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81.
Hema Mittal Sunita Rai Dheeraj Shah S. V. Madhu Gopesh Mehrotra Rajeev Kumar Malhotra Piyush Gupta 《Indian pediatrics》2014,51(4):265-272
Objective
To evaluate the non-inferiority of a lower therapeutic dose (300,000 IU) in comparison to standard dose (600,000) IU of Vitamin D for increasing serum 25(OH) D levels and achieving radiological recovery in nutritional rickets.Design
Randomized, open-labeled, controlled trial.Setting
Tertiary care hospital.Participants
76 children (median age 12 mo) with clinical and radiologically confirmed rickets.Intervention
Oral vitamin D3 as 300,000 IU (Group 1; n=38) or 600,000 IU (Group 2; n=38) in a single day.Outcome variables
Primary: Serum 25(OH)D, 12 weeks after administration of vitamin D3; Secondary: Radiological healing and serum parathormone at 12 weeks; and clinical and biochemical adverse effects.Results
Serum 25(OH)D levels [geometric mean (95% CI)] increased significantly from baseline to 12 weeks after therapy in both the groups [Group 1: 7.58 (5.50–10.44) to 16.06 (12.71–20.29) ng/mL, P<0.001]; Group 2: 6.57 (4.66–9.25) to 17.60 (13.71–22.60, P<0.001]. The adjusted ratio of geometric mean serum 25(OH)D levels at 12 weeks between the groups (taking baseline value as co-variate) was 0.91 (95% CI: 0.65–1.29). Radiological healing occurred in all children by 12 weeks. Both groups demonstrated significant (P<0.05) and comparable fall in the serum parathormone and alkaline phosphatase levels at 12 weeks. Relative change [ratio of geometric mean (95% CI)] in serum PTH and alkaline phosphatase, 12 weeks after therapy, were 0.98 (0.7–1.47) and 0.92 (0.72–1.19), respectively. The serum 25(OH)D levels were deficient (<20 ng/mL) in 63% (38/60) children after 12 weeks of intervention [Group 1: 20/32 (62.5%); Group 2: 18/28 (64.3%)]. No major clinical adverse effects were noticed in any of the children. Hypercalcemia was documented in 2 children at 4 weeks (1 in each Group) and 3 children at 12 weeks (1 in Group 1 and 2 in Group 2). None of the participants had hypercalciuria or hypervitaminosis D.Conclusion
A dose of 300,000 IU of vitamin D3 is comparable to 600,000 IU, administered orally, over a single day, for treating rickets in under-five children although there is an unacceptably high risk of hypercalcemia in both groups. None of the regime is effective in normalization of vitamin D status in majority of patients, 3 months after administering the therapeutic dose. 相似文献82.
83.
84.
Mandyam MC Vedantham V Scheinman MM Tseng ZH Badhwar N Lee BK Lee RJ Gerstenfeld EP Olgin JE Marcus GM 《The American journal of cardiology》2012,110(3):364-368
Alcohol and vagal activity may be important triggers for paroxysmal atrial fibrillation (PAF), but it remains unknown if these associations occur more often than would be expected by chance alone because of the lack of a comparator group in previous studies. We compared self-reported frequency of these triggers in patients with PAF to those with other supraventricular tachycardias (SVTs). Consecutive consenting patients presenting for electrophysiology procedures at a single university medical center underwent a structured interview regarding arrhythmia triggers. Two hundred twenty-three patients with a documented arrhythmia (133 with PAF and 90 with SVT) completed the survey. After multivariable adjustment, patients with PAF had a 4.42 greater odds (95% confidence interval [CI] 1.35 to 14.44) of reporting alcohol consumption (p = 0.014) and a 2.02 greater odds (95% CI 1.02 to 4.00) of reporting vagal activity (p = 0.044) as an arrhythmia trigger compared to patients with SVT. In patients with PAF, drinking primarily beer was associated with alcohol as a trigger (odds ratio [OR] 4.49, 95% CI 1.41 to 14.28, p = 0.011), whereas younger age (OR 0.68, 95% CI 0.49 to 0.95, p = 0.022) and a family history of AF (OR 5.73, 95% CI 1.21 to 27.23, p = 0.028) each were independently associated with having vagal activity provoke an episode. Patients with PAF and alcohol triggers were more likely to have vagal triggers (OR 10.32, 95% CI 1.05 to 101.42, p = 0.045). In conclusion, alcohol consumption and vagal activity elicit PAF significantly more often than SVT. Alcohol and vagal triggers often were found in the same patients with PAF, raising the possibility that alcohol may precipitate AF by vagal mechanisms. 相似文献
85.
Jain P Javdan M Feger FK Chiu PY Sison C Damle RN Bhuiya TA Sen F Abruzzo LV Burger JA Rosenwald A Allen SL Kolitz JE Rai KR Chiorazzi N Sherry B 《Haematologica》2012,97(4):599-607
Background
The levels and clinical relevance of Th17 cells and other interleukin-17-producing cells have not been analyzed in chronic lymphocytic leukemia. The objective of this study was to quantify blood and tissue levels of Th17 and other interleukin-17-producing cells in patients with this disease and correlate blood levels with clinical outcome.Design and Methods
Intracellular interleukin-17A was assessed in blood and splenic mononuclear cells from patients with chronic lymphocytic leukemia and healthy subjects using flow cytometry. Interleukin-17A-producing cells were analyzed in formalin-fixed, paraffin-embedded spleen and lymph node sections using immunohistochemistry and immunofluorescence.Results
The absolute numbers of Th17 cells in peripheral blood mononuclear cells and the percentages of Th17 cells in spleen cell suspensions were higher in patients with chronic lymphocytic leukemia than in healthy subjects; in six out of eight paired chronic lymphocytic leukemia blood and spleen sample comparisons, Th17 cells were enriched in spleen suspensions. Circulating Th17 levels correlated with better prognostic markers and longer overall survival of the patients. Two “non-Th17” interleukin-17-expressing cells were identified in chronic lymphocytic leukemia spleens: proliferating cells of the granulocytic lineage and mature mast cells. Granulocytes and mast cells in normal spleens did not express interleukin-17. Conversely, both chronic lymphocytic leukemia and healthy lymph nodes contained similar numbers of interleukin-17+ mast cells as well as Th17 cells.Conclusions
Th17 cells are elevated in chronic lymphocytic leukemia patients with better prognostic markers and correlate with longer survival. Furthermore, non-Th17 interleukin-17A-expressing cells exist in chronic lymphocytic leukemia spleens as maturing granulocytes and mature mast cells, suggesting that the microenvironmental milieu in leukemic spleens promotes the recruitment and/or expansion of Th17 and other IL-17-expressing cells. The pathophysiology of Th17 and non-Th17-interleukin-producing cells in chronic lymphocytic leukemia and their distributions and roles in this disease merit further study. 相似文献86.
The majority of people throughout the world show extreme preference for the right hand. We studied lateral bias depicted in ancient Indian sculptures dating between the 7th and 9th centuries ad. A total of 288 sculptures were selected from various excavation sites/museums and the frequencies were computed on 13 different criteria in order to see the preferential bias for hand depicted in sculptures of male and female figures. The findings are discussed in the light of Hindu mythology and rituals. 相似文献
87.
Anand Vijay Somuri A. Bhagavandas Rai Manju Pillai 《Journal of maxillofacial and oral surgery》2013,12(2):130-132
Objective
The aim of this study is to demonstrate whether articaine hydrochloride administered alone as a single buccal infiltration in maxillary tooth removal, can provide favourable palatal anesthesia as compared to buccal and palatal injection of lidocaine.Study Design
The study population consisted of 30 patients who were undergoing orthodontic treatment, and who required bilateral extraction of maxillary permanent premolars as per their orthodontic treatment plan. On the experimental side, 4 % articaine/HCl was injected into the buccal vestibule of the tooth to be extracted. On the control side, 2 % lignocaine HCl was injected both into the buccal and the palatal side of the tooth to be extracted. Following tooth extraction all patients completed a 100-mm visual analogue scale (VAS) and faces pain scale (FPS) to rate the pain on extraction.Results
According to the VAS and FPS scores, the pain on extraction between buccal infiltration of articaine and the routine buccal and palatal infiltration of lignocaine was statistically insignificant.Conclusions
The routine use of a palatal injection for the removal of permanent maxillary premolar teeth may not be required when articaine/HCl is used as the local anesthetic. 相似文献88.
In vivo laser speckle imaging reveals microvascular remodeling and hemodynamic changes during wound healing angiogenesis 总被引:1,自引:0,他引:1
Laser speckle contrast imaging (LSCI) is a high-resolution and high contrast optical imaging technique often used to characterize
hemodynamic changes in short-term physiological experiments. In this study, we demonstrate the utility of LSCI for characterizing
microvascular remodeling and hemodynamic changes during wound healing angiogenesis in vivo. A 2 mm diameter hole was made
in the mouse ear and the periphery of the wound imaged in vivo using LSCI over 12 days. We were able to visualize and quantify
the vascular and perfusion changes that accompanied wound healing in the microenvironment proximal to the wound, and validated
these changes with histology. We found that consistent with the stages of wound healing, microvessel density increased during
the initial inflammatory phase (i.e., day 0–3), stayed elevated through the tissue formation phase (i.e., until day 7) and
returned to baseline during the tissue remodeling phase (i.e., by day 12). Concomitant “wide area mapping” of blood flow revealed
that tissue perfusion in the wound periphery initially decreased, gradually increased from day 3–7, and subsided as healing
completed. Interestingly, some regions exhibited a reestablishment of tissue perfusion approximately 6 days earlier than the
~18 days usually reported for the long term remodeling phase. The results from this study demonstrate that LSCI is an ideal
platform for elucidating in vivo changes in microvascular hemodynamics and angiogenesis, and has the potential to offer invaluable
insights in a range of disease models involving abnormal hemodynamics, such as diabetes and tumors. 相似文献
89.
Ethanol is widely used in various pharmaceutical and cosmetic formulations in order to enhance skin penetration of active ingredients. While it is well known that ethanol partitions into the skin and enhances the permeation of both polar and nonpolar molecules, the exact mechanisms by which it enhances skin permeability are not fully understood. Several mechanisms have been proposed including lipid extraction from the stratum corneum (SC), fluidisation of SC lipid bilayer, alteration of SC protein conformation and enhancement of the drug solubility in the SC lipids. In this study, we performed molecular dynamics (MD) simulations of SC lipid bilayers comprised of an equimolar mixture of ceramides, cholesterol and free fatty acid in the presence of aqueous mixtures of ethanol. Various unrestrained MD simulations were performed in the presence of aqueous ethanol solution at molar ratios (x) ranging from x = 0 to x = 1. It was found that ethanol enhances bilayer permeability by dual actions (a) extraction of the skin lipids and (b) enhancing the mobility of lipid chains. Ethanol''s permeation enhancing effect arises from its superior ability to form hydrogen bonds with headgroup atoms of skin lipids. Further, the free energy of extraction of ceramides (CER) and fatty acids (FFA) from the lipid bilayer was studied using umbrella sampling simulations. The free energy of extraction of CER was found to be much higher compared to FFA for all ethanol concentrations which shows that CER are difficult to extract as compared to FFA. Finally, the permeation of benzoic acid drug molecules through the skin lipid bilayer is shown in presence of ethanol molecules. It was found that ethanol selectively targets the FFA of the skin lipid bilayer and extracts it out of the lipid bilayer within few microseconds. Further, ethanol penetrates inside the lipid layer and creates the channels from which drug molecules can easily cross the lipid layer. Our observations (both in unrestrained and umbrella sampling simulations) are consistent with the experimental findings reported in the literature. The simulation methodology could be used for design and testing of permeation enhancers (acting on skin SC lipid lamella) for topical and transdermal drug delivery applications.Concentration dependent action of mechanism of ethanol on skin SC lipid barrier. 相似文献
90.
Hayser Medina Lucena Harnek Rai Chrysostomos Siozos Douglas G. Tincello Sambita Basak Ilias Giarenis 《International urogynecology journal》2016,27(10):1529-1533