Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

The Efficacy of Fampridine on Upper Extremity Functions in Individuals with Multiple Sclerosis: Is There a Difference between Cerebellar and Pyramidal Dysfunction?

Objective: Similar to its positive effect on the lower extremities, fampridine can also affect upper extremity dysfunction. This study evaluated thepotential effect of fampridine therapy on upper extremity functions in patients with multiple sclerosis (pwMS) by comparing these on the basis ofcerebellar and pyramidal dysfunctions.Materials and Methods: Patients aged between 18 and 60 years with a diagnosis of multiple sclerosis and eligible for fampridine therapy due towalking difficulties were followed-up. Of these, patients with problems such as lack of coordination in hand functions or deficiencies in fine motorskills, dressing, writing, and/or buttoning were invited to take part in the study. Upper extremity functions were evaluated using the 9-Hole Peg Test(9-HPT), and general disability was evaluated with the Expanded Disability Status Scale.Results: One hundred fifty-nine patients were followed-up for 12 months, and 151of them were included in the analysis. Seventy-seven (50women) healthy controls (HCs) were also included. There was no statistically significant difference between the demographic characteristics ofthe two groups. A 19.8% improvement was observed in 9-HPT scores after one month of treatment (p=0.004). This improvement was observedto persist at the 24th month. Patients with a cerebellar FS score of 0 to 2 (n=76) improved significantly more (p&lt;0.001) than those (23.5%) with acerebellar FS score of 3 or higher (9.2%).Conclusion: The results of this study show that fampridine improves upper extremity functions in pwMS. This improvement was more pronouncedin the group with cerebellar dysfunction.Keywords: Multiple sclerosis, fampridine, upper extremity, disability level&nbsp;</p

The Impact of Pulp Temperature on the Flotation Performance of Copper-Lead-Zinc Sulphide Ore

Flotation performance can significantly be affected by seasonal variations due to the changes in water temperature and pulp temperature, type and concentration of dissolved ions in process water. Extreme temperature conditions could be the major factor affecting flotation performance and mask the influence of water chemistry. Therefore, the interactive effects of the temperature and water chemistry should be taken into consideration, particularly for mine sites experiencing extreme temperature conditions. In this paper, effects of temperature, sulphate (SO42−), thiosulphate (S2O32−) and calcium (Ca2+) ions on the flotation performance of a Cu-Pb-Zn complex sulfide ore were investigated using a statistical experimental design and modelling approach. The results were evaluated using ANOVA and regression analysis to determine the significant parameters and derive individual regression models for each flotation response using Design Expert software version 6.0.8. Individual regression models were developed for mass pull, water recovery, grade and recovery of the sulfide minerals using the statistically significant main effects and their interactions. The models were used to determine the concentration of the dissolved ions and pulp temperature required to achieve the maximum zinc recovery, maximum zinc grade or the optimum zinc grade and recovery. The results showed that the water chemistry (i.e., the concentrations of Ca2+, SO42− and S2O32−) affected the flotation performance significantly at low temperature (25 °C). At high pulp temperature (60 °C), however, the temperature was the dominant parameter and masked the effects of water chemistry. Details of the statistical experimental design, discussions of the effects of experimental factors and their interactions on flotation performance, and the development of regression models are presented in this paper

The effectiveness of a pictorial asthma action plan for improving asthma control and the quality of life in illiterate women

Background: Written asthma action plans are an important part of asthma management, but cannot be used for illiterate people. Objective: The aim of this study was to establish the effectiveness of a pictorial asthma action plan on asthma control, health-related quality of life (HRQoL), and asthma morbidity in a population of illiterate women with asthma. Methods: Forty illiterate women with moderate-severe persistent asthma were assigned alternatively to receive either asthma education alone (control group) or asthma education and a pictorial asthma action plan (study group). Asthma control was assessed using the asthma control test (ACT), HRQoL was assessed using the St George's Respiratory Questionnaire (SGRQ), and the frequency of non-scheduled hospital or emergency visits was monitored. Results: Thirty-four patients completed the study. The ACT and SGRQ scores of both groups improved at every follow-up time point compared with baseline (p < 0.001). The ACT scores at 1 month (22.44 versus 20.75, p = 0.034) and 2 months (23.28 versus 21.81, p = 0.010) were higher in the study group than in the control group, but this was not maintained at 6 months (24.00 versus 23.25, p = 0.069). The SGRQ scores at 6 months were better in the study group (18.12) than in the control group (23.96, p = 0.033). No hospital admissions were recorded for either group. Conclusion: Education provides a significant improvement in asthma control and HRQoL while managing illiterate asthma patients, additionally the pictorial asthma action plan can be a helpful tool for self-medication

Laser-assisted laterally positioned flap operation: A randomized controlled clinical trial

The purpose of this randomized, controlled clinical trial was to compare the effectiveness of a new treatment approach, which consisted of laterally positioned flap (LPF) procedure combined with an external vestibular releasing incision made by a diode laser (LALPF) to LPF alone for the treatment of isolated gingival recession defects.status: publishe

The Effects of Academic Motivations of Secondary School Students on Their Attitudes Towards the Chemistry Course

This study aimed to analyze the effect of secondary school students' academic motivations on their attitudes towards the chemistry course. The sampling consisted of Grade 9, 10, 11 and 12 students studying at the secondary schools in Ankara. The data were collected through the "Academic Motivation Scale" developed by Bozanoglu (2004) and "The Scale of Attitudes towards Chemistry" developed by Kan & Akbas (2005). The Crobach alpha reliability coefficient of the Academic Motivation Scale was found to be 0.88 and the reliability coefficient value for The Scale of Attitudes towards Chemistry was 0.92. (C) 2012 Published by Elsevier Ltd. Selection and/or peer review under responsibility of Prof. Dr. Huseyin UzunboyluWo

Yumurtacı japon bıldırcınlarında diyete ilave edilen zeytin yaprağı özütü ve zarlı yumurta kabuğunun performans, yumurta kalitesi, kan biyokimyasal ve kemik parametreleri üzerine etkileri

This study was conducted to determine the effects of dietary supplementation of olive leaf extract (OLE), eggshell with the membrane (ESM), and the ESM that absorbed the OLE (OLE+ESM) on the performance, egg quality, biochemical, and bone parameters in laying Japanese quail. A total of 112 quail, being 45-day-old, were divided into 4 groups with 4 replicates. The quail were fed with four diets: i) basal diet ii) basal diet supplemented with 400 ppm OLE iii) basal diet supplemented with 2% ESM, and iv) basal diet supplemented with 2% ESM that absorbed with 400 ppm OLE. Egg weight was observed to be higher in the OLE group (P0.05). There was no statistical difference in tibia bone parameters (P>0.05). The lowest concentration of serum lactate dehydrogenase (LDH) was observed in control group (P<0.01). Serum uric acid level decreased in ESM group (P<0.01). OLE supplementation had limited impacts on quail nutrition. Consequently, while the individual usage of OLE and ESM did not show remarkable effects, the mixture of OLE and ESM has been found to positively affect the egg quality and performance parameters

A novel computer-based method for measuring the acetabular angle on hip radiographs

Objective: The aim of this study was to propose a new computer based method for measuring acetabular angles on hip radiographs and to assess its practicality, sensitivity and reliability for acetabular angle measurement. Methods: A total of 314 acetabulum were assessed on 157 pelvic X-ray images. Acetabular angles were measured with both the conventional method (Method 1) and our proposed method (Method 2). All the Acetabular Index (AI) angle, Acetabular Angle (AA) and Acetabular Center (ACM) angle were measured with both methods. Results: The mean AI angle for Method 1 is 11.02 degrees +/- 2.7 degrees and the mean AI angle for Method 2 is 10.08 degrees +/- 1.88 degrees, the mean AA angle for Method 1 is 39.5 degrees +/- 5.3 degrees and the mean AA angle for Method 2 is 39.36 degrees +/- 4.68 degrees, the mean ACM angle for Method 1 is 50.5 degrees +/- 6.01 degrees and the mean ACM angle for Method 2 is 55.42 degrees +/- 12.43 degrees. Conclusion: Our novel automated method appear to be reliable and practical for acetabular angle measurement on hip radiographs. (C) 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V