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UK Prospective Study of Therapies of Maturity-Onset Diabetes, I: effect of diet, sulphonylurea, insulin or biguanide therapy on fasting plasma glucose and body weight over one year. Diabetologia. 1983; 24 6 ; : 404-411. Heilbronn LK, Noakes M, Clifton PM. Effect of energy restriction, weight loss, and diet composition on plasma lipids and glucose in patients with type 2 diabetes. Diabetes Care. 1999; 22 6 ; : 889-895. Wing RR, Jeffery RW. Food provision as a strategy to promote weight loss. Obes Res. 2001; 9 suppl 4 ; : 271S-275S. The Food Guide Pyramid. Washington, DC: Department of Agriculture, Center for Nutrition Policy and Promotion; 1996. de Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999; 99 6 ; : 779-785. Pearson TA, Blair SN, Daniels SR, et al. AHA guidelines for primary prevention of cardiovascular disease and stroke: 2002 update: consensus panel guide to comprehensive risk reduction for adult patients without coronary or other atherosclerotic vascular diseases [AHA Scientific Statement]. Circulation. 2002; 106 3 ; : 388-391. National Heart, Lung, and Blood Institute. ATP III Guidelines At-A-Glance Quick Desk Reference. NIH Publication No. 01-3305. May 2001. US Department of Health and Human Services, Office of the Surgeon General. The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity. Rockville, MD: US Department of Health and Human Services; 2001. US Department of Health and Human Services. Leading health indicators: overweight and obesity. In: Healthy People 2010 [conference edition in 2 vols]. Washington, DC: US Department of Health and Human Services; 2000: 24-45. Anderssen S, Holme I, Urdal P, Hjermann I. Diet and exercise intervention have favourable effects on blood pressure in mild hypertensives: the Oslo Diet and Exercise Study ODES ; . Blood Press. 1995; 4 6 ; : 343-349. Bertram SR, Venter I, Stewart RI. Weight loss in obese women - exercise vs dietary education. S Afr Med J. 1990; 78 1 ; : 15-18. Wood PD, Stefanick ML, Dreon DM, et al. Changes in plasma lipids and lipoproteins in overweight men during weight loss through dieting as compared with exercise. N Engl J Med. 1988; 319 18 ; : 1173-1179.
PSD 506 and its superiority over a marketed anti-muscarinic. Studies are planned in three patient groups: spinal injury patients experiencing spontaneous contraction of the bladder muscles causing incontinence; patients with BPH and LUTS, and in men and women with urge incontinence. Following completion of Phase IIa or Phase IIb clinical trials, Roche has an option, subject to the payment of certain fees and royalties to cancel the licence and require the Group to grant Roche a licence to the relevant intellectual property developed by the Group and develop the antimuscarinic itself. Market potential & competitive position in urge incontinence overactive bladder A number of pharmaceuticals are already marketed for the treatment of overactive bladder urge incontinence in women. The established agents tolerodine Detrol LA : Pfizer ; and oxybutynin chloride Ditropar XL : Johnson & Johnson ; , which have joint global sales of more than US$1 billion have been joined by the selective anti-muscarinics, trospium chloride Sanctura : Indevus Pliva ; , darifenacin Enablex : Novartis ; and solifenacin succinate Vesicare : Yamanouchi GSK ; , all of which have recently received marketing approval in the US. Similar adverse event profiles such as dry mouth and constipation have been found with each of these newly approved agents and the Directors believe that demonstration of comparable clinical efficacy with a more benign safety profile would be sufficient to differentiate PSD 506 from the existing competing treatments. The estimated female moderate to severe UUI treatment population in North America, France, Germany, Italy, Spain and the United Kingdom is over 6 million women, while a further 10 million women suffer from moderate to severe mixed incontinence. The Directors estimate the total, maximum potential market for UUI BPH-LUTS drugs in Europe and the US to be $30 billion each year and that, assuming PSD 506 meets all of the clinical criteria set for the drug and is prescribed in 10 per cent. of patients with moderate to severe symptoms, successful licensing of PSD 505 could generate up to $381 million in royalty payments for the Group. Market potential and competitive position in BPH LUTS Men with mild to moderate BPH LUTS benefit from drug therapy with -adrenergic agonists such as tamsulosin Harnal : Yamanouchi; Flomax : Boehringer Ingelheim ; , doxazosin mesylate Cardura : Pfizer ; and alfuzosin hydrochloride Uroxatral : Sanofi-Synthelabo ; and the 5 -reductase inhibitors finasteride Proscar : Merck ; and dutasteride Avodagt : GSK ; . Annual global sales of these products exceed US$2 billion. The -adrenergic agonists are generally more effective in LUTS, with the benefit of the 5 -reductase inhibitors being confined to those with large prostates. However, patient dissatisfaction with either adverse effects or insufficient treatment efficacy means that there is a poor treatment compliance with both these classes of drug, and more than a quarter of patients discontinue their treatments early. LUTS is a condition in older men and the Directors believe that demonstration of at least similar clinical efficacy to the established -adrenergic agonists but with better patient compliance would give PSD 506 a significant competitive advantage. The Directors estimate that more than 38 million men between the ages of 40 and 80 in North America and Western European nations will experience moderate to severe LUTS. COLLABORATIVE DEVELOPMENT PROGRAMMES Plethora has the benefit of an agreement with QinetiQ Limited for the parties to collaborate to develop technology relating to non-invasive measurement of urodynamics in the field of urology and nephrology. The Directors believe this arrangement will give the Group access to leading biosensor technology and signal processing software for urological and andrological applications. Under the terms of the agreement Plethora and QinetiQ will collaborate on the research and development of certain products in the field of urology and nephrology. In addition, Plethora has an exclusive option to take a licence of QinetiQ's intellectual property to develop further products arising from the collaborative research. The Directors believe that this arrangement will facilitate the development of novel systems that may expedite clinical trial methodology in urology. PSD 404 and PSD 405 are two projects emanating from this programme. 21 and dutasteride.
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THE HERS TRIAL DESIGN AND PARTICIPANTS Women were eligible for the HERS trial if they were postmenopausal 55 to 80 years old, with a uterus ; with established coronary artery disease. The presence of coronary disease was documented by history of previous myocardial infarction, mechanical revascularization, or at least 50% occlusion of a major coronary artery. Women were excluded if their cardiac event had occurred within six months of randomization, if they had taken HRT within three months of screening, if they were in another clinical trial, or if they seemed unlikely to take the study drug for the five years of the trial. Importantly, they were also excluded if HRT was contraindicated. These contraindications included history of deep vein thrombosis or pulmonary embolism, a history of breast cancer or suspicious mammogram findings, or endometrial anomalies history of cancer, hyperplasia, thickening, or abnormal bleeding ; . Subjects were enrolled at 20 different U.S. academic medical centers. The subjects were randomized into two treatment groups: a group taking .625 mg conjugated equine estrogens plus 2.5 mg MPA in one tablet daily n 1, 380 ; , and a placebo group n 1, 383 ; . Table 1 shows some demographic characteristics of the study group. Among the 4, 830 women who.
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SUBJECTS AND METHODS Subjects The study sites were 2 elementary schools in 2 rural villages: Santa Elena school 1 ; , in the municipality of Santo Tomas, Batangas province; and Hukay school 2 ; , in the municipality of Silang, Cavite province. These villages are 70 and 50 km south of Manila, respectively. Santa Elena was chosen on the basis of a 1993 survey done by the Nutrition Center of the Philippines that showed a 30% prevalence of low serum retinol concentrations 0.70 mol L ; in schoolchildren in Santo Tomas 23 ; . Hukay was chosen on the basis of 1995 school health records that showed a 27% prevalence of moderately and severely underweight schoolchildren. Children of both sexes who were enrolled in grades 16 were eligible to participate in the screening procedures. Informed consent was obtained from parents or guardians. Approval to conduct these studies was obtained from the Ethical Review Board of the Philippine Council for Health Research and Development and the Tufts UniversityNew England Medical Center Human Investigation Review Committee. The screening procedures took place in July and August 1996 and consisted of a physical examination, including an eye examination for xerophthalmia; anthropometric measurements weight, height, and midupper arm circumference conjunctival impression cytology CIC ; for vitamin A status 24 stool collection for examination of intestinal parasites by using the Kato Katz method 25 and a blood draw for determination of serum.
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The Zurich Study Angst 3 ; , in Zurich, has conducted the only other longterm prospective study of mood disorders. In that study, 173 hospitalized patients with unipolar depression were identified between 1959 and 1963. This group was then evaluated every 5 years for up to 21 years of follow-up. The Medical Outcomes Study MOS ; The MOS 4 ; examined the course of several diseases myocardial infarction, congestive heart failure, hypertension, diabetes, and depression ; in a variety of health care settings, including large medical group practices, small group practices, and solo practices, in three cities Los Angeles, Boston, and Chicago ; . A representative sample of different medical specialties--including psychiatry--was chosen, and all patients seen from February through October 1986 were asked to participate in the study. In all, over 20, 000 patients participated, and were evaluated yearly for 3 years. THE COURSE OF DEPRESSION: CHANGE POINTS Traditionally, depression was pictured as an acute illness, self-limited, and lasting approximately 6 to 9 months from time of onset to full recovery. A number of studies, including those mentioned above, however, show the potential for great variation from this traditional model. Recovery may take much longer, or not occur at all i.e., chronic depression ; . Furthermore, the risk of relapse and recurrence of illness must be considered. Recovery In the CDS, approximately 70% of patients recovered from the index episode of major depression within the first year, for example, avodatr blood pressure.
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Why Post-Traumatic Stress Disorder? In choosing the patient population to study, one of the criteria was that the unique properties of MDMA-enhanced psychotherapy needed to be matched to a patient population in which MDMA therapy could offer a dramatic benefit. Ideally, this benefit would require only from one to three drug sessions to produce significant, measurable and long-lasting clinical progress. Alternative medications for this patient population should be relatively ineffective, at least in some subpopulation of patients. The patient population should also be a group that the general public feels compassion towards, in order to help overcome resistance to the idea of the therapeutic use of psychedelics. The core of the MDMA experience has been described by one of the pioneering psychiatrists who worked with MDMA-assisted psychotherapy in terminal cancer patients as "reducing the fear response to a perceived emotional threat." When used therapeutically, MDMA is administered as an adjunct to psychotherapy on an intermittent basis within a larger therapeutic relationship, usually fewer than four times and frequently only once or twice. Numerous case histories and anecdotal reports testify to MDMA's ability to assist people struggling to come to terms with difficult life events Stevens 1999 2000; Otalora 1984 ; . These reports suggest that MDMA-assisted psychotherapy should initially be explored not in patients whose psychiatric symptoms originated with biological imbalances with possible genetic components, though MDMA might still be helpful in some ways with such patients, but rather in patients who need some assistance in processing difficult emotions that have a deep component of fear and or anxiety. Two of the main categories of patients that fit this description are people suffering from PTSD and people facing terminal illness. People with these two types of clinical conditions have been treated with MDMA with some remarkable results in some patients and acenocoumarol.
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Attenuation of UVA-induced human skin keratinocytes damage by - ; epigallocatechin-3-gallate EGCG ; J Xia, 1 X Song, 1 Z Bi1 and Y Wan2 1 Nanjing Medical University, Nanjing, China and 2 Providence College, Providence, RI Cellular effects of UV irradiation are implicated in human skin photoaging. Previous studies indicated that UV irradiation induces generation of reactive oxygen species leading to skin cell damage. EGCG is the major constituent of tea catechin with antioxidant activity. In this study, the protective effects of EGCG on UVA irradiated human keratinocytes HaCat cells ; were investigated with detection of cell proliferation and apoptosis. Expression of matrix metalloproteinases MMPs ; that are responsible for the degradation of collagen knowingly leading to cutaneous aging was also measured. EGCG was applied to the cell culture medium immediately after UVA 1.98 and 3.96 mJ cm2 ; and UVB 21, 42 and 126 mJ cm2 ; irradiation. The final concentration of EGCG was 0.3, 1.5, and 3 mM. MTT dye assay was used at 24 hours post UV irradiation to determine cell proliferation. Apoptotic and dead cells and bcl-2 protein were detected by FACS analysis. RT-PCR was utilized to measure the expression of MMP1 and MMP3 mRNA. The results showed that UVA and UVB significantly induced apoptosis, inhibited cell proliferation, reduced bcl-2 protein level, and up-regulated mRNA expression of MMP1 and MMP3 in cultured human keratinocytes. In all UV-exposed then EGCG-treated 0.3 mM ; groups, cell proliferation, apoptosis rate, and bcl-2 level were restored to the level of non-irradiated groups. The mRNA expression of MMP1 and MMP3 were also comparable to that of unexposed groups. These results suggest that EGCG can be applied to attenuate UV-induced skin cell damage due to its effect on reduction of apoptosis, restoration of cell proliferation and inhibition of MMP expression.
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