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We reviewed the literature and the manufacturer's U.S. clinical data pool for safety data on long-term administration of ciprofloxacin (Bayer, West Haven, CT). Only controlled clinical trials including patients treated for > 30 days were selected. We identified 636 patients by literature search and 413 patients in the Bayer U.S. database who fulfilled our search criteria; the average treatment duration for these patients was 130 and 80 days, respectively. Main indications for long-term therapy were osteomyelitis, skin and soft-tissue infection, prophylaxis for urinary tract infection, mycobacterial infections, and inflammatory bowel disease. Adverse events, premature discontinua-tion of therapy, and deaths occurred at a similar frequency in both treatment arms. Most adverse events occurred early during therapy with little increase in frequency over time. As with short-term therapy, gastrointestinal events were more frequent than central nervous system or skin reactions, but pseudomembranous colitis was not observed. No previously unknown adverse events were noted. We conclude that ciprofloxacin is tolerated as well as other antibiotics when extended courses of therapy are required. [ABSTRACT FROM AUTHOR]

Background: Repetitive high bone strain and/or strain rates, such as those that occur during running, contribute to stress fractures as well as promoting maintenance of or increase in bone mass. Kinematic differences are known to exist between overground and treadmill running and these may be reflected in different bone strains and strain rates during the two running techniques.Aim: To measure in vivo strains and strain rates in human tibia during treadmill and overground running and determine if there are significant differences in strain and strain rate levels between the two running techniques.Methods: A strain gauged bone staple was mounted percutaneously along the axial direction in the mid diaphysis of the medial tibia in three subjects, and in vivo tibial strains were measured during treadmill and overground running at 11 km/h.Results: Axial compression strains (p<0.0001), tension strains (p<0.001), compression strain rates (p<0.0001), and tension strain rates (p<0.0001) were 48-285% higher during overground running than during treadmill running.Conclusions: On the basis of lower in vivo strains and strain rates, treadmill runners are at lower risk of developing tibial stress fractures, but less likely to achieve tibial bone strengthening, than overground runners. [ABSTRACT FROM AUTHOR]

Measures in vivo strains and strain rates in human tibia during treadmill and overground running. Examination of whether there are significant differences in strain and strain rate levels between the two running techniques; Contribution of repetitive high bone strain and/or strain rates to stress fractures; Significance to studies of sports medicine.

Heart failure (HF) poses a major health burden worldwide, and early detection of at-risk populations is of clinical importance. The triglyceride-glucose index (TGI), a surrogate marker of insulin resistance, is thought to be associated with a higher risk of developing cardiovascular disease. Nonetheless, its predictive value for the future development of HF in healthy populations is unknown. We thus investigated the utility of TGI for the prediction of HF development in healthy adults. The study population comprised 19,829 self-referred adults, evaluated annually in a screening program, who were free of baseline diabetes and cardiovascular disease. The TGI was calculated as: ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. The primary end-point was the development of any HF. An HF specialist classified all HF events in accordance with guidelines. The mean age was 50±8 years for the cohort, 14,039 (71%) were men, and 2,709 (14%) were obese. Baseline TGI was 8.53±0.54. During a median follow-up of 14 years (IQR 8-18), 193 (1%) subjects developed HF. Univariate Cox regression showed that each 1 unit increase in TGI was associated with a significant 67% increased risk of developing any HF during follow-up (95% CI 1.30-2.16, p<.001). A multivariate model, adjusted for age, sex, baseline hypertension, LDL, obesity, and fitness level consistently showed that each 1 unit increase in TGI was associated with a 39% increased risk of developing HF (95% CI 1.05-1.84, p=.020). The association between the baseline TGI and the development of HF was obesity dependent, such that for obese patients each 1 unit increase in TGI was associated with a significant 61% increase in the risk of HF (95% CI 1.18-2.20, p=.003), while for non-obese subjects the association was non-significant (p NS; p for interaction.018). High TGI in the healthy adult population is associated with an increased risk of HF and is a promising potential marker for the later development of HF. The impact of interventions aiming to decrease TGI on HF outcomes should be assessed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Mass vaccination is the principal preventive measure against a smallpox outbreak after an act of bioterrorism. Vaccination of subjects who received immunosuppressive therapies is problematic because of smallpox vaccine reactogenicity. Moreover, long-term immunity to vaccinia might be affected. OBJECTIVE: The objective of the study was to examine the effect of cytotoxic chemotherapy on long-term immunity to vaccinia. METHODS: In a case-control study, 67 patients with breast cancer who received cytotoxic chemotherapy and who were disease free for at least 1 year were matched with healthy controls according to age, sex, and the number of smallpox vaccinations received. Markers of immunity to smallpox were examined. Forty-one patients with breast cancer who did not receive chemotherapy were used to assess the affect of cancer and radiotherapy on immunity to smallpox. RESULTS: Patients with breast cancer who received chemotherapy had lower levels of vaccinia total immunoglobulin G and immunoglobulin G1 (expressed as enzyme-linked immunosorbent assay units per milliliter), neutralizing antibodies, vaccinia:memory B cell ratio (expressed as a percentage), and interferon-gamma level (expressed as picograms per milliliter), compared with healthy control individuals. CONCLUSIONS: Immunity to smallpox is reduced after receipt of chemotherapy for breast cancer. This finding should be considered when planning smallpox vaccination campaigns. The effect of immunosuppressive treatments on persistence of immunity should be tested with respect to additional vaccines or natural infections. [ABSTRACT FROM AUTHOR]

We report here a bench study of TOF resolution using a 90 ° bend curved solid light-guide (LG) used to transport the light from a plastic scintillator counter to a photomultiplier (PMT). The 90 ° LG allows the rotation of the PMT axis to be vertical to the detector axis, in an environment featured by a strong magnetic field along the detector surface, or other geometrical constrains. We show that with a TOF counter of 2000 × 100 × 60 mm3 and light read-out by PMTs at its two 100 × 60 mm2 sides, when 90 ° LG benders are used between the scintillating bar and the PMTs on both sides, the TOF resolution is worsen, by 5–10%. [ABSTRACT FROM AUTHOR]

Background Increased blood levels of alanine amino transferase (ALT, also known as SGPT; serum glutamic pyruvic transaminase) serve as a marker of liver injury by various mechanisms. Less is known about the clinical implications associated with low-normal ALT levels. Previous studies showed low ALT levels to be associated with poor long-term outcomes among elderlies, serving as a biomarker for increased incidence of frailty and subsequent risk of mortality. However, it has not been determined yet whether low-normal ALT values might be predictive of frailty and mortality in younger, middle-aged adults. Methods We conducted a historical prospective cohort analysis. Results A total of 23,506 adults with ALT levels within the normal range, at the mean age of 48 ± 11 years, participating in an annual screening program for preventive medicine, were followed-up for a median period of 8.5 years during which 638 died. Low-normal ALT values (serum ALT activity < 17 IU/L) were found to be predictive for increased risk of all-cause mortality (HR = 1.6; 95% CI 1.34–1.92; p < 0.001). Statistically significant correlation was demonstrated even after applying a multifactorial model correction for age, gender, eGFR, low albumin, arterial hypertension, diabetes mellitus and ischemic heart disease. Conclusions We suggest that low-normal ALT values may serve as an independent predictive marker for increased long-term mortality in middle-aged adults. [ABSTRACT FROM AUTHOR]

The article reports on the post-epidemic serosurvey of West Nile Fever (WNF) in Israel. In this study, serum samples were taken from subjects in two distinct geographical districts: 1,408 samples were from people residing in 85 localities in the center of Israel, the epicenter of the 2000 epidemic, and 485 samples were from people residing in 35 localities in southern Israel, an area with no diagnosed cases during the 2000 outbreak. West Nile virus (WNV) is invading new territories each year, causing large outbreaks, but endemic areas are also vulnerable to large epidemics. The seroprevalence of WNV antibodies found in our study indicates a large proportion of the population in Israel remains susceptible to WNF.