A randomized double-blind placebo-controlled trial of Lactobacillus GG for abdominal pain disorders in children

BACKGROUND

Functional abdominal pain disorders (FAPD) are common in school-aged children; however, there is no reliable treatment.

AIM

To determine the efficacy of Lactobacillus rhamnosus GG (LGG) for treating FAPD in children.

METHODS

A total of 104 children who fulfilled the Rome II criteria for functional dyspepsia (FD), or irritable bowel syndrome (IBS), or functional abdominal pain (FAP) were enrolled in a double-blind, randomized controlled trial in which they received LGG (n = 52), or placebo (n = 52) for 4 weeks.

RESULTS

For the overall study population, those in the LGG group were more likely to have treatment success (no pain) than those in the placebo group (25% vs. 9.6%, relative benefit (RB) 2.6, 95% confidence interval (CI): 1.05-6.6, number needed to treat (NNT) 7, 95% CI: 4-123). For children with IBS (n = 37), those in the LGG group were more likely to have treatment success than those in the placebo group (33% vs. 5%, RB 6.3, 95% CI: 1.2-38, NNT 4, 95% CI: 2-36) and reduced frequency of pain (P = 0.02), but not pain severity (P = 0.10). For the FD group (n = 20) and FAP group (n = 47), no differences were found.

CONCLUSION

The LGG appears to moderately increase treatment success, particularly among children with IBS.

109 HYDROSTATIC PRESSURE INDUCED INCREASE IN POST-THAW MOTILITY OF FROZEN BOAR SPERMATOZOA

Formerly we reported that a sublethal shock, high hydrostatic pressure (HHP), significantly improves the post-thaw survival of frozen mouse blastocysts and post-thaw motility of frozen bull sperm, presumably from the HHP induced changes in the protein profile [e.g. heat shock proteins (HSPs)] (Pribenszky et al. 2005 Rep. Fert. Dev. 17, 199–200; Pribenszky et al. 2005 Anim. Rep. Sci. 87, 143–150). We now report the effect of HHP on the motility of fresh boar semen, and we compare post-thaw motility of HHP-treated frozen boar semen with non-pressurized frozen-thawed controls. Pressurization was done both at RT and at body temperature (BT). Exp. 1: Semen was extended with Beltsville thawing solution (BTS), centrifuged, diluted with lactose-egg yolk diluent with a final concentration of 6% glycerol and 0.5% Equex (Minitüb, Tiefenbach, Germany) to a sperm concentration of 3 × 109/mL. Diluted sperm were loaded into 0.25-mL straws (IMV, Paillette Crista, France) at RT. Straws were heat sealed then assorted to one of the treatment groups (100, 200, 400, or 800 bar for 40, 80, or 120 min). Non-pressurized samples were left at RT for the corresponding time. For freezing, straws were put at 15°C for 3 h, and then 5°C for 2 h, followed by 3 cm above LN2 for 10 min before plunging into LN2. Exp. 1 was repeated on two boars. Exp. 2: Sperm was treated with 400 bar for 80 min at RT or BT, and was then prepared and frozen as described above, together with non-pressurized controls. Exp. 2 was repeated in five boars. For evaluation, straws were thawed in a 37°C water bath for 2 min. Motility was analyzed with CASA SpermVision 3.0 (Minitüb). For hypothesis testing, a linear mixed model was fit to the motility data. The analysis was carried out in R statistical software. In Exp. 1, the 100-, 200-, and 400-bar treatments did not affect motility; 800 bar treatments resulted in reduced motility compared to control. After 5 h of cold acclimatization, only the groups with 800 bar treatments and the non-pressurized controls had significantly reduced motility. After freezing-thawing motility (% ± SE) in groups pre-treated for 80 min with 200 or 400 bar was 43.2 ± 5.24 and 42 ± 3.24, respectively; control: 23.2 ± 1.83 motility in groups pre-treated for 120 min with 200 or 400 bar was 51 ± 2.33; 55.5 ± 3.63, respectively; control: 41.88 ± 2.97. The pre-treated groups displayed significantly enhanced motility compared to the nontreated controls. In Exp. 2, the HHP treatment performed at BT yielded the highest post-thaw motility compared to the HHP treatment at RT, or the non-pressurized controls (59.75 ± 2.59; 46.43 ± 2.05; 37.37 ± 2.19, respectively). All of these results differed significantly from each other. In conclusion, HHP treatment, simply inserted before the freezing step, can significantly increase post-thaw motility and yield consistent acceptable results. The effect of the treatment is even stronger at BT, but great care has to be taken to maintain BT from the time of sperm collection till the end of the treatment. Further experiments are being conducted concerning the pressure-induced alterations in the protein profile of boar spermatozoa (fresh and frozen-thawed). This work was supported by OTKA061975 and TST050157.

Results of a randomised, multicentre study comparing a new water-based gel of clindamycin 1% versus clindamycin 1% topical solution in the treatment of acne vulgaris

Several topical formulations of clindamycin phosphate are currently marketed for the treatment of acne vulgaris. This 12 week, multi-centre, investigator-blind, randomised, active and placebo-controlled, parallel group study assessed the clinical efficacy and safety of clindamycin 1% gel once-a-day vs clindamycin 1% solution twice-a-day, and to demonstrate its superiority vs its vehicle alone. A total of 592 subjects were included. After 12 weeks, a 65% reduction in inflammatory lesion count was observed with both active treatments. The gel was superior to its vehicle for total and inflammatory lesion reduction, Global Assessment of Improvement, and Global Severity Grade at final visit (all p < 0.01). No difference was found between the 2 active treatments for any of the evaluated criteria. Local tolerance in each active treatment group was slightly better with clindamycin gel (1.9% of subjects) relative to 3.1% in the topical solution group. In conclusion, the new water-based gel once-a-day formulation of clindamycin 1% is an effective, safe, and convenient alternative to the twice-a-day topical solution formulation in the treatment of acne vulgaris.

Prescribing practices in German and Swiss psychiatric university and in non-university hospitals: national differences

OBJECTIVE

There are great variations between hospitals in the way drugs are prescribed, and these variations may be due to multiple factors such as local prescribing traditions, pharmacoeconomic considerations, drug availability, regional differences of population, disease prevalence etc. Available studies on prescribing habits, apart from studies performed in a unique center, have until now been mainly restricted to single countries or regions and the comparisons across countries or regions have often been limited by the use of diverse methodologies and definitions. The aim of the present study was to compare drug prescriptions between German and Swiss psychiatric services with regard to their preference of newer psychotropics.

MATERIAL AND METHODS

Five psychiatric hospitals, associated to the AMSP project, were chosen to represent Swiss and German clinics, university and non-university settings. Data were available from one index day on 572 patients and 1,745 prescriptions. The comparisons were adjusted for age and gender.

RESULTS

There was a significant difference (p < 0.001) with regard to the prescription of newer antidepressants (NAD), Swiss clinicians giving proportionally more (65.2%) than the German psychiatrists (48.3%). No significant difference was, on the other hand, found as to the proportion of atypical antipsychotics, the lack of difference being due to the higher proportion of clozapine among the atypical antipsychotics in Germany.

CONCLUSION

There seems, therefore, to be a higher propensity for Swiss hospital psychiatrists to prescribe newer antidepressants. This seems to be due to national or regional prescribing traditions. Further studies are needed to investigate the economical influences on antidepressant prescribing in Swiss and German clinics.

Kinetic study of zinc sulphate release from lipophilic matrices prepared for the therapy of Wilson's disease

The rate and extent of drug release from the most controlled release wax matrices are influenced by the drug loading/embedding excipient ratio of the systems. In the present study hydrophobic wax - zinc sulphate matrices with different drug loadings were prepared for the therapy of Wilson's disease. The drug release was tested by the paddle method of USP and the dissolution data were analysed. Both the dissolution rate and kinetic profile can be controlled by alteration in the quantity of embedding material. Matrices of 75% zinc sulphate loadings showed steady state diffusion-controlled matrix release with good correlation in vitro. Good absorption of zinc sulphate from the gastrointestinal tract was proven by significant elevation of serum zinc level in patients with Wilson's disease.

A randomized, double-blind, parallel-group, duration-finding study of oral terbinafine and open-label, high-dose griseofulvin in children with tinea capitis due to Microsporum species

BACKGROUND

Tinea capitis, a common clinical pattern of dermatophyte infection in children is becoming a public health hazard in some countries. Several studies have reported terbinafine to be a safe and well-tolerated fungicidal drug for the treatment of this infection. However, the optimal treatment duration for its use in the treatment of tinea capitis caused by Microsporum species has not yet been determined.

OBJECTIVE

(i) To establish the optimal duration for terbinafine treatment to bring about complete cure of tinea capitis due to Microsporum infection in a large paediatric population, and (ii) to obtain information on the maximum therapeutic effect of the existing therapy.

PATIENTS AND METHODS

This parallel-group, double-blind, multicentre study was conducted in Europe and South America. Patients were randomized to one of four oral terbinafine treatment arms (6, 8, 10 or 12 weeks treatment) or to an open label, 12-week, high-dose griseofulvin (20 mg x kg(-1) x day(-1)) arm at a 1 : 1 : 1 : 1 : 1 ratio. All patients were followed up for 4 weeks after the end of the treatment phase.

RESULTS

In this group of 134 intention-to-treat patients, effective treatment was observed at the end of study in 62% of patients treated with terbinafine for 6 weeks and in 63% treated for 8 weeks. Mycological cure was obtained in 59% and 57%, respectively, and clinical cure in 76% and 80%. In the griseofulvin group, effective treatment was 88%, mycological cure was 76% and clinical cure 96%. However, these high rates were believed to be due to the high dosage of this drug and the prolonged course of treatment. Complete cure was observed at the end of study in 62% patients treated with terbinafine for 6 weeks, in 60% treated for 8 weeks and in 84% patients treated with griseofulvin for 12 weeks.

CONCLUSIONS

Although there was no statistical trend between the duration of terbinafine treatment within the groups for complete cure at the end of study, there was a positive correlation between the daily dose of terbinafine (mg x kg(-1)) and complete cure. Terbinafine therapy for 6 weeks could represent an alternative to griseofulvin for the treatment of Microsporum tinea capitis. However, further clinical trials are required in order to optimize the dose regimen to allow higher cure rates to be reached.

Isolation, characterisation and expression of mRNAs encoding the ovine CC chemokines, monocyte chemoattractant protein (MCP)-1alpha and -2

CC chemokines are important mediators of immune responses, orchestrating the differential recruitment of various leukocyte populations. Despite the large number of known CC chemokines in other species, no cDNA encoding ovine CC chemokines have been isolated. A homology cloning strategy was utilised to isolate the cDNA of ovine CC chemokines. Full-length monocyte chemoattractant protein (MCP)-1alpha and -2 cDNA have been isolated. The predicted ovine MCP-1alpha amino acid sequence shares 87 and 75% identity with bovine MCP-1alpha and porcine MCP-1, respectively. The predicted ovine MCP-2 amino acid sequence shares 92 and 85% identity with bovine and porcine MCP-2, respectively. Northern blot analysis of MCP-1alpha revealed that it is strongly expressed in cells isolated from mammary lavage fluid (MAL) of ewes given intramammary infusions of Haemonchus contortus. Weak signals were detected in mammary and abomasal tissue. Southern blot analysis of reverse transcriptase-polymerase chain reaction (RT-PCR) products indicates that MCP-1alpha mRNA levels increase in abomasum after challenge with H. contortus. MCP-1alpha mRNA levels were also increased in bronchoalveolar lavage (BAL) cells and lung tissue after house dust mite extract (HDME) challenge. Similarly, MCP-2 mRNA was detected by Northern blot analysis at high levels in MAL cells after H. contortus intramammary infusion, and increased in BAL cells and lung tissue in HDME-challenged sheep. MCP-2 mRNA was not detected by Northern blots in whole mammary or abomasal tissue, but Southern blot analysis of RT-PCR products also indicates that MCP-2 mRNA increases in abomasal tissue after challenge with H. contortus. Hence, two ovine CC chemokine mRNA have been isolated that are up-regulated in response to parasite infection and allergen challenge. Ultimately the isolation of these and other ovine CC chemokines will help elucidate a wide variety of immune responses in sheep.

Disinhibition of libido: an adverse effect of SSRI?

BACKGROUND

The article focuses on adverse drug reactions (ADR) to selective serotonin reuptake inhibitors (SSRI) concerning libido and sexual behaviour: cases of disinhibition of libido observed at the Psychiatric Hospital of Kilchberg near Zurich are described.

METHOD

Within the scope of a drug safety program, the physicians of the hospital are regularly asked about severe and unexpected events under drug treatment.

RESULTS

During remission of depression, five outpatients noticed an increase of libido experienced as strange to them, i.e. preoccupation with sexual thoughts, first appearance of promiscuity, of unsafe sexual intercourse, and of excessive pursuit of pornography, respectively, during administration, change in dose or discontinuation of SSRI.

DISCUSSION

The case studies suggest that SSRI treatment might be associated with increase and disinhibition of libido. The phenomena are discussed as a "selective switch" into partly manic symptomatology or an induction of mixed states with prevailing sexual symptoms.

Cryopreservation of spermatozoa in cyprinid fishes

The present study investigated semen cryopreservation in cyprinid fish using computer-assisted sperm motility analysis for viability control. Spermatozoa of the bleak, Chalcalbumus chalcoides, were used as a basic model to describe the toxic and cryoprotective effects of internal and external cryoprotectants, their most effective concentrations and combinations, the freezing and thawing conditions, and the effects of equilibration. We also used these data to develop a cryopreservation protocol for Barbus barbus, Chondrostoma nasus, Ctenopharyngodon idella, Cyprinus cario, Hypohtalmichthys molitrix, Leuciscus cephalus, Rutilus meidingerii, and Vimba vimba. For all investigated species the optimal extender composition was a buffered physiological sperm motility-inhibiting saline solution containing 10% DMSO and 0.5% glycin. The optimal sperm equilibration period in the extender was < or = 5 min. Freezing was performed in an insulated box in liquid nitrogen vapor and it was optimal at 4 to 5 cm above the surface of the liquid, depending on the species. Thawing was optimal in a 25 degrees C water bath whereby the thawing time ranged depending on species from 15 to 45 sec. This cryopreservation protocol resulted in frozen-thawed semen with 35 to 65% motile and 5 to 25% locally motile spermatozoa depending on the quality of fresh semen.

Five-year experience with a suture annuloplasty for mitral valve repair

We present five years' experience with mitral plication annuloplasty, performed with a semicircular buttressed suture around the posterior leaflet in 130 patients (mean age 58 +/- 11 years) with primary mitral valve disease (n = 71) or functional mitral regurgitation (n = 59). In 65 cases the mitral valve itself was also repaired. Concomitant myocardial revascularization was performed in 40 cases and aortic valve replacement in 43. All but three patients were followed up (97.6%). Postoperative echocardiography showed acceptable mitral area (2.28 +/- 0.39 cm2) and good valve competence in all cases. Inhospital mortality was 3% and late mortality 4.8%. During the follow-up period (22.8 +/- 10.9 months) 8 patients (6.6%) required mitral valve replacement because of progression of native valve disease (n = 4), technical failure (2) or expansion of the annuloplasty suture (2). Mitral annuloplasty thus can be performed simply and with good results, using a strong, non-stretchable buttressed suture. This procedure can be an inexpensive alternative to ring implantation.

Detection of the mitochondrially encoded cytochrome c oxidase subunit I in the trypanosomatid protozoan Leishmania tarentolae. Evidence for translation of unedited mRNA in the kinetoplast

With the aim of identification of kinetoplast-encoded proteins we investigated the subunit composition of cytochrome c oxidase (respiratory complex IV) from kinetoplast mitochondria of the trypanosomatid protozoan Leishmania tarentolae. Eleven stoichiometric subunits were visible in Coomassie-stained, two-dimensional Blue Native/Tricine-SDS electrophoretic gels. Their partial amino acid sequences indicated that these polypeptides are nuclear-encoded. The mitochondrial subunit I was detected with the polyclonal antibodies against an internal region of this polypeptide. In two-dimensional (9 versus 14%) polyacrylamide glycine-SDS gels this subunit is found as a series of spots located off the main diagonal, a property that can be explained by abnormal electrophoretic migration and aggregation. In gels loaded with high amounts of the purified, enzymatically active oxidase, the subunit I spots could be visualized by staining. The determined N-terminal amino acid sequence of the putative monomeric subunit I (MFXLCLVCLSVS) matched with the predicted sequence, thus indicating that the corresponding kinetoplast unedited mRNA is translated into a functional protein.