One-week therapy with omeprazole, clarithromycin and metronidazole or ornidazole, followed by 3 weeks' treatment with omeprazole, eradicates Helicobacter pylori equally and heals duodenal ulcer

OBJECTIVE: To estimate and compare the efficacy of 'triple' 1-week regimens--omeprazole, clarithromycin and a nitroimidazole (metronidazole or ornidazole)--followed by omeprazole, for an additional 3 weeks, on Helicobacter pylori eradication and duodenal ulcer (DU) healing, in a country with a high resistance rate of H. pylori to metronidazole. DESIGN: Open, prospective, two-centre study. METHODS: Patients older than 18 years with active duodenal ulcer (DU), diagnosed by endoscopy and found to be infected with H. pylori (modified Giemsa stain and CLO test, Delta West, Australia), were included in the study. Three triple-drug regimens, given for 7 days, were used. (1) omeprazole (Om) 20 mg once a day, plus clarithromycin (Cl) 250 mg twice daily, plus ornidazole (Or) 500 mg twice daily (O1COr); (2) Om 20 mg twice daily, plus Cl 250 mg twice daily, plus Or 500 mg twice daily (OCOr); and (3) Om 20 mg twice daily, plus Cl 250 mg twice daily, plus metronidazole (M) 500 mg twice daily (OCM). Two hundred and three consecutive H. pylori-positive patients were included in the study, randomly assigned as follows: 50 patients (group A1: 32 men, 18 women, age 23-77 years) on O1COr; 47 patients (group A2: 29 men, 18 women, age 27-77 years) on OCOr; and 106 (group B: 71 men, 35 women, age 18-83 years) on OCM. Ulcer healing and H. pylori eradication were assessed endoscopically, 8-9 weeks after the start of treatment. H. pylori was considered eradicated if both histology and rapid urease test (six biopsies, antrum-body) were negative. RESULTS: Eleven patients were lost to follow-up; 192 patients were analysed. Group A1: 48; group A2: 44; group B: 100. 'Per-protocol' analysis: H. pylori eradication, 90-93% (P = 0.901); ulcer healing, 90-98% (P = 0.300). 'Intention to treat' analysis: H. pylori eradication, 85-88% (P = 0.887); ulcer healing, 86-91% (P = 0.657). Compliance was excellent, no serious side effects were observed and no patients withdrew due to side effects. CONCLUSIONS: No differences were observed in the H. pylori eradication and the healing rate among the groups. It seems that twice daily omeprazole is no better than single daily dosage and that ornidazole is as effective as metronidazole. In addition, in the studied population which is believed to have a high prevalence of metronidazole resistance, all the regimens used were effective.     

Prevalence and clinical significance of posterolateral thigh perforator vein incompetence

PURPOSE: Posterolateral thigh perforator (PLTP) veins are part of the lateral thigh venous system, which in most people remains undeveloped. This study was designed to determine the prevalence and clinical significance of these veins. METHODS: Over the past 6 years, 2820 lower limbs with signs and symptoms of chronic venous disease (CVD) were evaluated for venous reflux using color flow duplex imaging. Superficial, perforating, and deep veins were examined in the standing, sitting, and reversed Trendelenburg positions. PLTP veins were best identified in the standing position with the patient facing away from the examiner. RESULTS: Twenty-six incompetent PLTP veins were found in 24 limbs (0.85%) of 21 patients (mean age, 43 +/- 16 years; range, 22 to 77 years). All PLTP veins pierced the fascia lata 12 to 25 cm (mean, 16 +/- 3 cm) above the popliteal skin crease in the lateral aspect of the thigh. At this level, the PLTP veins dove posteriorly 3 to 8 cm to join primarily tributaries of the deep femoral vein, superficial femoral vein, or both. Eight PLTP veins were duplicated at 1 to 2 cm below the fascia. Seven PLTP veins gave rise to superficial tributaries that were extended to the lower lateral and posterior thigh, whereas the remaining 19 PLTP veins gave rise to tributaries alongside the lesser saphenous vein and the anterior arch of the greater saphenous vein. On nine occasions, reflux was found in the PLTP veins and their associated tributaries alone. In all of these cases, reflux was adequately controlled with a tourniquet placed distal to the fascial defect. In the remaining 17 PLTP veins, reflux was also seen in the greater saphenous vein, the lesser saphenous vein, or both. None of the limbs that had PLTP vein reflux alone exceeded CVD class 3. When PLTP vein reflux was combined with saphenous reflux, there were five limbs classified as CVD class 4 and one limb each as CVD classes 5 and 6. Twenty limbs underwent ligation and stripping of the varicosities. Three of the earlier patients in the series underwent incomplete operations, which resulted in immediate residual varicosities from the PLTP tributaries. All three patients underwent reoperation successfully within a year. CONCLUSIONS: The prevalence of PLTP vein reflux is quite low. Reflux in the PLTP veins alone is associated with mild to moderate clinical presentation. However, when it is combined with saphenous reflux skin damage can be present. Failure to recognize PLTP veins may result in an incomplete or unnecessary operation, leaving the patients with residual varicose veins.     

Verbal learning and memory in children with myelomeningocele

Examined verbal learning and memory in children with myelomeningocele using the California Verbal Learning Test (CVLT). Participants included 41 children with myelomeningocele, 8 to 15 years of age, 33 of whom had a history of shunted hydrocephalus, and 41 matched, unaffected controls. Children with myelomeningocele and shunted hydrocephalus performed worse than controls on the CVLT. They recalled as many words as controls on the first learning trial, but acquired words more slowly across trials, so that their overall recall was lower. Their learning was characterized by a pronounced recency effect. Their delayed recall of the original list was worse than controls, but not their recognition. Performance of children with myelomeningocele but without shunts was generally not significantly different from that of the other two groups, although they did demonstrate better long-delay free recall than children with shunts. Myelomeningocele is associated with significant retrieval problems when accompanied by shunted hydrocephalus.     

Abnormally rapid disengagement of covert attention to global and local stimulus levels may underlie the visuoperceptual impairment in Parkinson's patients.

Parkinson's disease (PD) patients were administered a divided attention task that involved the use of global-local stimuli. Across two consecutive trials, the target could appear at either the same global-local level or at the other level. When the target remained at the same level across two consecutive trials, the PD patients responded slower than normal controls to the second stimulus relative to the first. In addition, when the target changed levels across consecutive trials, the PD patients responded faster than normal controls to the second stimulus relative to the first. These results suggest that PD patients may show an abnormally rapid disengagement of attention. The PD patients' abnormal shifting of covert attention was significantly related to the number of perceptual errors they made in identifying target stimuli, suggesting that a deficiency in maintaining covert attention may underlie the visuoperceptual impairment in PD patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differentiation of Alzheimer's, Huntington's, and Parkinson's disease patients on the basis of verbal learning characteristics.

Examined the degree to which patients with dementia could be differentiated on the basis of their verbal learning characteristics. 83 patients with Parkinson's disease (PD), 22 with Huntington's disease (HD), and 22 with probable Alzheimer's disease were administered the California Verbal Learning Test. PD and HD Ss were divided into subgroups to control for the severity of overall memory impairment. Intrusions, perseverations, and rate of forgetting were the most discriminating variables. Profile differences between HD and PD were sufficiently robust to separate these 2 groups. Results do not support a simplistic cortical–subcortical dichotomy; rather, individual dementing syndromes have unique patterns of verbal learning performance that are distinct from one another. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Focused crawling for the hidden web

A constantly growing amount of high-quality information resides in databases and is guarded behind forms that users fill out and submit. The Hidden Web comprises all these information sources that conventional web crawlers are incapable of discovering. In order to excavate and make available meaningful data from the Hidden Web, previous work has focused on developing query generation techniques that aim at downloading all the content of a given Hidden Web site with the minimum cost. However, there are circumstances where only a specific part of such a site might be of interest. For example, a politics portal should not have to waste bandwidth or processing power to retrieve sports articles just because they are residing in databases also containing documents relevant to politics. In cases like this one, we need to make the best use of our resources in downloading only the portion of the Hidden Web site that we are interested in. We investigate how we can build a focused Hidden Web crawler that can autonomously extract topic-specific pages from the Hidden Web by searching only the subset that is related to the corresponding area. In this regard, we present an approach that progresses iteratively and analyzes the returned results in order to extract terms that capture the essence of the topic we are interested in. We propose a number of different crawling policies and we experimentally evaluate them with data from four popular sites. Our approach is able to download most of the content in search in all cases, using a significantly smaller number of queries compared to existing approaches.     

Edith Kaplan (1924–2009).

This article honors the life accomplishments of Edith Kaplan. She is widely regarded as the mother of clinical neuropsychology; she passed away on September 3, 2009, at the age of 85. Her modifications to the original Wechsler Adult Intelligence Scale (WAIS) and Wechsler Memory Scale led to the development of a new school of clinical neuropsychology known as “the process approach,” of which Kaplan is unequivocally regarded as the pioneer and chief architect. She is best known for her work in test development, and she is the lead or senior author on numerous assessment instruments designed for both children and adults that are used nationally and internationally. At the time of her death, Kaplan was working as a professor of psychology at Suffolk University, an adjunct professor of neurology and psychiatry at Boston University School of Medicine, and an affiliate professor of psychology at Clark University. And, of great importance to the field, she continued to be vigorously involved in her most beloved activity of all, teaching students about neuropsychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)