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41.
Research examining the relationship between body mass index (BMI) and sexual risk outcomes among men who have sex with men (MSM) has yielded inconsistent results. Using a web-based survey, single-identified (e.g., not in a relationship) young MSM (N = 431) between the ages of 18 and 24 years who sought romantic partners online were asked to respond to items regarding their BMI, body image (e.g., attribution, dissatisfaction, and pride), and sexual risk behaviors. We used Poisson regressions to examine the relationships between BMI, body image, and the number of unprotected receptive anal intercourse (URAI) occasions and partners in the past 2 months. We found a curvilinear relationship between BMI and URAI occasions, and a linear relationship between BMI and URAI partners. These relationships persisted after accounting for body image. Further, we found that body attribution served as a protective factor whereas body pride served as a risk factor. We discuss the implications of our findings for sexual health education and HIV prevention.  相似文献   
42.

Background

Clomiphene citrate (CC) is first line treatment in women with World Health Organization (WHO) type II anovulation and polycystic ovary syndrome (PCOS). Whereas 60% to 85% of these women will ovulate on CC, only about one half will have conceived after six cycles. If women do not conceive, treatment can be continued with gonadotropins or intra-uterine insemination (IUI). At present, it is unclear for how many cycles ovulation induction with CC should be repeated, and when to switch to ovulation induction with gonadotropins and/or IUI.

Methods/Design

We started a multicenter randomised controlled trial in the Netherlands comparing six cycles of CC plus intercourse or six cycles of gonadotrophins plus intercourse or six cycles of CC plus IUI or six cycles of gonadotrophins plus IUI.Women with WHO type II anovulation who ovulate but did not conceive after six ovulatory cycles of CC with a maximum of 150 mg daily for five days will be included.Our primary outcome is birth of a healthy child resulting from a pregnancy that was established in the first eight months after randomisation. Secondary outcomes are clinical pregnancy, miscarriage, multiple pregnancy and treatment costs. The analysis will be performed according to the intention to treat principle. Two comparisons will be made, one in which CC is compared to gonadotrophins and one in which the addition of IUI is compared to ovulation induction only. Assuming a live birth rate of 40% after CC, 55% after addition of IUI and 55% after ovulation induction with gonadotrophins, with an alpha of 5% and a power of 80%, we need to recruit 200 women per arm (800 women in total).An independent Data and Safety Monitoring Committee has criticized the data of the first 150 women and concluded that a sample size re-estimation should be performed after including 320 patients (i.e. 80 per arm).

Discussion

The trial will provide evidence on the most effective, safest and most cost effective treatment in women with WHO type II anovulation who do not conceive after six ovulatory cycles with CC with a maximum of 150 mg daily for five days. This evidence could imply the need for changing our guidelines, which may cause a shift in large practice variation to evidence based primary treatment for these women.

Trial registration number

Netherlands Trial register NTR1449
  相似文献   
43.
Varenicline is an effective and increasingly prescribed drug for smoking cessation, but has been associated with depressive symptoms and suicidal behavior. However, it remains unclear whether those changes in mood and behavior are directly related to varenicline use, or caused by smoking cessation itself or reflects depression and suicidality rates in smokers, independent of treatment. To investigate the influence of varenicline on mood and behavior independent of smoking and smoking cessation, we assessed the effects of varenicline on emotional processing (a biomarker of depressogenic effects), emotion-potentiated startle reactivity, impulsivity (linked with suicidal behavior), and cognitive performance in non-smoking subjects. We used a randomized, double-blind design, in which we administered varenicline or placebo to healthy subjects over 7 days (0.5 mg/day first 3 days, then 1 mg/day). Cognitive and emotional processing was assessed by a battery of computerized tasks and recording of emotion-potentiated startle response. A total of 41 subjects were randomized, with 38 subjects included in the analysis. The varenicline group did not differ from placebo in terms of negative biases in emotional processing or mood. However, compared with placebo, the varenicline group scored higher on working and declarative memory. In conclusion, short-term varenicline use did not influence negative biases in emotional processing or impulsivity in non-smoking subjects, thereby not supporting direct depressogenic or suicidal risk behavior-inducing effects. In contrast, varenicline may have cognitive-enhancing effects.  相似文献   
44.
45.
Magnetic resonance (MR) imaging was performed on 14 patients with histologically proved osteosarcoma (mean age, 14.4 years). There was excellent correlation of intramedullary tumor extent as determined with MR imaging and pathologic examination (r = 99%). This was facilitated by the presence of a chemical shift artifact at the tumor-marrow interface on the T1-weighted images. The correlation between CT and pathologic findings was not as good (r = 84%). In a single patient, however, a 10-cm length of sclerotic bone was incorrectly interpreted as being tumor. If this case is excluded, the correlation between CT and pathologic findings improves significantly (r = 96%). T2-weighted images were optimal in demonstrating soft-tissue bulk and breach of the epiphysis or cortex. Vascular involvement was also readily defined. The T2 value of the tumor soft-tissue component decreased in patients who were deemed to have responded well to therapy. Two patients with very high T2 values after chemotherapy developed wide-spread metastatic disease and died. Phosphorus-31 MR spectroscopy of five patients with osteosarcoma showed elevated levels of phosphomonoesters (PMEs), inorganic phosphate (Pi), and phosphodiesters (PDEs). PME and PDE peak areas decreased in three patients after chemotherapy, while Pi peak areas increased.  相似文献   
46.
The effects of magnetic resonance (MR) pulse sequences and timing parameters on tumor-liver contrast were studied in an animal model of metastatic liver cancer. Six spin-echo (SE), three inversion-recovery (IR), and four gradient-echo (GRE) sequences were evaluated at 0.6 T before and after injection of super-paramagnetic iron oxide. GRE techniques, irrespective of echo time and flip angle, showed the greatest change in signal intensity (enhancement) of the liver after administration of iron oxide. Single-acquisition GRE sequences (16 seconds) matched the contrast-to-noise ratio (C/N) performance of the most effective 6.4-minute SE sequences. Multiexcitation GRE sequences showed tumor-liver C/Ns per unit time that were significantly (P less than .05) higher than those achieved with SE and IR sequences. GRE sequences, which recruit intravoxel dephasing as an additional source of transverse relaxation enhancement (T2*), show a higher C/N per unit time and in this respect seem superior to SE and IR sequences for MR imaging with superparamagnetic iron oxide.  相似文献   
47.
目的:目前电磁辐射对生物体行为学方面的研究还很薄弱,设立不同磁场的强度和不同照射的周期,观察中频领域磁场照射对小鼠的自主活动和学习记忆的影响。方法:实验于2007-05-10/06-15在清华大学医学院和中国医学科学院药用植物研究所完成。①实验材料:磁场发生装置:中频交变磁场发生装置由清华大学工程物理系医学物理与工程研究所自主研发,可产生频率为40kHz,场强为28.8A/m,28.8kA/m的中频交变磁场。自主活动测试箱:中国医学科学院药用植物研究所提供,为一可封闭的金属箱,内置摄像头。4只黑色塑料测试桶分别置于箱子四角。水迷宫测试箱:中国医学科学院药用植物研究所提供。②实验动物及方法:将80只小鼠随机分为不同场强照射组和对照组。强磁场照射1组:11.6kA/m/40kHz,1h/d,连续照射7d。强磁场照射2组:11.6kA/m/40kHz,2h/d,连续照射7d。强磁场照射3组:11.6kA/m/40kHz,2h/d连续照射15d。弱磁场照射组:28.8kA/m/40kHz,2h/d,连续照射7d。对照组除了未放入磁场照射,其他条件与照射组一致。实验过程中对动物处置符合动物伦理学要求。③实验评估:观察其一般活动的改变,并采用自主活动测试箱和水迷宫测试箱进行测试,观察各组小鼠的自主活动和学习记忆的改变。结果:①一般行为观察:与对照组小鼠对比,经过中频交变磁场照射过的各组小鼠活跃度减低,毛色较差。强磁场照射3组(145G,2h/d,连续15d)于第11天和13天分别死亡1只。②自主活动检测结果:强磁场照射2,3组小鼠的运动路程、运动速度、运动时间明显低于对照组(P<0.05)。③水迷宫测试结果:在学习记忆检测阶段撤掉平台,发现各组动物2min内穿越平台原来所在象限的次数没有明显差别(P>0.05)。结论:中频交变磁场照射会给小鼠的自发活动造成一定影响,对学习记忆没有影响。  相似文献   
48.
Peri-prosthetic infection remains a serious complication of joint replacement surgery. Herein, we demonstrate that a vancomycin-containing sol-gel film on Ti alloy rods can successfully treat bacterial infections in an animal model. The vancomycin-containing sol-gel films exhibited predictable release kinetics, while significantly inhibiting S. aureus adhesion. When evaluated in a rat osteomyelitis model, microbiological analysis indicated that the vancomycin-containing sol-gel film caused a profound decrease in S. aureus number. Radiologically, while the control side showed extensive bone degradation, including abscesses and an extensive periosteal reaction, rods coated with the vancomycin-containing sol-gel film resulted in minimal signs of infection. µCT analysis confirmed the radiological results, while demonstrating that the vancomycin-containing sol-gel film significantly protected dense bone from resorption and minimized remodeling. These results clearly demonstrate that this novel thin sol-gel technology can be used for the targeted delivery of antibiotics for the treatment of periprosthetic as well as other bone infections. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27: 701–709, 2009  相似文献   
49.
50.
Word production is a complex multistage process linking conceptual representations, lexical entries, phonological forms and articulation. Previous studies have revealed a network of predominantly left‐lateralized brain regions supporting this process, but many details regarding the precise functions of different nodes in this network remain unclear. To better delineate the functions of regions involved in word production, we used event‐related functional magnetic resonance imaging (fMRI) to identify brain areas where blood oxygen level‐dependent (BOLD) responses to overt picture naming were modulated by three psycholinguistic variables: concept familiarity, word frequency, and word length, and one behavioral variable: reaction time. Each of these variables has been suggested by prior studies to be associated with different aspects of word production. Processing of less familiar concepts was associated with greater BOLD responses in bilateral occipitotemporal regions, reflecting visual processing and conceptual preparation. Lower frequency words produced greater BOLD signal in left inferior temporal cortex and the left temporoparietal junction, suggesting involvement of these regions in lexical selection and retrieval and encoding of phonological codes. Word length was positively correlated with signal intensity in Heschl's gyrus bilaterally, extending into the mid‐superior temporal gyrus (STG) and sulcus (STS) in the left hemisphere. The left mid‐STS site was also modulated by reaction time, suggesting a role in the storage of lexical phonological codes. Hum Brain Mapp, 2009. © 2009 Wiley‐Liss, Inc.  相似文献   
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