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Mulligan JK, Nord D, Villanueva MV, Justice J, Lobo B, Schlosser RJ, Atkinson C. Role of C3a as a Novel Regulator of 25(OH)D 3 to 1α,25-Dihydroxyvitamin D 3 Metabolism in Upper Airway Epithelial Cells. J Immunol 2022; 209:262-269. [PMID: 35793909 PMCID: PMC9432430 DOI: 10.4049/jimmunol.2000726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 04/29/2022] [Indexed: 05/21/2023]
Abstract
In patients with chronic rhinosinusitis with nasal polyps, primary human sinonasal epithelial cell (HSNEC) 1α-hydroxylase levels are reduced, as is their ability to metabolize 25-hydroxycholecalciferol [25(OH)D3] to its active metabolite, 1α,25-dihydroxyvitamin D3 [1,25(OH)2D3]. In this study, we sought to identify the factor responsible for the regulation of HSNEC metabolism of 25(OH)D3, focusing on C3 and C3a. Multiple inhaled irritants trigger the release of complement components, C3 and C3a, leading to suppression of 1α-hydroxylase levels in HSNECs. Recombinant C3a was able to decrease 1α-hydroxylase and impair 25(OH)D3 to 1,25(OH)2D3 metabolism, while addition of a C3a receptor antagonist restored conversion. Conversely, 1,25(OH)2D3 suppressed Aspergillus fumigatus-induced C3 and C3a levels in HSNEC supernatant. Given the ability of 1,25(OH)2D3 to modulate LL37 in other cell types, we examined its regulation in HSNECs and relationship to C3a. 1,25(OH)2D3 stimulated the secretion of LL37, whereas A. fumigatus and C3a suppressed it. Conversely, LL37 reduced the release of C3/C3a by HSNECs. Lastly, oral steroid use and in vitro dexamethasone application both failed to increase 1α-hydroxylase or reduce C3a levels. In summary, in this article, we describe for the first time a novel relationship between complement activation and local vitamin D metabolism in airway epithelial cells. The presence of elevated C3/C3a in patients with asthma and/or chronic rhinosinusitis with nasal polyps may account for their impaired HSNEC 25(OH)D3 to 1,25(OH)2D3 metabolism and explain why they receive limited therapeutic benefit from oral vitamin D3 supplementation.
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Affiliation(s)
- Jennifer K Mulligan
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL
- Department of Otolaryngology, University of Florida, Gainesville, FL; and
| | - Dianna Nord
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL
| | - Maria V Villanueva
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL
| | - Jeb Justice
- Department of Otolaryngology, University of Florida, Gainesville, FL; and
| | - Brian Lobo
- Department of Otolaryngology, University of Florida, Gainesville, FL; and
| | - Rodney J Schlosser
- Department of Otolaryngology, Medical University of South Carolina, Charleston, SC
| | - Carl Atkinson
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL;
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Manikwar P, Mulagapati SHR, Kasturirangan S, Moez K, Rainey GJ, Lobo B. Characterization of a Novel Bispecific Antibody With Improved Conformational and Chemical Stability. J Pharm Sci 2019; 109:220-232. [PMID: 31288034 DOI: 10.1016/j.xphs.2019.06.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/02/2019] [Accepted: 06/18/2019] [Indexed: 02/08/2023]
Abstract
Bispecific antibodies containing single-chain variable fragment (scFv) appended to immunoglobulins G offer unique development challenges. Here, we describe the stability of a novel bispecific format, BiS5, where the scFv is tethered to the CH3 domain. BiS5 showed an improved conformational and chemical stability compared with that of BiS4 in which the scFv is appended in the hinge region between the Fab and Fc. By switching the location of the scFv from hinge region to the CH3, there was an improved stabilization of CH2 and scFv domains. Interestingly, no noticeable impact was observed on the conformational stability of CH3 and Fab domains. BiS4 and BiS5 showed different aggregation and fragmentation rates under accelerated temperature stress conditions. BiS4 showed higher fragmentation rates compared with BiS5 likely owing to fragmentation in the linker region on either side of the scFv while BiS5 is more resistant toward fragmentation owing to tethering of scFv to the CH3 domain at its N and C terminus. In conclusion, the location of scFv affects both aggregation and fragmentation kinetics. These insights into the molecular structure and correlations with their physical and chemical stability will help formulation development of these novel bispecific antibodies.
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Affiliation(s)
- Prakash Manikwar
- Dosage Form Design & Development, AstraZeneca, Gaithersburg, Maryland 20878.
| | | | - Srinath Kasturirangan
- Antibody Discovery and Protein Engineering, AstraZeneca, Gaithersburg, Maryland 20878
| | - Khashayar Moez
- Dosage Form Design & Development, AstraZeneca, Gaithersburg, Maryland 20878
| | - Godfrey Jonah Rainey
- Antibody Discovery and Protein Engineering, AstraZeneca, Gaithersburg, Maryland 20878
| | - Brian Lobo
- Dosage Form Design & Development, AstraZeneca, Gaithersburg, Maryland 20878
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3
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Affiliation(s)
- Marc B. Taraban
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, Maryland 21201, United States
| | - Roberto A. DePaz
- Dosage Form Design and Development, MedImmune, One MedImmune Way, Gaithersburg, Maryland 20878, United States
| | - Brian Lobo
- Dosage Form Design and Development, MedImmune, One MedImmune Way, Gaithersburg, Maryland 20878, United States
| | - Y. Bruce Yu
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, Maryland 21201, United States
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4
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Affiliation(s)
- Marc B. Taraban
- Department
of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, Maryland 21201, United States
| | - Roberto A. DePaz
- Formulation
Sciences, MedImmune, One MedImmune Way, Gaithersburg, Maryland 20878, United States
| | - Brian Lobo
- Formulation
Sciences, MedImmune, One MedImmune Way, Gaithersburg, Maryland 20878, United States
| | - Y. Bruce Yu
- Department
of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, Maryland 21201, United States
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Cremon C, Stanghellini V, Barbaro MR, Cogliandro RF, Bellacosa L, Santos J, Vicario M, Pigrau M, Alonso Cotoner C, Lobo B, Azpiroz F, Bruley des Varannes S, Neunlist M, DeFilippis D, Iuvone T, Petrosino S, Di Marzo V, Barbara G. Randomised clinical trial: the analgesic properties of dietary supplementation with palmitoylethanolamide and polydatin in irritable bowel syndrome. Aliment Pharmacol Ther 2017; 45:909-922. [PMID: 28164346 DOI: 10.1111/apt.13958] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 09/02/2016] [Accepted: 01/08/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Intestinal immune activation is involved in irritable bowel syndrome (IBS) pathophysiology. While most dietary approaches in IBS involve food avoidance, there are fewer indications on food supplementation. Palmithoylethanolamide, structurally related to the endocannabinoid anandamide, and polydatin are dietary compounds which act synergistically to reduce mast cell activation. AIM To assess the effect on mast cell count and the efficacy of palmithoylethanolamide/polydatin in patients with IBS. METHODS We conducted a pilot, 12-week, randomised, double-blind, placebo-controlled, multicentre study assessing the effect of palmithoylethanolamide/polydatin 200 mg/20 mg or placebo b.d. on low-grade immune activation, endocannabinoid system and symptoms in IBS patients. Biopsy samples, obtained at screening visit and at the end of the study, were analysed by immunohistochemistry, enzyme-linked immunoassay, liquid chromatography and Western blot. RESULTS A total of 54 patients with IBS and 12 healthy controls were enrolled from five European centres. Compared with controls, IBS patients showed higher mucosal mast cell counts (3.2 ± 1.3 vs. 5.3 ± 2.7%, P = 0.013), reduced fatty acid amide oleoylethanolamide (12.7 ± 9.8 vs. 45.8 ± 55.6 pmol/mg, P = 0.002) and increased expression of cannabinoid receptor 2 (0.7 ± 0.1 vs. 1.0 ± 0.8, P = 0.012). The treatment did not significantly modify IBS biological profile, including mast cell count. Compared with placebo, palmithoylethanolamide/polydatin markedly improved abdominal pain severity (P < 0.05). CONCLUSIONS The marked effect of the dietary supplement palmithoylethanolamide/polydatin on abdominal pain in patients with IBS suggests that this is a promising natural approach for pain management in this condition. Further studies are now required to elucidate the mechanism of action of palmithoylethanolamide/polydatin in IBS. ClinicalTrials.gov number, NCT01370720.
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Affiliation(s)
- C Cremon
- Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, University of Bologna, Bologna, Italy
| | - V Stanghellini
- Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, University of Bologna, Bologna, Italy
| | - M R Barbaro
- Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, University of Bologna, Bologna, Italy
| | - R F Cogliandro
- Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, University of Bologna, Bologna, Italy
| | - L Bellacosa
- Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, University of Bologna, Bologna, Italy
| | - J Santos
- Digestive System Research Unit, Departments of Gastroenterology, Institut de Recerca Vall d'Hebron Hospital Universitari Vall d'Hebron Universitat Autònoma de Barcelona (Departamento de Medicina) Barcelona and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - M Vicario
- Digestive System Research Unit, Departments of Gastroenterology, Institut de Recerca Vall d'Hebron Hospital Universitari Vall d'Hebron Universitat Autònoma de Barcelona (Departamento de Medicina) Barcelona and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - M Pigrau
- Digestive System Research Unit, Departments of Gastroenterology, Institut de Recerca Vall d'Hebron Hospital Universitari Vall d'Hebron Universitat Autònoma de Barcelona (Departamento de Medicina) Barcelona and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - C Alonso Cotoner
- Digestive System Research Unit, Departments of Gastroenterology, Institut de Recerca Vall d'Hebron Hospital Universitari Vall d'Hebron Universitat Autònoma de Barcelona (Departamento de Medicina) Barcelona and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - B Lobo
- Digestive System Research Unit, Departments of Gastroenterology, Institut de Recerca Vall d'Hebron Hospital Universitari Vall d'Hebron Universitat Autònoma de Barcelona (Departamento de Medicina) Barcelona and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - F Azpiroz
- Digestive System Research Unit, Departments of Gastroenterology, Institut de Recerca Vall d'Hebron Hospital Universitari Vall d'Hebron Universitat Autònoma de Barcelona (Departamento de Medicina) Barcelona and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | | | - M Neunlist
- Institut des Maladies de l'Appareil Digestif, Hotel Dieu, Nantes, France
| | - D DeFilippis
- Department of Pharmacy, University of Naples "Federico II", Naples, Italy
| | - T Iuvone
- Department of Pharmacy, University of Naples "Federico II", Naples, Italy
| | - S Petrosino
- Institute of Biomolecular Chemistry, Consiglio Nazionale delle Ricerche, Pozzuoli, Italy.,Epitech Group SpA, Saccolongo, Italy
| | - V Di Marzo
- Institute of Biomolecular Chemistry, Consiglio Nazionale delle Ricerche, Pozzuoli, Italy
| | - G Barbara
- Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, University of Bologna, Bologna, Italy
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Lobo B, D'Anza B, Recinos P, Kshettry V, Snyderman C, Woodard T, Sindwani R. Trends in Perioperative Management of Endoscopic Skull Base Surgery Patients. Skull Base Surg 2017. [DOI: 10.1055/s-0037-1600603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Brian Lobo
- Cleveland Clinic Foundation, Cleveland, Ohio, United States
| | - Brian D'Anza
- Case Western Reserve University, Cleveland, Ohio, United States
| | - Pablo Recinos
- Cleveland Clinic Foundation, Cleveland, Ohio, United States
| | - Varun Kshettry
- Cleveland Clinic Foundation, Cleveland, Ohio, United States
| | - Carl Snyderman
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
| | - Troy Woodard
- Cleveland Clinic Foundation, Cleveland, Ohio, United States
| | - Raj Sindwani
- Cleveland Clinic Foundation, Cleveland, Ohio, United States
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7
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Pigrau M, Rodiño-Janeiro BK, Casado-Bedmar M, Lobo B, Vicario M, Santos J, Alonso-Cotoner C. The joint power of sex and stress to modulate brain-gut-microbiota axis and intestinal barrier homeostasis: implications for irritable bowel syndrome. Neurogastroenterol Motil 2016; 28:463-86. [PMID: 26556786 DOI: 10.1111/nmo.12717] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/05/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Intestinal homeostasis is a dynamic process that takes place at the interface between the lumen and the mucosa of the gastrointestinal tract, where a constant scrutiny for antigens and toxins derived from food and microorganisms is carried out by the vast gut-associated immune system. Intestinal homeostasis is preserved by the ability of the mucus layer and the mucosal barrier to keep the passage of small-sized and antigenic molecules across the epithelium highly selective. When combined and preserved, immune surveillance and barrier's selective permeability, the host capacity of preventing the development of intestinal inflammation is optimized, and viceversa. In addition, the brain-gut-microbiome axis, a multidirectional communication system that integrates distant and local regulatory networks through neural, immunological, metabolic, and hormonal signaling pathways, also regulates intestinal function. Dysfunction of the brain-gut-microbiome axis may induce the loss of gut mucosal homeostasis, leading to uncontrolled permeation of toxins and immunogenic particles, increasing the risk of appearance of intestinal inflammation, mucosal damage, and gut disorders. Irritable bowel syndrome is prevalent stress-sensitive gastrointestinal disorder that shows a female predominance. Interestingly, the role of stress, sex and gonadal hormones in the regulation of intestinal mucosal and the brain-gut-microbiome axis functioning is being increasingly recognized. PURPOSE We aim to critically review the evidence linking sex, and stress to intestinal barrier and brain-gut-microbiome axis dysfunction and the implications for irritable bowel syndrome.
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Affiliation(s)
- M Pigrau
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada.,Laboratory of Neuro-immuno-gastroenterology, Digestive Diseases Research Unit. Vall d'Hebron Institut de Recerca, Department of Gastroenterology, Hospital Universitario Vall d'Hebron & Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - B K Rodiño-Janeiro
- Laboratory of Neuro-immuno-gastroenterology, Digestive Diseases Research Unit. Vall d'Hebron Institut de Recerca, Department of Gastroenterology, Hospital Universitario Vall d'Hebron & Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Casado-Bedmar
- Laboratory of Neuro-immuno-gastroenterology, Digestive Diseases Research Unit. Vall d'Hebron Institut de Recerca, Department of Gastroenterology, Hospital Universitario Vall d'Hebron & Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - B Lobo
- Laboratory of Neuro-immuno-gastroenterology, Digestive Diseases Research Unit. Vall d'Hebron Institut de Recerca, Department of Gastroenterology, Hospital Universitario Vall d'Hebron & Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Vicario
- Laboratory of Neuro-immuno-gastroenterology, Digestive Diseases Research Unit. Vall d'Hebron Institut de Recerca, Department of Gastroenterology, Hospital Universitario Vall d'Hebron & Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - J Santos
- Laboratory of Neuro-immuno-gastroenterology, Digestive Diseases Research Unit. Vall d'Hebron Institut de Recerca, Department of Gastroenterology, Hospital Universitario Vall d'Hebron & Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - C Alonso-Cotoner
- Laboratory of Neuro-immuno-gastroenterology, Digestive Diseases Research Unit. Vall d'Hebron Institut de Recerca, Department of Gastroenterology, Hospital Universitario Vall d'Hebron & Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
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Jayaraman J, Wu J, Brunelle MC, Cruz AMM, Goldberg DS, Lobo B, Shah A, Tessier PM. Plasmonic measurements of monoclonal antibody self-association using self-interaction nanoparticle spectroscopy. Biotechnol Bioeng 2014; 111:1513-20. [DOI: 10.1002/bit.25221] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Jayapriya Jayaraman
- Center for Biotechnology & Interdisciplinary Studies, Isermann Department of Chemical and Biological Engineering; Rensselaer Polytechnic Institute; Troy New York 12180
| | - Jiemin Wu
- Center for Biotechnology & Interdisciplinary Studies, Isermann Department of Chemical and Biological Engineering; Rensselaer Polytechnic Institute; Troy New York 12180
| | - Molly C. Brunelle
- Center for Biotechnology & Interdisciplinary Studies, Isermann Department of Chemical and Biological Engineering; Rensselaer Polytechnic Institute; Troy New York 12180
| | - Anna Marie M. Cruz
- Center for Biotechnology & Interdisciplinary Studies, Isermann Department of Chemical and Biological Engineering; Rensselaer Polytechnic Institute; Troy New York 12180
| | | | - Brian Lobo
- Department of Formulation Sciences; MedImmune; Gaithersburg Maryland 20874
| | - Ambarish Shah
- Department of Formulation Sciences; MedImmune; Gaithersburg Maryland 20874
| | - Peter M. Tessier
- Center for Biotechnology & Interdisciplinary Studies, Isermann Department of Chemical and Biological Engineering; Rensselaer Polytechnic Institute; Troy New York 12180
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Hevia M, Abascal-Junquera JM, Sacristán R, Suárez J, Lobo B, Méndez S, Pellejero P, Abascal-García R. [Haemostasis control during laparoscopic partial nephrectomy without parenchymal renorrhaphy: the VIVOSTAT(®) experience]. Actas Urol Esp 2013; 37:47-53. [PMID: 22819491 DOI: 10.1016/j.acuro.2012.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 03/07/2012] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To present our experience using an autologous fibrin sealant prepared with the Vivostat system(®) to control haemostasis without any renal parenchymal reconstruction. MATERIAL AND METHODS We performed 45 laparoscopic partial nephrectomies using this haemostatic agent. The surgical steps were: colon mobilization, identification of ureter, renal vessels and renal tumor, renal artery control with Rummel tourniquet, tumor excision with harmonic scalpel, application of fibrin glue to the resection bed twice (before and after kidney reperfusion). Patients were evaluated for acute or delayed bleeding. RESULTS Mean age was 63.9 years (33-80); mean tumor size was 2.5cm (1.5-4); mean operative time was 136.1min (90-180). Mean warm ischemia time was 19.2min (10-30). Mean blood loss was 97ml (50-300). Individual haemostatic stitches were performed before application of the sealant if acute bleeding was observed (14 cases). We did not achieve any case of postoperative bleeding from resection bed or renal failure. 1 patient required transfusion due to an abdominal wall haematoma. 65% were clear cell carcinoma, 10% were papillary carcinoma, 20% were oncocitoma. Free margin rate was 100%. Mean hospital stay was 4 days (2-6). Mean follow-up was 14 months (5-45). CONCLUSIONS Excluding renorrhaphy during laparoscopic partial nephrectomy is feasible and safe. Our initial experience with the vivostat system in laparoscopic partial nephrectomy has been encouraging, but longer follow-up is needed to determine the real benefit of this surgical technique in laparoscopic partial nephrectomy.
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Affiliation(s)
- M Hevia
- Servicio de Urología, Hospital Universitario Central de Asturias, Oviedo, España
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Nagy K, Ramos L, Courtet-Compondu MC, Braga-Lagache S, Redeuil K, Lobo B, Azpiroz F, Malagelada JR, Beaumont M, Moulin J, Acquistapache S, Sagalowicz L, Kussmann M, Santos J, Holst B, Williamson G. Double-balloon jejunal perfusion to compare absorption of vitamin E and vitamin E acetate in healthy volunteers under maldigestion conditions. Eur J Clin Nutr 2012; 67:202-6. [PMID: 23212132 DOI: 10.1038/ejcn.2012.183] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES The vitamin E derivative, α-tocopheryl acetate, is often included in formulations used in enteral nutrition. In this respect, we compared α-tocopherol and α-tocopheryl acetate absorption under 'maldigestion' conditions, such as occurring during enteral tube feeding, using differentially labeled RRR-[5,7-methyl-((2)H(6))]-α-tocopherol and RRR-[5-methyl-(2)H(3)]-α-tocopheryl acetate allowing direct comparison between free and esterified forms. SUBJECTS/METHODS The two derivatives were given together in a single dose to six volunteers directly into the jejunum using a double-balloon perfusion system. Perfusion lasted for 1 h, and the collected blood and effluent samples were analyzed by liquid chromatography-mass spectrometry. RESULTS In the isolated 20-cm length of exposed jejunum, on average ~ 6% of the two vitamin E forms were absorbed >1 h based on subtraction of effluent from influent. There was substantial difference in the absolute absorbed quantity between individuals, but no significant differences were observed in the absorption between the two labeled forms as assessed in the plasma. (2)H(3)-α-tocopherol was not present in the influent, but appeared in the effluent, indicating that the acetylated form of vitamin E is cleaved by brush border enzymes in the small intestine. CONCLUSIONS This study shows that even in the absence of digestive enzymes and bile salts, the appropriately solubilized acetylated form of α-tocopherol exhibits the same bioavailability as free α-tocopherol. This suggests that both forms can be absorbed equally under maldigestion conditions such as present clinically during enteral tube feeding.
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Affiliation(s)
- K Nagy
- Nestlé Research Center, Nestec Ltd, Lausanne, Switzerland
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Alonso C, Guilarte M, Vicario M, Ramos L, Rezzi S, Martínez C, Lobo B, Martin FP, Pigrau M, González-Castro AM, Gallart M, Malagelada JR, Azpiroz F, Kochhar S, Santos J. Acute experimental stress evokes a differential gender-determined increase in human intestinal macromolecular permeability. Neurogastroenterol Motil 2012; 24:740-6, e348-9. [PMID: 22625665 DOI: 10.1111/j.1365-2982.2012.01928.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Intestinal epithelial dysfunction is a common pathophysiologic feature in irritable bowel syndrome (IBS) patients and might be the link to its clinical manifestations. We previously showed that chronic psychosocial stress induces jejunal epithelial barrier dysfunction; however, whether this epithelial response is gender-specific and might thus explain the enhanced female susceptibility to IBS remains unknown. METHODS Intestinal responses to acute stress were compared in age-matched groups of healthy women and men (n = 10 each) experiencing low background stress. A 20-cm jejunal segment, was perfused with an isosmotic solution, and intestinal effluents were collected under basal conditions, for 15 min during cold pain stress and for a 45-min recovery period. Epithelial function (net water flux and albumin output), changes in stress hormones, and cardiovascular and psychologic responses to cold stress were measured. KEY RESULTS Heart rate and blood pressure significantly increased during cold pain stress with no differences between men and women. Adrenocorticotropic hormone and cortisol levels during cold pain stress were significantly higher in men. Basal net water flux and epithelial permeability were similar in men and women. Cold pain stress increased water flux in both groups (72 ± 23 and 107 ± 18 μL min(-1) cm(-1) , respectively; F(5, 90) = 5.5; P = 0.003 for Time) and, interestingly, this was associated with a marked increase of albumin permeability in women but not in men (0.8 ± 0.2 vs.-0.7 ± 0.2 mg/15 min; P < 0.0001). CONCLUSIONS & INFERENCES Intestinal macromolecular permeability in response to acute experimental stress is increased in healthy women, a mechanism that may contribute to female oversusceptibility to IBS.
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Affiliation(s)
- C Alonso
- Laboratory of Neuro-Immuno-Gastroenterology, Digestive Diseases Research Unit, Institut de Recerca Vall d'Hebron, Hospital Universitari Vall d'Hebron; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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12
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Lobo B, Oya S, Sade B, Lee J. Operative Outcome and Risk Factors in Meningioma Surgery: A Personal Review of 800 Consecutive Cases. Skull Base Surg 2012. [DOI: 10.1055/s-0032-1314234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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13
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Lee J, Recinos P, Lobo B, Sade B, Oya S. Analysis of Operative Mortality Following 800 Consecutive Patients: A Single Surgeon's Experience. Skull Base Surg 2012. [DOI: 10.1055/s-0032-1314208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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14
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Cicutin GL, Navarro O' Connor M., Lobo B, Jado I, Anda P. Evidencia molecular de Anaplasma platys en caninos domésticos ele la Ciudad Autónoma de Buenos Aires. FAVE Cs Vet 2011. [DOI: 10.14409/favecv.v10i2.1537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Leite L, Lobo B, Lima N, Mengarda C. Acolhimento Multiprofissional em Estratégia de Saúde da Família: Espaço de Atuação para o Profissional Psicólogo. Revista de Psicologia da IMED 2010. [DOI: 10.18256/2175-5027/psico-imed.v2n1p276-287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Serra J, Villoria A, Azpiroz F, Lobo B, Santos J, Accarino A, Malagelada JR. Impaired intestinal gas propulsion in manometrically proven dysmotility and in irritable bowel syndrome. Neurogastroenterol Motil 2010; 22:401-6, e91-2. [PMID: 20047636 DOI: 10.1111/j.1365-2982.2009.01447.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Intestinal manometry is the current gold standard for diagnosing small bowel dysmotility; however, the functional significance of abnormal manometry is unknown. Our aim was to determine whether, and to what extent, intestinal gas propulsion is impaired in patients with manometrically proven dysmotility compared with healthy controls and patients with IBS. METHODS Clearance and tolerance of a jejunal gas load (12 mL min(-1) for 2 h) were measured in 15 patients with severe abdominal symptoms and intestinal dysmotility evidenced by manometry, 15 patients with IBS and 15 healthy subjects. Thereafter, the effect of neostigmine (0.5 mg i.v. bolus) vs placebo (i.v. saline) was tested in six dysmotility patients. KEY RESULTS After 2-h gas infusion, patients with dysmotility developed significantly more gas retention (717 +/- 91 mL) than IBS patients (372 +/- 82 mL; P = 0.0037) and healthy subjects (17 +/- 67 mL; P < 0.0001 vs dysmotility; P = 0.0060 vs IBS). Despite the greater retention in dysmotility patients, abdominal perception (2.5 +/- 0.6 score) and distension (7 +/- 2 mm girth increment) were similar to IBS (3.9 +/- 0.6 score and 7 +/- 2 mm, respectively). In dysmotility patients, neostigmine produced immediate clearance of gas, and by 30 min had reduced gas retention (by -552 +/- 182 vs 72 +/- 58 mL after saline; P = 0.008), abdominal symptoms (by -0.8 +/- 0.3 score vs 0.3 +/- 0.2 after saline; P = 0.019) and distension (girth change -5 +/- 1 mm; P = 0.003 vs-2 +/- 2 mm after saline). CONCLUSION & INFERENCES Patients with manometric dysmotility have markedly impaired intestinal gas propulsion. In IBS patients, impaired gas propulsion is less pronounced but associated with concomitant sensory dysfunction and poor tolerance of gas retention.
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Affiliation(s)
- J Serra
- University Hospital Vall d'Hebron; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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Serra J, Villoria A, Azpiroz F, Lobo B, Santos J, Accarino A, Malagelada JR. Impaired intestinal gas propulsion in manometrically proven dysmotility and in irritable bowel syndrome. Neurogastroenterol Motil 2010. [PMID: 20047636 DOI: 10.1111/j.1365-2982.2009.01447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Intestinal manometry is the current gold standard for diagnosing small bowel dysmotility; however, the functional significance of abnormal manometry is unknown. Our aim was to determine whether, and to what extent, intestinal gas propulsion is impaired in patients with manometrically proven dysmotility compared with healthy controls and patients with IBS. METHODS Clearance and tolerance of a jejunal gas load (12 mL min(-1) for 2 h) were measured in 15 patients with severe abdominal symptoms and intestinal dysmotility evidenced by manometry, 15 patients with IBS and 15 healthy subjects. Thereafter, the effect of neostigmine (0.5 mg i.v. bolus) vs placebo (i.v. saline) was tested in six dysmotility patients. KEY RESULTS After 2-h gas infusion, patients with dysmotility developed significantly more gas retention (717 +/- 91 mL) than IBS patients (372 +/- 82 mL; P = 0.0037) and healthy subjects (17 +/- 67 mL; P < 0.0001 vs dysmotility; P = 0.0060 vs IBS). Despite the greater retention in dysmotility patients, abdominal perception (2.5 +/- 0.6 score) and distension (7 +/- 2 mm girth increment) were similar to IBS (3.9 +/- 0.6 score and 7 +/- 2 mm, respectively). In dysmotility patients, neostigmine produced immediate clearance of gas, and by 30 min had reduced gas retention (by -552 +/- 182 vs 72 +/- 58 mL after saline; P = 0.008), abdominal symptoms (by -0.8 +/- 0.3 score vs 0.3 +/- 0.2 after saline; P = 0.019) and distension (girth change -5 +/- 1 mm; P = 0.003 vs-2 +/- 2 mm after saline). CONCLUSION & INFERENCES Patients with manometric dysmotility have markedly impaired intestinal gas propulsion. In IBS patients, impaired gas propulsion is less pronounced but associated with concomitant sensory dysfunction and poor tolerance of gas retention.
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Affiliation(s)
- J Serra
- University Hospital Vall d'Hebron; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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Lobo B, Ropp JD, Middaugh CR. The 1st annual meeting of the American Society of Gene Therapy. Expert Opin Investig Drugs 2005; 7:1719-26. [PMID: 15991913 DOI: 10.1517/13543784.7.10.1719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The inaugural meeting of the American Society of Gene Therapy (ASGT) attracted over 1700 participants to the Pacific gateway city of Seattle, Washington for a multifaceted 4 day meeting organised into a series of symposia, workshops, poster sessions and educational opportunities representative of gene therapy's immense diversity. Presentations from the international assemblage of industrial and academic scientists covered a blend of data from cutting edge research to current clinical investigations across a spectrum of therapeutic targets. Unique educational sessions allowed participants to gain basic information regarding areas of gene therapy research in which they lacked familiarity, whereas several 'Meet the Investigator' sessions allowed participants to interact directly with experts in small group settings in order to obtain a more sophisticated perspective through informal dialogue. A large majority of the symposia and poster presentations showcased the development and current successes of viral-mediated gene therapy although non-viral approaches received their share of attention. Despite the fact that promising results were presented from ongoing clinical trials using viral-mediated gene therapy, much of the symposia addressed the accompanying problems of immunogenicity, low levels of gene expression and lack of control of gene expression that are presently limiting the clinical success of virally mediated gene transfer.
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Affiliation(s)
- B Lobo
- Department of Pharmaceutical Chemistry, University of Kansas, 2095 Constant Avenue, Lawrence, KS 66047, USA
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Lobo B, Casellas F, de Torres I, Chicharro L, Malagelada JR. Usefulness of jejunal biopsy in the study of intestinal malabsorption in the elderly. Rev Esp Enferm Dig 2004; 96:259-64. [PMID: 15117239 DOI: 10.4321/s1130-01082004000400005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND small bowel structure and function are not different between elderly people and young people. Thus, in principle it is advisable to perform diagnostic investigation of elderly patients as well as younger patients when they present with symptoms suggestive of intestinal malabsorption. A key test for the etiologic diagnosis of intestinal malabsorption, jejunal biopsy, has not been specifically examined to assess its usefulness and risk of complications in this advanced age patients. AIM to establish the usefulness of jejunal biopsy with the Watson's capsule in the elderly patients with suspected intestinal malabsorption. PATIENTS patients older than 65 years referred to our Unit for performance of a jejunal biopsy from 1996 to 2001 for suspicion of intestinal malabsorption. RESULTS forty-seven patients were included. Appropriate biopsy sample was obtained in 45 cases, although in 3 patients a second try was required. Histologic findings: partial villous atrophy in 10 cases (22.2%), complete villous atrophy in 5 cases (11.1%), intraepithelial lymphocytosis in 5 cases (11.1%), and single cases of intestinal lymphangiectasia, amyloidosis, unspecific jejunitis, and Whipple's disease. Histology was normal in 19 cases (42%). Definitive diagnosis was celiac disease in 14 patients, bacterial overgrowth in 3, jejunitis in 3, Whipple's disease in 1, lymphangiectasia in 1, atrophic gastritis in 3, amyloidosis in 1, and ischemic colitis in 1. Jejunal biopsy achieved an etiologic diagnosis in 20 patients. There were no cases of perforations or bleeding. CONCLUSION jejunal biopsy is a useful and safe test for the etiologic diagnosis of intestinal malabsorption in elderly patients.
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Affiliation(s)
- B Lobo
- Service of Digestive Diseases, University Hospital Vall d'Hebron, Barcelona, Spain
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Agrelo F, Lobo B, Chesta M, Berra S, Sabulsky J. [Growth of breastfed and bottle-fed infants up to 2 years of age: CLACYD (Lactation, Alimentation, Growth and Development) study 1993-1995]. Rev Panam Salud Publica 1999; 6:44-52. [PMID: 10446514 DOI: 10.1590/s1020-49891999000600006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Studies done in various countries show important differences in the growth of breastfed and bottle-fed children. In addition, it has been found that breast-fed children grow more slowly beginning at the age of 2 or 3 months in comparison with the reference pattern of the U.S. National Center for Health Statistics (NCHS) and the World Health Organization (WHO). These results cast doubt on whether maximum growth is the same as optimal growth. The objective of this study was to compare the growth in weight and length, from birth to 24 months, for a group of children who were breast-fed with that of a group who were bottle-fed. The study was also intended to describe the growth of the breastfed group in relation to the NCHS/WHO norms and a WHO "12-month breast-fed pooled data set." For this research, data were analyzed from the "Cordoba: lactation, feeding, growth, and development" study (or CLACYD study, for its Spanish-language acronym). That study looked at a representative cohort, stratified by social class, of children born in 1993 in the city of Cordoba, Argentina. The researchers analyzed anthropometric data on 74 children who were breast-fed during the first year of life and on 108 bottle-fed children. The data had been recorded, using standardized techniques, at birth and at 6, 12, and 24 months of age. Both groups were homogenous with respect to the age and schooling of the parents, social stratum, birth order, maternal height, and child's weight and length at birth. The living conditions (housing construction and availability of water and sewer services) were better among the group that was bottle-fed (P = 0.04). The breast-fed children had a lower weight and a shorter length at 6, 12, and 24 months than did the bottle-fed children. The breast-fed children also showed a slowing in growth with respect to the NCHS/WHO guidelines beginning in the second semester. This indicates that the NCHS/WHO norms are not totally adequate for evaluating the growth of breast-fed children in Cordoba, Argentina. In the high and middle social strata, the values for the breast-fed group resembled those for the WHO "pooled data set," both in weight and length. In the low and very low social strata, weight values were satisfactory, but the figures for length were less than those of the "pooled data set." The gap in length found among the low and very low social strata does not reduce the validity of the WHO "pooled data set" reference, but rather indicates the influence of living conditions on linear growth.
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Affiliation(s)
- F Agrelo
- Departamento de Maternidad e Infancia, Provincia de Córdoba, Argentina
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Agrelo F, Pascual LR, Lobo B, Sabulsky J. [Adult body height in women in Cordoba, Argentina, and exploration of the current trend (1978-198)]. Rev Panam Salud Publica 1999; 5:17-22. [PMID: 10050610 DOI: 10.1590/s1020-49891999000100003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The objective of this work was to contribute local data concerning the full adult height of women in Cordoba, Argentina, and to explore the possibility of a secular trend in their heights. For the study, 513 women were examined during May and June 1994. All of the women were between 18 and 40 years of age and were mothers of children who were included in a study on lactation, feeding, growth, and development in Córdoba. The measurements were carried out applying standardized techniques and using as a reference standard the 50th-percentile level data from the U.S. National Center for Health Statistics. The mean full height of the Córdoba population studied was 157.9 cm, 0.97 standard deviation (SD) below the reference norm. For the women from the highest of six socioeconomic strata, the mean height was 159.7 cm (-0.67 SD); the mean for women from the lowest stratum was 156.2 cm (-1.25 SD). The difference in the means of those two socioeconomic groups was statistically significant (P < 0.001). Of the population studied, 2.3% (6.4% of the lowest social stratum) were shorter than 145 cm. In order to explore the possibility of a secular trend, the resulting data were categorized into two groups according to the mother's age at the time of the anthropometric examination, one group with a mean age of 24 and a second group with a mean age of 34. The younger women had a mean adult height 0.4 cm greater than that of the older women (P = 0.47). This secular increase in height is notably smaller than that reported for other Argentine provinces (1.2 and 1.4 cm/decade) and somewhat lower than the average reported in population studies in Australia, Belgium, the United States, Japan, and Norway (0.6 cm/decade). The authors conclude that in the period analyzed, 1978-1988, the living conditions in the city of Córdoba have not improved in a way that is reflected in a significant increase in the height of adult women. The authors recommend that maternal health and nutrition programs concentrate their resources on the mothers from the lowest socioeconomic stratum who are shorter than 145 cm.
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Affiliation(s)
- F Agrelo
- Ministerio de Salud de la Provincia de Córdoba, Departamento de Maternidad e Infancia, Argentina
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Peckham D, Crouch S, Humphreys H, Lobo B, Tse A, Knox AJ. Effect of antibiotic treatment on inflammatory markers and lung function in cystic fibrosis patients with Pseudomonas cepacia. Thorax 1994; 49:803-7. [PMID: 7522353 PMCID: PMC475128 DOI: 10.1136/thx.49.8.803] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND The acquisition of Pseudomonas cepacia in patients with cystic fibrosis is associated with increasing deterioration in lung function and more frequent hospital admissions. Pseudomonas cepacia is usually resistant to several antibiotics in vitro, but the response of patients colonised with the organism has not been extensively studied in vivo. METHODS A three month prospective study was performed to investigate the response of 14 Ps cepacia positive patients and 10 Ps cepacia negative patients to a two week course of intravenous antibiotics. All those who were Ps cepacia negative and six of the 14 Ps cepacia positive patients had Ps aeruginosa in their sputum which was sensitive to the prescribed therapy. The inflammatory markers C-reactive protein, white blood cell count, serum lactoferrin, neutrophil elastase/alpha 1-antitrypsin complex, and tumour necrosis factor alpha were measured at the start and end of each antibiotic course. RESULTS The median (range) % improvement in baseline FEV1 and FVC following treatment in the group as a whole was 15.2% (-23.5% to 156.3%) and 23.9% (-36.8% to 232.7%) respectively. There was no statistical difference in improvement in lung function, body weight, or inflammatory markers between individuals who were Ps cepacia positive and those who were Ps cepacia negative. CONCLUSIONS Patients who are Ps cepacia positive appear to respond as well to intravenous antibiotics as those who are Ps cepacia negative, despite having lower lung function and a bacterium in their sputum which is resistant in vitro to the antibiotics used.
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Affiliation(s)
- D Peckham
- Division of Respiratory Medicine, City Hospital, Nottingham
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Vijayaram S, Ramamani PV, Chandrashekhar NS, Sudharshan R, Heranjal R, Lobo B, Obedullah D, Bhargava MK. Continuing care for cancer pain relief with oral morphine solution. One-year experience in a regional cancer center. Cancer 1990; 66:1590-5. [PMID: 1698528 DOI: 10.1002/1097-0142(19901001)66:7<1590::aid-cncr2820660725>3.0.co;2-r] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This report is a prospective study of 223 patients with intractable cancer pain who were offered continuing care during the year 1988 at the Pain Relief Unit, Kidwai Memorial Institute of Oncology, Bangalore, India, with a minimum follow-up of 4 months and a maximum follow-up of 16 months. A high percentage of pain relief was attained within a mean duration of 4 days, which on follow-up was maintained at a steady level in most patients (91.1%). Oral morphine could not be continued in three patients because of vomiting. The main side effects noticed were nausea and vomiting, itching, and constipation. At any time during the first 140 days, only 30% of patients had side effects and appropriate medication successfully managed these side effects. During the rest of the study period, the side effects were minimal. Oral morphine used with proper adjuncts offers the best pain palliation in most patients, with minimal side effects.
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Affiliation(s)
- S Vijayaram
- Department of Anaesthetics and Pain Relief, Kidwai Memorial Institute of Oncology, Bangalore, India
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Abstract
The authors report a prospective survey of 88 patients with cancer pain who were treated with oral morphine solution during a period of 140 days at the Pain Relief Unit, Kidwai Memorial Institute of Oncology, Bangalore. A high percentage of pain relief was achieved at the end of the first week of titrated therapy; relief was maintained at satisfactory levels throughout the study period in a majority of patients (86%). Interruption of oral morphine administration was necessitated by intractable vomiting in two patients. The majority of patients (65%) did not manifest any side effects, and appropriate medication successfully managed those who did. Oral morphine therapy for cancer pain offers effective pain relief with minimal side effects in the majority of patients.
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Agrelo F, Lobo B, Bazán M, Mas LB, Lozada C, Jazán G, Orellana L. [Prevalence of thinness and excessive fatness in a group of school children of the city of Cordoba, Argentina]. Arch Latinoam Nutr 1988; 38:69-80. [PMID: 3256287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Findings of a nutritional evaluation study, using triceps skinfold, are reported. The study was carried out in 1,615 school-children from 5 to 12 years, pertaining to the low socioeconomic status of the city of Córdoba, Argentina. Measurements were done during the years 1983 and 1984 by Center's examiners with a Lange caliper, according to international anthropometric methodology. Interintra observer technical error was found to be within tolerance limits reported by other authors. Local standards were used to determine the prevalence of thinness and excessive fatness, by comparing them to tricep skinfold of each child, and selecting those children where this parameter presented values less than or equal to 10th percentile and fatness greater than or equal to 90th percentile. Furthermore, comparison between median triceps skinfold of the examined group, the local standards and Frisancho's norms for US population was also made. Results revealed that: a) the prevalence of thinness (19.9%) was almost twice the percentage expected for a normal population; in contrast, occurrence of excessive fatness (6.4%) was found to be below the expected value; b) prevalence of thinness was not statistically associated to age nor sex; c) frequency of excessive fatness was significantly higher in the 8-11 year-old male group (8, 9%, p much less than 0.0005) and in the girls group (10.8%), P much less than 0.005) the prevalence of fatness in girls increased with age, and figures revealed that from eight years onwards this exceeded the expected percentage, and d) median triceps skinfold of the group under study was generally below local and foreign norms. It is concluded that potential or real nutrition problems as those mentioned above, may be grossly identified using the triceps skinfold as the single anthropometric indicator.
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Affiliation(s)
- F Agrelo
- Centro de Estudios del crecimiento y Desarrollo del Niño Hospital Pediátrico del Niño Jesús Córdoba, Argentina
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Lobo B. [25th anniversary of the National Nursing School of Caracas]. Bol Asoc Venez Enferm Prof 1966; 5:41-5. [PMID: 5178593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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