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125 EVALUATION OF RAPID DIANGOSTIC ASSAYS FOR VIBRIO CHOLERAE O1: DOES SENSITIVITY VARY BY SKILL LEVEL? Kalluri P, Rahman S, Ansaruzzaman M, Bird M, Faruque ASG, Naheed A, Bhuiyan NA, Nato F, Fournier JM, Bopp C, Mintz ED, Breiman RF, Nair GB. Centers for Disease Control and Prevention, Atlanta, GA; ICDDR, B: Centre for Health and Population Research, Dhaka, Bangladesh; Institut Pasteur, Paris, France. Cholera outbreaks often occur in refugee camps or remote areas with limited laboratory facilities and financial resources. Timely confirmation of outbreaks could be achieved by low-skilled personnel using sensitive diagnostic tests. We report preliminary findings from an ongoing evaluation of diagnostic assays for Vibrio cholerae. We enrolled every 50th symptomatic patient at a diarrhea treatment center in Dhaka, Bangladesh. The SMARTTM, MedicosTM Cholera Dip Stick, and an immunochromatographic dipstick from the Institut Pasteur IP ; were performed on stool by high- and low-skilled staff. Assays were compared to stool culture. We calculated sensitivity Se ; , specificity Sp ; , positive PPV ; and.
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TABLE 1. Effect of Direct Renal Interstitial Volume Expansion on Clearance Parameters in the Presence and Absence of Cyclooxygenase-1 Inhibition by Piroxicam and Cyclooxygenase-2 Inhibition by NS-398 and Meloxicam.
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Contact-inhibited endothelial cells were injured using a multichannel wounder 27 ; , switching them from a physiological "off" state to a pathophysiological "on" state. As shown in Fig. 4, the addition of HGF SF 10 9 induced a significant regeneration into the denuded area. Furthermore, HGF SF induced a significant proliferation of endothelial cells Fig. 4 ; . Both NS398 and meloxicam blocked the HGF SF-induced regeneration in a concentration-dependent manner without affecting the basal regeneration or the HGF SF-induced cell proliferation Fig. 4, AE ; . Fig. 5 shows the effects of COX-1-selective inhibitors, ketoprofen and SC560, on the HGF SF-induced regeneration and cell proliferation. Unlike COX-2 inhibitors, ketoprofen failed to inhibit the HGF SF-induced regeneration or cell proliferation at concentrations selective for COX-1. SC560 is a selective COX-1 inhibitor IC50 for COX-1, 9 nM; IC50 for COX2, 50 M; Ref. 28 ; and was used to confirm the observation with ketoprofen. As shown in Fig. 5, SC560 failed to alter HGF SF-induced regeneration at concentrations at which it selectively blocks COX-1. Effect of COX-1 and COX-2 Inhibitors on HGF SF-induced Chemoinvasion of Endothelial Cells. One of the earliest steps during angiogenesis is the migration of endothelial cells after invading the basement membrane. To dissect out the possible roles for COX-1 and COX-2 in this phenomenon, we used a chemoinvasion assay in which the endothelial cells were stimulated to invade into a matrix and migrate through pores between two chambers of a transwell. As shown in Fig. 6, the HUVECs demonstrated a strong chemoinvasive behavior toward HGF SF. In the presence of constant blockade of COX-2 by NS398, the chemoinvasion of cells toward HGF SF reverted to basal levels in a concentration-dependent manner. In contrast, the highly selective COX-1 inhibitor SC560 failed to alter the HGF SF-induced chemoinvasion at a COX-1-selective concentration. Effect of COX-1 and COX-2 Inhibitors on HGF SF-induced Tube Formation. The administration of HGF SF 10 9 induced significant endothelial tubulogenesis compared with vehicle treatment. None of the COX-1 and COX-2 inhibitors were found to alter the basal or HGF SF-induced tubulogenesis Fig. 7 ; . Effect of HGF SF on COX-2 Protein Expression. As shown in Fig. 8A, the treatment of an injured monolayer of HUVECs with HGF SF induced a strong expression of COX-2 protein in the cells. This expression was susceptible to the inhibition by a PI3K inhibitor, LY294002. We could not detect any COX-1 in the experiment. Effect of COX-2 Inhibitors on HGF SF-induced Phosphorylation of MAPK. We have demonstrated previously that HGF SF can induce a rapid and prolonged temporal phosphorylation of MAPKs ERK1 2; Ref. 15 ; . Because the HGF SF-induced MAPK phosphorylation returns to basal levels before 24 h, the time point at which cellular phenotypes were quantified, we evaluated the effects of the COX-1- and COX-2-selective NSAIDs on the early 30 min ; and delayed 12 h ; phases of HGF SF-induced phosphorylation of ERK1 and ERK2. As shown in Fig. 8, neither NS398 nor meloxicam inhibited the early phase. In contrast, the late phase of MAPK phosphorylation was susceptible to the inhibition of COX-2. Effect of the Inhibition of the Lipoxygenase Pathway on HGF SF-induced Angiogenesis. The arachidonate metabolism can traverse down the LOX pathway and result in the systhesis of leukotrienes that have been implicated in angiogenesis 29 ; . To dissect out any role of LOXs in HGF SF-induced angiogenesis, we used NDGA and L655238, which at the concentrations used inhibit LOX 30 ; and 5-LOX-activating protein 31 ; , respectively. As shown in supplementary Fig. 1, neither NDGA nor L655238 exerted any effect on HGF SF-induced regeneration or cell proliferation, although loss of cells was evident at high concentrations!
4. Valat JP, Accardo S, Reginster JY, Wouters M, Hettich M, Lieu PL. A comparison of the efficacy and tolerability of meloxicam and diclofenac in the treatment of patients with osteoarthritis of the lumbar spine. Inflammation Research 2001; 50: S30-34. 5. Goldstein JL, Correa P, Zhao WW, Burr AM, Hubard RC, Verburg KM, Geis GS. Reduced incidence of gastroduodenal ulcers with celecoxib, a novel cyclooxygenase inhibitor, compared to naproxen in patients with arthritis. The American Journal of Gastroenterology 2001; 96: 1019-27. McKenna F, Borenstein D, Wendt H, Wallemark C, Lefkowith JB, Geis. Celecoxib versus diclofenac in the management of osteoarthritis of the knee. Scandinavian Journal of Rheumatology 2001; 30: 11-8. Acevedo E, Castaeda O, Ugaz M, Beaulieu AD, Pons-Estel B, Caeiro F, Casas N, Garza-Elizondo M, Irazoque F, Hinojosa W, Gutierrez-Urea S, Vandormael K, Rodgers DB, Leurenzi M. Tolerability profiles of rofecoxib Vioxx ; and Arthrotec. Scandinavian Journal of Rheumatology 2001; 30: 19-24. Ehrich E, Bolognese JA, Watson DJ, Kong SX. Effect of rofecoxib therapy on measures of health-related quality of life in patients with osteoarthritis. The American Journal of Managed Care 2001; 7 6 ; : 609-16. 9. McKenna F, Weaver A, Fiechtner JJ, Bello AE, Fort J. Cox-2 specific inhibitors in the management of osteoarthritis of the knee: a placebo-controlled, randomized, double-blind study. Journal of Clinical Rheumatology 2001; 7: 151-9. Saag K, Van dr Heijde D, Fischer C, Samara A, DeTora L, Bolognese J, Sperling R, Daniels B. Rofecoxib, a new cyclooxygenase 2 inhibitor, shows sustained efficacy, comparable with other nonsteroidal anti-inflammatory drugs. Arch Fam Med 2000; 9: 1124-34.
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Alloantibody associated with a presumably new canine red cell antigen, which is lacking in some Dalmatians. Serological tests, including blood typing, crossmatching and Coombs' test, were performed by standard tube techniques, in addition to a novel gel column technology DiaMed ; used in human blood banking. A DEA 1.1 positive female spayed Dalmatian with chronic renal failure and anemia was referred for renal dialysis. Two crossmatchcompatible DEA 1.1 positive blood transfusions were administered without incident within a two-day period. Because of progressive anemia and failure to respond to recombinant human erythropoietin, the dog required additional transfusions by week 4, but a compatible donor was not readily available; all major crossmatch tests to 50 nonDalmatian dogs were incompatible. In addition, the two initial donors were now also incompatible, suggesting the development of an alloantibody to a common antigen on the red cell membrane. All auto-controls performed were consistently negative, and a direct Coombs' test at 37oC was also negative. No siblings of the anemic Dalmatian were available for compatibility assessment. However, 3 of 13 randomly crossmatched Dalmatians were compatible suggesting that they were also missing the same antigen. One of the compatible red cell units was transfused with the expected beneficial effects. The canine patient was found to be DEA 1.1, 3, 4, as well as 5 positive, but DEA 7 negative reagents to other blood types are currently not available ; . Further blood typing and crossmatching results did not support an association to any of these known blood types. Thus, the red cell antigen recognized by this antiserum was called Dal. This Dalmatian's serum had a 1: 8 anti-Dal titer 37C ; which, based upon dithiothreitol exposure, was of the IgG class. The three other Dal-negative Dalmatians had not been transfused and their serum contained no detectable anti-Dal alloantibodies. Based upon the identification of an alloantibody in a Dalmatian, a presumably new blood type named Dal was identified. The Dal red cell antigen seems to be lacking in several Dalmatians. Following sensitization via transfusion, the development of anti-Dal alloantibodies may result in ineffective transfusions or in hemolytic transfusion reactions if Dal positive blood products are subsequently used. Further studies are needed to determine the frequency of the Dal negative blood type in Dalmatians as well as other breeds, and to characterize the Dal red cell antigen and its mode of inheritance. In addition, the clinical importance of anti-Dal antibodies in transfusion medicine must be investigated.
ABSTRACT The purpose of this study was to assess the selectivity and potency of the nonsteroidal anti-inflammatory drug NSAID ; , flurbiprofen, and its enantiomers in their inhibition of cyclooxygenase-1 COX-1 ; and cyclooxygenase-2 COX-2 ; . An assay was used with freshly drawn heparinized human whole blood, incubated with 25 mM calcium ionophore A 23187 during 60 min to produce thromboxane B2 TXB2 ; by activity of COX-1 in platelets. Incubation with E.Coli lipopolysaccharide LPS ; during 24 hours produced prostaglandin E2 PGE2 ; by induction of COX-2 in monocytes, suppressing any possible contribution of COX-1 activity by addition of acetylsalicylic acid. Concentration inhibition curves were determined with racemic, S + ; , and R - ; flurbiprofen in final concentrations ranging from 10-3 to 10-10 M. The stereoselectivity of S + ; flurbiprofen vs. R - ; flurbiprofen, expressed as the reciprocal of the ratio of the concentrations giving 50% inhibition IC50 ; , is 340 for COX-1 and 56 for COX-2. The selectivity for COX-1 vs. COX-2, expressed as the reciprocal ratio of the IC50, was 16 for racemic, 32 for S + ; , and 5.3 for R - ; flurbiprofen. Mekoxicam in the same assay showed COX-2 selectivity with a ratio of 0.19. INTRODUCTION Cyclooxygenase COX; prostaglandin-endoperoxide synthase, E.C.1: 14.99.1 ; , the rate limiting enzyme in the production of proinflammatory prostaglandins, exists in two isoforms: COX-1, the constitutive form, and COX-2 the inducible form. COX-1 has clear physiological functions such as in the protection of the stomach, kidney, and vessel walls, whereas COX-2 is induced by inflammatory stimuli and by cytokines in migratory and other cells, leading to inflammatory conditions. The therapeutic use of non-steroidal anti-inflammatory drugs NSAIDs ; , in general, is based on their ability to inhibit the COX-2 activity, while inhibition of COX-1 might explain the undesired side effects such as gastric and renal toxicity and hematological disorders. On the basis of their inhibitory activity on COX-1 and COX-2 at least three major aspects of NSAIDs are distinguished: 1 ; preferential COX-1 inhibition, 2 ; preferential COX-2 inhibition, and 3 ; nonpreferential inhibition. Selectivities, varying between COX-1 preferential 1-3 ; and nonpreferential 1, 4, 5 ; , have been reported for flurbiprofen, possibly because of methodological variations .The assay systems to investigate the potency and selectivity of NSAIDs include intact cells, broken cells, purified enzymes and microsomal preparations of recombinantly expressed enzymes. Some of the reasons for variation have been identified such as the use of animal or human cells, microsomal preparations, incubation time of the assay or protein binding of the NSAID and vermox.
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Vascular risk in a patient with ESRD which could possibly be improved by timing adjustment of his current medication. Discussion This evidence-based review confirms PWV as a robust and important indicator of vascular disease and supports its role as a routine investigation in clinical practice. Therefore, the clinical utilization of this cardiovascular disease indicator should result in better management of patients with established risk factors. The definitions of hypertension, hypercholesterolemia and diabetes have been reevaluated over recent years because evidence has indicated a significant morbidity and mortality among people with a blood pressure, lipid and glucose below the previously defined levels for disease description. For instance, the vascular risk associated with blood pressure exhibits a close and continuous association, at least to a systolic blood pressure as low as 110 mmHg, 28, 29 so that a threshold of 140 90 mmHg is neither a sensitive 71% ; nor specific 54% ; predictor of cardiovascular risk.28 In addition, evidence from published trials supports medical intervention for high risk patients irrespective of initial blood pressure.30, 31 This uncertainty remains true for diabetes and hypercholesterolemia, and the controversy about where to start treatment has lead to moving from a "goalposts" definition to a risk assessment approach. As a result, the clinical application of cardiovascular risk calculators has become increasingly important in routine clinical practice, a trend encouraged by EBM. While this review used PWV data in risk assessment for a series of common case scenarios, PWV is not incorporated in current cardiovascular risk calculations. However, with accumulating data such a development should soon be achievable and cycrin.
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Bog H, Yorston D, Foster A, 1993, Results of Community-based Eyelid Surgery for Trichiasis due to Trachoma. British Journal of Ophthalmology 77: 81-83. Esrey S, J Potash, L Roberts, C Shiff 1991, Effects of Improved Water Supply and Sanitation on Ascariasis, Diarrhea, Dracunculiasis, Hookworm Infection, Schistosomiasis, and Trachoma, WHO Bulletin 69 5 ; : 609-621 Mecaskey JW, Knirsch CA, Kumaresan JA, Cook JA 2003, The Possibility of Eliminating Blinding Trachoma. The Lancet 3 11 ; . Mecaskey JW, Ngirwamungu E, Kilima 2003, Integration of Trachoma Control into Primary Health Care: The Tanzanian Experience, American Journal of Tropical Medicine and Hygiene 69 Suppl 5 ; : 29-32 West, SK 2003, Blinding Trachoma: Prevention with the SAFE Strategy, American Journal of Tropical Medicine and Hygiene, 69 Suppl 5 ; : 18-23 West SK, Congdon N, Katala S, Mele L, 1991, Facial Cleanliness and Risk of Trachoma in Families. Arch Ophthalmology 1098: 855-857 and mefenamic.
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The Houston Discovery Workshop was held in Houston, Texas on Tuesday, January 31st. Over 40 prospects from 20 institutions attended! Discovery Workshops are a unique opportunity for 20-30 accounts to have an entire day learning about TREK products, with no outside interruptions. Attendees to the workshops arrive at 8: 30 for a continental breakfast before the workshop begins at 9: 00 am. During the morning session, the attendees learn the scientific principles behind our products from the experts and hear testimonials from actual VersaTREK and Sensititre product users. Dr. Kirk Doing from Affiliated Laboratory, Inc. in Bangor, Maine and Verna Morton from Cox Medical Center in Springfield, Missouri were our testimonial speakers at the Houston Discovery Workshop. Right before lunch, there is a raffle for a couple of "door prizes" and then the group breaks for an hour lunch with TREK employees. In the afternoon session, the attendees are broken into two groups to participate in handson VersaTREK and Sensititre product demonstrations. Attendees to the workshop also receive 4 P.A.C.E. credits. The feedback from the attendees was all very positive! We look forward to hosting more Discovery Workshops in 2006. We currently have plans to sponsor a Discovery Workshop in Philadelphia, Cleveland, and Chicago. For more information on these workshops, or an upcoming workshop in your area, please contact us at info trekds and ponstel.
CRAWFORD: Well, there's a really special yoga class here in L.A. that's taught by a woman named Gumook. And really, what you get out of it I mean, yes, you do exercise and there's probably a lot of benefit to that but what I personally remember about it was just sharing that space and that time with other pregnant women and celebrating, you know, being pregnant. NARRATOR: ER STAR MING-NA ALSO MADE YOGA A PART OF HER PREGNANCY, AS DID MELROSE PLACE ALUMS JOSIE BISSETT AND LISA RINNA. BUT FOR LISA, IT WASN'T THE YOGA STUDIO WHICH MADE HER FEEL MOST AT EASE, IT WAS THE NURSERY. LISA RINNA: It's so magical, it's so yummy. You walk in and you just want to hang out. Your room is so special to you it's your first home and so I just want this baby to love her room and be comfortable. NARRATOR: ALEX KINGSTON, ANOTHER ER STAR, ALSO HAD DREAMS OF A NURSERY, BUT THE ROAD WAS NOT AN EASY ONE. ALEX KINGSTON: It was a strain, it really was. And whenever we discovered that friends or acquaintances had become pregnant, I got very upset that it wasn't happening to me. Certainly, I would say with the help of the yoga I was doing and with the infertility therapy, I know that that helped me to conceive. I'd say I probably wanted to have children from the age of 18, so it's been a long time coming, I have to say. NARRATOR: THEIR ROLES ON TELEVISION HAVE MADE THEM FAMOUS, BUT IT'S THEIR ROLES AS MOMS WHICH HAVE MADE THEM COMPLETE, for instance, mdloxicam contraindications.
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Conditions perforations bleeding ; event group log rank test, P 0.3012 ; . Cross-tabulation of risk factors with event groups revealed associations between symptomatic acid peptic ; upper GI events and age 2 P 0.001 ; , past medical history of upper GI problems 2 P 0.001 ; and sex 2 P 0.001 ; . Conversely, there was only evidence of a significant association between experiencing complicated upper GI conditions perforations bleeding ; and age P 0.0001 ; . A higher proportion of patients who were prescribed celecoxib and who experienced symptomatic acid peptic ; upper GI events had a medical history of upper GI problems than those prescribed meloicam [75.1% 665 885 ; vs 53.5% 660 1233 ; , respectively, 2 P 0.0001]. Similarly a higher proportion of patients who were prescribed celecoxib, who experienced complicated upper GI conditions perforations bleeding ; , had a past medical history of upper GI problems than those prescribed meloxicam [67.7% 23 34 ; vs 34.9% 22 63 ; , respectively, 2 P 0.008]. There was no significant difference between the two cohorts, for either group of GI symptoms, in the number who had been prescribed a NSAID within 3 months prior to starting treatment 2 P 0.861 and 0.859, respectively ; . A similar proportion of patients from the celecoxib and meloxicam cohorts were reported to have been diagnosed with Helicobacter pylori infection 0.04%, n 7 and 0.09%, n 17, respectively, 2 P 0.068 ; . Overall a higher proportion of patients diagnosed with H. pylori experienced symptomatic acid peptic ; upper GI events 0.5%, n 13 vs 0.03%, n 11, 2 P 0.0001 ; than those who did not experience such symptoms. However, no complicated upper GI conditions perforations bleeding ; were reported for patients diagnosed with H. pylori. Limited information on starting dose and dose at event were recorded from the green forms for meloxicam, and reporting was incomplete for celecoxib. Where information on dose at event was provided for celecoxib, 92.2% 671 727 ; of patients reported to have symptomatic acid peptic ; conditions were taking 200 mg day or less, and 83.9% 26 31 ; of patients reported to have complicated upper GI conditions perforations bleeding ; were taking 200 mg or less. Celecoxib users were less likely to have a `dose increase' reported as an event than meloxicam users 1.2%, n 207 vs 1.8%, n 350, 2 P 0.0001 ; , but no evidence of a difference was found between the cohorts in those for whom a `dose reduction' was reported 0.3%, n 46 and 0.3%, n 61, 2 P 0.321 ; . As the reporting of dose data was low, it was not adjusted for in the multivariate analysis. Table 3 shows crude event rates per 1000 person-years for both drug cohorts over the first 9 months of treatment and RR for each risk factor category. As indicated earlier in the results, a possible relationship exists between age and both event groups. Regarding symptomatic acid peptic ; upper GI events, celecoxib users who are aged 40 59 yr, 6079 yr and 80 yr or more had a higher but not significant ; rate of having these events than the reference group aged under 40 yr ; . reported previously, a.
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Rine Alchem, Dublin, Ireland ; was prepared as a stock solution of 1 mmol L. Series of dilutions were made in deionized water on the day of experimentation and were maintained on ice for the duration of the experiment. Fresh Krebs-Henseleit physiologic salt solution was made daily. The integrals of contractile activity were measured for a 20-minute period for each bath concentration of COX-2 inhibitor. Hence, the effects of nimesulide, meloxicam, and celecoxib on myometrial contractility were calculated for each 20-minute period of exposure to 1 nmol L, 10 nmol L, 100 nmol L, 1 mol L, 10 mol L, and 100 mol L, respectively, and these values were expressed as a percentage of the integral measured for the 20-minute period before addition of any drug. The integral of contractile activity calculated after bath addition of the final dose of COX-2 inhibitor, subtracted from 100% ie, before any drug addition ; , represented the maximal relaxant effect for the compound. The EC50 value is the concentration of drug that results in 50% of the maximal inhibitory effect and was used as a means of comparing potency. Because the EC50 values were in the micromolar range ie, 10 6 molar ; , values for the log10 molar concentration of relaxant that produces 50% inhibition ie, log10 EC50 values ; were used for the analysis eg, 1 mol L 10 6 mol L log10 EC50 of 6.0 ; . Values for the log10 molar concentration of relaxant that produces 50% inhibition log10 EC50 values ; were calculated by linear regression of the probit of response versus log10 molar concentration for each of the COX-2 inhibitors studied in isolated strips of human myometrium. The log10 EC50 values and the mean maximal inhibition values for the three compounds, in the three different tissue types, were compared using a 3 factorial analysis of variance ANOVA ; test. Post-hoc testing, when indicated, was performed using Fishers Least Significant Difference LSD ; protected t test. A value of P .05 was accepted as statistically significant. RESULTS The demographic features of women who underwent elective and emergency cesarean delivery and hysterec and oxsoralen and meloxicam.
University Hospital, Queen's Medical Centre, Nottingham, * Hopital Cochin, Paris, France, Sportklinik Stuttgart, Germany, Hospital de Enfermedades Reumaticas, Barcelona, Spain, CMS Foch, Suresnes, Hopital Pellegrin-Carriere, Bordeaux, France, dU Z Pellenberg, Lubbeek, Belgium, * Rheumatism Foundation Hospital, Heinola, Finland, Monash Medical Centre, Victoria, Australia, Heinrich-Heine-Universitat, Dusseldorf, Germany and District General Hospital of Athens, Greece SUMMARY Although widely used, non-steroidal anti-inflammatory drugs NSAIDs ; are associated with a high incidence of gastrointestinal GI ; side-effects. Inhibition of the cyclooxygenase COX ; enzyme is the basis for both the efficacy and toxicity of NSAIDs. The discovery of two COX isoforms, constitutive COX-1 and inducible COX-2, has led to the hypothesis that selective inhibition of COX-2 will minimize the potential for GI toxicity without compromising efficacy. The Meloxicaam Large-scale International Study Safety Assessment MELISSA ; trial reported here was therefore set up to investigate the tolerability of meloxicam, a preferential inhibitor of COX-2, compared to diclofenac. MELISSA was a large-scale, double-blind, randomized, international, prospective trial, conducted over 28 days in patients with symptomatic osteoarthritis. Patients received either meloxicam 7.5 mg or diclofenac 100 mg slow release, the recommended doses for the treatment of osteoarthritis. Evaluation of the profile of adverse events was the main aim of the trial, together with assessment of efficacy. A total of 9323 patients received treatment 4635 and 4688 in the meloxicam and diclofenac groups, respectively ; . Significantly fewer adverse events were reported by patients receiving meloxicam. This was attributable to fewer GI adverse events 13% ; compared to diclofenac 19%; P 0.001 ; . Of the most common GI adverse events, there was significantly less dyspepsia P 0.001 ; , nausea and vomiting P 0.05 ; , abdominal pain P 0.001 ; and diarrhoea P 0.001 ; with meloxicam compared to diclofenac. Five patients on meloxicam experienced a perforation, ulcer or bleed vs seven on diclofenac not significant ; . No endoscopically verified ulcer complication was detected in the meloxicam group compared to four with diclofenac. There were five patient days of hospitalization in patients on meloxicam compared to 121 with diclofenac. Adverse events caused withdrawal from the study in 254 patients receiving meloxicam 5.48% ; compared to 373 7.96% ; on diclofenac P 0.001 ; . These differences were attributable to differences in reported GI adverse events 3.02% on meloxicam vs 6.14% on diclofenac; P 0.001 ; . Differences in efficacy, as assessed by visual analogue scales, consistently favoured diclofenac. In all instances, 95% confidence intervals did not cross zero, suggesting a statistically significant effect. However, differences were small 4.59.0% difference ; and did not reach pre-determined levels of clinical significance. Nevertheless, significantly more patients discontinued meloxicam because of lack of efficacy 80 out of 4635 vs 49 out of 4688; P 0.01 ; . The MELISSA trial confirms earlier studies suggesting that meloxicam has a significantly improved GI tolerability profile in comparison with other NSAIDs, including diclofenac. These results may in part reflect the preferential COX-2 selectivity of meloxicam, although the dose and other aspects of tolerability may be important. These results may provide support for the hypothesis that selective inhibition of COX-2 relative to COX-1 might be an effective approach towards improved NSAID therapy. KEY WORDS: Meloxicam, NSAID, COX-2, Osteoarthritis, Large-scale clinical trial.
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The study group consisted of premenopausal women diagnosed as having breast ductal carcinoma who underwent mastectomy in hospitals affiliated to Shiraz University of Medical Sciences from 2001 through 2004. Based on the days lasting from the first day of the last menstrual period at the operation time, the patients were categorized into four groups: early follicular days 0 7, EF ; , late follicular days 8 14, LF ; , early luteal days 15 21, EL ; , and late luteal days 22 33, LL ; phases. The patients who had a recent menstrual cycle in excess of 34 days were excluded from the study. The appropriate paraffin block was chosen for IHC. After blocking the endogenous peroxidase and nonspecific binding, antigen retrieval was performed by boiling the slides in citrate buffer pH 6.0 ; for 40 min. The receptor analysis was performed, using diluted monoclonal antibody 1: 100 ; for ER and prediluted polyclonal antibody for PR Dako, Denmark ; , and visualized by the universal Streptavidin Biotin kit LSAB Kit, Dako ; followed by diaminobenzidine colorization. The slides were then lightly counterstained with hematoxylin. For statistical evaluation 2 test was used to compare the frequencies of expression rates of the receptors. The significance level of P value was set at 0.05.
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Prachatip Kata. The study on social capital and the role of social capital in social movement : case study of healthy civil society in one village in north-eastern region of Thailand. Bangkok : Mahidol University, 2004. 89 p. T E32997 ; Stewart, Robb. Civil society and policy advocacy in Thailand : the role of advocacy coalitions in the establishment of the National Human Rights Commission, 1990-2000. Bangkok : Chulalongkorn University, 2001. 217 p. T E19707 ; Theerasak Prompunjai. The existence of civil society organizations fighting violence against women : a case study of one organization in northeast of Thailand. Bangkok : Mahidol University, 2005. 115 p. T E33813 ; Wirat Kamsrichan. Civic-minded in the context of Thai civil society. Bangkok : Mahidol University, 2001. 119 p. T E16382 ; . Roles of local civil society in community economic development. : , 2542. 137 . 101372 ; . : .2536-2538 Democracy-oriented groups in the civil society : roles in pressuring for the political reform policy, 1993-1995. : , 2541. 191 . 101431, because novo meloxicam.
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