AIM:To investigate the ability of curcumin to counteract the impact of bile acids on gene expression of esophageal epithelial cells.METHODS:An esophageal epithelial cell line(HET1A)was treated with curcumin in the pre...AIM:To investigate the ability of curcumin to counteract the impact of bile acids on gene expression of esophageal epithelial cells.METHODS:An esophageal epithelial cell line(HET1A)was treated with curcumin in the presence of deoxycholic acid.Cell proliferation and viability assays were used to establish an appropriate dose range for curcumin.The combined and individual effects of curcumin and bile acid on cyclooxygenase-2(COX-2)and superoxide dismutase(SOD-1 and SOD-2)gene expression were also assessed.RESULTS:Curcumin in a dose range of 10-100μmol/L displayed minimal inhibition of HET-1A cell viability.Deoxycholic acid at a concentration of 200μmol/L caused a 2.4-fold increase in COX-2 gene expression compared to vehicle control.The increased expression of COX-2 induced by deoxycholic acid was partially reversed by the addition of curcumin,and curcumin reduced COX-2 expression 3.3-to 1.3-fold.HET-1A cells exposed to bile acid yielded reduced expression of SOD-1 and SOD-2 genes with the exception that high dose deoxycholic acid at 200μmol/L led to a 3-fold increase in SOD-2 expression.The addition of curcumin treatment partially reversed the bile acid-induced reduction in SOD-1 expression at all concentrations of curcumin tested.CONCLUSION:Curcumin reverses bile acid suppression of gene expression of SOD-1.Curcumin is also able to inhibit bile acid induction of COX-2 gene expression.展开更多
The incidence of hepatocellular carcinoma(HCC)in patients with human immunodeficiency virus(HIV) is rising.HCC in HIV almost invariably occurs in the context of hepatitis C virus(HCV)or hepatitis B virus (HBV)co-infec...The incidence of hepatocellular carcinoma(HCC)in patients with human immunodeficiency virus(HIV) is rising.HCC in HIV almost invariably occurs in the context of hepatitis C virus(HCV)or hepatitis B virus (HBV)co-infection and,on account of shared modes of transmission,this occurs in more than 33% and 10% of patients with HIV worldwide respectively.It has yet to be clearly established whether HIV directly accelerates HCC pathogenesis or whether the rising incidence is an epiphenomenon of the highly active antiretroviral therapy(HAART)era,wherein the increased longevity of patients with HIV allows long-term complications of viral hepatitis and cirrhosis to develop.Answering this question will have implications for HCC surveillance and the timing of HCV/HBV therapy,which in HIV co-infection presents unique challenges.Once HCC develops,there is growing evidence that HIV co-infection should not preclude conventional therapeutic strategies,including liver transplantation.展开更多
Graphene-based materials are intriguing from the perspective of fundamental science and technol- ogy because they are non-toxic, chemically and thermally tolerant, and mechanically robust. Graphene exhibits superior e...Graphene-based materials are intriguing from the perspective of fundamental science and technol- ogy because they are non-toxic, chemically and thermally tolerant, and mechanically robust. Graphene exhibits superior electrical conductivity, high surface area and a broad electrochemical window that may be particularly advantageous for their applications in energy storage devices. In addition, graphene can be prepared in the form of a colloidal suspension with adjustable solubility and thus is suitable for printing applications and offers both transparency and good conductivity at the same time. In this review, appli- cations of graphene in solar cells, batteries, supercapacitors and fuel cells are summarized with the latest developments. Furthermore, graphene as a conductive ink for printed electronics is also discussed.展开更多
Displays using direct light emission from microscale inorganic light-emitting diodes(μILEDs)have the potential to be very bright and also very power efficient.High-throughput technologies that accurately and cost-eff...Displays using direct light emission from microscale inorganic light-emitting diodes(μILEDs)have the potential to be very bright and also very power efficient.High-throughput technologies that accurately and cost-effectively assemble microscale devices on display substrates with high yield are key enablers forμILED displays.Elastomer stamp transfer printing is such a candidate assembly technology.A variety ofμILED displays have been designed and fabricated by transfer printing,including passive-matrix and active-matrix displays on glass and plastic substrates.展开更多
Background:Retreatments are sometimes necessary to correct residual or induced refractive errors following refractive surgery.Many different combinations of primary treatment methods and retreatment techniques have be...Background:Retreatments are sometimes necessary to correct residual or induced refractive errors following refractive surgery.Many different combinations of primary treatment methods and retreatment techniques have been studied,however,few studies have investigated wavefront-optimized(WFO)technology for retreatment following primary refractive surgery.This study aimed to report the outcomes of WFO photorefractive keratectomy(PRK)retreatments of refractive error following previous laser refractive surgery with PRK,laser in situ keratomileusis(LASIK),or laser-assisted subepithelial keratectomy(LASEK).Methods:We reviewed records of patients who underwent WFO PRK retreatments using the Allegretto Wave Eye-Q 400 Hz Excimer Laser System(Alcon Surgical)between January 2008 and April 2011 at Walter Reed Army Medical Center and Madigan Army Medical Center.Outcomes were recorded in terms of uncorrected distance visual acuity(UDVA),manifest refraction spherical equivalent(MRSE),corrected distance visual acuity(CDVA),and complications at 1 month(M),3 M,and 6 M post-op.Results:Seventy-eight patients(120 eyes)underwent WFO PRK retreatment during the study period.Primary surgery was surface ablation in 87 eyes(78 PRK,9 LASEK)and LASIK in 33 eyes.The mean spherical equivalent before retreatment was−0.79±0.94 D(−3.00 to 1.88 D).UDVA was≥20/20 in 69 eyes(60.0%)at 1 M,54 eyes(71.1%)at 3 M,and 27 eyes(73.0%)at 6 M follow-up.MRSE was within±0.50 D of emmetropia in 78 eyes(67.8%)at 1 M,59 eyes(77.6%)at 3 M,and 25 eyes(67.6%)at 6 M follow-up.CDVA was maintained within±1 line of pre-op in 113 of 115 eyes(98.3%)at 1 M,74 of 76 eyes(97.4%)at 3 M,and 37 eyes(100%)at 6 M follow-up.Conclusion:Although follow-up was limited beyond 3 M,WFO PRK retreatments in patients with residual refractive error may be a safe and effective procedure.Further studies are necessary to determine the long-term safety and stability of outcomes.展开更多
As medical care progresses and the number of patients with chronic conditions increases there is the inevitable challenge of managing patients with multiple comorbidities.Inflammatory bowel disease(IBD)is an umbrella ...As medical care progresses and the number of patients with chronic conditions increases there is the inevitable challenge of managing patients with multiple comorbidities.Inflammatory bowel disease(IBD)is an umbrella term for are inflammatory conditions affecting the gastrointestinal tract,the two most common forms being Ulcerative Colitis and Crohn’s disease.These diseases,usually diagnosed in young adults,exhibit a relapsing and remitting course and usually require longterm treatment.IBD can be treated with a number of topical and systemic treatments.We conducted a review of the current published evidence for the effects these medications can have on diabetes mellitus(DM)and glycaemic control.Searches were conducted on medline and embase with a timeframe from 1947(the date from which studies on embase are recorded)to November 2020.Suitable publications were selected and reviewed.Current evidence of the impact of aminosalicylates,corticosteroids,thiopurines,and biologic agents was reviewed.Though there was limited evidence for certain agents,IBD medications have been shown to have an effect of DM and these effects should be considered in managing patients with dual pathologies.The effects of steroids on blood sugar control is well documented,but consideration of other agents is also important.In patients requiring steroids for Ulcerative Colitis,locally acting steroid agents delivered rectally may be preferred to minimise side effects in those with distal bowel Ulcerative Colitis.A switch to other agents should be considered as soon as possible in people with diabetes to limit the impact on glycaemic control.5-aminosalicylates appear to play a role in the reduction of hemoglobin A1c(HbA1c),although the literature suggests these may be falsely low readings.Consequently,monitoring of people with diabetes on these agents may require daily monitoring of capillary blood sugars rather than relying simply on HbA1c;for example fructosamine performed 3-6 monthly,although this risks missing the rise in readings.There is展开更多
There is increasing recognition of the potential morbidity and mortality associated with HIV-1 and hepatitis C (HCV)co-infection. HIV appears to adversely affect HCV disease while the reciprocal effect of HCV on HIV r...There is increasing recognition of the potential morbidity and mortality associated with HIV-1 and hepatitis C (HCV)co-infection. HIV appears to adversely affect HCV disease while the reciprocal effect of HCV on HIV remains controversial.We therefore studied the effect of co-infection on dendritic cell function versus HIV infection alone, as previous work has shown that HCV impairs dendritic cell (DC) function. HIV-1 positive individuals with HCV were matched for CD4count, HIV- 1 RNA viral load and therapy, to HIV- 1 positive patients without HCV. Monocyte-derived DC were generated and mixed leukocyte reactions were performed. We assessed allostimulatory capacity with and without administration of exogenous Thl cytokines, using thymidine uptake and cell division analyses with the vital dye CFSE. We found that monocyte-derived DC from co-infected individuals showed no significant differences in allostimulatory capacity to ex vivo generated DC from HIV-1 infected individuals without HCV. Unlike the situation with HCV infection alone, this impairment was not reversed by increasing concentrations of either interleukin-2 or -12. Monocyte-derived DC from HIV-1 and HCV co-infected individuals have a similar allostimulatory capacity to DC from matched patients with HIV-1alone. These findings are compatible with results of prior clinical studies that found no evidence that HCV co-infection altered HIV disease progression and has implications for immunotherapeutic approaches in co-infected individuals.展开更多
Purpose: Optimal pain management strategies for patients undergoing component separation hernia repair are not defined. Epidural analgesia (EA) has been shown to decrease pulmonary complications and duration of ileus ...Purpose: Optimal pain management strategies for patients undergoing component separation hernia repair are not defined. Epidural analgesia (EA) has been shown to decrease pulmonary complications and duration of ileus and to improve pain control in other patient populations. In this study we examined outcomes of patients receiving EA after separation of components (SOC). Methods: After obtaining IRB approval, a retrospective review was performed of patients undergoing ventral hernia repair with SOC from January 2006 to October 2010 at the University of Kentucky. Patients were identified from hospital operative records. Pre-operative patient characteristics and operative data were obtained from the medical record. Information was collected relating to use of EA, complications, and length of hospitalization (LOS). Post-operative outcomes were compared between those that had epidurals and those that did not. Results: One hundred seventeen patients were identified that underwent SOC, 34 of whom had EA. These two groups were similar in relation to age, BMI, and co-morbidities. Three patients in the epidural group had complications limiting epidural duration—two with hypotension and one with refractory pruritus. There was no difference in pneumonia, deep vein thrombosis (DVT), wound infection, urinary tract infection (UTI), recurrence, or mortality (Table 1). There was an increase in LOS (6.68 vs. 6.06 days, p 0.01) in patients with EA. Conclusions: The use of EA results in increased LOS in patients undergoing SOC. EA associated morbidity occurs infrequently. The incidence of post-operative complications is unaffected by EA. Further studies are needed to delineate the benefit of EA in this patient population.展开更多
Death related to acute hepatitis B occurs in approximately 1%of patients. We investigated an outbreak of hepatitis B virus (HBV) infections among injection d rug users (IDUs) resulting in several deaths. We conducted ...Death related to acute hepatitis B occurs in approximately 1%of patients. We investigated an outbreak of hepatitis B virus (HBV) infections among injection d rug users (IDUs) resulting in several deaths. We conducted a case-control study of fulminant (case patients) and nonfulminant (control patients) HBV infections . We directly sequenced the entire HBV genome from fulminant and nonfulminant ca ses. From October 1998 to July 2000,21 acute HBV infections, including 10 fulminant hepatitis B cases, were identified. The med ian age was 30 (range, 18-49) years, 12 (57%) were female, 20 (95%) were Amer ican Indians, and 20 (95%) reported injecting illicit drugs. All patients with fulminant hepatitis B died (case-fatality rate = 47.6%). Case patients (n = 5) and control patients (n = 9) were similar with respect to age, sex, race, and h epatitis C virus serostatus. All case patients used acetaminophen during their i llness compared with 44%of control patients (P = .08). Compared with control pa tients, case patients lost more weight in the 6 months before illness (P = .04); during their illness, they used more alcohol (P = .03) and methamphetamine (P = .04). All 9 isolates sequenced were genotype D, shared 99.7%homology, and incl uded mutations previously described in association with fulminant hepatitis B. I n conclusion, a high prevalence of exposure to factors potentiating hepatic dama ge with acute hepatitis B contributed to the outbreak’s high mortality rate; mu tations present in the outbreak strain might also have been a factor. Improved v accination coverage among IDUs has the potential to prevent similar outbreaks in the future.展开更多
PURPOSE: To compare the rate of epithelial healing following photorefractive keratectomy (PRK) with two commercially available fourth-generation fluoroquinolones, gatifloxacin (Zymar, Allergan, Irvine, California) and...PURPOSE: To compare the rate of epithelial healing following photorefractive keratectomy (PRK) with two commercially available fourth-generation fluoroquinolones, gatifloxacin (Zymar, Allergan, Irvine, California) and moxifloxacin (Vigamox, Alcon Laboratories, Fort Worth, Texas). DESIGN: Double-masked, randomized, prospective trial. METHODS: Thirty-five subjects received gatifloxacin in one eye and moxifloxacin in the fellow eye following PRK with a 9.0- mm epithelial defect. Patients were examined daily after surgery until the epithelium had healed completely in both eyes. Beginning on post-operative day 3, photos were taken and used to confirm epithelial healing or measure the area of residual epithelial defects. Healing times and defect sizes were compared using the Wilcoxon signed-ranks test. RESULTS: Both eyes healed on the same day in 18 of the 35 subjects (51.4% ). In 13 of 35 (37.1% ) subjects, the moxifloxacin-treated eye healed first, compared with only four of 35 (11.4% ) subjects whose gatifloxacin-treated eye healed first. All six of the eyes that took 2 days longer than their fellow eye to heal were gatifloxacin-treated. Median healing time for both groups was 4 days (moxifloxacin range: 3 to 7 days; gatifloxacin range: 3 to 9 days; P=.01), but only 69% of gatifloxacin-treated eyes had healed by day 4 compared with 80% of the moxifloxacint reated eyes. Overall, on each post-operative day, defect sizes were greater for the gatifloxacin-treated eyes. This difference was statistically significant on day 4 (P=.027). CONCLUSIONS: Eyes treated with moxifloxacin healed faster and had smaller defects compared with those treated with gatifloxacin. This provides another factor to consider in selecting antibiotic prophylaxis for corneal refractive surgery.展开更多
文摘AIM:To investigate the ability of curcumin to counteract the impact of bile acids on gene expression of esophageal epithelial cells.METHODS:An esophageal epithelial cell line(HET1A)was treated with curcumin in the presence of deoxycholic acid.Cell proliferation and viability assays were used to establish an appropriate dose range for curcumin.The combined and individual effects of curcumin and bile acid on cyclooxygenase-2(COX-2)and superoxide dismutase(SOD-1 and SOD-2)gene expression were also assessed.RESULTS:Curcumin in a dose range of 10-100μmol/L displayed minimal inhibition of HET-1A cell viability.Deoxycholic acid at a concentration of 200μmol/L caused a 2.4-fold increase in COX-2 gene expression compared to vehicle control.The increased expression of COX-2 induced by deoxycholic acid was partially reversed by the addition of curcumin,and curcumin reduced COX-2 expression 3.3-to 1.3-fold.HET-1A cells exposed to bile acid yielded reduced expression of SOD-1 and SOD-2 genes with the exception that high dose deoxycholic acid at 200μmol/L led to a 3-fold increase in SOD-2 expression.The addition of curcumin treatment partially reversed the bile acid-induced reduction in SOD-1 expression at all concentrations of curcumin tested.CONCLUSION:Curcumin reverses bile acid suppression of gene expression of SOD-1.Curcumin is also able to inhibit bile acid induction of COX-2 gene expression.
文摘The incidence of hepatocellular carcinoma(HCC)in patients with human immunodeficiency virus(HIV) is rising.HCC in HIV almost invariably occurs in the context of hepatitis C virus(HCV)or hepatitis B virus (HBV)co-infection and,on account of shared modes of transmission,this occurs in more than 33% and 10% of patients with HIV worldwide respectively.It has yet to be clearly established whether HIV directly accelerates HCC pathogenesis or whether the rising incidence is an epiphenomenon of the highly active antiretroviral therapy(HAART)era,wherein the increased longevity of patients with HIV allows long-term complications of viral hepatitis and cirrhosis to develop.Answering this question will have implications for HCC surveillance and the timing of HCV/HBV therapy,which in HIV co-infection presents unique challenges.Once HCC develops,there is growing evidence that HIV co-infection should not preclude conventional therapeutic strategies,including liver transplantation.
文摘Graphene-based materials are intriguing from the perspective of fundamental science and technol- ogy because they are non-toxic, chemically and thermally tolerant, and mechanically robust. Graphene exhibits superior electrical conductivity, high surface area and a broad electrochemical window that may be particularly advantageous for their applications in energy storage devices. In addition, graphene can be prepared in the form of a colloidal suspension with adjustable solubility and thus is suitable for printing applications and offers both transparency and good conductivity at the same time. In this review, appli- cations of graphene in solar cells, batteries, supercapacitors and fuel cells are summarized with the latest developments. Furthermore, graphene as a conductive ink for printed electronics is also discussed.
文摘Displays using direct light emission from microscale inorganic light-emitting diodes(μILEDs)have the potential to be very bright and also very power efficient.High-throughput technologies that accurately and cost-effectively assemble microscale devices on display substrates with high yield are key enablers forμILED displays.Elastomer stamp transfer printing is such a candidate assembly technology.A variety ofμILED displays have been designed and fabricated by transfer printing,including passive-matrix and active-matrix displays on glass and plastic substrates.
文摘Background:Retreatments are sometimes necessary to correct residual or induced refractive errors following refractive surgery.Many different combinations of primary treatment methods and retreatment techniques have been studied,however,few studies have investigated wavefront-optimized(WFO)technology for retreatment following primary refractive surgery.This study aimed to report the outcomes of WFO photorefractive keratectomy(PRK)retreatments of refractive error following previous laser refractive surgery with PRK,laser in situ keratomileusis(LASIK),or laser-assisted subepithelial keratectomy(LASEK).Methods:We reviewed records of patients who underwent WFO PRK retreatments using the Allegretto Wave Eye-Q 400 Hz Excimer Laser System(Alcon Surgical)between January 2008 and April 2011 at Walter Reed Army Medical Center and Madigan Army Medical Center.Outcomes were recorded in terms of uncorrected distance visual acuity(UDVA),manifest refraction spherical equivalent(MRSE),corrected distance visual acuity(CDVA),and complications at 1 month(M),3 M,and 6 M post-op.Results:Seventy-eight patients(120 eyes)underwent WFO PRK retreatment during the study period.Primary surgery was surface ablation in 87 eyes(78 PRK,9 LASEK)and LASIK in 33 eyes.The mean spherical equivalent before retreatment was−0.79±0.94 D(−3.00 to 1.88 D).UDVA was≥20/20 in 69 eyes(60.0%)at 1 M,54 eyes(71.1%)at 3 M,and 27 eyes(73.0%)at 6 M follow-up.MRSE was within±0.50 D of emmetropia in 78 eyes(67.8%)at 1 M,59 eyes(77.6%)at 3 M,and 25 eyes(67.6%)at 6 M follow-up.CDVA was maintained within±1 line of pre-op in 113 of 115 eyes(98.3%)at 1 M,74 of 76 eyes(97.4%)at 3 M,and 37 eyes(100%)at 6 M follow-up.Conclusion:Although follow-up was limited beyond 3 M,WFO PRK retreatments in patients with residual refractive error may be a safe and effective procedure.Further studies are necessary to determine the long-term safety and stability of outcomes.
文摘As medical care progresses and the number of patients with chronic conditions increases there is the inevitable challenge of managing patients with multiple comorbidities.Inflammatory bowel disease(IBD)is an umbrella term for are inflammatory conditions affecting the gastrointestinal tract,the two most common forms being Ulcerative Colitis and Crohn’s disease.These diseases,usually diagnosed in young adults,exhibit a relapsing and remitting course and usually require longterm treatment.IBD can be treated with a number of topical and systemic treatments.We conducted a review of the current published evidence for the effects these medications can have on diabetes mellitus(DM)and glycaemic control.Searches were conducted on medline and embase with a timeframe from 1947(the date from which studies on embase are recorded)to November 2020.Suitable publications were selected and reviewed.Current evidence of the impact of aminosalicylates,corticosteroids,thiopurines,and biologic agents was reviewed.Though there was limited evidence for certain agents,IBD medications have been shown to have an effect of DM and these effects should be considered in managing patients with dual pathologies.The effects of steroids on blood sugar control is well documented,but consideration of other agents is also important.In patients requiring steroids for Ulcerative Colitis,locally acting steroid agents delivered rectally may be preferred to minimise side effects in those with distal bowel Ulcerative Colitis.A switch to other agents should be considered as soon as possible in people with diabetes to limit the impact on glycaemic control.5-aminosalicylates appear to play a role in the reduction of hemoglobin A1c(HbA1c),although the literature suggests these may be falsely low readings.Consequently,monitoring of people with diabetes on these agents may require daily monitoring of capillary blood sugars rather than relying simply on HbA1c;for example fructosamine performed 3-6 monthly,although this risks missing the rise in readings.There is
文摘There is increasing recognition of the potential morbidity and mortality associated with HIV-1 and hepatitis C (HCV)co-infection. HIV appears to adversely affect HCV disease while the reciprocal effect of HCV on HIV remains controversial.We therefore studied the effect of co-infection on dendritic cell function versus HIV infection alone, as previous work has shown that HCV impairs dendritic cell (DC) function. HIV-1 positive individuals with HCV were matched for CD4count, HIV- 1 RNA viral load and therapy, to HIV- 1 positive patients without HCV. Monocyte-derived DC were generated and mixed leukocyte reactions were performed. We assessed allostimulatory capacity with and without administration of exogenous Thl cytokines, using thymidine uptake and cell division analyses with the vital dye CFSE. We found that monocyte-derived DC from co-infected individuals showed no significant differences in allostimulatory capacity to ex vivo generated DC from HIV-1 infected individuals without HCV. Unlike the situation with HCV infection alone, this impairment was not reversed by increasing concentrations of either interleukin-2 or -12. Monocyte-derived DC from HIV-1 and HCV co-infected individuals have a similar allostimulatory capacity to DC from matched patients with HIV-1alone. These findings are compatible with results of prior clinical studies that found no evidence that HCV co-infection altered HIV disease progression and has implications for immunotherapeutic approaches in co-infected individuals.
文摘Purpose: Optimal pain management strategies for patients undergoing component separation hernia repair are not defined. Epidural analgesia (EA) has been shown to decrease pulmonary complications and duration of ileus and to improve pain control in other patient populations. In this study we examined outcomes of patients receiving EA after separation of components (SOC). Methods: After obtaining IRB approval, a retrospective review was performed of patients undergoing ventral hernia repair with SOC from January 2006 to October 2010 at the University of Kentucky. Patients were identified from hospital operative records. Pre-operative patient characteristics and operative data were obtained from the medical record. Information was collected relating to use of EA, complications, and length of hospitalization (LOS). Post-operative outcomes were compared between those that had epidurals and those that did not. Results: One hundred seventeen patients were identified that underwent SOC, 34 of whom had EA. These two groups were similar in relation to age, BMI, and co-morbidities. Three patients in the epidural group had complications limiting epidural duration—two with hypotension and one with refractory pruritus. There was no difference in pneumonia, deep vein thrombosis (DVT), wound infection, urinary tract infection (UTI), recurrence, or mortality (Table 1). There was an increase in LOS (6.68 vs. 6.06 days, p 0.01) in patients with EA. Conclusions: The use of EA results in increased LOS in patients undergoing SOC. EA associated morbidity occurs infrequently. The incidence of post-operative complications is unaffected by EA. Further studies are needed to delineate the benefit of EA in this patient population.
文摘Death related to acute hepatitis B occurs in approximately 1%of patients. We investigated an outbreak of hepatitis B virus (HBV) infections among injection d rug users (IDUs) resulting in several deaths. We conducted a case-control study of fulminant (case patients) and nonfulminant (control patients) HBV infections . We directly sequenced the entire HBV genome from fulminant and nonfulminant ca ses. From October 1998 to July 2000,21 acute HBV infections, including 10 fulminant hepatitis B cases, were identified. The med ian age was 30 (range, 18-49) years, 12 (57%) were female, 20 (95%) were Amer ican Indians, and 20 (95%) reported injecting illicit drugs. All patients with fulminant hepatitis B died (case-fatality rate = 47.6%). Case patients (n = 5) and control patients (n = 9) were similar with respect to age, sex, race, and h epatitis C virus serostatus. All case patients used acetaminophen during their i llness compared with 44%of control patients (P = .08). Compared with control pa tients, case patients lost more weight in the 6 months before illness (P = .04); during their illness, they used more alcohol (P = .03) and methamphetamine (P = .04). All 9 isolates sequenced were genotype D, shared 99.7%homology, and incl uded mutations previously described in association with fulminant hepatitis B. I n conclusion, a high prevalence of exposure to factors potentiating hepatic dama ge with acute hepatitis B contributed to the outbreak’s high mortality rate; mu tations present in the outbreak strain might also have been a factor. Improved v accination coverage among IDUs has the potential to prevent similar outbreaks in the future.
文摘PURPOSE: To compare the rate of epithelial healing following photorefractive keratectomy (PRK) with two commercially available fourth-generation fluoroquinolones, gatifloxacin (Zymar, Allergan, Irvine, California) and moxifloxacin (Vigamox, Alcon Laboratories, Fort Worth, Texas). DESIGN: Double-masked, randomized, prospective trial. METHODS: Thirty-five subjects received gatifloxacin in one eye and moxifloxacin in the fellow eye following PRK with a 9.0- mm epithelial defect. Patients were examined daily after surgery until the epithelium had healed completely in both eyes. Beginning on post-operative day 3, photos were taken and used to confirm epithelial healing or measure the area of residual epithelial defects. Healing times and defect sizes were compared using the Wilcoxon signed-ranks test. RESULTS: Both eyes healed on the same day in 18 of the 35 subjects (51.4% ). In 13 of 35 (37.1% ) subjects, the moxifloxacin-treated eye healed first, compared with only four of 35 (11.4% ) subjects whose gatifloxacin-treated eye healed first. All six of the eyes that took 2 days longer than their fellow eye to heal were gatifloxacin-treated. Median healing time for both groups was 4 days (moxifloxacin range: 3 to 7 days; gatifloxacin range: 3 to 9 days; P=.01), but only 69% of gatifloxacin-treated eyes had healed by day 4 compared with 80% of the moxifloxacint reated eyes. Overall, on each post-operative day, defect sizes were greater for the gatifloxacin-treated eyes. This difference was statistically significant on day 4 (P=.027). CONCLUSIONS: Eyes treated with moxifloxacin healed faster and had smaller defects compared with those treated with gatifloxacin. This provides another factor to consider in selecting antibiotic prophylaxis for corneal refractive surgery.
