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Selected AbstractsA new endoscopic technique for suspension of esophageal prosthesis for refractory caustic esophageal stricturesDISEASES OF THE ESOPHAGUS, Issue 3 2008E. Ancona SUMMARY., There is no clear consensus concerning the best endoscopic treatment of benign refractory esophageal strictures due to caustic ingestion. Different procedures are currently used: frequent multiple dilations, retrievable self-expanding stent, nasogastric intubation and surgery. We describe a new technique to fix a suspended esophageal silicone prosthesis to the neck in benign esophageal strictures; this permits us to avoid the frequent risk of migration of the expandable metallic or plastic stents. Under general anesthesia a rigid esophagoscope was placed in the patient's hypopharynx. Using transillumination from the optical device, the patient's neck was pierced with a needle. A n.0 monofilament surgical wire was pushed into the needle, grasped by a standard foreign body forceps through the esophagoscope and pulled out of the mouth (as in percutaneous endoscopic gastrostomy procedure). After tying the proximal end of the silicone prosthesis with the wire, it was placed through the strictures under endoscopic view. This procedure was successfully utilized in four patients suffering from benign refractory esophageal strictures due to caustic ingestion. The prosthesis and its suspension from the neck were well-tolerated until removal (mean duration 4 months). A postoperative transitory myositis was diagnosed in only one patient. One of the most frequent complications of esophageal prostheses in refractory esophageal strictures due to caustic ingestion is distal migration. Different solutions were proposed. For example the suspension of a wire coming from the nose and then fixed behind the ear. This solution is not considered optimal because of patient complaints and moreover the aesthetic aspect is compromised. The procedure we utilized in four patients utilized the setting of a silicone tube hanging from the neck in a way similar to that of endoscopic pharyngostomy. This solution is a valid alternative both for quality of life and for functional results. [source] Pure aluminium shear panels as dissipative devices in moment-resisting steel framesEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 7 2007G. De Matteis Abstract The use of energy dissipation systems for the seismic control of steel structures represents a valid alternative to conventional seismic design methods. The seismic devices currently employed are mostly based on the metallic yielding technology due to the large feasibility and efficiency they can provide. Within this context, in the current paper an innovative solution based on the adoption of low-yield-strength pure aluminium shear panels (SPs) for seismic protection of steel moment-resisting frames is proposed and investigated. In order to prove the effectiveness of the system, a wide numerical study based on both static and dynamic non-linear analyses has been carried out, considering a number of different frame-to-shear panel combinations, aiming at assessing the effect of the main influential parameters on the seismic response of the structure. The obtained results show that the contribution provided by aluminium SPs is rather significant, allowing a remarkable improvement of the seismic performance of the structure in terms of stiffness, strength and ductility, with the possibility to strongly limit the damage occurring in the members of moment-resisting frames. In particular, it is clearly emphasized that the stiffening effect provided by SPs allows a more rational design procedure to be adopted, since the serviceability limit state check does not lead to unavoidable and uneconomical increase of the size of main structural members. Copyright © 2007 John Wiley & Sons, Ltd. [source] Amino acid profiling in plant cell cultures: An inter-laboratory comparison of CE-MS and GC-MSELECTROPHORESIS, Issue 9 2007Brad J. Williams Abstract A CE-MS method for metabolic profiling of amino acids was developed and used in an integrated functional genomics project to study the response of Medicago truncatula liquid suspension cell cultures to stress. This project required the analysis of more than 500 root cell culture extracts. The CE-MS method profiled 20 biologically important amino acids. The CE-MS method required no sample derivatization prior to injection and used minimal sample preparation. The method is described in terms of CE and MS operational parameters, reproducibility of migration times and response ratios, sample preparation, sample throughput, and reliability. This method was then compared with a previously published report that used GC-MS metabolic profiling for the same tissues. The data reveal a high level of similarity between the CE-MS and GC-MS amino acid profiling methods, thus supporting these as complementary technologies for metabolomics. We conclude that CE-MS is a valid alternative to GC-MS for targeted profiling of metabolites, such as amino acids, and possesses some significant advantages over GC-MS. [source] The role of calcimimetics in the treatment of hyperparathyroidismEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 12 2007R. P. Wüthrich Abstract Calcimimetics reduce serum levels of parathyroid hormone (PTH) and calcium, with a leftward shift in the set-point for calcium-regulated PTH secretion. The aim of this publication is to review the data available for calcimimetics in primary, secondary and tertiary hyperparathyroidism (HPT). Parathyroidectomy (PTX) is currently the only curative treatment for primary HPT, and recommended for patients with moderate-to-severe disease, as defined by a 2002 National Institute's of Health summary statement. In general, patients with primary HPT not meeting these surgical criteria, as well as those with contraindication or refusal for surgery, are monitored for signs and symptoms of primary HPT. There are currently no non-surgical therapies approved for use in primary HPT, although bisphosphonates are used in some patients, in an effort to control serum calcium levels. Calcimimetics decrease PTH and calcium levels and are a potential alternative for patients contraindicated for PTX, or who have failed previous PTX and have recurrent primary HPT. Secondary HPT develops early in chronic kidney disease and is present virtually in all patients with end-stage renal disease (ESRD). Secondary HPT is a progressive disease and is associated with several systemic complications, including renal osteodystrophy, soft tissue and vascular calcifications, and adverse cardiovascular outcomes. In ESRD patients, calcimimetics were shown to simultaneously reduce PTH, calcium, phosphate and calcium × phosphate product. In addition, observational analyses of use of calcimimetics in the ESRD population have shown a reduction of important clinical outcomes. In renal allograft recipients with tertiary HPT and hypercalcaemia, calcimimetics are a promising treatment option to control the parameters of calcium phosphate metabolism and may be a valid alternative to PTX. Based on its unique mechanism of action, the calcimimetic cinacalcet may play a role in the medical treatment of primary and tertiary forms of HPT, in addition to the registered indication for the treatment of secondary HPT. [source] Analysis and implementation issues for the numerical approximation of parabolic equations with random coefficientsINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN ENGINEERING, Issue 6-7 2009F. Nobile Abstract We consider the problem of numerically approximating statistical moments of the solution of a time-dependent linear parabolic partial differential equation (PDE), whose coefficients and/or forcing terms are spatially correlated random fields. The stochastic coefficients of the PDE are approximated by truncated Karhunen,Loève expansions driven by a finite number of uncorrelated random variables. After approximating the stochastic coefficients, the original stochastic PDE turns into a new deterministic parametric PDE of the same type, the dimension of the parameter set being equal to the number of random variables introduced. After proving that the solution of the parametric PDE problem is analytic with respect to the parameters, we consider global polynomial approximations based on tensor product, total degree or sparse polynomial spaces and constructed by either a Stochastic Galerkin or a Stochastic Collocation approach. We derive convergence rates for the different cases and present numerical results that show how these approaches are a valid alternative to the more traditional Monte Carlo Method for this class of problems. Copyright © 2009 John Wiley & Sons, Ltd. [source] Bacteriotherapy with Lactobacillus plantarum in burnsINTERNATIONAL WOUND JOURNAL, Issue 1 2009Maria C Peral Abstract Bacterial colonisation and infection remain the major causes of delayed healing and graft rejection following burns. Topical treatment is necessary to reduce the incidence of burn wound infection. Silver sulphadiazine (SD-Ag) is an often used microbicidal agent. However, this treatment produces adverse reactions and side-effects. On the basis of experimental data and clinical application of lactobacilli as probiotics, we performed this exploratory study to establish the effectiveness of bacteriotherapy with topical application of the innocuous bacteria Lactobacillus plantarum cultured in De Man, Rogosa and Sharpe medium to provide an alternative method for burn treatment using SD-Ag as a reference. These innocuous bacteria would compete with other bacteria that are wound pathogens and would modify the wound environment and promote tissue repair. Eighty burned patients from the Plastic Surgery and Burns Unit were grouped into infected (delayed) second- and third-degree and non infected (early) third-degree burns and treated with L. plantarum or SD-Ag. The proportion of patients with delayed second-degree burns was 0·71 for L. plantarum and 0·73 for SD-Ag (relative rate: ,2·72%) with respect to the decrease in bacterial load (<105 bacteria/g of tissue), promotion of granulating tissue wound bed and healing. In early third-degree burns, the values were 0·75 for L. plantarum and 0·84 for SD-Ag (relative rate: ,1·07%) in preventing wound infection and promotion of granulation tissue, 0·90 in graft taking for both treatments (relative rate: 0%) and 0·75 for L. plantarum and 0·77 for SD-Ag (relative rate: ,2·60%) in healing. In delayed third-degree burns, values were 0·83 for L. plantarum and 0·71 for SD-Ag (relative rate: +16·90%) with respect to the decrease in the bacterial load (<105 bacteria/g of tissue) and providing a granulating tissue wound bed, 0·90 in graft taking for both treatments (relative rate: 0%) and 0·75 for L. plantarum and 0·64 for SD-Ag (relative rate: + 17·19%) in healing. Although the number of patients (between 12 and 15 per group) did not enable the application of a power statistical test, these results suggest that the L. plantarum treatment should be studied in greater depth and could be used as a valid alternative for the topical treatment of burns. [source] Peracetic acid as an alternative wastewater disinfectant to chlorine dioxideJOURNAL OF APPLIED MICROBIOLOGY, Issue 5 2002S. Stampi Aims: The aim of this study was to compare the efficiency of peracetic acid with that of chlorine dioxide in the disinfection of wastewater from a sewage treatment plant (serving about 650 000 inhabitants) that has been using peracetic acid as a disinfectant since 1998. Methods and Results: A total of 23 samplings were made, each consisting of three samples: from secondary effluent, effluent disinfected with 2 mg l,1 of peracetic acid and effluent disinfected with 2·2 mg l,1 of chlorine dioxide (contact time 20 min). For each sample, measurements were made of the heterotrophic plate count at 36°C, total and faecal coliforms, Escherichia coli, enterococci, pH, suspended solids and chemical oxygen demand (COD). During the first phase of the experiment the peracetic acid was seen to be less efficient than chlorine dioxide. To improve the disinfectant action a system of mechanical agitation was added which led to a greater efficiency in the inactivation of bacteria of faecal origin. Conclusions: Both products were found to be influenced by the level of microbial contamination, the amount of suspended solids and COD but not by the pH of the effluent before disinfection. The immediate mixing of the wastewater and disinfectant caused a greater reduction in enterococci. Significance and Impact of the Study: Since peracetic acid was seen to produce a high abatement of micro-organisms, it can be considered as a valid alternative to chlorine dioxide in the disinfection of wastewaters. [source] Cost effectiveness of mass screening for coeliac disease is determined by time-delay to diagnosis and quality of life on a gluten-free dietALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2010T. HERSHCOVICI Aliment Pharmacol Ther,31, 901,910 Summary Background, Coeliac disease is frequently diagnosed after a long delay resulting in increased morbidity and mortality. Aims, To define the parameters which have the highest impact on the cost-effectiveness of mass screening for coeliac disease. Methods, A Markov model examined a coeliac disease screening programme of the healthy young-adult general population compared with a no-screening strategy. The main outcome measures were quality adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER). Effects of variables were examined using sensitivity analyses. Results, The screening strategy resulted in a gain of 0.0027 QALYs. The ICER of screening vs. no-screening strategy was US$48 960/QALYs. The variables with the largest impact on cost effectiveness were: the time delay from symptom onset to diagnosis, the utility of adherence to a gluten-free diet (GFD) and the prevalence of coeliac disease. Screening would be cost-effective if the time delay to diagnosis is longer than 6 years and utility of GFD adherence is greater than 0.978. Conclusions, Our model suggests that mass screening for coeliac disease of the young-adult general population is associated with improved QALYs and is a cost effectiveness strategy. Shortening of the time-delay to diagnosis by heightened awareness of health-care professionals may be a valid alternative to screening. [source] Transient elastography: a valid alternative to biopsy in patients with chronic liver diseaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2006E. GÓMEZ-DOMÍNGUEZ Summary Background Transient elastography is a novel and non-invasive technique for the evaluation of fibrosis in chronic liver disease. Few studies that exist value the efficacy of transient elastography, mainly in hepatitis C virus-infected patients. Aim To evaluate the effectiveness, objectivity, reproducibility and safety of this technique. Methods We included 103 consecutive patients who underwent a liver biopsy in the last 48 months with a wide spectrum of chronic liver diseases. Median stiffness value (expressed as kilopascals , kPa) was kept as representative of the liver elastic modulus. All biopsy specimens were analysed by the same pathologist according to the METAVIR scoring system. Results Median value of stiffness in patients with mild or moderate fibrosis (FI and FII), and severe fibrosis or cirrhosis (FIII and FIV) was of 7, 4 ± 5 and 16, 4 ± 10 kPa, respectively, with a significant difference between them (P < 0.05). The areas under the receiver operating characteristic curves showed the optimal liver stiffness cut-off values for each group. Conclusions We found a positive correlation between the liver stiffness found by transient elastography and fibrosis stage on biopsy in all patients, independently of the liver disease aetiology. Transient elastography is an easy, quick to perform and safe non-invasive procedure, reliable for assessing liver fibrosis. [source] Noninvasive serum markers in the diagnosis of structural liver damage in chronic hepatitis C virus infectionLIVER INTERNATIONAL, Issue 9 2006Edison R. Parise Abstract: Aim: Several noninvasive markers are being used to assess the structural liver damage in patients with chronic hepatitis C (CHC). We evaluated the capacity of serum hyaluronic acid (HA), aspartate aminotransferase (AST)/ALT ratio, the AST to platelet ratio index (APRI) and ,-glutamyltransferase (GGT) levels to predict the intensity of hepatic fibrosis in patients with CHC. Patients and methods: In a total of 206 hepatitis C virus RNA-positive biopsied patients, AST, ALT, GGT levels, platelet count and serum HA concentration were determined. The APRI was calculated as the ratio of AST to platelets. Results: HA levels were best correlated with disease stage (r=,0.694; P<0.001). In the diagnosis of significant fibrosis (F2,F4), HA levels [AUC=0.879, 95% CI (0.832,0.927)] and APRI [AUC=0.824 (0.772,0.903)] were the markers with the best diagnostic accuracy. These parameters also best identified the presence of cirrhosis (F4), with an AUC of 0.908 (0.868,0.949) for HA and of 0.837 (0.772,0.903) for APRI. Conclusion: Serum HA was the parameter that alone presented the best diagnostic accuracy in the assessment of hepatic fibrosis in CHC. The APRI showed a better diagnostic sensitivity than GGT levels or the AST/ALT ratio. Its simple determination and low cost make this index a valid alternative for the noninvasive staging of CHC. [source] Partial left lateral segment transplant from a living donorLIVER TRANSPLANTATION, Issue 1 2000Eduardo de Santibañes A shortage of liver donors for low-weight transplant recipients has prompted the development of procedures for liver-reduction, split-liver, and living related donor transplantations. For pediatric recipients weighing less than 10 kg, the left lateral segment is often still too large. We describe the procedure of monosegmental transplantation using segment II after segment III was resected in situ from a living related donor. Successful monosegmental transplantation is technically feasible and is a valid alternative to be considered for cases of size discrepancy between the recipient's volume and the donor's left lateral segment. [source] A simple protocol for paraffin-embedded myelin sheath staining with osmium tetroxide for light microscope observationMICROSCOPY RESEARCH AND TECHNIQUE, Issue 7 2008Federica Di Scipio Abstract Experimental investigation of peripheral nerve fiber regeneration is attracting more and more attention among both basic and clinical researchers. Assessment of myelinated nerve fiber morphology is a pillar of peripheral nerve regeneration research. The gold standard for light microscopic imaging of myelinated nerve fibers is toluidine blue staining of resin-embedded semithin sections. However, many researchers are unaware that the dark staining of myelin sheaths typically produced by this procedure is due to osmium tetroxide postfixation and not due to toluidine blue. In this article, we describe a simple pre-embedding protocol for staining myelin sheaths in paraffin-embedded nerve specimens using osmium tetroxide. The method involves immersing the specimen in 2% osmium tetroxide for 2 h after paraformaldeyde fixation, followed by routine dehydration and paraffin embedding. Sections can then be observed directly under the microscope or counterstained using routine histological methods. Particularly good results were obtained with Masson's trichrome counterstain, which permits the imaging of connective structures in nerves that are not detectable in toluidine blue-stained resin sections. Finally, we describe a simple protocol for osmium etching of sections, which makes further immunohistochemical analysis possible on the same specimens. Taken together, our results suggest that the protocol described in this article is a valid alternative to the conventional resin embedding-based protocol: it is much cheaper, can be adopted by any histological laboratory, and allows immunohistochemical analysis to be conducted. Microsc. Res. Tech., 2008. © 2008 Wiley-Liss, Inc. [source] Validation of Criteria for Selective His Bundle and Para-Hisian Permanent PacingPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 12 2006F. CANTÙ M.D. Background: His Bundle (HB) pacing is a valid alternative to right ventricular pacing for patients with preserved His-ventricle conduction who are candidates for permanent stimulation. Permanent pacing in the HB area enables Selective HB pacing (SHBP) or para-Hisian pacing (PHP) to be achieved. The aim of our study was to draw up a set of easy criteria to differentiate and validate the two kinds of stimulations according to the pacing output and the ECG/EKG signals. Methods and Results: From February to July 2005, 17 patients eligible for a pacemaker (PM) procedure underwent implantation with the Medtronic SelectSecure® lead (Medtronic, Minneapolis, MN, USA) screwed into the HB area.SHBP was defined when the intrinsic QRS was equal, in both duration and morphology, to the paced QRS, the His-Ventricular (H-V) interval was equal to Pace-Ventricular interval (Vp-V) and, at low output, only the HB was captured, while increasing the output resulted in both the HB and right ventricular (RV) being captured (widening of QRS at high output). Conversely, PHP was defined when the intrinsic QRS differed from the paced one, either in morphology or in duration and, at high output, both the RV and HB were captured (non-SHBP), while decreasing the output resulted in losing HB capture (widening of QRS at low output). According to these criteria, SHBP was achieved in 11 patients, while in the remaining 6, PHP was obtained. No adverse events were reported. Conclusions: The above criteria enabled SHBP and PHP to be validated easily and clearly. A longer follow-up will be needed in order to ascertain whether the clinical outcome of these two approaches differs. [source] PhadiatopTM compared to skin-prick test as a tool for diagnosing atopy in epidemiological studies in schoolchildrenPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 3 2007Luis Garcia-Marcos The validity of the PhadiatopTM test as compared to the skin-prick test (SPT) for diagnosing atopy in the epidemiological field has not been studied in schoolchildren. The aim of the present study was to evaluate its validity for classifying schoolchildren 9,12 yr old into atopics and non-atopics. A total of 621 children whose parents authorized both a SPT and a blood extraction from all children participating in the phase II of the International Study of Allergies in Children (ISAAC) in Cartagena (Spain) were included in the analysis. A positive SPT was that with at least a wheal having a maximum diameter of 3 mm, once the negative value had been subtracted. PhadiatopTM was performed according to the manufacturer instructions. Diagnostic tests using SPT as the gold standard were calculated for the whole group of children and also for those with asthma or rhinoconjunctivitis and for children without any of them. The results of the tests were: sensitivity 85.0% (95% CI 82.2,87.8%), specificity 85.5% (95%CI 82.7,88.3%), positive predictive value 72.7% (95%CI 69.0,76.1%), negative predictive value 92.7% (95%CI 90.6,94.7%) and accuracy 85.3% (95%CI 82.3,88.0%). The results improved among the symptomatic groups. PhadiatopTM can be used as a valid alternative to SPT in the epidemiological setting to diagnose atopy. [source] Bosentan and sildenafil: Should the combination therapy be a valid alternative in childhood to prostacyclin infusion?PEDIATRIC TRANSPLANTATION, Issue 1 2007Gianluca Brancaccio Abstract:, We report a case of a seven-yr-old girl with a PAH treated with continuation therapy of bosentan and sildenafil. The combination therapy revealed safety and efficacy in long-term follow up. [source] Home mechanical ventilation in children: Retrospective survey of a pediatric populationPEDIATRICS INTERNATIONAL, Issue 6 2007GIANCARLO OTTONELLO Abstract Background: Home care support is beneficial for children needing mechanical ventilation, when clinically stable. Methods: A retrospective analysis was carried out of the long-term home ventilation management of a pediatric population with chronic respiratory failure composed of 20 ventilator-dependent children categorized according to age, diagnosis and ventilation support. Age groups consisted of 10% under 1 year, 30% between 2 and 5 years, 30% between 6 and 12 years, and 30% older than 12 years. Diagnostic categories included myopathic disorder, n = 5; congenital central hypoventilation syndrome, n = 6; chest wall disorder, n = 5; cystic fibrosis, n = 1; pulmonary hypertension, n = 1; and diaphragmatic paralysis, n = 2. Results: Sixty-five percent were ventilated using non-invasive mode (NIMV): eight with nasal mask, five with full-face mask, and two children in NIMV also used negative pressure mode; 35% were ventilated using tracheostomy, one of them also used a diaphragmatic pacer. Seventy percent needed nocturnal ventilatory support, (20% 12,18 h, 10% full-day). A total of 18 children were included in the home care and follow-up program. Two children died: one because of worsening of his chronic disease and one because of septic shock. Conclusion: Although home care ventilation is not yet widely diffused, it represents a valid alternative to long hospitalization for children with stable chronic respiratory failure. [source] Learning Curve for Translaryngeal Tracheotomy in Head and Neck SurgeryTHE LARYNGOSCOPE, Issue 4 2001Gioacchino Giugliano MD Abstract Objectives Translaryngeal tracheotomy (TLT) is a widely accepted procedure in intensive-care units for its simplicity of execution, low morbidity, rapid wound closure after cannula removal, good esthetic results, and lack of long-term sequelae. The aim of this study was to evaluate the feasibility and use of adopting TLT in patients with cancer undergoing major head and neck surgery. Study Design Prospective analysis of learning curve and incidence of complications in 41 patients with cancer who underwent TLT at the Division of Head and Neck Surgery of the European Institute of Oncology from November 1997 to June 1999. Methods Patient characteristics, pathology, anatomic characteristics of the neck, and surgical short-term and long-term complications were noted. The patients were divided into consecutive groups of six or seven patients, and time trends in occurrence of complications and time to execute the procedure were assessed. Results TLT performance time decreased from 50 minutes in the first seven patients to 24 minutes in the last group. The technique was easy to perform and safe, with only two minor complications during surgery. However, minor complications occurred in three and major complications in 17 patients in the days immediately following surgery, almost entirely attributable to lack of counter-cannu1a and stylet. Conclusions In view of the high proportion of major complications, TLT using the presently available kit is unsuitable for major head and neck surgery. However, the considerable advantages of the technique would recommend it as a valid alternative to surgical tracheotomy if the kit included a counter-cannu1a and stylet. [source] Probiotics for shrimp larviculture: review of field data from Asia and Latin AmericaAQUACULTURE RESEARCH, Issue 4 2008Olivier Decamp Abstract Disease problems have emerged as major constraints in aquaculture production. The prophylactic application of antibiotics is expensive and detrimental, i.e. selection of bacteria that are drug-resistant or more virulent and the prevalence of drug residues in reared animals. Probiotics, which compete with bacterial pathogens for nutrients and/or inhibit the growth of pathogens, could be a valid alternative to the prophylactic application of chemicals. A mixture of specific Bacillus strains was designed following a research programme on the ability of numerous Bacillus strains to inhibit a range of pathogenic Vibrio strains, to grow under conditions prevailing in shrimp hatcheries and to degrade waste products. These strains were then included in bioassays and challenge tests in order to confirm the lack of toxin production and pathogenicity to humans, target organisms and the environment. Here, we report on the performance of a commercially available mixture of Bacillus strains (SANOLIFE® MIC), using data from Asian and Latin-American hatcheries, with Penaeus monodon (Fabricius 1798) and Litopenaeus vannamei (Boone 1931). These results show that probiotics may be a suitable alternative to the prophylactic use of antibiotics. Obviously, minimizing the risk of vibriosis demands a multi-disciplinary approach, including good hygiene and sanitation measures to reduce the input of potential pathogens, as well as a suitable farm management. [source] PREDICTION-FOCUSED MODEL SELECTION FOR AUTOREGRESSIVE MODELSAUSTRALIAN & NEW ZEALAND JOURNAL OF STATISTICS, Issue 4 2007Gerda Claeskens Summary In order to make predictions of future values of a time series, one needs to specify a forecasting model. A popular choice is an autoregressive time-series model, for which the order of the model is chosen by an information criterion. We propose an extension of the focused information criterion (FIC) for model-order selection, with emphasis on a high predictive accuracy (i.e. the mean squared forecast error is low). We obtain theoretical results and illustrate by means of a simulation study and some real data examples that the FIC is a valid alternative to the Akaike information criterion (AIC) and the Bayesian information criterion (BIC) for selection of a prediction model. We also illustrate the possibility of using the FIC for purposes other than forecasting, and explore its use in an extended model. [source] A critical analysis of the role of gut Oxalobacter formigenes in oxalate stone diseaseBJU INTERNATIONAL, Issue 1 2009Siddharth Siva Hyperoxaluria is a major risk factor for the formation of calcium oxalate stones, but dietary restriction of oxalate intake might not be a reliable approach to prevent recurrence of stones. Hence, other approaches to reduce urinary oxalate to manage stone disease have been explored. The gut-dwelling obligate anaerobe Oxalobacter formigenes (OF) has attracted attention for its oxalate-degrading property. In this review we critically evaluate published studies and identify major gaps in knowledge. Recurrent stone-formers are significantly less likely to be colonized with OF than controls, but this appears to be due to antibiotic use. Studies in animals and human subjects show that colonization of the gut with OF can decrease urinary oxalate levels. However, it remains to be determined whether colonization with OF can affect stone disease. Reliable methods are needed to detect and quantify colonization status and to achieve durable colonization. New information about oxalate transport mechanisms raises hope for pharmacological manipulation to decrease urinary oxalate levels. In addition, probiotic use of lactic acid bacteria that metabolize oxalate might provide a valid alternative to OF. [source] Efficacy and tolerability of zonisamide as add-on in brain tumor-related epilepsy: preliminary reportACTA NEUROLOGICA SCANDINAVICA, Issue 3 2009M. Maschio Background,, Zonisamide (ZNS) is an antiepileptic drug (AED) with broad spectrum action that demonstrated a good efficacy in controlling seizures as add-on in adult and pediatric epilepsy. To date there have been no studies on ZNS in patients with brain tumor-related epilepsy (BTRE). Aim of the study,, To evaluate efficacy and tolerability of ZNS as add-on in BTRE. Methods, We followed six patients suffering from BTRE who had already been treated with other AEDs and who had had not experienced adequate seizure control. Three patients underwent chemotherapy while being treated with ZNS. Mean duration of follow-up was 8 months. Results,, Mean seizure number in the last month prior to the introduction of ZNS had been 27.7/month. ZNS mean dosage was of 283.3 mg/day. At last follow-up, the mean seizure number was reduced to 8.8/month. Responder rate was 83.3%. Two patients discontinued the drug because of side effects. There were no other reported side effects. Conclusions,, Preliminary data on the use of ZNS in add-on in patients with BTRE indicate that this drug may represent a valid alternative as add-on in this particular patient population. However, larger samples are necessary to draw definitive conclusions. [source] Vincristine, an efficacious alternative for diffuse neonatal haemangiomatosisACTA PAEDIATRICA, Issue 2 2010S Pérez-Valle Abstract Diffuse neonatal haemangiomatosis (DNH) is an uncommon condition characterized by multiple cutaneous and visceral haemangiomas frequently causing severe complications. Corticosteroids constitute the first therapeutic line; however, when they fail, other alternatives are available, provided possible side effects are closely monitored during and after treatment. We present a case of life-threatening DNH, non-responsive to corticosteroids, successfully treated with Vincristine with minor side effects. We conclude that Vincristine is a valid alternative in corticosteroid-resistant DNH. [source] Hovenkamp's ostracized vicariance analysis: testing new methods of historical biogeographyCLADISTICS, Issue 4 2008Article first published online: 7 DEC 200, Simone Fattorini All methods currently employed in cladistic biogeography usually give contrasting results and are theoretically disputed. In two overlooked papers, Hovenkamp (1997, 2001) strongly criticized methods currently used by biogeographers and proposed two other methods. However, his criticisms have remained unanswered and his methods rarely applied. I used three different data sets to show the superiority of Hovenkamp's methods. Both methods proposed by Hovenkamp do not suffer from the unrealistic assumptions that underlie other methods commonly used in cladistic biogeography. The method proposed in 2001 is more powerful than the previous method published in 1997, because it does not use a priori assumptions about the areas involved. However, the method proposed in 1997 may be a valid alternative for large data sets. © The Willi Hennig Society 2007. [source] Desloratadine in combination with montelukast in the treatment of chronic urticaria: a randomized, double-blind, placebo-controlled studyCLINICAL & EXPERIMENTAL ALLERGY, Issue 9 2004E. Nettis Summary Background Chronic urticaria (CU) is a common skin condition. It is frequently a disabling disease due to the persistency of clinical symptoms, the unpredictable course and negative influence on the quality of life. Objective The aim of this study is to determine whether montelukast, a LTD4 receptor antagonist, plus desloratadine, is more efficacious than desloratadine alone in the treatment of chronic urticaria. Materials A randomized, double-blind, placebo-controlled study was conducted on 81 patients with a diagnosis of CU. A 1-week single-blind placebo run-in period (baseline) was followed by a 6-weeks double blind active treatment period. The patients were randomized to receive the following treatment once daily: (a) oral desloratadine (5 mg) plus placebo; (b) desloratadine (5 mg) plus montelukast (10 mg); (c) oral placebo alone. The study ended after another 1-week single-blind placebo washout period. Results The evaluable population thus consisted of 76 patients. Both desloratadine alone and desloratadine plus montelukast administered once daily yielded improvements with respect to the baseline assessment as regards pruritus, number of separate episodes, size and number of weals, visual analogue score and patients' quality of life and with respect to the placebo group both in the active treatment period and in the run-out period. However, desloratadine plus montelukast was shown to improve the symptoms and patients' quality of life significantly more than desloratadine alone, although it did not have a significant effect on the number of urticarial episodes. Conclusion The combination of desloratadine plus montelukast is effective in the treatment of CU. It may therefore be a valid alternative in patients with relatively mild CU, in view of its efficacy and the lack of adverse events. [source] No demonstrable association between the Leningrad,Zagreb mumps vaccine strain and aseptic meningitis in a large clinical trial in EgyptCLINICAL MICROBIOLOGY AND INFECTION, Issue 4 2010H. J. Sharma Clin Microbiol Infect 2010; 16: 347,352 Abstract To address the claim that the Leningrad,Zagreb (L-Z) mumps vaccine strain is causally associated with aseptic meningitis, a prospective, post-marketing safety study was conducted with a measles-mumps-rubella vaccine (MMR) (TRESIVAC®; Serum Institute of India Ltd., Pune, India), which uses the L-Z strain as its mumps component in Egypt. In all, 453 119 children (65 423 children aged 16,24 months and 329 211 children aged 5,7 years) received MMR. The control groups which, as a result of local health regulations, were slightly younger than vaccinees, comprised 12 253 and 46 232 children, respectively. Using questionnaires, the parents recorded solicited local, systemic and neurological adverse events for up to 42 days post-vaccination. All data were analysed externally on an intention-to-treat basis by individuals not participating in the study. Local and/or systemic reactions were reported in a small percentage of participants, with pain, fever and parotitis being the most common signs among vaccinees in both age groups. No case of aseptic meningitis, encephalitis, anaphylaxis or convulsions was observed in any participant. Thus, in this series of more than 450 000 Egyptian children, the L-Z mumps vaccine strain in this vaccine did not cause aseptic meningitis. The vaccine is considerably cheaper than Western competitors and a valid alternative to other MMR vaccines. [source] A systematic review on the clinical diagnosis of gastrointestinal stromal tumorsJOURNAL OF SURGICAL ONCOLOGY, Issue 5 2008Marco Scarpa MD Abstract Background The aim of this work was to assess the prevalence of symptoms of gastrointestinal stromal tumors (GISTs) and the diagnostic yield of clinical procedures for its diagnosis. Methods Medical databases were consulted between 1998 and 2006 for potentially relevant publications. All studies dealing with the clinical presentation of GIST and related diagnostic procedures were included. Two researchers worked independently on the study selection, quality assessment, data extraction, and analysis phases of the study. Results Forty-six observational studies were included with a total of 4,534 patients. Gastrointestinal bleeding was the most common clinical presentation. Twenty studies provided adequate information on the diagnostic yield of various procedures. The pooled diagnostic yield of endoscopy,+,mucosal biopsy and of intestinal contrast radiography was 33.8% (0,100%) and 35.1% (11,100%), respectively, while that of EUS and that of EUS-FNA was 68.7% (40,100%) and 84.0% (73.8,100%), respectively. Abdominal CT scan and MRI had similar pooled diagnostic yields: 73.6% (34.8,100%), and 91.7% (75,100%), respectively. Conclusion Endoscopy,+,mucosal biopsy should be reserved to patients with gastrointestinal bleeding. EUS-FNA provides direct visualization of the neoplasm and adequate samples for molecular diagnosis. EUS, abdominal CT and MRI may be considered valid alternatives whenever EUS-FNA is unavailable or a cytological diagnosis is unnecessary. J. Surg. Oncol. 2008;98:384,392. © 2008 Wiley-Liss, Inc. [source] Comparison between differentcell kinetic variables in human breast cancerCELL PROLIFERATION, Issue 2 2000F. Barzanti Cell kinetics holds a prominent role among biological factors in predicting clinical outcome and response to treatment in neoplastic patients. Different cell kinetic variables are often considered as valid alternatives to each other, but the limited size of case series analysed in several studies and the lack of simultaneous determinations of all the variables on the same tumours do not justify this conclusion. In the present study, the correlation between [3H]thymidine labelling index ([3H]dT LI), flow cytometric S phase cell fraction (FCM-S) and Ki-67 immunoreactivity (Ki-67/MIB-1) was verified and the type of correlation with the most important clinical, pathological and biological patient and tumour characteristics was investigated in a very large series of breast cancer patients. Ki-67/MIB-1, FCM-S and [3H]dT LI were determined in 609, 526 and 485 patients, respectively, and all three cell proliferation indices were evaluated in parallel on the same tumour in a series of 330 breast cancer patients. All the cell kinetic determinations were performed within the context of National Quality Control Programmes. Very poor correlation coefficients (ranging from 0.37 to 0.18) were observed between the different cell kinetic variables determined in parallel on the same series of breast cancers. Moreover, Ki-67/MIB-1 and FCM-S showed a significant relationship with histological type, grade and tumour size, whereas statistically significant correlations were not observed for [3H]dT LI. In conclusion, the results show that the different cell kinetic variables provide different biological information and cannot be considered as alternatives to each other. [source] | |||||||||||||||||||||||||||||||