Adjunct effect of loratadine in the treatment of acute sinusitis in patients with allergic rhinitis

H₁-blockers are often added to the standard treatment of acute sinusitis, but this is not supported by a controlled study. A multicentric, randomized, double-blind, placebo-controlled, parallel-group study was done in 139 allergic patients (15–65 years) to assess the adjunct efficacy of loratadine in acute exacerbation of rhinosinusitis. Sinusitis was diagnosed by symptoms and confirmed by rhinoscopy and sinus radiograph. Allergy was characterized by skin tests, RAST, and history. Patients were treated with antibiotics (14 days), oral corticosteroids (10 days), and loratadine (10 mg OD) or placebo (28 days). Treatment efficacy was assessed over 28 days by symptom scores quoted daily by patients. Physicians also rated total symptom scores at entry and at day 28. At entry, both groups had similar symptoms. Placebo-treated patients improved significantly, but patients who received loratadine had a significantly greater improvement in sneezing ( P =0.003) after 14 days, and in nasal obstruction ( P =0.002) after 28 days. Physicians found that patients receiving loratadine were significantly improved compared to placebo patients ( P =0. 0125). Loratadine in addition to standard therapy was found to improve the control of some symptoms of sinusitis.     

肿瘤坏死因子α基因多态性与老年2型糖尿病的相关性研究

目的研究肿瘤坏死因子α(TNF-α)基因多态性与老年2型糖尿病的相关性。方法利用DNA测序法对60例老年2型糖尿病患者及30例正常对照者的TNF-α基因-308位点和-238位点进行基因多态性分析。结果TNF-α基因-308位点在患病组中变异的G/A基因型频率为21.7%,与对照组组间比较有高度显著差异(P<0.01),而-238位点在两组之间无显著性差异(P>0.05)。结论TNF-α基因G-308A单核苷酸多态性与老年2型糖尿病可能存在相关性。     

Investigation of Electrical Transitions in the First Steps of Spark Plasma Sintering: Effects of Pre-Oxidation and Mechanical Loading within Copper Granular Media

Spark Plasma Sintering (SPS) has become a conventional and promising sintering method for powder consolidation. This study aims to well understand the mechanisms of densification encountered during SPS treatments, especially in the early stages of sintering. The direct current (DC) electrical behavior of copper granular medium is characterized. Their properties are correlated with their microstructural evolutions through post-mortem scanning electron microscope (SEM) observations to allow a thorough understanding of the involved Branly effect that is suspected to occur in SPS. The electrical response is studied by modifying the initial thickness of the oxide layer on particles surfaces and applying various mechanical loads on the granular medium. Without load and at low current, the measured quasi-reversible behavior is connected to the formation of spots at the microcontacts between the particles. By increasing the current, the Branly transition from an insulating to a conductive state suddenly occurs. The insulating oxide layer is destroyed, and micro-bridges are created. The application of a mechanical pressure strongly modifies the DC Branly effect. Increasing low stress leads to a strong decrease in the breakdown field. For high-applied pressure, successive drops in the electric field are detected during the electrical transition. These successive drops are induced by microcracking of the insulating oxide layer.     

Population-based study of factors influencing occurrence and prognosis of local recurrence after surgery for rectal cancer

BACKGROUND: Few data are available from population-based statistics on the risk of local recurrence after surgery for rectal cancer. The aims of this study were to determine factors influencing local control and to analyse treatment and prognosis of recurrences in a well defined population. METHODS: Data were obtained from the cancer registry of the C?te d'Or (France). From 1976 to 1995, 682 patients resected for cure for a rectal carcinoma were included. Recurrence rates and survival rates were calculated using actuarial methods. A relative survival analysis and Cox multivariate analysis were performed. RESULTS: During the study 135 local recurrences were registered. The 5-year cumulative local recurrence rate was 22.7 per cent. In multivariate analysis the two variables significantly associated with local recurrence risk were stage at diagnosis and the macroscopic type of growth. There was a non-significant decrease in local recurrence rate in patients treated by preoperative radiotherapy compared with that in patients treated by surgery alone. The proportion of patients re-resected for cure was 25.2 per cent, and increased from 13.0 per cent in 1976-1985 to 37.9 per cent in 1986-1995 (P = 0.001). The 5-year relative survival rate was 13.6 per cent overall and 40.6 per cent after resection for cure (P < 0.001). CONCLUSION: Local recurrence of rectal cancer following resection remains a substantial problem. Improvement can be expected from better care and earlier diagnosis.     

Can the e-OAKHQOL be an alternative to measure health-related quality of life in knee osteoarthritis?

Quality of Life Research - To assess the validity of the e-OAKHQOL questionnaire and analyze whether the answers were affected by the form of administration (electronic vs. paper). Two samples of...     

Targeted Melanoma Prevention Intervention: A Cluster Randomized Controlled Trial

PURPOSE

Targeted interventions to reduce the risk and increase the early detection of melanoma have the potential to save lives. We aimed to assess the effect of such an intervention on patient prevention behavior.

METHODS

We conducted a pilot clustered randomized controlled trial, comparing a targeted screening and education intervention with a conventional information-based campaign in 20 private surgeries in western France. In the intervention group, 10 general practitioners identified patients at elevated risk for melanoma with a validated assessment tool, the Self-Assessment Melanoma Risk Score (SAMScore), examined their skin, and counseled them using information leaflets. In the control group, 10 general practitioners displayed a poster and the leaflets in their waiting room and examined patients’ skin at their own discretion. The main outcome measures were sunbathing and skin self-examinations among patients at elevated risk, assessed 5 months later with a questionnaire.

RESULTS

Analyses were based on 173 patients. Compared with control patients, intervention patients were more likely to remember the campaign (81.4% vs 50.0%, P = .0001) and to correctly identify their elevated risk of melanoma (71.1% vs 42.1%, P = .001). Furthermore, intervention patients had higher levels of prevention behaviors: they were less likely to sunbathe in the summer (24.7% vs 40.8%, P = .048) and more likely to have performed skin self-examinations in the past year (52.6% vs 36.8%, P = .029). The intervention was not associated with any clear adverse effects, although there were trends whereby intervention patients were more likely to worry about melanoma and to consult their general practitioner again about the disease.

CONCLUSIONS

The combination of use of the SAMScore and general practitioner examination and counseling during consultations is an efficient way to promote patient behaviors that may reduce melanoma risk. Extending the duration of follow-up and demonstrating an impact on morbidity and mortality remain major issues for further research.     

移植胚鼠弓状核细胞后对动脉粥样硬化形成的影响

为进一步证实毁损弓状核可诱发动脉粥样硬化的早期变化这一作用 ,用毁损弓状核诱发动脉粥样硬化早期变化后 ,重新植入胚鼠弓状核细胞悬液来观察动脉壁的变化是否能得以恢复。实验用新生Wistar大鼠 18只 ,按出生后 1、3、5、7、9天皮下注射 10 %谷氨酸单钠 4g kg体重 ,共注射 5次 ,为毁损弓状核诱发动脉粥样硬化动物模型 ,存活 30天后 ,取 6只动物主动脉作为对照组Ⅰ ,另 12只动物分为实验组和对照组Ⅱ ,实验组在弓状核区重新植入 14天胚鼠弓状核细胞悬液 5 μL(细胞浓度为 1× 10 1 5 L) ,对照组Ⅱ植入等量生理盐水继续存活 30天后各取主动脉作电镜观察。结果发现 :对照组Ⅰ动物主动脉壁内皮细胞腔面可见微绒毛样突起 ,内皮细胞核有些扭曲 ,不规则 ,内皮下层未见增厚 ;对照组Ⅱ动物内皮细胞变性、脱落 ,内皮下层明显增厚 ,出现许多大小不等的空泡和胶原纤维 ,有巨噬细胞和平滑肌细胞迁入内皮下层 ,这些变化是动脉粥样硬化发病的早期特征性病变 ;实验组动物内皮细胞核完整 ,内皮与内皮下层连接紧密 ,偶尔可见内皮细胞核扭曲。实验证明 ,在被毁损弓状核区重新植入胚鼠弓状核细胞后对动脉粥样硬化有明显恢复作用 ,从而证实下丘脑弓状核对动脉粥样硬化的形成具有重要调控作用     

Importance of reciprocal ST segment depression in leads V5 and V6 as an indicator of disease of the left anterior descending coronary artery in acute inferior wall myocardial infarction

The purpose of this study was to determine the coronary angiographic correlations (specifically disease of the left anterior descending coronary artery) of reciprocal ST segment depression appearing during inferior acute myocardial infarction. Forty six patients (41 men and five women; mean age 56 years) were allocated into two groups based on the extent of precordial ST segment depression: widespread (V1-V6) ST depression v localised (V1-V4) ST depression. Patients with no reciprocal ST depression or patients with ST depression in V1-V4 but with ST elevation in V5 and V6 (inferolateral acute myocardial infarction) were excluded. All patients were catheterised during hospital admission for infarction. Twenty four of the 28 patients with ST depression in V1-V6 had significant lesions in the left anterior descending coronary artery whereas 16 of the 18 patients with ST depression in V1-V4 had insignificant or no lesions in the left anterior descending artery. The sensitivity, specificity, and positive and negative predictive values of widespread ST depression in predicting disease in the left anterior descending coronary artery were 92%, 80%, and 86% and 89% respectively. In patients with inferior acute myocardial infarction and precordial ST depression, the extent of ST depression is of clinical significance. Widespread (V1-V6) ST depression suggests disease of the left anterior descending coronary artery, whereas localised ST depression (V1-V4) indicates its absence.