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1.
Contact Dermatitis ; 89(4): 250-258, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37579775

RESUMEN

INTRODUCTION: Insufficient knowledge about protection and care of the skin among Danish hospital cleaners, particularly immigrant cleaners, is guessed to be a widespread issue that can increase the likelihood of them developing occupational hand eczema (OHE). This study aimed to design and validate 10 pictograms and 10 short video clips showing recommendations for skin care that would help prevent OHE among professional cleaners. METHODS: Ten pictograms and 10 short, educational video clips, based on standard, recommended information were developed in collaboration with a medical illustrator and a video director. The materials were validated in a two-step process that included bus drivers (primary validation) and professional cleaners (secondary validation). RESULTS: During the primary validation, 5 of the 10 pictograms (50%) were comprehended correctly by at least 85%. Those that were misinterpreted, were modified and retested several times until they were understood correctly by at least 85%. During the secondary validation, all 10 pictograms achieved acceptable levels of comprehension among professional cleaners. All the video clips were comprehended correctly by both bus drivers and cleaners. CONCLUSION: Ten easy-to-understand pictograms and 10 educational video clips for cleaners about the prevention of OHE have been designed and validated.


Asunto(s)
Dermatitis Alérgica por Contacto , Dermatitis Profesional , Humanos , Comprensión , Dermatitis Profesional/prevención & control , Piel , Cuidados de la Piel
2.
Brain Behav Immun ; 99: 147-156, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34624483

RESUMEN

BACKGROUND: There is increasing evidence that dysregulation of polyunsaturated fatty acids (FAs) mediated membrane function plays a role in the pathophysiology of schizophrenia. Even though preclinical findings have supported the anti-inflammatory properties of omega-3 FAs on brain health, their biological roles as anti-inflammatory agents and their therapeutic role on clinical symptoms of psychosis risk are not well understood. In the current study, we investigated the relationship of erythrocyte omega-3 FAs with plasma immune markers in a clinical high risk for psychosis (CHR) sample. In addition, a mediation analysis was performed to examine whether previously reported associations between omega-3 FAs and clinical outcomes were mediated via plasma immune markers. Clinical outcomes for CHR participants in the NEURAPRO clinical trial were measured using the Brief Psychiatric Rating Scale (BPRS), Schedule for the Scale of Assessment of Negative Symptoms (SANS) and Social and Occupational Functioning Assessment Scale (SOFAS) scales. The erythrocyte omega-3 index [eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA)] and plasma concentrations of inflammatory markers were quantified at baseline (n = 268) and 6 month follow-up (n = 146) by gas chromatography and multiplex immunoassay, respectively. In linear regression models, the baseline plasma concentrations of Interleukin (IL)-15, Intercellular adhesion molecule (ICAM)-1 and Vascular cell adhesion molecule (VCAM)-1 were negatively associated with baseline omega-3 index. In addition, 6-month change in IL-12p40 and TNF-α showed a negative association with change in omega-3 index. In longitudinal analyses, the baseline and 6 month change in omega-3 index was negatively associated with VCAM-1 and TNF-α respectively at follow-up. Mediation analyses provided little evidence for mediating effects of plasma immune markers on the relationship between omega-3 FAs and clinical outcomes (psychotic symptoms and functioning) in CHR participants. Our results indicate a predominantly anti-inflammatory relationship of omega-3 FAs on plasma inflammatory status in CHR individuals, but this did not appear to convey clinical benefits at 6 month and 12 month follow-up. Both immune and non-immune biological effects of omega-3 FAs would be resourceful in understanding the clinical benefits of omega-3 FAs in CHR papulation.


Asunto(s)
Ácidos Grasos Omega-3 , Trastornos Psicóticos , Biomarcadores , Ácidos Docosahexaenoicos , Ácido Eicosapentaenoico , Humanos
3.
Brain Behav Immun ; 103: 50-60, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35341915

RESUMEN

BACKGROUND: Functional outcomes are important measures in the overall clinical course of psychosis and individuals at clinical high-risk (CHR), however, prediction of functional outcome remains difficult based on clinical information alone. In the first part of this study, we evaluated whether a combination of biological and clinical variables could predict future functional outcome in CHR individuals. The complement and coagulation pathways have previously been identified as being of relevance to the pathophysiology of psychosis and have been found to contribute to the prediction of clinical outcome in CHR participants. Hence, in the second part we extended the analysis to evaluate specifically the relationship of complement and coagulation proteins with psychotic symptoms and functional outcome in CHR. MATERIALS AND METHODS: We carried out plasma proteomics and measured plasma cytokine levels, and erythrocyte membrane fatty acid levels in a sub-sample (n = 158) from the NEURAPRO clinical trial at baseline and 6 months follow up. Functional outcome was measured using Social and Occupational Functional assessment Score (SOFAS) scale. Firstly, we used support vector machine learning techniques to develop predictive models for functional outcome at 12 months. Secondly, we developed linear regression models to understand the association between 6-month follow-up levels of complement and coagulation proteins with 6-month follow-up measures of positive symptoms summary (PSS) scores and functional outcome. RESULTS AND CONCLUSION: A prediction model based on clinical and biological data including the plasma proteome, erythrocyte fatty acids and cytokines, poorly predicted functional outcome at 12 months follow-up in CHR participants. In linear regression models, four complement and coagulation proteins (coagulation protein X, Complement C1r subcomponent like protein, Complement C4A & Complement C5) indicated a significant association with functional outcome; and two proteins (coagulation factor IX and complement C5) positively associated with the PSS score. Our study does not provide support for the utility of cytokines, proteomic or fatty acid data for prediction of functional outcomes in individuals at high-risk for psychosis. However, the association of complement protein levels with clinical outcome suggests a role for the complement system and the activity of its related pathway in the functional impairment and positive symptom severity of CHR patients.


Asunto(s)
Proteómica , Trastornos Psicóticos , Ensayos Clínicos como Asunto , Complemento C5 , Proteínas del Sistema Complemento , Citocinas , Ácidos Grasos , Humanos , Aprendizaje Automático , Trastornos Psicóticos/diagnóstico
4.
Int J Mol Sci ; 22(9)2021 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-33922396

RESUMEN

Major depressive disorders (MDDs) are often associated with a deficiency in long-chain omega-3 polyunsaturated fatty acids (ω-3 PUFAs), as well as signs of low-grade inflammation. Epidemiological and dietary studies suggest that a high intake of fish, the major source of ω-3 PUFAs, is associated with lower rates of MDDs. Meta-analyses of randomized placebo-controlled ω-3 PUFAs intervention-trials suggest that primarily eicosapentaenoic acid (EPA), but not docosahexaenoic acid (DHA), is responsible for the proposed antidepressant effect. In this review, we dissect the current biological knowledge on EPA and DHA and their bioactive lipid metabolites to search for a pharmacological explanation of this, to date, unexplained clinical observation. Through enzymatic conversion by cyclooxygenase (COX), lipoxygenase (ALOX), and cytochrome P-450 monooxygenase (CYP), EPA and DHA are metabolized to major anti-inflammatory and pro-resolving lipid mediators. In addition, both ω-3 PUFAs are precursors for endocannabinoids, with known effects on immunomodulation, neuroinflammation, food intake and mood. Finally, both ω-3 PUFAs are crucial for the structure and organization of membranes and lipid rafts. While most biological effects are shared by these two ω-3 PUFAs, some distinct features could be identified: (1) The preferential CYP monooxygenase pathway for EPA and EPA derived eicosanoids; (2) The high CB2 receptor affinities of EPA-derived EPEA and its epoxy-metabolite 17,18-EEQ-EA, while the DHA-derived endocannabinoids lack such receptor affinities; (3) The competition of EPA but not DHA with arachidonic acid (AA) for particular glycerophospholipids. EPA and AA are preferentially incorporated into phosphatidylinositols, while DHA is mainly incorporated into phosphatidyl-ethanolamine, -serine and -choline. We propose that these distinct features may explain the superior antidepressant activity of EPA rich ω-3 PUFAs and that these are potential novel targets for future antidepressant drugs.


Asunto(s)
Antidepresivos/uso terapéutico , Trastorno Depresivo Mayor/tratamiento farmacológico , Ácidos Grasos Omega-3/uso terapéutico , Animales , Trastorno Depresivo Mayor/patología , Humanos
5.
Phys Rev Lett ; 124(6): 062502, 2020 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-32109128

RESUMEN

The nuclei below lead but with more than 126 neutrons are crucial to an understanding of the astrophysical r process in producing nuclei heavier than A∼190. Despite their importance, the structure and properties of these nuclei remain experimentally untested as they are difficult to produce in nuclear reactions with stable beams. In a first exploration of the shell structure of this region, neutron excitations in ^{207}Hg have been probed using the neutron-adding (d,p) reaction in inverse kinematics. The radioactive beam of ^{206}Hg was delivered to the new ISOLDE Solenoidal Spectrometer at an energy above the Coulomb barrier. The spectroscopy of ^{207}Hg marks a first step in improving our understanding of the relevant structural properties of nuclei involved in a key part of the path of the r process.

6.
Phys Rev Lett ; 123(18): 185002, 2019 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-31763898

RESUMEN

Slow dynamics in an amorphous quasi-two-dimensional complex plasma, comprised of microparticles of two different sizes, was studied experimentally. The motion of individual particles was observed using video microscopy, and the self-part of the intermediate scattering function as well as the mean-squared particle displacement was calculated. The long-time structural relaxation reveals the characteristic behavior near the glass transition. Our results suggest that binary complex plasmas can be an excellent model system to study slow dynamics in classical supercooled fluids.

7.
Psychother Psychosom ; 86(5): 292-299, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28903120

RESUMEN

BACKGROUND: Cognitive-behavioural therapy (CBT) is the first-choice treatment in clients with ultra-high risk (UHR) for psychosis. However, CBT is an umbrella term for a plethora of different strategies, and little is known about the association between the intensity and content of CBT and the severity of symptomatic outcome. METHODS: A sample of 268 UHR participants received 6 months of CBT with case management (CBCM) in the context of the multi-centre NEURAPRO trial with monthly assessments of attenuated psychotic symptoms (APS). Using multilevel regressions and controlling for the initial severity of APS, the associations between (1) number of CBCM sessions received and severity of APS and (2) specific CBCM components and severity of APS were investigated. RESULTS: In month 1, a higher number of sessions and more assessment of symptoms predicted an increase in APS, while in month 3, a higher number of sessions and more monitoring predicted a decrease in the level of APS. More therapeutic focus on APS predicted an overall increase in APS. CONCLUSIONS: Our findings indicate that the association between intensity/content of CBCM and severity of APS in a sample of UHR participants depends on the length of time in treatment. CBCM may positively impact the severity of APS later in the course of treatment. Therefore, it would seem important to keep UHR young people engaged in treatment beyond this initial period. Regarding the specific content of CBCM, a therapeutic focus on APS may not necessarily be beneficial in reducing the severity of APS, a possibility in need of further investigation.


Asunto(s)
Manejo de Caso , Terapia Cognitivo-Conductual/métodos , Trastornos Psicóticos/prevención & control , Adolescente , Método Doble Ciego , Ácidos Grasos Omega-3/administración & dosificación , Femenino , Humanos , Masculino , Escalas de Valoración Psiquiátrica , Factores de Riesgo
8.
Aust N Z J Psychiatry ; 51(10): 1041-1051, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28670977

RESUMEN

OBJECTIVE: Ventricular enlargement is common in established schizophrenia; however, data from ultra high-risk for psychosis and first-episode psychosis studies are inconclusive. This study aims to investigate ventricular volumes at different stages of psychosis. METHODS: Ventricular volumes were measured using a semi-automated and highly reliable method, for 89 established schizophrenia, 162 first-episode psychosis, 135 ultra high-risk for psychosis and 87 healthy controls using 1.5T magnetic resonance images. Clinical outcome diagnoses for ultra high-risk for psychosis were evaluated at long-term follow-up (mean: 7.5 years). RESULTS: Compared to controls, we identified significant ventricular enlargement of 36.2% in established schizophrenia ( p < 0.001). Ventricular enlargement was not significant in first-episode psychosis (6%) or ultra high-risk for psychosis (-3%). Examination across stages of schizophrenia-spectrum diagnoses subgroups revealed a significant linear trend ( p = 0.006; established schizophrenia = 36.2%, first-episode psychosis schizophrenia = 18.5%, first-episode psychosis schizophreniform = -4.2% and ultra high-risk for psychosis-schizophrenia converters = -18.5%). CONCLUSION: Ventricular enlargement is apparent in patients with established schizophrenia but is not a feature at the earliest stages of illness (ultra high-risk for psychosis and first-episode psychosis). Further research is needed to fully characterize the nature and timing of ventricular volume changes early in the course of illness and how these changes impact outcomes.


Asunto(s)
Ventrículos Cerebrales/patología , Progresión de la Enfermedad , Trastornos Psicóticos/patología , Esquizofrenia/patología , Adolescente , Adulto , Ventrículos Cerebrales/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Masculino , Trastornos Psicóticos/diagnóstico por imagen , Riesgo , Esquizofrenia/diagnóstico por imagen , Adulto Joven
9.
Phys Rev Lett ; 116(12): 125001, 2016 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-27058083

RESUMEN

Complex (dusty) plasmas allow experimental studies of various physical processes occurring in classical liquids and solids by directly observing individual microparticles. A major problem is that the interaction between microparticles is generally not molecularlike. In this Letter, we propose how to achieve a molecularlike interaction potential in laboratory 2D complex plasmas. We argue that this principal aim can be achieved by using relatively small microparticles and properly adjusting discharge parameters. If experimentally confirmed, this will make it possible to employ complex plasmas as a model system with an interaction potential resembling that of conventional liquids.

10.
Phys Rev Lett ; 116(13): 132501, 2016 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-27081972

RESUMEN

In this contribution it is explored whether γ-ray spectroscopy following ß decay with high Q values from mother nuclei with low ground-state spin can be exploited as a probe for the pygmy dipole resonance. The suitability of this approach is demonstrated by a comparison between data from photon scattering, ^{136}Xe(γ,γ^{'}), and ^{136}I [J_{0}^{π}=(1^{-})]→^{136}Xe^{*} ß-decay data. It is demonstrated that ß decay populates 1^{-} levels associated with the pygmy dipole resonance, but only a fraction of those. The complementary insight into the wave functions probed by ß decay is elucidated by calculations within the quasiparticle phonon model. It is demonstrated that ß decay dominantly populates complex configurations, which are only weakly excited in inelastic scattering experiments.

11.
Phys Rev Lett ; 116(11): 112503, 2016 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-27035298

RESUMEN

The neutron-rich nucleus ^{144}Ba (t_{1/2}=11.5 s) is expected to exhibit some of the strongest octupole correlations among nuclei with mass numbers A less than 200. Until now, indirect evidence for such strong correlations has been inferred from observations such as enhanced E1 transitions and interleaving positive- and negative-parity levels in the ground-state band. In this experiment, the octupole strength was measured directly by sub-barrier, multistep Coulomb excitation of a post-accelerated 650-MeV ^{144}Ba beam on a 1.0-mg/cm^{2} ^{208}Pb target. The measured value of the matrix element, ⟨3_{1}^{-}∥M(E3)∥0_{1}^{+}⟩=0.65(+17/-23) eb^{3/2}, corresponds to a reduced B(E3) transition probability of 48(+25/-34) W.u. This result represents an unambiguous determination of the octupole collectivity, is larger than any available theoretical prediction, and is consistent with octupole deformation.

12.
Ther Umsch ; 72(10): 619-32, 2015 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-26423880

RESUMEN

Adolescence is associated with a dramatic surge in suicide rate. While worldwide age-adjusted suicides rate per 100'000 in under 14-year olds are relatively low around 0.6, a dramatic increase to 7.4 can be observed in 15 ­ 19 year olds with suicide being one of the three leading causes of mortality in most countries in this age group. From 2000 to 2013 the Swiss annual average of completed suicides in 15 ­ 19 year olds was 33.1 (minimum 24; maximum 47). This corresponds to an average age-specific death rate of 7.6, which is slightly above the global mean. Suicide prevention and treatment of suicidality in adolescents is a complex underpinning. Subjectively experienced feelings of insufficiency, hopelessness and the feeling of worthlessness combined with concrete suicidal ideations and the capacity to act out are important indicators for assessing suicidal risk. Suicide attempts as the strongest risk factor for suicide should always be taken seriously, even if they occur in the context of situational crisis. Narcissistic personality traits or increased impulsivity are further indicators of risk. The early detection and effective treatment of mental disorders such as depression, anxiety disorders, bipolar-affective disorders or psychotic disorders provide a great opportunity to reduce the frequency of suicide attempts and suicide. Particular caution is required when co-morbid addictions are present. The maintenance or establishment of sustainable relationships with significant others is considered a key protecting factor. Increasing withdrawal from significant others is an important warning sign and needs urgent involvement of experts. In acute suicidality, the admission to a psychiatric hospital must be considered, if necessary against the will of affected adolescent and their relatives. Personality-related recurrent suicidal behavior requires specific treatment approaches taking into account the prevention of iatrogenic worsening of suicidal patterns.


Asunto(s)
Psicología del Adolescente/métodos , Prevención del Suicidio , Suicidio/psicología , Adolescente , Femenino , Humanos , Masculino , Medición de Riesgo , Suicidio/estadística & datos numéricos , Suiza/epidemiología , Adulto Joven
13.
Blood ; 120(24): 4706-11, 2012 Dec 06.
Artículo en Inglés | MEDLINE | ID: mdl-23047822

RESUMEN

An urgent need for new treatment modalities is emerging in elderly patients with acute myeloid leukemia (AML). We hypothesized that targeting VEGF might furnish an effective treatment modality in this population. Elderly patients with AML were randomly assigned in this phase 2 study (n = 171) to receive standard chemotherapy (3 + 7) with or without bevacizumab at a dose of 10 mg/kg intravenously at days 1 and 15. In the second cycle, patients received cytarabine 1000 mg/m(2) twice daily on days 1-6 with or without bevacizumab. The complete remission rates in the 2 arms were not different (65%). Event-free survival at 12 months was 33% for the standard arm versus 30% for the bevacizumab arm; at 24 months, it was 22% and 16%, respectively (P = .42). The frequencies of severe adverse events (SAEs) were higher in the bevacizumab arm (n = 63) compared with the control arm (n = 28; P = .043), but the percentages of death or life-threatening SAEs were lower in the bevacizumab arm (60% vs 75% of SAEs). The results of the present study show that the addition of bevacizumab to standard chemotherapy does not improve the therapeutic outcome of older AML patients. This trial is registered as number NTR904 in The Nederlands Trial Register (www.trialregister.nl).


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Leucemia Mieloide/tratamiento farmacológico , Enfermedad Aguda , Anciano , Anciano de 80 o más Años , Anticuerpos Monoclonales Humanizados/administración & dosificación , Anticuerpos Monoclonales Humanizados/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Bélgica , Bevacizumab , Investigación Biomédica , Supervivencia sin Enfermedad , Esquema de Medicación , Femenino , Neoplasias Hematológicas/diagnóstico , Neoplasias Hematológicas/terapia , Humanos , Cooperación Internacional , Tiempo de Internación , Masculino , Persona de Mediana Edad , Países Bajos , Inducción de Remisión , Suiza , Factores de Tiempo , Resultado del Tratamiento
14.
Phys Rev Lett ; 112(11): 115002, 2014 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-24702381

RESUMEN

We study the onset and characteristics of vortices in complex (dusty) plasmas using two-dimensional simulations in a setup modeled after the PK-3 Plus laboratory. A small number of microparticles initially self-arranges in a monolayer around the void. As additional particles are introduced, an extended system of vortices develops due to a nonzero curl of the plasma forces. We demonstrate a shear-thinning effect in the vortices. Velocity structure functions and the energy and enstrophy spectra show that vortex flow turbulence is present that is in essence of the "classical" Kolmogorov type.


Asunto(s)
Modelos Teóricos , Nanopartículas , Gases em Plasma , Simulación por Computador , Tamaño de la Partícula , Transición de Fase
15.
Artículo en Inglés | MEDLINE | ID: mdl-38600049

RESUMEN

AIM: Lithium, even at low doses, appears to offer neuroprotection against a wide variety of insults. In this controlled pilot, we examined the safety (i.e., side-effect profile) of lithium in a sample of young people identified at ultra-high risk (UHR) for psychosis. The secondary aim was to explore whether lithium provided a signal of clinical efficacy in reducing transition to psychosis compared with treatment as usual (TAU). METHODS: Young people attending the PACE clinic at Orygen, Melbourne, were prescribed a fixed dose (450 mg) of lithium (n = 25) or received TAU (n = 78). The primary outcome examined side-effects, with transition to psychosis, functioning and measures of psychopathology assessed as secondary outcomes. RESULTS: Participants in both groups were functionally compromised (lithium group GAF = 56.6; monitoring group GAF = 56.9). Side-effect assessment indicated that lithium was well-tolerated. 64% (n = 16) of participants in the lithium group were lithium-adherent to week 12. Few cases transitioned to psychosis across the study period; lithium group 4% (n = 1); monitoring group 7.7% (n = 6). There was no difference in time to transition to psychosis between the groups. No group differences were observed in other functioning and symptom domains, although all outcomes improved over time. CONCLUSIONS: With a side-effect profile either comparable to, or better than UHR antipsychotic trials, lithium might be explored for further research with UHR young people. A definitive larger trial is needed to determine the efficacy of lithium in this cohort.

16.
Exp Dermatol ; 22(4): 284-9, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23528215

RESUMEN

Over the past few years, the application of cold atmospheric plasma (CAP) in medicine has developed into an innovative field of research of rapidly growing importance. One promising new medical application of CAP is cancer treatment. Different studies revealed that CAP may potentially affect the cell cycle and cause cell apoptosis or necrosis in tumor cells dependent on the CAP device and doses. In this study, we used a novel hand-held and battery-operated CAP device utilizing the surface micro discharge (SMD) technology for plasma production in air and consequently analysed dose-dependent CAP treatment effects on melanoma cells. After 2 min of CAP treatment, we observed irreversible cell inactivation. Phospho-H2AX immunofluorescence staining and Flow cytometric analysis demonstrated that 2 min of CAP treatment induces DNA damage, promotes induction of Sub-G1 phase and strongly increases apoptosis. Further, protein array technology revealed induction of pro-apoptotic events like p53 and Rad17 phosphorylation of Cytochrome c release and activation of Caspase-3. Interestingly, using lower CAP doses with 1 min of treatment, almost no apoptosis was observed but long-term inhibition of proliferation. H3K9 immunofluorescence, SA-ß-Gal staining and p21 expression revealed that especially these low CAP doses induce senescence in melanoma cells. In summary, we observed differences in induction of apoptosis or senescence of tumor cells in respond to different CAP doses using a new CAP device. The mechanism of senescence with regard to plasma therapy was so far not described previously and is of great importance for therapeutic application of CAP.


Asunto(s)
Melanoma/terapia , Gases em Plasma/uso terapéutico , Neoplasias Cutáneas/terapia , Apoptosis , Línea Celular Tumoral , Fragmentación del ADN , Diseño de Equipo , Puntos de Control de la Fase G1 del Ciclo Celular , Humanos , Melanoma/metabolismo , Melanoma/patología , Neoplasias Cutáneas/metabolismo , Neoplasias Cutáneas/patología
17.
Ann Hematol ; 92(8): 1049-56, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23572137

RESUMEN

Despite the revolutionary change in the prognosis of chronic myeloid leukemia (CML) patients with the introduction of imatinib, patients with resistant disease still pose a considerable problem. In this multicenter, randomized phase III trial, we investigate whether the combination of high-dose imatinib and intermediate-dose cytarabine compared to high-dose imatinib alone, improves the rate of major molecular response (MMR) in newly diagnosed CML patients. This study was closed prematurely because of declining inclusion due to the introduction of second generation tyrosine kinase inhibitors and only one third of the initially required patients were accrued. One hundred nine patients aged 18-65 years were randomly assigned to either imatinib 800 mg (n = 55) or to imatinib 800 mg in combination with two successive cycles of cytarabine 200 mg/m(2) for 7 days (n = 54). After a median follow-up of 41 months, 67 % of patients were still on protocol treatment. The MMR rate at 12 months was 56 % in the imatinib arm and 48 % in the combination arm (p = 0.39). Progression-free survival was 96 % after 1 year and 89 % after 4 years. Four-year overall survival was 97 %. Adverse events grades 3 and 4 were more common in the combination arm. The addition of intermediate-dose of cytarabine to imatinib did not improve the MMR rate at 12 months. However, the underpowering of the study precludes any definitive conclusions. This trial is registered at www.trialregister.nl (NTR674).


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Benzamidas/uso terapéutico , Leucemia Mieloide de Fase Crónica/tratamiento farmacológico , Piperazinas/uso terapéutico , Inhibidores de Proteínas Quinasas/uso terapéutico , Pirimidinas/uso terapéutico , Adolescente , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Benzamidas/administración & dosificación , Benzamidas/efectos adversos , Citarabina/administración & dosificación , Citarabina/efectos adversos , Supervivencia sin Enfermedad , Terminación Anticipada de los Ensayos Clínicos , Femenino , Enfermedades Gastrointestinales/inducido químicamente , Enfermedades Hematológicas/inducido químicamente , Humanos , Mesilato de Imatinib , Infecciones/etiología , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Dolor/inducido químicamente , Piperazinas/administración & dosificación , Piperazinas/efectos adversos , Inhibidores de Proteínas Quinasas/administración & dosificación , Inhibidores de Proteínas Quinasas/efectos adversos , Pirimidinas/administración & dosificación , Pirimidinas/efectos adversos , Tamaño de la Muestra , Resultado del Tratamiento , Adulto Joven
18.
J Am Acad Child Adolesc Psychiatry ; 62(9): 998-1009, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-36806728

RESUMEN

OBJECTIVE: To compare psychiatric emergencies and self-harm at emergency departments (EDs) 1 year into the pandemic, to early pandemic and pre-pandemic, and to examine the changes in the characteristics of self-harm presentations. METHOD: This retrospective cohort study expanded on the Pandemic-Related Emergency Psychiatric Presentations (PREP-kids) study. Routine record data in March to April of 2019, 2020, and 2021 from 62 EDs in 25 countries were included. ED presentations made by children and adolescents for any mental health reasons were analyzed. RESULTS: Altogether, 8,174 psychiatric presentations were recorded (63.5% female; mean [SD] age, 14.3 [2.6] years), 3,742 of which were self-harm presentations. Rate of psychiatric ED presentations in March to April 2021 was twice as high as in March to April 2020 (incidence rate ratio [IRR], 1.93; 95% CI, 1.60-2.33), and 50% higher than in March to April 2019 (IRR, 1.51; 95% CI, 1.25-1.81). Rate of self-harm presentations doubled between March to April 2020 and March to April 2021 (IRR, 1.98; 95% CI, 1.68-2.34), and was overall 1.7 times higher than in March to April 2019 (IRR, 1.70; 95% CI, 1.44-2.00). Comparing self-harm characteristics in March to April 2021 with March to April 2019, self-harm contributed to a higher proportion of all psychiatric presentations (odds ratio [OR], 1.30; 95% CI, 1.05-1.62), whereas female representation in self-harm presentations doubled (OR, 1.98; 95% CI, 1.45-2.72) and follow-up appointments were offered 4 times as often (OR, 4.46; 95% CI, 2.32-8.58). CONCLUSION: Increased pediatric ED visits for both self-harm and psychiatric reasons were observed, suggesting potential deterioration in child mental health. Self-harm in girls possibly increased and needs to be prioritized. Clinical services should continue using follow-up appointments to support discharge from EDs. DIVERSITY & INCLUSION STATEMENT: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.


Asunto(s)
COVID-19 , Conducta Autodestructiva , Niño , Humanos , Femenino , Adolescente , Masculino , Pandemias , Estudios Retrospectivos , COVID-19/epidemiología , Conducta Autodestructiva/epidemiología , Conducta Autodestructiva/psicología , Servicio de Urgencia en Hospital
19.
Appl Environ Microbiol ; 78(15): 5077-82, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22582068

RESUMEN

Physical cold atmospheric surface microdischarge (SMD) plasma operating in ambient air has promising properties for the sterilization of sensitive medical devices where conventional methods are not applicable. Furthermore, SMD plasma could revolutionize the field of disinfection at health care facilities. The antimicrobial effects on Gram-negative and Gram-positive bacteria of clinical relevance, as well as the fungus Candida albicans, were tested. Thirty seconds of plasma treatment led to a 4 to 6 log(10) CFU reduction on agar plates. C. albicans was the hardest to inactivate. The sterilizing effect on standard bioindicators (bacterial endospores) was evaluated on dry test specimens that were wrapped in Tyvek coupons. The experimental D(23)(°)(C) values for Bacillus subtilis, Bacillus pumilus, Bacillus atrophaeus, and Geobacillus stearothermophilus were determined as 0.3 min, 0.5 min, 0.6 min, and 0.9 min, respectively. These decimal reduction times (D values) are distinctly lower than D values obtained with other reference methods. Importantly, the high inactivation rate was independent of the material of the test specimen. Possible inactivation mechanisms for relevant microorganisms are briefly discussed, emphasizing the important role of neutral reactive plasma species and pointing to recent diagnostic methods that will contribute to a better understanding of the strong biocidal effect of SMD air plasma.


Asunto(s)
Atmósfera/química , Bacterias/efectos de los fármacos , Candida albicans/efectos de los fármacos , Gases em Plasma/farmacología , Esporas Bacterianas/efectos de los fármacos , Esterilización/métodos , Recuento de Colonia Microbiana , Gases em Plasma/análisis , Espectrofotometría Ultravioleta
20.
Phys Rev Lett ; 109(16): 162502, 2012 Oct 19.
Artículo en Inglés | MEDLINE | ID: mdl-23215071

RESUMEN

The neutron-rich lead isotopes, up to (216)Pb, have been studied for the first time, exploiting the fragmentation of a primary uranium beam at the FRS-RISING setup at GSI. The observed isomeric states exhibit electromagnetic transition strengths which deviate from state-of-the-art shell-model calculations. It is shown that their complete description demands the introduction of effective three-body interactions and two-body transition operators in the conventional neutron valence space beyond (208)Pb.

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