On the other hand, we now understand a great deal of the pathogen

On the other hand, we now understand a great deal of the pathogenesis underlying the disease now called juvenile myelomonocytic leukemia (JMML). JMML also fits in the new category of mixed myelodysplastic/myeloproliferative diseases. JMML is an excellent model malignancy for investigating and understanding dysregulated and aberrant signal transduction in the Ras pathway. It has also served as a teaching tool for exploring inherited predispositions

to cancer.”
“The anterodorsal (MeAD) and posteroventral (MePV) subnuclei would form the proposed “”ventral”" division of the rat medial nucleus of the amygdala (MeA). These parts receive chemosensorial inputs, have gonadal hormone receptors

and modulate hypothalamic neuroendocrine secretion and selleck inhibitor defensive/reproductive behaviors. The aims of this study were: (1) to provide further data on the morphology of Golgi-impregnated dendrites from the MeAD and the MePV of adult rats; and (2) to compare the results obtained for dendritic branching and predominant dendritic spatial distribution in both these subnuclei in males and diestrus females. Dendritic arborization levels, number of branches in each level, distribution of dendrites around the cell body and distally from it, and the preferred spatial distribution of dendritic branches were studied using different techniques and compared between sexes. WAD and MePV multipolar neurons had spiny dendrites with sparse ramifications. The main statistically Etomoxir significant differences were found in the predominant dendritic spatial distribution in the MeAD (rather medially and laterally

in males and ventromedially in females, p < 0.02) and in the MePV (rather medially and mediodorsally in males and ventrally in females, p < 0.01). Results suggest that synaptic information might be processed and see more integrated differently in the dendrites of males and females in these sex steroid-responsive MeA subnuclei. The inclusion of the MeAD and the MePV in one single “”ventral”" MeA division is further discussed. (c) 2008 Elsevier Ireland Ltd. All rights reserved.”
“Lenalidomide is an immunomodulatory drug, structurally related to thalidomide, with pleiotropic activity including antiangiogenic and antineoplastic properties. It is the product of advances in our understanding of the biology of myeloma cells, their interactions with the microenvironment and of the underlying molecular pathways. In preclinical and clinical studies, lenalidomide was more potent and less toxic than thalidomide. Subsequent phase II and III studies confirmed the activity of lenalidomide either as a single agent or in combination with dexamethasone in relapsed or refractory myeloma patients, whereas combinations with chemotherapy induce high response rates and durable remissions.

The primary end point was newly acquired infection with HIV type

The primary end point was newly acquired infection with HIV type 1 or 2. The secondary end point was newly

acquired gonococcal or chlamydial infection. The primary analysis was based on a log-rank test of no difference in the distribution of time to HIV infection, stratified according to site.

Results: A total of SB202190 solubility dmso 1398 women were enrolled and randomly assigned to receive cellulose sulfate gel (706 participants) or placebo (692 participants) and had follow-up HIV test data. There were 41 newly acquired HIV infections, 25 in the cellulose sulfate group and 16 in the placebo group, with an estimated hazard ratio of infection for the cellulose sulfate group of 1.61 (P=0.13). This result, which is not significant, is in contrast to the interim finding that led to the trial being stopped prematurely (hazard ratio, 2.23; P=0.02) and the suggestive result of a preplanned secondary (adherence-based) analysis (hazard ratio, 2.18; P=0.03). No significant effect of cellulose sulfate as compared with placebo was found on the risk of gonorrheal infection (hazard ratio, 1.10; 95% confidence interval [CI], 0.74

to 1.62) or chlamydial infection (hazard ratio, 0.71; 95% CI, 0.47 to 1.08).

Conclusions: Cellulose sulfate did not prevent HIV infection and may have increased the risk of HIV acquisition. (ClinicalTrials.gov number, NCT00153777; and Current Controlled Trials number, ISRCTN95638385.).”
“Objectives. Although evidence suggests that physical disability and depression may be reciprocally related, questions of, causalily Versus spuriousness and Temsirolimus mw the direction of causality remain to be confidently answered. This study considered the hypotheis of reciprocal influence the possibility of spuriousness in relation to pain, stress, and lifetime major depression; and the

possible mediating effects of pain and social stress.

Methods. We analyzed data from a two-wave panel Study of Miami-Dade County residents (n = 1,455) that included a substantial oversampling of individuals reporting a physical disability. Results. Results S3I-201 cell line indicated that, although prior levels of physical limitations predicted changes in depressive symptoms, there was no evidence of the reversc association.

Results also indicated that pail of the association between prior physical limitations and changes in depressive symptoms was explained by intervening level of pain and, to a lesser extent, by the day-to-day experience of discrimination.

Discussion. Much of whatever causation may be involved in the linkage between physical limitations and depressive symptomatology flows from limitations to depression rather than in the reverse direction. Results also make clear that this linkage is not in artifact of shared associations with pain, social stress, or litetime major depression.


“It was reported that ritanserin, a 5HT2A/2C antagonist, i


“It was reported that ritanserin, a 5HT2A/2C antagonist, improves negative symptoms when added to neuroleptics in inpatients with predominantly negative symptoms. Nevertheless, the results of published studies are contradictory so far. This study was designed to investigate the effect of ritanserin added to risperidone as augmentation therapy in patients with chronic schizophrenia and prominent negative symptoms in a double blind and randomized clinical trial. Eligible participants in this study were

40 patients with chronic Pritelivir solubility dmso schizophrenia. All patients were inpatients and were in the active phase of the illness, and met DSM-IV-TR criteria for schizophrenia. Patients were allocated in a random fashion, 20 to risperidone 6 mg/day plus ritanserin 12 mg/day (6 mg bid) and 20 to risperidone 6 mg/day plus placebo. The principal measure of the outcome was Positive and Negative Syndrome Scale (PANSS). Although both protocols significantly decreased the score of the positive, negative and general psychopathological symptoms over the trial period, the combination of risperidone and ritanserin showed a significant superiority over risperidone alone in decreasing negative symptoms and PANSS total scores. The present Selleckchem ACY-1215 study indicates ritanserin as a potential adjunctive treatment strategy for the negative symptoms of schizophrenia.

Nevertheless, results of larger controlled trials are needed. before recommendation before for a broad clinical application can be made. (c) 2008 Elsevier Inc All rights reserved.”
“The direction-selective circuit in the retina extracts the directional information of image motion in the visual scene. It is a classic model for neural circuit analysis because its input and output are well-defined and accessible to physiological measurements. However, the neural basis of direction selectivity is still not fully understood. Indeed, this ostensibly simple computation arises from a collection of complex neural mechanisms at all levels of circuit organization. In this review, we describe recent advances in genetic, imaging and optogenetic techniques that have improved our understanding

of the synaptic organization and development underlying retinal direction selectivity.”
“The TAR RNA binding protein, TRBP, is a cellular double-stranded RNA (dsRNA) binding protein that can promote the replication of HIV-1 through interactions with the viral TAR element as well as with cellular proteins that affect the efficiency of translation of viral transcripts. The structured TAR element, present on all viral transcripts, can impede efficient translation either by sterically blocking access of translation initiation factors to the 5′-cap or by activating the dsRNA-dependent kinase, PKR. Several mechanisms by which TRBP can facilitate translation of viral transcripts have been proposed, including the binding and unwinding of TAR and the suppression of PKR activation.

8 g per 24 h, serum albumin was 3 4 g per 100 ml (normal > 2 5

8 g per 24 h, serum albumin was 3.4 g per 100 ml (normal > 2.5 g per 100 ml), and blood pressure was 80/50 mm Hg. A renal biopsy was performed.”
“Amyloid stained by Congo red is traditionally said to show apple-green birefringence in polarized light, although in practice various colors may be seen between Cell Cycle inhibitor accurately crossed polarizing filters, called polarizer and analyzer. Other colors are seen as the polarizer and analyzer are uncrossed and sometimes when the slide is rotated. Previously, there has been no satisfactory

explanation of these properties. Birefringence means that a material has two refractive indices, depending on its orientation in polarized light. Birefringence can change linearly polarized light to elliptically polarized, which allows light to pass a crossed analyzer. The birefringence of orientated Congo red varied with wavelength and was maximal near its absorption peak, changing from negative (slow axis of transmission perpendicular to smears or amyloid fibrils) on the

shortwave side of the peak to positive ( slow axis parallel) on the longwave side. This was explained by a property of any light-absorbing substance called anomalous dispersion of the refractive index around an absorption peak. Negative birefringence gave transmission of blue, positive gave yellow, and the mixture was perceived as green. This explains how green occurs in ideal conditions. Additional or strain birefringence in the optical see more system,

such as in glass slides, CHIR98014 partly or completely eliminated blue or yellow, giving yellow/green or yellow, and blue/green or blue, which are commonly seen in practice and in illustrations. With uncrossing of polarizer or analyzer, birefringent effects declined and dichroic effects appeared, giving progressive changes from green to red as the plane of polarization approached the absorbing axis and from green to colorless in the opposite way. This asymmetry of effects is useful to pathologists as a confirmation of amyloid. Rather than showing ‘apple-green birefringence in polarized light’ as often reported, Congo red-stained amyloid, when examined between crossed polarizer and analyzer, should more accurately be said to show anomalous colors.”
“Recent studies in mice have demonstrated that the protein tyrosine phosphatase SHP-1 is a crucial negative regulator of cytokine signaling, inflammatory gene expression, and demyelination in central nervous system. The present study investigates a possible similar role for SHP-1 in the human disease multiple sclerosis (MS). The levels of SHP-1 protein and mRNA in PBMCs of MS patients were significantly lower compared to normal subjects. Moreover, promoter II transcripts, expressed from one of two known promoters, were selectively deficient in MS patients. To examine functional consequences of the lower SHP-1 in PBMCs of MS patients, we measured the intracellular levels of phosphorylated STAT6 (pSTAT6).

5 ng/ml or less 1 month after the injection For patients who had

5 ng/ml or less 1 month after the injection. For patients who had testosterone levels of 0.5 ng/ml or less after 1 month, 93% and 98% of those receiving maintenance doses of 60 and 80 mg, respectively, had testosterone

levels that were consistently 0.5 ng/ml or less at all monthly measurements from 1 month to 1 year. No evidence of testosterone surge was detected. In both groups prostate specific antigen decreased by 96% after 1 year and median time to 90% reduction in prostate specific antigen was 56 days. Six patients (5%) withdrew from the study due to adverse events.

Conclusions: Degarelix treatment for 1 year resulted in a fast, profound and sustained suppression of testosterone and prostate specific antigen with no evidence of testosterone surge. Degarelix was well tolerated.”
“Viewing images of other humans in pain elicits a variety

of responses including Selleckchem Talazoparib distress, anxiety, and a sensation that is similar to pain. We aimed to evaluate whether transcranial direct current stimulation (tDCS) could be effective in modulating the emotional aspects of selleck chemicals pain as to further explore mechanisms of tDCS in pain relief. Twenty-three healthy subjects rated images with respect to unpleasantness and discomfort/pain (baseline). and then received stimulation with tDCS under four different conditions of stimulation: anodal tDCS of the left primary motor cortex (M1), dorsolateral prefrontal cortex (DLPFC), occipital cortex (V1); and sham tDCS. The order of conditions was randomized and counterbalanced across subjects. During each stimulation session (after 3 min of stimulation), subjects were shown a new set of aversive images and were again asked to rate the images with respect to unpleasantness and discomfort/pain. The results showed that ratings of unpleasantness and discomfort/pain were significantly decreased during DLPFC tDCS only, as compared to baseline

and sham tDCS. The other conditions of stimulation (M1 and V1 tDCS) did not result in any significant changes. These results support the notion that DLPFC is a critical area for the emotional processing of pain and also suggests that DLPFC may be a potential target of stimulation for alleviation of pain with a significant emotional-affective component. Our results also suggest that the mechanism of tDCS OTX015 in vitro in modulating emotional pain involve pathways that are independent of those modulating the somatosensory perception of pain. (C) 2008 Elsevier Ltd. All rights reserved.”
“Previous studies have reported two types of event-related potential (ERP) mismatch responses in infants to infrequent auditory changes: a broad discriminative positivity in younger infants and a negativity resembling adult mismatch negativity (MMN) in older infants. In the present study, we investigated whether the positive discriminative slow wave and the adult-like MMN are functionally distinct by examining how they are affected by presentation rate and magnitude of change.

These findings support an aggressive, disciplined pretreatment ev

These findings support an aggressive, disciplined pretreatment evaluation to define disease site, extent and grade before focal therapy.”
“ADHD is associated with altered reinforcement sensitivity, despite a number of inconsistent findings. This review focuses on the overlap

and differences between seven neurobiologically valid models and lists 15 predictions assessing reinforcement sensitivity in ADHD. When comparing the models it becomes clear that there are great differences in the level of explanation. For example, Selleck Blebbistatin some models try to explain a single core deficit in terms lower-level reinforcement systems, such as the dopamine transfer to reward back in time. Other models explain multiple deficits, by describing higher-level systems, such as impaired bottom-up prefrontal activation. When reviewing the available experimental evidence in support of the predictions, most experimental studies have been focusing on behavioral changes in the face

of reward and response cost over no-reward, and on delay discounting. There is currently a lack in studies that focus on explaining underlying cognitive or neural mechanisms of altered reinforcement sensitivity in ADHD. Additionally, there is a lack in studies that try to understand what subgroup of children with ADHD shows PF299804 alterations in reinforcement sensitivity. The scarcity in studies testing the neurobiological predictions is explained partly by a lack in knowledge how to test some of these predictions in humans. Nevertheless, we believe that

these predictions can serve as a useful guide to the systematic evaluation of altered reinforcement sensitivity in ADHD. (C) 2009 Elsevier Ltd. All rights reserved.”
“Purpose: We evaluated whether a positive surgical margin at the apex confers a different I-BET151 in vivo likelihood of biochemical recurrence than at other sites.

Material and Methods: A total of 3,087 men underwent radical prostatectomy between January 2000 and June 2008. Patients with prior treatment, positive seminal vesicles, lymph node involvement or less than 6 months of followup were excluded from analysis. The remaining 1,667 men were grouped by margin status, including negative surgical margins, a solitary positive apical margin, a solitary nonapical positive margin and multiple positive margins. Kaplan-Meier analysis was used to compare biochemical recurrence across groups. Cox proportional hazards models were constructed to determine whether a solitary positive apical margin is an independent risk factor for biochemical recurrence.

Results: Median followup was 21.1 months. Of the cases 1,295 (77.7%) had negative surgical margins, 96 (5.8%) had a solitary positive apical margin, 82 (4.9%) had a solitary positive nonapical margin and 194 (11.6%) had multiple positive margins.

Differences in basal and stress-induced responses of NPY and BDNF

Differences in basal and stress-induced responses of NPY and BDNF were not supported between control and abstinent alcohol-dependent subjects.”
“High relapse rates during abstinence are a pervasive problem in drug addiction treatment. Relapse is often associated with stress exposure, which can provoke a subjective state of drug craving that can also be demonstrated under controlled laboratory conditions. Stress-induced relapse and craving in humans can be modeled in mice, rats, and monkeys using a reinstatement model in which drug-taking behaviors are extinguished

and then reinstated by acute exposure to certain stressors. Studies using the reinstatement model in rats have identified the role of several neurotransmitters and brain sites in stress-induced https://www.selleckchem.com/products/VX-765.html reinstatement of drug seeking, Quizartinib in vivo but the degree to which these preclinical findings are relevant to the human condition is largely unknown.

Here, we address this topic by discussing recent results on the effect of alpha-2 adrenoceptors and substance P-NK1 receptor

antagonists on stress-induced reinstatement in mice and rats and stress-induced craving and potentially stress-induced relapse in humans. We also discuss brain sites and circuits involved in stress-induced reinstatement of drug seeking in rats and those activated during stress-induced craving in humans.

There is evidence that alpha-2 adrenoceptor agonists and NK1 receptor antagonists decrease stress-induced drug seeking in rats and stress-induced craving in humans. Whether these drugs would also prevent stress-induced drug relapse in humans and whether similar or different brain mechanisms are involved in stress-induced reinstatement selleck screening library in non-humans and stress-induced drug craving and relapse in humans

are subjects for future research.”
“Reactivity to stressors and environmental cues, a putative cause of relapse in addiction, may be a useful target for relapse-prevention medication. In rodents, alpha-2 adrenergic agonists such as clonidine block stress-induced reinstatement of drug seeking, but not drug cue-induced reinstatement.

The objective of this study is to test the effect of clonidine on stress- and cue-induced craving in human cocaine users.

Healthy, non-treatment-seeking cocaine users (n = 59) were randomly assigned to three groups receiving clonidine 0, 0.1, or 0.2 mg orally under double-blind conditions. In a single test session, each participant received clonidine or placebo followed 3 h later by exposure to two pairs of standardized auditory-imagery scripts (neutral/stress and neutral/drug). Subjective measures of craving were collected.

Subjective responsivity (“”crave cocaine”" Visual Analog Scale) to stress scripts was significantly attenuated in the 0.1- and 0.2-mg clonidine groups; for drug-cue scripts, this attenuation occurred only in the 0.2-mg group.

A significant and positive correlation was observed between HCV R

A significant and positive correlation was observed between HCV RNA levels measured in the same samples with ART and CAP-CTM with all the genotypes tested.

However, in 33 of the 204 (16%) clinical samples, the individual difference between HCV RNA levels measured by both assays was above +/-0.5 log(10) Such viral load variations above 0.5 log(10) should be considered as significant. HCV RNA levels estimated by CAP-CTM for genotype 4 were significantly lower than those for genotypes 1, 2, and 3 (P < 0.0001). IPI145 solubility dmso This study shows that using the same assay in multicenter trials and cohorts is still relevant due to inter-assay differences observed in HCV plasma load measurements. (C) 2012 Elsevier BM. All rights reserved.”
“MALDI-TOF MS can be used for the identification of microorganism species. We have extended its application to a novel https://www.selleckchem.com/products/LDE225(NVP-LDE225).html assay of Candida albicans susceptibility to fluconazole, based on monitoring modifications of the proteome of yeast cells grown in the presence of varying drug concentrations.

The method was accurate, and reliable, and showed full agreement with the Clinical Laboratory Standards Institute’s reference method. This proof-of-concept demonstration highlights the potential for this approach to test other pathogens.”
“Previous studies demonstrated that exendin-4 (Ex-4) may possess neurotrophic and neuroprotective functions in ischemia insults, but its mechanism remained unknown. Here, by using real-time PCR and ELISA, we identified the distribution of active GLP-1Rs in the rat primary cortical neurons. After establishment selleck kinase inhibitor of an in vitro ischemia

model by oxygen/glucose deprivation (OGD), neurons were treated with various dosages of Ex-4. The MTT assay showed that the relative survival rate increased with the dosage of Ex-4 ranging from 0.2 to 0.8 mu g/ml (P < 0.001, vs. OGD group). The apoptosis rate was reduced from (49.47 +/- 2.70)% to (14.61 +/- 0.81)% after Ex-4 treatment (0.4 mu g/ml) 12 h after OGD (P < 0.001). Moreover, immunofluorescence staining indicated that Ex-4 increased glucose-regulated proteins 78 (GRP78) and reduced C/EBP-homologous protein (CHOP). Western blot analysis demonstrated that, after neurons were treated with Ex-4, GRP78 was up-regulated over time (P < 0.01, vs. OGD group), while CHOP levels rose to a peak 8 h after OGD and then decreased (P < 0.05, vs. OGD group). This effect was changed by both the protein kinase A (PKA) inhibitor H89 (P < 0.01, P < 0.05, respectively, vs. Ex-4 group) and the phosphatidylinositol 3-kinase (PI3K) inhibitor LY294002 (P < 0.01, P < 0.01, respectively, vs. Ex-4 group) but not by the mitogen-activated protein kinase (MAPK) inhibitor U0126.

82 +/- 1 42 Hz vs 10 58 +/- 1 56 Hz; P= 0009), and higher sensiti

82 +/- 1.42 Hz vs 10.58 +/- 1.56 Hz; P=.0009), and higher sensitivities to the gap junction inhibitor (preconditioned engineered tissue constructs vs embryonic heart slices: 0.22 +/- 0.07 mmol/L vs 0.93 +/- 0.15 mmol/L; P=.0004).

Conclusions: We have generated skeletal myoblast-based transplantable grafts that electrically

couple to myocardium. (J Thorac Cardiovasc Surg 2012;144:1176-84)”
“Adenosine agonists or low doses of morphine exert anti-convulsant effects in different models of seizures. On the other hand, a tight interaction has been reported between morphine and adenosine in various paradigms. This study investigated the effect of the interaction of adenosine and morphine on seizure susceptibility in the intravenous mouse model of pentylenetetrazole (PTZ)-induced clonic seizures. The researchers used acute systemic administration of morphine, N-6-cyclohexyladenosine

(CHA) (a selective A(1) receptor agonist), naltrexone (an opioid receptor selleck chemicals antagonist) and 8-Cyclopentyl-1,3-dimethylxanthine (8-CPT) (a selective A(1) receptor antagonist). Acute administration of morphine (0.25, 0.5 and 1 mg/kg) or CHA (0.25, 0.5, 1, 2 and 4 mg/kg) raised the threshold of seizures induced by PTZ. Non-effective dose of 8-CPT (2 mg/kg) inhibited the anticonvulsant effects of CHA (0.5 and 1 mg/kg). Combination of sub-effective doses of morphine (0.125 mg/kg) and CHA (0.125 mg/kg) increased clonic seizure latency showing the additive effect of morphine and CHA. The enhanced latency induced by combination of low doses of morphine and CHA completely reversed by 8-CPT (2 mg/kg) click here or naltrexone (1 mg/kg). Moreover, 8-CPT (2 mg/kg) inhibited anticonvulsant effects of morphine (0.25 and 0.5 mg/kg) and naltrexone (1 mg/kg) inhibited anticonvulsant effects Beta adrenergic receptor kinase of CHA (0.25, 0.5 and I mg/kg). Combination of low doses of 8-CPT (1 mg/kg) and naltrexone (0.5 mg/kg) inhibited the anticonvulsant effect of CHA (0.5 and 1 mg/kg).

In conclusion, adenosine and morphine exhibit an additive effect on the enhancement of the pentylenetetrazole-induced seizure threshold in mice, probably through A(1) or mu receptors. (C) 2013 Elsevier Ltd. All rights reserved.”
“Background. Cognitive-behavioral therapy (CBT) consisting of exposure and response prevention (EX/RP) is efficacious as a treatment for obsessive-compulsive disorder (OCD). However, about half of patients have a partial or poor response to EX/RP treatment. This study examined potential predictors and moderators of CBT augmentation of pharmacotherapy, to identify variables associated with a poorer response to OCD treatment.

Method. Data were drawn from a large randomized controlled trial that compared the augmenting effects of EX/RP to stress management training (SMT; an active CBT control) among 108 participants receiving a therapeutic dose of a serotonin reuptake inhibitor (SRI). Stepwise regression was used to determine the model specification.

Results.

In mid stance (single-limb support phase), patients had significa

In mid stance (single-limb support phase), patients had significantly selleck chemicals llc reduced knee and hip power due to the decreased torques produced by the knee extensors and the hip flexors. In late stance (propulsion phase), reduced propulsion was noted with significant reduction in ankle plantar flexor torques and power. These differences were present before and after the onset of pain, with certain parameters worsening in association with pain.

Conclusions: The gait of claudication is characterized by failure

of specific and identifiable muscle groups needed to perform normal walking (weight acceptance, single-limb support, and propulsion). Parameters of gait are abnormal with the first steps taken, in the absence of pain, and certain of these parameters worsen after the onset of claudication pain. (J Vasc Surg 2010;52:340-7.)”
“Noise-induced hearing loss (NIHL) is thought to primarily involve Selleck Etomoxir damage to the sensory hair cells of the cochlea via mechanical and metabolic mechanisms. Unfortunately, initial studies assessing the effectiveness of post-exposure treatment after

hearing loss have yielded largely disappointing results. This study explored the effects of oral treatment with Korean red ginseng (RG) and with two bioavailable ginsenoside metabolites, ginsenoside Rh1 and ginsenoside compound K (GCK), in response to NIHL in a murine model. Pharmacological treatments began 24 h after noise exposure and were continued once daily for 7 days. Central auditory function was evaluated using auditory middle latency responses, and cochlear function was determined based on transient evoked otoacoustic emissions. Additionally, cochlear hair cell morphology

was investigated after noise exposure. Both Korean red ginseng and compound K reduced threshold shifts, central auditory function damage, and cochlear functional and morphological deficits. In contrast, treatment with ginsenoside Rh1 did not result in recovery of NIHL in mice. These results suggest that consumption of Korean red ginseng may facilitate recovery from noise-induced hearing loss. Furthermore, one of the active constituents in ginseng is likely ginsenoside compound K. (C) 2010 Elsevier Ireland Ltd. All rights reserved.”
“Objective: The initial treatment for intermittent claudication is supervised exercise Urease therapy (SET). Owing to limited capacity and patient transports costs of clinic-based SET, a concept of SET provided by local physiotherapists was developed. We hypothesized that provision of daily feedback with an accelerometer in addition to SET would further increase walking distance.

Methods. This multicenter randomized trial was set in vascular surgery outpatient clinics and included 304 patients with intermittent claudication. Patients were randomized to exercise therapy in the form of “”go home and walk”" advice (WA), SET, or SET with feedback.