Small proportions: what to report for confidence intervals?

The original article to which this Erratum refers was published in Pharmacoepidemiology and Drug Safety 2005; 14: 239–247.     

The effect of a highly specific serotonin agonist on osmoregulated vasopressin secretion in healthy man

OBJECTIVE: To explore a possible interaction of the serotonin neurotransmitter system and posterior pituitary function, we have looked at the effect of fluoxetine treatment on osmoregulated vasopressin secretion in normal men in two placebo controlled studies. DESIGN: In each study subjects took in random order for 7 days one capsule daily of placebo or 40 mg fluoxetine. On the 8th day subjects underwent assessment. Study 1 A hypo-osmotic stimulus of an oral water load of 20 ml/kg. Study 2 A hyperosmotic stimulus of intravenous infusion of 5% (855 mmol/l) saline at 0.06 ml/kg/min for 120 minutes. PATIENTS: Normal, healthy male volunteers. Study 1, 9; Study 2, 10. MEASUREMENTS: In both studies regular measures of plasma osmolality, sodium and vasopressin were made. In Study 1 urine osmolality was measured together with urine volume at set time points and an accumulative measure of percentage of water load excreted. Free water clearance was calculated. In Study 2 the relationship of plasma vasopressin to change in plasma osmolality was calculated for each subject by linear regression analysis. RESULTS: Serotonin agonism had no effect on baseline measurements in either study. Study 1 After 4 hours subjects excreted 95 and 99% of the water load after placebo and fluoxetine respectively (P = 0.407). There was no effect of fluoxetine compared to placebo on the pattern or extent of change of plasma osmolality (nadir 285.9 +/- 1.4 mosm/kg placebo, 283.1 +/- 1.1 mosm/kg fluoxetine, P = 0.145) or free water clearance or maximum urine dilution after oral water loading. Plasma vasopressin suppressed to a minimum concentration after both treatments in response to hypo-osmolality 0.5 +/- 0.1 pmol/l (placebo), 0.3 +/- 0.01 pmol/l (fluoxetine), P = 0.195. Study 2 Fluoxetine had no significant effect on the sensitivity of vasopressin release to change in plasma osmolality (0.33 +/- 0.06 pmol/l per mosm/kg placebo, 0.36 +/- 0.06 pmol/l per mosm/kg fluoxetine, P = 0.347). Nor was there a significant effect on the theoretical osmotic threshold for release of vasopressin (287.0 +/- 1.21 mosm/kg placebo, 286.9 +/- 1.09 mosm/kg fluoxetine, P = 0.700). CONCLUSION: We have found no evidence of a physiologically relevant effect of serotonin agonism on osmoregulated vasopressin release, or on the ability of normal man to excrete a water load. The possible reasons for this contrast to animal work are discussed.     

Lipodermatosclerosis: review of cases evaluated at Mayo Clinic.

BACKGROUND: Lipodermatosclerosis describes bound-down, sclerotic skin involving the lower extremities. OBJECTIVE: Our purpose was to describe the demographic and clinical features of patients with lipodermatosclerosis. METHODS: This was a retrospective study of patients presenting to Mayo Clinic between 1976 and 1998 with a diagnosis of lipodermatosclerosis. RESULTS: Of 97 patients, 84 (87%) were women. Mean age was 62 years (range, 25-88 years). Mean body mass index was 34.3 (range, 17.8-71.5). Clinical signs were bilateral involvement in 44 patients (45%), induration localized to a discrete plaque in 49 (51%), erythema in 69 (71%), hyperpigmentation in 57 (59%), ulceration in 13 (13%), concomitant edema in 69 (71%), and varicosities in 55 (57%). Vascular studies performed on 72 patients showed abnormalities in 49: deep venous incompetence in 33 (67%), calf muscle pump abnormality in 19 (39%), abnormal pulsatility in 10 (20%), and obstruction in 1 (2%). CONCLUSION: Lipodermatosclerosis was associated with female sex, middle age, high body mass index, and venous abnormalities.     

同种异体黑素细胞移植治疗白癜风

0　引言　白癜风患者免疫紊乱 ,黑素细胞 (melanocyte,MC)异体移植有可能不被排斥 ,治疗如成功将有很大临床前景 [1 ] .探索同种异体黑素细胞移植后的效果很有意义 .1　病例报告　女 ,2 7岁 ,确诊白癜风 (稳定期 ) ,患者皮肤自幼出现色素脱失斑 ,逐渐增多扩大 . 1996年外用“敏白灵”,前2 mo有效 . 1999- 0 7外用补骨酯酊 ,日服 5 g· L- 1 硫酸铜 10m L和中药 1剂 ,转移因子 4m L ,sc,1· 2 d- 1 .皮损缩小 ,4mo后稳定 .用健康男青年环切的包皮培养 MC,第 4代大约80 %融合时 ,用 2 .5 g· L- 1 胰酶消化 5 min,加入含 2 0 0 g·L- 1小…     

Effects on Smokers of Exposure to Graphic Warning Images

Background and Objectives : Several countries have introduced graphic warning images aimed at discouraging smoking. The objective of this study was to evaluate the impact on smokers of graphic warnings showing cosmetically important harm caused by smoking. Methods : Fifty‐six adult smokers were randomly assigned to view either written smoking warnings or the same written warnings with related graphic images. The smokers viewed the warnings at a rate of one per week for 4 weeks. The smokers were assessed before and after the warnings with regard to stage of change toward smoking cessation and level of smoking. Results : The randomized control trial showed that the warnings with graphic images led to significantly more progress in stage of change toward smoking cessation than written warnings alone. However, the images did not lead to decreases in smoking rates. Conclusions and Scientific Significance : The results indicate that written smoking warnings accompanied by images of cosmetically important harm caused by smoking have more potential than warnings alone in prompting changes in the direction of quitting. (Am J Addict 2012;21:555–557)     

Variability and reproducibility of transcutaneous oxygen tension measurements in the assessment of peripheral vascular disease

Transcutaneous oxygen tension (TcPO2) was measured according to a standard protocol in 43 limbs from 23 subjects, by use of oxygen-sensing electrodes attached to the chest (at a single site) or dorsum of the foot (at proximal and distal sites, located 1-2 cm apart). With the subjects supine, distal foot TcPO2 differed from proximal by an average of +/- 7.4 mmHg, and in 80% of all limbs the differences were between -6 mmHg and +15 mmHg. The two TcPO2's were subsequently combined to yield a single "average" value for each foot. TcPO2 measurements were repeated twenty-four to forty-eight hours later; in the supine position the change in "average" foot TcPO2 from the first to second measurement was +/- 6.9 mmHg, and in 80% of limbs the changes were between -11 mmHg and +9 mmHg. Similar reproducibility data were also obtained for ankle/brachial blood pressure indices (ABIs), chest TcPO2, and foot TcPO2 during three minutes of leg elevation at 30 degrees. The authors conclude that: (1) TcPO2 measurements from adjacent areas on the dorsum of the foot usually differ by 20-25% or less and (2) the short-term reproducibility of TcPO2 between studies is comparable to that for ABIs.