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Improved Scores (improved + score)
Selected AbstractsA United States compassionate use study of lamivudine treatment in nontransplantation candidates with decompensated hepatitis B virus,related cirrhosisLIVER TRANSPLANTATION, Issue 1 2003Hie-Won L. Hann MD Patients with hepatitis B,related decompensated cirrhosis have limited treatment options. This prospective, multicenter study assessed lamivudine in 75 patients with decompensated cirrhosis, the majority of whom (93%) were not candidates for liver transplantation. At baseline, all 75 patients tested positive for hepatitis B surface antigen [HBsAg (+)] and 62% tested positive for hepatitis B e antigen [HBeAg (+)]. Hepatitis B virus (HBV) DNA levels were detectable in 64% of patients by the branched chain DNA (bDNA) assay. Patients received lamivudine 100 mg once daily (median duration, 12.7 months; range, 0.5 to 33 months). In patients with detectable HBV DNA pretreatment, the virus became undetectable by the bDNA assay in 69% of patients with , 6 months treatment and in 64% overall. Alanine aminotransferase (ALT) level improved in 90% and normalized in 55% of patients with , 6 months treatment and in 48% overall. Improvements in bilirubin and albumin levels occurred throughout treatment. The median Child-Pugh score improved from a baseline of 10 to 8 at last visit, with 31% (23/75) having an improved score of , 2 points, 57% (43/75) unchanged (< 2 points), and 12% (9/75) worsened (, 2 points). A virologic breakthrough developed in eight of 41 patients (18%) after a median of 13.1 months of treatment. Tyrosine-methionine-aspartate-aspartate (YMDD) variant HBV was detected in three of four patients tested. Nevertheless, at last visit, ALT, albumin, and bilirubin levels were similar for patients with and without breakthrough. Lamivudine treatment can lead to significant improvements in liver disease severity in nontransplantation candidates with advanced disease. Additional studies of lamivudine in combination with other antivirals are indicated for the large population of patients worldwide with advanced HBV-related cirrhosis and inadequate access to liver transplantation. [source] A randomized clinical trial of strength training in young people with cerebral palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 10 2003Karen J Dodd PhD This randomized clinical trial evaluated the effects of a home-based, six-week strength-training programme on lower limb strength and physical activity of 21 young people (11 females, 10 males; mean age 13 years 1 month, SD 3 years 1 month; range 8 to 18 years) with spastic diplegic cerebral palsy (CP) with independent ambulation, with or without gait aids; (Gross Motor Function Classification System levels I to III). Compared with the 10 controls, the 11 participants in the strength-training programme increased their lower limb strength (combined ankle plantarflexor and knee extensor strength as measured by a hand-held dynamometer) at 6 weeks (F(1,19)=4.58, p=0.046) and at a follow-up 12 weeks later (F(1,18)=6.25, p=0.041). At 6 weeks, trends were also evident for improved scores in Gross Motor Function Measure dimensions D and E for standing, running and jumping, and faster stair climbing. A relatively short clinically feasible home-based training programme can lead to lasting changes in the strength of key lower-limb muscles that may impact on the daily function of young people with CP. [source] An adenosine A2A receptor agonist reduces interleukin-8 expression and glycosaminoglycan loss following septic arthrosis,JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2005Steven B. Cohen Abstract The purpose of this study was to determine whether an adenosine A2A receptor agonist (ATL146e) might augment the current treatment regimen of antibiotics plus irrigation and debridement to prevent the arthritic effects associated with joint sepsis. Staphylococcus aureus bacteria were injected into knees of rabbits, which were divided into 4 treatment groups (12 rabbits per group): no treatment, ATL146e only, antibiotics only, or antibiotics plus ATL146e. Analysis at days 1, 3, and 7 consisted of gross joint appearance, synovial fluid, serum, histologic, immunohistochemical, and biochemical analysis. Synovial fluid cultures at day 7 were negative in all antibiotic and antibiotic plus ATL146e treated knees indicating clearance of bacteria. Average WBC counts from synovial fluid aspirates significantly decreased with treatment of antibiotics alone and antibiotics plus ATL146e. Treatment with antibiotics plus ATL146e significantly decreased the Interleukin-8 content when compared to other treatment groups (p < 0.001) indicating inflammatory response suppression. Histologic grading resulted in notably improved scores in the antibiotics plus ATL146e group compared to other treatment groups (p < 0.001). Glycosaminoglycan assay values were significantly greater in the ATL146e plus antibiotics group compared to the untreated control group (p < 0.04) indicating chondroprotection. The results of this study indicate that administration of an adenosine A2A agonist in combination with antibiotic therapy diminishes joint WBC chemotaxis and reduces joint inflammation, while not compromising the clearance of intraarticular bacteria in a rabbit model. Early bacterial clearance with modulation of the inflammatory response appears to prevent the early degradative effects of joint sepsis. © 2005 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source] Bifocals in children with Down syndrome (BiDS) , visual acuity, accommodation and early literacy skillsACTA OPHTHALMOLOGICA, Issue 6 2010Krithika Nandakumar Acta Ophthalmol. 2010: 88: e196,e204 Abstract. Purpose:, Reduced accommodation is seen in children and young adults with Down syndrome (DS), yet providing bifocals has not become a routine clinical management. This study investigates the impact of bifocals on visual function, visual perceptual and early literacy skills in a group of school children with DS. Methods:, In this longitudinal study, each child was followed for 5 months with single-vision (SV) lenses after which bifocals were prescribed if required, based on their accommodative response. Visual acuity (VA), accommodation, perceptual and literacy skills were measured after adaptation to bifocals and 5 months later. Educational progress and compliance with spectacle wear were assessed through school and parental reports. Results:, Fourteen children and young adults with DS participated in the study. Eighty-five percent required bifocals with additions ranging from +1.00 D to +3.50 D. The mean near logMAR VA improved with bifocals (p = 0.007) compared to SV lenses. Repeated measures anova showed that there was more accurate focus (less accommodative lag) through the bifocals (p = 0.002), but no change in the accommodation exerted through the distance portion compared to SV lenses (p = 0.423). There was a main effect of time on sight words (p = 0.013), Word Identification (p = 0.047), Visual Closure (p = 0.006) and Visual Form Constancy (p = 0.001). Conclusion:, Bifocals provide clearer near vision in DS children with reduced accommodation. This is shown by improved VA and decreased lag of accommodation. The results indicate that the improvement in VA results in improved scores in early literacy skills. Better compliance with bifocals over SV lenses was seen. [source] | ||||||||||