Numerous Attempts (numerous + attempt)

Distribution by Scientific Domains

Selected Abstracts

Unlocking the opportunity of tight glycaemic control

Inhaled insulin: clinical efficacy
Numerous attempts have been made to develop novel routes of insulin delivery that are both effective and tolerable. Of all the potential non-invasive delivery options, pulmonary delivery is the most clinically viable. Early studies demonstrate that the inhaled insulin is rapidly absorbed and is closer to biological insulin than standard subcutaneous insulin (SC). To date, inhaled insulin (Exubera®) has been clinically assessed in more than 3500 patients with type 1 or type 2 diabetes, some treated for more than 7 years. Several phase 3 studies of 24-week duration have demonstrated comparable glycosylated haemoglobin (HbA1c) control in patients with type 1 diabetes treated with Exubera® vs. SC insulin. Similar results have also been recorded in patients with type 2 diabetes. Furthermore, Exubera® has shown clinical superiority to oral agent regimens in patients with type 2 diabetes who failed to achieve their target HbA1c using lifestyle modification and oral agents. Exubera® was well tolerated and treatment satisfaction was high, with Exubera® being the preferred insulin therapy in all studies. The results of these trials, and others, suggest that Exubera® may be a valuable tool to help a wide variety of patients with type 1 or type 2 diabetes reach their recommended goals for glycaemic control, irrespective of their current therapy. [source]

Pathology of non-infective gastritis

A Srivastava
The discovery of Helicobacter pylori and its intimate role in the development of the most common form of chronic gastritis has elicited a much-needed interest in non-neoplastic gastric pathology. This has been paralleled by an increase in upper endoscopic examinations, which allow recognition of novel patterns and distribution of mucosal injury. Numerous attempts at classification have been made, most based on the acuteness or chronicity of gastric mucosal injury. In this review, we will not offer a new classification but present a detailed description of the major clinicopathological entities, based either on the salient morphological features or the underlying aetiologies, i.e. iatrogenic, autoimmune, vascular or idiopathic. [source]

The Elusive Path to Cartilage Regeneration

ADVANCED MATERIALS, Issue 32-33 2009
Ernst B. Hunziker
Abstract Numerous attempts have been made to develop an efficacious strategy for the repair of articular cartilage. These endeavors have been undaunted, if not spurred, by the challenge of the task and by the largely disappointing outcomes in animal models. Of the strategies that have been lately applied in a clinical setting, the autologous-chondrocyte-transplantation technique is the most notorious example. This methodology, which was prematurely launched on the clinical scene, was greeted with enthusiasm and has been widely adopted. However, a recent prospective and randomized clinical trial has revealed the approach to confer no advantage over conventional microfracturing. Why is the repair of articular cartilage such a seemingly intractable problem? The root of the evil undoubtedly lies in the tissue's poor intrinsic healing capacity. But the failure of investigators to tackle the biological stumbling blocks systematically rather than empirically is hardly a less inauspicious circumstance. Moreover, it is a common misbelief that the formation of hyaline cartilage per se suffices, whereas to be durable and functionally competent, the tissue must be fully mature. An appreciation of this necessity, coupled with a thorough understanding of the postnatal development of articular cartilage, would help to steer investigators clear of biological cul-de-sacs. [source]

Difficult-to-Control Bleeding

Jane S. Bellet M.D.
The surgery was complicated by unexpected difficult-to-control bleeding in the operating room. Numerous attempts to obtain hemostasis were unsuccessful including the use of local anesthetic containing epinephrine, direct pressure, wall suction, monopolar electrocautery using different tip sizes, sponge sticks, and Gelfoam®. Finally bleeding was contained using a suction-electocautery unit frequently used by otolaryngology. This article reviews the usual causes of unexpected bleeding in the pediatric population and both familiar and unfamiliar methods to control operative bleeding. [source]

Bone marrow stem cells regenerate infarcted myocardium

Donald Orlic
Abstract: Heart disease is the leading cause of death in the United States for both men and women. Nearly 50% of all cardiovascular deaths result from coronary artery disease. Occlusion of the left coronary artery leads to ischemia, infarction, necrosis of the affected myocardial tissue followed by scar formation and loss of function. Although myocytes in the surviving myocardium undergo hypertrophy and cell division occurs in the border area of the dead tissue, myocardial infarcts do not regenerate and eventually result in the death of the individual. Numerous attempts have been made to repair damaged myocardium in animal models and in humans. Bone marrow stem cells (BMSC) retain the ability throughout adult life to self-renew and differentiate into cells of all blood lineages. These adult BMSC have recently been shown to have the capacity to differentiate into multiple specific cell types in tissues other than bone marrow. Our research is focused on the capacity of BMSC to form new cardiac myocytes and coronary vessels following an induced myocardial infarct in adult mice. In this paper we will review the data we have previously published from studies on the regenerative capacity of BMSC in acute ischemic myocardial injury. In one experiment donor BMSC were injected directly into the healthy myocardium adjacent to the injured area of the left ventricle. In the second experiment, mice were treated with cytokines to mobilize their BMSC into the circulation on the theory that the stem cells would traffic to the myocardial infarct. In both experimental protocols, the BMSC gave rise to new cardiac myocytes and coronary blood vessels. This BMSC-derived myocardial regeneration resulted in improved cardiac function and survival. [source]

Follow-Up of 1 mg Finasteride Treatment of Male Pattern Baldness,Difference between Clinical Trials and Private Office Follow-Up: Influences on Prescribing Habits Evaluated

Marvin J. Rapaport MD
Background. Finasteride (Propecia) was approved by the FDA in 1998 for treating men with androgenetic alopecia. The published clinical trials demonstrated statistical differences between drug and placebo. Rarely do new drugs undergo further non-drug-company-sponsored studies of efficacy. Concerns about clinical studies and marketing of drugs prompted this evaluation of a large group of patients taking this medication. Objective. Finasteride usage offered an opportunity not only to understand the acceptance of a cosmetically oriented medication, but also to evaluate subjective comments and compliance after a long period of time. Methods. A total of 1261 patients were monitored with phone calls every 3 months after finasteride was initially prescribed. After 12 months, a detailed questionnaire was sent to all patients with an additional letter and two telephone calls if no response was received. Statistical analysis of the patients' data was made. Results. Thirty-two percent or 414 men continued to take finasteride daily for 1 to 3 years. Twenty-four percent or 297 men discontinued the drug between 3 and 15 months owing to poor results. The remaining 44% or 549 men were lost to follow-up despite numerous attempts to contact them. Conclusion. A total of 414 men continued to take the medication, but only 211 returned detailed questionnaires. A small percentage of this group felt that they grew hair. The remaining patients noted poor results. [source]

Identification of a Parathyroid Hormone in the Fish Fugu rubripes,

Janine A Danks
Abstract A PTH gene has been isolated from the fish Fugu rubripes. The encoded protein of 80 amino acid has the lowest homology with any of the PTH family members. Fugu PTH(1,34) had 5-fold lower potency than human PTH(1,34) in a mammalian cell system. Introduction: Parathyroid hormone (PTH) is the major hypercalcemic hormone in higher vertebrates. Fish lack parathyroid glands, but there have numerous attempts to identify and isolate PTH from fish. Materials and Methods: Polymerase chain reaction (PCR) was performed with primers based on preliminary data from the Joint Genome Institute database. PCR amplification was performed on genomic DNA isolated from Fugu rubripes. PCR products were purified and DNA was sequenced. All sequence was confirmed from more than one independently amplified PCR product. Multiple sequence alignments were carried out, and the percentage of identities and similarities were calculated. An unrooted phylogenetic tree, using all the known PTH and PTH-related protein (PTHrP) amino acid sequences, was determined. Synthetic peptides were tested in a biological assay that measured cyclic adenosine 3,,5,-monophosphate formation in UMR106.1 cells. Rabbit polyclonal antisera specific for N-terminal human PTHrP and one rabbit polyclonal antiserum specific for N terminus hPTH were used to test the cross-reactivity with fPTH(1,34) in immunoblots. [source]

Putting the Image Back in Imagination

Despite their intuitive appeal and a long philosophical history, imagery-based accounts of the imagination have fallen into disfavor in contemporary discussions. the philosophical pressure to reject such accounts seems to derive from two distinct sources. First, the fact that mental images have proved difficult to accommodate within a scientific conception of mind has led to numerous attempts to explain away their existence, and this in turn has led to attempts to explain the phenomenon of imagining without reference to such ontologically dubious entities as mental images. Second, even those philosophers who accept mental images in their ontology have worried about what seem to be fairly obvious examples of imaginings that occur without imagery. In this paper, I aim to relieve both these points of philosophical pressure and, in the process, develop a new imagery-based account of the imagination: the imagery model. [source]

Departmental websites and female student recruitment

Kristin Hanks
Female recruitment and retention in technology related fields is still low, despite numerous attempts to reverse this trend. As a recruitment device, a school's webpage may be the only visual representation a student will see before deciding whether or not to apply. Thus, understanding the possible implications of this medium is important within the larger conversation on gender equity and opportunities. This research addresses several questions: At first glance, do websites give gender cues, whether intentional or not? Is there a relationship between certain web content and the number of women recruited into technology related schools and departments? Do applied fields (Informatics, Information Science, Instructional Technology, Information Systems) differ in their online recruitment practices from more traditional Computer Science and Engineering departments? It is important to note that this research is not an attempt to find the best web practices to recruit female students or an attempt to punish or blame specific institutions regarding their recruitment practices. [source]

Unique ramus anatomy for Neandertals?

Milford H. Wolpoff
Abstract The ramus of Neandertal mandibles is said to show a suite of uniquely Neandertal character states that demonstrate the independent course of Neandertal evolution. This is the latest of numerous attempts to define cranial and mandibular autapomorphies for Neandertals. We examine variation in the four presumably autapomorphic ramal features and show they are neither monomorhic within Neandertals (to the contrary Neandertals are at least as variable as other human samples) nor unique to Neandertals, since they regularly appear in populations predating and postdating them. Neandertals differ from other human populations, both contemporary and recent, but the question of whether this fact reflects a divergent evolutionary trajectory must be addressed by the pattern of differences. In this case, as in the other attempts to establish Neandertal autapomorphies, rather than showing restricted variation and increased specialization, the Neandertal sample shows that the range of human variation in the recent past encompasses, and in some cases exceeds, human variation today, even in the very features claimed to be autapomorphic. Am J Phys Anthropol, 2005. © 2005 Wiley-Liss, Inc. [source]

Teledermatology in the U.K.: lessons in service innovation

T.L. Finch
Summary Background, Teledermatology has the potential to revolutionize the delivery of dermatology services by facilitating access to specialist services at a distance. In the U.K. over the previous decade there have been numerous attempts at introducing and using teledermatology; however, the development of teledermatology as routine service provision remains limited. Objectives, To identify factors that promote successful use of teledermatology as a part of routine service provision. Methods, A longitudinal qualitative study of teledermatology, drawing on data from in-depth semistructured interviews; observations of systems in practice; and public meetings. Data were analysed collectively by the research team using established qualitative analytical techniques to identify key thematic categories. The sample consisted of teledermatology services within the U.K. (n = 12) studied over 8 years (1997,2005). Individual participants (n = 68 interviews) were consultant dermatologists, researchers, teledermatology nurses, administrators, patient advocates, general practitioners and technologists. Results, The analysis compared services that did or did not become part of routine healthcare practice to identify features that supported the normalization of teledermatology. Requirements for using and integrating teledermatology into practice included: political support; perceived benefit and relative commitment that outweighs effort; pragmatic approaches to proving efficacy and safety; perception of risk as being ,manageable' on the basis of professional judgement; high levels of flexibility in practice (in terms of individuals, technology and organization); and reconceptualizing professional roles. Conclusions, Successful implementation of teledermatology as a routine service requires greater understanding of and attention to the interplay between social and technical aspects of teledermatology, and how this is accommodated both by healthcare professionals and the organizations in which they work. [source]