Potential bias in ophthalmic pharmaceutical clinical trials

To make clinicians aware of potential sources of error in ophthalmic pharmaceutical clinical trials that can lead to erroneous interpretation of results, a critical review of the study design of various pharmaceutical ophthalmic clinical trials was completed. Discrepancies as a result of study shortcomings may explain observed differences between reported ophthalmic trial data and observed clinical results

Does progesterone treatment influence risk factors for recurrent preterm delivery?

Journal ArticleOBJECTIVE: To examine how demographic and pregnancy characteristics can affect the risk of recurrent preterm delivery and the how the effectiveness of progesterone treatment for prevention alters these relationships. METHODS: This was a secondary analysis of a randomized trial of 17alpha-hydroxyprogesterone caproate to prevent recurrent preterm delivery in women at risk. Associations of risk factors for preterm delivery (less than 37 completed weeks of gestation) were examined separately for the women in the 17alpha-hydroxyprogesterone caproate (n = 310) and placebo (n = 153) groups. RESULTS: Univariate analysis found that the number of previous preterm deliveries and whether the penultimate delivery was preterm were significant risk factors for preterm delivery in both the placebo and progesterone groups. High body mass index was protective of preterm birth in the placebo group. Multivariate analysis found progesterone treatment to cancel the risk of more than 1 previous preterm delivery, but not the risk associated with the penultimate pregnancy delivered preterm. Obesity was associated with lower risk for preterm delivery in the placebo group but not in the women treated with progesterone. CONCLUSION: The use of 17alpha-hydroxyprogesterone caproate in women with a previous preterm delivery reduces the overall risk of preterm delivery and changes the epidemiology of risk factors for recurrent preterm delivery. In particular, these data suggest that 17alpha-hydroxyprogesterone caproate reduces the risk of a history of more than 1 preterm delivery. LEVEL OF EVIDENCE: I

Redefining amaurosis fugax

Amaurosis fugax is a common term fraught with different interpretations. Disparities inunderstanding appear to be related to professional training. A new framework to facilitateinterdisciplinary communication and clinical research is presented

Model combustion-generated particulate matter containing persistent free radicals redox cycle to produce reactive oxygen species

Particulate matter (PM) is emitted during thermal decomposition of waste. During this process, aromatic compounds chemisorb to the surface of metal-oxide-containing PM, forming a surface-stabilized environmentally persistent free radical (EPFR). We hypothesized that EPFR-containing PM redox cycle to produce ROS and that this redox cycle is maintained in biological environments. To test our hypothesis, we incubated model EPFRs with the fluorescent probe dihydrorhodamine (DHR). Marked increases in DHR fluorescence were observed. Using a more specific assay, hydroxyl radicals ( •OH) were also detected, and their level was further increased by cotreatment with thiols or ascorbic acid (AA), known components of epithelial lining fluid. Next, we incubated our model EPFR in bronchoalveolar lavage fluid (BALF) or serum. Detection of EPFRs and •OH verified that PM generate ROS in biological fluids. Moreover, incubation of pulmonary epithelial cells with EPFR-containing PM increased •OH levels compared to those in PM lacking EPFRs. Finally, measurements of oxidant injury in neonatal rats exposed to EPFRs by inhalation suggested that EPFRs induce an oxidant injury within the lung lining fluid and that the lung responds by increasing antioxidant levels. In summary, our EPFR-containing PM redox cycle to produce ROS, and these ROS are maintained in biological fluids and environments. Moreover, these ROS may modulate toxic responses of PM in biological tissues such as the lung. © 2013 American Chemical Society

Risk of Uterine Rupture and Placenta Accreta With Prior Uterine Surgery Outside of the Lower Segment

Objective—Women with a prior myomectomy or prior classical cesarean delivery are often delivered early by cesarean due to concern for uterine rupture. Although theoretically at increased risk for placenta accreta, this risk has not been well quantified. Our objective was to estimate and compare the risks of uterine rupture and placenta accreta in women with prior uterine surgery. Methods—Women with prior myomectomy or prior classical cesarean delivery were compared to women with a prior low transverse cesarean to estimate rates of both uterine rupture and placenta accreta. Results—One hundred seventy-six women with a prior myomectomy, 455 with a prior classical cesarean delivery, and 13,273 women with a prior low transverse cesarean were evaluated. Mean gestational age at delivery differed by group (p0.99) or in the prior classical cesarean delivery group (0.88%, p=0.13). Placenta accreta occurred in 0% (95% CI 0-1.98%) of prior myomectomy compared with 0.19% in the low transverse cesarean group (p>0.99) and 0.88% in the prior classical cesarean delivery group (p=0.01 relative to low transverse cesarean). The adjusted OR for the prior classical cesarean delivery group (relative to low transverse cesarean) was 3.23 (1.11-9.39) for uterine rupture and 2.09 (0.69-6.33) for accreta. The frequency of accreta for those with previa was 11.1% for the prior classical cesarean delivery and 13.6% for low transverse cesarean groups (p>0.99=1.0). Conclusion—A prior myomectomy is not associated with higher risks of either uterine rupture or placenta accreta. The absolute risks of uterine rupture and accreta after prior myomectomy are low

Sexual minority experiences of cancer care : a systematic review

There is a lack of published evidence from within the UK examining the needs of LGB cancer patients. A full systematic review of the worldwide literature was carried out with the aim to ascertain the experiences of sexual minority cancer patients and identify specific needs required.Key databases were searched with a variety of terms relating to the sexual minority cancer experience. Suitable literature was reviewed and references within all articles were search to ensure as inclusive a review as possible. Articles were subject to critical appraisal and scoring using The Support Unit for Research Evidence (SURE 2013) critical appraisal tools to assess eligibility for inclusion within the review. Twenty-five articles were selected for inclusion and were analysed. The papers were categorised into the emerging themes from the literature: Experiences of care (n = 6), Coping and Wellbeing (n = 6), Emotional Support (n = 4), Body Image (n = 3), and Sexual Function (n = 6). The data extraction revealed contrasting views and experiences of LGB individuals' experience of cancer care. Lesbian and gay individuals have different perspectives of cancer care and needs from heterosexuals. Discriminatory attitudes were found to be present in many studies as well as inequalities and gaps within care and support.There is evidence that supports the development of sexual minority specific cancer support groups. Further research of sexual minorities affected by cancer in the UK should be carried out to increase the evidence base and better identify the needs in this cultural group

Search for a dark vector gauge boson decaying to π+π−\pi^+ \pi^- using η→π+π−γ\eta \rightarrow \pi^+\pi^- \gamma decays

We report a search for a dark vector gauge boson $U^\prime$ that couples to quarks in the decay chain $D^{*+} \to D^0 \pi^+, D^0 \to K^0_S \eta, \eta \to U^\prime \gamma$, $U^\prime \to \pi^+ \pi^-$. No signal is found and we set a mass-dependent limit on the baryonic fine structure constant of $10^{-3} - 10^{-2}$ in the $U^\prime$ mass range of 290 to 520 MeV/$c^2$. This analysis is based on a data sample of 976 fb$^{-1}$ collected by the Belle experiment at the KEKB asymmetric-energy $e^+e^-$ collider.Comment: 6 pages, 4 figure

Invariant-mass and fractional-energy dependence of inclusive production of di-hadrons in e+e−e^+e^- annihilation at s=\sqrt{s}= 10.58 GeV

The inclusive cross sections for di-hadrons of charged pions and kaons ($e^+e^- \rightarrow hhX$) in electron-positron annihilation are reported. They are obtained as a function of the total fractional energy and invariant mass for any di-hadron combination in the same hemisphere as defined by the thrust event-shape variable and its axis. Since same-hemisphere di-hadrons can be assumed to originate predominantly from the same initial parton, di-hadron fragmentation functions are probed. These di-hadron fragmentation functions are needed as an unpolarized baseline in order to quantitatively understand related spin-dependent measurements in other processes and to apply them to the extraction of quark transversity distribution functions in the nucleon. The di-hadron cross sections are obtained from a $655\,{\rm fb}^{-1}$ data sample collected at or near the $\Upsilon(4S)$ resonance with the Belle detector at the KEKB asymmetric-energy $e^+ e^-$ collider.Comment: 21 pages, 18 figures plus 25 figures in supplemental material, submitted to PR

Energy scan of the e+e−→hb(nP)π+π−e^+e^- \to h_b(nP)\pi^+\pi^- (n=1,2)(n=1,2) cross sections and evidence for Υ(11020)\Upsilon(11020) decays into charged bottomonium-like states

Using data collected with the Belle detector at the KEKB asymmetric-energy $e^+e^-$ collider, we measure the energy dependence of the $e^+e^- \to h_b(nP)\pi^+\pi^-$ $(n=1,2)$ cross sections from thresholds up to $11.02\,$GeV. We find clear $\Upsilon(10860)$ and $\Upsilon(11020)$ peaks with little or no continuum contribution. We study the resonant substructure of the $\Upsilon(11020) \to h_b(nP)\pi^+\pi^-$ transitions and find evidence that they proceed entirely via the intermediate isovector states $Z_b(10610)$ and $Z_b(10650)$. The relative fraction of these states is loosely constrained by the current data: the hypothesis that only $Z_b(10610)$ is produced is excluded at the level of 3.3 standard deviations, while the hypothesis that only $Z_b(10650)$ is produced is not excluded at a significant level.Comment: 8 pages, 4 figures, submitted to Physical Review Letter

Observation of D0→ρ0γD^0\to \rho^0\gamma and search for CPCP violation in radiative charm decays

We report the first observation of the radiative charm decay $D^0 \to \rho^0 \gamma$ and the first search for $CP$ violation in decays $D^0 \to \rho^0 \gamma$, $\phi\gamma$, and $\overline{K}{}^{*0} \gamma$, using a data sample of 943 fb$^{-1}$ collected with the Belle detector at the KEKB asymmetric-energy $e^+e^-$ collider. The branching fraction is measured to be $\mathcal{B}(D^0 \to \rho^0 \gamma)=(1.77 \pm 0.30 \pm 0.07) \times 10^{-5}$, where the first uncertainty is statistical and the second is systematic. The obtained $CP$ asymmetries, $\mathcal{A}_{CP}(D^0 \to \rho^0 \gamma)=+0.056 \pm 0.152 \pm 0.006$, $\mathcal{A}_{CP}(D^0 \to \phi \gamma)=-0.094 \pm 0.066 \pm 0.001$, and $\mathcal{A}_{CP}(D^0 \to \overline{K}{}^{*0} \gamma)=-0.003 \pm 0.020 \pm 0.000$, are consistent with no $CP$ violation. We also present an improved measurement of the branching fractions $\mathcal{B}(D^0 \to \phi \gamma)=(2.76 \pm 0.19 \pm 0.10) \times 10^{-5}$ and $\mathcal{B}(D^0 \to \overline{K}{}^{*0} \gamma)=(4.66 \pm 0.21 \pm 0.21) \times 10^{-4}$