A total of 160 benign papillomas without atypia that were diagnos

A total of 160 benign papillomas without atypia that were diagnosed at CNB and excised surgically in 143 women (age range, 19-77 years) were assessed. Medical records and sonograms in the women were reviewed. Two radiologists working in consensus correlated

imaging findings with the biopsy result to determine concordance. For the upgrade to malignancy after excision, malignant lesions were compared with nonmalignant lesions for the collected clinical and radiologic variables, which included patient age, lesion size, and lesion distance from the nipple, by using the x(2) or Fisher exact test for categoric variables and the Selleck ZD1839 Mann-Whitney U test for continuous variables.

Results: Eight (5.0%) of 160 papillomas were upgraded to malignancy. Lesions that were 1 cm or larger (seven [11%] of 63) showed a higher upgrade rate than lesions that were smaller than 1 cm (one [1%] of 97) (P = .006). The upgrade rate was higher in patients aged 50 years or older (six [16%] of 37) than in patients younger than 50 years (two [2%] of 123) (P = .002).

Lesions that were 3 cm or farther from the nipple (four [13%] of 31) showed a higher upgrade rate than lesions that were less than 3 cm from the nipple (four [3.1%] of 129) (P = .046). Upgrade rates for BIX 01294 nmr Breast Imaging Reporting and Data System (BI-RADS) category 3, 4a, 4b, 4c, and 5 lesions were 0%, 2.5%, 6%, 27%, and 25%, respectively (P = .010).

Conclusion: At US-guided 14-gauge CNB, benign papilloma without atypia could be diagnosed accurately. Discordance between imaging and pathology results, as well as patient age of 50 years or older, lesion size of 1 cm or greater, lesion distance from the nipple of 3 cm or greater, and BI-RADS category buy CHIR-99021 may be helpful in predicting the possibility

of upgrade to malignancy. (C) RSNA, 2010″
“In patients with chronic Chagas cardiomyopathy, there are forms of the disease that affect the electrical conduction system almost exclusively. The most common disorders include right bundle branch block alone or in association with left anterior fascicular block. We present an unusual case of a patient with Chagas cardiomyopathy in association with a preexcitation syndrome. (PACE 2012; 35:e38e39)”
“Aims: Plasma levels of the adipokine adiponectin are accepted as excellent correlates to metabolic health. Here, we aim to characterise associations between circulating plasma adiponectin complexes and baseline parameters in a population of patients with type 2 diabetes mellitus (DM) with increased risk of cardiovascular disease.

Methods: We measured levels of high molecular weight (HMW), low molecular weight (LMW) and trimeric adiponectin.

Results: The study population comprised 53 subjects, mean age 57 years, 36% non-white and 44% women, with an average body mass index (BMI) of 34 and duration of DM of 8.5 years. There was an established history of cardiovascular disease in 36% of the patients.

Published by Elsevier Ltd “
“Objective: To assess health car

Published by Elsevier Ltd.”
“Objective: To assess health care costs associated with Cushing disease and to determine changes in overall and comorbidity-related costs after surgical treatment.

Methods: In

this retrospective cohort study, patients with Cushing disease were identified from insurance claims databases by International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes for Cushing Selleck MAPK inhibitor syndrome (255.0) and either benign pituitary adenomas (227.3) or hypophysectomy (07.6x) between 2004 and 2008. Each patient with Cushing disease was age- and sex-matched with 4 patients with nonfunctioning pituitary adenomas and 10 population control subjects. Comorbid conditions and annual direct health care costs were assessed within each calendar year. Postoperative changes in health care costs and comorbidity-related costs were compared between patients presumed to be in remission and those with presumed persistent disease.

Results: Of 877 identified patients with Cushing disease,

79% were female and the average age was 43.4 years. Hypertension, diabetes mellitus, and hyperlipidemia were more common among patients with Cushing disease than in patients with nonfunctioning pituitary adenomas or in control patients (P<.01). For every calendar year studied, patients with Cushing disease had significantly higher total health care costs (2008: $26440 [Cushing disease] vs $13708 Citarinostat in vitro [nonfunctioning pituitary adenomas] vs $5954 [population control], P<.01). Annual outpatient costs decreased significantly for patients in remission after surgery, and there was a trend towards improvement in overall disease-related costs with remission. A significant increase in postoperative health care costs was observed Prexasertib in those patients not in remission.

Conclusions: Patients with Cushing disease had more comorbidities than patients with nonfunctioning pituitary adenomas or control patients and incurred significantly higher annual health care costs; these costs decreased after successful surgery and increased after unsuccessful

surgery. (Endocr Pract. 2011;17:681-690)”
“MicroRNAs (miRNAs) negatively regulate gene expression at the posttranscriptional level, primarily by base-pairing with the 3′-untranslated region (3′-UTR) of their target mRNAs. Many miRNAs are expressed in a tissue/organ-specific manner and are associated with an increasing number of cell proliferation, differentiation, and tissue development events. Cardiac muscle expresses distinct genes encoding structural proteins and a subset of signal molecules that control tissue specification and differentiation. The transcriptional regulation of cardiomyocyte development has been well established, yet only until recently has it been uncovered that miRNAs participate in the regulatory networks.

Micro-costing improves the specificity

of the cost estima

Micro-costing improves the specificity

of the cost estimate, but it is often impractical to precisely JQ-EZ-05 measure resources at this level and the price weights for these micro-units may not be available. Gross-costing may be more practical, and price weights are often easier to find and are more reliable, but important resource differences between treatment groups may be lost in the bundling of resources. Price weights can either tie nationally determined or centre specific, but the appropriate price weight will depend oil perspective, convenience, completeness and accuracy. Identifying the resource types and the appropriate price weights for these resources are the essential elements to an accurate valuation of costs.

Once medical services are valued, the resulting individual patient cost estimates must be analysed. The difference in the mean cost between treatment groups is the important summary statistic for cost-effectiveness analysis from both the budgetary and the social perspectives. The statistical challenges with cost data typically stein from PF-00299804 inhibitor its skewed distribution and the resulting possibility that the sample mean may be inefficient and possibly inappropriate for

statistical inference. Multivariable analysis of cost is useful, even if the data come from an RCT, but the same distributional problems that affect univariate tests of cost also affect use of cost as a dependent variable in a multivariable regression analysis. The generalized linear model (GLM) overcomes many of the problems of more common cost models, but caution must be used when applying this model because it is prone to mis-specification and precision losses in data

with a heavy-tailed log error term.

Attention to the appropriate cost valuation and analysis techniques reviewed here will help bring the same level of rigor and attention to the methodological issues in cost valuation as is currently applied to clinical evidence within RCTs.”
“Objectives: This study aimed to investigate the role of tumor necrosis factor (TNF)-alpha and the neuronal buy Bafilomycin A1 nitric oxide synthase enzyme in dysregulation of indoleamine 2,3-dioxygenase (IDO) enzyme, and hence serotonin availability in chronic mild stress (CMS), an animal model of depression.

Methods: Rats were divided into five groups: two control and CMS-exposed for 6 weeks, and another three groups exposed to CMS and administered pentoxifylline 50 mg/kg/day intraperitoneally, 7-nitroindazole 40 mg/kg/day subcutaneously, or imipramine 20 mg/kg/day intraperitoneally for the previous 3 CMS weeks. Rats were assessed for neurochemical and immunohistochemical abnormalities.

Results: Pentoxifylline-, 7-nitroindazole-, and imipramine-treated rats showed amelioration of CMS-induced behavioral deficits that was accompanied by significant reduction in kynurenine/serotonin molar ratio and nitrates/nitrites in frontal cortex and hippocampus.

Transthoracic echocardiography was performed in all patients to a

Transthoracic echocardiography was performed in all patients to assess pulmonary artery systolic and diastolic pressure with cardiac dysfunction. The NT-proBNP was analyzed for correlation with pulmonary artery pressure.

Results: Our results showed that prohormone serum concentrations and pulmonary arterial pressures were significantly higher BTSA1 in the study group than in the control group at the preoperative evaluation. A significant decrease was detected among patients after surgery (p < 0.05). There was no significant difference between the study and control groups for prohormone serum concentration and pulmonary arterial pressure at the postoperative evaluation (p > 0.05).


We found increased serum prohormone levels and height pulmonary artery pressures in the children with adenoid and tonsil hypertrophy when comparing with healthy subjects. Our study supported that increased serum prohormone

levels and pulmonary artery pressures as a result of adenoid and tonsil hypertrophy are reversible. Pediatric cardiologs and otolaryngologs should keep in mind an increased pulmonary artery pressure during management of children with adenoid and tonsil hypertrophy. Furthermore, Doppler echocardiography may be useful in the monitoring of pulmonary arterial pressure and in the follow-up of surgical outcome of children with JQEZ5 Epigenetics inhibitor adenoid and tonsil hypertrophy. (C) 2013 Elsevier Ireland Ltd. All rights reserved.”
“New 4-aminoquinoline-derived esters containing the redox-active ferrocene group brought in by either ferrocenyformic or 4-ferrocenylbutanoic acids were synthesized and tested in vitro for their

antiplasmodial activity. The Sapitinib concentration results revealed that only esters derived from ferrocenylformic acid were active against both chloroquine (CQ)-resistant Dd2 and CQ-sensitive D10 strains of Plasmodium falciparum. However, none of these showed higher activity than CQ against the sensitive strain. Ester 16, which possesses a butyl branch in the structure, was the most active of all. With an IC(50) of 0.13 mM on the resistant strain, this ester possessed 2.5-fold higher activity than CQ (IC(50) = 0.34 mM). All tested esters showed good selectivity towards P. falciparum with indexes higher than 60.”
“Objective: To evaluate the efficacy of an immunostimulant (bacterial lysate) Broncho-Vaxom in the management of children with recurrent acute tonsillitis.

Methods: A 5-year retrospective cohort study of 177 children presenting with a diagnosis of recurrent acute tonsillitis. Patients’ demographics and laboratory studies at presentation were retrieved. For patients given Broncho-Vaxom, we defined response as a decrease in the frequency of acute tonsillitis episodes after 3 months of therapy (partial: by <= 50% and total: by >50%). Patients showing response to Broncho-Vaxom were further followed until study-end or need for tonsillectomy.

05) in

women who used wood or kerosene alone compared wit

05) in

women who used wood or kerosene alone compared with women who used liquefied petroleum gas (LPG), coal briquette or a combination of fuels. An increase in the concentrations of creatinine adjusted 9-hydroxy-fluorene, 1-hydroxy-phenanthrene, 2-hydroxy-phenanthrene, 4-hydroxy-phenanthrene and 1-hydroxy-pyrene in the third trimesters was also observed. Weak positive correlation (Spearman correlation coefficient, p<0.4; p<0.05) was absented between all first Cilengitide research buy trimester creatinine adjusted OH-PAHs and indoor (kitchen and living room), and personal 48-h TWA PM2.5. Women who cooked exclusively with wood or kerosene had higher creatinine adjusted OH-PAH levels in their urine samples compared to women who cooked with LPG or coal briquette. (C) 2012 Elsevier Ltd. All rights reserved.”
“Under torsion and beyond the buckling point, multi-walled carbon nanotubes (MWCNTs) develop a periodic wave-like rippling morphology. Here, we show that torsional rippling deformations can be accurately described by a simple sinusoidal shape function. Combining this observation with the geometry optimization, we develop high throughput screening compounds an effective coarse-grained model that reproduces the complex nonlinear mechanical responses of thick MWCNTs under torsion predicted

by large-scale atomistic simulations. Furthermore, the model allows us to simulate super-thick tubes, inaccessible by other coarse-grained methods. With this effective coarse-grained model, we show from an energetic analysis that the rippling deformation is a result of in-plane strain energy relaxation, click here penalized by the increase in the interlayer van der

Waals interaction energy. Our simulations reveal that the torsional response of MWCNTs with up to 100 layers approximately follows a simple bilinear law, and the ratio of the torsional rigidities in the pre- and post-buckling regimes is nearly a constant, independent of the tube radius. In contrast, the bifurcation torsional strain powerly scales with the tube radius. We also find that the wave number in the circumferential direction linearly increases with tube radius, while the wavelength monotonically increases with tube radius, and approaches a constant in the limit of bulk graphite. The bilinear constitutive relation, together with the scaling law of the bifurcation torsional strain, furnishes a simple nonlinear beam theory, which facilitates the analysis of MWCNT bundles and networks.”
“The inhibitory effects of fluoroquinolones on the enzyme activity, protein levels and mRNA expression of liver cytochrome P450 (CYP) 1A and 3A were investigated in male broiler chicks. Enrofloxacin (20 mg/kg), sarafloxacin (8 mg/kg) and marbofloxacin (5.5 mg/kg) were administrated in drinking water for 7 consecutive days. A cocktail of the probe drugs caffeine and dapsone was used to determine CYP1A and 3A activity.

5 and 5 5% of control activity for 100 mu M of baicalin and baica

5 and 5.5% of control activity for 100 mu M of baicalin and baicalein, respectively. Noncompetitive inhibition was demonstrated for the inhibition

of baicalein towards UGT1A10, and the inhibition kinetic parameter (K-i) was calculated to be 8.1 mu M. All these results showed the stronger inhibition capability of baicalin than baicalein towards intestinal UDP-glucuronosyltransferase (UGT) 1A10.”
“Background-The influence of cytochrome P450 (CYP) 2C19 genotype on platelet function in patients treated with ticagrelor versus clopidogrel is unknown.

Methods and Results-CYP2C19 (*1, *2, *3, *4, *5, *6, *7, *8, *17) genotyping was performed in patients with coronary artery disease treated with ticagrelor (180-mg load, 90 mg BID) (n=92) or clopidogrel check details VX-689 cell line (600-mg load, 75 mg/d) (n=82). All patients received 75 to 100 mg/d aspirin. Platelet function was measured by aggregometry, VerifyNow P2Y12 assay, and vasodilator-stimulated phosphoprotein-phosphorylation

assay at predose, 8 hours postloading, and maintenance. In each treatment group, patients were categorized according to 2C19 genotype carrier status (loss-of-function, gain-of-function) and metabolizer status. Kruskal-Wallis test was used to compare platelet function among these categories for each treatment, and Wilcoxon rank sum test was used to compare platelet function between the clopidogrel and ticagrelor groups for each category. There was no statistically significant influence of genotype on platelet function during aspirin therapy alone. Ticagrelor exhibited lower platelet reactivity than clopidogrel by all assays irrespective of 2C19 genotype or metabolizer status (P<0.01). Loss-of-function carriers had greater platelet reactivity during clopidogrel therapy. The influence of genotype on platelet reactivity was greatest during clopidogrel

maintenance and best demonstrated by the VerifyNow P2Y12 assay.

Conclusions-This report is the first to demonstrate the superior pharmacodynamic effect of ticagrelor compared with clopidogrel irrespective of CYP2C19 click here genotype. Whereas CYP2C19 genotype influenced the antiplatelet effect of clopidogrel, there was no effect of CYP2C19 genotype during ticagrelor therapy.”
“Background: Early substance use (SU) in adolescence is known to be associated with an elevated risk of developing substance use disorders (SUD); it remains unclear though whether early SU is associated with more rapid transitions to SUD.

Objective: To examine the risk and speed of transition from first SU (alcohol, nicotine, cannabis) to SUD as a function of age of first use.

Methods: N=3021 community subjects aged 14-24 years at baseline were followed-up prospectively over 10-years. SU and SUD were assessed using the DSM-IV/M-CTDI.

Results: (1) The conditional probability of substance-specific SU-SUD transition was the greatest for nicotine (36.0%) and the least for cannabis (18.3% for abuse, 6.

The demagnetization temperature was found to be strongly dependen

The demagnetization temperature was found to be strongly dependent on the Co-content and crystal size and varied between 106 degrees C and 540 degrees C. Mossbauer spectroscopy confirmed the strong influence of the synthesis conditions on the superparamagnetic fraction in the samples. (C) 2011 American Institute of Physics. [doi:10.1063/1.3536349]“
“The https://www.selleckchem.com/products/pf-06463922.html past two decades have seen an upsurge in detecting the genetic determinants of hypertension. Thereafter, alpha-adducin gene ranks high and one polymorphism, G460W (rs4961), has attracted special attention. We first performed a case-control study to investigate the association of this polymorphism with essential hypertension among Shanghai

residents, and then metaanalyzed all available evidence. A total of 950 subjects were recruited for genetic association study. Genotyping for G460W was conducted using PCR and restriction fragment length polymorphism techniques. Meta-analysis search was limited to articles published in English and studies on humans. Data and study quality were assessed in duplicate. Publication bias was evaluated using the fail-safe number. Our case-control study provided no evidence for the association of G460W with essential hypertension,

even under assumptions of three genetic modes of inheritance (P>0.05). The subsequent meta-analysis BI 2536 solubility dmso including 15 studies with 4417 cases and 5716 controls also failed to demonstrate overall this association, even upon stratification by race (Caucasians and Asians). For example, the summary odds ratio (OR) under a random effects model indicated that carriers of 460W allele were 1.09 times more likely to develop hypertension (95% confidence interval (CI), 0.96-1.24; P = 0.19) buy DAPT among Asians, whereas a protective effect of this allele was observed in Caucasians (OR, 0.93; 95% CI, 0.73-1.18; P = 0.54).

The fail-safe number at the level of 0.05 was in favour of our findings. Our case-control study and the following meta-analysis failed to provide evidence for the genetic association of a-adducin gene G460W polymorphism with hypertension. Journal of Human Hypertension (2010) 24, 467-474; doi: 10.1038/jhh.2009.88; published online 3 December 2009″
“Ferrite nanoparticles of composition Zn(0.5)Ni(0.5)Fe(2)O(4) were prepared by forced hydrolysis in a polyol (polyol process) from the corresponding iron, nickel, and zinc acetates. Synthesis conditions allowed for obtaining polycrystalline epitaxial clusters of about 22 nm in size with an average crystal size of about 5 nm. These powders were subsequently consolidated by spark plasma sintering (SPS) technique under a pressure of 80 MPa and temperatures in the 350 to 500 degrees C range for short periods (5 to 10 min). Densities reached 92% to 94% of the theoretical density. Particle size remained smaller than 61 nm, even for the highest temperature. Ferromagnetic resonance experiments at 77 K showed broadened resonance lines.

The histological quality of the cryobiopsy specimens was not impa

The histological quality of the cryobiopsy specimens was not impaired by the freezing process, whereas forceps biopsies showed typical crush artifacts. Despite the larger defects left in the tracheobronchial system after cryobiopsy, bleeding frequency and duration were not higher compared to forceps biopsy. Conclusions: Since cryobiopsy sampling is not associated with a higher bleeding risk compared with forceps biopsy, this new biopsy technique offers-in addition to a good specimen quality-a

safe and valuable tool with the potential of improving the outcome of diagnostic endoscopy. Copyright (C) 2010 S. Karger AG, Basel”
“Hiatal hernia (HH) repairs are commonly done concomitantly with laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic adjustable gastric banding (LAGB) to decrease gastroesophageal reflux disease Galardin mw (GERD). There is limited evidence about the additional surgical risk these combined procedures engender. We used the United States Nationwide Inpatient Sample 2004-2009 to compare mortality risk, prolonged length of stay (PLOS), and perioperative adverse events using propensity score-matched analysis. We repeated the analysis after removing patients diagnosed with GERD. There were 42,272 weighted patients undergoing LRYGB alone representing 206,559

discharges nationally and an additional 1,945 and 9,060, respectively, undergoing LRYGB + HH repair. For LAGB, there were 10,558 records representing VX-770 manufacturer 52,901 LAGB-only discharges and 1,959 representing 9,893 LAGB + HH repair discharges. Thirty-eight percent (95 % CI: 36, 41 %) of the patients LY2606368 solubility dmso in the LRYGB-only group had GERD compared to 55 % (51, 59 %) in the LRYGB + HH repair group. Among the LAGB groups, 31 % (28, 34 %) of LAGB-only patients had GERD compared to 44 % (38, 49 %) in the LAGB + HH repair group. We find that the average

treatment effect on the treated (considering the concomitant procedure as treatment and the single procedure as control) for PLOS was -0.12353 (-0.15909, -0.08797) between the LRYGB groups and -0.04353 (-0.07488, -0.01217) for the LAGB groups. We find no evidence of increased risk of perioperative adverse events among patients undergoing concomitant HH repair with LRYGB or LAGB. Patients undergoing the combined procedure appear to be at lower risk of PLOS; this may be due to surgical training norms.”
“Bronchiectasis is a chronic disorder characterized by impaired mucociliary clearance and a relentless cycle of infection, inflammation and bronchial wall injury, which has a debilitating impact on the patient’s quality of life and results in increased morbidity and mortality. It is a disease for which there are no currently registered therapeutic products, limited epidemiological data and no validated endpoints that have been accepted by the majority of regulatory authorities.

In this paper, we discuss different molecular actions of some of

In this paper, we discuss different molecular actions of some of the major xenoestrogens found in food or the environment, and we summarize

the current models used to evaluate environmental estrogens.”
“This article reviews budget-impact analyses (BIAs) published to date in peer-reviewed bio-medical journals with reference to current best practice, and discusses where future research needs to be directed.

Published BIAs were identified by conducting a computerized search on PubMed using the search term ‘budget impact analysis’. The years covered by the search included January 2000 through November 2008. Only studies (i) named by authors as BIAs and (ii) predicting financial consequences of adoption and diffusion

of a new health intervention(s) within a specific healthcare setting were included. Relevant studies were evaluated according Givinostat purchase to the checklist that focuses on issues unique to BIA, highlighting areas HKI 272 of agreement or dissent between published studies and methodological guidelines.

A total of 34 studies met the inclusion criteria, the majority published in 2007-8. Of these, 41% were from the US, 54% were prepared for pharmaceuticals and 65% had BIA as their main aim. The published BIAs were heterogeneous in respect of methods for deriving budget-impact estimates, time horizon and population. There is fairly good agreement between published studies and methodological guidelines within the scope of perspective, comparator, cost included and data sources. Specific issues that need to be addressed and/or improved are reporting format, sensitivity analysis and discounting.

The results indicate

that, recently, BIAs have appeared more frequently in peer-reviewed journals, providing stimulus to development, validation and dissemination of methods. Many published studies fail to BI-2536 reach the desired quality, but this situation should change with good research practice principles that will help codify and clarify important issues and promote standardization and transparency. Future research needs to be directed to quality assurance of published BIAs and investment in data collection for parameters specific to BIAs.”
“Congenital hypothyroidism (CH) with multinodular goiter (MNG) is uncommonly seen in children. However, CH associated with goiter is often caused by defective Thyroid peroxidase (TPO) gene. In this study, we screened for mutation(s) in the TPO gene in two siblings with CH and MNG and their healthy family members. The two sisters, born to consanguineous parents, were diagnosed with CH during infancy and received treatment since then. They developed MNG during childhood despite adequate L-thyroxine replacement and negative thyroid antibody screening.

Activation of the beta 2AR in cultured keratinocytes signals the

Activation of the beta 2AR in cultured keratinocytes signals the down-regulation of the AKT pathway, accompanied by a stabilization of the actin cytoskeleton and an increase in focal adhesion formation, resulting in a nonmigratory phenotype. Burn wound injury in excised human skin also rapidly up-regulates the intra-epithelial expression

of the epinephrine synthesizing enzyme phenylethanolamine-N-methyltransferase, SCH 900776 purchase and tissue levels of epinephrine rise dramatically (15-fold) in the burn wounded tissue (values of epinephrine expressed as pg/ug protein +/- standard error of the mean: unburned control, 0.6 +/- 0.36; immediately postburn, 9.6 +/- 1.58; 2 h postburn, 3.1 +/- 1.08; 24 h post-burn, 6.7 +/- 0.94). Finally, using an animal burn wound model (20% body surface in mice), we found that systemic treatment with beta AR antagonists results in a significant increase (44%, 95% CI 27%-61%, p < 0.00000001) in the rate of burn wound re-epithelialization.

Conclusions This work demonstrates an alternate pathway by which stress can impair healing: by stress-induced elevation of epinephrine levels resulting in activation of the keratinocyte beta 2AR and the impairment of cell otility and wound re-epithelialization. Furthermore, since the burn wound locally generates epinephrine in

response to wounding, epinephrine levels are locally, as well as systemically, AMPK inhibitor elevated, and wound healing is impacted by these dual mechanisms. Treatment with beta adrenergic antagonists significantly improves the rate of burn wound re-epithelialization. This work suggests that specific beta 2AR antagonists may be apt, near-term translational therapeutic targets for enhancing burn wound healing, and may provide a novel, low-cost, safe approach GS-9973 molecular weight to improving skin wound repair in the stressed individual.”
“Background: The absorption of cocoa flavanols in the small intestine is limited, and the majority of the flavanols reach the

large intestine where they may be metabolized by resident microbiota.

Objective: We assessed the prebiotic potential of cocoa flavanols in a randomized, double-blind, crossover, controlled intervention study.

Design: Twenty-two healthy human volunteers were randomly assigned to either a high-cocoa flavanol (HCF) group (494 mg cocoa flavanols/d) or a low-cocoa flavanol (LCF) group (23 mg cocoa flavanols/d) for 4 wk. This was followed by a 4-wk washout period before volunteers crossed to the alternant arm. Fecal samples were recovered before and after each intervention, and bacterial numbers were measured by fluorescence in situ hybridization. A number of other biochemical and physiologic markers were measured.

Results: Compared with the consumption of the LCF drink, the daily consumption of the HCF drink for 4 wk significantly increased the bifidobacterial (P<0.01) and lactobacilli (P<0.001) populations but significantly decreased clostridia counts (P<0.001).