Medical management is designed to decrease serum calcium levels b

Medical management is designed to decrease serum calcium levels by use of intravenous fluid diuresis with administration CHIR-99021 supplier of furosemide and prednisolone. Biphosphate pamidronate

is used to inhibit calcium release from the bone. Phosphate binders aid in decreasing phosphate availability to interact with calcium. The prognosis is better if treatment is instituted early before development of hypercalcemia and hyperphosphatemia enables tissue mineralization to progress. (C) 2013 Published by Elsevier Inc.”
“The article reviews the current state and future of psychodynamic psychotherapies. In the past few decades psychodynamic psychotherapies have fallen into disrepute due to the fractious and dogmatic nature of different psychodynamic schools of thought and the lack of interest in validating some of its major premises or its effectiveness in comparison with other psychotherapy modalities. Despite these self-inflicted wounds, psychodynamic theory and treatment is staging a comeback. Many of the major premises that comprise the complex, layered model of the mind that are the basis

of psychodynamic treatments have again begun to be validated. A list of basic psychodynamic concepts is described. The evidence for each of these concepts varies, but as a whole the evidence is broad and deep for the model of the mind posited by psychoanalysis. This evidence is coming from many fields of knowledge that are not necessarily influenced by psychoanalysis. There have also been significant advances in developing methods and tools that can probe systematically into the complex nature of psychodynamic treatment SCH 900776 inhibitor processes. Finally, statistical tools-such as meta-analytic studies-that can aggregate and compare many different Studies at once are GSK621 beginning to show the effectiveness of dynamic psychotherapies in comparison with other modalities of treatment.”
“The WAVE regulatory complex (WRC) controls actin cytoskeletal dynamics throughout the cell by stimulating the actin-nucleating activity of the Arp2/3 complex at distinct membrane sites. However, the factors that recruit

the WRC to specific locations remain poorly understood. Here, we have identified a large family of potential WRC ligands, consisting of similar to 120 diverse membrane proteins, including proto-cadherins, ROBOs, netrin receptors, neuroligins, GPCRs, and channels. Structural, biochemical, and cellular studies reveal that a sequence motif that defines these ligands binds to a highly conserved interaction surface of the WRC formed by the Sra and Abi subunits. Mutating this binding surface in flies resulted in defects in actin cytoskeletal organization and egg morphology during oogenesis, leading to female sterility. Our findings directly link diverse membrane proteins to the WRC and actin cytoskeleton and have broad physiological and pathological ramifications in metazoans.

2 kg (52 8 and 128 04 lb) Procedures-Dogs were randomly selected

2 kg (52.8 and 128.04 lb). Procedures-Dogs were randomly selected to receive maropitant (2.0 to 4.0 mg/kg [0.9 to 1.8 mg/lb]) or placebo (lactose monohydrate) orally 2 hours prior to receiving hydromorphone (0.1 mg/kg [0.045 mg/lb], IM). A blinded observer recorded the occurrence of vomiting or signs of nausea (eg, salivation or lip-licking) during a 30-minute period after hydromorphone administration. Two-tailed Fisher exact tests were used to compare the incidences of vomiting and signs of nausea with or without vomiting between treatment CX-6258 in vivo groups. Results-Of the 20 dogs receiving maropitant, none vomited but 12 (60%) developed

signs of nausea. Of the 20 dogs receiving placebo, 5 (25%) vomited and 11 (55%) developed signs of nausea; overall, 16 of 20 (80%) dogs in the placebo treatment group vomited or developed signs of nausea. Compared with the effects of placebo, maropitant significantly decreased the incidence of vomiting but not signs of nausea in dogs administered hydromorphone. Conclusions and Clinical

Relevance-Among the 40 study dogs, the incidence of vomiting associated with hydromorphone administration was 25%. Oral administration of maropitant prevented vomiting but not signs of nausea associated with hydromorphone administration in dogs.”
“Cryptic species complexes are common among parasites, which tend to have large populations and are subject to rapid BTSA1 mw evolution. Such complexes may arise through host-parasite co-evolution and/or host switching. For parasites that reproduce directly on their host, there might be increased opportunities for sympatric speciation, either by exploiting different hosts or different micro-habitats within the same host. The genus Gyrodactylus is a specious group of viviparous monogeneans. These ectoparasites transfer between teleosts during social contact and cause significant host mortality. Their impact on the guppy ( Poecilia reticulata),

an iconic evolutionary and ecological model species, is well established and yet the population genetics and phylogenetics of these parasites remains understudied. Fer-1 nmr Using mtDNA sequencing of the host and its parasites, we provide evidence of cryptic speciation in Gyrodactylus bullatarudis, G. poeciliae and G. turnbulli. For the COII gene, genetic divergence of lineages within each parasite species ranged between 5.7 and 17.2%, which is typical of the divergence observed between described species in this genus. Different lineages of G. turnbulli and G. poeciliae appear geographically isolated, which could imply allopatric speciation. In addition, for G. poeciliae, co-evolution with a different host species cannot be discarded due to its host range. This parasite was originally described on P. caucana, but for the first time here it is also recorded on the guppy. The two cryptic lineages of G. bullatarudis showed considerable geographic overlap. G.

05) Further, we found that dietary LC-O3PUFAs impacted the level

05). Further, we found that dietary LC-O3PUFAs impacted the levels of neurotransmitters and selleck the mitochondrial metabolism, as evidenced by significant increases in the levels of N-acetylglutamate (+43 %) and acetyl CoA levels (+27 %), respectively. Interestingly, this dietary intervention resulted in a global correction of the pro-oxidant metabolic profile that characterized

the SCI-mediated sensorimotor dysfunction. In summary, the significant benefits of metabolic homeostasis and increased antioxidant defenses unlock important neurorestorative pathways of dietary LC-O3PUFAs against SCI.”
“Astaxanthin (Asx) is known to be a potent quencher of singlet oxygen and an efficient scavenger of superoxide anion. Therefore, Asx would be expected to be a useful antioxidant for the prevention of oxidative stress, a causative factor in severe diseases such as ischemic reperfusion injury. However, it is still unclear whether Asx has scavenging capability against the most potent reactive oxygen species (ROS), this website hydroxyl radical, because the hydrophobicity of Asx prevents analysis of hydroxyl radical scavenging ability in aqueous solution. In this study, to solve this problem, liposomes containing Asx (Asx-lipo), which could be dispersed in water, were prepared, and the scavenging ability of Asx-lipo for

the hydroxyl radical was examined. The liposomal formulation enabled encapsulation of a high concentration of Asx. Asx-lipo gave a dose-dependent reduction of chemiluminescence intensity induced by hydroxyl radical in aqueous solution. Hydroxyl radical scavenging of Asx was more potent than alpha-tocopherol. The absorbance of Asx in the liposome decreased after reduction of hydroxyl radicals, indicating the direct hydroxyl radical scavenging by Asx. Moreover, Asx-lipo prevented hydroxyl radical-induced cytotoxicity in cultured NIH-3T3 cells. In conclusion, Asx has potent JPH203 scavenging capability

against hydroxyl radicals in aqueous solution, and this paper is the first report regarding hydroxyl radial scavenging by Asx.”
“The pro-apoptotic tumor necrosis factor (TNF)-receptor 1-associated death domain protein (TRADD) was initially identified as the central signaling adapter molecule of TNF-receptor 1 (TNFR1). Upon stimulation with the proinflammatory cytokine TNF alpha, TRADD is recruited to the activated TNFR1 by direct interaction between the death domains of both molecules. TRADD mediates TNFR1 activation of NF-kappa B and c-Jun N-terminal kinase (JNK), as well as caspase-dependent apoptosis. Surprisingly, TRADD is also recruited by latent membrane protein 1 (LMP1), the major oncoprotein of the human Epstein-Barr tumor virus.

Phylogenetic analysis of the crossover region further confirmed t

Phylogenetic analysis of the crossover region further confirmed these findings. This current study describes the molecular characterization of the new isolate SVCV-265 from China and is the first report of homologous recombination in SVCV. (C) 2014 Elsevier B.V. All rights reserved.”
“Lammers

WJ, Ver Donck L, Stephen B, Smets D, Schuurkes JA. Origin and propagation of the slow wave in the canine stomach: the outlines of a gastric conduction system. Am J Physiol Gastrointest Liver Physiol 296: G1200-G1210, 2009. First published April 9, 2009; doi:10.1152/ajpgi.90581.2008.-Slow waves are known to originate orally in the stomach and to propagate Vorinostat mouse toward the antrum, but the exact location of the pacemaker and the precise pattern of propagation have not yet been studied. Using assemblies of 240 extracellular electrodes, simultaneous recordings of electrical activity were made on the fundus, LY2606368 cell line corpus, and antrum in open abdominal anesthetized dogs. The signals were analyzed off-line, pathways of slow wave propagation were reconstructed, and slow wave velocities and amplitudes were measured. The gastric pacemaker is located in the upper part of the fundus, along the greater curvature. Extracellularly recorded slow waves in the pacemaker area exhibited large amplitudes

(1.8 +/- 1.0 mV) and rapid velocities (1.5 +/- 0.9 cm/s), whereas propagation in

the remainder of the fundus and in the corpus was slow (0.5 +/- 0.2 cm/s) with low-amplitude waveforms (0.8 +/- 0.5 mV). In the antrum, slow wave propagation was fast (1.5 +/- 0.6 cm/s) with large amplitude deflections (2.0 +/- 1.3 mV). Two areas were identified where slow waves did not propagate, the first in the oral medial fundus and the second distal in the antrum. Finally, recordings from the entire ventral surface revealed the presence of three to five simultaneously propagating slow waves. High resolution mapping of the origin and propagation of the slow wave in the canine stomach revealed areas of high amplitude and rapid velocity, areas with fractionated low amplitude selleck kinase inhibitor and low velocity, and areas with no propagation; all these components together constitute the elements of a gastric conduction system.”
“We used Monte Carlo simulations of Brownian dynamics of water to study anisotropic water diffusion in an idealised model of articular cartilage. The main aim was to use the simulations as a tool for translation of the fractional anisotropy of the water diffusion tensor in cartilage into quantitative characteristics of its collagen fibre network. The key finding was a linear empirical relationship between the collagen volume fraction and the fractional anisotropy of the diffusion tensor.

ERP data

in the form of N1 amplitude was modulated within

ERP data

in the form of N1 amplitude was modulated within some irrelevant sound conditions suggesting that attentional aspects APR-246 concentration are involved in the elicitation of the irrelevant sound effect. (C) 2010 Elsevier B.V. All rights reserved.”
“Although urban areas are often considered to have uniformly negative effects on biodiversity, cities are most accurately characterized as heterogeneous mosaics of buildings, streets, parks, and gardens that include both good’ and bad’ areas for wildlife. However, to date, few studies have evaluated how human impacts vary in direction and magnitude across a heterogeneous urban landscape. In this study, we assessed the distribution of floral resources and flower-visiting insects across a variety of land uses in New York City. We visited both green spaces (e.g. parks, cemeteries) and heavily developed neighborhood blocks (e.g. with high or low density residential zoning) and used structural equation modeling (SEM) to evaluate the direct and indirect effects of median income, vegetation, and development intensity on floral resources and insects in both settings. Abundance AZD8186 solubility dmso and taxonomic richness of flower-visiting

insects was significantly greater in green spaces than neighborhood blocks. The SEM results indicated that heavily-developed neighborhoods generally had fewer flower-visiting insects consistent with reductions in floral resources. However, some low-density residential neighborhoods maintained high levels of floral resources and flower-visiting insects. We found that the effects of surrounding vegetation on floral resources, and thus indirect effects on insects, varied considerably Selleckchem C188-9 between green spaces and neighborhood blocks. Along neighborhood blocks, vegetation consisted of a mosaic of open gardens and sparsely distributed trees and had a positive indirect effect on flower-visiting insects. In contrast, vegetation in urban green spaces was associated with increased canopy cover and thus had a negative indirect effect on flower-visiting insects through

reductions in floral resources. In both neighborhood blocks and green spaces, vegetation had a positive direct effect on flower-visiting insects independent of the influence of vegetation on floral resources. Our results demonstrate how inter-related components of an urban ecosystem can vary with respect to one another across a heterogeneous urban landscape, suggesting that it is inappropriate to generalize about urban systems as a whole without first addressing differences among component land use types.”
“The purpose of this case report is to describe the regression of vascular calcifications (VC) in a patient with secondary hyperparathyroidism (SHPT) after having added cinacalcet to her treatment.

Based on the graph theory and Razumikhin technique, some conditio

Based on the graph theory and Razumikhin technique, some conditions are captured to guarantee that SFDEN is p-th moment and almost sure exponentially stable. Furthermore, the criterion Selleckchem Screening Library ensuring the exponential stability for stochastic coupled systems on networks with time-varying delay is established, by applying Razumikhin-type theorem. Finally, a numerical example is provided to demonstrate the

effectiveness of the theoretical results. (C) 2013 Elsevier B.V. All rights reserved.”
“A 10-year-old female spayed German Shepherd dog, with a year-long history of recurrent left ear infections, was presented for progressive ataxia, head tilt, and pain on opening of the mouth. On physical examination, a large amount of ceruminous debris was present in the left ear and multiple neurologic defects localizing to the cerebellum and vestibular system were identified. Magnetic resonance imaging (MRI) demonstrated a minimally contrast-enhancing mass within the left bulla, an intracranial space-occupying, heterogeneously contrast-enhancing lesion at the Selleckchem Prexasertib level of the left cerebello-medullary junction, and contrast enhancement of the ipsilateral meninges. Cerebrospinal fluid analysis revealed a marked mixed cell pleocytosis (nucleated cell count

655cells/L). The mass was visualized within the horizontal ear canal by otoscopic examination and a biopsy was taken. Impression smears of the biopsy contained many anucleate keratinized squamous epithelial cells, mild mixed inflammation, and few presumptive fibroblasts. With the provided clinical history and MRI findings, a cytologic diagnosis of cholesteatoma was made. A ventral bulla osteotomy was performed, and histopathologic examination of resected tissue confirmed the cytologic diagnosis of cholesteatoma. The dog’s clinical symptoms improved postoperatively, but the dog died of unrelated causes, 3.5months later. To our knowledge, this is the first description of the cytologic

features of a cholesteatoma, which is a nonneoplastic, but locally invasive epidermoid cyst, in the middle ear of dogs.”
“Urotensin II (U-II) is a disulfide bridged peptide hormone identified as the ligand of a G-protein-coupled receptor. MK-0518 ic50 Human U-II (H-Glu-Thr-Pro-Asp-c[Cys-Phe-Trp-Lys-Tyr-Cys]-Val-OH) has been described as the most potent vasoconstrictor compound identified to date. We have recently identified both a superagonist of human U-II termed P5U (H-Asp-c[Pen-Phe-Trp-Lys-Tyr-Cys]-Val-OH) and the compound termed urantide (H-Asp-c[Pen-Phe-d-Trp-Orn-Tyr-Cys]-Val-OH), which is the most potent UT receptor peptide antagonist described to date. In the present study, we have synthesized four analogues of P5U and urantide in which the Trp7 residue was replaced by the highly constrained l-Tpi and d-Tpi residues. The replacement of the Trp7 by Tpi led to active analogues. Solution NMR analysis allowed improving the knowledge on conformationactivity relationships previously reported on UT receptor ligands.

Each patient in the T/SP group underwent the operation by a diffe

Each patient in the T/SP group underwent the operation by a different surgeon, two of whom were the authors, including the first author; the first author performed all operations in the O/IP and O/SP groups. The first author evaluated the shape of the developed breasts using the frontal-and oblique-view photographs. We also investigated PD98059 cell line the location of the lateral border of the mammary gland in seven other adolescent and adult female patients using three-dimensional computed tomography images. Results: Lateral depression of the breast occurred in four of eight breasts with a transverse incision, and flattening of the lowermost

portion of the inframammary fold occurred in six of 10 breasts with suprapectoral dissection. None of Dinaciclib cost the eight breasts with an oblique incision and subpectoral dissection exhibited deformities. The lateral border of the mammary gland was on the fifth rib in five patients and on the fifth intercostal space in two patients. Conclusion: An oblique lateral thoracic skin incision along the sixth rib and subpectoral dissection may reduce the occurrence of breast deformity. (C) 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.”
“Poly(lactide-co-glycolide)

(PLGA) has been extensively investigated for controlled drug release. Because they undergo bulk degradation, they do not allow Anlotinib for a good controlled-release of drugs. The objective of this study is therefore to understand if a multi-layer-cum-irradiation technique would elicit surface erosion

from PLGA polymers. A linear loss of mass and film thinning from PLGA films were observed. Also, the erosion of the top layer, of this multi-layered structure, accelerates degradation of the underlying layers. It is this effect that results in the observed pseudo-surface erosion for irradiated multi-layered PLGA. (C) 2008 Elsevier B.V. All rights reserved.”
“Activation of the mitogen-activated protein (MAP) pathway kinases p38 and MK2 induces phosphorylation of the chaperone Hsp27 and stabilization of mRNAs containing AU-rich elements (AREs) (ARE-mRNAs). Likewise, expression of phosphomimetic mutant forms of Hsp27 also stabilizes ARE-mRNAs. It appears to perform this function by promoting degradation of the ARE-mRNA decay factor AUF1 by proteasomes. In this study, we examined the molecular mechanism linking Hsp27 phosphorylation to AUF1 degradation by proteasomes. AUF1 is a target of beta-TrCP, the substrate recognition subunit of the E3 ubiquitin ligase Skp1-cullin-F-box protein complex, SCF beta-TrCP. Depletion of beta-TrCP stabilized AUF1.

Multilevel selection significantly reduced mortality (6 6% K vs

Multilevel selection significantly reduced mortality (6.6% K vs. 8.5% R) and increased weight (1.30 g/MG K vs. 0.13 g/MG R) resulting in response an order of magnitude greater with Kin than Random. Thus, multilevel selection was effective in reducing detrimental social interactions,

which contributed to improved weight gain. The observed rates of response did not differ significantly from expected, demonstrating that current theory is adequate to explain multilevel selection response. Based on estimated genetic parameters, group selection would always be superior to any other combination of multilevel selection. Further, near optimal results could be attained using multilevel selection if 20% of the weight was on the group component regardless

of group composition. Thus, in nature the conditions LDC000067 cell line for multilevel selection to be effective NCT-501 in bringing about social change maybe common. In terms of a sustainability of breeding programs, multilevel selection is easy to implement and is expected to give near optimal responses with reduced rates of inbreeding as compared to group selection, the only requirement is that animals be housed in kin groups.”
“Chiral ligand-exchange enantioseparation of aliphatic and aromatic amino acids was successfully performed using a new open-tubular zwitterionic column with tentacle-type polymer stationary phase. The polymeric stationary phase was prepared using 3-chloro-2-hydroxypropyl methacrylate (HPMA-Cl), a new reactive monomer. The preparation procedure of the open-tubular column included silanization, in situ graft polymerization with HPMA-Cl, and L-histidine (L-His) modification. L-His was used as a chiral ligand-exchange selector and copper(II) as a central ion. Successful enantioseparation of six pairs of amino acid enantiomers was achieved with a buffer of 5 mM CuSO4, 20 mM (NH4)(2)SO4 at pH 3.0. (C) 2013 Elsevier Inc. All rights reserved.”
“The cDNAs of six manganese-dependent peroxidases (MnPs) were isolated from white-rot

fungus Polyporus brumalis. The MnP proteins shared similar properties with each other in terms of size (approximately 360-365 amino acids) and primary structure, showing 62-96 % amino acid sequence identity. RT-PCR analysis indicated that these six genes were EGFR inhibitor predominantly expressed in shallow stationary culture (SSC) in a liquid medium. Gene expression was induced by treatment with dibutyl phthalate (DBP) and wood chips. Expression of pbmnp4 was strongly induced by both treatments, whereas that of pbmnp5 was induced only by DBP, while pbmnp6 was induced by wood chips only. Then, we overexpressed pbmnp4 in P. brumalis under the control of the GPD promoter. Overexpression of pbmnp4 effectively increased MnP activity; the transformant that had the highest MnP activity also demonstrated the most effective decolorization of Remazol Brilliant Blue R dye.

Methods: A randomised controlled trial compared students who unde

Methods: A randomised controlled trial compared students who underwent two, week-long, extended simulations, several months apart (Intervention), with students who attended related workshops and seminars alone (Control), for a range of outcome measures. Results: Eighty-four third year students in a graduate-entry medical program were randomised, and 82 completed the study. At the end of the first week, Intervention students scored a mean of 75% on a prescribing test, compared with 70% for Control students (P = 0.02) and Intervention teams initiated cardiac compressions

a mean of 29.1 seconds into a resuscitation test scenario, compared with 70.1 seconds for Control teams (P smaller than 0.01). At the beginning of the second week, see more an average of nine months later, a significant difference was maintained in relation to the prescribing test only (78% vs 70%, P smaller than 0.01). At the end of the second week, significant Intervention vs Control differences were seen on knowledge and reasoning tests, a further prescribing test (71% vs 63% [P smaller than 0.01]) and a paediatric resuscitation scenario test (252 seconds to initiation of fluid resuscitation vs

339 seconds [P = 0.05]). Conclusions: The study demonstrated long-term retention of improved prescribing this website skills, and an immediate effect on knowledge acquisition, reasoning and resuscitation skills, from contextualising learning activities through extended multi-method simulation.”
“Rationale: Although oxidative stress is

a cardinal feature of asthma, the roles of oxidant air pollutants and antioxidant genes heme oxygenase 1 (HMOX-1), catalase (CAT), and manganese superoxide dismutase (MNSOD) in asthma pathogenesis have yet to be determined.\n\nObjectives: We hypothesized that the functional polymorphisms of HMOX-1 ([GT](n) repeat), CAT (-262C > T -844C > T), and MNSOD (Ala-9Val) are associated with new-onset selleck compound asthma, and the effects of these variants vary by exposure to ozone, a potent oxidant air pollutant.\n\nMethods: We assessed this hypothesis in a population-based cohort of non-Hispanic (n = 11,1125) and Hispanic white (n = 586) children who resided in 12 California communities and who were followed annually for 8 years to ascertain new-onset asthma.\n\nMeasurements and Main Results: Air pollutants were continuously measured in each of the study communities during the 8 years of study follow-up. HMOX-1 “short” alleles (< 23 repeats) were associated with a reduced risk for new-onset asthma among non-Hispanic whites (hazard ratio [HR], 0.64; 95% confidence interval [CI], 0.41-0.99). This protective effect was largest in children residing in low-ozone communities (HR, 0.48; 95% CI, 0.25-0.91) (interaction Pvalue = 0.003). Little evidence for an association with HMOX-1 was observed among Hispanic children. In contrast, Hispanic children with a variant of the CAT-262 “T” allele (CT or TT) had an increased risk for asthma (H R, 1.

There was a significant difference between the exposure and contr

There was a significant difference between the exposure and control sites regarding the doses

of metals obtained from the exposure pathways of household dust and aerosols. However, regarding the exposure pathways of rice, non-rice dishes, and drinking water, no significant difference between the exposure and the control sites was observed for most metals. Residents who lived within 30 meters of diesel selleck chemical transport roads at the exposure sites were selected as the exposure groups for urine sampling, while residents of the control sites were selected as the control groups. The metal concentrations in the urine of the exposure groups were all higher than those of the control groups. With regards to the urinary metals Fe, Pb, Cu, Ni, and Mo, the levels of urinary metals in residents and the daily intakes of metals from the five exposure pathways showed that the exposure pathways from environmental media (i.e., drinking water, aerosols, and household dust) were a greater factor than food pathways (i.e., rice

and non-rice dishes) in the resulting comparative differences between urinary concentration levels of Fe, Pb, Cu, and Mo in exposure groups and control groups. However, the food exposure pathways, rather than the environmental GS-1101 datasheet pathways, led to greater comparative differences between the urinary concentration levels of Mn within the two groups.”
“The expression of mRNA of cytokines and immunoregulatory molecules characterizing the interaction of mesenchymal stromal cells from chorionic villi of postpartum placenta and allogenic mononuclear blood cells was studied during 3-day co-culturing of these cells. The expression of foxp3, il2ra, and il10 mRNA in floating mononuclear cells increased from day 1

to 3 in co-culture, which can refl ect the process of induction of regulatory T cells in the learn more lymphocyte population under the action of mesenchymal stromal cells.”
“Flares in chronic hepatitis B are often detrimental but sometimes lead to sustained immune control and disease remission. The aim of this study was to estimate the frequency of hepatitis flares which occur during and/or after cessation of nucleos(t)ide analogue (NA) therapy, and to assess their outcomes. In a single centre cohort study we investigated 227 patients who received a total of 351 NA treatment courses. NA therapy was discontinued after 149 treatment courses. In total, 27 flares were observed during 9779 on-treatment patient-months. The frequency was estimated as 3.2 per 100 person-years (95% CI 2.2-4.7). Lamivudine (LAM)-treated patients demonstrated the highest frequency (4.9/100 person-years, 95% CI 3.2-7.4). Twenty (74%) of 27 on-therapy flares were associated with development of genotypic resistance, which all occurred during LAM therapy. NA withdrawal flares occurred after a median post-treatment follow-up of 3.5 months in 17 (11%) of 149 treatment discontinuations. No flares were observed in patients who switched to another antiviral agent (n = 51).