Pharmacokinetics and pharmacodynamics of sibrafiban (Ro 48-3657), an orally active IIb/IIIa antagonist, administered alone or in combination with heparin, aspirin, and recombinant tissue-type plasminogen activator in beagles

OBJECTIVE: The study aimed to determine the effectiveness of prophylactic medical intervention in reducing the incidence of cystoid macular edema (CME) and the effectiveness of medical treatment for chronic CME after cataract surgery. DESIGN: The study design was a systematic review and meta-analysis of published reports of randomized clinical trials (RCTs). PARTICIPANTS: Sixteen RCTs involving 2898 eyes examining the effectiveness of medical prophylaxis of CME and 4 RCTs involving 187 eyes testing the effectiveness of medical treatment of chronic CME were used in the study. INTERVENTIONS: Medical prophylaxis of treatment (cyclo-oxygenase inhibitors or corticosteroids) versus control (placebo or active treatment) was performed. MAIN OUTCOME MEASURES: Incidence of angiographically diagnosed CME, incidence of clinically significant CME, and vision were measured. RESULTS: Thirty-six articles reported testing a prophylactic medical intervention for CME after cataract surgery. The incidence of CME varied extensively across studies and was related to the study design used. Summary odds ratios (OR) indicated that prophylactic intervention was effective in reducing the incidence of both angiographic CME (OR = 0.36; 95% confidence interval [CI] = 0.28-0.45) and clinically relevant CME (OR = 0.49; 95% CI = 0.33-0.73). There also was a statistically significant positive effect on improving vision (OR = 1.97; 95% CI = 1.14-3.41). A combination of the results of the four RCTs testing medical therapy for chronic CME indicated a treatment benefit in terms of improving final visual acuity by two or more Snellen lines (OR = 2.67; 95% CI = 1.35-5.30). Assessment of the quality of the 20 RCTs included in the meta-analyses indicated problems in the design, execution, and reporting of a number of trials. CONCLUSION: A combination of the results from RCTs indicates that medical prophylaxis for aphakic and pseudophakic CME and medical treatment for chronic CME are beneficial. Because most of the RCTs performed to date have problems related to quality, a well-designed RCT is needed to confirm this result, using clinical CME and vision as outcomes.     

The simplified two-pipette technique is more efficient than the conventional three-pipette method for blastomere biopsy in human embryos

Kell and Kx are two quantitatively minor proteins from the human erythrocyte membrane which carry blood groups antigens and are thought to be a metalloprotease and a membrane transporter, respectively. In the red cell membrane, these proteins form a complex stabilized by disulfide bond(s). Phosphorylation status of these proteins was studied, in the presence or absence of effectors of several kinases, either on intact cells incubated with [32P]-orthophosphate or on ghosts incubated with [gamma-32P]ATP. Purification of Kell-Kx complex, by immunochromatography on an immobilized human monoclonal antibody of Kell blood group specificity allowed to establish that (i) neither protein is phosphorylated on tyrosine; (ii) the Kell protein is a putative substrate for Casein Kinase II (CKII) and Casein Kinase I (CKI) but not for protein kinase C (PKC), whereas Kx protein is phosphorylated by CKII and PKC but not by CKI; (iii) Protein Kinase A neither phosphorylates the Kell nor the Kx proteins.     

Preparation and Crystal Structure of KFeCl3 and KFeBr3

The preparation and crystal structures of anhydrous KFeCl₃ and KFeBr₃ are described. X-ray diffraction data obtained at room temperature indicate that the two compounds belong to the orthorhombic system, space group Pnma and z = 4. Unit cell parameters are a = 8.712 Å, b = 3.845 Å, c = 14.15 Å for KFeCl₃ and a = 9.220 Å, b = 4.026 Å, c = 14.899 Å for KFeBr₃. Atomic positions were determined.     

Effects of insulin therapy on non-insulin-dependent diabetics with secondary oral hypoglycemic agent failure

A recent trend among physicians is the categorisation of lung scans as normal [excludes pulmonary embolism (PE)], high probability (confirms PE) and non-diagnostic (no judgement on PE risk). The low probability scan is therefore being eliminated as a functional category. This occasional survey contends that such an approach is misguided. Correction of the original PIOPED data with certain assumptions provides a more reproducible, albeit restricted, low probability scan category which excludes PE in 97% of cases in the low pre-test clinical category. Patients with a low probability scan with risk factors for PE (i.e. medium clinical risk) will require further investigation. More important, the very low probability scan category excludes PE in 98% of patients with low and more than 92% of patients with medium pre-test clinical likelihood. The demise of "low probability" is premature.     

Human immunodeficiency virus infection, Part II

The acceptance of highly active antiretroviral therapy (HAART) among patients and health care providers has had a dramatic impact on the epidemiology and clinical characteristics of many opportunistic infections associated with human immunodeficiency virus (HIV). Previously intractable opportunistic infections and syndromes are now far less common. In addition, effective antibiotic prophylactic therapies have had a profound impact on the risk of patients developing particular infections and on the incidence of these infections overall. Most notable among these are Pneumocystis carinii, disseminated Mycobacterium avium complex, tuberculosis, and toxoplasmosis. Nevertheless, infections continue to cause significant morbidity and mortality among patients who are infected with HIV. The role of HAART in many clinical situations is unquestioned. Compelling data from clinical trials support the use of these therapies during pregnancy to prevent perinatal transmission of HIV. HAART is also recommended for health care workers who have had a "significant" exposure to the blood of an HIV-infected patient. Both of these situations are discussed in detail in this article. In addition, although more controversial, increasing evidence supports the use of HAART during the acute HIV seroconversion syndrome. An "immune reconstitution syndrome" has been newly described for patients in the early phases of treatment with HAART who develop tuberculosis, M avium complex, and cytomegalovirus disease. Accumulating data support the use of hydroxyurea, an agent with a long history in the field of myeloproliferative disorders, for the treatment of HIV. Newer agents, particularly abacavir and adefovir dipivoxil, are available through expanded access protocols, and their roles are being defined and clarified.     

On the Retirement of E. P. Goldfinch, Founder of Radiation Protection Dosimetry

In June of 2004, Eddie Goldfinch will be retiring from his dutiesas Executive Editor of Radiation Protection Dosimetry (RPD).Oxford University Press is publishing the journal, however itshould be noted that Eddie has not completely stopped his publishingactivities or his association with RPD. He will remain as anemeritus member of the Editorial     

Topical safety and vasoconstrictive assay-based bioequivalence of a new reformulated mometasone cream

Objectives: A new improved mometasone furoate (Elocon?) cream with an emulsification system that produces a stable emulsion has been developed. In order to register the product in various markets, it was essential to ensure the cream was topically well tolerated and that it was bioequivalent to the reference product.

Methods: Phase I clinical studies were performed to assess the local safety and tolerability upon multiple dosing of this new cream as well as to assess the single-dose bioequivalence relative to the marketed product. Bioequivalence was assessed using a vasoconstrictive assay (VCA) after a dose-duration pilot study was completed with the marketed Elocon cream.

Key findings: The new mometasone cream and its vehicle were nonirritating in healthy subjects during 21-day patch application (MCII <0.025). The positive control was moderately irritating in the same study. The pivotal VCA study enrolled 162 subjects with 105 detectors included in the analysis of bioequivalence. In the 105 detectors, the ratio (×100%) of AUEC values at ED₅₀ for test vs. standard (90% CI) was 112.91% (105.55, 120.87), within the bioequivalence criteria of (80, 125).

Conclusions: These studies supported the registration of reformulated mometasone cream in various markets.     

Global modeling of hydrogen using GFDL-AM4.1: Sensitivity of soil removal and radiative forcing

Hydrogen (H₂) has been proposed as an alternative energy carrier to reduce the carbon footprint and associated radiative forcing of the current energy system. Here, we describe the representation of H₂ in the GFDL-AM4.1 model including updated emission inventories and improved representation of H₂ soil removal, the dominant sink of H₂. The model best captures the overall distribution of surface H₂, including regional contrasts between climate zones, when v_d(H₂) is modulated by soil moisture, temperature, and soil carbon content. We estimate that the soil removal of H₂ increases with warming (2–4% per K), with large uncertainties stemming from different regional response of soil moisture and soil carbon. We estimate that H₂ causes an indirect radiative forcing of 0.84 mW m^?2/(Tg(H₂)yr^?1) or 0.13 mW m^?2 ppbv^?1, primarily due to increasing CH₄ lifetime and stratospheric water vapor production.     

Purchased energy and policy impacts in the US manufacturing sector

The US manufacturing sector, which consists of industries that produce durable and nondurable goods, accounts for about 30 % of all the final energy consumed in the country. In this study, manufacturing sector data coming primarily from the Annual Survey of Manufacturers are used to estimate the total impact of one mode of energy efficiency policy, market persuasion programs, on aggregate electricity consumption and energy expenditures. Using a panel model consisting of data for 184 industries, the findings indicate that the cumulative effects since 2002 of this policy mode is a reduction in 2010 electricity consumption of 5.4 %, of electricity expenditures of 2.4 %, and of all other fuel expenditures of 5.7 %. These estimates are derived after controlling for changes in output, other production inputs, and economic conditions. Particular attention in this study is given to the effects of a permanent shift in demand, and temporary business cycle shock, on model external validity.     

The composite structure of peak 5 in the glow curve of LiF:Mg,Ti (TLD-100): confirmation of peak 5a arising from a locally trapped electron-hole configuration

The hypothesis that glow peak 5a arises from localised e-h capture is confirmed by the following experimental observations: (i) The high conversion efficiency (CE) (CE5a-->4 = 3 +/- 0.5) of peak 5a to peak 4 (a hole-only trap) deduced from detailed Im-Tstop optical bleaching studies at 310 nm compared to the much lower CE of peak 5 (an electron-only trap) (CE5-->4 = 0.0026+/-0.012). (ii) The lack of an increase in the sensitivity of glow peak 5a following 2.6 MeV and 6.8 MeV He ion irradiation in 'sensitised' material compared to the factor two increase in the sensitivity of peak 5; (S/S0)5a = 0.86+/-0.12, compared to (S/S0)5 = 2.0+/-0.2. (iii) The late entry into saturation of the 2.6 MeV and 6.8 MeV He ion TL-fluence response curves for peak 5a compared to peak 5 in sensitised and normal material resulting in the following values for the track radial saturation parameter: (r50)5a = 100+/-20) Angstroms compared to (r50)5 = 380+/-30 Angstroms. (iv) The low value of 0.1 for the 'track-escape' parameter of peak 5a deduced from the Extended Track Interaction Model analysis of He ion TL fluence response compared to order of magnitude greater values for peaks 5 and 5b.