Good results for early treatment of clinically isolated syndrome prior to multiple sclerosis with interferon beta-1b and glatiramer group

The first sign of developing multiple sclerosis is a clinically isolated syndrome that resembles a multiple sclerosis relapse. Objective/methods: The objective was to review the clinical trials of two medicines in clinically isolated syndromes (interferon β and glatiramer acetate) to determine whether they prevent progression to definite multiple sclerosis. In the BENEFIT trial, after 2 years, 45% of subjects in the placebo group developed clinically definite multiple sclerosis; the rate was lower in the interferon β-1b group. All subjects were then offered interferon β-1b, and the original interferon β-1b group became the early-treatment group and the placebo group became the delayed-treatment group. After 5 years, the number of subjects with clinical definite multiple sclerosis remained lower in the early-treatment than in the late-treatment group. In the PreCISe trial, after 2 years, the time for 25% of the subjects to convert to definite multiple sclerosis was prolonged in the glatiramer group. Interferon β-1b and glatiramer acetate slow the progression of clinically isolated syndromes to definite multiple sclerosis. However, it is not known whether this early treatment slows the progression to the physical disabilities experienced in multiple sclerosis.     

以肠梗阻症状为首发表现的阑尾炎30例临床分析

目的探讨以肠梗阻症状为首发表现的阑尾炎临床特征,提高临床诊断率。方法选择30例以肠梗阻症状为首发表现的急性阑尾炎患者作为观察组,选取30例不伴肠梗阻症状首发表现的急性阑尾炎患者为对照组,分别比较2组的年龄及首发临床表现。结果 <8岁和>60岁年龄段,观察组例数明显高于对照组,差别均有统计学意义(P<0.05);16~60岁年龄段,观察组例数明显低于对照组,差别有统计学意义(P<0.05);观察组发热、恶心呕吐、腹胀、肠鸣音消失及腹部气过水声患者例数明显高于对照组,差别有统计学意义(P<0.05或0.01)。结论以肠梗阻为首发表现的不典型阑尾炎术前常常不易确诊,应详细询问病史,细致全面的体格检查,有助于减少肠梗阻症状为首发表现阑尾炎的误诊。     

The potential use of toll-like receptor (TLR) agonists and antagonists as prophylactic and/or therapeutic agents

Toll-like receptors (TLR) and their ligands are one of the main players in the initiation of innate immunity which precedes, and is required, for the establishment of adaptive immunity. Manipulating the immune response by using TLR agonists or antagonists might be of therapeutic and/or prophylactic value. This review covers; 1-TLR. their natural ligands and ligand - TLR signaling events, 2-TLR againsts and their use in clinical trials as vaccine adjuvants, and to treat allergy, cancer and infectious diseases, 3-TLR antagonists and their use in clinical trials to treat septic shock and autoimmune diseases. Potential drawbacks related to their potential use as prophylactic and/or therapeutic agents are discussed.     

Comparison of numerical calculations with phantom experiments and clinical measurements

Three-dimensional models, while fundamentally desirable in hyperthermia treatment simulation, are only beginning to emerge and may take a number of years to perfect for routine clinical use. Two dimensional calculations, on the other hand, can be efficiently performed on today's inexpensive computer workstations; however, the accuracy of two-dimensional models in the pretreatment planning context is questionable. This paper investigates the ability of a general two-dimensional finite element model to predict power deposition patterns in phantoms and temperature distributions during actual clinical treatments. The experiments and simulations have been performed for an annular phased array (APA) operating at 70 MHz. Comparisons between model predictions and measurements show that quantitative agreement occurs in phantoms containing moderate complexities in heterogeneity, but that only qualitative agreement appears possible in clinical treatments. However, the results suggest that the lack of blood flow information may contribute as much, if not more, to the uncertainties in the clinical predictions than the two-dimensional nature of the model itself.     

Sarpogrelate: cardiovascular and renal clinical potential

Sarpogrelate is a selective 5-hydroxytryptamine receptor subtype 2A (5-HT_2A) antagonist. It is metabolised to racemic M-1 and both enantiomers of M-1 are also antagonists of 5-HT_2A receptors. Sarpogrelate inhibits responses to 5-HT mediated by 5-HT_2A receptors such as platelet aggregation, vasoconstriction and vascular smooth muscle proliferation. There is no information available on the pharmacokinetics of sarpogrelate. Sarpogrelate is efficacious in animal models of thrombosis, coronary artery spasm, atherosclerosis, restenosis, peripheral vascular disease, pulmonary hypertension, ischaemic heart disease, myocardial infarction, diabetes and kidney disease. Small clinical trials indicate that sarpogrelate may be beneficial in the treatment of coronary artery disease, angina, restenosis, heart valve prostheses surgery, diabetes mellitus, Raynaud’s phenomenon, systemic sclerosis and Buerger’s disease. Larger, randomised, double-blind, placebo-controlled clinical trials of sarpogrelate in intermittent claudication, coronary artery disease, restenosis and diabetes should be considered.     

Utilizing registries in systemic lupus erythematosus clinical research

Systemic lupus erythematosus is a complex and heterogeneous autoimmune disease with a relatively low incidence. Clinical research in this disease at individual centers is complicated by the difficulty of accruing enough patient numbers. In this context, the development of cohorts and multi-institutional registries during the last decades has allowed an increase in knowledge regarding the clinical course and management of this disease. This article aims to describe the main study designs linked to lupus registries and to give an overview of the main international registries and cohorts, as well as their principal achievements in the context of this complex entity.     

How does yoga reduce stress? A systematic review of mechanisms of change and guide to future inquiry

Yoga is increasingly used in clinical settings for a variety of mental and physical health issues, particularly stress-related illnesses and concerns, and has demonstrated promising efficacy. Yet the ways in which yoga reduces stress remain poorly understood. To examine the empirical evidence regarding the mechanisms through which yoga reduces stress, we conducted a systematic review of the literature, including any yoga intervention that measured stress as a primary dependent variable and tested a mechanism of the relationship with mediation. Our electronic database search yielded 926 abstracts, of which 71 were chosen for further inspection and 5 were selected for the final systematic review. These five studies examined three psychological mechanisms (positive affect, mindfulness and self-compassion) and four biological mechanisms (posterior hypothalamus, interleukin-6, C-reactive protein and cortisol). Positive affect, self-compassion, inhibition of the posterior hypothalamus and salivary cortisol were all shown to mediate the relationship between yoga and stress. It is striking that the literature describing potential mechanisms is growing rapidly, yet only seven mechanisms have been empirically examined; more research is necessary. Also, future research ought to include more rigorous methodology, including sufficient power, study randomisation and appropriate control groups.