Objectives: To develop evidence-based European League Against Rheumatism (EULAR) recommendations for the management of Behçet disease (BD) supplemented where necessary by expert opinion. Methods: The multidisciplinary expert committee, a task force of the EULAR Standing Committee for Clinical Affairs (ESCCA), consisted of nine rheumatologists (one who was also a clinical epidemiologist and one also a Rehabilitation Medicine doctor), three ophthalmologists, one internist, one dermatologist and one neurologist, representing six European countries plus Tunisia and Korea. A patient representative was also present. Problem areas and related keywords for systematic literature research were identified. Systematic literature research was performed using Medline and the Cochrane Library databases from 1966 through to December 2006. A total of 40 initial statements were generated based on the systematic literature research. These yielded the final recommendations developed from two blind Delphi rounds of voting. Results: Nine recommendations were developed for the management of different aspects of BD. The strength of each recommendation was determined by the level of evidence and the experts' opinions. The level of agreement for each recommendation was determined using a visual analogue scale for the whole committee and for each individual aspect by the subgroups, who consider themselves experts in that field of BD. There was excellent concordance between the level of agreement of the whole group and the ''experts in the field''. Conclusion: Recommendations related to the eye, skinmucosa disease and arthritis are mainly evidence based, but recommendations on vascular disease, neurological and gastrointestinal involvement are based largely on expert opinion and uncontrolled evidence from open trials and observational studies. The need for further properly designed controlled clinical trials is apparent.The aim of treatment in Behçet disease (BD) is to prevent irreversible damage that mostly occurs early in the course of disease, especially in the highrisk group, young men, 1 2 and to prevent exacerbations of mucocutaneous and joint involvement, usually not causing damage but affecting quality of life. The multisystem involvement mandates collaboration between different specialties.Our aim was to develop recommendations for the management of BD, in line with the European Leage Against Rheumatism (EULAR)'s standardised operating procedures, 3 combining current evidence from clinical trials with expert opinion. The recommendations target all doctors and surgeons who are involved in the treatment of BD. METHODS The expert committeeThe committee consisted of nine rheumatologists (one who was also a clinical epidemiologist and one also a rehabilitationist), three ophthalmologists, one internist, one dermatologist and one neurologist, representing six European countries plus Tunisia and Korea. A patient representative was also present. Development of recommendationsThe experts were invited to propose problem areas and r...

Using a cluster randomization design, schools were randomly assigned to implement Success for All, a comprehensive reading reform model, or control methods. This article reports final literacy outcomes for a 3-year longitudinal sample of children who participated in the treatment or control condition from kindergarten through second grade and a combined longitudinal and in-mover student sample, both of which were nested within 35 schools. Hierarchical linear model analyses of all three outcomes for both samples revealed statistically significant school-level effects of treatment assignment as large as one third of a standard deviation. The results correspond with the Success for All program theory, which emphasizes both comprehensive school-level reform and targeted student-level achievement effects through a multi-year sequencing of literacy instruction.

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Properly designed, controlled studies (new and confirmatory) are still needed to guide us in managing BD.

Stainless steel coupons were treated with skim milk and subsequently challenged with individual bacterial suspensions ofStaphylococcus aureus, Pseudomonas fragi,Escherichia coli, Listeria monocytogenes, andSerratia marcescens. The numbers of attached bacteria were determined by direct epifluorescence microscopy and compared with the attachment levels on clean stainless steel with two different surface finishes. Skim milk was found to reduce adhesion of S. aureus, L. monocytogenes, and S. marcescens. P. fragi and E. coli attached in very small numbers to the clear surfaces, making the effect of any adsorbed protein layer difficult to assess. Individual milk proteins α-casein, β-casein, κ-casein, and α-lactalbumin were also found to reduce the adhesion of S. aureus and L. monocytogenes. The adhesion of bacteria to samples treated with milk dilutions up to 0.001% was investigated. X-ray photoelectron spectroscopy was used to determine the proportion of nitrogen in the adsorbed films. Attached bacterial numbers were inversely related to the relative atomic percentage of nitrogen on the surface. A comparison of two types of stainless steel surface, a 2B and a no. 8 mirror finish, indicated that the difference in these levels of surface roughness did not greatly affect bacterial attachment, and reduction in adhesion to a milk-treated surface was still observed. Cross-linking of adsorbed proteins partially reversed the inhibition of bacterial attachment, indicating that protein chain mobility and steric exclusion may be important in this phenomenon.