This trial is registered with ClinicalTrials gov, number NCT00540

This trial is registered with ClinicalTrials.gov, number NCT00540449.

Findings SB202190 research buy 346 patients were randomly assigned to receive rilpivirine and 344 to receive efavirenz and received at least one dose of study drug, with

287 (83%) and 285 (83%) in the respective groups having a confirmed response at week 48. The point estimate from a logistic regression model for the percentage difference in response was -0.4 (95% CI -5.9 to 5.2), confirming non-inferiority with a 12% margin (primary endpoint). The incidence of virological failures was 13% (rilpivirine) versus 6% (efavirenz; 11% vs 4% by ITT-TLOVR). Grade 2-4 adverse events (55 [16%] on rilpivirine vs 108 [31%] on efavirenz, p<0.0001), discontinuations due to adverse events (eight [2%] on rilpivirine vs 27 [8%] on efavirenz), rash, dizziness, and abnormal dreams or nightmares were more common with efavirenz. Increases in plasma

lipids were significantly lower with rilpivirine.

Interpretation Rilpivirine showed non-inferior efficacy compared with efavirenz, with a higher virological-failure rate, but a more favourable safety https://www.selleckchem.com/products/ldn193189.html and tolerability profile.”
“Flagella are the chief organelles of motility in bacteria. In recent years, several new findings have illuminated the evolution of bacterial flagella, including cut-down versions of the organelle in Buchnera, a dispensable ATPase and structural evidence for homology between FliG (a component of the flagellar motor) and MgtE (a magnesium transporter). However, a fresh examination of the phylogenetic distribution of flagellar genes warns against a simplistic model of early flagellar evolution.”
“The central auditory system consists of the lemniscal and nonlemniscal systems. The thalamic lemniscal and nonlemniscal auditory nuclei are different

from each other SCH772984 manufacturer in response properties and neural connectivities. The cortical auditory areas receiving the projections from these thalamic nuclei interact with each other through corticocortical projections and project down to the subcortical auditory nuclei. This corticofugal (descending) system forms multiple feedback loops with the ascending system. The corticocortical and corticofugal projections modulate auditory signal processing and play an essential role in the plasticity of the auditory system. Focal electric stimulation – comparable to repetitive tonal stimulation – of the lemniscal system evokes three major types of changes in the physiological properties, such as the tuning to specific values of acoustic parameters of cortical and subcortical auditory neurons through different combinations of facilitation and inhibition. For such changes, a neuromodulator, acetylcholine, plays an essential role. Electric stimulation of the nonlemniscal system evokes changes in the lemniscal system that is different from those evoked by the lemniscal stimulation.

Results: The most ideal pseudotumor models were created from a mi

Results: The most ideal pseudotumor models were created from a mixture of gelatin, Metamucil (R) and methylene blue (metagel) or from Kromopan (R) hydrocolloid. We created 33 tumors 0.5 to 3.5 cm in size (mean 2.8). All

tumors were a solid palpable mass on gross examination and ultrasonography revealed clearly visible hyperechoic lesions in 30 of 33. A renal vein tumor pseudothrombus model was successfully created in 3 pigs. We successfully performed robotic excision of pseudotumors, including partial nephrectomy for 16 and radical nephrectomy with renal vein thrombectomy for 3. Percutaneous needle core biopsy under ultrasound guidance was also successfully performed.

Conclusions: We describe what is to our knowledge a novel technique of creating solid renal tumors and tumor thrombi that can be used for training in minimally invasive kidney surgery.”
“Natural Cell Cycle inhibitor antisense transcripts and overlapping sense transcripts are expressed in a variety of tissues, including adult mouse brain. Here we show that a subset of mRNA-like sense-antisense transcript pairs are co-expressed within synaptoneurosomes of adult mouse forebrain, a subcellular fraction that is enriched click here in pinched-off dendritic spines of pyramidal neurons. Several of these pairs involve mRNAs that have been implicated in synaptic functions and in Alzheimer disease pathways. This study provides evidence that a new class of noncoding

RNAs (natural antisense transcripts) are expressed near synapses, and encourages further studies of their roles in neuronal function. (C) 2008 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.”
“Purpose: WAVE1 belongs to the Wiskott-Aldrich

syndrome family of proteins, which have an integral part in cell motility, a crucial step in cancer metastasis. We investigated the expression pattern and the effects of manipulating endogenous WAVE1 expression in prostate cancer cells.

Materials and Methods: WAVE1 protein expression in normal and cancer specimens, and in prostate cell lines was assessed using immunohistochemistry and reverse transcriptase-polymerase chain reaction, respectively. Hammerhead IWR1 ribozyme transgenes were synthesized and cloned into the mammalian expression vector pEF6/V5-His TOPO TA, and transfected by electroporation into PC-3(Delta W1R1/2) and DU-145(Delta W1R1/2) cell lines. In vitro invasion, adhesion and growth assays were used to assess the impact of WAVE1 knockdown.

Results: Immunohistochemistry of prostate tissue specimens showed that the cytoplasm of cancer cells had stronger staining than normal epithelium. Reverse transcriptase-polymerase chain reaction for WAVE1 showed strong expression in the PC-3 (European Collection of Cell Cultures, Salisbury, United Kingdom) and DU-145 (ATCC (R)) cell lines. WAVE1 knockdown was associated with a significant decrease in invasion but not in adhesion. The mean +/- SEM number of invading PC-3(Delta W1R1) and PC-3(Delta W1R2) cells was 7.27 +/- 0.

Conclusions: GA treatment decreases blood pressure and proteinuri

Conclusions: GA treatment decreases blood pressure and proteinuria in diabetic mice and may thus prove beneficial in diabetic nephropathy. Copyright (c) 2012 S. Karger AG, Basel”
“The PA28 complexes (also termed REG or 11S complexes) are described as activators of the 20S proteasome,

a major intracellular protease in eukaryotic cells. They bind to the ends of the barrel-shaped 20S proteasome, and activate its peptidase activities. The interferon gamma inducible PA28 alpha beta, made of the two related subunits PA28 alpha and beta, is under sustained investigation as it plays important roles in the production by the proteasome of class I Y-27632 datasheet antigen peptides. However, in vitro studies of this complex have been impaired by the difficulty of producing large amount of this protein, mainly due to the poor solubility of its beta subunit when expressed in Escherichia coli. Here we describe the construction of a bicistronic vector, allowing simultaneous production of functional human PA28 alpha and beta subunits in E. coli. Co-expression of the two proteins allows

SN-38 order efficient formation of active PA28 alpha beta complexes, that remain soluble and can be easily purified by regular chromatographic procedures. (C) 2008 Elsevier Inc. All rights reserved.”
“Bacteriophages are viruses of bacteria that are used for controlling bacterial food-borne pathogens and have been proposed for more extensive usage in infection control. Protists are now recognised to harbour viruses and virus-like particles. We propose that investigation of their prevalence in parasites be intensified. We also propose

that such viruses might be considered for virotherapy to control certain parasite infections of man and animals.”
“The effect of nicotine exposure on the subsequent self-administration of amphetamine, extinction of this behavior, and amphetamine-induced reinstatement of drug seeking was assessed with particular attention to the contribution of contextual tuclazepam stimuli paired or unpaired with nicotine during exposure. Rats were exposed to five injections, one injection every third day, of either saline or nicotine (0.4 mg/kg, P. base) in three experiments. In one, exposure injections were administered in the home cage. In another, they were administered in the self-administration chambers with the levers retracted. In a third, nicotine was administered either explicitly paired or unpaired with the self-administration chambers using a discrimination learning procedure. Starting 13-15 days later, rats were trained to self-administer amphetamine (100 mu g/kg/infusion, IV), tested under a progressive ratio (PR) schedule for 6 days, subjected to up to 20 days of extinction training, and were then tested for reinstatement by non-contingent injections of amphetamine (0, 0.2, 0.4, and 0.75 mg/kg, IP).

APP-BP1 expression was increased in the dentate gyrus of the hipp

APP-BP1 expression was increased in the dentate gyrus of the hippocampus and in the subventricular zone of rats exposed to focal transient cerebral ischemia. In addition, APP-BP1 immunoreactivity Ilomastat overlapped

with antidoublecortin and anti-5-bromo-2deoxyuridine labeling. Focal transient cerebral ischemia has been reported earlier to induce neurogenesis in adult brains. The upregulation of APP-BP1 expression in neural progenitor cells after focal transient ischemia suggests that this protein contributes to the neurogenesis induced by transient ischemia and reperfusion. NeuroReport 22:200-205 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.”
“Purpose: Few groups have examined health related quality of life for adolescents with bladder exstrophy-epispadias. We studied parent reported health related quality of life for adolescents with bladder exstrophy-epispadias using the Child Health Questionnaire-Parent Form 50.

Materials and Methods: We recruited 11 to 17-year-old participants with bladder exstrophy-epispadias and their parents. Parents served as proxy respondents for the adolescents by self-administering a validated generic Bleomycin mw health related quality of life instrument, the Child Health Questionnaire-Parent Form 50. We collected urinary incontinence, catheterization status, and medical and

surgical history data. Mean questionnaire scores were compared to population based norms.

Results:

Median age of the 55 patients was 14 years, 69% were male and 84% were white. Diagnoses included bladder exstrophy in 48 cases and epispadias in 7. Of the participants 29 (53%) reported urinary incontinence. The median number of lifetime surgeries was 9. Although physical and psychosocial summary measure scores were comparable to norms, Selleckchem SRT1720 the mean general health perception score was significantly worse than that of a population based sample (65.8 points, 95% CI 61.4-70.2 vs 73, 95% CI 71.3-74.7, p = 0.004). Mean family activity and parent emotional impact scores were also significantly worse than in a population based sample (83.6 points, 95% CI 79.3-88.0 vs 89.7, 95% CI 87.9-91.5, p = 0.02 and 67.7, 95% CI 61.9-73.6 vs 80.3, 95% CI 78.4-82.2, p < 0.0001, respectively). Comparison of incontinent to continent children revealed a lower mean score on the parent emotional impact scale (62.6 points, 95% CI 55.5-69.8 vs 73.4, 95% CI 63.9-82.9), which approached significance (p = 0.06).

Conclusions: Although overall adolescent quality of life was comparable to norms, parents reported significantly impaired adolescent general health and family activity as well as a negative parental emotional impact. Further research is needed to identify interventions that can decrease the adverse impact of bladder exstrophy-epispadias on family activity and parent emotional distress.

Data were collected retrospectively from the Danish Vascular Regi

Data were collected retrospectively from the Danish Vascular Registry (Karbase), the National Population Registry, and the National Inpatient Registry. The groups were analyzed for the incidences of MI, stroke, and death, with up to 20 years of follow-up.

Results: AAA patients had an annual MI incidence of 2.5% selleck chemicals (hazard ratio, 2.1;

95% confidence interval [CI], 1.9-2.2) compared with the general population. The annual incidence of stroke was 2.9% (hazard ratio, 1.8; 95% CI, 1.6-1.9), and there was a 2.4-fold (95% CI, 2.3-2.4) increase in the hazard of all-cause mortality compared with the general population.

Conclusion: AAA patients of both sexes have a high risk of atherosclerotic events (MI, stroke) and death, so lifelong prophylaxis must be considered from our epidemiologic data. Randomized

trials investigating the potential benefit of aspirin and statin therapy in AAA patients are needed. (J Vase Surg 2012;55:311-7.)”
“Rho is an essential ATP-dependant homohexameric helicase that is found in the vast majority of bacterial species. It is responsible for transcription termination at factor-dependent www.selleckchem.com/products/dmh1.html terminators. Rho binds to a specific region of the newly-synthesised mRNA and translocates along the chain until it reaches and disassembles the transcription complex. Basically,

two crystallographic structures of Rho hexamer from Escherichia coli have been reported: an open ring with RNA (or ssDNA) bound to the RNA-binding domain, and a closed ring with the RNA bound to both the RNA-binding domain and the ATP-ase domain. The structure of the protein free from RNA is these still unknown, but thermophilic bacteria enable an alternative approach to its characterization as their proteins often crystallize more easily than those of their mesophilic homologs. We report here the heterologous expression in E. coli of full-length Rho from the thermophile Thermotoga maritima, a simple protocol for the purification of its hexameric nucleic acid-free form, and the obtainment of 2.4 angstrom-diffracting crystals. (C) 2009 Elsevier Inc. All rights reserved.”
“Advances in the understanding of the endogenous cannabinoid system have led to several therapeutic indications for new classes of compounds that enhance cannabinergic responses. Endocannabinoid levels are elevated during pathogenic conditions, and inhibitors of endocannabinoid inactivation promote such on-demand responses. The endocannabinoids anandamide and 2-arachidonoyl glycerol have been implicated in protective signaling against excitotoxic episodes, including seizures.

Patient demographics, pre- and post-procedure ankle-brachial indi

Patient demographics, pre- and post-procedure ankle-brachial indices (ABI), and H 89 clinical trial anatomic factors (including categorization by TASC 11 classification, lesion length, and runoff vessel status) were analyzed. Outcomes evaluated included freedom from restenoses, freedom from re-intervention, overall patency, and assisted-patency.

Results: A total of 237 total limbs

were treated during the period reviewed. The study group included 108 TASC B and 32 TASC C limbs in 125 patients (mean age 73.1 +/- 10.4 years, male sex: 59%). Seventy-one percent of patients were Rutherford classification 2/3 while the remaining 29% were Rutherford classification 4/5. Mean follow-tip period was 12.7 months (range, 1-52 in). Forty-one (41) limbs experienced AZD1208 datasheet restenosis or occlusion at a mean time of 8 months (range, 1-24 in). Freedom

front restenosis/occlusion was 58.9% at 12 months and 47.9% at 24 months. Predictors of restenosis included a preoperative ABI < 0.5 (hazard ratio [HR] 3.05, 95% confidence interval [CI] 1.36-6.86, P = .007) and hypercholesterolemia (HR 2.42, 95% Cl 1.11-5.25, P = .025). Lesion length as a Continuous variable (per centimeter) also correlated with a higher risk of restenosis (HR 1.06, 95% CI 1.00-1.12, P = .057). The overall assisted-primary and secondary-patency rates were 87% and 94% respectively at 3 years with no significant differences between TASC B and TASC C limbs.

Conclusion: Endovascular interventions for TASC I I B and C lesions are associated with restenosis/occlusion rates that

are at least as good as those of open femoropopliteal bypass surgery from historical, previously published series. Furthermore, overall assisted-patency rates are excellent, although low preoperative ABIs continue to be associated with worse outcomes.”
“The use of deep brain stimulation (DBS) as an effective clinical therapy for a number of neurological disorders has been greatly hindered by the lack of understanding of the mechanisms which underlie the observed clinical improvement in patients. This problem is confounded by the difficulty of investigating the neuronal effects of DBS in situ, and the impossibility of measuring the induced current in vivo. In our recent computational work using a quasi-static finite element Olopatadine (FEM) model we have quantitatively shown that the properties of the depth electrode-brain interface (EBI) have a significant effect on the electric field induced in the brain volume surrounding the DBS electrode. In the present work, we explore the influence of the reactivity of the EBI on the crossing electric current using the Fourier-FEM approach to allow the investigation of waveform attenuation in the time domain. Results showed that the EBI affected the waveform shaping differently at different post-implantation stages, and that this in turn had implications on induced current distribution across the EBI.

The analysis was conducted from a societal perspective with a 2-y

The analysis was conducted from a societal perspective with a 2-year time frame using 3-month cycles. The primary outcome was the incremental cost-effectiveness ratio, defined as the difference in cost (botulinum toxin A cost – anticholinergic cost) divided by the difference in effectiveness (botulinum toxin A quality adjusted life-years – anticholinergic quality adjusted life-years).

Results: While the botulinum strategy was more expensive ($4,392 vs $2,563) it was also more effective (1.63 vs 1.50 quality adjusted life-years) compared to the anticholinergic regimen. The calculated incremental cost-effectiveness ratio was $14,377 per quality adjusted life-year,

meaning that botulinum toxin A cost $14,377 per quality adjusted life-year gained. Cl-amidine A strategy is often considered cost-effective when the incremental cost-effectiveness ratio is less than $50,000 per quality adjusted life-year. Given this definition botulinum toxin A is cost-effective compared to anticholinergics. To determine if there are situations in which anticholinergics would become cost-effective we performed sensitivity analyses. Anticholinergics become cost-effective if compliance exceeds 75% (33% in the base case) and if the botulinum toxin A procedure cost exceeds $3,875 ($1,690

in the base case). For the remainder of the sensitivity analyses botulinum toxin A remained cost-effective.

Conclusions: Botulinum toxin A injection was cost-effective compared to anticholinergic LY411575 ic50 medications for the treatment of refractory urge incontinence. Anticholinergics become cost-effective if patients are highly compliant with medications or if the botulinum procedure costs increase substantially..”
“Microglia do not constitute a single, uniform cell population, but rather comprise cells with varied phenotypes, some which are beneficial and others that may require active regulatory control. Thus, gaining a better understanding JAK inhibitor of the heterogeneity

of resident microglia responses will contribute to any interpretation regarding the impact of any such response in the brain. Microglia are the primary source of the pro-inflammatory cytokine, tumor necrosis factor (TNF) that can initiate various effects through the activation of membrane receptors. The TNF p55 receptor contains a death domain and activation normally leads to cellular apoptosis; however, under specific conditions, receptor activation can also lead to the activation of NF-kappa B and contribute to cell survival. These divergent outcomes have been linked to receptor localization with receptor internalization leading to cell death and membrane localization supporting cell survival. A second TNF receptor, TNF p75 receptor, is normally linked to cell growth and survival, however, it can cooperate with the p55 receptor and contribute to cell death.

This study shows that in addition to stabilizing beta-catenin, Vp

This study shows that in addition to stabilizing beta-catenin, Vpu leads to the depression of both total and beta-catenin-associated E-cadherin levels through beta-TrCP-dependent stabilization of the transcriptional repressor Snail. We showed that Volasertib solubility dmso both downregulation of overall E-cadherin levels and dissociation of E-cadherin from beta-catenin result in enhanced viral release. By contrast, the overexpression of E-cadherin or the prevention of the dissociation of E-cadherin from beta-catenin results in depressed levels of virus release. Since E-cadherin is expressed only in dendritic cells and macrophages,

and not in T cells, our data suggest that the HIV-1 vpu gene may have CH5183284 molecular weight evolved to counteract different restrictions to assembly in different cells.”
“OBJECTIVE: Moyamoya disease is a cerebrovascular disorder characterized by progressive occlusion of vessels comprising the circle of Willis, resulting in formation of collaterals that have a cloudy appearance on angiography.

Neuropsychological research on the cognitive effects of the disorder in adults has been limited in scope and generalizability; only a few case studies have been published. The current study was intended to more comprehensively document the nature of cognitive impairment in moyamoya disease by assessing a large number of adult cases with a neuropsychological assessment test battery.

METHODS: Thirty-six adult patients with neurodiagnostically confirmed moyamoya disease were given presurgical neuropsychological assessments.

RESULTS: Mean group performances were within normal limits for all measures assessed. The highest rate of impairment was for measures of executive functioning. The lowest rates occurred with memory and perception measures. Cognitive RAD001 impairment was present in 11 (31 %) of the patients; it was judged to be moderate to severe in four patients (11 %). Five patients reported a mild level of depression, and two patients reported a moderate level.

CONCLUSION: The present findings suggest that moyamoya

disease diagnosed in adults can impair cognition but that the effect is not as severe as in pediatric cases. Executive functioning is most affected. Memory and, to a large extent, intellect are spared. The current pattern of results suggests brain region-behavior correlations that deserve further study.”
“Dengue viruses (DV), composed of four distinct serotypes (DV1 to DV4), cause 50 to 100 million infections annually. Durable homotypic immunity follows infection but may predispose to severe subsequent heterotypic infections, a risk conferred in part by the immune response itself. Antibody-dependent enhancement (ADE), a process best described in vitro, is epidemiologically linked to complicated DV infections, especially in Southeast Asia.

Sixteen magnetic resonance imaging scans demonstrated evidence of

Sixteen magnetic resonance imaging scans demonstrated evidence of ventricular wall violation including all 8 patients with postoperative confusion. The relative risk of having postoperative confusion after traversing the ventricle is 87 (P < .001).

CONCLUSION: Violating the ventricular system during STN DBS surgery correlated significantly with postoperative altered mental status and subsequent increased length of hospital stay. This finding may explain why cognitive complications are observed more frequently in Parkinson disease patients undergoing DBS at the STN compared SC75741 concentration with the internal globus pallidus.”
“BACKGROUND: Low blood

flow velocity in the middle cerebral artery (MCA) correlates with the development of postoperative cerebral ischemic lesions related to generation of microemboli during dissection of carotid arteries in carotid endarterectomy (CEA).

OBJECTIVE: The

purpose check details of this prospectively controlled trial was to determine whether increased mean blood flow velocity in the MCA by intentional hypertension during carotid dissection in CEA prevented postoperative development of new cerebral ischemic lesions caused by intraoperative microemboli.

METHODS: Patients with ipsilateral internal carotid artery stenosis (>70%) underwent CEA under transcranial Doppler monitoring of mean blood flow velocity and microembolic signals in the ipsilateral MCA. Attempts were made to keep systolic blood pressure during carotid dissection between -10% and +10% of the preoperative value (controls, n = 65) or above a +10% increase (intentional hypertension group, n = 65).

RESULTS: Incidence of new ischemic lesions on postoperative diffusion-weighted magnetic resonance imaging was significantly lower in the intentional hypertension group both for all patients (controls, 15.4%; intentional hypertension group, 3.1%; P = .03) and in a subgroup of 37 patients showing microembolic signals during carotid dissection (controls, 52.6%; intentional hypertension group, 11.1%; P = .013). Logistic regression analysis demonstrated the absence

of intentional hyperperfusion (95% confidence interval: 1.77-100.00; P = .012) and high number of microembolic signals (95% confidence interval: 1.00-1.62; P = .05) EPZ015666 mw during carotid dissection were significant independent predictors of the postoperative development of new ischemic lesions on diffusion-weighted magnetic resonance imaging.

CONCLUSION: Increased MCA mean blood flow velocity by intentional hypertension during dissection of the carotid artery in CEA prevents the postoperative development of new cerebral ischemic lesions caused by intraoperative microemboli.”
“BACKGROUND: Long-term patency of extracranial-to-intracranial (EC-IC) vein bypass is poorly understood.

OBJECTIVE: We report our experience of patency of arterial pedicle grafts and interposition vein grafts for the purpose of EC-IC bypass.

Predictors of a procedure included an index prescription in 1999

Predictors of a procedure included an index prescription in 1999 or later, a urologist visit Dinaciclib in vivo and nonadherence

to any benign prostatic hyperplasia medication (p = 0.01, <0.0001 and <0.0001, respectively).

Conclusions: Adherence to alpha-blockers was less than adherence to finasteride or multiple medications and nonadherence was significantly associated with a procedure. Interventions focused on improving adherence to benign prostatic hyperplasia medications are clearly needed.”
“Prenatal cocaine exposure (PCE) may be associated with alterations in children’s developing emotional arousal and regulation systems.

Objective: We examined emotional responses to a frustrating task and subsequent behavior problems in 225 2 1/2 year olds (129 Prenatally Cocaine and Other Drug Exposed [PCE], 30 Non Cocaine but other drug Exposed [NCE], 66 Non Drug Exposed [NDE]).

Method: Children’s behaviors in a frustrating toy wait task at age 2 1/2 were coded for emotional arousal and regulation behaviors.

Results: Findings indicated a trend for PCE toddlers to show greater agitated emotional arousal than NCE and NDE toddlers. Further, PCE boys made more references to their caregivers in the task than NDE boys. Higher agitated arousal

at age 2 1/2 years was related to greater decreases in externalizing behaviors through age 5 1/2 years.

Conclusion: Findings suggest a link between cocaine exposure and emotional arousal and regulation and highlight the need to understand complex relations between emotion and risk for later psychopathology in exposed youth. (C) 4SC-202 solubility dmso Givinostat in vitro 2009 Elsevier Inc. All rights reserved.”
“Purpose: We examined sexual function in overweight and obese women with urinary incontinence, and evaluated the effects of an intensive behavioral weight reduction intervention on sexual function in this population.

Materials and Methods: A total of 338 overweight and obese women reporting 10 or more incontinence episodes weekly were randomized to an intensive behavioral change (226) or structured education program (112) for 6 months. Sexual function was assessed using self-administered

questionnaires. Multivariate regression was used to examine factors associated with baseline and 6-month change in sexual function as well as intervention effects.

Results: Two-thirds of participants (233) were sexually active at baseline but more than half (188) reported low desire and a quarter (91) were sexually dissatisfied. More than half of sexually active participants (123) reported problems with arousal, lubrication, orgasm or incontinence during sex. Compared to controls women in the intervention group demonstrated a borderline increase in frequency of sexual activity at 6 months (OR 1.34, 95% CI 0.99-1.81, p = 0.06) but no differences in satisfaction (OR 1.28, 95% CI 0.83-1.99, p = 0.26), desire (OR 1.12, 95% CI 0.79-1.61, p = 0.52) or problems (beta +/- SE 0.03 +/- 0.07, p = 0.68 for intervention effects on problems score).