Potential benefits of combining two long-acting injectable antipsychotic: a retrospective study.

OBJECTIVE: The aim of this study was to evaluate the efficacy and tolerability of the combination of two long-acting injectable antipsychotics (LAIA) in psychiatric disorders, especially in schizophrenia. PATIENTS AND METHODS: Eighty-three patients treated with dual LAIA were included in the study by retrospective screening from the hospital registration system. The present study was designed as an observational, retrospective, naturalistic mirror-image study. The number of hospitalizations before and after switching to dual LAIA was compared in patients who received oral antipsychotics and single LAIA during the study period. In addition, it was analyzed which was the preferred dual antipsychotic combination. RESULTS: Of the patients, 44.6% had schizophrenia, 41.0% had schizoaffective disorder, and 14.4% had other psychiatric disorders. The number of patients receiving oral treatment prior to dual LAIA use was 80 (96.4%). Data on dual LAIA regimens showed that 31.3% were receiving paliperidone and aripiprazole, 24.1% were receiving paliperidone and flupenthixol, 18.1% were receiving paliperidone and zuclopenthixol, and 26.5% were receiving the other combinations. After dual LAIA treatment, there was a significant decrease in the number of hospitalizations compared to before (from 5.95 to 0.99, p<0.001). In addition, while the number of patients who did not require hospitalization in the pre-treatment period was 10.8%, it reached 48.1% in the post-treatment period (p<0.001). No significant adverse effect related to the use of dual LAIA was observed in any patient during the treatment period. CONCLUSIONS: The use of dual LAIA instead of oral antipsychotics or single LAIA in chronic psychotic patients with poor social support and irregular medication use is thought to reduce hospitalization and related treatment costs and regularize medication use.

Ultrasound-guided wire localization biopsy in non-palpable breast lesions: predictive factors for malignancy.

OBJECTIVE: The aim of the study was to evaluate the results of ultrasound-guided excisional biopsy in patients with nonpalpable breast lesions and examine factors associated with malignancy. PATIENTS AND METHODS: A total of 380 patients who underwent ultrasound-guided excisional biopsy for suspected nonpalpable breast masses, between May 2012 and 2018, were retrospectively examined. Histopathological results of the patients were compared regarding age, ultrasound findings, ultrasonographic and mammographic Breast Imaging Reporting and Data System (BI-RADS) categories and factors predicting malignancy were determined. RESULTS: The mean age of the patients was 48.35 ± 11.23 (17-86) years. There was a history of breast cancer in the families of 22 (5.8%) patients, and 187 (49.2%) patients were in menopause. The complication rate was found to be 6.6%. Malignant lesions were detected in 76 (20%) patients and benign lesions were detected in 304 (79.99%) patients. Some benign lesions were high-risk lesions (16.8%). Most of the patients with malignant lesions had early-stage breast cancer (83.3%). In univariate analyzes, ultrasonographic BI-RADS, mammographic BI-RADS and age variables were found to be associated with malignancy (p = 0.0001). In the multiple logistic regression analysis, ultrasonographic and mammographic BI-RADS values were found to be risk factors for malignancy (p = 0.0001). CONCLUSIONS: BI-RADS scoring was used to determine risk factors in predicting malignancy in the evaluation of suspected nonpalpable lesions. The ultrasound-guided wire localization biopsy is a useful method in nonpalpable breast lesions with suspected malignancy that cannot be diagnosed by core/vacuum biopsy or in cases where incompatibility between pathology and radiology results exists.

Alpha 7 nicotinic receptor agonist and positive allosteric modulators improved social and molecular deficits of MK-801 model of schizophrenia in rats.

Schizophrenia is a common psychiatric disease that cannot be fully treated with current antipsychotic drugs. It has shown that glutamatergic NMDA receptor antagonists such as MK-801 cause schizophrenia-like phenotype in rodents. Recent studies indicated that α7 nicotinic acetylcholine receptor (nAChR) deficits contribute to schizophrenia. Enhancing its activity with agonist or positive allosteric modulators (PAMs) may be a valuable approach for treatment. The certain intracellular pathways such as Akt/Glycogen synthase kinase 3 beta (GSK-3ß) and phosphodiesterase-4 (PDE-4)/cAMP are associated with the pathogenesis of schizophrenia. In this study, we examined the effect of α7 nAChR agonists and PAMs on the behavioral and molecular phenotype of schizophrenia in the subchronic MK-801 administered rats. Social interaction, the levels of α7 nAChR, and related intracellular pathways (cAMP, PDE4A, PDE4D, p-Akt/Akt, p-GSK-3ß/GSK-3ß) were measured by behavioral or ELISA and western blot tests. Subchronic MK-801 administration decreased the following behaviors and increased the avoiding behaviors. However, only α7 nAChR agonist (A-582941) increased the following behavior while α7 nAChR agonist, PAMs (CCMI and PNU-120596), and clozapine decreased the avoiding behavior compared to MK-801. For molecular parameters, MK-801 administration decreased the α7 nAChR, p-Akt/Akt, p-GSK-3ß/GSK-3ß expressions, and cAMP levels while it increased PDE4A, PDE4D expressions in the prefrontal cortex. Besides, MK-801 decreased the α7 nAChR, p-GSK-3ß/GSK-3ß expressions in the hippocampus. We found clozapine, α7 nAChR agonists, and PAMs reversed the molecular deficits induced by MK-801. Herein, we showed that prefrontal cortex is more sensitive to the devastating effects of subchronic MK-801 administration, especially for PDE4, in rats. In addition to clozapine, α7 nAChR agonists and PAMs found to be beneficial on both social and molecular deficits induced by MK-801 in rats. We suggested that α7 nAChR agonists and PAMs might be valuable approaches to treat negative symptoms of schizophrenia when unmet needs and current limitations considered in this pathology.

Enrichment of probiotic ice cream with different dietary fibers: Structural characteristics and culture viability.

This study evaluated the effect of 5 dietary fibers (apple, orange, oat, bamboo, and wheat) on the physicochemical, rheological, and textural characteristics; sensory properties; and culture viability of probiotic ice cream stored at -18°C for 180 d. The presence of orange and apple fibers increased the titratable acidity, decreased the lightness (color) value of the ice creams, and enhanced the red and yellow coloration. Compared with the control sample, the consistency indices and apparent viscosities of the experimental samples increased with the addition of all dietary fibers except oat fiber. The highest viscosity was obtained in the sample fortified with apple fiber, whereas the ice cream containing orange fiber showed the highest hardness after d 60 of storage. The addition of orange and apple fibers significantly increased melting resistance; however, panelists did not generally like these samples in terms of taste-flavor. All ice creams had viable counts of Lactobacillus acidophilus of ≥7 log cfu/g during storage except the samples with orange and bamboo fiber. Bifidobacterium lactis counts were also found to be >6 log cfu/g in those samples until d 150 of storage.

Monoplane 3D-2D registration of cerebral angiograms based on multi-objective stratified optimization.

Registration of 3D pre-interventional to 2D intra-interventional medical images has an increasingly important role in surgical planning, navigation and treatment, because it enables the physician to co-locate depth information given by pre-interventional 3D images with the live information in intra-interventional 2D images such as x-ray. Most tasks during image-guided interventions are carried out under a monoplane x-ray, which is a highly ill-posed problem for state-of-the-art 3D to 2D registration methods. To address the problem of rigid 3D-2D monoplane registration we propose a novel multi-objective stratified parameter optimization, wherein a small set of high-magnitude intensity gradients are matched between the 3D and 2D images. The stratified parameter optimization matches rotation templates to depth templates, first sampled from projected 3D gradients and second from the 2D image gradients, so as to recover 3D rigid-body rotations and out-of-plane translation. The objective for matching was the gradient magnitude correlation coefficient, which is invariant to in-plane translation. The in-plane translations are then found by locating the maximum of the gradient phase correlation between the best matching pair of rotation and depth templates. On twenty pairs of 3D and 2D images of ten patients undergoing cerebral endovascular image-guided intervention the 3D to monoplane 2D registration experiments were setup with a rather high range of initial mean target registration error from 0 to 100 mm. The proposed method effectively reduced the registration error to below 2 mm, which was further refined by a fast iterative method and resulted in a high final registration accuracy (0.40 mm) and high success rate ([Formula: see text]96%). Taking into account a fast execution time below 10 s, the observed performance of the proposed method shows a high potential for application into clinical image-guidance systems.

HIV-1 non-group M phenotypic susceptibility to integrase strand transfer inhibitors.

Objectives: To determine natural phenotypic susceptibility of non-group M HIV-1 to integrase strand transfer inhibitors (INSTIs) in a large panel of 39 clinical strains from groups O, N and P and to identify genotypic polymorphisms according to susceptibility levels. Methods: Susceptibility to raltegravir, elvitegravir and dolutegravir was evaluated in 36 HIV-1/O, 2 HIV-1/N and 1 HIV-1/P strains plus an HIV-1/M reference strain. IC50 values were determined after 3 days, and fold changes (FCs) were calculated relative to the HIV-1/M strain. Genotypic polymorphism was determined by amplification of codons 19-263 of the integrase; the natural occurrence of resistance-associated mutations was analysed using the main resistance algorithms and the IAS-USA list. VESPA analysis of the strain sequences was used to determine a signature pattern associated with higher FC. Results: Similar IC50 results were observed for the three drugs. Based on the value for the HIV-1/M reference strain, the data showed FC values <2.5 for raltegravir and dolutegravir, whereas the distribution for elvitegravir was heterogeneous, with FC > 10 for six strains (15%). Analysis of the non-M integrase sequences showed a high level of polymorphism without a major genotypic impact; it also revealed mutations that may be associated with the highest FC values obtained for elvitegravir. Conclusions: Our phenotypic data showed that non-M strains are globally susceptible to the three currently used INSTIs, but the impact of the high FC values observed for some strains with elvitegravir needs to be explored. Clinical data are now needed to confirm these phenotypic results.

An overview of challenges to eradication of Helicobacter pylori infection and future prospects.

The eradication of H. pylori infection continues to be a challenge due to the evolution of drug-resistant bacteria, lack of a gold standard diagnostic method, and ineffectiveness of current vaccines. Additionally, there still is no consensus in the literature about the main source of gastric H. pylori infection. The bacterium has also been demonstrated to colonize in dental plaque and the oral cavity. We believe that to develop new approaches for successful eradication of the disease, factors such as the biology of the bacterium, reservoir differentiations, host-bacterium interactions and problems in diagnosis, treatment and vaccination must be comprehensively considered. Therefore, the main goal of this study is to gather all of the literature analysis about the problems in the eradication of the infection, reconsider contradictions about extra-gastric reservoirs of the bacterium, and propose new strategies aimed at disease eradication.

Effects of methylphenidate treatment on the cerebellum in adult attention-deficit hyperactivity disorder: a magnetic resonance spectroscopy study.

OBJECTIVE: This study investigated the relationship between the use of methylphenidate (MPH) and changes in creatine, choline, and N-acetyl-aspartate (NAA) in the dorsolateral prefrontal cortex (DLPFC), striatum, cerebellum, and anterior cingulate cortex (ACC) in adults with attention-deficit hyperactivity disorder (ADHD). PATIENTS AND METHODS: The study enrolled 60 patients 18-60 years of age who met the criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) for ADHD. The amounts of NAA, creatine, and choline in the ACC, cerebellum, striatum, and DLPFC were measured using magnetic resonance spectroscopy. After the first measurement, the patients were given 10 mg oral MPH, and the same metabolite levels were measured 30 minutes later. RESULTS: No significant differences were observed in the NAA and choline levels in the DLPFC, ACC, cerebellum, and striatum after MPH. Although there were no significant differences in the creatine levels in the DLPFC, ACC, and striatum after MPH, the creatine level in the cerebellum increased significantly. CONCLUSIONS: Our results suggest that MPH affects the cerebellum in adult ADHD. Therefore, we suggest that, due to its effects on the cerebellum, MPH can be used in adult ADHD not only for attention deficit symptoms but also for hyperactivity symptoms.

Relationship between the SNAP-25 gene and the effects of methylphenidate on the anterior cingulate cortex of patients with adult attention deficit hyperactivity disorder: a magnetic resonance spectroscopy study.

OBJECTIVE: The effects of certain genetic alterations in the brain function of patients with attention deficit hyperactivity disorder (ADHD) remain unclear and, in fact, there is a limited amount of data in this field. For example, the relationship between the SNAP-25 polymorphism and brain metabolites in response to methylphenidate (MPH) has yet to be investigated. Thus, the present study aimed to determine the relationship between changes in creatine (Cr), choline (Cho), and N-acetyl aspartate (NAA) levels in the prefrontal cortex (PFC) and anterior cingulate cortex (ACC) of adults with ADHD and the SNAP-25 gene polymorphism following the use of MPH. PATIENTS AND METHODS: The present study assessed 60 patients between 18 and 60 years of age who were diagnosed with ADHD according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). Genetic analyses were carried out using blood samples obtained from the ADHD patients and included a detailed clinical evaluation for the SNAP-25 gene polymorphism. The NAA, Cr, and Cho levels in the ACC and PFC were measured using magnetic resonance spectroscopy (MRS). Following the evaluation, 10 mg of oral MPH was given to the patients, and the same metabolite levels were measured after 30 minutes. RESULTS: The levels of NAA, Cr, and Cho in the PFC and ACC of patients with the SNAP-25 Ddel and Mnll polymorphism genotypes did not significantly differ before and after the administration of MPH. However, in patients with the SNAP-25 Ddel polymorphism T/T genotype and the Mnll polymorphism G/G genotype, there was a significant increase in NAA levels in the ACC after MPH treatment compared with before MPH treatment. CONCLUSION: The present results suggest that the SNAP-25 Ddel and Mnll polymorphisms might be associated with MPH-related changes in NAA levels in the ACC.

Relationship between the DAT1 gene and the effects of methylphenidate administration in adult attention deficit hyperactivity disorder: a magnetic resonance spectroscopy study.

OBJECTIVE: This study investigated the relationship between DAT1 gene polymorphisms and the effects of methylphenidate (MPH) administration on N-acetyl aspartate (NAA), creatine (Cr), and choline (Cho) levels in the anterior cingulate cortex, prefrontal cortex, striatum, and cerebellum in adult patients with attention deficit hyperactivity disorder (ADHD). This was the first study to investigate the relationship between DAT gene variable number tandem repeat (VNTR) polymorphisms and the responses of brain metabolites to MPH. PATIENTS AND METHODS: Samples in this study were collected from 60 patients aged between 18 and 60 years with ADHD according to DSM-IV criteria. Genetic analysis of DAT1 gene polymorphisms was carried out using blood samples obtained after a detailed clinical evaluation. Levels of NAA, Cr, and Cho were measured in the anterior cingulate cortex, prefrontal cortex, striatum, and cerebellum by magnetic resonance spectroscopy. After this evaluation, 10 mg of MPH was given orally to patients, and the levels of the same metabolites were measured 30 min later. RESULTS: No marked difference in NAA, Cr, or Cho levels was detected before and after MPH administration with respect to the DAT1 gene VNTR polymorphisms. A considerable increase in Cr levels in the cerebellum was identified after MPH administration in individuals with the 10/10 repeat genotype as the DAT1 VNTR polymorphism (p=0.008). CONCLUSIONS: An increase in the previously decreased blood flow after MPH therapy may induce an increase in creatine levels in patients with the 10/10 repeat genotype. Our results thus suggest that the 10R allele as the DAT1 gene VNTR polymorphism might be associated with MPH-related changes in brain metabolites in adults with ADHD.

Bridging the Gap between RF and Optical Patch Antenna Analysis via the Cavity Model.

Although optical antennas with a variety of shapes and for a variety of applications have been proposed and studied, they are still in their infancy compared to their radio frequency (rf) counterparts. Optical antennas have mainly utilized the geometrical attributes of rf antennas rather than the analysis tools that have been the source of intuition for antenna engineers in rf. This study intends to narrow the gap of experience and intuition in the design of optical patch antennas by introducing an easy-to-understand and easy-to-implement analysis tool in rf, namely, the cavity model, into the optical regime. The importance of this approach is not only its simplicity in understanding and implementation but also its applicability to a broad class of patch antennas and, more importantly, its ability to provide the intuition needed to predict the outcome without going through the trial-and-error simulations with no or little intuitive guidance by the user.

Standardized evaluation framework for evaluating coronary artery stenosis detection, stenosis quantification and lumen segmentation algorithms in computed tomography angiography.

Though conventional coronary angiography (CCA) has been the standard of reference for diagnosing coronary artery disease in the past decades, computed tomography angiography (CTA) has rapidly emerged, and is nowadays widely used in clinical practice. Here, we introduce a standardized evaluation framework to reliably evaluate and compare the performance of the algorithms devised to detect and quantify the coronary artery stenoses, and to segment the coronary artery lumen in CTA data. The objective of this evaluation framework is to demonstrate the feasibility of dedicated algorithms to: (1) (semi-)automatically detect and quantify stenosis on CTA, in comparison with quantitative coronary angiography (QCA) and CTA consensus reading, and (2) (semi-)automatically segment the coronary lumen on CTA, in comparison with expert's manual annotation. A database consisting of 48 multicenter multivendor cardiac CTA datasets with corresponding reference standards are described and made available. The algorithms from 11 research groups were quantitatively evaluated and compared. The results show that (1) some of the current stenosis detection/quantification algorithms may be used for triage or as a second-reader in clinical practice, and that (2) automatic lumen segmentation is possible with a precision similar to that obtained by experts. The framework is open for new submissions through the website, at http://coronary.bigr.nl/stenoses/.

Microstructural, textural, and sensory characteristics of probiotic yogurts fortified with sodium calcium caseinate or whey protein concentrate.

The influence of milk protein-based ingredients on the textural characteristics, sensory properties, and microstructure of probiotic yogurt during a refrigerated storage period of 28 d was studied. Milk was fortified with 2% (wt/vol) skim milk powder as control, 2% (wt/vol) sodium calcium caseinate (SCaCN), 2% (wt/vol) whey protein concentrate (WPC) or a blend of 1% (wt/vol) SCaCN and 1% (wt/vol) WPC. A commercial yogurt starter culture and Bifidobacterium lactis Bb12 as probiotic bacteria were used for the production. The fortification with SCaCN improved the firmness and adhesiveness. Higher values of viscosity were also obtained in probiotic yogurts with SCaCN during storage. However, WPC enhanced water-holding capacity more than the caseinate. Addition of SCaCN resulted in a coarse, smooth, and more compact protein network; however, WPC gave finer and bunched structures in the scanning electron microscopy micrographs. The use of SCaCN decreased texture scores in probiotic yogurt; probably due to the lower water-holding capacity and higher syneresis values in the caseinate-added yogurt sample. Therefore, the textural characteristics of probiotic yogurts improved depending on the ingredient variety.

A comparison of the efficacy of conventional and new retreatment instruments to remove gutta-percha in curved root canals: an ex vivo study.

AIM: To compare the efficacy of conventional and new retreatment instruments when removing gutta-percha root fillings in curved root canals. METHODOLOGY: A total of 56 curved molar roots were instrumented with ProFile instruments and filled using system B and Obtura II. The root fillings were removed with manual K-files and Hedström files (Dentsply Maillefer), ProFile (Dentsply Maillefer), R-Endo (Micro-Mega) or ProTaper Universal retreatment files (Dentsply Maillefer). Eucalyptol was used as a solvent with all techniques. Bucco-lingual and proximal radiographs of the roots were exposed and the percentage area of the remaining material was calculated by dividing the area of remaining filling material by the area of canal wall. Data were statistically analysed with Kruskal-Wallis and Mann-Whitney U tests (P = 0.05). RESULTS: None of the techniques completely removed the root filling materials. No significant differences were found amongst the coronal, middle and apical thirds in both radiographic projections (P > 0.05). In the bucco-lingual direction, the remaining filling material was significantly less following manual instrumentation than R-Endo and ProTaper instrumentation (P < 0.05). In the proximal view, it was significantly less following manual and ProFile instrumentation than R-Endo (P < 0.05). Complete removal of filling material occurred only in three specimens (with manual instruments). Manual instruments were significantly faster than R-Endo and ProFile (P < 0.05). More procedural errors (five fractured instruments and two perforation) were noted when using ProTaper (P < 0.05). CONCLUSIONS: In this laboratory study in curved molar roots, ProTaper Retreatment and R-Endo instruments were less effective in removing filling material from canal walls than manual and ProFile instruments.

Determination of hormones inducing oocyte maturation in Chalcalburnus tarichi (Pallas, 1811).

Chalcalburnus tarichi is an endemic cyprinid species living in the Lake Van basin, in eastern Anatolia, Turkey. The present study was undertaken to determine which hormones induce oocyte maturation in C. tarichi. The levels of 17alpha,20beta,21-trihydroxyprogesterone (20beta-S), progesterone (P), 17alpha-hydroxyprogesterone (17alpha-HOP), 11-deoxycortisol (11-DOC), and 17alpha-hydroxy-20beta-dihydroprogesterone (17,20beta-P) were measured in fish caught from Lake Van and the Karasu River, and injected with human chorionic hormone (hCG) (1,000 and 1,500 IU/kg). Oocytes of fish caught from the lake were also incubated in vitro with different doses (50, 200, and 1,000 ng/ml) of 20beta-S, 17alpha-HOP, 11-DOC, and 17,20beta-P. 11-DOC was found to be the most effective hormone among those measured for inducing oocyte maturation in vivo and in vitro. 17,20beta-P could not be determined in the plasma of any fish in vivo (P < 0.05). 1,000 IU/kg dose of hCG given by injection caused a statistically significant increase in all plasma hormone levels (P < 0.05). It was found that there was a significant decrease in the P level only at 1,500 IU/kg dose of hCG injected (P < 0.05), while the level of other hormones increased at this dose (P < 0.05). It was also determined that all the hormones were effective in germinal vesicle breakdown (GVBD) in in vitro oocyte culture (P < 0.05). However, 11-DOC was found to be the most effective hormone in GVBD at a dose of 200 ng/ml (70% GVBD). In conclusion, 11-DOC synthesized during final oocyte maturation in C. tarichi was found to be a potent inducer of GVBD, which shows that 11-DOC may be described as an oocyte maturation steroid in this species.

Effects of fructooligosaccharide and whey protein concentrate on the viability of starter culture in reduced-fat probiotic yogurt during storage.

Viability of yogurt starter cultures and Bifidobacterium animalis was assessed during 28 d storage in reduced-fat yogurts containing 1.5% milk fat supplemented with 1.5% fructooligosaccharide or whey protein concentrate. These properties were examined in comparison with control yogurts containing 1.5% and 3% milk fat and no supplement. Although fructooligosaccharide improved the viability of Streptococcus thermophilus, Lactobacillus delbrueckii subs. bulgaricus, and Bifidobacterium animalis, the highest growth was obtained when milk was supplemented with whey protein concentrate in reduced-fat yogurt (P < 0.05). Supplementation with 1.5% whey protein concentrate in reduced-fat yogurt increased the viable counts of S. thermophilus, L. delbrueckii subs. bulgaricus, and B. animalis by 1 log cycle in the 1st week of storage when compared to control sample. Similar improvement in the growth of both yogurt bacteria and B. animalis was also obtained in the full-fat yogurt containing 3% milk fat and no supplement. Addition of whey protein concentrate also resulted in the highest content of lactic and acetic acids (P < 0.05). A gradual increase was obtained in organic acid contents during the storage.

Comparison of cold lateral compaction and continuous wave of obturation techniques following manual or rotary instrumentation.

AIM: To compare different combinations of root canal preparation and obturation technique. METHODOLOGY: A total of 48 freshly extracted human maxillary central incisors were divided into two identical groups on the basis of root canal length and apical diameter. The root canals were prepared by manual crown-down pressureless technique or with a rotary system (ProFile; Dentsply Maillefer, Ballaigues, Switzerland) in a crown-down technique. The coronal diameter and apical size of the root canals were standardized in both preparation techniques. Each main group was then divided into two subgroups and obturated with either cold lateral compaction or continuous wave of obturation with System B (EIE-Analytic Technology, Orange, CA, USA). The distribution of filling material in each canal was assessed by stereomicroscopic examination of eight cross-sections on each tooth. Areas of sealer, gutta-percha and voids were measured on the digital images of a total of 384 samples. Manipulation time and apical extrusion for each group was also determined. Data were statistically analysed using Kruskal-Wallis, anova (Bonferroni/Dunn) or Student's t-test. RESULTS: The percentage of sealer, gutta-percha and voids area between the obturation techniques was not significantly different (P > 0.05). Continuous wave groups had significantly more apical extrusion of sealer (P < 0.05), while none of the obturation techniques had gutta-percha extrusion. Rotary instrumentation was significantly faster than the manual technique (P < 0.05); continuous wave obturation was significantly faster than lateral compaction (P < 0.05). Total manipulation time in the rotary/continuous wave group was significantly shorter than the other groups (P < 0.0001). CONCLUSION: The distribution of filling materials was similar in all combinations of instrumentation and obturation techniques. The continuous wave technique was faster than lateral compaction and it extruded more sealer.

A psychometric comparison of health-related quality of life measures in chronic liver disease.

Four generic [the Sickness Impact Profile (SIP-68), Short-Form Health Survey (SF-36), EuroQol instrument (EQ-5D), COOP/WONCA charts], two domain-specific health-related quality of life measures [the sexuality scale of the HIV Overview Problems Evaluating System (HOPES), Multi-dimensional Fatigue Index (MFI-20)], and a self-developed 12-item symptom index were compared in terms of feasibility, test-retest reliability, internal consistency reliability, construct validity, and known groups validity in patients with chronic liver disease. All instruments could be completed within 10 min and exhibited a good psychometric performance in patients with chronic liver disease. The SF-36 and the MFI-20 performed relatively best in terms of reliability, construct validity, and discriminative ability. The sexuality scale of the HOPES demonstrated a relatively poor performance, as the missing value rate was higher than 5%. Further research is needed into the sensitivity to important clinical changes of the instruments.

Indapamide-induced pemphigus foliaceus.

A variety of drugs have been implicated to induce or trigger pemphigus. A case of pemphigus foliaceus that was probably caused by indapamide, in whom the diagnosis was based on clinical, histologic and direct immunofluorescence testing, is reported here. To the best of the authors' knowledge, this is the first reported patient with indapamide-induced pemphigus.

Restoration of error-diffused images using projection onto convex sets.

A novel inverse halftoning method is proposed to restore a continuous tone image from a given half-tone image. A set theoretic formulation is used where three sets are defined using the prior information about the problem. A new space-domain projection is introduced assuming the halftoning is performed using error diffusion, and the error diffusion filter kernel is known. The space-domain, frequency-domain, and space-scale domain projections are used alternately to obtain a feasible solution for the inverse halftoning problem which does not have a unique solution.