Comparison of the candesartan cilexetil and angiotensin-converting enzyme inhibitor therapy in mild to moderate hypertension

peer reviewe

Evaluation of the GERD Impact Scale, an international, validated patient questionnaire, in daily practice. Results of the ALEGRIA study.

BACKGROUND AND STUDY AIMS: Gastroesophageal reflux disease (GERD) is a common chronic disease that is primarily diagnosed based on symptom severity and frequency. This study gathered epidemiological data in a population of GERD patients and evaluated the added-value of the GERD Impact Scale (GIS), a novel, validated patient questionnaire, as a tool for initial and long-term patient management. PATIENTS AND METHODS: This observational study recruited patients (296 study centers) with symptomatic GERD and a history of erosive, or reflux, esophagitis. Symptoms were assessed by GIS and physician-subject interview and recorded at baseline (visit 1), at 4-6 weeks (visit 2) and 8-14 weeks (visit 3); also recorded at each visit was the physician's assessment of GERD severity and treatment changes. Analyses were performed on an intent-to-treat basis. RESULTS: Subjects (n = 1919; mean age, 55 years) were 54% female. Lifestyle characteristics included stress (approximately 70% of subjects), mean daily consumption of five cups of caffeine-containing beverages (approximately 70%), alcohol consumption of approximately nine units per week (approximately 50%) and smoking/ex-smoker (41%). Proton pump inhibitors were prescribed in 99% of cases: mainly esomeprazole (82%), with a median dose of 40 mg. Prescribed therapy was changed (mainly dosage levels) between visits in approximately 60% of subjects. The severity of GERD symptoms and GIS scores decreased substantially throughout the study. Mean GIS scores correlated positively with increasing GERD severity and clinical judgment at all visits. Physicians reported that the GIS helped them define the appropriate treatment for the patient and to evaluate the patient's response to treatment in 81% of cases. CONCLUSIONS: This study demonstrates the added-value and usefulness of the patient self-assessment GIS as a management tool for GERD

Technology adds new principles to persuasive psychology: Evidence from health education

Computer-technology has led to the use of new principles of persuasion. These new principles constitute the unique working mechanisms of persuasion by means of computer. In the present study, three tailored messages that each contained one potential working mechanism - personalization, adaptation or feedback - were compared with a standard information condition. Two hundred and two students who smoked tobacco daily were randomly divided over four conditions. After the computer pre-test questionnaire, they read the information in their condition and filled in the immediate post-test. After 4 months, they were sent a follow-up questionnaire assessing their quitting activity. The data show that personalization (44.5%) and feedback (48.7%) but not adaptation (28.6%) led to significantly more quitting activity after 4 months than did the standard information (22.9%). Moreover, the effect of condition on quitting activity was mediated by individuals' evaluations of the extent to which the information took into account personal characteristics

Accuracy of scleral transillumination techniques to identify infant ciliary body for sclerostomy and intravitreal injections

Importance: There is variation in the literature for sclerotomy and intravitreal injection placement in young children, ranging from 0.5 to 3.0 mm from the limbus. We assess the accuracy of scleral transillumination to identify the ciliary body in infants for safe sclerotomy and intravitreal injections in young children. Background: The study compares the perilimbal “dark band” seen on scleral transillumination (STI) with the ultrasound biomicroscopy (UBM), and compares these measurements with the current guidelines for sclerotomy in infants. Design: Prospective case series in a tertiary paediatric hospital. Participants: Children aged ≤36 months undergoing general anaesthesia for eye procedures. Methods: Scleral transillumination was performed to measure the perilimbal dark band. UBM of the ciliary body region was then performed, and correlated with transillumination findings. Main Outcome Measures: The midpoints of STI and UBM were compared to current cadaver-based guidelines to assess the safe point for sclerotomy. Results: Twenty children were recruited, 36 STI and 35 UBM measurements were obtained. The posterior edge of the dark band had good correlation with the posterior border of the ciliary body. Transillumination and UBM correlated well for midpoint measurements. The midpoint of the dark band on transillumination was confirmed to be in the ciliary body by UBM in all cases. Conclusions and Relevance: The STI technique is a useful and fast technique to demonstrate the ciliary body. The midpoint of the dark band on STI correlates well with the UBM, and has a potential use for confirming safe-entry into the posterior segment if using current guidelines. The current cadaver-based paediatric guidelines safely avoid retinal injury