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Prisoners' oral health and general health are closely connected and generally poorer than that of the wider population. Moreover, knowledge of prisoners' health literacy is scarce. This study aimed to explore prisoners' perceived oral and general health and how they accessed, understood and assessed health information to gain insight into their health literacy. Twelve prisoners in a high-security prison and a halfway house participated in individual semi-structured interviews. Data was analysed through thematic analysis, which identified five themes: inconsistent self-reporting of general and oral health; autonomous health behaviour through utilizing personal resources; preference for personalized adapted health information; psychological and physical proximity; and barriers. The prisoners perceived their oral and general health as good despite several health problems. They expressed scepticism towards health information from public authorities and made their own health-related choices based on previous experiences, their own 'common sense' and the experiences of people they trusted. Health information was considered useful when adjusted to their needs. Obtaining health-related information through physical encounters was considered more accessible than through online platforms. Adapting the communication to prisoners' expressed needs and their health literacy can enhance the accessibility to improve their oral and general health. In-person encounters would be preferable.
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Prisioneros , Prisiones , Humanos , Prisioneros/psicología , Investigación Cualitativa , Confianza , Estado de SaludRESUMEN
BACKGROUND: The concept of minimal intervention dentistry (MID) includes both delayed restorative treatment and conservative caries removal, and is now recognised as an evidence-based approach for dental caries management. In order to determine if dental professionals in Russia are incorporating this concept into their clinical practice, we investigated the restorative treatment decisions of Russian dentists and dental students, and the factors associated with these decisions. METHODS: We included 171 general dental practitioners and dental therapists (collectively referred to here as "dentists") from North-West Russia, and 76 dental undergraduate students from the Northern State Medical University in Arkhangelsk (response rate of 11.5% and 67.9%, respectively). Participants completed a questionnaire, which collected background information (sex, region of work, place of dental school graduation, practice type, years of working experience, working in an urban or rural area, and specialisation in restorative dentistry) and information on restorative treatment decisions for proximal and occlusal carious lesions of permanent teeth. Treatment options in accordance with MID were defined as intervention at dentin level and minimally invasive cavity preparation. Multinomial logistic regression was used for statistical analysis. RESULTS: For the proximal carious lesion, 9.4% of participants said they would employ both MID treatment options; 60.7% said they would choose only one; and 29.9% said they would use neither option. For the occlusal carious lesion, the corresponding figures were 37.2%, 52.1%, and 10.7%. No differences in restorative treatment options were observed among general dental practitioners, dental therapists, and dental students. For the proximal carious lesion, dentists from regions outside Arkhangelsk had 4.15 (95% confidence interval [CI] 1.13-15.27) times higher odds of following one versus both MID treatment options. For the occlusal carious lesion, working experience above 15 years was associated with higher odds of using only one versus both MID treatment options (adjusted odds ratio = 3.04, 95% CI 1.33-6.91). Almost all respondents preferred tooth-coloured materials for restorations; more than 75% chose resin-based composite. CONCLUSIONS: The majority of Russian dentists and dental students do not apply the MID concept when treating dental caries in permanent teeth. Clinical protocols on dental caries treatment and dental school curriculums should be updated to place an enhanced focus on evidence-based practice and preventive strategies. Further studies with larger samples of Russian dentists and dental students and alternative methods of recruitment are needed to validate our results.
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Caries Dental , Caries Dental/terapia , Restauración Dental Permanente , Dentina , Odontólogos , Humanos , Pautas de la Práctica en Odontología , Rol Profesional , Estudiantes de OdontologíaRESUMEN
OBJECTIVE: To develop and validate an interview instrument to assess oral health literacy in Norwegian adult dental patients. MATERIALS AND METHODS: The instrument, Adult Health Literacy Instrument for Dentistry (AHLID), was based on an OECD instrument used to assess general literacy in adults. One hundred and thirty Norwegian adults (mean age = 48 years; 57% women) participated. AHLID included a selection of oral health-related printed texts that ranged from 1-5 with respect to difficulty. A questionnaire regarding socio-demographic variables and knowledge of risk factors for oral disease was used. DMFT, stimulated salivary flow rate and streptococcus mutans and lactobacillus in saliva was also examined. RESULTS: The Cronbach's alpha values of AHLID were 0.98 for internal consistency reliability (p < 0.01) and 0.81 for test-re-test reliability (p < 0.05). AHLID score 3 was most frequent while very few fulfilled the criteria for score 1 and 5. Linear multiple regression analysis showed that lactobacillus in saliva and knowledge of risk factors for periodontitis and caries were predictor variables of AHLID score. CONCLUSIONS: AHLID appears to be reliable and valid to assess oral health literacy in Norwegian adults and suggests a method for country-specific health literacy instruments.
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Alfabetización en Salud/estadística & datos numéricos , Salud Bucal/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Carga Bacteriana , Comprensión , Índice CPO , Caries Dental/etiología , Conducta Alimentaria , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Lactobacillus/aislamiento & purificación , Masculino , Persona de Mediana Edad , Noruega , Higiene Bucal , Periodontitis/etiología , Reproducibilidad de los Resultados , Factores de Riesgo , Saliva/metabolismo , Saliva/microbiología , Tasa de Secreción/fisiología , Fumar , Streptococcus mutans/aislamiento & purificación , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Treatments for papulopustular rosacea (PPR) are limited. OBJECTIVE: To demonstrate the efficacy and safety of once-daily ivermectin 1% cream in subjects with moderate to severe PPR. METHODS: Two identically designed, randomized, double-blind, controlled studies of ivermectin 1% cream (IVM 1%) or vehicle once daily for 12 weeks were conducted in subjects with moderate to severe PPR. Efficacy assessments were Investigator's Global Assessment (IGA) of disease severity and inflammatory lesion counts. Safety assessments included incidence of adverse events (AEs) and local tolerance parameters. Subjects evaluated their rosacea and completed satisfaction and quality of life (QoL) questionnaires. RESULTS: In both studies, a greater proportion of subjects in the IVM 1% group achieved treatment success (IGA "clear" or "almost clear"): 38.4% and 40.1% vs 11.6% and 18.8% for vehicle (both P<.001), respectively. Ivermectin was superior to vehicle in terms of reduction from baseline in inflammatory lesion counts (76.0% and 75.0% vs 50.0% for both vehicle groups, respectively). For all endpoints, starting at week 4 and continuing through week 12, IVM 1% was statistically significantly superior (P<.001). Fewer subjects treated by IVM 1% reported dermatologic AEs, and a higher proportion of subjects were observed to have no skin dryness or itching compared to vehicle. Significantly more subjects receiving IVM 1% reported having an "excellent" or "good" improvement, along with an improved QoL. CONCLUSION: Ivermectin 1% cream was effective and safe in treating inflammatory lesions of papulopustular rosacea.
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Fármacos Dermatológicos/uso terapéutico , Ivermectina/uso terapéutico , Calidad de Vida , Rosácea/tratamiento farmacológico , Administración Cutánea , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/efectos adversos , Método Doble Ciego , Femenino , Humanos , Ivermectina/administración & dosificación , Ivermectina/efectos adversos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Rosácea/patología , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Resultado del Tratamiento , Adulto JovenRESUMEN
IMPORTANCE: Carbapenem-resistant Enterobacteriaceae (CRE) producing the New Delhi metallo-ß-lactamase (NDM) are rare in the United States, but have the potential to add to the increasing CRE burden. Previous NDM-producing CRE clusters have been attributed to person-to-person transmission in health care facilities. OBJECTIVE: To identify a source for, and interrupt transmission of, NDM-producing CRE in a northeastern Illinois hospital. DESIGN, SETTING, AND PARTICIPANTS: Outbreak investigation among 39 case patients at a tertiary care hospital in northeastern Illinois, including a case-control study, infection control assessment, and collection of environmental and device cultures; patient and environmental isolate relatedness was evaluated with pulsed-field gel electrophoresis (PFGE). Following identification of a likely source, targeted patient notification and CRE screening cultures were performed. MAIN OUTCOMES AND MEASURES: Association between exposure and acquisition of NDM-producing CRE; results of environmental cultures and organism typing. RESULTS: In total, 39 case patients were identified from January 2013 through December 2013, 35 with duodenoscope exposure in 1 hospital. No lapses in duodenoscope reprocessing were identified; however, NDM-producing Escherichia coli was recovered from a reprocessed duodenoscope and shared more than 92% similarity to all case patient isolates by PFGE. Based on the case-control study, case patients had significantly higher odds of being exposed to a duodenoscope (odds ratio [OR], 78 [95% CI, 6.0-1008], P < .001). After the hospital changed its reprocessing procedure from automated high-level disinfection with ortho-phthalaldehyde to gas sterilization with ethylene oxide, no additional case patients were identified. CONCLUSIONS AND RELEVANCE: In this investigation, exposure to duodenoscopes with bacterial contamination was associated with apparent transmission of NDM-producing E coli among patients at 1 hospital. Bacterial contamination of duodenoscopes appeared to persist despite the absence of recognized reprocessing lapses. Facilities should be aware of the potential for transmission of bacteria including antimicrobial-resistant organisms via this route and should conduct regular reviews of their duodenoscope reprocessing procedures to ensure optimal manual cleaning and disinfection.
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Carbapenémicos/farmacología , Desinfección/métodos , Duodenoscopios/microbiología , Infecciones por Enterobacteriaceae/etiología , Contaminación de Equipos , Escherichia coli , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Estudios de Cohortes , Infección Hospitalaria/epidemiología , Brotes de Enfermedades , Farmacorresistencia Bacteriana , Infecciones por Enterobacteriaceae/epidemiología , Escherichia coli/enzimología , Escherichia coli/aislamiento & purificación , Femenino , Hospitales , Humanos , Illinois/epidemiología , Masculino , Persona de Mediana Edad , beta-LactamasasRESUMEN
Objective: This study aimed to quantitatively investigate the accumulation of Streptococcus mutans biofilm on enamel and root surfaces and assess the amount of biofilm removal using (1) experimental toothpaste and (2) water, in a closed system of flow chamber. Methods: Eight sound premolars were embedded in epoxy resin and polished with silicon carbide grinding papers to display enamel and root surfaces. To mimic biofilm, cultures of Streptococcus mutans were prepared and grown on the tooth surfaces over night before they were exposed to either 2 liters of Milli Q water or 2 liters of 40% experimental toothpaste in the flow chamber. The amount of biofilm was measured and quantified in Fluorescence microscopy. Mean fluorescence values were recorded and analysed using Microsoft® Excel® (MS Excel 2016). Results: The ability to grow biofilm was equally present at both the enamel and root surfaces. The use of water and 40% experimental toothpaste showed a significant reduction of areas covered with biofilm on both enamel and root dentin in comparison to untreated surfaces (p < 0.01). Significantly more biofilm was removed from enamel compared to root surfaces when treated with either water and toothpaste (p < 0.01). Slightly less biofilm was removed by the use of water compared to toothpaste on both enamel and root dentin surfaces, although the differences were not statistically significant. Conclusion: The results indicate that less biofilm is removed from the root surfaces than enamel by the use of water and 40% experimental toothpaste in flow chamber. Assessing oral biofilm accumulation and monitoring biofilm formation on enamel and root dentin surfaces give oral health professionals important directions that could strenghten the significance of dental caries prevention. Improving older individuals' oral hygiene practices should therefore be considered an important measure to prevent root caries.
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BACKGROUND: Moderate to severe acne vulgaris is often treated with a combination of an oral antibiotic, topical antibiotic/retinoid, and benzoyl peroxide (BP), but data are limited on the efficacy of this and other combination regimens that incorporate both oral and topical therapies.
METHODS: Patients were required to be aged 12-30 years with moderate to severe acne (grades 3-4 acne on the Investigator's Global Assessment [IGA]) and deemed potential candidates for treatment with isotretinoin. Enrolled patients were given triple-combination therapy, defined in this study as oral minocycline HCl extended release 1 mg/kg QD, 6% BP foaming cloths used QD, and clindamycin phosphate 1.2%/tretinoin 0.025% gel applied QD, and were evaluated at baseline and weeks 2, 4, 8, and 12.
RESULTS: A total of 97 patients were enrolled in the study. At week 12, 89% of patients had at least a one-grade improvement from baseline IGA and 96% had at least a one-grade improvement from baseline Global Aesthetic Improvement Scale score. Mean ± SD in- flammatory, non-inflammatory, and total lesion counts decreased from baseline by 61.8% ± 38.3%, 48.8% ± 34.5%, and 56.5% ± 29.9%, respectively. The percentage of patients evaluated as candidates for isotretinoin by independent photographic review was 77% (69/90) at baseline and only 16% (14/90) at week 12. Treatment-related adverse events (AEs) occurred in eight of 97 (8%) patients. Triplecombination therapy was not associated with any serious AEs or AEs leading to discontinuation.
CONCLUSION: Triple-combination therapy was well tolerated and substantially reduced facial acne lesion counts, with 84% of patients judged to no longer be candidates for isotretinoin therapy by study end. These data support the clinical observation that a triple-combination regimen incorporating oral minocycline (dosed by patient weight), BP foaming cloths 6% QD, and clindamycin phosphate 1.2%/ tretinoin 0.025% gel QD can substantially improve moderate to severe acne vulgaris.
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Acné Vulgar/tratamiento farmacológico , Fármacos Dermatológicos/uso terapéutico , Acné Vulgar/patología , Administración Cutánea , Administración Oral , Adolescente , Adulto , Antibacterianos/administración & dosificación , Antibacterianos/efectos adversos , Antibacterianos/uso terapéutico , Peróxido de Benzoílo/administración & dosificación , Peróxido de Benzoílo/efectos adversos , Peróxido de Benzoílo/uso terapéutico , Niño , Clindamicina/administración & dosificación , Clindamicina/efectos adversos , Clindamicina/uso terapéutico , Preparaciones de Acción Retardada , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/efectos adversos , Combinación de Medicamentos , Quimioterapia Combinada , Femenino , Geles , Humanos , Inflamación/tratamiento farmacológico , Inflamación/patología , Masculino , Minociclina/administración & dosificación , Minociclina/efectos adversos , Minociclina/uso terapéutico , Índice de Severidad de la Enfermedad , Comprimidos , Resultado del Tratamiento , Tretinoina/administración & dosificación , Tretinoina/efectos adversos , Tretinoina/uso terapéutico , Adulto JovenRESUMEN
The discovery and optimisation of a series of zwitterionic CCR3 antagonists is described. Optimisation of the structure led to AZ12436092, a compound with excellent selectivity over activity at hERG and outstanding pharmacokinetics in preclinical species.
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Descubrimiento de Drogas , Piperidinas/química , Piperidinas/farmacocinética , Receptores CCR3/antagonistas & inhibidores , Animales , Humanos , Concentración 50 Inhibidora , Estructura Molecular , RatasRESUMEN
We describe the discovery of small molecule benzazepine derivatives as agonists of human peroxisome proliferator-activated receptor δ (PPARδ) that displayed excellent selectivity over the PPARα and PPARγ subtypes. Compound 8 displayed good PK in the rat and efficacy in upregulation of pyruvate dehydrogenase kinase, isozyme 4 (PDK4) mRNA in human primary myotubes, a biomarker for increased fatty acid oxidation.
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Anilidas/síntesis química , Benzazepinas/química , PPAR delta/agonistas , Anilidas/química , Anilidas/farmacocinética , Animales , Benzazepinas/síntesis química , Benzazepinas/farmacocinética , Sitios de Unión , Simulación por Computador , Hepatocitos/metabolismo , Humanos , Microsomas Hepáticos/metabolismo , PPAR alfa/agonistas , PPAR alfa/metabolismo , PPAR delta/metabolismo , PPAR gamma/agonistas , PPAR gamma/metabolismo , Proteínas Serina-Treonina Quinasas/genética , Proteínas Serina-Treonina Quinasas/metabolismo , Piruvato Deshidrogenasa Quinasa Acetil-Transferidora , Ratas , Regulación hacia ArribaRESUMEN
Small molecule isoindoline and tetrahydroisoquinoline derivatives have been identified as selective agonists of human peroxisome proliferator-activated receptor δ (PPARδ. Compound 18 demonstrated efficacy in a biomarker for increased fatty acid oxidation, with upregulation of pyruvate dehydrogenase kinase, isozyme 4 (PDK4) in human primary myotubes.
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Indoles/química , PPAR delta/agonistas , Tetrahidroisoquinolinas/química , Sitios de Unión , Dominio Catalítico , Simulación por Computador , Humanos , Indoles/síntesis química , Indoles/farmacología , PPAR delta/metabolismo , Proteínas Serina-Treonina Quinasas/genética , Proteínas Serina-Treonina Quinasas/metabolismo , Piruvato Deshidrogenasa Quinasa Acetil-Transferidora , Relación Estructura-Actividad , Tetrahidroisoquinolinas/síntesis química , Tetrahidroisoquinolinas/farmacologíaRESUMEN
PURPOSE: Allergic rhinitis (AR) affects ~20% of the population worldwide. The objectives of this study were to evaluate the safety and efficacy of iodixanol nasal solution (Nasapaque) for AR treatment, using the Allergen BioCube® (ABC®), an environmental exposure unit. Iodixanol is a commonly used contrast media agent that shows efficacy on the signs and symptoms of AR. PATIENTS AND METHODS: Seventy-three adult subjects with AR were randomized to iodixanol or placebo treatment in a double-masked efficacy and safety study conducted outside of ragweed pollen season. In-office treatment was administered after BioCube® ragweed pollen exposure, and again 8 days later prior to ragweed exposure. Nasal and ocular efficacy and safety assessments were conducted before and after treatment. RESULTS: Iodixanol treatment resulted in statistically significantly lower total nasal symptom scores as compared to placebo at several time points post-treatment and ABC exposure. Individual nasal and ocular symptoms, notably nasal itching and ocular itching, showed evidence of lower scores in the iodixanol group. Peak nasal inspiratory flow (PNIF) improved (9%-16%) with iodixanol from baseline as compared to PNIF in the placebo group which ranged from 3% worsening to improvement of 2%. Few (9) adverse events occurred. CONCLUSION: Iodixanol nasal solution demonstrated efficacy for relief of several nasal and ocular allergic rhinoconjunctivitis signs and symptoms, and was safe and well tolerated in this early Phase II exploratory trial. Further studies with iodixanol are warranted. Allergy challenge models such as the ABC provide valuable assessments of allergen exposures and drug efficacies. STUDY IDENTIFICATION NUMBER: NCT02377895.
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BACKGROUND: One position in integrated delivery networks (IDNs) that provides centralized oversight to optimize patient safety is the corporate-level infection prevention (IP) director. After noting variability in their roles, responsibilities, and IP programs, a national network of IDN IP directors planned a member survey to better understand common and variable elements. Nine network members volunteered to design a survey to describe the current role, responsibilities, and resourcing of all members of the corporate IP director group. METHODS: A 17-question survey was designed using the Survey Monkey multiple-choice format with a comment option. The questions were reviewed by the entire network to ensure content validity. The survey was delivered to all 72 network members by e-mail, and a 44% response rate was achieved. RESULTS: Survey responses revealed variation and commonalities relative to role structure, responsibilities, resourcing, and level of physician support for corporate IP directors. In addition, advantages of the position were described. CONCLUSIONS: The results of the survey will serve as a foundation on which to build, supporting standardization and reliable design for the role, responsibilities, and resourcing of corporate IP directors, with the ultimate goal of improving patient safety.
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Infección Hospitalaria/prevención & control , Transmisión de Enfermedad Infecciosa/prevención & control , Control de Infecciones/organización & administración , Ejecutivos Médicos , Rol Profesional , Instituciones de Salud , Humanos , Liderazgo , Seguridad del Paciente , Análisis de SistemasRESUMEN
Currently, there is no imaging procedure for radionuclide therapy utilizing Erbium-169 (Er-169). We have recently published the first post-radiosynovectomy imaging of Er-169 citrate in a case report (Farahati et al., 2017). In this study, we performed in-vitro and in-vivo studies to evaluate the feasibility to assess the distribution of Er-169 citrate after radiosynovectomy in fourteen patients with seventeen affected joints treated for refractory chronic synovitis. Post-radiosynovectomy imaging revealed the feasibility of post-radiosynovectomy detection and distribution utilizing Er-169 citrate in all cases. However, additional in-vitro studies including in-vitro imaging, gamma spectrometry and analysis of half-life indicated that emitted gamma-rays of the Ytterbium-169 in the radiopharmaceutical together with bremsstrahlung induced by Er-169 are the imaging source of emitted counts. Post-radiosynovectomy imaging utilizing Er-169 citrate is feasible and should be implemented in the guidelines for theranostics for quality control, patient safety and therapy monitoring.
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Erbio/uso terapéutico , Radioisótopos/uso terapéutico , Radiofármacos/uso terapéutico , Sinovectomía/métodos , Sinovitis/diagnóstico por imagen , Sinovitis/radioterapia , Adulto , Anciano , Artritis Reumatoide/diagnóstico por imagen , Artritis Reumatoide/radioterapia , Enfermedad Crónica , Ácido Cítrico/uso terapéutico , Estudios de Factibilidad , Femenino , Humanos , Técnicas In Vitro , Masculino , Persona de Mediana Edad , Osteoartritis/diagnóstico por imagen , Osteoartritis/radioterapia , Espectrometría gammaRESUMEN
Numerous conceptual models of health literacy have been proposed in the literature, but very few have been empirically validated in clinical contexts. The aim of this study was to test the effects of the conceptual model of health literacy as a risk in a clinical dental context. A convenience sample of 133 Norwegian-speaking adults was recruited. Participants were randomly allocated to an intervention group (n = 64, 54% women, mean age = 50 years) and a control group (n = 69, 49% women, mean age = 46 years). Clinical measurements were conducted pre-intervention and six months post-intervention. In the intervention group, communication regarding patients' oral health was tailored to their health literacy levels using recommended communication techniques, whereas the control group received brief information not tailored to health literacy levels. The ANCOVA showed significant between-group effects, finding reduced post-intervention mean gingival (p < 0.000) and mean plaque (p < 0.000) indices in the intervention group when controlling for baseline index scores. The adjusted Cohen's d indicated large effect sizes between the intervention group and the control group for both the mean gingival index (-0.98) and the mean plaque index (-1.33). In conclusion, the conceptual model of health literacy as a risk had a large effect on important clinical outcomes, such as gingival status and oral hygiene. The model may be regarded as a suitable supplement to patient education in populations.
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Alfabetización en Salud , Modelos Teóricos , Salud Bucal , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Educación del Paciente como Asunto , Medición de RiesgoRESUMEN
INTRODUCTION: Field studies for allergic rhinitis (AR) commonly have inconsistent allergen concentrations and subject exposure patterns due to varying environmental conditions and subject behaviors. A technical and clinical validation study was conducted for the Allergen BioCube® using timothy grass to confirm uniform allergen concentration and clinically relevant subject symptom responses. METHODS: Allergen concentrations were verified by laser particle counts. Subjects (N = 14) with positive skin test reactions and no symptoms at screening received four 3-h timothy grass exposures in the BioCube over consecutive days. Subjects evaluated nasal itching, sneezing, rhinorrhea, and nasal congestion while in the BioCube; Total Nasal Symptom Score (TNSS) was computed. Peak Nasal Inspiratory Flow (PNIF), Peak Expiratory Flow Rate (PEFR), sIgE blood tests, and Nasal Inflammation Score (NIS) were assessed. A correlation analysis was conducted for mean sIgE, skin test, and TNSS. RESULTS: Uniform timothy grass concentrations were achieved in the BioCube, both spatially and temporally, at all subject positions. Mean TNSS increased substantially from pre-exposure levels (0.36 ± 0.74 to 1.86 ± 2.14) to maximums of 7.07 ± 2.76 at 1.5 h and 6.71 ± 2.70 at 3 h BioCube exposure. Twelve (86%) subjects had TNSS increases ≥6 units. PNIF decreased 12-24% from baseline at 3-h BioCube exposure. NIS increased (baseline = 0) to 3.7 (maximum score = 4). A low/moderate correlation (r = 0.485) occurred between mean sIgE blood levels and mean skin tests; neither sIgE or skin tests correlated with mean TNSS. However, subjects with high skin test scores or positive blood IgE tended to also have higher TNSS. CONCLUSIONS: The Allergen BioCube achieved technical and clinical validation for uniform timothy grass concentration and clinically meaningful AR sign and symptom responses. The Allergen BioCube can be used to assess the efficacy of therapies for reduction of AR signs and symptoms resulting from grass exposure.
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Alérgenos/inmunología , Cámaras de Exposición Atmosférica , Phleum/inmunología , Rinitis Alérgica Estacional/diagnóstico , Adolescente , Adulto , Anciano , Humanos , Inmunoglobulina E/sangre , Persona de Mediana Edad , Nariz/patología , Nariz/fisiología , Ápice del Flujo Espiratorio , Rinitis Alérgica Estacional/sangre , Rinitis Alérgica Estacional/fisiopatología , Pruebas Cutáneas , Adulto JovenRESUMEN
Currently, there is no protocol for the detection of intra-articular distribution of Er-169 citrate after radiosynovectomy. We propose post-therapeutic imaging using scintigraphy and cobalt-57 pen-marker autoradiography. This technique evaluates the efficacy of the radiosynovectomy and patient safety and could be utilized for dosimetric protocol.
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INTRODUCTION: This Phase 2 clinical trial assessed the efficacy and safety of the novel antioxidative, renewable compound SkQ1 for topical treatment of dry eye signs and symptoms. METHODS: In a single-center, randomized, double-masked, placebo-controlled, 29-day study, 91 subjects with mild to moderate dry eye instilled the study drug twice daily and recorded dry eye symptoms daily. Subjects were randomized 1:1:1 into one of three ophthalmic solution treatment groups: SkQ1 1.55 µg/mL, SkQ1 0.155 µg/mL, or 0.0 µg/mL (placebo). Subjects were exposed to a controlled adverse environment chamber at 3 of the 4 study visits (Day -7, Day 1, and Day 29). Investigator assessments occurred at all study visits. RESULTS: SkQ1 was safe and efficacious in treating dry eye signs and symptoms. Statistically significant improvements with SkQ1 compared to placebo occurred for the dry eye signs of corneal fluorescein staining and lissamine green staining in the central region and lid margin redness, and for the dry eye symptoms of ocular discomfort, dryness, and grittiness. In addition, SkQ1 demonstrated greater efficacy compared to placebo, although the differences were not statistically significant, for corneal fluorescein staining in other regions and/or time points (total staining score, central region, corneal sum score, and temporal region), lissamine green staining for the central and nasal regions, and blink rate scores. CONCLUSIONS: This Phase 2 study indicated that SkQ1 is safe and efficacious for the treatment of dry eye signs and symptoms and supported previous study results. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT02121301. FUNDING: Miotech S.A.
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Síndromes de Ojo Seco/tratamiento farmacológico , Plastoquinona/análogos & derivados , Adolescente , Adulto , Córnea , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Femenino , Fluoresceína , Humanos , Masculino , Soluciones Oftálmicas , Plastoquinona/administración & dosificación , Plastoquinona/efectos adversos , Plastoquinona/uso terapéutico , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Allergic rhinitis is a common condition, with ragweed pollen one of the more prevalent aeroallergens. Environmental exposure units such as the Allergen BioCube® are valuable models for clinical allergy studies. A study was conducted to validate the Allergen BioCube for uniform ragweed pollen concentrations and clinically relevant sign and symptom responses to ragweed exposure. METHODS: Ragweed pollen concentrations were measured on 3 consecutive days in the Allergen BioCube and verified by Rotorod collection and continuous laser particle count measurements. Subjects (N=10) were exposed to ragweed pollen in the BioCube for 3 hours per day for 3 consecutive days. Subjects assessed their nasal itching, sneezing, rhinorrhea, and nasal congestion during each BioCube exposure; total nasal symptom score was computed. Peak nasal inspiratory flow was also assessed during BioCube exposure. RESULTS: Uniform ragweed pollen concentrations were obtained throughout each of the 3-hour testing periods in the Allergen BioCube, both spatially and temporally, at all subject positions, with a low mean standard deviation of 10%. Pronounced increases in mean total nasal symptom scores (6.7±0.94 to 7.6±0.86, last 90 minutes of exposure) occurred for all three BioCube ragweed pollen exposure visits. Mean peak nasal inspiratory flow decreased 24% at 3 hours of BioCube exposure on Day 3. No safety issues of concern occurred in this study. CONCLUSION: The Allergen BioCube achieved technical and clinical validation for ragweed allergen. Ragweed pollen concentration was uniform both temporally and spatially. Allergic rhinitis signs and symptoms were induced in subjects during exposure to ragweed in the BioCube at clinically meaningful levels for allergy studies.
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The impact of Motivational Interviewing (MI) on risky behaviors of incarcerated adolescents and adults has been investigated with promising results. Findings suggest that MI reduces substance use, improves motivation and confidence to reduce use, and decreases risky behaviors. The current study investigated the impact of MI on general, alcohol-related, and marijuana-related delinquent behaviors in incarcerated adolescents. Participants in the study were incarcerated adolescents in a state correctional facility in the Northeast region and were assessed as part of a larger randomized clinical trial. Adolescents were randomly assigned to receive MI or relaxation therapy (RT) (N=189) treatment. Delinquent behaviors and depressive symptomatology were measured using the Delinquent Activities Scale (DAS; Reavy, Stein, Paiva, Quina, & Rossi, 2012) and the Center for Epidemiological Studies-Depression scale (CES-D; Radloff, 1991) respectively. Findings indicate that depression moderated treatment effects. Compared to RT, MI was better at reducing predatory aggression and alcohol-related predatory aggression 3 months post-release when depressive symptoms were low. Identifying an efficacious treatment for these adolescents may benefit society in that it may decrease crimes against persons (i.e., predatory aggression) post release.
Asunto(s)
Alcoholismo/terapia , Abuso de Marihuana/terapia , Entrevista Motivacional/métodos , Prisioneros/psicología , Adolescente , Depresión/prevención & control , Humanos , Escalas de Valoración Psiquiátrica , Terapia por Relajación , Asunción de Riesgos , Resultado del TratamientoRESUMEN
Topical corticosteroids have been the mainstay of topical anti-inflammatory therapy of psoriasis and are available in different treatment strengths or doses and various formulations or vehicles. Traditional formulations have included ointments, creams, and lotions. More recently, the mid-potency corticosteroid betamethasone valerate (BMV) and the ultra-high-potency corticosteroid clobetasol propionate (CP) have become available in a novel, thermolabile, low-residue foam vehicle for topical application. This review examines recent clinical studies on efficacy and safety of these two new formulations, BMV 0.12% foam (Luxiq; Connetics Corp, Palo Alto, Calif) and CP 0.05% foam (OLUX, Connetics Corp), as treatments for scalp and nonscalp psoriasis. The studies demonstrated that BMV foam and CP foam are safe and effective treatments for psoriasis affecting scalp and nonscalp regions of the body. BMV foam and CP foam were absorbed more rapidly and demonstrated greater total absorption than their respective comparison formulations, namely BMV lotion and CP solution. The foam vehicle also appears to be associated with better compliance and improvements in quality of life. The unique nature of the foam vehicle, together with the positive findings of in vitro studies suggest these new foam formulations may expand the options currently available for combination therapy.