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Background & Aims: Several antibiotic treatments aiming to prevent spontaneous bacterial peritonitis (SBP) in cirrhotic patients with low‐protein content in ascitic fluid have been tested; however, there are limited data on the comparative efficacy of these regimens. We assessed their comparative efficacy through a network meta‐analysis and using GRADE criteria to appraise quality of evidence. Methods: Through literature review through October 2018, we identified 10 randomized controlled trials comparing antibiotic treatments (norfloxacin, ciprofloxacin, trimethoprim/sulfamethoxazole and rifaximin) with each other or placebo. Primary outcome was SBP occurrence, with mortality rate and rate of other infections as secondary outcomes. Results: In comparison with placebo, moderate quality evidence supports the use of norfloxacin and ciprofloxacin in primary prophylaxis of SBP (risk ratio 0.23; 95% CI, 0.09‐0.56; P = 0.001 and 0.23; 0.07‐0.79; P = 0.02 respectively) while only low quality evidence suggests superiority of rifaximin (risk ratio 0.15; 0.05‐0.42). When antimicrobial agents were compared to each other, no significant difference was found. With regard to mortality, moderate quality supports the superiority of norfloxacin over placebo (risk ratio, 0.68; 95% CI, 0.47‐0.99; P = 0.04), while ciprofloxacin and rifaximin showed only a non‐significant benefit and no significant difference was found in the other comparisons. None of the tested antibiotics proved to significantly decrease the rate of other infections. Conclusions: Norfloxacin appears to have significant benefit both in terms of SBP prevention and mortality; ciprofloxacin represents a valuable option although without a clear survival benefit. Rifaximin shows interesting results but needs to be tested in further trials. [ABSTRACT FROM AUTHOR]

Unrepairable comminuted fractures of the radial head Mason type III or type IV have poor outcomes when treated by open reduction and internal fixation. Radial head resection has been proposed as good option for surgical treatment, while in the last decades, the development of technology and design in radial head prosthesis has increased efficacy in prosthetic replacement. The present review was conducted to determine the best surgical treatment for comminuted radial head when ORIF is not possible. Better outcomes are reported for radial head arthroplasty in terms of elbow stability, range of motion, pain, and fewer complications compared to radial head excision. Nevertheless, radial head resection still can be considered an option of treatment in isolated radial head fractures with no associated ligament injuries lesion of ligaments or in case of older patients with low demanding function. [ABSTRACT FROM AUTHOR]

Dowling-Degos disease (DDD) is a rare genodermatosis, which was first described by Dowling and Freudenthal in 1938 and then by Degos and Ossipowski in 1954. GLO:DF2/01dec19:ced13914-fig-0001.jpg PHOTO (COLOR): (a) Dowling-Degos disease of the mother's vulva: multiple hyperpigmented brownish macules showing dark brown to black macules in both solitary and confluent patterns. GLO:DF2/01dec19:ced13914-fig-0002.jpg PHOTO (COLOR): (a) Dowling-Degos disease of the daughter's vulva: the macules were lighter in colour (light brown) and fewer in number than in the mother. [Extracted from the article]

The aim of this paper is to present the relation between an evolutionary variational inequality with long-term memory and Lagrange multipliers. More precisely, we study the oligopolistic market equilibrium problem in which the profit function depends also on previous events of the market by means of a long-term memory which takes into account the previous states of the equilibrium. Moreover, thanks to the variational formulation, we are able to show existence and regularity results for equilibrium solutions. Then, we apply the infinite dimensional duality theory through which we obtain the existence of Lagrange multipliers which are great utility in order to understand the behaviour of the market. Finally, an example is provided, which allows to analyse the influence of the long-term memory on the equilibrium solution. [ABSTRACT FROM AUTHOR]

This study demonstrates that the flavonoid quercetin (Q), a plant-derived compound with low toxicity in vivo, greatly potentiates the growth-inhibitory activity of Adriamycin (ADR) on MCF-7 ADR-resistant human breast cancer cells. The effect of Q was dose-dependent at concentrations ranging between 1 and 10 microM. Since ADR resistance in these cells is associated with the expression of high levels of P-glycoprotein (Pgp), we evaluated the effect of Q and related flavonoids of Pgp activity in cytofluorographic efflux experiments with the fluorescent dye rhodamine 123 (Rh 123). Our results indicate that Q and 3-OMe Q (3',4',7-trimethoxyquercetin) but not the 3-rhamnosylglucoside of Q (rutin) inhibit the Pgp pump-efflux activity in a dose-related manner. Moreover, 10 microM Q reduces the expression of the immunoreactive Pgp in MCF-7 ADR-resistant cells as evaluated by cytofluorimetric assay. In conclusion, these findings provide a further biological basis for the potential therapeutic application of Q as an anti-cancer drug either alone or in combination with ADR in multidrug-resistant breast tumor cells. [ABSTRACT FROM AUTHOR]

It has been demonstrated that the flavonoid quercetin (3,3',4',5,7-pentahydroxyflavone; Q) inhibits the growth of several cancer cell lines. There is evidence suggesting that the antiproliferative activity of this substance is mediated by the so-called type II estrogen-binding site (type II EBS). We looked for the presence of type II EBS and the effect of Q on the proliferation of an Adriamycin-resistant estrogen-receptor-negative human breast-cancer cell line (MCF-7 ADRr). By whole-cell assay using estradiol labelled with 6,7-tritium [( 3H]-E2) as a tracer, we demonstrated that MCF-7 ADRr cells contain type II EBSs. Competition analysis revealed that diethylstilbestrol (DES) and Q competed with similar potency for [3H]-Es binding to type II EBSs. The antiestrogen tamoxifen (TAM) competed for type II EBSs, albeit to a lesser extent than either DES or Q. Growth experiments demonstrated that Q and DES exerted a dose-dependent inhibition of cell proliferation in the range of concentrations between 10 nM and 10 microM, whereas TAM was less effective. Q could also inhibit colony formation in a clonogenic assay. Our results indicate that multidrug-resistant estrogen-receptor-negative MCF-7 cells express type II EBSs and are sensitive to the inhibitory effect of Q. This substance could be the parent compound of a novel class of anticancer agents. [ABSTRACT FROM AUTHOR]

Background:The NGR-hTNF (asparagine-glycine-arginine-human tumour necrosis factor) is able to promote antitumour immune responses and to improve the intratumoural doxorubicin uptake by selectively damaging tumour blood vessels.Methods:Patients progressing after 1 platinum/taxane-based regimen received NGR-hTNF 0.8 μg m−2 and doxorubicin 60 mg m−2 every 3 weeks. Primary endpoint was a Response Evaluation Criteria in Solid Tumors-defined response rate with a target of more than 6 out of 37 responding patients.Results:A total of 37 patients with platinum-free interval lower than 6 months (PFI<6; n=25), or between 6 and 12 months (PFI=6-12; n=12) were enrolled. Median baseline peripheral blood lymphocyte count (PBLC) was 1.6 per ml (interquartile range, 1.2-2.1). In all, 18 patients (49%) received more than 6 cycles. Febrile neutropaenia was registered in one patient (3%). Among 35 assessable patients, 8 (23%; 95% CI 12-39%) had partial response (2 with PFI<6; 6 with PFI=6-12) and 15 (43%) had stable disease (10 with PFI<6; 5 with PFI=6-12). Median progression-free survival (PFS) was 5.0 months for all patients, 3.8 months for patients with PFI<6, and 7.8 months for patients with PFI=6-12. Median overall survival (OS) was 17.0 months. Patients with baseline PBLC higher than the first quartile had improved PFS (P=0.01) and OS (P=0.001).Conclusion:Tolerability and activity of this combination warrant further randomised testing in patients with PFI<6. The role of PBLC as a blood-based biomarker deserves further investigation. [ABSTRACT FROM AUTHOR]

The authors describe a sample of 815 acutely ill schizophrenia patients hospitalized under a petition for involuntary inpatient treatment and illustrate how this group of patients can be considered as more representative of involuntary commitment status than more traditional “involuntary” patients drawn from State hospitals' wards. Available demographics of the general population from which the sample was drawn are also presented for comparison. The authors then report the gender distribution of several variables—age, marital status, psychoactive substance use, comorbidity, length of stay, and frequency of readmissions—among the study sample and discuss the relevance of these findings. [ABSTRACT FROM PUBLISHER]

Gamma-hydroxybutyric acid is an allegedly benign illicit substance that is gaining increasing recognition and attention among substance abusers and athletes. Alongside foreign-made brands, the compound is also easily available, at low cost because of the facility with which it can be produced in one's kitchen. Named by some "Nature's Quaalude" or sold as a health product, it is often used with a false sense of security as it may cause serious and disabling complications, as illustrated by this clinical vignette. [ABSTRACT FROM AUTHOR]

Frequency and results of urine toxicology screens in a state-guided system of emergency rooms in a large city were compared with frequency and results of the same tests in the same population at a university-run intensive treatment psychiatric unit. Differences both in prevalence and in results were noted, with the emergency rooms testing significantly less patients than the intensive treatment unit and documenting a significantly lower rate of active substance abuse comorbidity to psychiatric disorders. Possible explanations for these differences are discussed, including clinical, attitudinal, and cost containment factors. These findings have a definite impact on treatment decision making, diagnostic precision, and validity of epidemiologic reports. [ABSTRACT FROM AUTHOR]

We consider the control processes We show that under appropriate assumptions on the data A, B, C, F, if the process ( E) is completely controllable, then the perturbed process ( Ē) is completely controllable too. The result is obteined proving for the evolution matrix V, a continuous dependence on the coefficients A, B, C. [ABSTRACT FROM AUTHOR]

Let (E)z +A(x, y)z+B(x, y)z+C(x, y)z=U(x, y) a.e. in Δ=]0, a[×]0, b[, be a distributed parameter control process. We study the uniqueness of some optimal control problems (minimum distance and minimum effort problems) relative to ( E). We take the Orlicz space L (Δ) as the «permanent control space, whereas both the «initial control» space and the «target» space are subspaces of the Orlicz-Sobolev space W (]0, a[)× W (]0, b[). [ABSTRACT FROM AUTHOR]

Reports on the results of a study carried out on the use of psychoactive substances in a number of patients. Methods of conducting the study; Conclusions of the study.