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Selected AbstractsBenefits and risks of interferon therapy for hepatitis B,HEPATOLOGY, Issue S5 2009Robert Perrillo Alpha interferon is the only licensed drug for hepatitis B with immunomodulatory as well as viral inhibitory properties. Potential advantages of interferon compared to nucleoside analogs include a lack of drug resistance, a finite and defined treatment course, and a higher likelihood for hepatitis B surface antigen (HBsAg) clearance. Approximately 30% of hepatitis B e antigen (HBeAg)-positive and 40% of HBeAg-negative cases have a sustained virological response (when defined as HBeAg seroconversion and/or hepatitis B virus (HBV) DNA levels below 20,000 copies/mL, respectively) 6 months after completion of a 48-week course of peginterferon alfa-2a These responses remain durable in 80% and 50% of cases, respectively, when evaluated several years later. Recent studies have shown that changes in HBsAg and HBeAg concentration during treatment predict sustained virological response and serial monitoring of HBsAg is helpful in predicting HBsAg clearance. HBeAg-positive patients with genotype A have higher rates of HBeAg and HBsAg clearance, whereas HBeAg-negative patients with genotype D have the lowest rate of response to interferon therapy. Long-term follow-up of virological responders to either standard alpha interferon or peginterferon has demonstrated a progressive increase in the rate of HBsAg clearance, particularly in patients who were initially HBeAg-positive. Future studies need to address if specific virological benchmarks during therapy can be used to tailor treatment duration. Conclusion: Peginterferon alfa has a place as first-line therapy of hepatitis B in patients who are carefully selected on the basis of pretreatment serum HBV DNA and aminotransferase levels, safety considerations, and viral genotype. (HEPATOLOGY 2009;49:S103,S111.) [source] Homelessness in Europe and the United States: A Comparison of Prevalence and Public OpinionJOURNAL OF SOCIAL ISSUES, Issue 3 2007Paul A. Toro Random samples of 250,435 adults were interviewed by telephone in five different nations (N= 1,546): Belgium, Germany, Italy, the UK, and the United States. The interview included questions on respondent attitudes, knowledge, and opinions regarding homelessness; respondents' own personal experiences with homelessness and homeless people; and demographic characteristics of the respondents. The highest rates for lifetime literal homelessness were found in the UK (7.7%) and United States (6.2%), with the lowest rate in Germany (2.4%), and intermediate rates in Italy (4.0%) and Belgium (3.4%). Less compassionate attitudes toward the homeless were also found on many dimensions in the United States and the UK. Possible explanations of these findings, drawn from various theoretical perspectives, and policy implications are provided. [source] Calcium Phosphate Bioceramics with Various Porosities and Dissolution RatesJOURNAL OF THE AMERICAN CERAMIC SOCIETY, Issue 12 2002Soon-Ho Kwon Porous bioceramics, such as hydroxyapatite (HA), tricalcium phosphate (TCP), and biphasic HA/TCP, were fabricated using the polyurethane sponge technique. The porosity of the ceramics was controlled by a multiple coating of the porous body. When a porous body was produced by a single coating, the porosity was ,90%, and the pores were completely interconnected. When the sintered body was coated five times after the porous network had been made, the porosity decreased to 65%. As the porosity decreased, the strength increased exponentially. The TCP exhibited the highest dissolution rate in a Ringer's solution, and the HA had the lowest rate. The biphasic HA/TCP showed an intermediate dissolution rate. [source] A new method for analyzing scientific productivityJOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 13 2001John C. Huber Previously, a new method for measuring scientific productivity was demonstrated for authors in mathematical logic and some subareas of 19th-century physics. The purpose of this article is to apply this new method to other fields to support its general applicability. We show that the method yields the same results for modern physicists, biologists, psychologists, inventors, and composers. That is, each individual's production is constant over time, and the time-period fluctuations follow the Poisson distribution. However, the productivity (e.g., papers per year) varies widely across individuals. We show that the distribution of productivity does not follow the normal (i.e., bell curve) distribution, but rather follows the exponential distribution. Thus, most authors produce at the lowest rate and very few authors produce at the higher rates. We also show that the career duration of individuals follows the exponential distribution. Thus, most authors have a very short career and very few have a long career. The principal advantage of the new method is that the detail structure of author productivity can be examined, such as trends, etc. Another advantage is that information science studies have guidance for the length of time interval being examined and estimating when an author's entire body of work has been recorded. [source] Prospective study of port wine stain treatment with dye laser: Comparison of two wavelengths (585 nm vs.LASERS IN SURGERY AND MEDICINE, Issue 2 2004595 nm), two pulse durations (0.5 milliseconds vs. Abstract Background and Objectives The conventional pulsed-dye laser (wavelength 585 nm, pulse duration 0.5 milliseconds) is seen as the standard treatment for port wine stains (PWS). Using the pulsed-dye laser at wavelengths of 590, 595, and 600 nm and at varying pulse durations of 1.5,40 milliseconds is one of the newest developments in the field, the therapeutic value of which has been examined in only a few studies. Treatment of PWS with short- and long-pulse dye lasers. Comparison of two wavelengths (585 nm vs. 595 nm) and two pulse durations (0.5 milliseconds vs. 20 milliseconds). Study Design/Materials and Methods Fifteen patients with untreated PWS were included in a randomized prospective study with three different laser settings. Patients underwent one treatment session. The following treatment parameters were chosen at a uniform spot size of 7 mm: (1) 585 nm/0.5 milliseconds/5.5 J/cm2, (2) 595 nm/0.5 milliseconds/5.5 J/cm2, and (3) 595 nm/20 milliseconds/13 J/cm2. The clearance as well as side effects was evaluated. All treatments were performed with cold air-cooling. Follow-up took place immediately, 2 days and 4 weeks after the treatment. The PWS was assigned a clearance score (CS) from 1 to 4 (1,=,poor to 4,=,excellent). Results Descriptively, 585 nm/0.5 milliseconds generated the best average CS of 2.7, followed by 595 nm/20 milliseconds (2.5) and 595 nm/0.5 milliseconds (1.6)); statistically, there is no difference between the CS of 585 nm/0.5 milliseconds and 595 nm/20 milliseconds. The best lightening rates overall were achieved in purple PWS (CS,=,3.5) versus red (CS,=,2.5) and pink (CS,=,2.0). Purple PWS responded best to 585 nm/0.5 milliseconds; red and pink PWS yielded similar results with 585 nm/0.5 milliseconds and 595 nm/20 milliseconds. The setting, 595 nm/0.5 milliseconds was clearly not as effective as the other laser settings. Purpura, pain, and crusting were most commonly reported after treatments with 585 nm/0.5 milliseconds (93%/93%/33%), closely followed by treatments at 595 nm/20 milliseconds (86%/93%/20%). The settings 595 nm/0.5 milliseconds yielded the lowest rate of adverse effects (67%/60%/0%). Hypopigmentation only occurred in one case (585 nm/0.5 milliseconds), and there were no reports of hyperpigmentation or scarring. Conclusions With respect to treating PWS, the conventional pulsed-dye laser set to 585 nm/0.5 milliseconds yields a significantly greater clearance rate than it does at a setting of 595 nm (with the same pulse duration, fluence, and spot size), although the former also entails the highest spectrum of adverse effects. In this study, purple PWS treated at these parameters showed the best results. In dealing with pink PWS, the results were similar to those of the conventional pulsed-dye laser when the pulse duration was increased to 20 milliseconds and fluence was increased. As a rule, the clearance rate corresponded to the extent of the postoperative purpura. Lasers Surg. Med. 34:168,173, 2004. © 2004 Wiley-Liss, Inc. [source] Intraoperative Study of Polarization and Evoked Response Signals in Different Endocardial Electrode DesignsPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 7 2001CHING LAU LAU, C., et al.: Intraoperative Study of Polarization and Evoked Response Signals in Different Endocardial Electrode Designs. Some new generation pacemakers use an algorithm based on evoked response (ER) detection to verify beat-to-beat capture and to enable automatic adjustment of output. This is a prospective acute study of polarization signal (PS) and ER in nine currently available electrodes. Intraoperative testing of ventricular bipolar electrodes used the Autocapture (AC) algorithm. The intrinsic R wave, PS, ER, acceptance of AC function, and stimulation thresholds (STs) were obtained. Ventricular electrodes were categorized as follows: titanium nitride (TiN)-coated passive and active fixation, high impedance (HI), passive fixation (VP), iridium oxide-coated titanium (IROX) (VI), and platinum helix (PH) active fixation. Acute testing was performed in 217 patients with an average age of 74.26 years, 59.6% were men with primary pacing indication-SSS (46.3%). There were no significant differences found with respect to R wave and threshold between the various electrodes. PH active-fixation electrodes had significantly higher ER and PS than other groups including the TiN-coated active-fixation electrodes. TiNcoated electrodes (active and passive fixation) had significantly lower PS than other electrodes. As a result, TiN electrodes had a significantly higher functional rate of AC (91.7%), whereas PH had the lowest rate (0%). In conclusion, (1) polarization characteristics are significantly different for commercially available ventricular electrodes, (2) certain physical features at the tissue to electrode interface like TiN coating appears to be more important in determining PS than electrode tip size and fixation method, and (3) the current algorithm for AC requires electrodes that provide low polarization for satisfactory performance. [source] Benefits of polyspecific associations for the Goeldi's monkey (Callimico goeldii)AMERICAN JOURNAL OF PRIMATOLOGY, Issue 3 2001Leila M. Porter Abstract Polyspecific associations are an important component of Callimico goeldii behavior and ecology. On average, Callimico goeldii was found in proximity to or in vocal contact with Saguinus troops (S. fuscicollis and S. labiatus) during 53% of all time intervals sampled. Polyspecific associations varied considerably between seasons, however, with association rates peaking during the wet-season month of February (89%) and declining in the dry season, with the lowest rate (13%) in July. The primary benefits of associations appear to be an increased use of the lower and middle canopy, and an increase in feeding behaviors during the wet season. Thus, Callimico goeldii appear to benefit most from associations during the wet season when fruits are its principal food source. Fruits are eaten more in the forest canopy than in the understory; thus, an increase in height use likely permits an increase in the fruit resources on which Callimico goeldii can forage and feed. In addition, Saguinus groups, with their smaller home ranges, are likely to be more knowledgeable than Callimico goeldii about the location and abundance of ripe fruits in their home ranges. Thus, Callimico goeldii may parasitize Saguinus for their fruit knowledge by following them through their ranges. In the dry season, limited dietary overlap between Callimico goeldii and Saguinus groups is likely to make associations less beneficial for Callimico goeldii as they adopt different foraging and ranging strategies. Am. J. Primatol. 54:143,158, 2001. © 2001 Wiley-Liss, Inc. [source] Improvement in Long-Term Renal Graft Survival due to CMV Prophylaxis with Oral Ganciclovir: Results of a Randomized Clinical TrialAMERICAN JOURNAL OF TRANSPLANTATION, Issue 5 2008V. Kliem Oral ganciclovir prophylaxis and intravenous preemptive therapy are competitive approaches to prevent cytomegalovirus (CMV) disease after renal transplantation. This trial compared efficacy, safety and long-term graft outcome in 148 renal graft recipients randomized to ganciclovir prophylaxis (N = 74) or preemptive therapy (N = 74). Hierarchical testing revealed (i) patients with CMV infection had more severe periods of impaired graft function (creatinine clearancemax-min 25.0 ± 14.2 mL/min vs. 18.1 ± 12.5 mL/min for patients without CMV infection; p = 0.02),(ii) prophylaxis reduced CMV infection by 65% (13 vs. 33 patients; p < 0.0001) but (iii) creatinine clearance at 12 months was comparable for both regimes (54.0 ± 24.9 vs. 53.1 ± 23.7 mL/min; p = 0.92). No major safety issues were observed, and patient survival at 12 months was similar in both groups (5 deaths [6.8%] vs. 4 [5.4%], p = 1.0000). Prophylaxis significantly increased long-term graft survival 4 years posttransplant (92.2% vs. 78.3%; p = 0.0425) with a number needed to treat of 7.19. Patients with donor +/recipient + CMV serostatus had the lowest rate of graft loss following prophylaxis (0.0% vs. 26.8%; p = 0.0035). In conclusion, it appears that routine oral prophylaxis may improve long-term graft survival for most renal transplant patients. Preemptive therapy can be considered in low risk patients in combination with adequate CMV monitoring. [source] Relationships between the addition rates of cellulase or glucose and silage fermentation at different temperaturesANIMAL SCIENCE JOURNAL, Issue 3 2010Jian-Guo ZHANG ABSTRACT The influence of the application rates of cellulase preparation and glucose on silage fermentation at different temperatures was studied with the straw of naked barley (Hordeum vulgare L. emand Lam) and guineagrass (Panicum maximum Jacq.). Addition rate of cellulase and glucose, temperature and their interaction had significant effects on pH value, lactic acid content, butyric acid content and propionic acid content of naked barley straw silage and significant effects on all the parameters of guineagrass silage (P < 0.01). Temperature and interaction had significant effect on acetic acid content (P < 0.05) and no significant effect on NH3 -N content of naked barley straw silage (P > 0.05). Under all the temperatures, the pH values of barley straw and guineagrass silages were reduced by cellulase and glucose addition even at the lowest rate (P < 0.05), compared with their corresponding control. Lactic acid contents of silages were the highest within the same temperature and same additive when glucose and cellulase were added at the highest rates, whereas the effect of cellulase and glucose addition on butyric acid production varied with their application rates and silage storage temperature. The addition rate of restricting butyric acid fermentation was lower at 20°C than that at 30°C, and it was the lowest at 40°C where cellulase and glucose addition restricted butyric acid fermentation even at 0.1 g/kg and 10 g/kg, respectively, when compared to the control. While the addition rate was lower than the above level, cellulase and glucose addition also promoted butyric acid fermentation. [source] Cutaneous melanoma in New Zealand: 2000,2004ANZ JOURNAL OF SURGERY, Issue 5 2010Jennifer J. C. Liang Abstract Background:, In 2004, we published data on the trends in New Zealand (NZ) cutaneous melanoma (CM) for the period 1995,1999. The present report documents the trends in the next period from 2000 to 2004. Method:, Data were obtained from the New Zealand Cancer Registry by way of a computerized search of CM ICD-10 (172) codes from 2000 to 2004. Only one registration per person was made to avoid including patients with metastatic melanoma. The exclusion criteria were: incorrect or absent data; benign naevi; and melanoma in situ. Incidence rates were age standardised to the Segi world population. Results:, The total study population was 8262 patients. There was no increase found in the overall incidence rate over the time period, but men had a statistically higher overall incidence rate (P= 0.0002) and thicker CMs (P= 0.003) compared with women. This gender difference was particularly marked in those patients aged greater than 59 years. Breslow thickness increased from 0.7 to 0.8 mm. The incidence rates varied quite significantly among District Health Boards, with Taranaki having the highest rate (70.3/100 000/year) and Southland had the lowest rate (20.1/100 000). Overall, NZ had a CM incidence rate of 41.2/100 000/year). Conclusion:, The current study confirmed that NZ has the highest overall CM incidence rate in the world. Elderly men (>59 years old) have the highest risk of developing melanoma. The increase in melanoma thickness with its associated higher mortality risk is of grave concern. [source] Short communication: The relationship between pre-pregnancy care and early pregnancy loss, major congenital anomaly or perinatal death in type I diabetes mellitusBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 1 2007DWM Pearson The relationships between markers of pregnancy planning and pre-pregnancy care and adverse outcomes (early pregnancy loss, major congenital anomaly and perinatal death) were examined in 423 singleton pregnancies in women with pre-gestational type I diabetes mellitus. Pregnancy planning and markers of pre-pregnancy care were associated with reduced risks of adverse pregnancy outcomes. ,Documentation of achievement of an optimal haemoglobin A1c prior to discontinuation of contraception' was the marker associated with the lowest rate of adverse outcome (OR 0.2; 95% CI 0.06,0.67) and might serve as an appropriate definition of pre-pregnancy care for research and audit purposes. [source] Factors that predict changing the type of phosphodiesterase type 5 inhibitor medication among men in the UKBJU INTERNATIONAL, Issue 4 2007Philip D. Kell OBJECTIVE To evaluate predictors of changing the type of phosphodiesterase type 5 (PDE5) inhibitor (switching) among men with erectile dysfunction (ED) in the UK, the largest consumer of PDE5 inhibitors in Europe, as switching medication is often associated with higher resource use, and there are three oral PDE5 inhibitor medications currently available. PATIENTS AND METHODS Patients were identified from The Health Improvement Network database in the UK; men initiating therapy with sildenafil, tadalafil or vardenafil from May 2003 to August 2004 with ,,6 months of prescription history before and after their initial PDE5 inhibitor prescription were included. Switching was evaluated as the proportion of second PDE5 inhibitor prescriptions that were for a drug differing from the first. Logistic regression was used to adjust for factors that might be associated with switching (dose, age and the presence of hypertension, dyslipidaemia, diabetes or depression). RESULTS Of the 2703 eligible men who initiated PDE5 inhibitor treatment during the study period, 91 (3.4%) switched to a different PDE5 inhibitor at their second prescription. The choice of initial PDE5 inhibitor therapy was a highly significant predictor of switching; men initiated on sildenafil were less likely to switch than those initiated on tadalafil (P < 0.001) or vardenafil (P < 0.003). Age and the presence of comorbidities were not significantly associated with switching (P > 0.05). CONCLUSION Initiating ED therapy with sildenafil was associated with the lowest rate of PDE5 inhibitor switching, which might reflect treatment satisfaction and patient preference. [source] Comparison of diagnostic accuracy for cutaneous malignant melanoma between general dermatology, plastic surgery and pigmented lesion clinicsBRITISH JOURNAL OF DERMATOLOGY, Issue 2 2003J.E. Osborne SummaryBackground Since the 1980s there have been dedicated pigmented lesion clinics (PLCs) in the U.K. Important considerations when comparing the efficacy of the PLC with other referral clinics include diagnostic accuracy. Objectives To compare the false-negative rate of clinical diagnosis (FNR) in the PLC with that in the other clinics of primary referral of malignant melanoma (MM) in the same geographical area. We have previously shown that certain clinical features are risk factors for diagnostic failure of MM. A further aim of this study was to correct for any differences in frequency of these factors in the melanoma populations between clinics and to estimate the false-positive diagnostic rate (FPR) in the PLC. Methods To compare the FNR between clinics, the case notes of all patients presenting with histologically proven cutaneous MM in Leicestershire between 1987 and 1997 were examined retrospectively. A false-negative diagnosis was defined as documentation of another diagnosis and/or evidence in the case notes that the diagnosis was not considered to be MM. The FNR was estimated as the number of false-negative clinical diagnoses/number of true-positive histological diagnoses. To estimate the diagnostic FPR, which was defined as the number of false-positive clinical diagnoses of MM/total number of positive clinical diagnoses, in the PLC, the outcome of 500 consecutive patients attending the PLC was surveyed. Results The case notes of 731 patients were available, of whom approximately two-thirds initially attended the PLC, one-fifth the General Dermatology clinics (D) and the remainder were divided approximately equally (one-twentieth each) between Plastic Surgery clinics (P), other clinics (O) and the surgery of the general practitioner (GP). The last was regarded as the primary referral clinic if the lesion were excised there prior to any referral. The FNR was lowest for the PLC, at 10%, compared with 29% (D), 19% (P), 55% (O) and 54% (GP) (P < 0·0001). Lesions with risk factors for diagnostic failure were under-represented in the PLC (P < 0·0001), the mean frequencies of the risk factors being 20% (PLC), 25% (D), 22% (P), 31% (O) and 30% (GP). Differences were not large but still could partially explain the lower FNR of the PLC. However, when the FNR was estimated for lesions exhibiting each of these risk factors, the PLC was found to have the lowest rate in every case (PLC vs. all clinics combined, P = 0·04 to P < 0·0001). The mean FNR for the risk factors combined was 18% (PLC), 45% (D), 50% (P), 68% (O) and 71% (GP). Also on logistic multivariable analysis of the PLC vs. all the other clinics on FNR and the above factors, the higher FNR of the other clinics retained significance (odds ratio 5·9, P < 0·0001). In the 500 patients surveyed separately in the PLC, the MM pick-up rate on biopsy was 32% and the diagnostic FPR was 41%. Conclusions The FNR of MM was lower in the PLC than in the other clinics, while the pick-up rate for MM on biopsy and the FPR were acceptably low. [source] Causative factors, surgical treatment and outcome of incisional hernia after liver transplantationBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2002Dr H. Janßen Background: Little is known about the incidence and causes of herniation, and the results of hernia repair in patients undergoing liver transplantation. Likewise, nothing is known about the best surgical approach for hernia repair. Methods: A retrospective analysis was conducted of the occurrence of incisional hernia in 290 patients who had liver transplantation between 1990 and 2000, and survived more than 6 months. Follow-up data were obtained from medical records and the outpatient service. Patients were evaluated for various clinical and surgical factors. Hernias were analysed with respect to localization, type of surgical repair and recurrence rate. Results: Some 17 per cent of the transplanted patients experienced an incisional hernia. Risk factors were acute rejection with affiliated steroid bolus therapy (P = 0·025), a low platelet count after transplantation (P = 0·048), and a transverse abdominal incision with upper midline approach (P = 0·04). Hernias were mainly located at the junction of the transverse and midline incision (P < 0·001) and the recurrence rate was highest here (P = 0·007). Prosthetic hernia repair achieved the lowest rate of recurrence and did not increase the incidence of infectious complications. Conclusion: Improved immunosuppression should avoid early steroid bolus therapy after transplantation. A low platelet count promotes herniation. Transverse abdominal incision seems to be the best approach for liver transplantation. Prosthetic hernia repair does not increase the complication rate. © 2002 British Journal of Surgery Society Ltd [source] Safety and effectiveness of the INVATEC MO.MA® proximal cerebral protection device during carotid artery stenting: Results from the ARMOUR pivotal trial,CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 1 2010Gary M. Ansel MD Abstract Objective: The multicenter ARMOUR (ProximAl PRotection with the MO.MA Device DUring CaRotid Stenting) trial evaluated the 30-day safety and effectiveness of the MO.MA® Proximal Cerebral Protection Device (Invatec, Roncadelle, Italy) utilized to treat high surgical risk patients undergoing carotid artery stenting (CAS). Background: Distal embolic protection devices (EPD) have been traditionally utilized during CAS. The MO.MA device acts as a balloon occlusion "endovascular clamping" system to achieve cerebral protection prior to crossing the carotid stenosis. Methods: This prospective registry enrolled 262 subjects, 37 roll-in and 225 pivotal subjects evaluated with intention to treat (ITT) from September 2007 to February 2009. Subjects underwent CAS using the MO.MA device. The primary endpoint, myocardial infarction, stroke, or death through 30 days (30-day major adverse cardiac and cerebrovascular events [MACCE]) was compared to a performance goal of 13% derived from trials utilizing distal EPD. Results: For the ITT population, the mean age was 74.7 years with 66.7% of the cohort being male. Symptomatic patients comprised 15.1% and 28.9% were octogenarians. Device success was 98.2% and procedural success was 93.2%. The 30-day MACCE rate was 2.7% [95% CI (1.0,5.8%)] with a 30-day major stroke rate of 0.9%. No symptomatic patient suffered a stroke during this trial. Conclusions: The ARMOUR trial demonstrated that the MO.MA® Proximal Cerebral Protection Device is safe and effective for high surgical risk patients undergoing CAS. The absence of stroke in symptomatic patients is the lowest rate reported in any independently adjudicated prospective multicenter registry trial to date. © 2010 Wiley-Liss, Inc. [source] Complication and failure rates in patients treated for chronic periodontitis and restored with single crowns on teeth and/or implantsCLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2010Kurt Schmidlin Abstract Objectives: To assess the biological and technical complication rates of single crowns on vital teeth (SC-V), endodontically treated teeth without post and core (SC-E), with a cast post and core (SC-PC) and on implants (SC-I). Material and methods: From 392 patients with chronic periodontitis treated and documented by graduate students during the period from 1978 to 2002, 199 were reexamined during 2005 for this retrospective cohort study, and 64 of these patients were treated with SCs. Statistical analysis included Kaplan,Meier survival functions and event rates per 100 years of object-time. Poisson regression was used to compare the four groups of crowns with respect to the incidence rate ratio of failures, and failures and complications combined over 10 years and the entire observation period. Results: Forty-one (64%) female and 23 (36%) male patients participated in the reexamination. At the time of seating the crowns, the mean patient age was 46.8 (range 24,66.3) years. One hundred and sixty-eight single unit crowns were incorporated. Their mean follow-up time was 11.8 (range 0.8,26.4) years. During the time of observation, 22 biological and 11 technical complications occurred; 19 SC were lost. The chance for SC-V (56) to remain free of any failure or complication was 89.3% (95% confidence interval [CI] 76.1,95.4) after 10 years, 85.8% (95% CI 66,94.5) for SC-E (34), 75.9% for SC-PC (39), (95% CI 58.8,86.7) and 66.2% (95% CI 45.1,80.7) for SC-I (39). Over 10 years, 95% of SC-I remained free of failure and demonstrated a cumulative incidence of failure or complication of 34%. Compared with SC-E, SC-I were 3.5 times more likely to yield failures or complications and SC-PC failed 1.7 times more frequently than did SC-E. SC-V had the lowest rate of failures or complications over the 10 years. Conclusions: While SCs on vital teeth have the best prognosis, those on endodontically treated teeth have a slightly poorer prognosis over 10 years. Crowns on teeth with post and cores and implant-supported SCs displayed the highest incidence of failures and complications. To cite this article: Schmidlin K, Schnell N, Steiner S, Salvi GE, Pjetursson B, Matuliene G, Zwahlen M, Brägger U, Lang NP. Complication and failure rates in patients treated for chronic periodontitis and restored with single crowns on teeth and/or implants Clin. Oral Impl. Res. 21, 2010; 550,557. doi: 10.1111/j.1600-0501.2009.01907.x [source] Exoenzyme activities as indicators of dissolved organic matter composition in the hyporheic zone of a floodplain riverFRESHWATER BIOLOGY, Issue 8 2010SANDRA M. CLINTON Summary 1. We measured the hyporheic microbial exoenzyme activities in a floodplain river to determine whether dissolved organic matter (DOM) bioavailability varied with overlying riparian vegetation patch structure or position along flowpaths. 2. Particulate organic matter (POM), dissolved organic carbon (DOC), dissolved oxygen (DO), electrical conductivity and temperature were sampled from wells in a riparian terrace on the Queets River, Washington, U.S.A. on 25 March, 15 May, 20 July and 09 October 1999. Dissolved nitrate, ammonium and soluble reactive phosphorus were also collected on 20 July and 09 October 1999. Wells were characterised by their associated overlying vegetation: bare cobble/young alder, mid-aged alder (8,20 years) and old alder/old-growth conifer (25 to >100 years). POM was analysed for the ash-free dry mass and the activities of eight exoenzymes (,-glucosidase, ,-glucosidase, , -N-acetylglucosaminidase, xylosidase, phosphatase, leucine aminopeptidase, esterase and endopeptidase) using fluorogenic substrates. 3. Exoenzyme activities in the Queets River hyporheic zone indicated the presence of an active microbial community metabolising a diverse array of organic molecules. Individual exoenzyme activity (mean ± standard error) ranged from 0.507 ± 0.1547 to 22.8 ± 5.69 ,mol MUF (g AFDM),1 h,1, was highly variable among wells and varied seasonally, with the lowest rates occurring in March. Exoenzyme activities were weakly correlated with DO, DOC and inorganic nutrient concentrations. 4. Ratios of leucine aminopeptidase : ,-glucosidase were low in March, May and October and high in July, potentially indicating a switch from polysaccharides to proteins as the dominant component of microbial metabolism. 5. Principal components analysis indicated that there were patch effects and that these effects were strongest in the summer. 6. DOM degradation patterns did not change systematically along hyporheic flowpaths but varied with overlying forest patch type in the Queets River hyporheic zone, suggesting that additional carbon inputs exist. We hypothesise that the most likely input is the downward movement of DOM from overlying riparian soils. Understanding this movement of DOM from soils to subsurface water is essential for understanding both the hyporheic metabolism and the carbon budget of streams and rivers. [source] Migraine Headache Recurrence: Relationship to Clinical, Pharmacological, and Pharmacokinetic Properties of TriptansHEADACHE, Issue 4 2003Gilles Géraud MD Background and Objectives.,Triptan use is associated with headache recurrence, and this has been cited as an important reason for patient dissatisfaction with the treatment. The mechanism by which recurrence occurs is not clear, and the incidence of recurrence varies with the triptan used. In order to explore the pharmacological and physiological interaction of triptans and migraine headache recurrence further, some specific clinical, pharmacological, and pharmacokinetic factors that might influence migraine recurrence were evaluated in a review of the major efficacy data for the drugs in the triptan class. These factors were 5-HT1B and 5-HT1D receptor activities, the pharmacokinetic elimination half-life of each triptan, and the clinical efficacy of each compound, determined by the proportion of patients with headache relief and the therapeutic gain over placebo. Methods.,Clinical data were derived from 31 triptan, placebo-controlled, major efficacy studies used in a previous meta-analysis. The mean recurrence rate, mean headache response, and therapeutic gain were calculated using the results from the individual clinical studies. Mean headache response and therapeutic gain were calculated at the time point used to define recurrence in each study. Data for binding affinity and potency were taken from a direct-comparison in vitro pharmacology study, and the elimination half-life quoted in the data sheet for each triptan was used. Rank correlation with recurrence rate was performed for each of the test parameters. Results.,Mean headache recurrence rates ranged from 17% for frovatriptan 2.5 mg to 40% for rizatriptan. Elimination half-life and recurrence were inversely correlated (r = ,1.0, P = .0016). There was also a significant inverse correlation between 5-HT1B receptor potency and recurrence (r = ,0.68, P = .034), but 5-HT1D receptor potency was not correlated with recurrence (r = ,0.20, P = .54). In addition, the binding affinities for the 5-HT1B and 5-HT1D receptors were not correlated to headache recurrence. Importantly, it also was demonstrated that initial clinical efficacy was not correlated to headache recurrence. The correlation coefficient for headache response was 0.18 (P = .53) and for therapeutic gain, ,0.11 (P = .71). Conclusion.,The incidence of migraine headache recurrence varies between drugs in the triptan class. Migraine recurrence does not appear to be related to initial clinical efficacy, but is influenced by the pharmacological and pharmacokinetic properties of the individual triptans. The triptans with longer half-lives and greater 5-HT1B receptor potency had the lowest rates of headache recurrence. [source] Forest canopy and community dynamics in a temperate old-growth evergreen broad-leaved forest, south-western Japan: a 7-year study of a 4-ha plotJOURNAL OF ECOLOGY, Issue 5 2001Masahiro Miura Summary 1Forest canopy gap and community dynamics were studied in a 4-ha permanent plot of an old-growth evergreen broad-leaved forest dominated by Castanopsis cuspidata var. sieboldii and Distylium racemosum in the Tatera Forest Reserve, Tsushima Islands, south-western Japan. The forest was affected by a powerful typhoon in 1987 and was monitored from 1990 to 1997. 2In 1990, all woody stems , 5 cm diameter at breast height (d.b.h.) in the plot were identified, mapped and marked, and the state of 1600 5 m × 5 m contiguous quadrats used to locate canopy gaps. Gaps occupied 17.1% of the plot, which contained 4494 tree and shrub stems (total basal area 63.48 m2 ha,1). Gaps were re-censused in 1997 and both marked and newly recruited (, 5 cm d.b.h.) stems were recorded in 1992 and 1997. 3Over 7 years the rates of canopy gap formation and closure were 0.72% year,1 and 1.61% year,1, respectively, mortality and recruitment rates were 0.97% year,1 and 0.99% year,1, and the rates of loss and gain in basal area were 0.95% year,1 and 0.83% year,1. 4The mortality of stems was size-dependent, with those in middle size classes having the lowest rates. Mortality of stems was lower in canopy and higher in the understorey, while the proportion of stems killed by disturbances increased with height. 5Stems that died during the 7 years were predominantly located in newly created gaps, whereas stems were recruited into both established and new gaps. Deciduous broad-leaved species were largely restricted to gaps that remained open throughout the study. 6Both composition and structure of the forest changed in response to disturbance-related effects on canopy dynamics. [source] Cholesterol and Lipid Oxidation Products in Cooked Meat as Affected by Raw-Meat Packaging and Irradiation and by Cooked-Meat Packaging and Storage TimeJOURNAL OF FOOD SCIENCE, Issue 9 2001M. Du ABSTRACT: Aerobic packaging significantly increased cholesterol oxidation products (COPs) and thiobarbituric acid reactive substances (TBARS) in cooked turkey, pork, and beef patties after 7-d storage, but vacuum packaging was very effective in preventing cholesterol and lipid oxidation. Packaging of meat after cooking had a much stronger effect on COPs formation than before cooking, and irradiation had only a minor effect. The amount of total COPs correlated well with TBARS in cooked meat. Turkey had the highest rates of COPs and TBARS formation and beef had the lowest rates after 7-d storage, which were closely related to the fatty acid composition of meats. 7a-hydroxycholesterol, 7p-hydroxycholesterol, and 7-ketocholesterol were the major COPs detected in all 3 cooked meat patties. [source] 16 Comparisons of macrophyte cover and community primary productivity on two southern california shoresJOURNAL OF PHYCOLOGY, Issue 2003A. M. Bullard Light-saturated net photosynthetic rates and cover of rocky intertidal macrophytes were determined between January and March 2003 at two southern California sites characterized by different macrophyte standing stocks. Overall macrophyte cover at Little Corona del Mar was low (75.4%) and was dominated by articulated corallines, and small, turf-forming crustose algae that provide little habitat structure. Macrophyte cover was higher at Dana Point (99.4%), where larger, frondose seaweeds were more abundant (34% vs < 5% cover). Our light-saturated photosynthetic rates for Little Corona del Mar and Dana Point macrophytes were similar to values for the same species obtained during the 1970s and 1980s. Highest photosynthetic rates were obtained for thinner, sheet-like, and branched, frondose seaweeds, while lowest rates were found for articulated coralline and crustose algae. We estimated the net community productivity of the two sites using photosynthetic rates (calculated as mg C m,2 · h,1) and percent cover data for the most abundant populations. We also compared our community productivity estimates for Little Corona del Mar and Dana Point with values for the same sites calculated using macrophyte cover values obtained during the mid-1970s. Re-sampling studies of these and other regional sites reveal that lower-producing, crustose and coralline algae have become increasingly abundant while the cover of higher-producing, frondose algae has declined on many southern California shores. Our studies at Little Corona del Mar and Dana Point, indicate that changing macrophyte abundances can have significant effects on the primary productivity of rocky intertidal communities. [source] The Impact of Trade Liberalisation on Economic Growth: Evidence from a Quantile Regression AnalysisKYKLOS INTERNATIONAL REVIEW OF SOCIAL SCIENCES, Issue 4 2008Neil Foster SUMMARY Individual country experience with trade liberalisation has been mixed. This paper examines the relationship between liberalisation and growth for a sample of 75 liberalising countries. To consider the importance of heterogeneity in the growth response to liberalisation this paper employs quantile regression methods which allow the coefficient on liberalisation to vary across the conditional growth distribution. The results suggest that countries experiencing the lowest rates of growth benefit most from liberalisation. The results also suggest that while such countries benefit most in the long-run they are the most likely to suffer from short-run negative effects of liberalisation. [source] Cover Picture , Mol.MOLECULAR NUTRITION & FOOD RESEARCH (FORMERLY NAHRUNG/FOOD), Issue 2 2009Nutr. Prostate cancer is the second most common cancer diagnosed in men and has increased dramatically in the past two decades partly as a result of lifestyle changes. Indeed, prostate cancer is a disease of the affluent West while Japan has one of the lowest rates of prostate cancer amongst economically developed nations. The traditional Japanese diet may reduce the risk of prostate cancer through a combination of increased soybean products and fish intake, with reduced red meat consumption. Also, the Mediterranean diet, as well as tomatoes and other red and orange coloured vegetables and fruits, may be protective against prostate cancer. While reading the special issue on "Diet and Prostate Cancer" we suggest you relax with a good cup of tea as tea may well play an important role in prostate cancer prevention. [source] Sites of recurrence in oral and oropharyngeal cancers according to the treatment approachORAL DISEASES, Issue 3 2003AL Carvalho OBJECTIVE: The purpose of this study is to evaluate the rates and the sites of tumour recurrence in patients with oral and oropharyngeal carcinomas. DESIGN: This is a retrospective study of a series of cases treated in a single institution. PATIENTS AND METHODS: A series of 2067 patients with oral and oropharyngeal squamous carcinoma, treated from 1954 to 1998 were analysed. The treatment approach was: surgery, 624 cases (30.2%); radiotherapy alone, 729 cases (35.3%); radiotherapy and surgery, 552 cases (26.7%) and radiotherapy and chemotherapy, 162 cases (7.8%). MAIN OUTCOME MEASURES: Tumour recurrence was observed in 1079 patients (52.2%): 561 cases of local recurrences (27.1%); 168 neck recurrences (8.1%); 252 locoregional recurrences (12.2%); 59, distant metastasis (2.9%) and 39 (1.9%), combination of distant metastasis with local, neck or locoregional recurrence. RESULTS: The rates of recurrence varied significantly according to the treatment performed. Oral cavity cancer patients undergoing radiotherapy alone or in combination with chemotherapy presented the highest rates of neck recurrences (22.5 and 40.0%, respectively) for clinical stage (CS) I/II and of local (41.2 and 30.1%) and locoregional (21.7 and 31.1%) recurrences for CS III/IV; yet, for CS III/IV, surgery without neck dissection was associated with the highest rates of neck recurrences (20.7%), but no differences were observed in the rates of local or locoregional recurrences for CS I/II patients. For oropharynx cancer patients with CS I/II there was no difference in the rate of locoregional failures according to the treatment. However, patients with CS III/IV undergoing radiotherapy present a highest rate of local (42.3%) and locoregional (28.8%) failures. CONCLUSION: The results suggest that surgery should be the first option for initial clinical stage oral and oropharyngeal cancers. For advanced cases independently of the site of the tumour, surgery and postoperative radiotherapy should be the standard of care because it is associated with the lowest rates of locoregional recurrence. [source] Dental wear, wear rate, and dental disease in the African apesAMERICAN JOURNAL OF PRIMATOLOGY, Issue 6 2010Alison A. Elgart Abstract The African apes possess thinner enamel than do other hominoids, and a certain amount of dentin exposure may be advantageous in the processing of tough diets eaten by Gorilla. Dental wear (attrition plus abrasion) that erodes the enamel exposes the underlying dentin and creates additional cutting edges at the dentin-enamel junction. Hypothetically, efficiency of food processing increases with junction formation until an optimal amount is reached, but excessive wear hinders efficient food processing and may lead to sickness, reduced fecundity, and death. Occlusal surfaces of molars and incisors in three populations each of Gorilla and Pan were videotaped and digitized. The quantity of incisal and molar occlusal dental wear and the lengths of dentin,enamel junctions were measured in 220 adult and 31 juvenile gorilla and chimpanzee skulls. Rates of dental wear were calculated in juveniles by scoring the degree of wear between adjacent molars M1 and M2. Differences were compared by principal (major) axis analysis. ANOVAs compared means of wear amounts. Pearson correlation coefficients were calculated to compare the relationship between molar wear and incidence of dental disease. Results indicate that quantities of wear are significantly greater in permanent incisors and molars and juvenile molars of gorillas compared to chimpanzees. The lengths of dentin,enamel junctions were predominantly suboptimal. Western lowland gorillas have the highest quantities of wear and the most molars with suboptimal wear. The highest rates of wear are seen in Pan paniscus and Pan t. troglodytes, and the lowest rates are found in P.t. schweinfurthii and G. g. graueri. Among gorillas, G. b. beringei have the highest rates but low amounts of wear. Coefficients between wear and dental disease were low, but significant when all teeth were combined. Gorilla teeth are durable, and wear does not lead to mechanical senescence in this sample. Am. J. Primatol. 72:481,491, 2010. © 2010 Wiley-Liss, Inc. [source] Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: Results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registryARTHRITIS & RHEUMATISM, Issue 1 2010Merete Lund Hetland Objective To compare tumor necrosis factor , inhibitors directly regarding the rates of treatment response, remission, and the drug survival rate in patients with rheumatoid arthritis (RA), and to identify clinical prognostic factors for response. Methods The nationwide DANBIO registry collects data on rheumatology patients receiving routine care. For the present study, we included patients from DANBIO who had RA (n = 2,326) in whom the first biologic treatment was initiated (29% received adalimumab, 22% received etanercept, and 49% received infliximab). Baseline predictors of treatment response were identified. The odds ratios (ORs) for clinical responses and remission and hazard ratios (HRs) for drug withdrawal were calculated, corrected for age, disease duration, the Disease Activity Score in 28 joints (DAS28), seropositivity, concomitant methotrexate and prednisolone, number of previous disease-modifying drugs, center, and functional status (Health Assessment Questionnaire score). Results Seventy percent improvement according to the American College of Rheumatology criteria (an ACR70 response) was achieved in 19% of patients after 6 months. Older age, concomitant prednisolone treatment, and low functional status at baseline were negative predictors. The ORs (95% confidence intervals [95% CIs]) for an ACR70 response were 2.05 (95% CI 1.52,2.76) for adalimumab versus infliximab, 1.78 (95% CI 1.28,2.50) for etanercept versus infliximab, and 1.15 (95% CI 0.82,1.60) for adalimumab versus etanercept. Similar predictors and ORs were observed for a good response according to the European League Against Rheumatism criteria, DAS28 remission, and Clinical Disease Activity Index remission. At 48 months, the HRs for drug withdrawal were 1.98 for infliximab versus etanercept (95% 1.63,2.40), 1.35 for infliximab versus adalimumab (95% CI 1.15,1.58), and 1.47 for adalimumab versus etanercept (95% CI 1.20,1.80). Conclusion Older age, low functional status, and concomitant prednisolone treatment were negative predictors of a clinical response and remission. Infliximab had the lowest rates of treatment response, disease remission, and drug adherence, adalimumab had the highest rates of treatment response and disease remission, and etanercept had the longest drug survival rates. These findings were consistent after correction for confounders and sensitivity analyses and across outcome measures and followup times. [source] Breast cancer incidence among American Indian and Alaska Native women: US, 1999,2004,,§CANCER, Issue S5 2008Phyllis A. Wingo PhD Abstract BACKGROUND. Breast cancer is a leading cause of cancer morbidity and mortality among American Indian and Alaska Native (AI/AN) women. Although published studies have suggested that breast cancer rates among AI/AN women are lower than those among other racial and ethnic populations, accurate determinations of the breast cancer burden have been hampered by misclassification of AI/AN race. METHODS. Cancer incidence data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program were combined to estimate age-adjusted rates for the diagnosis years 1999 through 2004. Several steps were taken to reduce the misclassification of AI/AN race: linking cases to Indian Health Service (IHS) patient services database, restricting analyses to Contract Health Service Delivery Area counties, and stratifying results by IHS region. RESULTS. Breast cancer incidence rates among AI/AN women varied nearly 3-fold across IHS regions. The highest rates were in Alaska (134.8) and the Plains (Northern, 115.9; Southern, 115.7), and the lowest rates were in the Southwest (50.8). The rate in Alaska was similar to the rate among non-Hispanic white (NHW) women in Alaska. Overall, AI/AN women had lower rates of breast cancer than NHW women, but AI/AN women were more likely to be diagnosed with late-stage disease. CONCLUSIONS. To the authors' knowledge, this report provides the most comprehensive breast cancer incidence data for AI/AN women to date. The wide regional variation indicates an important need for etiologic and health services research, and the large percentage of AI/AN women with late-stage disease demands innovative approaches for increasing access to screening. Cancer 2008;113(5 suppl):1191,202. Published 2008 by the American Cancer Society. [source] | |||||||||||||||||||||||||