Hormone replacement therapy and prevention of vertebral fractures: a meta-analysis of randomised trials

BACKGROUND: Hormone replacement therapy (HRT) is often seen as the treatment of choice for preventing fractures in women. We undertook a recent meta-analysis of randomised trials which suggested that HRT reduced non-vertebral fractures by 30%. In this analysis we extend that analysis to vertebral fractures. METHODS: We searched the main electronic databases until the end of August 2001. We sought all randomised controlled trials (RCTs) of HRT where women had been randomised to at least 12 months of HRT or to no HRT. RESULTS: We found 13 RCTs. Overall there was a 33% reduction in vertebral factures (95% confidence interval (CI) 45% to 98%). CONCLUSIONS: This review and meta-analysis showed a significant reduction in vertebral fractures associated with HRT use

Systematic review of topical treatments for fungal infections of the skin and nails of the feet

OBJECTIVE: To identify and synthesise the evidence for efficacy and cost effectiveness of topical treatments for superficial fungal infections of the skin and nails of the feet. DESIGN: Systematic review. INTERVENTIONS: Topical treatments for superficial fungal infections. MAIN OUTCOME MEASURES: Cure confirmed by culture and microscopy for skin and by culture for nails in patients with clinically diagnosed fungal infections. RESULTS: Of 126 trials identified in 121 papers, 72 (57.1%) met the inclusion criteria. Placebo controlled trials yielded pooled relative risks of failure to cure skin infections: allylamines (0.30, 95% confidence interval 0.24 to 0.38); azoles (0.54, 0.42 to 0.68); undecenoic acid (0.28, 0.11 to 0.74); and tolnaftate (0.46, 0.17 to 1.22). Although meta-analysis of 11 trials comparing allylamines and azoles showed a relative risk of failure to cure of 0.88 (0.78 to 0.99) in favour of allylamines, there was evidence of language bias. Seven reports in English favoured allylamines (0.79, 0.69 to 0.91), but four reports in foreign languages showed no difference between the two drugs (1.01, 0.90 to 1.13). Neither trial of nail infections showed significant differences between alternative topical treatments. CONCLUSIONS: Allylamines, azoles, and undecenoic acid were efficacious in placebo controlled trials. There are sufficient comparative trials to judge relative efficacy only between allylamines and azoles. Allylamines cure slightly more infections than azoles but are much more expensive than azoles. The most cost effective strategy is first to treat with azoles or undecenoic acid and to use allylamines only if that fails

Skin preparation with alcohol versus alcohol followed by any antiseptic for preventing bacteraemia or contamination of blood for transfusion (Review)

Background: Blood for transfusion may become contaminated at any point between collection and transfusion and may result in bacteraemia (the presence of bacteria in the blood), severe illness or even death for the blood recipient. Donor arm skin is one potential source of blood contamination, so it is usual to cleanse the skin with an antiseptic before blood donation. One-step and two-step alcohol based antiseptic regimens are both commonly advocated but there is uncertainty as to which is most effective. Objectives: To assess the effects of cleansing the skin of blood donors with alcohol in a one-step compared with alcohol in a two-step procedure to prevent contamination of collected blood or bacteraemia in the recipient. Search methods: In December 2014, for this third update, we searched the Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library; Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. Selection criteria: All randomised trials (RCTs) comparing alcohol based donor skin cleansing in a one-step versus a two-step process that includes alcohol and any other antiseptic for pre-venepuncture skin cleansing were considered. Quasi randomised trials were to have been considered in the absence of RCTs. Data collection and analysis: Two review authors independently assessed studies for inclusion. Main results: No studies (RCTs or quasi RCTs) met the inclusion criteria. Authors' conclusions: We did not identify any eligible studies for inclusion in this review. It is therefore unclear whether a two-step, alcohol followed by antiseptic skin cleansing process prior to blood donation confers any reduction in the risk of blood contamination or bacteraemia in blood recipients, or conversely whether a one-step process increases risk above that associated with a two-step process

Output state in multiple entanglement swapping

The technique of quantum repeaters is a promising candidate for sending quantum states over long distances through a lossy channel. The usual discussions of this technique deals with only a finite dimensional Hilbert space. However the qubits with which one implements this procedure will "ride" on continuous degrees of freedom of the carrier particles. Here we analyze the action of quantum repeaters using a model based on pulsed parametric down conversion entanglement swapping. Our model contains some basic traits of a real experiment. We show that the state created, after the use of any number of parametric down converters in a series of entanglement swappings, is always an entangled (actually distillable) state, although of a different form than the one that is usually assumed. Furthermore, the output state always violates a Bell inequality.Comment: 11 pages, 6 figures, RevTeX

Methane emissions among individual dairy cows during milking quantified by eructation peaks or ratio with carbon dioxide

The aims of this study were to compare methods for examining measurements of CH4 and CO2 emissions of dairy cows during milking and to assess repeatability and variation of CH4 emissions among individual dairy cows. Measurements of CH4 and CO2 emissions from 36 cows were collected in 3 consecutive feeding periods. In the first period, cows were fed a commercial partial mixed ration (PMR) containing 69% forage. In the second and third periods, the same 36 cows were fed a high-forage PMR ration containing 75% forage, with either a high grass silage or high maize silage content. Emissions of CH4 during each milking were examined using 2 methods. First, peaks in CH4 concentration due to eructations during milking were quantified. Second, ratios of CH4 and CO2 average concentrations during milking were calculated. A linear mixed model was used to assess differences between PMR. Variation in CH4 emissions was observed among cows after adjusting for effects of lactation number, week of lactation, diet, individual cow, and feeding period, with coefficients of variation estimated from variance components ranging from 11 to 14% across diets and methods of quantifying emissions. No significant difference was detected between the 3 PMR in CH4 emissions estimated by either method. Emissions of CH4 calculated from eructation peaks or as CH4 to CO2 ratio were positively associated with forage dry matter intake. Ranking of cows according to CH4 emissions on different diets was correlated for both methods, although rank correlations and repeatability were greater for CH4 concentration from eructation peaks than for CH4-to-CO2 ratio. We conclude that quantifying enteric CH4 emissions either using eructation peaks in concentration or as CH4-to-CO2 ratio can provide highly repeatable phenotypes for ranking cows on CH4 output

Gamma-ray emission expected from Kepler's SNR

Nonlinear kinetic theory of cosmic ray (CR) acceleration in supernova remnants (SNRs) is used to investigate the properties of Kepler's SNR and, in particular, to predict the gamma-ray spectrum expected from this SNR. Observations of the nonthermal radio and X-ray emission spectra as well as theoretical constraints for the total supernova (SN) explosion energy E_sn are used to constrain the astronomical and particle acceleration parameters of the system. Under the assumption that Kepler's SN is a type Ia SN we determine for any given explosion energy E_sn and source distance d the mass density of the ambient interstellar medium (ISM) from a fit to the observed SNR size and expansion speed. This makes it possible to make predictions for the expected gamma-ray flux. Exploring the expected distance range we find that for a typical explosion energy E_sn=10^51 erg the expected energy flux of TeV gamma-rays varies from 2x10^{-11} to 10^{-13} erg/(cm^2 s) when the distance changes from d=3.4 kpc to 7 kpc. In all cases the gamma-ray emission is dominated by \pi^0-decay gamma-rays due to nuclear CRs. Therefore Kepler's SNR represents a very promising target for instruments like H.E.S.S., CANGAROO and GLAST. A non-detection of gamma-rays would mean that the actual source distance is larger than 7 kpc.Comment: 6 pages, 4 figures. Accepted for publication in Astronomy and Astrophysics, minor typos correcte

Clinical trial of lamivudine in children with chronic hepatitis B.

N Engl J Med. 2002 May 30;346(22):1706-13. Clinical trial of lamivudine in children with chronic hepatitis B. Jonas MM, Mizerski J, Badia IB, Areias JA, Schwarz KB, Little NR, Greensmith MJ, Gardner SD, Bell MS, Sokal EM; International Pediatric Lamivudine Investigator Group. of Gastroenterology, Children's Hospital, Boston, MA 02115, USA. Erratum in: N Engl J Med 2002 Sep 19;347(12):955. Kelley, Deirdre [corrected to Kelly, Deirdre]. Comment in: J Hepatol. 2003 May;38(5):698-9. N Engl J Med. 2002 May 30;346(22):1682-3. Abstract BACKGROUND: Lamivudine therapy is effective for chronic hepatitis B infection in adults. We evaluated the efficacy and tolerability of lamivudine as a treatment for chronic infection with hepatitis B virus (HBV) in children. METHODS: Children with chronic hepatitis B were randomly assigned in a 2:1 ratio to receive either oral lamivudine (3 mg per kilogram of body weight; maximum, 100 mg) or placebo once daily for 52 weeks. The primary end point was virologic response (defined by the absence of serum hepatitis B e antigen and serum HBV DNA) at week 52 of treatment. RESULTS: Of the 403 children screened, 191 were randomly assigned to receive lamivudine and 97 to receive placebo. The rate of virologic response at week 52 was higher among children who received lamivudine than among those who received placebo (23 percent vs. 13 percent, P=0.04). Lamivudine therapy was well tolerated and was also associated with higher rates of seroconversion from hepatitis B e antigen to hepatitis B e antibody, normalization of alanine aminotransferase levels, and suppression of HBV DNA. CONCLUSIONS: In children with chronic hepatitis B, 52 weeks of treatment with lamivudine was associated with a significantly higher rate of virologic response than was placebo. PMID: 12037150 [PubMed - indexed for MEDLINE

The mixed problem in L^p for some two-dimensional Lipschitz domains

We consider the mixed problem for the Laplace operator in a class of Lipschitz graph domains in two dimensions with Lipschitz constant at most 1. The boundary of the domain is decomposed into two disjoint sets D and N. We suppose the Dirichlet data, f_D has one derivative in L^p(D) of the boundary and the Neumann data is in L^p(N). We find conditions on the domain and the sets D and N so that there is a p_0>1 so that for p in the interval (1,p_0), we may find a unique solution to the mixed problem and the gradient of the solution lies in L^p

Cartilage-specific ablation of XBP1 signaling in mouse results in a chondrodysplasia characterized by reduced chondrocyte proliferation and delayed cartilage maturation and mineralization

SummaryObjectiveTo investigate the in vivo role of the IRE1/XBP1 unfolded protein response (UPR) signaling pathway in cartilage.DesignXbp1flox/flox.Col2a1-Cre mice (Xbp1CartΔEx2), in which XBP1 activity is ablated specifically from cartilage, were analyzed histomorphometrically by Alizarin red/Alcian blue skeletal preparations and X-rays to examine overall bone growth, histological stains to measure growth plate zone length, chondrocyte organization, and mineralization, and immunofluorescence for collagen II, collagen X, and IHH. Bromodeoxyuridine (BrdU) and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) analyses were used to measure chondrocyte proliferation and cell death, respectively. Chondrocyte cultures and microdissected growth plate zones were analyzed for expression profiling of chondrocyte proliferation or endoplasmic reticulum (ER) stress markers by Quantitative PCR (qPCR), and of Xbp1 mRNA splicing by RT-PCR to monitor IRE1 activation.ResultsXbp1CartΔEx2 displayed a chondrodysplasia involving dysregulated chondrocyte proliferation, growth plate hypertrophic zone shortening, and IRE1 hyperactivation in chondrocytes. Deposition of collagens II and X in the Xbp1CartΔEx2 growth plate cartilage indicated that XBP1 is not required for matrix protein deposition or chondrocyte hypertrophy. Analyses of mid-gestation long bones revealed delayed ossification in Xbp1CartΔEx2 embryos. The rate of chondrocyte cell death was not significantly altered, and only minimal alterations in the expression of key markers of chondrocyte proliferation were observed in the Xbp1CartΔEx2 growth plate. IRE1 hyperactivation occurred in Xbp1CartΔEx2 chondrocytes but was not sufficient to induce regulated IRE1-dependent decay (RIDD) or a classical UPR.ConclusionOur work suggests roles for XBP1 in regulating chondrocyte proliferation and the timing of mineralization during endochondral ossification, findings which have implications for both skeletal development and disease

4f spin density in the reentrant ferromagnet SmMn2Ge2

The spin contribution to the magnetic moment in SmMn2Ge2 has been measured by magnetic Compton scattering in both the low and high temperature ferromagnetic phases. At low temperature, the Sm site is shown to possess a large 4f spin moment of 3.4 +/- 0.1 Bohr magnetons, aligned antiparallel to the total magnetic moment. At high temperature, the data show conclusively that ordered magnetic moments are present on the samarium site.Comment: 5 pages, 2 figures, transferred from PRL to PRB (Rapid Comm.