Hormone replacement therapy and prevention of vertebral fractures: a meta-analysis of randomised trials

BACKGROUND: Hormone replacement therapy (HRT) is often seen as the treatment of choice for preventing fractures in women. We undertook a recent meta-analysis of randomised trials which suggested that HRT reduced non-vertebral fractures by 30%. In this analysis we extend that analysis to vertebral fractures. METHODS: We searched the main electronic databases until the end of August 2001. We sought all randomised controlled trials (RCTs) of HRT where women had been randomised to at least 12 months of HRT or to no HRT. RESULTS: We found 13 RCTs. Overall there was a 33% reduction in vertebral factures (95% confidence interval (CI) 45% to 98%). CONCLUSIONS: This review and meta-analysis showed a significant reduction in vertebral fractures associated with HRT use

Systematic review of topical treatments for fungal infections of the skin and nails of the feet

OBJECTIVE: To identify and synthesise the evidence for efficacy and cost effectiveness of topical treatments for superficial fungal infections of the skin and nails of the feet. DESIGN: Systematic review. INTERVENTIONS: Topical treatments for superficial fungal infections. MAIN OUTCOME MEASURES: Cure confirmed by culture and microscopy for skin and by culture for nails in patients with clinically diagnosed fungal infections. RESULTS: Of 126 trials identified in 121 papers, 72 (57.1%) met the inclusion criteria. Placebo controlled trials yielded pooled relative risks of failure to cure skin infections: allylamines (0.30, 95% confidence interval 0.24 to 0.38); azoles (0.54, 0.42 to 0.68); undecenoic acid (0.28, 0.11 to 0.74); and tolnaftate (0.46, 0.17 to 1.22). Although meta-analysis of 11 trials comparing allylamines and azoles showed a relative risk of failure to cure of 0.88 (0.78 to 0.99) in favour of allylamines, there was evidence of language bias. Seven reports in English favoured allylamines (0.79, 0.69 to 0.91), but four reports in foreign languages showed no difference between the two drugs (1.01, 0.90 to 1.13). Neither trial of nail infections showed significant differences between alternative topical treatments. CONCLUSIONS: Allylamines, azoles, and undecenoic acid were efficacious in placebo controlled trials. There are sufficient comparative trials to judge relative efficacy only between allylamines and azoles. Allylamines cure slightly more infections than azoles but are much more expensive than azoles. The most cost effective strategy is first to treat with azoles or undecenoic acid and to use allylamines only if that fails

Skin preparation with alcohol versus alcohol followed by any antiseptic for preventing bacteraemia or contamination of blood for transfusion (Review)

Background: Blood for transfusion may become contaminated at any point between collection and transfusion and may result in bacteraemia (the presence of bacteria in the blood), severe illness or even death for the blood recipient. Donor arm skin is one potential source of blood contamination, so it is usual to cleanse the skin with an antiseptic before blood donation. One-step and two-step alcohol based antiseptic regimens are both commonly advocated but there is uncertainty as to which is most effective. Objectives: To assess the effects of cleansing the skin of blood donors with alcohol in a one-step compared with alcohol in a two-step procedure to prevent contamination of collected blood or bacteraemia in the recipient. Search methods: In December 2014, for this third update, we searched the Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library; Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. Selection criteria: All randomised trials (RCTs) comparing alcohol based donor skin cleansing in a one-step versus a two-step process that includes alcohol and any other antiseptic for pre-venepuncture skin cleansing were considered. Quasi randomised trials were to have been considered in the absence of RCTs. Data collection and analysis: Two review authors independently assessed studies for inclusion. Main results: No studies (RCTs or quasi RCTs) met the inclusion criteria. Authors' conclusions: We did not identify any eligible studies for inclusion in this review. It is therefore unclear whether a two-step, alcohol followed by antiseptic skin cleansing process prior to blood donation confers any reduction in the risk of blood contamination or bacteraemia in blood recipients, or conversely whether a one-step process increases risk above that associated with a two-step process

Output state in multiple entanglement swapping

The technique of quantum repeaters is a promising candidate for sending quantum states over long distances through a lossy channel. The usual discussions of this technique deals with only a finite dimensional Hilbert space. However the qubits with which one implements this procedure will "ride" on continuous degrees of freedom of the carrier particles. Here we analyze the action of quantum repeaters using a model based on pulsed parametric down conversion entanglement swapping. Our model contains some basic traits of a real experiment. We show that the state created, after the use of any number of parametric down converters in a series of entanglement swappings, is always an entangled (actually distillable) state, although of a different form than the one that is usually assumed. Furthermore, the output state always violates a Bell inequality.Comment: 11 pages, 6 figures, RevTeX

Gamma-ray emission expected from Kepler's SNR

Nonlinear kinetic theory of cosmic ray (CR) acceleration in supernova remnants (SNRs) is used to investigate the properties of Kepler's SNR and, in particular, to predict the gamma-ray spectrum expected from this SNR. Observations of the nonthermal radio and X-ray emission spectra as well as theoretical constraints for the total supernova (SN) explosion energy E_sn are used to constrain the astronomical and particle acceleration parameters of the system. Under the assumption that Kepler's SN is a type Ia SN we determine for any given explosion energy E_sn and source distance d the mass density of the ambient interstellar medium (ISM) from a fit to the observed SNR size and expansion speed. This makes it possible to make predictions for the expected gamma-ray flux. Exploring the expected distance range we find that for a typical explosion energy E_sn=10^51 erg the expected energy flux of TeV gamma-rays varies from 2x10^{-11} to 10^{-13} erg/(cm^2 s) when the distance changes from d=3.4 kpc to 7 kpc. In all cases the gamma-ray emission is dominated by \pi^0-decay gamma-rays due to nuclear CRs. Therefore Kepler's SNR represents a very promising target for instruments like H.E.S.S., CANGAROO and GLAST. A non-detection of gamma-rays would mean that the actual source distance is larger than 7 kpc.Comment: 6 pages, 4 figures. Accepted for publication in Astronomy and Astrophysics, minor typos correcte

The mixed problem in L^p for some two-dimensional Lipschitz domains

We consider the mixed problem for the Laplace operator in a class of Lipschitz graph domains in two dimensions with Lipschitz constant at most 1. The boundary of the domain is decomposed into two disjoint sets D and N. We suppose the Dirichlet data, f_D has one derivative in L^p(D) of the boundary and the Neumann data is in L^p(N). We find conditions on the domain and the sets D and N so that there is a p_0>1 so that for p in the interval (1,p_0), we may find a unique solution to the mixed problem and the gradient of the solution lies in L^p

Clinical trial of lamivudine in children with chronic hepatitis B.

N Engl J Med. 2002 May 30;346(22):1706-13. Clinical trial of lamivudine in children with chronic hepatitis B. Jonas MM, Mizerski J, Badia IB, Areias JA, Schwarz KB, Little NR, Greensmith MJ, Gardner SD, Bell MS, Sokal EM; International Pediatric Lamivudine Investigator Group. of Gastroenterology, Children's Hospital, Boston, MA 02115, USA. Erratum in: N Engl J Med 2002 Sep 19;347(12):955. Kelley, Deirdre [corrected to Kelly, Deirdre]. Comment in: J Hepatol. 2003 May;38(5):698-9. N Engl J Med. 2002 May 30;346(22):1682-3. Abstract BACKGROUND: Lamivudine therapy is effective for chronic hepatitis B infection in adults. We evaluated the efficacy and tolerability of lamivudine as a treatment for chronic infection with hepatitis B virus (HBV) in children. METHODS: Children with chronic hepatitis B were randomly assigned in a 2:1 ratio to receive either oral lamivudine (3 mg per kilogram of body weight; maximum, 100 mg) or placebo once daily for 52 weeks. The primary end point was virologic response (defined by the absence of serum hepatitis B e antigen and serum HBV DNA) at week 52 of treatment. RESULTS: Of the 403 children screened, 191 were randomly assigned to receive lamivudine and 97 to receive placebo. The rate of virologic response at week 52 was higher among children who received lamivudine than among those who received placebo (23 percent vs. 13 percent, P=0.04). Lamivudine therapy was well tolerated and was also associated with higher rates of seroconversion from hepatitis B e antigen to hepatitis B e antibody, normalization of alanine aminotransferase levels, and suppression of HBV DNA. CONCLUSIONS: In children with chronic hepatitis B, 52 weeks of treatment with lamivudine was associated with a significantly higher rate of virologic response than was placebo. PMID: 12037150 [PubMed - indexed for MEDLINE

Hospitality, Culture and Regeneration: Urban decay, entrepreneurship and the "ruin" bars of Budapest

This paper considers the relationships between hospitality, culture and urban regeneration through an examination of rom (ruin) venues, which operate in dilapidated buildings in Budapest, Hungary. The paper reviews previous work on culture and urban regeneration in order to locate the role of hospitality within emerging debates. It subsequently interrogates the evolution of the rom phenomenon and demonstrates how, in this context, hospitality thrives because of social and physical decay in urban locations, how operators and entrepreneurs exploit conflicts among various actors involved in regeneration, and how hospitality may be mobilised purposefully in the regeneration process. The paper demonstrates how networked entrepreneurship maintains these operations and how various forms of cultural production are entangled and mobilised in the venues’ hospitality propositions

4f spin density in the reentrant ferromagnet SmMn2Ge2

The spin contribution to the magnetic moment in SmMn2Ge2 has been measured by magnetic Compton scattering in both the low and high temperature ferromagnetic phases. At low temperature, the Sm site is shown to possess a large 4f spin moment of 3.4 +/- 0.1 Bohr magnetons, aligned antiparallel to the total magnetic moment. At high temperature, the data show conclusively that ordered magnetic moments are present on the samarium site.Comment: 5 pages, 2 figures, transferred from PRL to PRB (Rapid Comm.

Bacterial rotary export ATPases are allosterically regulated by the nucleotide second messenger cyclic-di-GMP

The widespread second messenger molecule cyclic di-GMP (cdG) regulates the transition from motile and virulent lifestyles to sessile, biofilm-forming ones in a wide range of bacteria. Many pathogenic and commensal bacterial-host interactions are known to be controlled by cdG signaling. Although the biochemistry of cyclic dinucleotide metabolism is well understood, much remains to be discovered about the downstream signaling pathways that induce bacterial responses upon cdG binding. As part of our ongoing research into the role of cdG signaling in plant-associated Pseudomonas species, we carried out an affinity capture screen for cdG binding proteins in the model organism Pseudomonas fluorescens SBW25. The flagella export AAA+ ATPase FliI was identified as a result of this screen and subsequently shown to bind specifically to the cdG molecule, with a KD in the low micromolar range. The interaction between FliI and cdG appears to be very widespread. In addition to FliI homologs from diverse bacterial species, high affinity binding was also observed for the type III secretion system homolog HrcN and the type VI ATPase ClpB2. The addition of cdG was shown to inhibit FliI and HrcN ATPase activity in vitro. Finally, a combination of site-specific mutagenesis, mass spectrometry, and in silico analysis was used to predict that cdG binds to FliI in a pocket of highly conserved residues at the interface between two FliI subunits. Our results suggest a novel, fundamental role for cdG in controlling the function of multiple important bacterial export pathways, through direct allosteric control of export ATPase proteins