DIGESTIVE ENDOSCOPY, Issue 1 2005
Masaho Ota
Objective:, The aim of the present study was to assess the usefulness of endoscopic ultrasonography (EUS) for evaluating the efficacy of neoadjuvant therapy for advanced esophageal carcinoma based on the Response Evaluation Criteria in Solid Tumors (RECIST). Patients and Methods:, Sixty-two patients with advanced esophageal carcinoma underwent surgical resection after neoadjuvant therapy. The maximal tumor thickness was measured by EUS before and after neoadjuvant therapy, and the percent reduction was compared with the pathological response. Based on the RECIST, PD-SD (progressive disease-stable disease) was defined as < 30% reduction of tumor thickness on EUS, PR (partial response) as , 30% reduction of tumor thickness, and CR (complete response) as no detectable tumor (100%). Results:, The percent reduction of the thickness of Grade 0,1, Grade 2 and Grade 3 tumor was 11.5 ± 21.0%, 48.2 ± 17.0% and 74.9 ± 21.1%, respectively. There were significant differences in the extent of reduction among the three groups. Based on the RECIST, 80% of Grade 0,1 cases, 91% of Grade 2 cases and 22% of Grade 3 cases were PD-SD, PR, and CR according to EUS, respectively. EUS correctly identified 80% of non-responders and 94% of responders. Conclusions:, The percentage reduction of tumor thickness on EUS closely reflected the pathological evaluation. EUS evaluation based on the RECIST seems to be useful for monitoring neoadjuvant therapy in patients with esophageal carcinoma. [source]

THE DEATH PENALTY FOR DRUGS IS A VIOLATION OF INTERNATIONAL HUMAN RIGHTS LAW; EFFICACY,WHETHER REAL OR IMAGINED,PROVIDES NO EXCUSE

ADDICTION, Issue 12 2009
RICK LINES
No abstract is available for this article. [source]

EVOLUTION OF BIRD SONG AFFECTS SIGNAL EFFICACY: AN EXPERIMENTAL TEST USING HISTORICAL AND CURRENT SIGNALS

EVOLUTION, Issue 8 2007
Elizabeth P. Derryberry
Mating signals act as behavioral barriers to gene flow in many animal taxa, yet little is known about how signal evolution within populations contributes to the formation of these barriers. Although variation in mating signals among populations is known to affect mating behavior, there is no direct evidence that the evolution of mating signals changes signal effectiveness within a natural population. Making use of historical recordings of bird song, I found that both male and female white-crowned sparrows (Zonotrichia leucophrys) respond more strongly to current than to historical songs, indicating that historical songs are less effective as signals in the current contexts of both mate choice and male,male competition. Finding that historical signals are less effective suggests that signal evolution within populations may ultimately contribute to the formation of behavioral barriers to gene flow between populations. [source]

PERSPECTIVE: SEX, RECOMBINATION, AND THE EFFICACY OF SELECTION,WAS WEISMANN RIGHT?

EVOLUTION, Issue 2 2000
Austin Burt
Abstract., The idea that sex functions to provide variation for natural selection to act upon was first advocated by August Weismann and it has dominated much discussion on the evolution of sex and recombination since then. The goal of this paper is to further extend this hypothesis and to assess its place in a larger body of theory on the evolution of sex and recombination. A simple generic model is developed to show how fitness variation and covariation interact with selection for recombination and illustrate some important implications of the hypothesis: (1) the advantage of sex and recombination can accrue both to reproductively isolated populations and to modifiers segregating within populations, but the former will be much larger than the latter; (2) forces of degradation that are correlated across loci within an individual can reduce or reverse selection for increased recombination; and (3) crossing-over (which can occur at different places in different meioses) will create more variability than having multiple chromosomes and so will have more influence on the efficacy of selection. Several long-term selection experiments support Weismann's hypothesis, including those showing a greater response to selection in populations with higher rates of recombination and higher rates of recombination evolving as a correlated response to selection for some other character. Weismann's hypothesis is also consistent with the sporadic distribution of obligate asexuality, which indicates that clones have a higher rate of extinction than sexuals. Weismann's hypothesis is then discussed in light of other patterns in the distribution of sexuality versus asexuality. To account for variation in the frequency of obligate asexuality in different taxa, a simple model is developed in which this frequency is a function of three parameters: the rate of clonal origin, the initial fitness of clones when they arise, and the rate at which that fitness declines over time. Variation in all three parameters is likely to be important in explaining the distribution of obligate asexuality. Facultative asexuality also exists, and for this to be stable it seems there must be ecological differences between the sexual and asexual propagules as well as genetic differences. Finally, the timing of sex in cyclical parthenogens is most likely set to minimize the opportunity costs of sex. None of these patterns contradict Weismann's hypothesis, but they do show that many additional principles unrelated to the function of sex are required to fully explain its distribution. Weismann's hypothesis is also consistent with what we know about the mechanics and molecular genetics of recombination, in particular the tendency for chromatids to recombine with a homolog rather than a sister chromatid at meiosis, which is opposite to what they do during mitosis. However, molecular genetic studies have shown that cis -acting sites at which recombination is initiated are lost by gene conversion as a result, a factor that can be expected to affect many fine details in the evolution of recombination. In summary, although Weismann's hypothesis must be considered the leading candidate for the function of sex and recombination, nevertheless, many additional principles are needed to fully account for their evolution. [source]

THE IMPACT OF CONTINUING EDUCATION TRAINING ON LAW GUARDIAN KNOWLEDGE, EFFICACY, AND PRACTICE BEHAVIORS

FAMILY COURT REVIEW, Issue 1 2007
Wendi Cross
There is an increased demand for law guardians in domestic violence cases, especially those involving child witnesses. Training is required for law guardians to meet child clients' needs. While workshops and conferences are typical venues for continuing education training, their effectiveness is unknown. This pilot study compared law guardians who attended a conference on community violence and children to nonattendees on several training outcomes. Results showed a positive impact on attendees' feelings of efficacy and intentions to carry out new practice behaviors post-conference; differences were maintained at follow-up. Limitations and implications of this pilot study are discussed. [source]

A RETROSPECTIVE CHART REVIEW OF THE TOLERABILITY AND EFFICACY OF INTRAVENOUS IMMUNOGLOBULIN IN THE TREATMENT OF ALZHEIMER'S DISEASE

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2008
Gayatri Devi MD
No abstract is available for this article. [source]

EVIDENCE-BASED EFFICACY OF OZONE FOR ROOT CANAL IRRIGATION

JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 5 2008
BDentSc, Edward Lynch MA, FDSRCS Ed, FDSRCS Lond Guest Expert, PhD Lond
[source]

LIPID-LOWERING EFFICACY OF PIPERINE FROM PIPER NIGRUM L. IN HIGH-FAT DIET AND ANTITHYROID DRUG-INDUCED HYPERCHOLESTEROLEMIC RATS

JOURNAL OF FOOD BIOCHEMISTRY, Issue 4 2006
RAMASAMY SUBRAMANIAM VIJAYAKUMAR
ABSTRACT Male Wistar rats were divided into two groups: control diet group and high-fat diet group (HFD). Both groups were divided into four subgroups, each consisted of 10 animals, and the diets were supplemented with the following ingredients for 10 weeks: (1) 1% carboxymethyl cellulose; (2) 10 mg carbimazole (CM)/kg body weight; (3) 10 mg CM + 40 mg piperine/kg body weight; and (4) 10 mg CM + 2 mg atorvastatin/kg body weight. Feeding HFD to rats significantly (P < 0.05) elevated plasma total cholesterol, triglycerides, phospholipids, free fatty acids, low-density lipoprotein (LDL), very low-density lipoprotein (VLDL) and the activity of 3-hydroxy 3-methyl glutaryl coenzyme A (HMG CoA) reductase in the liver, heart and aorta, while the activities of plasma and tissue lipoprotein lipase (LPL) and plasma lecithin cholesterol acyl transferase (LCAT) and high-density lipoprotein were significantly (P < 0.05) lowered compared to control rats. Supplementing piperine with HFD significantly (P < 0.05) reduced the levels of plasma total cholesterol, LDL, VLDL tissue HMG CoA reductase and significantly (P < 0.05) elevated the levels of LPL and LCAT compared to rats that did not receive piperine. Fecal bile acids and neutral sterols were also elevated in HFD-fed rats as compared to control animals, while simultaneous supplementation of piperine significantly (P < 0.05) enhanced further excretion of bile acids and neutral sterols. The results indicate that piperine can prevent the accumulation of plasma lipids and lipoproteins significantly by modulating the enzymes of lipid metabolism. [source]

EFFICACY OF SOUR WHEY AS A SHELF-LIFE ENHANCER: USE IN ANTIOXIDATIVE EDIBLE COATINGS OF CUT VEGETABLES AND FRUIT,

JOURNAL OF FOOD QUALITY, Issue 5 2007
JINHAN SHON
ABSTRACT The effectiveness of edible coatings containing sour whey powder (SWP), compared with soy protein isolate (SPI) and calcium caseinate (CC), in reducing oxidative browning and moisture loss during storage (4C) of cut apples, potatoes, carrots, and onions was investigated. Oxidative discoloration, as determined by the Commission Internationale de I'Eclairage L*a*b* color scale, was significantly reduced (P < 0.05) by treatments over a storage time of 120 min. Loss of lightness was reduced by CC, SPI and SWP coatings. These respectively showed 2.7, 3.3 and 1.5% change of L* value in coated apples as compared with 7.4% in the control. Browning in cut potatoes was significantly reduced from a 145.1% increase in the a* value of the control to 45.9, 37.0 and 30.3% increase for CC, SPI and SWP treatments, respectively. The b* values also reflected the effectiveness of SWP. The moisture barrier effect, tested over a period of 5 days at 4C, was significantly better for the treatments than control. SWP was the best and significantly reduced moisture loss in potatoes and carrots by 40 and 59%, respectively, over control. Cut onions did not show any treatment effect both in terms of off-color development and moisture loss. The reasons for the excellent moisture barrier and antioxidative property of SWP were discussed. PRACTICAL APPLICATIONS Oxidative degradation of fresh fruits and vegetables is a major problem faced by the industry today. Most of the fresh produce is grown in the southwestern part of the country, requiring days of transportation to retail outlets. As the educated consumer is highly health conscious, any effort in extending the shelf life will have to be nonchemical, and preferably natural. Because of small profit margins, the intervention must also be inexpensive. Millions of MT of sour whey, a by-product of cottage whey manufacture, is wasted because of the lack of appropriate food applications. It is natural, nutritious and presently very inexpensive. Our research investigated the possibility of using this by-product as a final wash to enhance the so-called window of freshness of fresh produce and fruit. [source]

EFFICACY OF SERUM PEPSINOGENS IN THE PREDICTION OF ENDOSCOPIC FEATURES OF GASTRITIS

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 12 2000
Yoshihisa Urita
Objective The efficacy of serum pepsinogen (PG) test is widely accepted as a screening test to select persons for endoscopy in the diagnosis of gastric cancer. In this study, we would like to examine whether serum PG levels give us information on endoscopic findings of gastric mucosa. Materials and methods The serum level of PG++ and PG+, and the PG+/PG, ratio were compared with endoscopic 13C-urea breath. H.pylori status was defined as an increase in the intragastric 13CO2/12CO2 ratio of 10% over baseline. Intestinal metaplasia was made visible as the purple-stained area using a 0.05% crystal violet spraying method. PG level of less than 70,g/L and I PG+/PG, ratio of less than 3 was adopted for a (+) result, and PG level of less than 30,g/L and a PG+/PG, ratio of less than 2 for a (++) result. Results Prevalence of endoscopic features and H. pylori infection in different groups classified by serum PG tests. Conclusions Lintestinal metaplasia was identified in more than 80% of PG positive patients. The prevalence of linear reddness and raised erosion in the antrum were higher in PG (-) group than in PG(+) and (++) groups. H. pylori-positive rate was the highest in PG (+) group. [source]

TEAM LEARNING VERSUS TRADITIONAL LECTURE: MEASURING THE EFFICACY OF TEACHING METHOD IN LEGAL STUDIES

JOURNAL OF LEGAL STUDIES EDUCATION, Issue 1 2001
Laurie A. Lucas
[source]

THE EFFICACY OF SHORT DAILY DIALYSIS,A SINGLE-CENTRE EXPERIENCE

JOURNAL OF RENAL CARE, Issue 3 2010
Glenda Rayment M Nursing (Renal)
SUMMARY Studies have shown that patients converted to short daily haemodialysis (SDHD) have reported many clinical benefits, decreased complications during dialysis and a better quality of life. A six-month prospective cohort study was conducted to examine the efficacy of SDHD to patients previously receiving three times per week haemodialysis therapy. Following informed consent, participants received haemodialysis daily, Monday,Saturday, between 2 and 2.5 hours for each treatment and followed-up for a six-month period. The participants continued to experience hypotension, cramping and headache and were noncompliant with fluid intake. There was a gradual reduction in blood pressure, cessation of antihypertensives and reduction of erythropoietin therapy (ERT). There were no hospital admissions or reports of access complications. The nursing staff reported an increase in activity levels and nursing interventions with the participants following conversion to SDHD. However, the participants reported a better quality of life. [source]

EFFICACY OF TOPICAL CALCIPOTRIOL IN THE TREATMENT OF A GIANT VIRAL WART

PEDIATRIC DERMATOLOGY, Issue 4 2005
JAVIER LABANDEIRA M.D., Ph.D.
No abstract is available for this article. [source]

EFFICACY OF SARGASSUM POLYCYSTUM (PHAEOPHYCEAE) SULPHATED POLYSACCHARIDE AGAINST PARACETAMOL-INDUCED DNA FRAGMENTATION AND MODULATION OF MEMBRANE-BOUND PHOSPHATASES DURING TOXIC HEPATITIS

CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 3 2007
HB Raghavendran
SUMMARY 1The aim of the present study was to assess the protective effect of Sargassum polycystum (sulphated polysaccharide) extract against paracetamol-induced DNA strand breaks and modulation of membrane-bound phosphatases, protein thiols and inorganic cations during toxic hepatitis. 2Seaweed extract (200 mg/kg per day for 21 days) was administered to male Wistar rats against paracetamol challenge. Serum and liver tissues were used to assess levels of ATPase, protein thiols and inorganic cations using atomic absorption spectroscopy. The fragmentation of DNA was assessed by agarose gel electrophoresis. 3Paracetamol induced intracellular stress, accompanied by changes in the structural and functional characteristics of liver cell membranes, which affected DNA integrity, membrane-bound ATPase and inorganic cations homeostasis. Rats intoxicated with paracetamol (800 mg/kg, i.p.) showed significant impairment in activities of total ATPase, Mg2+ -ATPase, Ca+ -ATPase and Na+/K+ -ATPase, with concomitant changes in the levels of tissue protein thiols and inorganic cations, such as Na+, K+ and Ca2+. These changes were prevented in animals pretreated with S. polycystum extract, which indicates that S. polycystum supplementation could exert some protective effect against paracetamol-induced toxic hepatitis in rats. 4The protective effect of the seaweed extract may be due to the presence of sulphated compounds that have free radical-scavenging activity. [source]

Increased Efficacies of an Individual Catalytic Site in Clustered Multivalent Dendritic Catalysts

ADVANCED SYNTHESIS & CATALYSIS (PREVIOUSLY: JOURNAL FUER PRAKTISCHE CHEMIE), Issue 14-15 2009
Govindasamy Jayamurugan
Abstract In the studies reported so far on dendrimer-mediated catalysis, the efficacies of the catalytic units were studied and compared primarily across the generations. In order to identify the efficacy of an individual catalytic unit with respect to the number of such units present within a given generation, a series of catalysts were prepared within a generation. Dendrimers incorporated with phosphine-metal complexes were chosen for the study and as many as 11 catalysts within three generations were synthesized. The CC bond-forming reactions, namely, the Heck and the Suzuki coupling reactions, were then selected to study the catalytic efficiencies of the series of partially and fully phosphine-metal complex functionalized dendrimers. The efficacies of the formation of cinnamate and biphenyl, catalyzed by the dendritic catalysts, were compared. The comparative analyses show that an individual catalytic site is far more effective in its catalytic activity when presented in multiple numbers, i.e., in a multivalent dendritic system, than as a single unit within the same generation, i.e., in a monovalent dendritic system. The study identifies the beneficial effects of the multivalent presentation of the catalytic moieties, both within and across the dendrimer generations. [source]

Efficacies of caspofungin and a combination of caspofungin and meropenem in the treatment of murine disseminated candidiasis,

APMIS, Issue 12 2006
SEMA KECELI OZCAN
Disseminated candidiasis is relatively common in immunocompromised patients. The treatment protocol of these patients usually includes broad-spectrum antibiotics and also emprical antifungals initiated due to unresponsiveness to antibiotics. In this study the efficacies of caspofungin and meropenem , separately and together , in mice with disseminated candidiasis were studied. Immunocompetent mice were infected intravenously with 2×106 CFU of Candida albicans. At 24 h postinfection, intraperitoneal therapy was initiated and was continued for 7 days. Therapy groups included those given caspofungin (0.5, 1.25, 5 mg/kg/day), meropenem (20 mg/kg/day), and a combination of the two drugs. The outcome of therapy was evaluated by kidney tissue burden studies and histologic examination. In vitro, drug susceptibilities were tested by checkerboard analysis. Kidney CFU counts showed that mice that had received both drugs had lower residual burdens. Caspofungin was effective at doses of 0.5, 1.25, 5 mg/kg compared to infected untreated controls. In vitro, MICs of caspofungin and meropenem were <0.075 ,g/ml and >64 ,g/ml, respectively. Synergism was observed with the combination. Histopathology showed that the degree of inflammation was 25% less and tubular necrosis was more restricted in combined therapy than monotherapy. The results indicate that concurrent caspofungin and meropenem therapy may be beneficial [source]

Tolerability, Safety, and Efficacy of ,-Blockade in Black Patients With Heart Failure in the Community Setting: Insights From a Large Prospective ,-Blocker Registry

CONGESTIVE HEART FAILURE, Issue 1 2007
William T. Abraham MD
Heart failure (HF) clinical trials suggest different responses of blacks and whites to ,-blockers. Differences between clinical trial and community settings may also have an impact. The Carvedilol Heart Failure Registry (COHERE) observed experience with carvedilol in 4280 patients with HF in a community setting. This analysis compares characteristics, outcomes, and carvedilol dosing of blacks and whites in COHERE. Compared with whites (n=3433), blacks (n=523) had more severe HF symptoms despite similar systolic function. At similar carvedilol maintenance doses, symptoms improved in 33% of blacks vs 28% of whites, while worsening in 10% and 11%, respectively (both nonsignificant), and HF hospitalization rates were reduced comparably in both groups (,58% vs ,56%, respectively; both P<.001). Incidence and hazard ratios of death were similar in blacks and whites (6.9% vs 7.5%, hazard ratio 1.2 vs 1.0, P=.276). Thus carvedilol was similarly effective in blacks and whites with HF in the community setting, consistent with carvedilol clinical trials. [source]

Where is Independent Director Efficacy?

CORPORATE GOVERNANCE, Issue 4 2007
Chin-Jung Luan
Theoretically and empirically, the linkage between outside directors and firm performance is not conclusive in previous studies. We suspect that the mixed results are due to the failure to meet the requirements of the independence of outside directors. As the Taiwanese government has a rigorous definition of outside director independence, we employ a data set from Taiwan to test the impact of independent outside director assignment on a firm's performance. Our findings suggest that after controlling for a firm's past performance, independent outside director appointments do have a significantly positive impact on a firm's performance, and outperforming firms may have better performance but not significantly when assigning outside directors due to their absorptive capacity. [source]

Efficacy of enamel matrix derivatives (Emdogain®) in treatment of replanted teeth , a systematic review based on animal studies

DENTAL TRAUMATOLOGY, Issue 5 2008
Annette Wiegand
A review of the published literature [search term: (Emdogain OR enamel matrix derivative OR enamel matrix protein] AND [avulsion OR replantation OR autotransplantation)] was conducted by two independent investigators according to defined selection criteria. For data extraction of the identified animal studies, the following histomorphometric findings were considered: (i) healed PDL, (ii) surface resorption, (iii) inflammatory resorption and (iv) replacement resorption. The heterogenity of data collection and the small amount of identified publications did not allow for statistical analysis. Four controlled trials (CT) conducted in animals, but no randomized controlled trials (RCT) or clinical controlled trials (CCT) could be received from the systematic search. From the selected studies, two CT gave evidence of EMD treatment to be effective in inducing healing of replanted teeth, while one CT found no differences between EMD treated teeth and controls. Finally, one CT compared EMD and sodium fluoride application, but revealed no differences between the treatments. The data of controlled trials available are limited and conflicting. No firm conclusion regarding the efficacy of EMD application on healing of replanted or autotransplanted permanent teeth can be drawn because of lack of RCT and CCT. [source]

Efficacy of laser Doppler flowmetry for the diagnosis of revascularization of reimplanted immature dog teeth

DENTAL TRAUMATOLOGY, Issue 2 2001
Kallaya Yanpiset
Abstract , This study was performed to assess if laser Doppler flowmetry (LDF) is an improved method for the detection of revascularization of replanted teeth. Teeth were extracted and reimplanted under different experimental conditions. LDF readings were taken before extraction and weekly for 3 months. In control teeth, LDF baseline readings were taken and then repeated after the apical blood vessels were cut surgically. At the end of 3 months it was determined radiographically and histologically whether revascularization had occurred, i.e. vitality had returned. Results: LDF readings correctly predicted the pulp status (vital vs. non-vital) in 83.7% of the readings. 73.9% (17 of 23) were correct for the vital teeth and 95% (19 of 20) were correct for the non-vital teeth. Fisher's exact test (2-tail) indicated that there was no significant association between the efficacy of LDF and tooth type (P=0.166), although P2 was the least accurate tooth tested. Wilcoxon's matched-pair signed rank test demonstrated that in the revascularized (vital) teeth, the flux value between the baseline and week 2 dropped significantly (P=0.0001), increased significantly from week 2 to week 4 (P=0.0001) and then decreased steadily until week 12. However, at week 12 the flux was still significantly higher than at week 2 (P=0.010). In the teeth that failed to revascularize, the flux value dropped significantly by weeks 1 and 2 (P=0.004 and P=0.0001, respectively). Flux values did not increase from week 2. A Fast Fourier Transform (FFT) analysis confirmed a pulse of dominant frequency of 2 Hz in the teeth that returned to vitality and the lack thereof in those that stayed non-vital. One tooth in which the flux value evaluation indicated a non-vital tooth but the radiographic/histologic findings showed vital (false negative) possessed a pulse of dominant frequency and proved by this method to have successfully revascularized. [source]

Efficacy of interpersonal therapy-group format adapted to post-traumatic stress disorder: an open-label add-on trial

DEPRESSION AND ANXIETY, Issue 1 2010
Rosaly F.B. Campanini MSc.
Abstract Background: Post-traumatic stress disorder (PTSD) is a highly prevalent condition, yet available treatments demonstrate only modest efficacy. Exposure therapies, considered by many to be the "gold-standard" therapy for PTSD, are poorly tolerated by many patients and show high attrition. We evaluated interpersonal therapy, in a group format, adapted to PTSD (IPT-G PTSD), as an adjunctive treatment for patients who failed to respond to conventional psychopharmacological treatment. Methods: Research participants included 40 patients who sought treatment through a program on violence in the department of psychiatry of Federal University of São Paulo (UNIFESP). They had received conventional psychopharmacological treatment for at least 12 weeks and failed to have an adequate clinical response. After signing an informed consent, approved earlier by the UNIFESP Ethics Review Board, they received a semi-structured diagnostic interview (SCID-I), administered by a trained mental health worker, to confirm the presence of a PTSD diagnosis according to DSM-IV criteria. Other instruments were administered, and patients completed out self-report instruments at baseline, and endpoint to evaluate clinical outcomes. Results: Thirty-three patients completed the trial, but all had at least one second outcome evaluation. There were significant improvements on all measures, with large effect sizes. Conclusions: IPT-G PTSD was effective not only in decreasing symptoms of PTSD, but also in decreasing symptoms of anxiety and depression. It led to significant improvements in social adjustment and quality of life. It was well tolerated and there were few dropouts. Our results are very preliminary; they need further confirmation through randomized controlled clinical trials. Depression and Anxiety, 2010. © 2009 Wiley-Liss, Inc. [source]

Efficacy and safety of two treatment algorithms in bipolar depression consisting of a combination of lithium, lamotrigine or placebo and paroxetine

ACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2010
M. L. M. Van Der Loos
van der Loos MLM, Mulder P, Hartong EGThM, Blom MBJ, Vergouwen AC, van Noorden MS, Timmermans MA, Vieta E, Nolen WA, for the LamLit Study Group. Efficacy and safety of two treatment algorithms in bipolar depression consisting of a combination of lithium, lamotrigine or placebo and paroxetine. Objective:, In a previous paper, we reported about the efficacy of the addition of lamotrigine to lithium in patients with bipolar depression. In the second phase of this study paroxetine was added to ongoing treatment in non-responders. Method:, Bipolar depressed patients (n = 124) treated with lithium were randomized to addition of lamotrigine or placebo. In non-responders after 8 weeks, paroxetine 20 mg was added for another 8 weeks to ongoing treatment. Results:, After 8 weeks the improvement in patients treated with lamotrigine vs. patients treated with placebo was significant. After addition of paroxetine this difference disappeared as a result of greater further improvement in the non-responders to placebo. Conclusion:, Addition of lamotrigine to lithium was found effective in bipolar depressed patients. Further addition of paroxetine in non-responders to lithium plus lamotrigine did not appear to provide additional benefit, while it appeared to do so in non-responders to lithium plus placebo. [source]

Efficacy and safety of duloxetine in the treatment of generalized anxiety disorder: a flexible-dose, progressive-titration, placebo-controlled trial

DEPRESSION AND ANXIETY, Issue 3 2008
Moira Rynn M.D.
Abstract Generalized anxiety disorder (GAD), a prevalent and chronic illness, is associated with dysregulation in both serotonergic and noradrenergic neurotransmission. Our study examined the efficacy, safety, and tolerability of duloxetine hydrochloride, a dual reuptake inhibitor of serotonin and norepinephrine, for short-term treatment of adults with GAD. In a 10-week, double-blind, progressive-titration, flexible-dose trial, 327 adult outpatients with a DSM-IV,defined GAD diagnosis were randomized to duloxetine 60,120,mg (DLX, N=168) or placebo (PLA, N=159) treatment. The primary efficacy measure was mean change from baseline to endpoint in Hamilton Anxiety Scale (HAMA) total score. Secondary outcome measures included response rate (HAMA total score reduction ,50% from baseline), Clinician Global Impression,Improvement (CGI-I) scores, and Sheehan Disability Scale (SDS) scores. Patients who received duloxetine treatment demonstrated significantly greater improvement in HAMA total scores (P=.02); a higher response rate (P=.03), and greater improvement (P=.04) than patients who received placebo. Duloxetine-treated patients were also significantly more improved than placebo-treated patients on SDS global functional (P<.01) and work, social, and family/home impairment scores (P<.05). The rate of discontinuation due to adverse events (AEs) was higher for the duloxetine group compared with the placebo group (P=.002). The AEs most frequently associated with duloxetine were nausea, dizziness, and somnolence. Duloxetine was an efficacious, safe, and well-tolerated treatment that resulted in clinically significant improvements in symptom severity and functioning for patients with GAD. Depression and Anxiety 0:1,8, 2007. © 2007 Wiley-Liss, Inc. [source]

Multidimensional effects of sertraline in social anxiety disorder

DEPRESSION AND ANXIETY, Issue 1 2006
Kathryn M. Connor M.D.
Abstract Clinical trials of social anxiety disorder (SAD) have largely focused on the effect of treatment on symptoms of fear and avoidance, while neglecting the third clinically relevant dimension, physiological arousal. Data were combined from two previously reported placebo-controlled trials of sertraline in the treatment of moderate-to-severe generalized SAD. Efficacy was evaluated using the Brief Social Phobia Scale (BSPS). Three hundred forty-six subjects were randomized to 12,13 weeks of treatment with sertraline and 273 subjects to placebo. Following treatment, significant improvement was noted in favor of sertraline on the full BSPS (P<.001), as well as on each of the individual BSPS subscales: fear (P=.001); avoidance (P<.0001); and physiological arousal (P<.0001). Of the physiological symptoms assessed, the treatment advantage with sertraline was maintained for blushing (P<.003) and palpitations (P<.03), but not for trembling and sweating. These results confirm the efficacy of treatment with a selective serotonin reuptake inhibitor (SSRI), sertraline, across the spectrum of fear, avoidance, and physiological arousal in generalized SAD (GSAD). Among common physiological symptoms in this population, blushing and palpitations appear more treatment responsive than trembling and sweating to acute treatment with sertraline. Depression and Anxiety 23:6,10, 2006. © 2005 Wiley-Liss, Inc. [source]

Open trial of nefazodone among Hispanics with major depression: Efficacy, tolerability, and adherence issues

DEPRESSION AND ANXIETY, Issue 3 2001
J. Arturo Sánchez-Lacay M.D., M.P.H.
Abstract The efficacy and tolerability of nefazodone in the treatment of major depression among Spanish-monolingual Hispanics was examined and compared to historical controls among English-speaking, predominantly non-Hispanic subjects. Fifty monolingual Hispanic outpatients with major depression and a HAM-D17 score ,18 were treated with nefazodone in a flexible-dose 8-week open-label protocol. Sixty-three percent of the intent-to-treat (ITT) sample with ,1 efficacy visit were considered responders according to CGI-I criteria, falling within the range of response rates (58,69%) reported in six prior nefazodone trials with non-Hispanic subjects. Significant improvement was found for the ITT and completer samples in HAM-D17, HAM-D28, and SCL-90 scores and in two measures of psychosocial functioning. Endpoint mean dose in the ITT sample was 379 mg/day (SD=170), also within the range of previous trials (321,472mg/day). Adverse effects were not elevated, with only dry mouth (8%) reported by >6% of subjects. However, 42% of the sample dropped out of treatment before study termination, usually because of side effects or due to family or work difficulties, a higher rate than previously reported for nefazodone (21,33%). This open trial finds nefazodone to be an efficacious treatment for major depression among monolingual Hispanics, with comparable efficacy to previous controlled trials among non-Hispanic subjects. Double-blind studies are required to confirm this comparable efficacy. Mean endpoint doses and adverse effect rates similar to previous trials do not support the need for reduced doses of nefazodone among Hispanics. However, an elevated rate of treatment discontinuation threatens treatment efficacy among this population. Causes for this elevated rate require explanation, given the apparently unremarkable pattern of adverse effect reports. Depression and Anxiety 13:118,124, 2001. © 2001 Wiley-Liss, Inc. [source]

Review of Fractional Photothermolysis: Treatment Indications and Efficacy

DERMATOLOGIC SURGERY, Issue 10 2009
EMILY P. TIERNEY MD
BACKGROUND Fractional photothermolysis (FP) is one of the most significant milestones in laser technology and resurfacing. METHODS Review of the Medline English literature and recent international conferences regarding FP technology, applications, and indications. RESULTS Successful conditions treated with nonablative FP reported in the literature include acne scarring; dyschromia and fine wrinkling of photoaging on the face, chest, neck, and hands; melasma; poikiloderma of Civatte; nevus of Ota; scars; minocycline hyperpigmentation; telangiectatic matting; residual hemangioma; granuloma annulare; colloid milium; and disseminated superficial actinic porokeratosis. An advance in 2007 was the introduction of ablative FP (AFP), which results in significantly greater improvement in skin laxity and textural abnormalities. Most recently, AFP has demonstrated significantly greater improvement than nonablative FP in reducing acne scarring and skin redundancy and laxity associated with photoaging. CONCLUSIONS Through the induction of microthermal zones of injury, FP technology stimulates a robust and rapid wound healing response resulting in improvement in a diversity of aesthetic, inflammatory, and preneoplastic skin disorders. Further investigation into the technology and diverse array of cutaneous conditions that can benefit from FP is highly needed. [source]

Efficacy of Polidocanol Sclerotherapy for Capillary Malformation with Masked Venous Malformation

DERMATOLOGIC SURGERY, Issue 1 2009
NORIKO SAITO MD
First page of article [source]

Long-Term Efficacy of Subcutaneous Sweat Gland Suction Curettage for Axillary Hyperhidrosis: A Prospective Gravimetrically Controlled Study

DERMATOLOGIC SURGERY, Issue 9 2008
STEPHANIE DARABANEANU PHD
BACKGROUND Subcutaneous sweat gland suction curettage (SSGSC) is gaining acceptance as a therapy for axillary hyperhidrosis. Despite its acceptance, there remains a lack of prospective data describing the efficacy and long-term outcome of SSGSC. OBJECTIVE We examined the sweat rates and patients' satisfaction of 12 months following SGSC in 28 patients with axillary hyperhidrosis. METHODS Axillary sweat rates were determined by semiquantitative gravimetry. A questionnaire was used to determine patients' satisfaction. RESULTS A 58% reduction in sweat rate under resting conditions and an 85% reduction during aerobic exercise in sweat rates was observed. A subdivision of patients into three groups based on their baseline preoperative sweat rates (<25, 25,50, and >50 mg/min) showed that patients with resting sweat rates over 25 mg/min benefited particularly from this procedure, whereas patients with less than 25 mg/min did not. CONCLUSION SSGSC produces a significant reduction in the preoperative sweat rates. A low complication rate and a high degree of patient satisfaction were observed. Long-term follow-up evaluations demonstrate a low number of relapses, making SSGSC a convenient and satisfactory method of treating axillary hyperhidrosis. It should be considered in patients refractory to conventional therapies with baseline sweat rates greater than 25 mg/min. [source]

A Multicenter, 47-Month Study of Safety and Efficacy of Calcium Hydroxylapatite for Soft Tissue Augmentation of Nasolabial Folds and Other Areas of the Face

DERMATOLOGIC SURGERY, Issue 2007
NEIL S. SADICK MD
OBJECTIVES Each soft tissue filler product has its own unique profile in terms of adverse events. In this large-scale study, we investigated the safety profile of Radiesse, an injectable calcium hydroxylapatite (CaHA) implant, in treatment of nasolabial folds and other areas of the face. We also investigated the efficacy in a subset of the larger patient group. METHODS After obtaining informed consent from the subjects, researchers injected CaHA at two treatment centers into 113 patients (100 women and 13 men, ranging in age from 26 to 78 years) for a variety of facial aesthetic applications over a period of 47 months. Seventy-five patients had a single injection session; 38 had multiple sessions. Most patients (102) received 1.0 mL of CaHA per session; 12 received 2.0 mL per session. Typically, CaHA was administered with a 27-gauge 0.5- or 1 1/4-in. needle. RESULTS Safety. Of 113 patients, only 7 reported minor adverse events that were short-term and resolved within 1 month: transient ecchymosis (3), nongranulatomous submucosal nodules of the lip (2), and inflammation and edema (2). Efficacy. Efficacy ratings were performed for a subset of patients (n=41). On a scale of 1 to 5 (1=unsatisfactory; 5=excellent), the mean patient evaluation score for look and feel of the implant was 4.6; the mean physician scores for the look and feel of the implant were 4.5 and 4.6, respectively. During the 6-month follow-up visit, patients' mean ratings of the look and feel of the implant were 4.8 and 4.9, respectively. The physician's mean ratings for the look and feel of the implant were 4.5 and 4.9, respectively. CONCLUSIONS In our study, CaHA performed well, with a favorable safety profile, high patient satisfaction (90% of patients reported very good or excellent results), and good durability. We are especially pleased with the low incidence of adverse events coupled with the favorable responses from the patients themselves due to longevity of correction. [source]

A Review of the Biologic Effects, Clinical Efficacy, and Safety of Silicone Elastomer Sheeting for Hypertrophic and Keloid Scar Treatment and Management

DERMATOLOGIC SURGERY, Issue 11 2007
BRIAN BERMAN MD
Silicone elastomer sheeting is a medical device used to prevent the development of and improve the appearance and feel of hypertrophic and keloid scars. The precise mechanism of action of silicone elastomer sheeting has not been defined, but clinical trials report that this device is safe and effective for the treatment and prevention of hypertrophic and keloid scars if worn over the scar for 12 to 24 hours per day for at least 2 to 3 months. Some of the silicone elastomer sheeting products currently on the market are durable and adhere well to the skin. These products are an attractive treatment option because of their ease of use and low risk of adverse effects compared to other treatments, such as surgical excision, intralesional corticosteroid injections, pressure therapy, radiation, laser treatment, and cryotherapy. Additional controlled clinical trials with large patient populations may provide further evidence for the efficacy of silicone elastomer sheeting in the treatment and prevention of hypertrophic and keloid scars. The purpose of this article is to review the literature on silicone elastomer sheeting products and to discuss their clinical application in the treatment and prevention of hypertrophic and keloid scars. [source]