Introduction:Selective serotonin reuptake inhibitors(SSRIs) are frequently used in the treatment of irritable bowel syndrome(IBS) although evidence of their efficacy is scarce.Aim:Twenty three non-depressed IBS patien...Introduction:Selective serotonin reuptake inhibitors(SSRIs) are frequently used in the treatment of irritable bowel syndrome(IBS) although evidence of their efficacy is scarce.Aim:Twenty three non-depressed IBS patients were recruited from a tertiary care centre and included in a crossover trial comparing six weeks of treatment with the SSRI citalopram(20 mg for three weeks,40 mg for three weeks) with placebo.IBS symptom severity was the primary outcome measure,and depression and anxiety scores were also measured.The effect of acute administration of citalopram on colonic sensitivity and on colonic response to feeding was investigated as a putative predictor of symptomatic response to the drug.Results:After three and six weeks of treatment,citalopram significantly improved abdominal pain,bloating,impact of symptoms on daily life,and overall well being compared with placebo.There was only a modest effect on stool pattern.Changes in depression or anxiety scores were not related to symptom improvement.The effect of acute administration of citalopram during a colonic barostat study did not predict clinical outcome.Analysis of the first treatment period as a double blind parallel arm study confirmed the benefit of citalopram over placebo.Conclusions:The SSRI citalopram significantly improves IBS symptoms,including abdominal pain,compared with placebo.The therapeutic effect is independent of effects on anxiety,depression,and colonic sensorimotor function.展开更多
(1) To determine the serum levels of vascular endothelial growth factor (VEGF) and insulin- like growth factor- 1 (IGF1) in women with polycystic ovary syndrome (PCOS). (2) To study Doppler blood flow changes within t...(1) To determine the serum levels of vascular endothelial growth factor (VEGF) and insulin- like growth factor- 1 (IGF1) in women with polycystic ovary syndrome (PCOS). (2) To study Doppler blood flow changes within the ovarian stroma of women with PCOS. (3) To evaluate the relationship between VEGF and IGF- 1 and Doppler indices as well as hormonal profile. Department of Obstetrics and Gynecology, and Department of Biochemistry, Faculty of Medicine, Assiut University, Egypt. Cross- sectional study. Fifty infertile women with PCOS diagnosed by ultrasound examination and a history of oligomenorrhea, hirsutism and obesity were studied. Serum levels of vascular endothelial growth factor (VEGF), insulin- like growth factor- 1 (IGF- 1) and hormonal profile were measured. Doppler blood flow velocity waveforms analysis in both right and left intraovarian arteries was done. Twenty healthy and fertile women with regular menstrual cycles served as a comparison group were similarly studied at the third day of the cycle. The serum levels of VEGF,IGF- 1 (4.79 ± 0.91, 253.15 ± 70.07 versus 2.39 ± 0.42, 186.65 ± 42.7) were significantly elevated (P < 0.001 and P < 0.01, respectively) in women with PCOS compared with control. Doppler indices, PI (2.01 ± 0.77, 2.66 ± 1.00 versus 2.98 ± 0.77, 3.75 ± 0.98) and RI (0.77 ± 0.12, 0.82 ± 0.09 versus 0.87 ± 0.09, 0.89 ± 0.09) in both right and left intraovarian vessels were significantly lower in the patients than controls. The VEGF and IGF- 1 levels were negatively correlated with RI and PI in the uterine and intraovarian arteries. VEGF level was positively correlated with IGF- 1 (r = 0.41, P <.0.05) in women with PCOS. Higher serum levels of VEGF and IGF- 1 in PCOS women may be related to the increased vascularity that underlies the increased blood flow demonstrated by Doppler blood flow measurements in these women.展开更多
Objective: To evaluate the 24-hour efficacy of brimonidine purite versus dorz olamide, each added to latanoprost. Design: Double-masked, 2-center, prospecti ve, crossover comparison. Participants: Primary open-angle g...Objective: To evaluate the 24-hour efficacy of brimonidine purite versus dorz olamide, each added to latanoprost. Design: Double-masked, 2-center, prospecti ve, crossover comparison. Participants: Primary open-angle glaucoma (POAG) subj ects. Methods: Subjects were randomized to brimonidine purite or dorzolamide, ea ch given twice daily, for the first 6-week treatment period after a 6-week lat anoprost run-in. Subjects began the opposite treatment for the second 6-week p eriod after a 6-week latanoprost-only treatment between periods. Intraocular p ressure (IOP) was measured at 8 am, 12 pm, 4 pm, 8 pm, 12 am, 4 am, and 8 am at each baseline and at the end of each treatment period. This study provided an 80 %power that a 1.5-mmHg difference could be excluded between groups if 27 subje cts completed the study. A standard deviation (SD) of 2.8 mmHg was assumed. Main Outcome Measures: Twentyfour-hour efficacy of intraocular pressures of brimoni dine purite versus dorzolamide, each added to latanoprost. Results: In 31 comple ted subjects, the baseline mean diurnal 24-hour IOP (±SD) was 19.0±1.7 mmHg f or brimonidine purite and 19.0±1.6 mmHg for dorzolamide (P=0.52). The 8 am IOP after 6 weeks of therapy was 18.4±2.1 mmHg for brimonidine purite and 18.9±1.9 mmHg for dorzolamide (P=0.40). The mean diurnal IOP was 16.9±1.5 mmHg for brim onidine purite and 16.8±1.5 mmHg for dorzolamide (P=0.66). Dorzolamide caused a more bitter taste (P=0.01) than brimonidine purite. Conclusions: This study sug gests that brimonidine purite and dorzolamide, added to latanoprost, have simila r efficacy and safety in POAG or ocular hypertensive subjects.展开更多
therapies for atrial tachyarrhythmias(ATs) by measuring the cumulative time(burden) the patient spends in arrhythmia. Contradictory results questioned either therapy efficacy or statistical power of the trials. We stu...therapies for atrial tachyarrhythmias(ATs) by measuring the cumulative time(burden) the patient spends in arrhythmia. Contradictory results questioned either therapy efficacy or statistical power of the trials. We studied AT burden variability in patients paced for sinus node disease(SND) in order to interpret currently published data appropriately and to evaluate reliable sample sizes. Methods and results: One hundred and five patients with AT and SND received a dual chamber pacemaker with antitachyarrhythmia- pacing capability, and were followed for 13 months. Seventy- eight patients(74% ) suffered AT recurrences. Device- gathered diagnostic measures were used to simulate results of randomized studies both with crossover and parallel design. The sample size required for statistically significant results was calculated as a function of the expected therapy- induced burden reduction. AT burden intra- patient variability was high: 43% of patients showed intrinsic fluctuations hiding any therapy- induced burden reduction lower than 30% . Demonstrating therapeutic breakthrough through a 6 month study would require 290 patients with crossover design and 5800 patients with parallel design. Doubling the study period requires 400 and 3000 patients, respectively. Conclusion: Patients with AT and paced for SND showed high intra- patient burden variability, which could possibly hide an AT burden reduction induced by a therapy. Previous studies involving non- pharmacological therapies utilizing AT burden end- points could lack the power to reach statistical significance.展开更多
Purpose To compare the nocturnal effects of once-daily timolol and latanopros t on intraocular pressure (IOP) in patients with ocular hypertension or early gl aucomatous changes. Design Prospective, open label, experi...Purpose To compare the nocturnal effects of once-daily timolol and latanopros t on intraocular pressure (IOP) in patients with ocular hypertension or early gl aucomatous changes. Design Prospective, open label, experimental study with cro ssover design. Methods Eighteen patients with ocular hypertension or early glauc omatous changes (aged 41 to 79 years) each received topical treatments with timo lol (0.5%Timoptic XE), latanoprost (0.005%Xalatan), and no IOP lowering medi cation, for at least 4 weeks. Timolol was given once in the morning upon awakeni ng and latanoprost once in the evening at bedtime. At the end of each treatment period, the patient was housed in a sleep laboratory for 24 hours and IOP was me asured every 2 hours using a pneumatonometer. Measurements were taken sitting an d supine during the 16 hour diurnal/wake period and only supine during the 8 h our nocturnal/sleep period. Mean diurnal and nocturnal IOP levels were compared among the treatments with timolol, latanoprost, and no medication. Results In th e diurnal period, the mean IOP under the timolol or the latanoprost treatment wa s significantly less than the mean IOP under no medication in both the sitting a nd the supine positions. There was no statistical difference between the timolol and latanoprost treatments. In the nocturnal period, supine IOP with timolol tr eatment was not different from the supine IOP with no medication but was signifi cantly higher than supine IOP with the latanoprost treatment. Conclusion Althoug h both once daily timolol and latanoprost were effective in lowering IOP during the diurnal period, only latanoprost reduced IOP during the nocturnal period.展开更多
文摘Introduction:Selective serotonin reuptake inhibitors(SSRIs) are frequently used in the treatment of irritable bowel syndrome(IBS) although evidence of their efficacy is scarce.Aim:Twenty three non-depressed IBS patients were recruited from a tertiary care centre and included in a crossover trial comparing six weeks of treatment with the SSRI citalopram(20 mg for three weeks,40 mg for three weeks) with placebo.IBS symptom severity was the primary outcome measure,and depression and anxiety scores were also measured.The effect of acute administration of citalopram on colonic sensitivity and on colonic response to feeding was investigated as a putative predictor of symptomatic response to the drug.Results:After three and six weeks of treatment,citalopram significantly improved abdominal pain,bloating,impact of symptoms on daily life,and overall well being compared with placebo.There was only a modest effect on stool pattern.Changes in depression or anxiety scores were not related to symptom improvement.The effect of acute administration of citalopram during a colonic barostat study did not predict clinical outcome.Analysis of the first treatment period as a double blind parallel arm study confirmed the benefit of citalopram over placebo.Conclusions:The SSRI citalopram significantly improves IBS symptoms,including abdominal pain,compared with placebo.The therapeutic effect is independent of effects on anxiety,depression,and colonic sensorimotor function.
文摘目的使用fMRI技术,研究刺激靶点为运动初级皮层(M1)的高精度经颅直流电刺激(HD-tDCS)对脑功能网络的影响。方法采取随机、双盲、交叉对照实验。招募40名健康受试者。每位受试者需要来访2次,每次访问时,会对受试者进行20 min电刺激干预(HD-tDCS or Sham),并在刺激前、刺激中、刺激后3个时间段,采集8、20、8 min静息态功能磁共振数据。然后对数据进行基于种子区域的功能连接分析。
文摘(1) To determine the serum levels of vascular endothelial growth factor (VEGF) and insulin- like growth factor- 1 (IGF1) in women with polycystic ovary syndrome (PCOS). (2) To study Doppler blood flow changes within the ovarian stroma of women with PCOS. (3) To evaluate the relationship between VEGF and IGF- 1 and Doppler indices as well as hormonal profile. Department of Obstetrics and Gynecology, and Department of Biochemistry, Faculty of Medicine, Assiut University, Egypt. Cross- sectional study. Fifty infertile women with PCOS diagnosed by ultrasound examination and a history of oligomenorrhea, hirsutism and obesity were studied. Serum levels of vascular endothelial growth factor (VEGF), insulin- like growth factor- 1 (IGF- 1) and hormonal profile were measured. Doppler blood flow velocity waveforms analysis in both right and left intraovarian arteries was done. Twenty healthy and fertile women with regular menstrual cycles served as a comparison group were similarly studied at the third day of the cycle. The serum levels of VEGF,IGF- 1 (4.79 ± 0.91, 253.15 ± 70.07 versus 2.39 ± 0.42, 186.65 ± 42.7) were significantly elevated (P < 0.001 and P < 0.01, respectively) in women with PCOS compared with control. Doppler indices, PI (2.01 ± 0.77, 2.66 ± 1.00 versus 2.98 ± 0.77, 3.75 ± 0.98) and RI (0.77 ± 0.12, 0.82 ± 0.09 versus 0.87 ± 0.09, 0.89 ± 0.09) in both right and left intraovarian vessels were significantly lower in the patients than controls. The VEGF and IGF- 1 levels were negatively correlated with RI and PI in the uterine and intraovarian arteries. VEGF level was positively correlated with IGF- 1 (r = 0.41, P <.0.05) in women with PCOS. Higher serum levels of VEGF and IGF- 1 in PCOS women may be related to the increased vascularity that underlies the increased blood flow demonstrated by Doppler blood flow measurements in these women.
文摘Objective: To evaluate the 24-hour efficacy of brimonidine purite versus dorz olamide, each added to latanoprost. Design: Double-masked, 2-center, prospecti ve, crossover comparison. Participants: Primary open-angle glaucoma (POAG) subj ects. Methods: Subjects were randomized to brimonidine purite or dorzolamide, ea ch given twice daily, for the first 6-week treatment period after a 6-week lat anoprost run-in. Subjects began the opposite treatment for the second 6-week p eriod after a 6-week latanoprost-only treatment between periods. Intraocular p ressure (IOP) was measured at 8 am, 12 pm, 4 pm, 8 pm, 12 am, 4 am, and 8 am at each baseline and at the end of each treatment period. This study provided an 80 %power that a 1.5-mmHg difference could be excluded between groups if 27 subje cts completed the study. A standard deviation (SD) of 2.8 mmHg was assumed. Main Outcome Measures: Twentyfour-hour efficacy of intraocular pressures of brimoni dine purite versus dorzolamide, each added to latanoprost. Results: In 31 comple ted subjects, the baseline mean diurnal 24-hour IOP (±SD) was 19.0±1.7 mmHg f or brimonidine purite and 19.0±1.6 mmHg for dorzolamide (P=0.52). The 8 am IOP after 6 weeks of therapy was 18.4±2.1 mmHg for brimonidine purite and 18.9±1.9 mmHg for dorzolamide (P=0.40). The mean diurnal IOP was 16.9±1.5 mmHg for brim onidine purite and 16.8±1.5 mmHg for dorzolamide (P=0.66). Dorzolamide caused a more bitter taste (P=0.01) than brimonidine purite. Conclusions: This study sug gests that brimonidine purite and dorzolamide, added to latanoprost, have simila r efficacy and safety in POAG or ocular hypertensive subjects.
文摘therapies for atrial tachyarrhythmias(ATs) by measuring the cumulative time(burden) the patient spends in arrhythmia. Contradictory results questioned either therapy efficacy or statistical power of the trials. We studied AT burden variability in patients paced for sinus node disease(SND) in order to interpret currently published data appropriately and to evaluate reliable sample sizes. Methods and results: One hundred and five patients with AT and SND received a dual chamber pacemaker with antitachyarrhythmia- pacing capability, and were followed for 13 months. Seventy- eight patients(74% ) suffered AT recurrences. Device- gathered diagnostic measures were used to simulate results of randomized studies both with crossover and parallel design. The sample size required for statistically significant results was calculated as a function of the expected therapy- induced burden reduction. AT burden intra- patient variability was high: 43% of patients showed intrinsic fluctuations hiding any therapy- induced burden reduction lower than 30% . Demonstrating therapeutic breakthrough through a 6 month study would require 290 patients with crossover design and 5800 patients with parallel design. Doubling the study period requires 400 and 3000 patients, respectively. Conclusion: Patients with AT and paced for SND showed high intra- patient burden variability, which could possibly hide an AT burden reduction induced by a therapy. Previous studies involving non- pharmacological therapies utilizing AT burden end- points could lack the power to reach statistical significance.
文摘Purpose To compare the nocturnal effects of once-daily timolol and latanopros t on intraocular pressure (IOP) in patients with ocular hypertension or early gl aucomatous changes. Design Prospective, open label, experimental study with cro ssover design. Methods Eighteen patients with ocular hypertension or early glauc omatous changes (aged 41 to 79 years) each received topical treatments with timo lol (0.5%Timoptic XE), latanoprost (0.005%Xalatan), and no IOP lowering medi cation, for at least 4 weeks. Timolol was given once in the morning upon awakeni ng and latanoprost once in the evening at bedtime. At the end of each treatment period, the patient was housed in a sleep laboratory for 24 hours and IOP was me asured every 2 hours using a pneumatonometer. Measurements were taken sitting an d supine during the 16 hour diurnal/wake period and only supine during the 8 h our nocturnal/sleep period. Mean diurnal and nocturnal IOP levels were compared among the treatments with timolol, latanoprost, and no medication. Results In th e diurnal period, the mean IOP under the timolol or the latanoprost treatment wa s significantly less than the mean IOP under no medication in both the sitting a nd the supine positions. There was no statistical difference between the timolol and latanoprost treatments. In the nocturnal period, supine IOP with timolol tr eatment was not different from the supine IOP with no medication but was signifi cantly higher than supine IOP with the latanoprost treatment. Conclusion Althoug h both once daily timolol and latanoprost were effective in lowering IOP during the diurnal period, only latanoprost reduced IOP during the nocturnal period.
