A randomized double-blind clinical trial of the effect of non-absorbable oral polymyxin on infants with severe infectious diarrhea

The present study evaluated the effect of non-absorbable oral polymyxin on the duodenal microflora and clinical outcome of infants with severe infectious diarrhea. Polymyxin was chosen because classic enteropathogenic Escherichia coli was more sensitive to this antibiotic. Twenty-five infants were randomly assigned to a 7-day treatment with oral polymyxin (2.5 mg/kg in 4 daily doses) or placebo. Duodenal and stool cultures were performed before and after the treatment. Five patients were excluded during the study because of introduction of parental antibiotic therapy due to clinical sepsis (N = 3) or rapid clinical improvement (N = 2). In the polymyxin group, small bowel bacterial overgrowth occurred in 61.5% of the cases (8/13) before treatment and in 76.9% (10/13) after treatment. In the placebo group these values were 71.4% (5/7) and 57.1% (4/7), respectively. By the 7th day, clinical cure was observed in 84.6% of the cases (11/13) in the polymyxin group and in 71.4% (5/7) in the placebo group (P = 0.587). Considering all 25 patients included in the study, clinical cure occurred on the 7th day in 12/14 cases (85.7%) in the polymyxin group and 6/11 cases (54.5%) in the placebo group (P = 0.102). Clinical sepsis occurred in 3/11 (27.3%) of the patients in the placebo group and in none (0/14) in the polymyxin group (P = 0.071). Oral polymyxin was not effective in reducing bacterial overgrowth or in improving the clinical outcome of infants hospitalized with severe infectious diarrhea. Taking into account the small sample size, the rate of cure on the 7th day and the rate of clinical sepsis, further studies with greater number of patients are necessary to evaluate these questions

A randomized, open-label study of conjugated equine estrogens plus medroxyprogesterone acetate versus tibolone: effects on symptom control, bleeding pattern, lipid profile and tolerability

Objective To compare the effects of continuous combined conjugated equine estrogens plus medroxyprogesterone acetate (CEE/MPA) with those of tibolone on symptom control, bleeding pattern, lipid profile and tolerability in postmenopausal women.Methods This was a randomized, open-label, parallel-group, multicenter study. Generally healthy postmenopausal women with an intact uterus and no contraindications to hormone replacement therapy (HRT) or tibolone were enrolled. Each subject was randomly assigned to receive CEE/MPA 0.625 mg-5.0 mg or tibolone 2.5 mg daily for 13 treatment cycles, each of 28 days.Results A total of 85 subjects were enrolled and received at least one dose of study medication, of which 76 (89.4%) subjects completed the study (n = 40, CEE/MPA; n = 363 tibolone). the incidence of postmenopausal symptoms decreased significantly over time in both treatment groups, compared with baseline, including significant decreases in the incidence of urogenital and sexual health symptoms. Significant differences in symptom control (other than hot flushes) were observed between treatment groups in a few different cycles for different symptoms, but no consistent or clinically significant trends were observed. No statistically significant differences in the incidence of bleeding were observed between treatment groups after cycle 4. Significant decreases in total cholesterol (5.6%) and low-density lipoprotein (LDL) cholesterol (7.5%) were observed at cycle 13, compared with baseline, in the CEE/MPA group, and significant decreases in high-density lipoprotein (HDL) cholesterol (8.5%) and triglycerides (13.7%) were observed at cycle 13, compared with baseline, in the tibolone group. Significant weight gain was observed at cycle 13 in the. tibolone group (3.05 kg), compared with the CEE/MPA group (0.96 kg). the incidences of adverse events were similar in both treatment groups.Conclusions Women treated with CEE/MPA or tibolone showed significant improvement of postmenopausal symptoms, including urogenital and sexual health symptoms, and had similar bleeding patterns after four cycles of therapy. CEE/MPA and tibolone each induced a different mix of changes in the lipid profile.Universidade Federal de São Paulo, BR-04024002 São Paulo, BrazilUniv Fed Bahia, BR-41170290 Salvador, BA, BrazilUniv Fed Rio de Janeiro, BR-21945 Rio de Janeiro, BrazilFac Med Sci Minas Gerais, Belo Horizonte, MG, BrazilPontifical Catholic Univ, Sorocaba, BrazilUniv Fed Rio Grande Norte, BR-59072970 Natal, RN, BrazilUniv Fed Paraiba, BR-58059900 Joao Pessoa, Paraiba, BrazilSanta Casa Misericordia, São Paulo, BrazilUniversidade Federal de São Paulo, EPM, BR-04024002 São Paulo, BrazilWeb of Scienc

Brief of Amici Curiae Privacy and First Amendment Law Professors in Support of Defendant-Appellant and Reversal

STATEMENT OF INTEREST: Amici curiae are law professors and scholars of data privacy, constitutional law, and the First Amendment. Amici write to provide the court with scholarly expertise on the complexities of data privacy law and its intersection with the First Amendment. Amici have collectively written scores of academic articles and multiple books on data privacy, technology, the First Amendment, and constitutional challenges to state and federal privacy regulation. Amici submit this brief pursuant to Fed. Rule App. P. 29(a) and do not repeat arguments made by the parties. No party’s counsel authored this brief, or any part of it. No party’s counsel contributed money to fund any part of the preparation or filing of this brief. Amici file this brief with the consent of the partie

Premature ovarian failure: morphological and ultrastructural aspects

The authors documented by means of light and transmission electron microscopy that the ovaries of women with premature ovarian failure (POF) displayed dense connective tissue and rare corpora albicantia. Eight of the ten studied cases did not present ovarian follicles; in two cases, it was verified the presence of ovarian follicles, atypical primordial follicles and in one case, a corpus luteum was identified (after stimulation with exogenous gonadotrophin). Regarding the ultrastructural analysis, it was noted that the fibroblasts were united one to each other by cellular prolongations that formed a woof, constituting a cellular syncicius.Os autores analisaram, através de microscopia de luz e de microscopia eletrônica de transmissão, os ovários de mulheres com insuficiência ovariana prematura. Observaram que são constituídos por tecido conjuntivo denso e raros corpos albicantes. Oito dos 10 casos não apresentavam folículos primordiais; em um caso verificou-se a presença de folículos ovarianos atípicos e, em outro, identificou-se corpo lúteo (após estimulação com gonadotrofina exógena). A ultra-estrutura, verificou-se que os fibroblastos achavam-se unidos uns aos outros através de prolongamentos celulares, formando um sincício celular.Escola Paulista de Medicina Department of Obstetrics and GynecologyEscola Paulista de Medicina Department of MorphologyUNIFESP, EPM, Department of Obstetrics and GynecologyEscola Paulista de Medicina Department of MorphologySciEL