BACKGROUND: At least 10-15% of patients with reflux symptoms have a normal endoscopy and physiological levels of acid reflux on pH monitoring. Such patients with 50% or more of symptoms associated ...with acid reflux episodes have "a positive symptom index" (SI), and it has been proposed that this defines the "sensitive oesophagus". AIM: To test the response to omeprazole 20 mg twice daily for four weeks of patients with normal levels of acid reflux using a randomised, placebo controlled, double blind, cross-over design. PATIENTS: Eighteen patients with normal levels of reflux, 12 of whom had a positive SI. METHODS: Response was measured by symptomatic assessment and the SF-36 quality of life (QOL) questionnaire. RESULTS: Patients with a positive SI showed the following improvements on omeprazole compared with placebo: decrease in symptom frequency (p < 0.01), severity (p < 0.01) and consumption of antacids (p < 0.01). In the group with a negative SI only one patient clearly improved. The QOL parameters for bodily pain (65.6 v 53.4, p = 0.03) and vitality (60.6 v 48.8, p = 0.049) were significantly better on omeprazole than placebo for the group overall. CONCLUSION: Omeprazole improves symptoms in 11 of 18 patients with normal endoscopy and pH monitoring, particularly those with a positive SI. This supports the theory that such patients have an oesophagus which is "sensitive" to acid reflux and are part of the GORD spectrum.
The preference rankings of a rural population in central British Columbia, Canada of potential environmental effects of climate change were assessed using the psychometric method of paired ...comparison. The survey results were used to develop an interval scale for eight hypothetical, but potential, environmental effects including major and minor impacts to water and fish, forest ecosystems, wildlife, and scenic and recreation. Interval scales were developed for the total sample as well as sub-samples made up of females, males, town residents, non-town residents, respondents with high school or less education, and respondents with at least some post-secondary education. Major impacts on water and fish were considered to be the most serious effects followed by major impacts on forest ecosystems and major impacts on wildlife. Major effects on scenic and recreation were ranked below minor effects on water and fish. Responses from the sub-samples were similar with some minor deviations. For example, females ranked major impacts on wildlife higher than males, and males ranked major impact on scenic and recreation higher than females. However, the overall rankings of females and males were highly correlated. This study showed climate change effects on environmental goods and services in terms of human preferences. A human preferences perspective (combined with biophysical assessments) is required for determining local adaptation priorities and for guiding impacts and adaptation research. The methodology and approach has potential for broader application.
Background
The decision to proceed to biopsy for the diagnosis of prostate cancer in clinical practice is a difficult one. Prostate cancer risk calculators allow for a systematic approach to the use ...of patient information to predict a patient’s likelihood of prostate cancer.
Aims
In this paper, we validate the two leading prostate cancer risk calculators, the prostate cancer prevention trial (PCPT) and the European Randomized Study of Screening for Prostate Cancer (ERSPC) in an Irish population.
Methods
Data were collected for 337 men referred to one tertiary referral center in Ireland. Calibration analysis, ROC analysis and decision curve analysis were undertaken to ascertain the performance of the PCPT and the ERSPC risk calculators in this cohort.
Results
Of 337 consecutive biopsies, cancer was subsequently diagnosed in 146 men (43 %), 98 (67 %) of which were high grade. The AUC for the PCPT and ERSPC risk calculators were 0.68 and 0.66, respectively for the prediction of prostate cancer. Each calculator was sufficiently calibrated in this cohort. Decision curve analysis demonstrated a net benefit via the use of the PCPT and ERSPC risk calculators in the diagnosis of prostate cancer.
Conclusions
The PCPT and ERSPC risk calculators achieve a statistically significant prediction of prostate cancer in this Irish population. This study provides external validation for these calculators, and therefore these tools can be used to aid in clinical decision making.
A search for the nonconservation of lepton flavor in the decay tau+/--->e+/-gamma has been performed with 2.07x10(8) e+e--->tau+tau- events collected by the BABAR detector at the SLAC PEP II storage ...ring at a center-of-mass energy near 10.58 GeV. We find no evidence for a signal and set an upper limit on the branching ratio of Beta(tau+/--->e+/-gamma)<1.1x10(-7) at 90% confidence level.
Bisphenol A (BPA, 2,2-bis (4-hydroxyphenyl) propane; CAS# 80-05-7) is a chemical used primarily in the manufacture of polycarbonate plastic, epoxy resins and as a non-polymer additive to other ...plastics. Recent evidence has demonstrated that human and wildlife populations are exposed to levels of BPA which cause adverse reproductive and developmental effects in a number of different wildlife species and laboratory animal models. However, there are major uncertainties surrounding the spectrum of BPA's mechanisms of action, the tissue-specific impacts of exposures, and the critical windows of susceptibility during which target tissues are sensitive to BPA exposures. As a foundation to address some of those uncertainties, this review was prepared by the “
In vitro” expert sub-panel assembled during the “
Bisphenol A: An Examination of the Relevance of Ecological, In vitro and Laboratory Animal Studies for Assessing Risks to Human Health” workshop held in Chapel Hill, NC, Nov 28-29, 2006. The specific charge of this expert panel was to review and assess the strength of the published literature pertaining to the mechanisms of BPA action. The resulting document is a detailed review of published studies that have focused on the mechanistic basis of BPA action in diverse experimental models and an assessment of the strength of the evidence regarding the published BPA research.
Purpose
Polymorphisms in the vitamin D receptor (
VDR
) gene may be of etiological importance in determining cancer risk. The aim of this study was to assess the association between common
VDR
gene ...polymorphisms and esophageal adenocarcinoma (EAC) risk in an all-Ireland population-based case–control study.
Methods
EAC cases and frequency-matched controls by age and gender recruited between March 2002 and December 2004 throughout Ireland were included. Participants were interviewed, and a blood sample collected for DNA extraction. Twenty-seven single nucleotide polymorphisms in the
VDR
gene were genotyped using Sequenom or TaqMan assays while the poly(A) microsatellite was genotyped by fluorescent fragment analysis. Unconditional logistic regression was applied to assess the association between
VDR
polymorphisms and EAC risk.
Results
A total of 224 cases of EAC and 256 controls were involved in analyses. After adjustment for potential confounders, TT homozygotes at rs2238139 and rs2107301 had significantly reduced risks of EAC compared with CC homozygotes. In contrast, SS alleles of the poly(A) microsatellite had significantly elevated risks of EAC compared with SL/LL alleles. However, following permutation analyses to adjust for multiple comparisons, no significant associations were observed between any
VDR
gene polymorphism and EAC risk.
Conclusions
VDR
gene polymorphisms were not significantly associated with EAC development in this Irish population. Confirmation is required from larger studies.
Observation of Upsilon(4S) decays to pi(+)pi(-)C and pi(+)pi(-)Upsilon(2S)We present the first measurement of Upsilon(4S) decays to pi(+)pi(-)Upsilon(1S) based on a sample of 230 x 106(4S) mesons ...collected with the BABAR detector. We measure the product branching fractions Beta(Upsilon(4S) --> pi(+)pi(-)Upsilon(1S)) x BetaUpsilon(1S) --> mu(+)mu(-) = (2.23 +/- 0.25(stat) +/- 0.27(syst))x 10(-6) and Beta(Upsilon(4S) --> pi(+)pi(-)Upsilon(2S) x Beta(Upsilon(2S) --> mu(+)mu(-))=(1.69 +/-0.26(stat) +/- 0.20(syst)) x 10(-)6, from which we derive the partial widths Gamma(Upsilon(4S) --> pi(+)pi(-)Upsilon(1S))=(1.8 +/-0.4) keV and Gamma(Upsilon(4S) --> pi(+)pi(-)Upsilon(2S))=(2.7 +/- 0.8) keV.
First, to define the relationships between critical opening and closing pressures and oxygenating efficiency, and second, to address whether respiratory inductive plethysmography (RIP) could be used ...to monitor changes in thoracic volume that follow changes in mean airway pressure during high- frequency oscillatory ventilation (HFOV).
Prospective, interventional animal study.
University research laboratory.
Five anesthetized, paralyzed, and ventilated pigs.
The animals were ventilated by using HFOV after lung injury. Pre- and post-HFOV pressure-volume curves were obtained by supersyringe. A pressure-volume curve was constructed during HFOV as mean airway pressure was increased from 10 to 40 cm H(2)O and then weaned back down to the minimum sustainable. Hemodynamic and oxygenation data were obtained at each data point.
RIP-derived thoracic volumes correlated with known lung volumes during supersyringe (r(2) =.78, p <.00001). During HFOV, three of five animals had an identifiable critical opening pressure of the lung, and four of five had an identifiable critical closing pressure. No consistent relationship between critical opening and critical closing pressures was observed. During the weaning phase of HFOV, a relative decrease in RIP-measured volume of >10% predicted the decrease in oxygenation associated with reaching the critical closing pressure.
The ability of RIP to detect optimal lung volume during the weaning of mean airway pressure may allow clinicians to more directly monitor lung volume changes during HFOV and use the lowest possible airway pressures after lung recruitment.
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