Objective: Tolerability and safety of 0.1% tacrolimus ointmentin treating nickel-induced allergic contact dermatitis (ACD)-were evaluated. Methods: Patients allergic to nickel applied nickel patches to each upper inne...Objective: Tolerability and safety of 0.1% tacrolimus ointmentin treating nickel-induced allergic contact dermatitis (ACD)-were evaluated. Methods: Patients allergic to nickel applied nickel patches to each upper inner aspect of the arm for 4 to 8 hours daily. Tacrolimus was applied to patch site on one arm and vehicle to patch site on the other, twice daily. Physician’ s Global assessment, signs and symptoms of ACD, pruritus scores, and adverse events were evaluated. Results: After 8 weeks, dermatitis in 45% of patients was clear or almost clear (Physician’ s Global Assessment) with tacrolimus; and 1% with vehicle (P < .001). Significant results were achieved as early as day8. Tacrolimus was superior in ACD signs and symptoms improvement and pruritus reduction (P < .001). Adverse events were similar between treatments. Limitations: This model,involving one agent, may not be generalizable for other agents.Conclusions: Tacrolimus ointment 0.1% is well tolerated and significantly more effective than vehicle in treating chronically exposed, nickel-induced ACD.展开更多
Objective: To evaluate the overall effect of assisted hatching (AH) on the implantation, pregnancy, and live birth rates in women undergoing intracytoplasmic sperm injection (ICSI)- cycles; and to determine the effect...Objective: To evaluate the overall effect of assisted hatching (AH) on the implantation, pregnancy, and live birth rates in women undergoing intracytoplasmic sperm injection (ICSI)- cycles; and to determine the effect of AH on the cytogenetic outcome (chromosomal constitution) of pregnancy.Design: Prospective, randomized study.Setting: Academic research environment.Patient(s): A total of 172 couples were enrolled in the study.Intervention(s): Assisted hatching was carried out on day- 3 ICSI embryos.Main Outcome Measure(s): Implantation, clinical pregnancy, and live birth rates; cytogenetic analysis of abortuses and umbilical cord blood samples from newborns.Result(s): Biochemical, clinical, and ongoing pregnancy rates were not significantly different between the AH and control groups.The implantation rate was higher in the AH group than in the control group (16% vs.8% ), especially in women aged ≥ 35 years.Postnatal umbilical cord blood samples were collected and cytogenetically analyzed from 39 live births (20 from the AH group, 19 from the control group).Two abnormal karyotypes were found (one AH, one control).There were seven spontaneous losses during the study interval.Six of the abortuses underwent cytogenetic study (five AH, one control), and four were found to have an abnormal karyotype (three AH, one control). Conclusion: We found that AH improves implantation rates of ICSI cycles and seems to be most effective in women aged ≥ 35 years.A larger sample size is needed to determine whether AH improves the take- home- baby rate.Assisted hatching did not affect the rate of chromosomal abnormalities in live births in this study.展开更多
PURPOSE: To compare the bacteriologic and clinical efficacy of gatifloxacin and ciprofloxacin for the treatment of bacterial keratitis. DESIGN: Prospective, randomized clinical trial. METHODS: A total of 104 eyes of 1...PURPOSE: To compare the bacteriologic and clinical efficacy of gatifloxacin and ciprofloxacin for the treatment of bacterial keratitis. DESIGN: Prospective, randomized clinical trial. METHODS: A total of 104 eyes of 104 patients with bacterial keratitis seen at a tertiary eye-care center were randomized to treatment with gatifloxacin 0.3%eyedrops (GAT group, 50 eyes) or ciprofloxacin 0.3%eyedrops (CIP group, 54 eyes). Patients and the treating physician were masked to the antibiotic being used. Main outcome measure studied was healing of the ulcer. Patients lost to follow-up before complete healing were excluded from further analysis. RESULTS: A significantly higher proportion of ulcers in the GAT group exhibited complete healing compared with those in the CIP group (39 eyes 95.1% vs 38 80.9% ; P=.042). Gatifloxacin demonstrated a significantly better action than ciprofloxacin against gram-positive cocci in vitro (P < .001), and the percentage of ulcers caused by these pathogens that healed in the GAT group was significantly better than in the CIP group (P=.009). Mean time taken for healing of ulcer and the efficacy against gram-negative bacteria did not significantly differ between the two groups. CONCLUSIONS: Gatifloxacin had a significantly better action against gram-positive cocci both in vitro and in vivo when compared with ciprofloxacin. In view of these organisms being the leading cause of keratitis worldwide, gatifloxacin may be a preferred alternative to ciprofloxacin as the first-line monotherapy in bacterial keratitis.展开更多
Objective: To compare the effects of combined oral contraceptives (OCs) containing cyproterone acetate or desogestrel on insulin sensitivity in adolescents with polycystic ovary syndrome (PCOS). Design: A prospective ...Objective: To compare the effects of combined oral contraceptives (OCs) containing cyproterone acetate or desogestrel on insulin sensitivity in adolescents with polycystic ovary syndrome (PCOS). Design: A prospective randomized clinical trial. Setting: Outpatient gynecological clinic of Aretaieion University Hospital. Patient(s): Thirty- six adolescent girls with hyperandrogenismand six or less menses in the preceding 12 months. Intervention(s): Patients were separated in two groups: group A (n = 18) received 0.15 mg of desogestrel plus 0.030 mg of ethinyl E2 daily; and group B (n = 18) received 2 mg of cyproterone acetate plus 0.035 mg of ethinyl E2 daily, for 21 days followed by a 7- day rest, for 12 months. Main Outcome Measure(s): Hirsutism score, lipid, androgen, and sex hormone- binding globulin (SHBG) levels were evaluated at baseline. An oral glucose tolerance test (OGTT)was performed and metabolism indices, based on previously studied mathematical formulas, were assessed at baseline and at 12 months. Result(s): After 12 months of treatment, the homeostasis model assessment index of insulin resistance increased significantly in both groups. The fasting glucose- to- insulin ratio and predicted insulin sensitivity index decreased in group B. The delta of the area under the OGTT curve for insulin and predicted first and second phase insulin secretion indices increased significantly only in group B. Conclusion(s): We conclude that treatment of adolescent girls with PCOS with the two combined OCs administered, results in unfavorable changes of insulin sensitivity. In addition, cyproterone acetate is associated with an increase of insulin secretion and hyperinsulinemia.展开更多
近年来,随着抗CD20单克隆性抗体-利妥昔单抗（rituximab R）的应用,弥漫大B细胞淋巴瘤（diffuse large B cell lymphoma,DLBCL）的疗效取得了里程碑式的进步,患者整体长期缓解率提高30%以上.针对利妥昔单抗联合化疗的几项国际多中心前...近年来,随着抗CD20单克隆性抗体-利妥昔单抗（rituximab R）的应用,弥漫大B细胞淋巴瘤（diffuse large B cell lymphoma,DLBCL）的疗效取得了里程碑式的进步,患者整体长期缓解率提高30%以上.针对利妥昔单抗联合化疗的几项国际多中心前瞻性随机临床试验的开展,确立了DLBCL依据危险度、年龄等因素进行分层治疗的策略,但随着研究的深入,基于利妥昔单抗联合化疗的治疗策略中仍有不少问题亟待解决,如利妥昔单抗的最佳疗程数和最佳联合方案的确立,放疗在DLBCL治疗中的地位,年轻高危DLBCL患者的标准治疗方案等.我们就DLBCL的治疗现状及下一步研究方向作一介绍.展开更多
文摘Objective: Tolerability and safety of 0.1% tacrolimus ointmentin treating nickel-induced allergic contact dermatitis (ACD)-were evaluated. Methods: Patients allergic to nickel applied nickel patches to each upper inner aspect of the arm for 4 to 8 hours daily. Tacrolimus was applied to patch site on one arm and vehicle to patch site on the other, twice daily. Physician’ s Global assessment, signs and symptoms of ACD, pruritus scores, and adverse events were evaluated. Results: After 8 weeks, dermatitis in 45% of patients was clear or almost clear (Physician’ s Global Assessment) with tacrolimus; and 1% with vehicle (P < .001). Significant results were achieved as early as day8. Tacrolimus was superior in ACD signs and symptoms improvement and pruritus reduction (P < .001). Adverse events were similar between treatments. Limitations: This model,involving one agent, may not be generalizable for other agents.Conclusions: Tacrolimus ointment 0.1% is well tolerated and significantly more effective than vehicle in treating chronically exposed, nickel-induced ACD.
文摘Objective: To evaluate the overall effect of assisted hatching (AH) on the implantation, pregnancy, and live birth rates in women undergoing intracytoplasmic sperm injection (ICSI)- cycles; and to determine the effect of AH on the cytogenetic outcome (chromosomal constitution) of pregnancy.Design: Prospective, randomized study.Setting: Academic research environment.Patient(s): A total of 172 couples were enrolled in the study.Intervention(s): Assisted hatching was carried out on day- 3 ICSI embryos.Main Outcome Measure(s): Implantation, clinical pregnancy, and live birth rates; cytogenetic analysis of abortuses and umbilical cord blood samples from newborns.Result(s): Biochemical, clinical, and ongoing pregnancy rates were not significantly different between the AH and control groups.The implantation rate was higher in the AH group than in the control group (16% vs.8% ), especially in women aged ≥ 35 years.Postnatal umbilical cord blood samples were collected and cytogenetically analyzed from 39 live births (20 from the AH group, 19 from the control group).Two abnormal karyotypes were found (one AH, one control).There were seven spontaneous losses during the study interval.Six of the abortuses underwent cytogenetic study (five AH, one control), and four were found to have an abnormal karyotype (three AH, one control). Conclusion: We found that AH improves implantation rates of ICSI cycles and seems to be most effective in women aged ≥ 35 years.A larger sample size is needed to determine whether AH improves the take- home- baby rate.Assisted hatching did not affect the rate of chromosomal abnormalities in live births in this study.
文摘PURPOSE: To compare the bacteriologic and clinical efficacy of gatifloxacin and ciprofloxacin for the treatment of bacterial keratitis. DESIGN: Prospective, randomized clinical trial. METHODS: A total of 104 eyes of 104 patients with bacterial keratitis seen at a tertiary eye-care center were randomized to treatment with gatifloxacin 0.3%eyedrops (GAT group, 50 eyes) or ciprofloxacin 0.3%eyedrops (CIP group, 54 eyes). Patients and the treating physician were masked to the antibiotic being used. Main outcome measure studied was healing of the ulcer. Patients lost to follow-up before complete healing were excluded from further analysis. RESULTS: A significantly higher proportion of ulcers in the GAT group exhibited complete healing compared with those in the CIP group (39 eyes 95.1% vs 38 80.9% ; P=.042). Gatifloxacin demonstrated a significantly better action than ciprofloxacin against gram-positive cocci in vitro (P < .001), and the percentage of ulcers caused by these pathogens that healed in the GAT group was significantly better than in the CIP group (P=.009). Mean time taken for healing of ulcer and the efficacy against gram-negative bacteria did not significantly differ between the two groups. CONCLUSIONS: Gatifloxacin had a significantly better action against gram-positive cocci both in vitro and in vivo when compared with ciprofloxacin. In view of these organisms being the leading cause of keratitis worldwide, gatifloxacin may be a preferred alternative to ciprofloxacin as the first-line monotherapy in bacterial keratitis.
文摘Objective: To compare the effects of combined oral contraceptives (OCs) containing cyproterone acetate or desogestrel on insulin sensitivity in adolescents with polycystic ovary syndrome (PCOS). Design: A prospective randomized clinical trial. Setting: Outpatient gynecological clinic of Aretaieion University Hospital. Patient(s): Thirty- six adolescent girls with hyperandrogenismand six or less menses in the preceding 12 months. Intervention(s): Patients were separated in two groups: group A (n = 18) received 0.15 mg of desogestrel plus 0.030 mg of ethinyl E2 daily; and group B (n = 18) received 2 mg of cyproterone acetate plus 0.035 mg of ethinyl E2 daily, for 21 days followed by a 7- day rest, for 12 months. Main Outcome Measure(s): Hirsutism score, lipid, androgen, and sex hormone- binding globulin (SHBG) levels were evaluated at baseline. An oral glucose tolerance test (OGTT)was performed and metabolism indices, based on previously studied mathematical formulas, were assessed at baseline and at 12 months. Result(s): After 12 months of treatment, the homeostasis model assessment index of insulin resistance increased significantly in both groups. The fasting glucose- to- insulin ratio and predicted insulin sensitivity index decreased in group B. The delta of the area under the OGTT curve for insulin and predicted first and second phase insulin secretion indices increased significantly only in group B. Conclusion(s): We conclude that treatment of adolescent girls with PCOS with the two combined OCs administered, results in unfavorable changes of insulin sensitivity. In addition, cyproterone acetate is associated with an increase of insulin secretion and hyperinsulinemia.
文摘近年来,随着抗CD20单克隆性抗体-利妥昔单抗（rituximab R）的应用,弥漫大B细胞淋巴瘤（diffuse large B cell lymphoma,DLBCL）的疗效取得了里程碑式的进步,患者整体长期缓解率提高30%以上.针对利妥昔单抗联合化疗的几项国际多中心前瞻性随机临床试验的开展,确立了DLBCL依据危险度、年龄等因素进行分层治疗的策略,但随着研究的深入,基于利妥昔单抗联合化疗的治疗策略中仍有不少问题亟待解决,如利妥昔单抗的最佳疗程数和最佳联合方案的确立,放疗在DLBCL治疗中的地位,年轻高危DLBCL患者的标准治疗方案等.我们就DLBCL的治疗现状及下一步研究方向作一介绍.
