms) and mean frequency (MEF) were computed to quantify muscle activity and fatigue levels. All muscles displayed significantly higher reduction in MEFs and a corresponding significant increase in EMGrms with the V than the Control, during fatiguing contractions (p < 0.05). Post vibration, all muscles showed higher levels of MEFs after recovery compared to the control. Our results show that near-maximal isometric fatiguing contractions superimposed on vibration stimulation lead to a higher rate of fatigue development compared to the isometric contraction alone in the upper limb muscles. Results also show higher manifestation of mechanical fatigue post treatment with vibration compared to the control. Vibration superimposed on isometric contraction not only seems to alter the neuromuscular function during fatiguing efforts by inducing higher neuromuscular load but also post vibration treatment.

Early efficacy and late gain in chronic and high-frequency episodic migraine with onabotulinumtoxinA.

The aim was to analyse the clinical characteristics of a long-term follow-up of patients with chronic and high-frequency episodic migraine in treatment with onabotulinumtoxinA. Patients diagnosed with high-frequency episodic migraine (HFEM) or chronic migraine (CM) according to the International Classification of Headache Disorders 3 beta were included. A comparative analysis was carried out at each study time point identifying outcome measures according to initial diagnosis and treatment duration. In all, 578 patients were recruited and after 24months outcome data were collected from 100 patients: 84.0% CM and 16.0% HFEM. After 24months, headache frequency was significantly reduced by 10.5days from baseline, 64.0% reported a ≥50% reduction in pain intensity and 70.0% of patients had ≥50% reduction in analgesic use. Comparing baseline diagnoses, at month 6 CM patients presented higher mean reduction in frequency (CM 44.3%±32.6% vs. HFEM 34.6%±24.8%) and analgesic use (CM 53.6%±35.4% vs. HFEM 39.3%±33.2%). At month 12, the mean reduction in frequency was similar in CM and HFEM patients (CM 44.7%±33.4% vs. HFEM 41.2%±28.2%). Improvement in pain intensity, analgesic use and Migraine Disability Assessment were proportional in both diagnoses. OnabotulinumtoxinA efficacy is significant at 6months in frequency and analgesic intake and remains stable during follow-up, whilst the intensity of pain decreases in a stepwise manner at each time point of the analysis. The improvement in CM and HFEM patients is proportional and significant after 1year of treatment.

Use of Bladder diary as diagnostic and therapeutic tool for Overactive Bladder

Aims: To evaluate use of diary for teaching patient with overactive bladder and see its therapeutic effects in terms of reduction in their symptoms&#x0D; Methods: A single-blind randomized clinical trial, regarding “Effects of Bladder Training and behavioral intervention in Female Patients with Over active Bladder syndrome, attending Urogynecology clinic at The Aga Khan University Hospital Karachi, Pakistan: A Randomized Controlled Trial (OAB) trial” We here present the additional conclusions drawn from results of ARM-1.Arm-1 patients were managed by behavioral intervention only and were asked to fill 7 days diary in 12 weeks .By using WHO software a minimum of 114 women needed to meet the study objectives. We recruited 50 women in each group (150 totals) as there was a possibility of drop out.We calculated the mean difference in fluid intake and reduction in urinary frequency, urgency, nocturia before and after educating the patient using the paired-T Test.&#x0D; Results: A total of 47 women completed follow up visits for overactive bladder treatment ARM-A. (Mean ± SD) Mean fluid intake on first diary was 2392.9 ml while on last diary fluid intake was reduced to 177.1ml with mean fluid intake difference of 621.8ml+622.2(p&lt;0.00).The mean reduction in frequency of micturition during day and nocturia was 2.9+2.7(P&lt;0.00) and 0.59+ 0.99(p&lt;0.00) respectively. The mean decrease in urgency score and reduction in leak accident was 1.19+1.2(p&lt;0.00) and 0.9+0.95(p&lt;0.00) respectively.&#x0D; Conclusions: The bladder diary for women with OAB has both diagnostic and therapeutic effect. In developing countries it is an easy least expensive but time consuming method of treatment for simple cases of OAB.

A Comparative Study of Probiotic Lactic Acid Bacilli Alone and in Combination with Bifidobacterium and Saccharomyces as Adjuvants to ORS and Zinc in the Management of Acute Pediatric Diarrhoea

Introduction: Pediatric diarrhoea is the second leading cause of childhood mortality. It is a major global health problem, particularly affecting children under the age of 5 years. It is managed with oral rehydration salt, and zinc supplements. Recently, there has been a trend of prescribing probiotics which help in reducing the frequency and duration of diarrhoea. As India is fast emerging as a potential market for probiotics, scientific studies are required to ensure their efficacy. With this background, this study was undertaken to evaluate the role of probiotics in the treatment of acute onset mild and moderate pediatric diarrhea. Materials and Methods: This was an observational, prospective, open label, comparative study. It was conducted on 90 children after obtaining informed consent from their guardian. The participants were allocated to one of three study groups as follows; Group A: ORS & zinc Group, B: ORS, Zinc and lactic acid bacilli; Group C: ORS, Zinc and combination of lactic acid bacilli acidophilus, Bifidobacterium lactis and Saccharomyces boulardii. They were followed up for 72 hours after receiving the treatment and after 7 days. The outcome measures were reduction in mean duration and mean frequency of diarrhea. Data was collected in case report forms. Statistical analysis was done using ANOVA followed by Dunnet’s test. Results: The mean frequency of diarrhea on day 1 in Group A, B and C were 5.87±1.23; 6.5±1.15 and 6.63±1.42 respectively. On day 2, in Group A it was 2.93±0.82; Group B, 3.23±0.99 and in Group C, 2.73±0.89 respectively. On day 3, in Group A it was 1.33±0.47; Group B, 0.86±0.5 and in Group C, 0.53±0.5 respectively. The mean duration of diarrhea in Group A, B and C were 4.5±0.76, 3.47±0.5 and 3.17±0.37 days respectively. There was significant reduction in mean frequency and duration of diarrhea in Group B and C compared to Group A (p˂0.05). Conclusion: Probiotics when used alone or in combination as adjuvant to ORS and Zinc in the treatment of acute pediatric diarrhea results in significant reduction in mean frequency and mean duration of diarrhea.

A study on the formation of center of gravity trajectory during sit-to-stand motion with asymmetrical foot placement

processed with a wavelet analysis. The angular information of the Biodex dynamometer was synchronized with the telemetric transmitter during the muscle fatigue assessment. Owing to the high variance in the sEMGand isokinetic torque assessment data of the first and final (the 1st and the 32nd) repetitions of maximum knee extension, data from these two repetitions were excluded. The rates of the muscle fatigue and the sEMG spectral shape were calculated as the decline in each contraction number by the bivariate liner regression. Skeletal muscle mass (SMM) was assessed by the bioelectrical impedance analysis. All the assessment procedures in this study were administered to all subjects by one investigator. Results: The fatigue index was not significantly different in genders (males = 26.15± 2.65%, females = 18.73± 5.98%, effect size = 1.61, β = 0.394). The VL was significantly decreased linearly in the sEMG of mean-frequency (MNF) and high-frequency power(HF) for males and females. In addition, the Males exhibited higher reduction in MNF and HF than females. The males SMM values were significantly higher than females (males = 31.36± 1.86 kg, females = 20.04± 0.37 kg, p< 0.01, effect size = 7.56). Conclusion(s): This study demonstrated that there is a significant reduction in sEMG of MNF and HF in males. This data suggests that males have a higher percentage of fast-twitch muscle fibers than females. Implications: Physical therapist engaged in rehabilitation should be aware of the gender-difference during resistance training or muscle assessment.

An Analysis of the Effect of Global Warming on the Intensity of Atlantic Hurricanes Using a GCM with Statistical Refinement

Abstract A statistical intensity adjustment is utilized to extract information from tropical cyclone simulations in a 50-km-resolution global model. A simple adjustment based on the modeled and observed probability distribution of storm lifetime maximum wind speed allows the model to capture the differences between observed intensity distributions in active/inactive year composites from the 1981–2008 period in the North Atlantic. This intensity adjustment is then used to examine the atmospheric model’s responses to different sea surface temperature anomalies generated by coupled models for the late twenty-first century. In the North Atlantic all simulations produce a reduction in the total number of cyclones, but with large intermodel spread in the magnitude of the reduction. The intensity response is positively correlated with changes in frequency across the ensemble. However, there is, on average, an increase in intensity in these simulations despite the mean reduction in frequency. The authors argue that it is useful to decompose these intensity changes into two parts: an increase in intensity that is intrinsic to the climate change experiments and a change in intensity positively correlated with frequency, just as in the active/inactive historical composites. By isolating the intrinsic component, which is relatively independent of the details of the SST warming pattern, an increase is found in storm-lifetime maximum winds of 5–10 m s−1 for storms with intensities of 30–60 m s−1, by the end of the twenty-first century. The effects of change in frequency, which are dependent on the details of the spatial structure of the warming, must then be superimposed on this intrinsic change.

POH05 Efficacy and safety of greater occipital nerve blocks in cluster headache

IntroductionGreater occipital nerve blocks (GONB) are used in the management of primary headaches.MethodsThe severity (verbal rating scale), duration (minutes) and frequency (per day) of headaches before and after GONB was...

Medium-dose riboflavin as a prophylactic agent in children with migraine: A preliminary placebo-controlled, randomised, double-blind, cross-over trial

Riboflavin seems to have a promising effect on migraine in adults. The present study examines whether riboflavin has a prophylactic effect on migraine in children. To investigate whether riboflavin in a dosage of 50 mg/day has a prophylactic effect on migraine attacks in young children. This randomised, placebo-controlled, double-blind, cross-over trial included 42 children (aged 6-13 years) with migraine of whom 14 children were also suffering from tension-type headache. Following a 4-week baseline period, all children received placebo for 16 weeks then riboflavin for 16 weeks (or vice versa) with a washout period of 4 weeks in between. The primary outcome measure was reduction in mean frequency of migraine attacks and tension-type headache in the last 4 weeks at the end of the riboflavin and placebo phase, compared with the preceding baseline or wash-out period. Secondary outcome measures were mean severity and mean duration of migraine and tension-type headaches in the last 4 weeks at the end of the riboflavin and placebo phase, compared with the preceding baseline or wash-out period. No significant difference in the reduction of mean frequency of migraine attacks in the last month of treatment was found between placebo and riboflavin (P = 0.44). However, a significant difference in reduction of mean frequency of headaches with a tension-type phenotype was found in favour of the riboflavin treatment (P = 0.04). In this group of children with migraine, there is no evidence that 50 mg riboflavin has a prophylactic effect on migraine attacks. We found some evidence that 50 mg riboflavin may have a prophylactic effect on interval headaches that may correspond to mild migraine attacks or tension-type headache attacks in children with migraine.

Evaluation of a hospital pharmacy-based pharmaceutical care services for asthma patients.

To implement and assess hospital-based pharmaceutical care services for patients with asthma. A prospective, randomized, controlled study was conducted in Shaab teaching hospital, Khartoum, Sudan. Patients were allocated randomly either in the intervention group (60) or control group (40) patients. The drug therapy of asthma for the patients in the intervention group was reviewed by a trained pharmacist, and interventions were suggested to the attending physicians for the identified problems. Intervention patients received comprehensive medication counselling and asthma education every 2 weeks, while the control group received the routine medical consultation and dispensing services. The outcome measures were recorded using structured forms at baseline and monitored during a follow-up of every two weeks for 6 months in both groups. Data were analyzed using SPSS version 13, level of significance was p<0.05. At the end of the study period the mean reduction in frequency of acute attacks (1.91; SD=0.18 vs. 1.0; SD=0.14; p=0.03), nocturnal asthma symptoms (3.5; SD=0.3 vs. 1.1; SD=0.2; p=0.02) and frequency of using inhaled β2 agonists per week (19.9; SD= 2.1 vs. 3.3; SD=0.3; p=0.01) were significantly greater in the intervention group compared to control. A significant mean reduction (p=0.002) in the days of sickness/week was in the intervention group, while in control group there was an increase in mean days of sickness/week. The intervention group showed a significant greater improvement in the score for assessing the inhalation technique (p<0.001), patient's knowledge about asthma (p<0.001), and its drug-therapy (p=0.01) compared with control. The present findings suggest that pharmacist's intervention can have positive impact on asthma-related outcomes in patients.

Guided self-help for bulimia nervosa in primary care: a randomized controlled trial

To increase access to cognitive behavioural therapy for bulimia nervosa new delivery modes are being examined. Guided Self-Help (GSH) in primary care is potentially valuable in this respect. This research aimed to compare outcomes following GSH delivered by general practitioners (GPs) in the normal course of their practice to a delayed treatment control (DTC) condition, and to examine the maintenance of treatment gains at 3 and 6 months following completion of GSH. Participants were 109 women with full syndrome or sub-threshold bulimia nervosa, randomly allocated to GSH ( n = 54) and DTC ( n = 55). The GSH group received direction and support from a GP over a 17-week period while working through the manual in Bulimia Nervosa and Binge-Eating: A Guide to Recovery by P. J. Cooper (1995). GSH and DTC groups were assessed pre-treatment and 1 week following the 17-week intervention or waiting interval. The GSH group was reassessed at 3- and 6-month follow-up. Intention-to-treat analyses at end of treatment revealed significant improvements in bulimic and psychological symptoms in GSH compared with DTC, reduction in mean frequency of binge-eating episodes by 60% in GSH and 6% in DTC, and remission from all binge-eating and compensatory behaviours in 28% of the GSH and 11% of the DTC sample. Treatment gains were maintained at 3- and 6-month follow-up. Outcomes in GSH compare favourably with those of specialist-delivered psychological treatments. These findings are considered in light of the nature of the therapy offered and the primary care context.

Field efficacy of a 10-day treatment of fumagillin against proliferative kidney disease in rainbow trout Oncorhynchus mykiss

Proliferative kidney disease (PKD) of salmonid fish is an endoparasitosis due to infection with an, as yet, unclassified myxosporean parasite, the so-called `PKX'. Malachite green and fumagillin are the only chemotherapeutants capable of controlling this disease. The efficacy of a single 10-day treatment of fumagillin, orally administered at 3 mg kg body weight (BW) −1 day −1 was assessed in 14 field trials conducted during the summers of 1994 and 1995 in trout farms located in France and the United Kingdom (UK), using populations of juvenile rainbow trout, naive to PKX infection. Each population was divided into a treated group and an untreated control group, that were run in parallel. The first day of medication (D0) was determined by collection for examination of a random sample of 50 fish within each population prior to medication. Depending on the frequency of PKX cells in kidney imprints from these samples (2–8%, 10–30%, or >30% frequency), fumagillin treatment was commenced at either 15–21 days, 7–15 days, or immediately after parasitic examination. Assessment of the treatment efficacy was based upon comparisons between treated and control groups of the distribution of renal hypertrophic lesions, final survival rates, total losses in body weight and food conversion ratios (FCR). The tolerance to the product was quantitatively assessed by comparing the intermediate survival rates among groups on D35; the end of a critical post-medication period identified in previous studies. Most treated fish exhibited significantly fewer severe lesions (mean reduction in frequency of 59.1%). A mean relative percent survival (RPS) of 36.7% in PKD mortality was obtained. RPS was higher in moderate cases of PKD. The mean difference of overall survival rates was +7.8% in favour of treated fish. The mean reduction of weight loss was 32% in treated fish compared to controls. An improvement of FCR was detected when a very severe PKD occurred in the farm. Overall, this study confirms that fumagillin is a safe and effective treatment for PKD in Salmonidae when administered at 3 mg kg BW −1 day −1 for 10 days during the PKD incubation phase.

Characterization of MRI response to treatment with interferon beta-1b: contrast-enhancing MRI lesion frequency as a primary outcome measure.

MRI is a valuable tool to examine the pathophysiology and natural history of multiple sclerosis (MS), and several large multicenter trials have utilized MRI as a secondary outcome measures. We previously examined the effect of interferon beta-1b on contrast-enhancing lesions on MRI using a baseline versus treatment design, and found that on treatment there is a reduction in mean frequency of enhancing lesions over the group. Using an expanded number of patients and the same trial design, we examined the individual response to treatment more extensively. We find that the effect seen previously is still present, and that there is heterogeneity in the amount of decrease in contrast-enhancing lesions. This expanded number of patients and trial design allows for the discussion of new criteria for individual response to treatment, which are applied in the current trial. These approaches may be useful in the examination, early testing, and comparison of experimental therapeutic agents in MS as well as in the characterization of patients who do or do not have a response seen on MRI.

Effects of Stress Management Training and Dietary Changes in Treating Ischemic Heart Disease

To evaluate the short-term effects of an intervention that consists of stress management training and dietary changes in patients with ischemic heart disease (IHD), we compared the cardiovascular status of 23 patients who received this intervention with a randomized control group of 23 patient who did not. After 24 days, patients in the experimental group demonstrated a 44% mean increase in duration of exercise, a 55% mean increase in total work performed, somewhat improved left ventricular regional wall motion during peak exercise, and a net change in the left ventricular ejection fraction from rest to maximum exercise of +6.4%. Also, we measured a 20.5% mean decrease in plasma cholesterol levels and a 91.0% mean reduction in frequency of anginal episodes. In this selected sample, short-term improvements in cardiovascular status seem to result from these adjuncts to conventional treatments of IHD.