A diagnosis of pyometra

A diagnosis of pyometra selleck inhibitor was made by radiology. After undergoing ovario-hysterectomy, the queen made a full recovery. Histopathological

examination of the uterus and ovary was made. A sterilization case was included for microscopic comparison. Results showed that endometrium of the cat with pyometra presented atrophy and shedding of superficial epithelium, and there were apparent cystic follicles in ovary. (c) 2013 PVJ. All rights reserved”
“Interactions between HIV and opioid dependence therapies are known to occur. We sought to determine if such interactions occurred between methadone and elvitegravir boosted with cobicistat (EVG/COBI). We performed a within-subject open-label pharmacokinetic and pharmacodynamic study of 11 HIV-seronegative subjects stabilized on at least 2 weeks of methadone. Subjects underwent baseline and steady-state evaluation of the effect of elvitegravir 150 mg once a click here day (QD) boosted with 150 mg QD of cobicistat (EVG/COBI) on methadone pharmacokinetic parameters. Safety and pharmacodynamics were monitored throughout the study. Compared to baseline values, the R-methadone mean area under the concentration-time

curve to the end of the dosing period (AUC(tau)) (5,550 versus 6,210 h . ng/ml) and mean maximum concentration of drug in serum (C-max) (316 versus 337 ng/ml) did not significantly increase in the presence of EVG/COBI. Compared to baseline values, the S-methadone mean AUC(tau) (7,040 versus 7,540 h . ng/ml) and mean C-max (446 versus 452 ng/ml) did not significantly increase in the presence of EVG/COBI. The AUC(tau), C-max, and C-tau of elvitegravir and cobicistat did not significantly differ from those of historical controls. Opioid withdrawal or overdose was not observed among subjects in this study. The addition of EVG/COBI to stabilized patients receiving methadone did not affect methadone pharmacokinetics and pharmacodynamics. These two agents can be safely coadministered.”
“While most breast cancers are thought to arise from the luminal layer of the breast tissue, it remains unclear which specific cells Anlotinib in the luminal layer are

the cells of origin of breast cancer. We have previously reported that WAP-positive luminal epithelial cells are at increased susceptibility to tumor initiation by ErbB2 compared to the bulk population, while the mammary cells with canonical Wnt signaling activity fail to evolve into tumors upon ErbB2 activation. Here, we used retrovirus to introduce ErbB2 into the Krt6a-positive mammary progenitor subset of the luminal epithelium and, for comparison, into the mammary luminal epithelium indiscriminately. Tumors developed from both groups of cells with a similar latency. These data indicate that the Krt6a-positive subset of mammary epithelial cells can be induced to form cancer by ErbB2 but it is not more susceptible to tumorigenesis initiated by ErbB2 than the bulk population of the luminal epithelium.

The mean values for the observed and the expected heterozygosity

The mean values for the observed and the expected heterozygosity were 0.66 and 0.73, respectively. There was very little genetic differentiation among populations, as was indicated by low overall values of Wright’s F(ST) (0.03) and Nei’s G(ST) (0.08). An analysis of molecular variance (AMOVA) showed that 96.8% of the total variance was attributable to differences between individuals within populations. Genetic

and geographic distances were nevertheless positively correlated, as evidenced by a Mantel test. The high Emricasan level of genetic diversity and the apparent lack of genetic structure in wild P. divaricata may be attributed to frequent long distance gene flow through frugivorous birds and possibly humans, as has been documented for other Prunus species.”
“To understand the organic sulfur (S) stabilization in volcanic soils, we investigated organic S transformation rates and their relationships to soil properties in incubation experiments using forest soils from the Nikko volcanic region, central Japan. We hypothesized

that carbon (C)-bonded S would first be transformed into ester sulfate-S and then into inorganic ARN-509 chemical structure sulfate-S. We separately calculated the rates of decrease of C-bonded S (velocity 1, v (1)) and ester sulfate-S (velocity 2, v (2)) concentrations. During incubation, the ester sulfate-S concentration increased in two soils characterized by a high concentration of both ammonium oxalate-extractable aluminum (Al-o) and pyrophosphate-extractable Al (Al-p), whereas the C-bonded S concentration decreased in all soils. A large proportion of the S that was lost in the incubation experiments consisted of C-bonded S rather than ester sulfate-S. Velocity 2 was negatively correlated with both of Al-o and Al-p contents when soils were incubated at 20 A degrees C. These results suggest that when C-bonded S is transformed into ester sulfate-S, complete mineralization to inorganic sulfate is inhibited, because ester sulfate-S

is stabilized due to organo-mineral association. Incubation temperatures significantly affected Protein Tyrosine Kinase inhibitor v (2). Thus, production of inorganic sulfate by mineralization of ester sulfate-S appeared to be regulated by soil Al contents and temperatures. Velocity 1 was proportional to soil pH ranging from 4.5 to 5.5, indicating that the degradation of C-bonded S is pH dependent.”
“In the previously isolated pAG20 plasmid from the Acetobacter aceti CCM3610 strain, the Rep20 protein was characterized as a main replication initiator. The pAG20 plasmid origin was localized in the vicinity of the rep20 gene and contained two 21-nucleotide-long iteron sequences, two 13-nucleotide-long direct repeats, and a DnaA-binding site. Electrophoretic mobility shift assay and nonradioactive fragment analysis confirmed that the Rep20 protein interacted with two direct repeats (5′-TCCAAATTTGGAT’-3′) and their requirement during plasmid replication was verified by mutagenesis.


“Enteric fever is a major cause of morbidity in several pa


“Enteric fever is a major cause of morbidity in several parts Napabucasin concentration of the Indian subcontinent. The treatment for typhoid fever majorly includes the fluoroquinolone group of antibiotics. Excessive and indiscriminate use of these antibiotics has led to development of acquired resistance in the causative organism Salmonella Typhi. The resistance towards fluoroquinolones is associated with mutations in the target gene of DNA Gyrase. We have estimated the Minimum Inhibitory Concentration (MIC) of commonly used fluoroquinolone representatives

from three generations, ciprofloxacin, ofloxacin, levofloxacin and moxifloxacin, for 100 clinical isolates of Salmonella Typhi from patients in the Indian subcontinent. The MICs have been found to be in the range of 0.032 to 8 mu g/ml. The gene encoding DNA Gyrase was subsequently sequenced and point mutations were observed in DNA Gyrase in the quinolone resistance determining region comprising Ser83Phe/Tyr and Asp87Tyr/Gly. The binding ability of these four fluoroquinolones in the quinolone binding pocket of wild type

as well as mutant DNA Gyrase was computationally analyzed by molecular docking to assess their differential binding behaviour. This study has revealed that mutations in DNA Gyrase alter the characteristics of the binding pocket resulting in the loss of crucial molecular https://www.selleckchem.com/products/Mizoribine.html interactions and consequently decrease the binding affinity of fluoroquinolones with the see more target protein. The present study assists in understanding the underlying molecular and structural mechanism for decreased fluoroquinolone susceptibility in clinical isolates as a consequence of mutations in DNA Gyrase.”
“Options are discussed for biochemical production of 4-hydroxybutyrate (4-HB) and its lactone, gamma-butyrolactone (GBL), from renewable sources. In the first part of the study, the thermodynamic feasibility of four potential metabolic pathways from glucose to 4-HB are analyzed. The calculations reveal that when the pathways are NAD(+) dependent

the intermediate succinate semialdehyde (SSA) accumulates leading to low 4-HB yields at equilibrium. For NADP+ dependent pathways the calculated yield of 4-HB improves, up to almost 100%. In the second part of this study, continuous removal of 4-HB from the solution is considered to shift SSA conversion into 4-HI3 so that SSA accumulation is minimized. One option is the enzymatic production of GBL from 4-HB. Candida antarctica Lipase B shows good lactonization rates at pH 4, but unfortunately this conversion cannot be performed in-vivo during 4-HB production because of the neutral intracellular pH.”
“There is a growing appreciation that it is not just the total intake of dietary Se that is important to health but that the species of Se ingested may also be important. The present review attempts to catalogue what is known about Se species in foods and supplements and the health effects in which they are implicated.

Male preschoolers suffered the highest IR (38 7/100 000) Migrant

Male preschoolers suffered the highest IR (38.7/100 000). Migrant children were overrepresented among amputees. Selleck IWR-1-endo Of all amputations, 64% occurred in the house/garden and 14% in day-care/school/sports activities, usually between 08:00 and 16:00 (61%). Doors were the product most commonly involved (55% overall; 72% in day-care/school/gym) followed by furniture/appliances (15%) and machinery/tools (7%). Crushing was the commonest mechanism. Inadequate supervision

and preventive measures were also frequently reported. 5% of the amputees were referred to specialised units for replantation/reconstructive surgery.\n\nConclusions The majority of paediatric hand and finger amputations could be prevented in Greece, particularly among preschoolers, by a single product modification, namely door closure systems, coupled with improved supervision. Paediatricians should incorporate this advice into their routine child-safety counselling. This country-specific profile supports the need for maintaining similar databases as an indispensable tool for assisting decision-making Selleckchem KU 57788 and preventing disabling and costly injuries.”
“MicroRNAs are implicated in the response to biotic stresses. Papaya meleira virus (PMeV) is the causal agent of sticky disease, a commercially important pathology in papaya for which there

are currently no resistant varieties. PMeV has a number of unusual features, such as residence in the laticifers of infected plants, and the response of the papaya to PMeV infection is not well understood. The protein levels of 20S proteasome subunits increase during PMeV infection, suggesting that proteolysis could be an important aspect of the plant defense response mechanism. To date, 10,598 plant microRNAs have been identified

in the Plant miRNAs Database, but only two, miR162 and miR403, are from papaya. In this study, known plant microRNA sequences were used to search for potential microRNAs in the papaya genome. A total of 462 microRNAs, representing 72 microRNA families, were identified. The expression Quizartinib cell line of 11 microRNAs, whose targets are involved in 20S and 26S proteasomal degradation and in other stress response pathways, was compared by real-time PCR in healthy and infected papaya leaf tissue. We found that the expression of miRNAs involved in proteasomal degradation increased in response to very low levels of PMeV titre and decreased as the viral titre increased. In contrast, miRNAs implicated in the plant response to biotic stress decreased their expression at very low level of PMeV and increased at high PMeV levels. Corroborating with this results, analysed target genes for this miRNAs had their expression modulated in a dependent manner. This study represents a comprehensive identification of conserved miRNAs inpapaya. The data presented here might help to complement the available molecular and genomic tools for the study of papaya.

Peripheral blood samples from 274 patients obtained prior to trea

Peripheral blood samples from 274 patients obtained prior to treatment, at time of surgery, and at 6 and 12 months post-surgery were examined by two different clonality assays: the HUMARA (HUMan Androgen Receptor) assay to estimate the incidence of early genetic damage by clonal proliferation, and microsatellite instability (MSI) testing to screen for LOH or defective DNA mismatch repair mechanisms. Clonal hematopoiesis was negative in 93.5% of the samples analyzed. Five FG-4592 cost patients showed a HUMARA-positive/MSI-negative

pattern, and no patients showed a HUMARA-negative/MSI-positive pattern. With a median follow-up of 3.1 years, one patient in our study developed

t-AML at 3 years 5 months after randomization. Our results indicate that clonal hematopoiesis assays performed within the 2 years following dose-intensive neoadjuvant therapy failed to identify AS1842856 mouse an emerging clonal hematopoietic stem cell population. Longer clinical follow-up will be necessary to define better the positive predictive value of detecting clonal hematopoiesis in the HUMARA+/MSI- cases.”
“Selenoproteins are proteins containing selenium in the form of the 21st amino acid, selenocysteine. Members of this protein family have many diverse functions, but their synthesis is dependent on a common set of cofactors; and oil dietary selenium. Although the functions of many selenoproteins; are unknown, several disorders involving changes in selenoprotein structure, activity

or expression have been reported. Selenium deficiency and mutations or polymorphisms PF-03084014 datasheet in selenoprotein genes and synthesis cofactors are implicated in a variety of diseases, including muscle and cardiovascular disorders, immune dysfunction, cancer, neurological disorders and endocrine function. Members of this unusual family of proteins have roles in a variety of cell processes and diseases.”
“Histone H4 lysine acetylation regulated by MOF (males absent on the first) was initially discovered as a dosage compensation epigenetic mark. Recent studies have revealed, however, that the epigenetic mark has a critical role in cellular function both during oogenesis as well as oncogenesis. Detailed molecular analysis of H4K16 isoforms and other posttranslational modified histones has been limited by the lack of means to prepare sufficient material for in vitro study. This paper describes an improved method to prepare acetylated H4K16 as well as other covalently modified histone H4 isoform for biophysical studies.”
“Objectives: Octreotide long acting repeatable (LAR) is commonly used to control the symptoms of patients with functional neuroendocrine tumors.

Previous work has shown that body weight and monthly LAR dose wil

Previous work has shown that body weight and monthly LAR dose will significantly affect circulating plasma octreotide levels in patients undergoing therapy.\n\nMethods: To determine if other parameters change circulating plasma octreotide levels, we prospectively studied 82 patients undergoing long-term LAR therapy.\n\nResults: Multivariate analysis demonstrated that the plasma octreotide levels decrease

by approximately 3.4% for each unit of body mass index (BMI) increase (P = 0.03), adjusting for sex and monthly LAR dose. Plasma octreotide levels for females were approximately 47.6% higher than those for males (P = 0.045), adjusting for BMI and monthly LAR dose. Initial and subsequent octreotide LAR doses should take into consideration sex and BMI. Males are estimated to require 14.1-mg (SD, 7.25) higher monthly LAR doses than females with the same BMI.\n\nConclusions: We have shown AR-13324 inhibitor that plasma octreotide levels are affected by not only monthly LAR dose but also BMI and sex. We hope these observations will make choosing initial and subsequent octreotide LAR doses easier for physicians.”
“Purpose of Study. Diagnosis of prosthetic loosening in hip and knee arthroplasty remains a challenge. Although there are a number of diagnostic tools, no single test or combination is 100% sensitive or www.selleckchem.com/products/a-769662.html specific. There has been

a recent interest in the use of radionuclide arthrography (RNA) for detection of prosthetic loosening. Methods. A retrospective review of 45 consecutive RNA scans from 2005 to 2010 was conducted. RNA findings were compared with intraoperative findings at revision and/or serial radiographic examinations to confirm loosening. A component

was considered loose if sequential radiographs demonstrated macromotion, gross subsidence, or progressive radiolucency. Results. There were 26 females and 17 males, with mean age at RNA of 71 years (range of 53-89 years) and mean time from index surgery, 6.4 years (range of 0.5-23 years). There were 23 total knee replacements (TKR) (19 primary and 4 revision) and 20 total hip replacements (THR) (11 primary Selleckchem LDN-193189 and 9 revision). 15 patients underwent revision surgery following RNA. Strict inclusion criteria allowed 27 patients for further analysis. Sixteen RNA scans were suggestive of loosening, of which 14 were confirmed loose. Eleven scans were suggestive of a stable prosthesis, of which 10 were confirmed well fixed. RNA had a sensitivity of 93%, specificity of 83%, positive predictive value of 88%, and negative predictive value of 91%. Conclusion. Radionuclide arthrography should be considered a useful adjunct in the diagnosis of prosthetic loosening in the challenging patient.”
“Antarctic krill (Euphausia superba) occupy a key position in the Southern Ocean linking primary production to secondary consumers.

Finally, we adopted the experimental design and statistical metho

Finally, we adopted the experimental design and statistical method to calculate the best combination proportion (CG-4: CG-10: CG-14=2.065: 1.782: 2.153) to optimize its therapeutic effect.”
“OBJECTIVES: Bidirectional

cavopulmonary anastomosis (BDCPA) is part of the staged Fontan palliation for congenital heart defects with MK-2206 cost single-ventricle morphology. The aim of this study was to describe incidence and characteristics of early postoperative arrhythmias in patients undergoing BDCPA. METHODS: Retrospective analysis of 60 patients undergoing BDCPA at the age of smaller than 12 months from 2001 to 2008 at a single centre. Arrhythmias were subclassified in sinus bradycardia, premature atrial/ventricular contraction, supraventricular tachycardia and atrioventricular block. The groups were compared according to age at operation and diagnosis. Postoperative follow-up data were included until Fontan completion. RESULTS: Postoperative arrhythmia was observed in SBE-β-CD cost 20 patients: 12 temporary and 8 persisting until hospital discharge. Sinus bradycardia is a common postoperative arrhythmia and occurred in 16 patients (9 transient, 7 persistent until hospital discharge). One patient undergoing

BDCPA and a Damus-Kaye-Stansel procedure had a persisting first-degree atrioventricular block. The occurrence of a postoperative arrhythmia was independent of age and diagnostic group (hypoplastic left heart vs non-hypoplasic left heart). After hospital discharge, five of the eight arrhythmia resolved spontaneously resulting in 2 patients with

sinus bradycardia and SNX-5422 1 patient with a first-degree AV block immediately before the Fontan completion was undertaken. CONCLUSIONS: Postoperative arrhythmias in patients with BDCPA occur early after surgery and are temporary. Severe and life-threatening arrhythmias are rare although the interventions are complex and the patients very young. The most common arrhythmia is sinus bradycardia.”
“Background: More than 100,000 US troops were potentially exposed to chemical warfare agents sarin (GB) and cyclosarin (GF) when an ammunition dump at Khamisiyah, Iraq was destroyed during the 1991 Gulf War (GW). We previously reported reduced hippocampal volume in GW veterans with suspected GB/GF exposure relative to matched, unexposed GW veterans estimated from 1.5 T magnetic resonance images (MRI). Here we investigate, in a different cohort of GW veterans, whether low-level GB/GE exposure is associated with structural alterations in specific hippocampal subfields, estimated from 4 T MRI.

The

first 13 consecutive patients operated on using this

The

first 13 consecutive patients operated on using this method were analysed. Twelve patients were operated on at one level and 1 at two levels. Disc herniation was centro-lateral in 10 cases, lateral in 2 and central (broad-based) in 2 patients.\n\nResults: EPZ-6438 inhibitor Regression of radicular pain was noted in all patients. No postoperative complications were observed except for prolongation of wound healing in 2 patients. According to modified MacNab criteria, excellent late outcome was achieved in 8 patients and good in 4 patients. There were no cases of recurrent radicular pain or need for surgical revision for herniation recurrence. One patient was reoperated on because of low back pain (implantation of an interspinous spacer).\n\nConclusions: Microscopically assisted lumbar discectomy using the METRx X-Tube system seems to be safe and effective. This method combines the advantages of modern minimally invasive techniques while avoiding the limitations of endoscopy.”
“Idiopathic pulmonary fibrosis (IPF) is a lethal, fibroproliferative disease. Pulmonary hypertension (PH) can develop secondary to IPF and increase mortality. Alternatively, activated macrophages (AAMs) contribute to the pathogenesis of both IPF and PH. Here we hypothesized that adenosine signaling through the ADORA2B on

AAMs impacts the progression of these disorders and that conditional deletion of ADORA2B on myeloid cells would have a beneficial effect in a model of these diseases. Conditional knockout mice lacking ADORA2B on myeloid cells (Adora2B(f/f)-LysM(Cre))

were exposed to the fibrotic agent EVP4593 in vivo bleomycin (BLM; 0.035 U/g body weight, i. p.). At 14, 17, 21, 25, or 33 d after exposure, SpO(2), bronchoalveolar lavage fluid (BALF), and histologic analyses were performed. On day 33, lung function and cardiovascular analyses were determined. Markers for AAM and mediators of fibrosis and PH were assessed. Adora2Bf/f-LysMCre mice presented with attenuated fibrosis, improved lung function, and no evidence of PH compared with control mice exposed to BLM. These findings were accompanied by reduced expression of CD206 and arginase-1, buy PR-171 markers for AAMs. A 10-fold reduction in IL-6 and a 5-fold decrease in hyaluronan, both linked to lung fibrosis and PH, were also observed. These data suggest that activation of the ADORA2B on macrophages plays an active role in the pathogenesis of lung fibrosis and PH.”
“The aim of this study was to explore the significance of plasma kisspeptin levels in diagnosis and therapeutic evaluation through the analysis of the kisspeptin levels of girls diagnosed with idiopathic central precocious puberty (ICPP) prior to treatment and after 6-months of treatment and those with simple premature thelarche (PT). A total of 70 girls including 24 girls diagnosed with ICPP, 21 girls with PT and 25 normal girls were enrolled in the study.

In particular, both levels of IgG2a (Th1) and IgG1 (Th2) were sig

In particular, both levels of IgG2a (Th1) and IgG1 (Th2) were significantly increased in mice vaccinated with viral vectors. These results show the nfa1-vaccination induce efficiently Th1 type, as well as Th2 type immune responses. This is the first report to construct viral vector systems and to evaluate immune responses

as DNA vaccination in N. fowleri infection. Furthermore, these results suggest that nfal vaccination may be an effective method for treatment of N. fowleri infection.”
“Nasal surgeries constitute an extensive manipulation of the nasal mucosa and therefore of structures related to trigeminal and olfactory sensitivity. While olfactory changes due to nasal surgery are relatively well investigated, there are only very few studies regarding trigeminal sensitivity. Aim of the present study was to investigate sensory changes AZD6738 learn more after nasal surgery with special regard to the trigeminal sensitivity. In 38 patients

prior to and around 12 weeks after nasal surgery the following psychophysical measures were performed: odor identification, odor discrimination, phenyl ethyl alcohol odor threshold, sensitivity to trigeminal stimuli, trigeminal detection thresholds and trigeminal pain thresholds. These results were compared to those of a control group (43 healthy volunteers). Psychophysical olfactory and trigeminal testing showed no major changes in patients after surgery compared to the control group. Independent from the time of measurement higher trigeminal detection thresholds were found in patients compared to healthy subjects, meaning that trigeminal thresholds Tubastatin A manufacturer were already increased before surgery. The present study revealed

a decreased trigeminal sensitivity in patients already before surgery. It may be hypothesized that patients also exhibit a decreased sensitivity for nasal airflow, which may also contribute to the patients’ impression of impaired nasal breathing.”
“Endometrial squamous metaplasia is a common type of metaplasia. Wide endometrial squamous metaplasia, or ichthyosis uteri, is a rare form of the disease. Malignant transformation based on ichthyosis uteri alone or ichthyosis uteri complicated by other malignant lesions is even rarer. In this study, we report a case of ichthyosis uteri complicated by poorly differentiated endometrial adenocarcinoma. A 74-year-old patient visited the doctor’s office after suffering from irregular and small amounts of vaginal hemorrhage for half a month. Gynecological examination showed a 2-month pregnancy-like uterine enlargement. Histopathological examination confirmed two types of lesions: poorly differentiated endometrioid adenocarcinoma and wide replacement of a large area of endometrium by mature squamous epithelium.

g assessment-only) at reducing alcohol consumed per week in stud

g. assessment-only) at reducing alcohol consumed per week in student and non-student populations. However,

most studies used the mean to summarize skewed data, which could be misleading in small samples. A sensitivity analysis of those studies that used suitable measures of central tendency Belnacasan concentration found that there was no difference between intervention and minimally active comparator groups in alcohol consumed per week by students. Few studies investigated non-student populations or compared interventions with active comparator groups.\n\nConclusion\n\nComputer-based interventions may reduce alcohol consumption compared with assessment-only; the conclusion remains tentative because of methodological weaknesses in the studies. Future research should consider that the distribution of alcohol consumption data is likely to be skewed

and that appropriate measures of central tendency are reported.”
“The objective of these studies was to evaluate the efficacy of several concentrations of 1-aminocyclopropane carboxylic acid (ACC) for thinning apple at the standard growth stage for chemical thinning timing and a late thinning growth stage. ACC was applied at concentrations of 0, 100, 300, or 500 mg.L-1 to ‘Golden Delicious’/Bud.9 apple trees at 10 mm or 20 mm fruit diameter. Treatments were applied to the point of drip to individual whole trees in a completely randomized design with five (2010) and six (2011) replications. When ACC was applied at 20 mm, there was a linear dose relationship between concentration and fruit thinning in both years. ACC was find more ineffective at 10 mm. The naturally occurring compound ACC shows potential for Etomoxir use as a reliable late chemical thinner for apple.”
“Context. There is wide interindividual variation in response to morphine

for cancer-related pain; 30% of patients do not have a good therapeutic outcome. Alternative opioids such as oxycodone are increasingly being used, and opioid switching has become common clinical practice. Objectives. To compare clinical response to oral morphine vs. oral oxycodone when used as first-line or second-line (after switching) treatment in patients with cancer-related pain. Methods. In this prospective, open-label, randomized, controlled trial (ISRCTN65155201) with a selected crossover phase, patients with cancer-related pain were randomized to receive either oral morphine or oxycodone as first-line treatment. Dose was individually titrated until the patient reported adequate pain control. Patients who did not respond to the first-line opioid (either because of inadequate analgesia or unacceptable adverse effects) were switched to the alternative opioid. Results. Two hundred patients were recruited. On intention-to-treat analysis (n = 198, morphine 98, oxycodone 100), there was no significant difference between the numbers of patients responding to morphine (61/98 = 62%) or oxycodone (67/100 = 67%) when used as a first-line opioid.