Phase-I clinical trial on the effect of palatal brushing on denture stomatitis

Introduction: La stomatite prothétique est une condition inflammatoire chronique de la muqueuse buccale recouverte par une prothèse. Cette maladie est considérée comme la lésion buccale la plus fréquente chez les porteurs de prothèses amovibles. Des études récentes sur l'étiologie de la stomatite prothétique suggèrent que des traitements basés sur la réduction de l'inflammation seraient efficaces dans le traitement de cette maladie. Objectifs: Évaluer l'efficacité du brossage du palais dans le traitement de la stomatite prothétique. Méthodes: Quarante-huit participants (âge moyen : 66,0 ± 11,2 ans) avec un diagnostic de stomatite prothétique, ont été sélectionnés à partir d’un examen préalable de 143 individus, afin de participer à cet essai clinique de phase I à deux centres, réalisé selon un devis de type pré-test/post-test à un seul groupe. L'intervention a consisté en un brossage du palais avec une brosse manuelle après chaque repas et avant le coucher. Des examens cliniques et microbiologiques ont été effectués avant le traitement, et à 1 mois et 3 mois de suivi. Des données supplémentaires ont été obtenues par l'utilisation d'un questionnaire validé. Les résultats primaires et secondaires étaient, respectivement, la rémission de stomatite prothétique et la diminution du nombre de colonies de Candida. Des tests statistiques descriptifs et non paramétriques ont été menés pour analyser les données. Résultats: À 3 mois de suivi, 10,4 % des participants ont été guéris et 70,8 % ont eu une amélioration clinique de la stomatite prothétique grâce au brossage du palais. Une réduction statistiquement significative de la surface et de l’intensité de l’inflammation après 3 mois de brossage du palais a été démontrée (p < 0,0001). L’ampleur de l’effet a varié d’un effet modéré à important (0,34 à 0,54) selon la classification utilisée pour le diagnostique de la stomatite prothétique. De plus, le nombre de colonies de Candida, recueillies par sonication des prothèses et par échantillonnage du palais, a diminué de manière statistiquement significative après 3 mois de brossage (p ≤ 0,05). Conclusion: Les résultats de cette étude suggèrent que le brossage du palais est efficace comme traitement de la stomatite prothétique.

Interim analyses and sequential designs in phase III studies

Recruitment of patients to a clinical trial usually occurs over a period of time, resulting in the steady accumulation of data throughout the trial's duration. Yet, according to traditional statistical methods, the sample size of the trial should be determined in advance, and data collected on all subjects before analysis proceeds. For ethical and economic reasons, the technique of sequential testing has been developed to enable the examination of data at a series of interim analyses. The aim is to stop recruitment to the study as soon as there is sufficient evidence to reach a firm conclusion. In this paper we present the advantages and disadvantages of conducting interim analyses in phase III clinical trials, together with the key steps to enable the successful implementation of sequential methods in this setting. Examples are given of completed trials, which have been carried out sequentially, and references to relevant literature and software are provided.

Stopping rules for phase II studies

This paper, the second in a series of three papers concerned with the statistical aspects of interim analyses in clinical trials, is concerned with stopping rules in phase II clinical trials. Phase II trials are generally small-scale studies, and may include one or more experimental treatments with or without a control. A common feature is that the results primarily determine the course of further clinical evaluation of a treatment rather than providing definitive evidence of treatment efficacy. This means that there is more flexibility available in the design and analysis of such studies than in phase III trials. This has led to a range of different approaches being taken to the statistical design of stopping rules for such trials. This paper briefly describes and compares the different approaches. In most cases the stopping rules can be described and implemented easily without knowledge of the detailed statistical and computational methods used to obtain the rules.

Structural Phase Transition Studies on PMN-0.35PT using Infrared Spectroscopy

The purpose of the present work is to report studies on structural phase transition for PMN-xPT ferroelectric, with melt PbTiO3 composition around the MPB (x = 0.35 mol %), using infrared spectroscopy technique. The study was centered on monitoring the behavior of the 1-(NbO), 1-(TiO) and 1-(MgO) stretching modes as a function of temperature. The increasing as a function of temperature for 1-(TiO) and 1-(MgO) modes, observed between 230 and 300 K, can be related to the monoclinic (MC) + tetragonal (T) phase coexistence in the PMN-PT.

Phase-transition studies of Ba(0.90)Ca(0.10)(Ti(1-x)Zr(x))O(3) ferroelectric ceramic compounds

Perovskite-structured Ba(0.90)Ca(0.10)(Ti(1-x)Zr(x))O(3) ceramics were prepared in this work and subsequently studied in terms of composition-dependent dielectric and high-resolution long-range order structural properties from 30 to 450 K. The dielectric response of these materials was measured at several frequencies in the range from 1 kHz to 1 MHz. Combining both techniques, including Rietveld refinement of the X-ray diffraction data, allowed observing that, when increasing Zr(4+) content, the materials change from conventional to diffuse and relaxor ferroelectric compounds, the transition occurring spontaneously at the x = 0.18 composition. Interestingly, this spontaneous transition turned out to be prevented for a further increase of Zr(4+). On the basis of all the dielectric and structural results processed, a phase diagram of this system is presented. (C) 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim

Structural Phase Transition Studies on PMN-0.35PT using Infrared Spectroscopy

The purpose of the present work is to report studies on structural phase transition for PMN-xPT ferroelectric, with melt PbTiO3 composition around the MPB (x = 0.35 mol %), using infrared spectroscopy technique. The study was centered on monitoring the behavior of the 1-(NbO), 1-(TiO) and 1-(MgO) stretching modes as a function of temperature. The increasing as a function of temperature for 1-(TiO) and 1-(MgO) modes, observed between 230 and 300 K, can be related to the monoclinic (MC) + tetragonal (T) phase coexistence in the PMN-PT.

Electrical conduction mechanism and phase transition studies using dielectric properties and Raman spectroscopy in ferroelectric Pb0.76Ca0.24TiO3 thin films

We have studied the phase transition behavior of Pb0.76Ca0.24TiO3 thin films using Raman scattering and dielectric measurement techniques. We also have studied the leakage current conduction mechanism as a function of temperature for these thin films on platinized silicon substrates. A Pb0.76Ca0.24TiO3 thin film was prepared using a soft chemical process, called the polymeric precursor method. The results showed that the dependence of the dielectric constant upon the frequency does not reveal any relaxor behavior. However, a diffuse character-type phase transition was observed upon transformation from a cubic paraelectric phase to a tetragonal ferroelectric phase. The temperature dependency of Raman scattering spectra was investigated through the ferroelectric phase transition. The soft mode showed a marked dependence on temperature and its disappearance at about 598 K. on the other hand, Raman modes persist above the tetragonal to cubic phase transition temperature, although all optical modes should be Raman inactive above the phase transition temperature. The origin of these modes must be interpreted in terms of a local breakdown of cubic symmetry by some kind of disorder. The lack of a well-defined transition temperature suggested a diffuse-type phase transition. This result corroborate the dielectric constant versus temperature data, which showed a broad ferroelectric phase transition in the thin film. The leakage current density of the PCT24 thin film was studied at elevated temperatures, and the data were well fitted by the Schottky emission model. The Schottky barrier height of the PCT24 thin film was estimated to be 1.49 eV. (C) 2003 American Institute of Physics.

Caribbean Information System-Economic and Social Planning (CARISPLAN): final report: phase I, period 1 May 1979-31 December 1980

Includes bibliography

Review of the economics of climate change (RECC) in the Caribbean project: Phase I climate change profiles in select Caribbean countries

These reports are the result of consultations which were conducted in 2008 in Aruba, Barbados, Netherlands Antilles, Dominican Republic, Guyana, Jamaica, Montserrat, Saint Lucia and Trinidad and Tobago. The objective was to obtain relevant information that would inform a Stern-type report where the economics of climate change would be examined for the Caribbean subregion. These reports will be complimented by future assessments of the costs of the “business as usual”, adaptation and mitigation responses to the potential impacts of climate change. It is anticipated that the information contained in each country report would provide a detailed account of the environmental profile and would, therefore, provide an easy point of reference for policymakers in adapting existing policy or in formulating new ones. ECLAC continues to be available to the CDCC countries to provide technical support in the area of sustainable development.

Phase I clinical trial of cell therapy in patients with advanced chronic obstructive pulmonary disease: follow-up of up to 3 years

BACKGROUND Chronic obstructive pulmonary disease is a major inflammatory disease of the airways and an enormous therapeutic challenge. Within the spectrum of chronic obstructive pulmonary disease, pulmonary emphysema is characterized by the destruction of the alveolar walls with an increase in the air spaces distal to the terminal bronchioles but without significant pulmonary fibrosis. Therapeutic options are limited and palliative since they are unable to promote morphological and functional regeneration of the alveolar tissue. In this context, new therapeutic approaches, such as cell therapy with adult stem cells, are being evaluated.OBJECTIVE This article aims to describe the follow-up of up to 3 years after the beginning of a phase I clinical trial and discuss the spirometry parameters achieved by patients with advanced pulmonary emphysema treated with bone marrow mononuclear cells.METHODS Four patients with advanced pulmonary emphysema were submitted to autologous infusion of bone marrow mononuclear cells. Follow-ups were performed by spirometry up to 3 years after the procedure.RESULTS The results showed that autologous cell therapy in patients having chronic obstructive pulmonary disease is a safe procedure and free of adverse effects. There was an improvement in laboratory parameters (spirometry) and a slowing down in the process of pathological degeneration. Also, patients reported improvements in the clinical condition and quality of life.CONCLUSIONS Despite being in the initial stage and in spite of the small sample, the results of the clinical protocol of cell therapy in advanced pulmonary emphysema as proposed in this study, open new therapeutic perspectives in chronic obstructive pulmonary disease. It is worth emphasizing that this study corresponds to the first study in the literature that reports a change in the natural history of pulmonary emphysema after the use of cell therapy with a pool of bone marrow mononuclear cells.

A Phase I clinical trial of lodenafil carbonate, a new phosphodiesterase Type 5 (PDE5) inhibitor, in healthy male volunteers

Lodenafil carbonate is a new phosphodiesterase Type 5 (PDE5) inhibitor used in treatment of erectile dysfunction. Objective: The present study was conducted to evaluate the safety, tolerability, and pharmacokinetics of lodenafil carbonate after administering ascending (1 - 100 mg) single oral doses to healthy male volunteers (n = 33). Methods: The study was an open-label, dose-escalation, Phase I clinical trial involving the administration of single oral doses of lodenafil carbonate. Lodenafil carbonate was administered sequentially, escalating in single doses of 1 mg - 100 mg with a washout period of at least 1 week between each dose. The progression to the next dose was allowed after clinical and laboratory exams, Ambulatory Monitoring of Arterial Pressure (AMAP) without relevant clinical modifications and adverse events without clinical relevancy. Blood samples were collected at pre-dose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 3.5, 4, 4.5, 5, 6, 7, 8, 10, 12, 14, 16, 20 and 24 h post-dosing. Plasma samples for measurement of lodenafil carbonate and lodenafil were analyzed by liquid chromatography coupled to tandem mass spectrometry. Results: No serious adverse events were observed, and none of the subjects discontinued the study due to intolerance. The AMAP measurements, clinical and laboratory exams and ECG revealed no significant changes even at higher doses. Lodenafil carbonate was not detected in any samples, indicating that it acts as a prodrug. The mean lodenafil pharmacokinetic parameters for t(max) and t(1/2) were 1.6 (+/- 0.4) h and 3.3 (+/- 1.1) h, respectively. This study demonstrated that lodenafil carbonate was well tolerated and showed a good safety profile in healthy male volunteers.

Biomimetic in vitro oxidation of lapachol: A model to predict and analyse the in vivo phase I metabolism of bioactive compounds

The bioactive naphtoquinone lapachol was studied in vitro by a biomimetic model with Jacobsen catalyst (manganese(III) salen) and iodosylbenzene as oxidizing agent. Eleven oxidation derivatives were thus identified and two competitive oxidation pathways postulated. Similar to Mn(III) porphyrins, Jacobsen catalyst mainly induced the formation of para-naphtoquinone derivatives of lapachol, but also of two ortho-derivatives. The oxidation products were used to develop a GC MS (SIM mode) method for the identification of potential phase I metabolites in vivo. Plasma analysis of Wistar rats orally administered with lapachol revealed two metabolites, alpha-lapachone and dehydro-alpha-lapachone. Hence, the biomimetic model with a manganese salen complex has evidenced its use as a valuable tool to predict and elucidate the in vivo phase I metabolism of lapachol and possibly also of other bioactive natural compounds. (C) 2012 Elsevier Masson SAS. All rights reserved.