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Perioperative neuromuscular blockade monitoring - a comparison between tertiary centres and with existing guidelines. IRISH MEDICAL JOURNAL 2024; 117:947. [PMID: 38682695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
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16 SARS-COV-2 INFECTION AND VACCINATION PATTERNS DETERMINE LONG-TERM ANTIBODY RESPONSES IN NURSING HOME RESIDENTS: DATA FROM NH-COVAIR. Age Ageing 2022. [PMCID: PMC9620582 DOI: 10.1093/ageing/afac218.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Older Nursing Home Residents (NHRs) are at greatest risk of morbidity and mortality from SARS-CoV-2, particularly in the context of both waning vaccine efficacy and the emergence of Variants-of-Concern (VOCs). However, the determinants of long-term vaccine-induced protective antibody responses are yet to be determined in this group. Methods NH-COVAIR recruited older NHRs for comprehensive clinical and frailty (NH-FRAIL) assessment. Blood samples were obtained pre-vaccination, at 6-weeks and 6-months following primary vaccination and 6-months following booster vaccination. Antibody titres were measured using both an electrochemiluminescence assay and a custom bead-based array (Luminex™) to measure antibody titre and avidity for Wuhan strain/major VOC antigens. Stepwise adjusted linear regression (log-transformed) assessed longitudinal determinants of vaccine-induced antibody responses. Results Of 86 participants (81.1 ± 10.8 years; 65% female), just under half (45.4%) had evidence of previous SARS-CoV-2 infection. All NHRs mounted a significant antibody-response to vaccination at 5 weeks followed by a significant decrease in antibody titre by 6 months. Previous SARS-CoV-2 infection was the strongest predictor of antibody waning at all timepoints (β: 3.59; 2.89, 4.28; P < 0.001 for 6-months). Independent of infection history, both age (β: –0.05; –0.08, –0.02; p<0.001) and frailty (β: –0.22; –0.33, –0.11; p<0.001) were associated with faster antibody waning at 6-months. Cross-reactivity and avidity were significantly lower for Beta (B.1.351) and Gamma (P.1) VOC strains (all p<0.001). Additionally, there was faster antibody waning and significantly reduced antibody avidity to Beta and Gamma VOCs in SARS-CoV-2 naïve NHRs. Conclusion Older NHRs are capable of mounting protective antibody responses to SARS-CoV-2 vaccination. Responses were more durable, with a greater cross-reactivity to and avidity for VOCs in those with previous SARS-CoV-2 infection. Increasing age and greater frailty in NHRs was associated with faster antibody waning. Our findings support ongoing serological surveillance and use of additional vaccine doses in older NHRs, particularly in those without previous SARS-CoV-2 exposure.
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953 PREVIOUS SARS-COV2 INFECTION, AGE AND FRAILTY PREDICT 6-MONTH BNT162B2 VACCINE-INDUCED ANTIBODY TITRE IN NURSING HOME RESIDENTS. Age Ageing 2022. [PMCID: PMC9384287 DOI: 10.1093/ageing/afac124.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Older nursing home residents are the population at greatest risk of morbidity and mortality from SARS-CoV-2 infection. No studies have examined the determinants of long-term antibody responses post-vaccination in this group.
Method
Longitudinal cohort study in residents of 5 nursing homes assessed prior to vaccination and at both 5-weeks and 6-months post SARS-CoV2 vaccine (BNT162b2). Comprehensive clinical assessment was performed, including assessment for comorbidity, frailty (NH-FRAIL) and SARS-CoV-2 infection history. Serum Nucleocapsid and Anti-Spike Receptor Binding Domain (RBD) antibodies were analysed at all timepoints and an in vitro Angiotensin Converting Enzyme (ACE2) Receptor-Spike RBD neutralisation assay used to assess serum neutralisation capacity.
Results
Of 86 participants (81.1 ± 10.8 years; 65% female), just-under half (45.4%; 39/86) had evidence of previous SARS-CoV-2 infection. All participants demonstrated a significant antibody response to vaccination at 5-weeks and a significant decline in this response by 6-months. SARS-CoV-2 infection history was the strongest predictor of antibody titre (log-transformed) at both 5-weeks (β: 3.00; 95% CI [Confidence Interval]: 2.32, 3.70; p < 0.001) and 6-months (β: 3.59; 95% CI: 2.89, 4.28; p < 0.001). Independent of SARS-CoV-2 infection history, both age in years (β: -0.05; 95% CI: −0.08, −0.02; p < 0.001) and frailty (β: -0.22; 95% CI: −0.33, −0.11; p < 0.001) were associated with a lower antibody titre at 6-months. Antibody titres at both 5-weeks and 6-months significantly correlated with in vitro neutralisation capacity.
Conclusion and Implications
In older nursing home residents, SARS-CoV-2 infection history was the strongest predictor of anti-spike antibody titres at 6-months, whilst age and frailty were independently associated with lower titres at 6-months. Antibody titres significantly correlated with in vitro neutralisation capacity. Whilst older SARS-CoV-2 naïve nursing home residents may be particularly vulnerable to breakthrough SARS-CoV-2 infection, the relationship between antibody titres, SARS-CoV-2 infection and clinical outcomes remains to be fully elucidated in this cohort.
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Sickle cell-related fat embolism syndrome: the need for venovenous extracorporeal membrane oxygenation with exchange transfusion, renal replacement therapy and plasma exchange. J Cardiothorac Vasc Anesth 2022; 36:3859-3862. [DOI: 10.1053/j.jvca.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/11/2022] [Accepted: 06/15/2022] [Indexed: 11/11/2022]
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78: Using pre-visit planning and electronic health record messaging to improve liver function and annual lab monitoring in the pediatric cystic fibrosis clinic. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01503-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
BACKGROUND The phenomenon of post-COVID syndrome (PCS) is evolving from an abstract array of non-specific symptoms to an identifiable clinical entity of variable severity. Its frequency and persistence have implications for service delivery and workforce planning. AIMS This study was aimed to assess the prevalence of symptoms consistent with PCS and the subjective degree of recovery in a cohort of healthcare workers, focusing on those who have returned to work. METHODS A study population of 1176 was surveyed when attending for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody testing. Two sub-groups were identified: those with known (i.e. diagnosed on PCR testing) and assumed (i.e. antibody evidence of previous infection) SARs-CoV-2 infection, at least 12 weeks prior to the study. Each group was asked about their subjective degree of recovery and the nature of their persistent symptoms. Results were analysed via excel and SPSS. RESULTS In total, 144 employees showed PCR evidence of previous infection, with 139 of these being infected at least 12 weeks prior to the study. Of these 139, only 19% (n = 26) reported feeling 100% recovered, and 71% reported persistent symptoms. Of those with assumed SARS-CoV-2 infection (n = 78), 32 (41%) were truly asymptomatic since the commencement of the pandemic, while 46 (59%) described symptoms suggestive of possible infection at least 12 weeks prior to the study. Of this latter group, 23% (n = 18) also reported residual symptoms. CONCLUSIONS PCS is prevalent among this group, including those not previously diagnosed with COVID-19. Its' frequency and duration present challenges to employers with regards to the management of work availability and performance.
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Up to 151.106 cumulated fold expansion of encapsulated hips cells in bioreactor over 28 days, and comparison with 2D culture and standard spheroid culture. Cytotherapy 2021. [DOI: 10.1016/s1465324921004734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Letter to the Editor: An Unknown Unknown: Early Identification of Dysphagia in Frail Patients in the Emergency Department. J Nutr Health Aging 2021; 25:1030-1031. [PMID: 34545925 DOI: 10.1007/s12603-021-1653-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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The spectrum of staphylococcal scalded skin syndrome: a case series in children. Clin Exp Dermatol 2019; 45:333-336. [PMID: 31587342 DOI: 10.1111/ced.14116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 09/28/2019] [Accepted: 10/03/2019] [Indexed: 11/28/2022]
Abstract
Staphylococcal scalded skin syndrome (SSSS) is a disease caused by certain toxigenic strains of Staphylococcus aureus. While the classic severe phenotype is widely recognized in children, SSSS in fact exists on a spectrum with mild and moderate variants. Misunderstanding the phenotypic spectrum of SSSS may result in misdiagnosis of an otherwise treatable condition. To increase awareness of the heterogeneity of SSSS, we report four cases that together represent a range of clinical presentations.
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Infection and metabolism – Streptococcus pneumoniae metabolism facing the host environment. Cytokine 2018; 112:75-86. [DOI: 10.1016/j.cyto.2018.07.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 07/15/2018] [Accepted: 07/16/2018] [Indexed: 12/21/2022]
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Severe group A streptococcal infections in mothers and their newborns in London and the South East, 2010-2016: assessment of risk and audit of public health management. BJOG 2018; 126:44-53. [PMID: 30070056 DOI: 10.1111/1471-0528.15415] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE We describe cases of invasive group A Streptococcus (iGAS) in mothers or neonates and assess management according to national guidelines, which recommend administering antibiotics to both mother and neonate if either develops iGAS infection within 28 days of birth and investigation of clusters in maternity units. DESIGN Cross-sectional retrospective study. SETTING AND POPULATION Notified confirmed iGAS cases in either mothers or neonates with onset within 28 days of birth in London and the South East of England between 2010 and 2016 METHOD: Review of public health records of notified cases. MAIN OUTCOME MEASURES Incidence and onset time of iGAS in postpartum mothers and babies, proportion given prophylaxis, maternity unit clusters within 6 months. RESULTS We identified 134 maternal and 21 neonatal confirmed iGAS infections. The incidence (in 100 000 person years) of iGAS in women within 28 days postpartum was 109 (95% CI 90-127) compared with 1.3 in other females aged 15-44. For neonates the incidence was 1.5 (95% CI 9-23). The median onset time was 2 days postpartum [interquartile range (IQR) 0-5 days] for mothers and 12 days (IQR 7-15 days) for neonates. All eligible mothers and most (109, 89%) eligible neonates received chemoprophylaxis. Of 20 clusters (59 cases of GAS and iGAS) in maternity units, two clusters involved possible transmission. However, in 6 of 15 clusters, GAS isolates were not saved for comparison even after relevant guidance was issued. CONCLUSIONS iGAS infection remains a potential postpartum risk. Prophylaxis among neonates and storage of isolates from maternity cases can be improved. TWEETABLE ABSTRACT Are public health guidelines being followed in the management of mothers and their newborns to reduce the risk of iGAS infection?
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648 The barrier abnormality of early-onset pediatric atopic dermatitis results from abnormalities in tight junctions and epidermal lipids, but not differentiation proteins. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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892 Atopic dermatitis endotypes based on allergen sensitization, staphylococcus reactivity, and underlying systemic inflammation. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Energy-Dependent Neutron Transport Theory in Plane Geometry II. Eigenfunctions and Full-Range Completeness. NUCL SCI ENG 2017. [DOI: 10.13182/nse66-a28159] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Energy-Dependent Neutron Transport Theory in Plane Geometry III. Half-Range Completeness and Half-Space Problems. NUCL SCI ENG 2017. [DOI: 10.13182/nse66-a28160] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Comparisons of Exact and SN Solutions of the Monoenergetic Critical Equation with Anisotropic Scattering. NUCL SCI ENG 2017. [DOI: 10.13182/nse65-a19770] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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41: What do internet-based patient evaluations of obstetricians and gynecologists mean? Am J Obstet Gynecol 2017. [DOI: 10.1016/j.ajog.2016.12.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Just a "Puff of Smoke". THE JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY : OFFICIAL ORGAN OF THE LOUISIANA STATE MEDICAL SOCIETY 2017; 169:48. [PMID: 28414666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
CASE A 44 year old woman with a history of stroke s/p aneurysm clipping, seizure, and substance abuse was brought to the hospital after a family member received a call from her friend saying she was acting unusual and may have had a seizure while hanging out on the street. At her baseline, she needed modest assistance in daily activities after her CVA and conversed without issue. Her mother died of a stroke. On exam the patient was afebrile, normotensive with mild tachycardia to 110. The patient moved all her extremities but was lethargic, agitated, responded to pain but would not follow commands and moaned nonsensical speech. Labs were unrevealing with mild leukocytosis (WBC: 11.7 × 109/L);, normal metabolic panel, ammonia, glucose, and a negative urine toxicology. Initial computed tomography (CT); of her head demonstrated atrophy with large area of encephalomalacia in Left middle cerebral artery (MCA); area. Repeat CT, 1 day later showed edema and sulcal effacement in the right occipital, posterior, temporal, and posterior parietal lobes with evolving infarct in right posterior cerebral artery (PCA); and right MCA territories. CT angiogram showed occlusion of the clinoid segments of both internal carotid arteries, consistent with Moyamoya pattern of collateral flow. Neurosurgery was consulted and recommended cerebral bypass. The patient was unable to consent for surgery and her closest relative refused surgery. The patient received supportive therapy with minimal improvements in word findings/ communication and no improvement in inability to perform daily activities. She was accepted to inpatient stroke rehab upon discharge. DISCUSSION Moyamoya disease is a rare vascular condition which leads to progressive stenosis of the internal carotid arteries through wall thickening of the associated arteries which leads to progressive strokes and the development of collateral vessels. Moyamoya is a Japanese term for a "puff of smoke" which describes the appearance on imaging of the small collateral vessels that develop around the progressively blocked arteries. There is a hereditary association and our patient's mother likely had the disease as well. The prognosis is poor and the disease will lead to a cognitive decline with associated CVAs. Treatment includes cerebral revascularization or bypass. The case highlights the need for early diagnosis, as our patient was too debilitated to make medical decisions for treatment at the time of her diagnosis.
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p53, Cyclin D1, p21 (WAF1) and Ki-67 (MIB1) Expression at Invasive Tumour Fronts of Oral Squamous Cell Carcinomas and Development of Local Recurrence. Asian Pac J Cancer Prev 2017; 17:1243-9. [PMID: 27039754 DOI: 10.7314/apjcp.2016.17.3.1243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Expression of p53, cyclin D1, p21 (WAF1) and Ki-67 (MIB1) was evaluated in oral squamous cell carcinoma (OSCC) to test whether levels of these markers at invasive tumour fronts (ITFs) could predict the development of local recurrence. MATERIALS AND METHODS Archived paraffin-embedded specimens from 51 patients with T1/T2 tumours were stained immunohistochemically and analysed quantitatively. Local recurrence-free survival was tested with Kaplan-Meier survival plots (log-rank test) using median values to define low and high expression groups and with a Cox's proportional hazards model in which the expression scores were entered as continuous variables. RESULTS The assessment of expression of all markers was highly reliable, univariate analysis showing that patients with clear surgical margins, with low cyclin D1 and high p21 expression at the ITF had the best local recurrence-free survival. Multivariate analysis showed that these three parameters were independent prognostic factors but that neither p53 nor MIB1 expression were of prognostic value. CONCLUSIONS Assessment of p53, cyclin D1, p21 (WAF1), and Ki-67 (MIB1) at the ITF could help to predict local recurrence in early stage oral squamous cell carcinoma cases.
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PROFICIENCY AT OBJECT CONTROL SKILLS BY NINE- TO TEN-YEAR-OLD CHILDREN IN SOUTH AFRICA: THE NW-CHILD STUDY. Percept Mot Skills 2015; 121:309-32. [PMID: 26334485 DOI: 10.2466/10.pms.121c15x8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Adequate proficiency at object control skills, which is influenced by biological and environmental constraints, underlies the development of more complex sport-specific skills. This study describes proficiency at six object control skills and demographic correlates associated with each skill and each skill criteria in 9- to 10-year-old children who were randomly selected from 20 schools (N=826) and tested with the Test of Gross Motor Development-2. Cross-tabulation and hierarchical linear models were used to analyze the effects of sex (433 boys, 393 girls), ethnicity (619 Black, 207 White), and high (n=312) and low (n= 514) socioeconomic school environments. Twenty-three percent of the sample showed below average proficiency. Significant sex and socioeconomic school environment differences were found favoring boys and children from higher socioeconomic environments, although kicking showed significant interaction effects. It is concluded that environmental opportunities are the primary cause of differences across skills and the rates at which the skills are learned.
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Factors influencing elevated serum apolipoprotein B48 in diabetic and control participants. Br J Biomed Sci 2015; 71:145-50. [PMID: 25562991 DOI: 10.1080/09674845.2014.11669979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Factors influencing the concentration of apolipoprotein B48 (apo B48) at fasting and post-prandial time frames are still being elucidated. This study assesses some possible contributing factors including the presence of type 2 diabetes and gender using an established enzyme-linked immunosorbent assay (ELISA) method. Apo B48 and triglyceride (TG) levels were measured before and for two, four and six hours post-prandially in 49 poorly controlled participants with type 2 diabetes and in 60 apparently healthy participants (controls). Apo B48 levels in the control participants increased post-prandially, peaking at four hours (14.81 ± 7.72 μg/mL) with similar responses demonstrated in TG concentrations. Post-prandial apo B48 levels were significantly higher in male control participants as demonstrated by apo B48 area under the curve (AUC); similar responses were also confirmed in triglyceride AUC. Post-prandial apo B48 concentrations in control participants correlated with HOMA-IR (P < 0.05). Apo B48 continued to increase throughout the six hours in participants with type 2 diabetes (17.73 ± 13.46 μg/mL), when levels were significantly greater than in the control participants (13.04 ± 7.67 μg/mL) (P < 0.05) despite a decrease in accompanying TG levels in participants with type 2 diabetes. Using an ELISA method, this study demonstrated that gender, insulin resistance (as evidenced by HOMA-IR) and diabetes status influence serum apo B48 levels. These effects were only apparent post-prandially.
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Evidence for interstellar origin of seven dust particles collected by the Stardust spacecraft. Science 2014; 345:786-91. [DOI: 10.1126/science.1252496] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Traveling waves in 2D hexagonal granular crystal lattices. GRANULAR MATTER 2014; 16:531-542. [PMID: 27053924 PMCID: PMC4819042 DOI: 10.1007/s10035-014-0487-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Indexed: 06/04/2023]
Abstract
This study describes the dynamic response of a two-dimensional hexagonal packing of uncompressed stainless steel spheres excited by localized impulsive loadings. The dynamics of the system are modeled using the Hertzian normal contact law. After the initial impact strikes the system, a characteristic wave structure emerges and continuously decays as it propagates through the lattice. Using an extension of the binary collision approximation for one-dimensional chains, we predict its decay rate, which compares well with numerical simulations and experimental data. While the hexagonal lattice does not support constant speed traveling waves, we provide scaling relations that characterize the directional power law decay of the wave velocity for various angles of impact. Lastly, we discuss the effects of weak disorder on the directional amplitude decay rates.
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P3.09 STIFFER ARTERIES IN “HEALTHY” SUBJECTS WITH COMPONENTS OF THE METABOLIC SYNDROME. Artery Res 2013. [DOI: 10.1016/j.artres.2013.10.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Abstract
There is a need to find a cure for pulmonary disease in cystic fibrosis (CF), though full benefit of this approach will be restricted to those patients with well-preserved lungs. The most promising route is currently that of a pharmacological mutation-specific approach aiming at correcting the mechanism by which mutations lead to impairment of chloride conductance across respiratory epithelial cells. In the past 14years, 7 candidate drugs (CPX, 4PBA, gentamicin, PTC124, VX-770 or Ivacaftor, VX-809 or Lumacaftor, and Miglustat) have been investigated in CF patients. A postulate of 14 out of the 15 published studies has been that an effective agent had to improve total chloride secretion as assessed in vivo by nasal potential difference measurements. The present review casts a critical look at these studies. Apparent inconsistencies are discussed as well as possible limitations of nasal potential difference measurements as outcome parameters in these trials. Primarily targeting a mutation carried by less than 2% of French CF patients, the 2 Ivacaftor studies could well be a milestone on the long road toward a cure for CF. However, further data on safety and long-term efficacy are obviously needed and the current price of this medication in the US would make it unaffordable for European patients.
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Effects of weak disorder on stress-wave anisotropy in centered square nonlinear granular crystals. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2012; 86:031305. [PMID: 23030910 DOI: 10.1103/physreve.86.031305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2012] [Indexed: 06/01/2023]
Abstract
The present study describes wave propagation characteristics in a weakly disordered two-dimensional granular media composed of a square array of spheres accommodating interstitial cylindrical intruders. Previous investigations, performed experimentally as well as numerically, emphasized that wave-front shapes in similar systems are tunable via choice of material combinations. Here, we investigate the effects of statistical variation in the particle diameters and compare the effects of the resulting disorder in experiments and numerical simulations, finding good agreement.
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50 Nasal potential measurements: repeatability and reproducibility of TCS in patients homozygous for the F508del mutation and healthy controls. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60219-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Stress wave anisotropy in centered square highly nonlinear granular systems. PHYSICAL REVIEW LETTERS 2012; 108:214301. [PMID: 23003261 DOI: 10.1103/physrevlett.108.214301] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 01/30/2012] [Indexed: 06/01/2023]
Abstract
Highly ordered, close packed granular systems present a nonlinear dynamic behavior stemming from the Hertzian contact interaction between particles. We investigated the propagation of elastic stress waves in an uncompressed, centered square array of spherical and cylindrical particles. We show, via experiments and numerical simulations, that systematic variations of the mass and stiffness ratios of the spherical and cylindrical particles lead to large variations in the characteristics of the propagating stress wave fronts traveling through the system. The ability to control the stress wave front properties in these granular systems may allow for the development of new wave-tailoring materials including systems capable of redirecting impact energy.
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Mucoviscidose : les techniques instrumentales de désencombrement des voies aériennes. Rev Mal Respir 2012; 29:128-37. [DOI: 10.1016/j.rmr.2011.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 04/19/2011] [Indexed: 10/14/2022]
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63 Resveratrol improves chloride secretion in cystic fibrosis mice homozygous for the F508del mutation. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60082-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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193 Cystic fibrosis (CF) and non-CF bronchiectasis: a cross-sectional comparison. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60209-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Does a Pre-Operative Urodynamic Diagnosis of Bladder Outflow Obstruction Improve Outcomes from Palliative Transurethral Prostatectomy? Urol Int 2011; 86:85-9. [DOI: 10.1159/000318568] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Accepted: 06/28/2010] [Indexed: 11/19/2022]
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Tigecycline activity: low resistance rates but problematic disc breakpoints revealed by a multicentre sentinel survey in the UK. J Antimicrob Chemother 2010; 65:2602-9. [DOI: 10.1093/jac/dkq370] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Clinical relevance of Exophiala dermatitidis in cystic fibrosis: a case study. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60205-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Isolation of Exophiala dermatitidis in cystic fibrosis: is ECA the optimal medium? J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60136-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Exophiala dermatitidis: can it chronically colonize and infect airways of patients with CF? J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60137-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Introduction to this Special Issue ‘Action Research in Organisational Cybernetics’. SYSTEMIC PRACTICE AND ACTION RESEARCH 2009. [DOI: 10.1007/s11213-009-9130-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
This paper presents results of a collaborative experiment between six laboratories which examined the yields of unstable chromosomal aberrations in human lymphocytes induced in vitro by X-rays over the dose range 0-300 mGy. The work included data points of nominal doses of 0, 3, 5, 6, 10, 20, 30, 50 and 300 mGy. Cells from 24 donors were examined and a total of about 300,000 metaphases were scored. The work was undertaken to determine the limits of sensitivity of the system taking into account variations in scoring data due to inter-donor sample and inter-laboratory effects. Despite the existence of these effects, aberration yields significantly in excess of control values were seen at doses greater than 20 mGy and these were consistent with a linear extrapolation from higher doses. Below 20 mGy the observed dicentric yields were generally lower than background, but not significantly so. Excess acentric aberrations, on the other hand, and centric rings, were higher than the controls but the increase was usually not significant. It is concluded that the statistical uncertainties are such that below 20 mGy this technique cannot distinguish between a linear or a threshold model.
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Peripherally Inserted Central Catheter (PICC) for home IV therapy: a Belgian CF center experience. J Cyst Fibros 2009. [DOI: 10.1016/s1569-1993(09)60365-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Omalizumab for exacerbations of allergic bronchopulmonary aspergillosis in patients with cystic fibrosis. BMJ Case Rep 2009; 2009:bcr07.2008.0379. [PMID: 21686833 DOI: 10.1136/bcr.07.2008.0379] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Anti-IgE therapy was proposed to two teenagers with cystic fibrosis (CF) with allergic bronchopulmonary aspergillosis (ABPA) exacerbation, reluctant to a further course of oral steroids. Both patients experienced ABPA exacerbations within the past 3 years, requiring oral steroid bursts. Clinical, laboratory and radiographic features were consistent with ABPA exacerbations (representing at the time of evaluation the fourth and third episodes for patient 1 and 2, respectively). Total serum IgE was very high, >1000 kU/litre in both cases. Treatment consisting of subcutaneous injections of 375 mg anti-IgE (omalizumab) twice monthly was successful in rapidly improving respiratory symptoms and lung function. Based on clinical and functional improvement, interval between injections was progressively increased and treatment could be withdrawn after 11 injections, without recurrence at 20 weeks of follow-up after withdrawal.
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Cutaneous and Systemic Plasmacytosis. J Cutan Pathol 2008. [DOI: 10.1111/j.0303-6987.2005.320ei.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Transient elastography (FibroScan) in patients with cystic fibrosis. J Cyst Fibros 2008. [DOI: 10.1016/s1569-1993(08)60315-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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[Cystic fibrosis and pseudomonas aeruginosa current and future strategies]. JOURNAL DE PHARMACIE DE BELGIQUE 2007; 62:25-8. [PMID: 17508664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Cystic fibrosis and Pseudomonas aeruginosa current and future strategies Pseudomonas aeruginosa is long recognized as the main pathogen in cystic fibrosis and avoiding or postponing chronic colonization of the lungs by this germ is considered as the most important challenge for the clinicians dedicated to the care of CF patient. The need for early intervention is widely accepted but its optimal modalities are still debated and the failure rate of this approach is estimated around 20%. This underlines the potential of other strategies including attempts to develop an effective vaccine against PA and anti-PA prophylaxis. Surprisingly enough, the latter approach which could involve early use of inhaled antibiotics has never been studied prospectively. In chronically colonized patients, inhaled antibiotics and oral azythromycin are of value, slowing the FEV1 decline and reducing the number of exacerbations. Whether intravenous antibiotics are to be used electively (during exacerbations) or more systematically (every 3 months for example) remains controversial.
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31P-NMR Methods for Investigating Phospholipid-Based Molecular Structure and Dynamics. PHOSPHORUS SULFUR 2006. [DOI: 10.1080/10426509308045634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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