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Promising
Kinds of Promising Terms modified by Promising Selected AbstractsReview article: yeast as probiotics ,Saccharomyces boulardiiALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2007D. CZERUCKA Summary Background Probiotics are defined as live micro-organisms which confer a health benefit on the host. Although most probiotics are bacteria, one strain of yeast, Saccharomyces boulardii, has been found to be an effective probiotic in double-blind clinical studies. Aims To compare the main properties that differentiates yeast from bacteria and to review the properties of S. boulardii explaining its potential benefits as a probiotic. Methods The PubMed and Medline databases were searched using the keywords ,probiotics', ,yeast', ,antibiotic associated diarrhea', ,Saccharomyces boulardii',,bacterial diarrhea' and ,inflammatory bowel disease' in various combinations. Results Several clinical studies have been conducted with S. boulardii in the treatment and prevention of various forms of diarrhoea. Promising research perspectives have been opened in terms of maintenance treatment of inflammatory bowel diseases. The mechanism of S. boulardii's action has been partially elucidated. Conclusion Saccharomyces boulardii is a strain of yeast which has been extensively studied for its probiotic effects. The clinical activity of S. boulardii is especially relevant to antibiotic-associated diarrhoea and recurrent Clostridium difficile intestinal infections. Experimental studies clearly demonstrate that S. boulardii has specific probiotic properties, and recent data has opened the door for new therapeutic uses of this yeast as an ,immunobiotic'. [source] Promising tumor-associated antigens for future prostate cancer therapyMEDICINAL RESEARCH REVIEWS, Issue 1 2010Yong Li Abstract Prostate cancer (CaP) is one of the most prevalent malignant diseases among men in Western countries. There is currently no cure for metastatic castrate-resistant CaP, and median survival for these patients is about 18 months; the high mortality rate seen is associated with widespread metastases. Progression of CaP from primary to metastatic disease is associated with several molecular and genetic changes that can affect the expression of specific tumor-associated antigens (TAAs) or receptors on the cell surface. Targeting TAAs is emerging as an area of promise for controlling late-stage and recurrent CaP. Several reviews have summarized the progress made in targeting signaling pathways for CaP but will not be discussed here. We describe some important CaP TAAs. These include prostate stem-cell antigen, prostate-specific membrane antigen, MUC1, epidermal growth factor receptor, platelet-derived growth factor and its receptor, urokinase plasminogen activator and its receptor, and extracellular matrix metalloproteinase inducer. We summarize recent advancements in our understanding of their role in CaP metastasis, as well as potential therapeutic options for targeting CaP TAAs. We also discuss the origin, identification, and characterization of prostate cancer stem cells (CSCs) and the potential benefits of targeting prostate CSCs to overcome chemoresistance and CaP recurrence. © 2009 Wiley Periodicals, Inc. Med Res Rev, 30, No. 1, 67,101, 2010 [source] Marvels, Mysteries, and Misconceptions of Vascular Compensation to Peripheral Artery OcclusionMICROCIRCULATION, Issue 1 2010MATTHEW A. ZIEGLER Microcirculation (2010) 17, 3,20. doi: 10.1111/j.1549-8719.2010.00008.x Abstract Peripheral arterial disease is a major health problem and there is a significant need to develop therapies to prevent its progression to claudication and critical limb ischemia. Promising results in rodent models of arterial occlusion have generally failed to predict clinical success and led to questions of their relevance. While sub-optimal models may have contributed to the lack of progress, we suggest that advancement has also been hindered by misconceptions of the human capacity for compensation and the specific vessels which are of primary importance. We present and summarize new and existing data from humans, Ossabaw miniature pigs, and rodents which provide compelling evidence that natural compensation to occlusion of a major artery (i) may completely restore perfusion, (ii) occurs in specific pre-existing small arteries, rather than the distal vasculature, via mechanisms involving flow-mediated dilation and remodeling (iii) is impaired by cardiovascular risk factors which suppress the flow-mediated mechanisms and (iv) can be restored by reversal of endothelial dysfunction. We propose that restoration of the capacity for flow-mediated dilation and remodeling in small arteries represents a largely unexplored potential therapeutic opportunity to enhance compensation for major arterial occlusion and prevent the progression to critical limb ischemia in the peripheral circulation. [source] Peptide immunotherapy for allergic diseasesALLERGY, Issue 3 2007M. Larché Specific allergen immunotherapy has been widely practised for almost 100 years. Whilst this approach is disease-modifying and efficacious, the use of whole allergen preparations is associated with an unacceptably high prevalence of allergic adverse events during treatment. Many approaches to reduce the allergenicity of immunotherapy preparations whilst maintaining immunogenicity are under development. One such approach is the use of short synthetic peptides which represent major T-cell epitopes of the allergen. Major potential advantages of this approach include markedly reduced capacity to cross-link immunoglobulin-E and activate mast cells and basophils, and ease of manufacture and standardization. Promising results in preclinical studies have led to the translation of this approach to clinical studies in humans. Peptide immunotherapy is currently under development for allergic and autoimmune diseases. [source] Endovascular repair of ruptured abdominal aortic aneurysmBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2008R. Balm Promising,but quality evidence lacking [source] Freeform Shape Representations for Efficient Geometry ProcessingCOMPUTER GRAPHICS FORUM, Issue 3 2003Leif Kobbelt The most important concepts for the handling and storage of freeform shapes in geometry processing applications are parametric representations and volumetric representations. Both have their specific advantages and drawbacks. While the algebraic complexity of volumetric representations is independent from the shape complexity, the domain of a parametric representation usually has to have the same structure as the surface itself (which sometimes makes it necessary to update the domain when the surface is modified). On the other hand, the topology of a parametrically defined surface can be controlled explicitly while in a volumetric representation, the surface topology can change accidentally during deformation. A volumetric representation reduces distance queries or inside/outside tests to mere function evaluations but the geodesic neighborhood relation between surface points is difficult to resolve. As a consequence, it seems promising to combine parametric and volumetric representations to effectively exploit both advantages. In this talk, a number of projects are presented and discussed in which such a combination leads to efficient and numerically stable algorithms for the solution of various geometry processing tasks. Applications include global error control for mesh decimation and smoothing, topology control for level-set surfaces, and shape modeling with unstructured point clouds. [source] Automatic Creation of Object Hierarchies for Radiosity ClusteringCOMPUTER GRAPHICS FORUM, Issue 4 2000Gordon Müller Using object clusters for hierarchical radiosity greatly improves the efficiency and thus usability of radiosity computations. By eliminating the quadratic starting phase very large scenes containing about 100k polygons can be handled efficiently. Although the main algorithm extends rather easily to using object clusters, the creation of ,good' object hierarchies is a difficult task both in terms of construction time and in the way how surfaces or objects are grouped to clusters. The quality of an object hierarchy for clustering depends on its ability to accurately simulate the hierarchy of the energy flow in a given scene. Additionally it should support visibility computations by providing efficient ray acceleration techniques. In this paper we will present a new approach of building hierarchies of object clusters. Our hybrid structuring algorithm provides accuracy and speed by combining a highly optimized bounding volume hierarchy together with uniform spatial subdivisions for nodes with regular object densities. The algorithm works without user intervention and is well suited for a wide variety of scenes. First results of using these hierarchies in a radiosity clustering environment are very promising and will be presented here. The combination of very deep hierarchies (we use a binary tree) together with an efficient ray acceleration structure shifts the computational effort away from form factor and visibility calculation towards accurately propagating the energy through the hierarchy. We will show how an efficient single pass gathering can be used to minimize traversal costs. [source] Horizontal Roadway Curvature Computation Algorithm Using Vision TechnologyCOMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 2 2010Yichang (James) Tsai However, collecting such data is time-consuming, costly, and dangerous using traditional, manual surveying methods. It is especially difficult to perform such manual measurement when roadways have high traffic volumes. Thus, it would be valuable for transportation agencies if roadway curvature data could be computed from photographic images taken using low-cost digital cameras. This is the first article that develops an algorithm using emerging vision technology to acquire horizontal roadway curvature data from roadway images to perform roadway safety assessment. The proposed algorithm consists of four steps: (1) curve edges image processing, (2) mapping edge positions from an image domain to the real-world domain, (3) calibrating camera parameters, and (4) calculating the curve radius and center from curve points. The proposed algorithm was tested on roadways having various levels of curves and using different image sources to demonstrate its capability. The ground truth curvatures for two cases were also collected to evaluate the error of the proposed algorithm. The test results are very promising, and the computed curvatures are especially accurate for curves of small radii (less than 66 m/200 ft) with less than 1.0% relative errors with respect to the ground truth data. The proposed algorithm can be used as an alternative method that complements the traditional measurement methods used by state DOTs to collect roadway curvature data. [source] A Massively Parallel Time-Dependent Least-Time-Path Algorithm for Intelligent Transportation Systems ApplicationsCOMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 5 2001Athanasios Ziliaskopoulos This article is concerned with the problem of computing in parallel time-dependent least-time paths that can be used in real-time intelligent transportation systems applications. A message-passing scheme is presented, and its correctness is proved. The algorithm's computational complexity is shown to be O(|T|2|V|2), an improvement by |V| over the best-known sequential algorithm. The algorithm is implemented, coded, and computationally tested on actual and random networks with promising results. The algorithm is implemented on a CRAY-T3D supercomputer using a Parallel Virtual Machine environment that allows portability to lower-end multiprocessor machines. [source] A parallel algorithm for static slicing of concurrent programsCONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 8 2004D. Goswami Abstract Slicing of concurrent programs is a compute-intensive task. To speed up the slicing process, we have developed a parallel algorithm. For this purpose we used the concurrent control flow graph (CCFG) as the intermediate representation. We used a network of communicating processes to develop our parallel algorithm. We have implemented our parallel algorithm and the experimental results appear promising. Copyright © 2004 John Wiley & Sons, Ltd. [source] FS05.1 Treatment of hand eczemaCONTACT DERMATITIS, Issue 3 2004Niels K Veien Hand eczema is a common skin disease that often becomes chronic, and treatment of the disease is often challenging. Skin protection is of great importance for the prevention of hand eczema and is a fundamental aspect of the treatment of hand eczema. Emollients have been shown to be successful in the primary prevention of hand eczema as well as in reducing eczema activity. Topical corticosteroids are still the mainstay of treatment, but randomised controlled trials of their efficacy are needed. A combination of tacrolimus and topical corticosteroids may reduce the risk of steroid-associated side-effects. UV-therapy and Grenz rays can also suppress hand eczema. Systemic treatment with immunosuppressants such as cyclosporine and methotrexate show promising results, and acitretin may suppress keratotic hand eczema. Treatment possibilities for hand eczema, indications and side effects will be discussed. [source] Evaluation of tumor affinity of mono-[123I]iodohypericin and mono-[123I]iodoprotohypericin in a mouse model with a RIF-1 tumorCONTRAST MEDIA & MOLECULAR IMAGING, Issue 3 2007Humphrey Fonge Abstract In this study we have compared the tumour-seeking properties of mono-[123I]iodoprotohypericin and mono-[123I]iodohypericin in C3H mice with a subcutaneous radiation-induced fibrosarcoma-1 tumor. After intravenous injection, both tracers were rapidly cleared from all organs and were retained by the tumors. There was no significant difference in tumor uptake of the two tracers at all studied time points (p,>,0.05). To study the plausible mechanism of hypericin and mono-iodohypericin uptake in tumor, their plasma binding profile was investigated. Both agents show high affinity for low-density lipoproteins and to a lesser extent high-density lipoproteins and other heavy proteins. Mono-[123I]iodohypericin appears to be more promising as a tumor diagnostic agent, given its faster clearance from all organs. Copyright © 2007 John Wiley & Sons, Ltd. [source] Density Diagnostic Using Stark Broadening of He I Spectral Line Emission from Rydberg LevelsCONTRIBUTIONS TO PLASMA PHYSICS, Issue 7-9 2006M. Koubiti Abstract Neutral helium line spectra of the diffuse series observed under recombining plasma conditions, are used for electron density diagnostics. The method is similar to that using high members of the Balmer series of hydrogen or its isotopes. It is based on the comparison of experimental line spectra to calculated Stark profiles obtained with the Stark line shape code PPP. Among the required atomic data, the dipole reduced matrix elements have been calculated using a hydrogenic approximation. A good agreement was found between the behaviors of the Einstein coefficients calculated using this approximation and the available corresponding values found in the literature. It is demonstrated here through its application to JET data that for relatively dense plasmas this method gives promising results which are consistent with other measurements. (© 2006 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Behavioral and cardiovascular effects of 7.5% CO2 in human volunteersDEPRESSION AND ANXIETY, Issue 1 2005Jayne E. Bailey M.Sc. Abstract The study of carbon dioxide (CO2) inhalation in psychiatry has a long and varied history, with recent interest in using inhaled CO2 as an experimental tool to explore the neurobiology and treatment of panic disorder. As a consequence, many studies have examined the panic-like response to the gas either using the single or double breath 35% CO2 inhalation or 5,7% CO2 inhaled for 15,20 min, or rebreathing 5% CO2 for a shorter time. However, this lower dose regime produces little physiological or psychological effects in normal volunteers. For this reason we have studied the effects of a higher concentration of CO2, 7.5%, given over 20 min. Twenty healthy volunteers were recruited to a double blind, placebo-controlled study where air and 7.5% CO2 were inhaled for 20 min. Cardiovascular measures and subjective ratings were obtained. When compared to air, inhaling 7.5% CO2 for 20 min increases systolic blood pressure and heart rate, indicating increased autonomic arousal. It also increases ratings of anxiety and fear and other subjective symptoms associated with an anxiety state. The inhalation of 7.5% CO2 for 20 min is safe for use in healthy volunteers and produces robust subjective and objective effects. It seems promising as an anxiety provocation test that could be beneficial in the study of the effects of anxiety on sustained performance, the discovery of novel anxiolytic agents, and the study of brain circuits and mechanisms of anxiety. Depression and Anxiety 00:000,000, 2005. © 2005 Wiley-Liss, Inc. [source] A randomized controlled study of paroxetine and cognitive-behavioural therapy for late-life panic disorderACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010G.-J. Hendriks Hendriks G-J, Keijsers GPJ, Kampman M, Oude Voshaar RC, Verbraak MJPM, Broekman TG, Hoogduin CAL. A randomized controlled study of paroxetine and cognitive-behavioural therapy for late-life panic disorder. Objective:, To examine the effectiveness of paroxetine and cognitive-behavioural therapy (CBT) in elderly patients suffering from panic disorder with or without agoraphobia (PD(A)). Method:, Forty-nine patients aged 60+ years with confirmed PD(A) were randomly assigned to 40 mg paroxetine, individual CBT, or to a 14-week waiting list. Outcomes, with avoidance behaviour and agoraphobic cognitions being the primary measures, were assessed at baseline and at weeks 8, 14 (conclusion CBT/waiting list), and at week 26 (treated patients only) and analysed using mixed models. Results:, All outcome measures showed that the patients having received CBT and those treated with paroxetine had significantly better improvement compared with those in the waiting-list condition. With one patient (1/20, 5%) in the CBT and three (3/14, 17.6%) in the paroxetine condition dropping out, attrition rates were low. Conclusion:, Patients with late-life panic disorder respond well to both paroxetine and CBT. Although promising, the outcomes warrant replication in larger study groups. [source] Variable-Pulse Nd:YAG Laser in the Treatment of Facial TelangiectasiasDERMATOLOGIC SURGERY, Issue 1 2006AVERY A. BEVIN MD BACKGROUND Variable-pulse 1,064 nm wavelength lasers have been used with good effectiveness on leg telangiectasias and reticular veins and have shown promising results on facial telangiectasias as well. OBJECTIVE To investigate the effectiveness of a variable-pulse neodymium:yttrium-aluminum-garnet (Nd:YAG) laser using a small spot size in the treatment of facial telangi-ectasias. METHODS Eight male patients (mean age 75 years) underwent a single treatment session using a variable-pulse 1.5 mm spot size Nd:YAG laser with epidermal cooling. Telangiectasia diameters were 0.3 to 2.0 mm. Test sites were performed using three pulse widths (3, 20, and 60 ms), with fluences varying depending on vessel size and response. Full treatments were per-formed using test parameters giving the best response. Thirteen weeks later, the patients returned for final evaluation and satisfaction rating. RESULTS Fluences ranged from 226 to 425 J/cm2, with smaller vessels requiring larger energies. Pulse duration was equally divided between the 20 and 60 ms settings. The shortest pulse width (3 ms) was inferior in all patients. Longer pulse durations achieved superior vessel elimination with minimal immediate purpura and no postinammatory hyperpigmentation. The average mean vessel clearance was 26 to 50% in half of the patients and 51 to 75% in the other half as evaluated by three unbiased dermatologists with extensive laser experience. CONCLUSION A small,spot size Nd:YAG laser using a pulse width of 20 ms or higher appears to be effective in clearing a significant percentage of facial telangectasias with a single pass. The side effects were minimal. [source] Review of Photorejuvenation: Devices, Cosmeceuticals, or Both?DERMATOLOGIC SURGERY, Issue 2005Cameron K. Rokhsar MD Background:. Both the public and the medical profession have placed a lot of attention on reversal of signs of aging and photodamage, resulting in numerous cosmeceutical products and nonablative laser techniques designed to achieve these results. Objective:. The purpose of this report is to briefly review both the cosmeceutical products and nonablative laser techniques that appear to be most promising based on published studies. After this review, recommendations for potential enhancement of benefits by combining cosmeceuticals and laser treatments will be explored. Results. Pulsed dye lasers targeting microvessels, intense pulsed light targeting both melanin and microvessels, and midinfrared lasers targeting dermal water and collagen all appear to have some ability to improve skin texture, color, and wrinkling. Retinoids, vitamin C, alpha-hydroxy acids, and topical growth factors may also stimulate repair mechanisms that result in similar improvements in photodamaged skin. Conclusion:. Although supported only by theoretic considerations and anecdotal reports, it seems logical that the concurrent use of appropriate cosmeceuticals with nonablative laser photorejuvenation should result in enhanced benefits. [source] Intense Pulsed Light for the Treatment of Refractory Melasma in Asian PersonsDERMATOLOGIC SURGERY, Issue 9 2004Chia-Chen Wang MD Background. Patients with dermal or mixed-type melasmas are often refractory to various treatments. Intense pulsed light has been used to treat melanocytic lesions with promising results. Objective. The purpose of this study was to clarify the effectiveness of intense pulsed light for refractory melasma in Asian persons. Methods. Seventeen patients were treated with intense pulsed light, during four sessions at 4-week intervals. The patients were also given 4% hydroquinone cream and broad-spectrum sunscreens to prevent and treat postinflammatory hyperpigmentation. Sixteen patients in the control group were treated with hydroquinone cream and sunscreens. The treatment efficacy was evaluated using reflectance spectrophotometer and patient satisfaction questionnaire. Results. Patients in the intense pulsed light group achieved an average of 39.8% improvement in relative melanin index, compared to 11.6% improvement in the control group (p<0.05) at Week 16. Six (35%) patients in the intense pulsed light group had more than 50% improvement, compared to two (14%) patients in the control group. Two patients in the intense pulsed light group, however, experienced transient postinflammatory hyperpigmentation, and partial repigmentation was noted 24 weeks after the last treatment session. Conclusion. Intense pulsed light is a safe and effective treatment for refractory melasma in Asian persons, with minimal side effects. Further treatment sessions are required for maintenance therapy. [source] Schizophrenia treatment: content versus deliveryACTA PSYCHIATRICA SCANDINAVICA, Issue 2009J. Van Os Objective:, To review the evidence supporting the importance of ensuring that patients with psychiatric disorders receive an optimal and appropriate level of non-pharmacological treatment, and how Assertive Community Treatment (ACT) may be able to contribute to this aim. Method:, Analysis of data from selected individual published studies on ACT, in addition to reviews from the Cochrane Library, and other study groups. Results:, Treatment management using ACT appears to offer benefits in terms of reduction in hospitalisation, although there is some debate as to whether this is the most representative outcome measure. Preliminary indications using remission as an outcome measure have also shown promising results in favour of ACT. Conclusion:, While further investigation and validation are necessary, current data indicate that ACT may be an appropriate strategy to facilitate the delivery of treatment to patients with psychotic disorders. [source] Strategies to prevent type 1 diabetesDIABETES OBESITY & METABOLISM, Issue 10 2009S. L. Thrower Type 1 diabetes is a chronic autoimmune condition resulting from T cell,mediated destruction of the insulin-producing cells in the islets of Langerhans. Its primary cause remains unknown, but it has been established that the clinical presentation is preceded by a long prodrome. This enables individuals at high risk of disease to be identified and offers the possibility of intervention to prevent clinical disease. Many groups are working in this field, concentrating on manipulation of environmental exposures that are potential triggers of autoimmunity and on immunomodulation strategies that aim to prevent destruction of ,-cells. Some interventions have shown promising results in early trials, but effective disease prevention remains elusive. This article reviews current progress in the field. [source] New prospects for immunotherapy at diagnosis of type 1 diabetesDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 4 2009Paolo Pozzilli Immune intervention at diagnosis of type 1 diabetes (T1D) aims to prevent or reverse the disease by blocking autoimmunity, thereby preserving/restoring ,-cell mass and function. Recent clinical trials of non-specific and of antigen-specific immune therapies have demonstrated the feasibility of modulation of islet-specific autoimmunity in patients with partial prevention of loss of insulin secretion. In a series of review articles published in this issue of the journal, some of the most promising approaches of immune intervention in T1D are presented. Here we outline the rationale of such interventions and future prospects in this area. Copyright © 2009 John Wiley & Sons, Ltd. Insulin therapy in type 1 diabetes (T1D) rescues the patient from a certain death but not cure the disease. The goal of any therapeutic intervention in T1D is the preservation of insulin-secreting cells; this is achieved by the abrogation of pathogenic reactivity to beta cell autoantigens while preserving full capacity to generate a normal immune response against foreign antigens. Although several therapeutic candidates have been investigated in experimental models of T1D many of which showed promising results, a successful extrapolation of these findings to human T1D has proved to be difficult. In part, this failure results from the considerable disease heterogeneity associated with diverse genetic and non-genetic disease determinants and the spectrum of clinical phenotype at diagnosis. Thus, a younger age at onset is associated with stronger genetic susceptibility, more intense immune response to ,-cell antigens, shorter duration of symptoms, more severe metabolic derangement at diagnosis and a more rapid rate of ,-cell-destruction 1,3. Therefore, designing therapies that would be effective in all clinical settings is definitely challenging. In this issue five different approaches are discussed ranging from antigen-specific therapies [DiaPep277 and glutamic acid decarboxylase(GAD)], to non-antigen-specific immunoregulation (anti-CD3) and to anti-inflammatory (anti-IL1 receptor antagonist). These approaches are currently being tested in large international multicenter trials, and all of them use very similar outcome in terms of a beneficial effect (C-peptide secretion as evidence of a therapeutic effect on restoration of ,-cell function). The authors have been asked to follow a similar format in presenting their approaches so that the reader can easily compare them in terms of rationale and therapeutic goals. [source] Suitability for psychoanalytic psychotherapy: a reviewACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2004K. Valbak Objective:, To review empirical studies on outpatients' pretherapy suitability for psychoanalytic psychotherapy. Method:, A literature search for studies in English was made in the databases MEDLINE, PsychInfo and EM-base. Forty-one studies spanning 20 years were selected for a thorough evaluation. Results:, Seventy-five per cent of the studies concerned brief dynamic psychotherapy. In general, application of single measures of suitability had a modest predictive value with correlations in the range of 0.17,0.73. There was no consistent difference between various formats of therapies. Most promising variables with the highest correlations with good outcome were: ,good quality of object relations', ,psychological mindedness' and ,motivation for change'. Some clinical guidelines can be drawn from quantitative research to provide the therapist with best method and format. Conclusion:, The importance of psychological variables known from the development of the brief dynamic therapies and earlier research was confirmed. Most correlations were modest and single factors could not be identified. Multivariate designs that combine different methods and formats with patient characteristics seem most promising in future predictor-outcome research. [source] Addressing insulin resistance in Type 1 diabetesDIABETIC MEDICINE, Issue 9 2008T. T. L. Pang Abstract Type 1 diabetes is recognised to include an element of insulin resistance. Insulin resistance is an independent risk factor for the development of macro- and microvascular complications of Type 1 diabetes and may also contribute to the development of the disease. This understanding comes at a time when the incidence of Type 1 diabetes appears to be rising and the public health burden from its vascular complications is high. A variety of safe and efficacious manoeuvres are available to redress insulin resistance in Type 2 diabetes. So far however, clinical trials addressing insulin resistance in Type 1 diabetes have been small with only short periods of follow-up. Regardless, these trials have yielded promising results. This review examines the evidence for insulin resistance in the pathophysiology of Type 1 diabetes and its complications, the problems associated with its measurement, and summarizes the trials aimed at reducing insulin resistance in Type 1 diabetes. This includes a meta-analysis of controlled trials of adjuvant metformin in Type 1 diabetes. [source] Recent concepts in non-alcoholic fatty liver diseaseDIABETIC MEDICINE, Issue 9 2005L. A. Adams Abstract Non-alcoholic fatty liver disease (NAFLD) is present in up to one-third of the general population and in the majority of patients with metabolic risk factors such as obesity and diabetes. Insulin resistance is a key pathogenic factor resulting in hepatic fat accumulation. Recent evidence demonstrates NAFLD in turn exacerbates hepatic insulin resistance and often precedes glucose intolerance. Once hepatic steatosis is established, other factors, including oxidative stress, mitochondrial dysfunction, gut-derived lipopolysaccharide and adipocytokines, may promote hepatocellular damage, inflammation and progressive liver disease. Confirmation of the diagnosis of NAFLD can usually be achieved by imaging studies, however, staging the disease requires a liver biopsy. NAFLD is associated with an increased risk of all-cause death, probably because of complications of insulin resistance such as vascular disease, as well as cirrhosis and hepatocellular carcinoma, which occur in a minority of patients. NAFLD is also now recognized to account for a substantial proportion of patients previously diagnosed with ,cryptogenic cirrhosis'. Diabetes, obesity and the necroinflammatory form of NAFLD known as non-alcoholic steatohepatitis, are risk factors for progressive liver disease. Current treatment relies on weight loss and exercise, although various insulin-sensitizing medications appear promising. Further research is needed to identify which patients will achieve the most benefit from therapy. [source] Preoperative chemoradiotherapy in cancer of the thoracic esophagusDISEASES OF THE ESOPHAGUS, Issue 1 2003G. Terrosu SUMMARY. Surgery with or without adjuvant radiotherapy (RT) is the standard treatment of esophageal cancer. Preoperative radio- and chemotherapy (CT) have been introduced to improve prognosis. We report a phase II prospective non-randomized trial of preoperative RT (42 Gy/25) plus CT (cisplatin 20 mg/mq/day plus 5-fluorouracil 600 mg/mq/day, 1,5 weeks) for the treatment of thoracic esophageal cancer. From 1993, 50 patients were enrolled (40 men and 10 women, mean age 57 years, range 30,75 years). Squamous cell carcinoma accounted for 90% of cases; 10% were adenocarcinoma. Downstaging of the disease was obtained in 77.3% of cases; there were 13 (29.5%) complete responses (CR) and 21 (47.7%) partial responses (PR). Median survival was 28 and 25 months, respectively, for CR and partial response (PR) plus stable disease (SD) and progressive disease (PD) (P = 0.05). Progressive-free median survival was 22 and 17 months, respectively, for CR and PR + SD + PD (P = 0.08). Multimodal treatment of esophageal cancer showed promising results, although not significant, in terms of survival and disease progression for patients achieving a complete pathologic response. [source] Technology and innovation in the psychosocial treatment of methamphetamine use, risk and dependenceDRUG AND ALCOHOL REVIEW, Issue 3 2008FRANCES J. KAY-LAMBKIN Abstract Issues. The dramatic increase in methamphetamine use has led to the urgent need for high-quality, effective treatments and management strategies for methamphetamine use problems to be developed and disseminated. Although some evidence exists for the use of psychological, pharmacological and other approaches to treatment for problematic methamphetamine use, other evidence suggests that many methamphetamine users do not access these treatment options due to a range of individual and service-level barriers. Approach. A review of available research literature was undertaken to identify treatment strategies for methamphetamine users, which overcome the problems associated with treatment access for this important target group and involve technological and other innovative approaches. Key Findings. Several approaches to addressing problematic methamphetamine use have been suggested, including assertive engagement strategies, flexibility in the provision of treatment and retention strategies and use of a multi-focused intervention package, such as stepped care, perhaps including new technologies as alternatives or supplements to face-to-face-delivered treatments. No research currently exists to examine the possible benefit of these strategies for people with methamphetamine use problems. Implications. The use of stepped-care intervention packages has the potential to address many of the current challenges faced by both clinicians and clients in treating methamphetamine use problems. Conclusions. Although promising, these approaches require further attention and research effort, particularly among the specific group of methamphetamine users. [source] REVIEW: Aortic Atheromas: Current Concepts and Controversies,A Review of the LiteratureECHOCARDIOGRAPHY, Issue 2 2008Thenappan Thenappan M.D. The frequent use of transesophageal echocardiogram (TEE) has led to the increased recognition of aortic atheromas. Retrospective and prospective follow-up studies have reported an association between aortic atheromas and stroke in the high-risk patient population, with complex plaques being more likely to embolize than simple plaques. However, TEE-based studies in the low-risk cohorts have failed to show a similar association. There is growing body of evidence suggesting that aortic atheroma is a marker of generalized atherosclerosis. Although magnetic resonance (MR) imaging and computed tomography (CT) scan are emerging as a powerful noninvasive tool for characterization of aortic atheromas, TEE is the imaging modality of choice. Currently, treatment of aortic atheromas is not well defined, and mixed outcomes have been reported for anticoagulation therapy with warfarin. Statins appear promising based on their plaque stabilization properties. However, there are no randomized control trials to establish the role of both anticoagulation and statins in patients with aortic atheromas, and are warranted in the future. [source] THE REVIVAL OF CULTURAL EXPLANATION IN ECONOMICSECONOMIC AFFAIRS, Issue 4 2003E. L. Jones Cultural explanations of economic change were largely dropped for a generation, as economists rejected their inconclusiveness and other social scientists labelled them as politically incorrect. Peter Bauer, however, expressed disquiet at the way deep influences like culture were being ignored in economic analysis. This paper discusses why high-profile attention has now turned back to culture. It does not find the expositions offered to be very persuasive but nevertheless agrees that Bauer's unease was understandable and describes other recent academic studies that are more promising. [source] Multiwalled Carbon Nanotubes Encased in Ruthenium Oxide Film as a Hybrid Material for Neurotransmitters SensorELECTROANALYSIS, Issue 16 2009Chien-Chieh Ti Abstract A hybrid film (MWCNTs-RuOx,nH2O) which contains multiwalled carbon nanotubes (MWCNTs) along with the incorporation of ruthenium oxide (RuOx,nH2O) has been synthesized on glassy carbon electrode (GCE), gold (Au), indium tin oxide (ITO) and screen printed carbon electrode (SPCE) by potentiostatic methods. The presence of MWCNTs in the hybrid film enhances surface coverage concentration (,) of RuOx,nH2O to ,2100%. The surface morphology of the hybrid film deposited on ITO has been studied using scanning electron microscopy and atomic force microscopy. These two techniques reveal that the RuOx,nH2O incorporated on MWCNTs. Electrochemical quartz crystal microbalance study too reveals the incorporation of MWCNTs and RuOx,nH2O. The MWCNTs-RuOx,nH2O hybrid film exhibits promising enhanced electrocatalytic activity towards the biochemical compounds such as epinephrine and norepinephrine. The electrocatalytic responses of these analytes at RuOx,nH2O, MWCNTs and MWCNTs-RuOx,nH2O hybrid films have been measured using cyclic voltammetry. The obtained sensitivity values from electrocatalysis studies of analytes for MWCNTs-RuOx,nH2O hybrid film are higher than the RuOx,nH2O and MWCNTs films. Finally, the flow injection analysis has been used for the amperometric studies of analytes at MWCNTs-RuOx,nH2O hybrid film modified SPCEs. [source] Conductive Organic Complex Salt TTF-TCNQ as a Mediator for Biosensors.ELECTROANALYSIS, Issue 24 2007An Overview Abstract Preparation and application of a conductive organic salt complex of tetrathiafulvalene-tetracyanoquinodimethane (TTF-TCNQ) for analytical bioelectrochemistry as a mediator is overviewed in this work. The third-generation biosensors based on this charge transfer salt are very promising for biosensors applied in vivo. Such mediated biosensors have been studied mainly for glucose determination, but at present other substrates are being applied in this system more and more often. [source] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||