Does injection of steroids and lidocaine in the shoulder relieve bursitis?

Subacromial steroid injection may provide a small, short-term benefit compared with placebo. The short-term effectiveness of steroid injection compared with nonsteroidal anti-inflammatory agents (NSAIDs) remains unclear. Steroid injections are better than physiotherapy alone in the short term. However, injection does not appear to provide any meaningful long-term benefit compared with other therapies (strength of recommendation: B). Data are insufficient to make recommendations regarding the proper timing of injection in the sequence of other treatments. Side effects of steroid injection, such as steroid flare and infection, are rare

What interventions reduce the risk of contrast nephropathy for high-risk patients?

Several interventions may reduce the risk of contrast nephropathy for high-risk patients; however, most evidence uses surrogate markers for clinically relevant outcomes. Because dehydration is a risk factor for developing contrast nephropathy, periprocedural hydration is routinely recommended (strength of recommendation [SOR]: C, expert opinion). Single studies have suggested that isotonic saline is associated with less risk than half-normal saline, and hydration with fluids containing sodium bicarbonate is more efficacious than those containing isotonic saline (SOR: B, single randomized controlled trial [RCT])

Does treatment of acne with Retin A and tetracycline cause adverse effects?

Self-Adverse reactions to long-term tetracycline therapy are rare, and most will occur within 2 months of initiating therapy (strength of recommendation [SOR]: B, systematic review of ecological studies). Rare but serious drug reactions include a severe cutaneous reaction, hypersensitivity syndrome reaction, serum sickness-like reaction, and isolated single-organ dysfunction (SOR: B, systematic review). Duration of antibiotic treatment is strongly associated with increased bacterial resistance (SOR: B, systematic review and 1 outcomes study), but antibiotics for acne do not appear to interfere with oral contraceptive efficacy (SOR: B, case-control study and supporting expert opinion). Laboratory monitoring is not indicated in otherwise healthy patients (SOR: B, consistent cohort studies). No reports have been published regarding long-term topical tretinoin (Retin A) therapy. Short-term follow-up reports note no systemic effects (SOR: C, expert opinion), no teratogenicity (SOR: B, single case control study), and negligible systemic absorption (SOR: B, outcome studies).Thus, long-term topical tretinoin is presumed to be safe (SOR: C, expert opinion and extrapolation of pharmacologic data)

What effect do inhaled steroids have on delaying the progression of COPD?

The annual rate of decline in forced expiratory volume for 1 second (FEV1) has been researchers' gold standard as an objective measure for progression of chronic obstructive pulmonary disease (COPD). Inhaled corticosteroids (ICS) do not consistently have a statistically significant impact on FEV1 decline, and thus on the progression of COPD (strength of recommendation [SOR]: B, 2 conflicting meta-analyses and numerous conflicting randomized controlled trials). In those studies that did show improvements in FEV1 decline, the change does not appear to be clinically significant (7.7 to 9.0 mL/year). These findings do not take into account the potential impact of ICS on such patient oriented outcomes as exacerbation rates, quality of life, outpatient visits, hospitalization, and mortality

Evidence for the intense exchange of MazG in marine cyanophages by horizontal gene transfer

Background: S-PM2 is a phage capable of infecting strains of unicellular cyanobacteria belonging to the genus Synechococcus. S-PM2, like other myoviruses infecting marine cyanobacteria, encodes a number of bacterial-like genes. Amongst these genes is one encoding a MazG homologue that is hypothesized to be involved in the adaption of the infected host for production of progeny phage. Methodology/Principal Findings: This study focuses on establishing the occurrence of mazG homologues in other cyanophages isolated from different oceanic locations. Degenerate PCR primers were designed using the mazG gene of S-PM2. The mazG gene was found to be widely distributed and highly conserved among Synechococcus myoviruses and podoviruses from diverse oceanic provinces. Conclusions/Significance: This study provides evidence of a globally connected cyanophage gene pool, the cyanophage mazG gene having a small effective population size indicative of rapid lateral gene transfer despite being present in a substantial fraction of cyanophage. The Prochlorococcus and Synechococcus phage mazG genes do not cluster with the host mazG gene, suggesting that their primary hosts are not the source of the mazG gene

Effectiveness and cost of recruitment strategies for a community-based randomised controlled trial among rainwater drinkers

<p>Abstract</p> <p>Background</p> <p>Community-based recruitment is challenging particularly if the sampling frame is not easily defined as in the case of people who drink rainwater. Strategies for contacting participants must be carefully considered to maximise generalisability and minimise bias of the results. This paper assesses the recruitment strategies for a 1-year double-blinded randomised trial on drinking untreated rainwater. The effectiveness of the recruitment strategies and associated costs are described.</p> <p>Methods</p> <p>Community recruitment of households from Adelaide, Australia occurred from February to July 2007 using four methods: electoral roll mail-out, approaches to schools and community groups, newspaper advertising, and other media involvement. Word of mouth communication was also assessed.</p> <p>Results</p> <p>A total of 810 callers were screened, with 53.5% eligible. Of those who were eligible and sent further information, 76.7% were willing to participate in the study and 75.1% were enrolled. The target for recruitment was 300 households, and this was achieved. The mail-out was the most effective method with respect to number of households randomised, while recruitment via schools had the highest yield (57.3%) and was the most cost effective when considering cost per household randomised (AUD$147.20). Yield and cost effectiveness were lowest for media advertising.</p> <p>Conclusion</p> <p>The use of electoral roll mail-out and advertising via schools were effective in reaching households using untreated rainwater for drinking. Employing multiple strategies enabled success in achieving the recruitment target. In countries where electoral roll extracts are available to researchers, this method is likely to have a high yield for recruitment into community-based epidemiological studies.</p