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1.
Br Poult Sci ; 64(3): 377-383, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36607318

RESUMEN

1. Two experiments were conducted to determine the apparent metabolisable energy (AME) and standardised amino acid digestibility coefficients (SIDC) of black soldier fly larvae (BSFL) for broiler chickens.2. The BSFL contained, on a g/kg dry matter basis: crude protein, 486; crude fat, 320; ash, 58.5; neutral detergent fibre, 181; calcium, 6.8 and phosphorus, 9.1.3. In Experiment 1, an AME assay was performed wherein broilers were fed two experimental diets (a maize-soy basal diet and a test diet containing 250 g/kg BSFL) for 4 d from d 18 posthatch. The AME of BSFL was calculated based on the difference between the AME values of basal and test diets. The AME and nitrogen-corrected AME were determined to be 19.1and 18.0 MJ/kg of dry matter, respectively.4. In Experiment 2, the ileal amino acid (AA) digestibility of BSFL was determined using 22-d-old broilers by the direct method and the digesta was collected on d 25. The ratios between the AA and titanium in the diet and digesta were used to calculate the apparent digestibility and then standardised using previously published endogenous losses to estimate the SIDC of AA. The SIDC of Lys, Met, Thr, Val and average SIDC of AA in our BSFL sample were 0.85, 0.90, 0.91, 0.87 and 0.84, respectively.5. The findings showed that the BSFL meal is a good source of available energy and digestible AA, and could be a potential substitute for soybean meal in broiler diets.


Asunto(s)
Pollos , Dípteros , Animales , Pollos/metabolismo , Digestión , Larva/metabolismo , Metabolismo Energético , Alimentación Animal/análisis , Dieta/veterinaria , Aminoácidos/metabolismo , Íleon/metabolismo , Dípteros/metabolismo , Fenómenos Fisiológicos Nutricionales de los Animales
2.
Colorectal Dis ; 20(12): 1125-1131, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30171744

RESUMEN

AIM: Ventral rectopexy (VR) has gained popularity in the management of obstructive defaecation syndrome (ODS) due to a symptomatic rectocele ± intussusception. Data on the efficacy and safety of VR are variable and there are few predictors of successful outcome. This study aimed to examine whether or not an adverse obstetric history influenced the functional outcome following VR for ODS. METHOD: This was a retrospective study of a cohort of 76 consecutive patients who had undergone VR for ODS at a tertiary referral centre between 2012 and 2015. Patients were followed up by telephone questionnaire. The obstetric history and pre- and postoperative symptoms of ODS and faecal incontinence (FI) were obtained from telephone interviews. RESULTS: In this cohort, symptoms of ODS were significantly improved by surgery, with 56% of patients showing a reduction of symptoms of 50% or more (P < 0.001). Subgroup analysis demonstrated that a lower body mass index (BMI; 24.4 vs 27.3 kg/m2 ; P < 0.05) and shorter duration of symptoms (7 vs 10 years; P < 0.05) led to a better outcome. VR had no effect on FI. Obstetric factors such as foetal weight, instrumental delivery, episiotomy, perineal tear and total number of deliveries did not influence outcomes. CONCLUSION: Patients with a less straightforward obstetric history can be reassured that this should not adversely influence the functional outcome after VR for ODS. Colorectal surgeons who offer this surgery should warn patients with an elevated BMI or with longstanding symptoms that the operation may be less successful than for those with a lower BMI or shorter duration of symptoms.


Asunto(s)
Estreñimiento/cirugía , Parto Obstétrico/efectos adversos , Procedimientos Quirúrgicos del Sistema Digestivo/efectos adversos , Obstrucción Intestinal/cirugía , Complicaciones Posoperatorias/etiología , Rectocele/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Estreñimiento/etiología , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Femenino , Humanos , Obstrucción Intestinal/etiología , Intususcepción/complicaciones , Intususcepción/cirugía , Persona de Mediana Edad , Embarazo , Rectocele/complicaciones , Estudios Retrospectivos , Factores de Riesgo , Mallas Quirúrgicas/efectos adversos , Resultado del Tratamiento
3.
N Z Vet J ; 66(5): 257-260, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29874523

RESUMEN

AIM To identify Bartonella spp. in rats from New Zealand using molecular methods. METHODS DNA was extracted from the spleens of 143 black rats (Rattus rattus) captured in the Tongariro National Park, New Zealand. PCR was performed using Bartonella genus-specific primers amplifying segments of the 16S-23S rRNA internal transcribed spacer and citrate synthase (gltA) and beta subunit of the RNA polymerase (rpoB) genes. PCR products were sequenced and compared online with sequences stored in the database of the National Center for Biotechnology Information of the United States of America. RESULTS DNA sequences matching Bartonella coopersplainsensis and B. henselae were detected in samples from 22/143 (15.4%) and 3/143 (2.1%) rats, respectively. Co-occurrence of B. coopersplainsensis and B. henselae sequences was observed in the sample from one rat. CONCLUSIONS AND CLINICAL RELEVANCE Gram-negative fastidious bacteria belonging to the genus Bartonella are associated with a range of human diseases. Rodents play an important role as reservoirs of a broad range of Bartonella species. To our knowledge, this is the first report of a molecular detection of Bartonella spp. DNA in rodents from New Zealand, and the first identification of B. henselae DNA in rats, worldwide. Whereas the public health significance of B. coopersplainsensis remains undefined, B. henselae is the agent of cat scratch disease, and the presence of this bacterium in rats may have public health implications. Our results are preliminary and additional analyses of larger samples, preferably by bacterial culture, would provide more information on the prevalence and diversity of Bartonella spp., in particular B. henselae, in rats.


Asunto(s)
Infecciones por Bartonella/veterinaria , Bartonella/aislamiento & purificación , ADN Bacteriano/análisis , Animales , Infecciones por Bartonella/diagnóstico , Infecciones por Bartonella/epidemiología , Infecciones por Bartonella/transmisión , Cartilla de ADN , Nueva Zelanda/epidemiología , Ratas
4.
Diabet Med ; 34(12): 1658-1666, 2017 12.
Artículo en Inglés | MEDLINE | ID: mdl-28636745

RESUMEN

A wide range of diabetes-directed interventions - including novel medications, devices and comprehensive education programmes - have been shown to be effective in clinical trials. But in the real world of diabetes care their efficacy is often dependent upon on how well a clinician is able to support personal engagement and motivation of the person with diabetes to use these new tools and knowledge consistently, and as directed. Although many person-centred motivational and behavioural strategies have been developed, for example, action planning, motivational interviewing and empowerment-based communication, the sheer number and apparent lack of clear differences among them have led to considerable confusion. The primary goal of this review, therefore, is to provide a practical framework that organizes and structures these programmes to enhance their more systematic use in clinical care. Its purpose is to enhance clinician efforts to respectfully encourage and support engagement and motivation for behaviour change in people with diabetes. The three-step framework for organizing and describing the specific clinical processes involved is based on self-determination theory and includes: clinician preparation for a different type of clinical encounter, clinician/person with diabetes relationship building, and clinician utilization of specific behavioural tools. We conclude with practical considerations for application of this framework to the real world of clinical care.


Asunto(s)
Diabetes Mellitus/terapia , Conductas Relacionadas con la Salud , Motivación , Participación del Paciente/métodos , Sistemas de Apoyo Psicosocial , Autocuidado , Diabetes Mellitus/psicología , Humanos , Autonomía Personal
5.
Clin Infect Dis ; 62(2): 250-257, 2016 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-26349551

RESUMEN

BACKGROUND: CD8 T-cell counts remain elevated in human immunodeficiency virus (HIV) infection even after long-term antiretroviral therapy (ART), which is associated with an increased risk of non-AIDS-related events. We assessed the impact of ART initiation in early versus chronic HIV infection on trajectories of CD8 cell counts over time. METHODS: Of 280 individuals enrolled during primary HIV infection (PHI), 251 were followed up for 24 months; 84 started ART before 6 months of infection (eART), 49 started between 6 and 24 months, and 118 remained untreated. Plasma HIV viral load (VL), CD4 and CD8 cell counts were assessed at each study visit. CD8 counts were also examined in 182 age-matched HIV-infected individuals who started ART during chronic infection and maintained undetectable plasma VL for ≥5 years. RESULTS: At PHI baseline, higher CD8 cell counts were associated with more recent infection (P = .02), higher CD4 cell counts (P < .001), and higher VL (P < .001). The CD8 count in the eART group decreased from 797 to 588 cells/µL over 24 months (P < .001), to a level lower than that in untreated PHI (834 cells/µL; P = .004) or in long-term-treated patients with chronic HIV infection (743 cells/µL; P = .047). More prominent CD4 T-cell recovery was observed in the eART group than in the delayed ART group. CONCLUSIONS: ART initiated in early HIV infection is associated with improved resolution of CD8 T-cell elevation compared with long-term ART initiated in chronic infection. Early ART may help reduce the risk of non-AIDS-related events by alleviating this elevation.


Asunto(s)
Antirretrovirales/administración & dosificación , Linfocitos T CD8-positivos/inmunología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/patología , Prevención Secundaria , Adulto , Femenino , Estudios de Seguimiento , Humanos , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , ARN Viral/sangre , Resultado del Tratamiento , Carga Viral
6.
Ann Oncol ; 27(12): 2251-2257, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-28007754

RESUMEN

BACKGROUND: To evaluate long-term outcome of myeloablative allogeneic stem cell transplantation (allo-SCT) (MAC) versus reduced-intensity allo-SCT (RIC) in patients with relapsed/refractory Hodgkin's lymphoma (HL) in recent years. PATIENTS AND METHODS: A total of 312 patients (63 MAC and 249 RIC) with relapsed/refractory HL who received allo-SCT between 2006 and 2010 and were reported to the EBMT Database were included in the study. RESULTS: With a median follow-up for alive patients of 56 (26-73) months, there were no significant differences in non-relapse mortality (NRM) between MAC and RIC. Relapse rate (RR) was somewhat lower in the MAC group (41% versus 52% at 24 months, P = 0.16). This lower RR translated into a marginal improvement in event-free survival (EFS) for the MAC group (48% versus 36% at 24 months, P = 0.09) with no significant differences in overall survival (73% for MAC and 62% for RIC at 24 months, P = 0.13). Multivariate analysis after adjusting for disease status at the time of allo-SCT showed that the use of MAC was of borderline statistical significance for predicting a lower RR and EFS [HR 0.7, 95% CI (0.5-1.0), P = 0.1] and [HR 0.7, 95% CI (0.5-1.0), P = 0.07], respectively, after allo-SCT. CONCLUSIONS: With modern transplant practices, the NRM associated with MAC for HL has strongly decreased, resulting into non-significant improvement of EFS because of a somewhat better disease control compared with RIC transplants. The intensity of conditioning regimens should be considered when designing individual allo-SCT strategies or clinical trials in patients with relapsed/refractory HL.


Asunto(s)
Enfermedad Injerto contra Huésped/epidemiología , Enfermedad de Hodgkin/terapia , Recurrencia Local de Neoplasia/terapia , Trasplante de Células Madre/métodos , Trasplante Homólogo/métodos , Adulto , Anciano , Médula Ósea , Supervivencia sin Enfermedad , Femenino , Enfermedad Injerto contra Huésped/etiología , Enfermedad Injerto contra Huésped/patología , Enfermedad de Hodgkin/patología , Humanos , Masculino , Recurrencia Local de Neoplasia/patología , Estudios Retrospectivos , Trasplante de Células Madre/efectos adversos , Acondicionamiento Pretrasplante , Trasplante Homólogo/efectos adversos , Resultado del Tratamiento
8.
Lett Appl Microbiol ; 60(2): 120-127, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25371065

RESUMEN

Laboratory studies have shown that small concentrations of silver are effective at inhibiting the growth micro-organisms through the disruption of important cell structures and processes. The additional ability to incorporate silver into surfaces has increased the usage of silver in the medical field and expanded its use into the consumer market. To understand the impact of increased silver-containing antimicrobial use, it is important to determine whether silver-based consumer goods are effective at reducing bacterial populations. Our study examined the antibacterial effectiveness of Agion silver zeolite technology applied to 25 silver- and control-coated door handles across a college campus. Door handles were sampled for 6 week periods in both the fall and spring semester, and bacteria were cultured and enumerated on tryptic soy agar (TSA), MacConkey agar (MAC) and mannitol salt agar (MSA). A significant difference was observed between the bacterial populations isolated from silver- and control-coated door handles after 3 years. However, bacteria were consistently isolated from silver-coated door handles suggesting that the silver zeolite was only effective against a portion of the bacterial populations, and further studies are necessary to determine the identities of the isolated bacteria and the prevalence of silver resistance.


Asunto(s)
Antibacterianos/farmacología , Bacterias/efectos de los fármacos , Desinfectantes/farmacología , Contaminación de Equipos , Artículos Domésticos , Compuestos de Plata/farmacología , Universidades , Carga Bacteriana , Factores de Tiempo , Zeolitas
10.
Occup Med (Lond) ; 64(4): 255-8, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24744344

RESUMEN

BACKGROUND: Although colorectal cancer (CRC) screening is widely recommended, screening rates remain low. Workplace interventions have the potential to increase rates of screening. AIMS: To evaluate the impact of a workplace CRC screening program targeting active duty and retired firefighters. METHODS: A letter, a fecal immunochemical test (FIT) kit and a survey were mailed to all active duty and retired San Francisco firefighters aged 40 and older during 2008-09. The survey included questions about CRC risk factors and prior CRC screening tests. The primary outcome was return of the completed FIT. RESULTS: FIT kits and surveys were sent to 1203 firefighters. In total, 445 individuals (37%) completed the survey, and 400 (33%) completed the FIT. Forty-five per cent of respondents had had a stool test for blood at some time, although few (8%) had had it within the past year. Thirty-six per cent of respondents said they had had a sigmoidoscopy at some time, although only 15% had had it within the past 5 years and 37% within the past 10 years. Among those aged 50 and older, 59% had had a test for colon cancer at some time. CONCLUSIONS: A workplace intervention can increase CRC screening rates in firefighters. Future studies should focus on the long-term sustainability of this type of program.


Asunto(s)
Neoplasias Colorrectales/diagnóstico , Detección Precoz del Cáncer , Bomberos , Tamizaje Masivo , Servicios de Salud del Trabajador , Adulto , Factores de Edad , Anciano , California , Recolección de Datos , Heces , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sangre Oculta , Sigmoidoscopía , Lugar de Trabajo
11.
HIV Med ; 14(1): 10-20, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22639840

RESUMEN

OBJECTIVES: Hepatitis C virus (HCV) has emerged as an important health problem in the era of effective HIV treatment. However, very few data exist on the health status and disease burden of HIV/HCV-coinfected Canadians. METHODS: HIV/HCV-coinfected patients were enrolled prospectively in a multicentre cohort from 16 centres across Canada between 2003 and 2010 and followed every 6 months. We determined rates of a first liver fibrosis or endstage liver disease (ESLD) event and all-cause mortality since cohort enrolment and calculated standardized mortality ratios compared with the general Canadian population. RESULTS: A total of 955 participants were enrolled in the study and followed for a median of 1.4 (interquartile range 0.5-2.3) years. Most were male (73%) with a median age of 44.5 years; 13% self-identified as aboriginal. There were high levels of current injecting drug and alcohol use and poverty. Observed event rates [per 100 person-years; 95% confidence interval (CI)] were: significant fibrosis (10.21; 8.49, 12.19), ESLD (3.16; 2.32, 4.20) and death (3.72; 2.86, 4.77). The overall standardized mortality ratio was 17.08 (95% CI 12.83, 21.34); 12.80 (95% CI 9.10, 16.50) for male patients and 28.74 (95% CI 14.66, 42.83) for female patients. The primary causes of death were ESLD (29%) and overdose (24%). CONCLUSIONS: We observed excessive morbidity and mortality in this HIV/HCV-coinfected population in care. Over 50% of observed deaths may have been preventable. Interventions aimed at improving social circumstances, reducing harm from drug and alcohol use and increasing the delivery of HCV treatment in particular will be necessary to reduce adverse health outcomes among HIV/HCV-coinfected persons.


Asunto(s)
Coinfección/mortalidad , Infecciones por VIH/mortalidad , Hepatitis C/mortalidad , Adulto , Canadá/epidemiología , Causas de Muerte , Costo de Enfermedad , Femenino , Infecciones por VIH/complicaciones , Estado de Salud , Hepatitis C/complicaciones , Humanos , Incidencia , Cirrosis Hepática/epidemiología , Cirrosis Hepática/etiología , Hepatopatías/epidemiología , Hepatopatías/etiología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo
12.
Br J Anaesth ; 108(3): 452-9, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-22298243

RESUMEN

BACKGROUND: Long-held assumptions of poor prognoses for patients with haematological malignancies (HM) have meant that clinicians have been reluctant to admit them to the intensive care unit (ICU). We aimed to evaluate ICU, in-hospital, and 6 month mortality and to identify predictors for in-hospital mortality. METHODS: A cohort study in a specialist cancer ICU of adult HM patients admitted over 5 yr. Data acquired included: patient characteristics, haematological diagnosis, haematopoietic stem cell transplant (HSCT), reason for ICU admission, and APACHE II scores. Laboratory values, organ failures, and level of organ support were recorded on ICU admission. Predictors for in-hospital mortality were evaluated using uni- and multivariate analysis. RESULTS: Of 199 patients, median age was 58 yr [inter-quartile range (IQR) 46-66], 51.7% were emergency admissions, 42.2% post-HSCT, 51.9% required mechanical ventilation, median APACHE II was 21 (IQR 16-25), and median organ failure numbered 2 (IQR 1-4). ICU, in-hospital, and 6 month mortalities were 33.7%, 45.7%, and 59.3%, respectively. Univariate analysis revealed bilirubin >32 µmol litre(-1), mechanical ventilation, ≥2 organ failures, renal replacement therapy, vasopressor support (all P<0.001), graft-vs-host disease (P=0.007), APACHE II score (P=0.02), platelets ≤20×10(9) litre(-1) (P=0.03), and proven invasive fungal infection (P=0.04) were associated with in-hospital mortality. Multivariate analysis revealed that ≥2 organ failures [odds ratio (OR) 5.62; 95% confidence interval (95% CI), 2.30-13.70] and mechanical ventilation (OR 3.03; 95% CI, 1.33-6.90) were independently associated with in-hospital mortality. CONCLUSIONS: Mortality was lower than in previous studies. Mechanical ventilation and ≥2 organ failures were independently associated with in-hospital mortality. 'Traditional' variables such as neutropenia, transplantation status, and APACHE II score no longer appear to be predictive.


Asunto(s)
Neoplasias Hematológicas/terapia , Unidades de Cuidados Intensivos , Servicio de Oncología en Hospital , Anciano , Inglaterra/epidemiología , Femenino , Neoplasias Hematológicas/complicaciones , Neoplasias Hematológicas/diagnóstico , Neoplasias Hematológicas/mortalidad , Trasplante de Células Madre Hematopoyéticas , Mortalidad Hospitalaria , Hospitalización , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Pronóstico , Respiración Artificial , Índice de Severidad de la Enfermedad , Acondicionamiento Pretrasplante/métodos , Resultado del Tratamiento
13.
J Mater Sci Mater Med ; 23(1): 181-93, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22180141

RESUMEN

Calcium alginate/poly-L-lysine beads were coated with either 50% hydrolyzed poly(methyl vinyl ether-alt-maleic anhydride) (PMM(50)), or with poly(vinyl dimethyl azlactone-co-methacrylic acid) (50:50, PMV(50)), to form covalently shell-crosslinked capsules, and compared with analogous capsules coated with sodium alginate. All capsule types were prepared with and without C2C12 murine myoblast cells, and implanted into mice for up to 6 weeks. Cell viability, capsule integrity, fibrotic overgrowth, and mechanical strength of the capsules were assessed, and correlated with inflammatory cytokine marker levels in tail vein blood samples taken at different time points. AP-PMM(50) capsules displayed the least amount of fibrotic overgrowth, were found to be the strongest, and showed the lowest levels of TNF-α in tail vein serum samples taken at 4 h, 24 h, 1 and 6 weeks post transplantation. The results for APA and AP-PMV(50) capsules were more variable and depended on the presence or absence of encapsulated cells.


Asunto(s)
Ingeniería Celular , Electrólitos/química , Animales , Línea Celular , Citocinas/análisis , Ratones , Microscopía Electrónica de Rastreo
14.
S Afr Med J ; 112(8): 526-538, 2022 08 02.
Artículo en Inglés | MEDLINE | ID: mdl-36214396

RESUMEN

BACKGROUND: Antenatal substance use is a significant public health concern in South Africa (SA). Information on smoking, drinking and drug use during pregnancy was collected prospectively for the Safe Passage Study of the PASS (Prenatal Alcohol in Sudden infant death syndrome and Stillbirth) Network. OBJECTIVES: Data from 4 926 pregnant women in a community near Tygerberg Academic Hospital, Cape Town, were examined to determine whether associations between different substance use groups and postnatal infant outcomes at birth and 1 year were significant. METHODS: Gestational age (GA) was determined by earliest ultrasound. Maternal data were collected at enrolment or first antenatal visit. Substance use data were obtained at up to four occasions. Birthweight data were derived from medical records, and birthweight z-scores (BWZs) were specifically calculated using INTERGROWTH-21st study data. Statistical analyses were done with Statistica version 13.  Results. Women who used more substances enrolled later, were younger, and had smaller mid-upper arm circumferences (MUACs), less education and lower monthly income than women who used no substances (control group). Infants born to women who used more substances had lower GA at delivery, birthweight and BWZ than infants from the control group. At 1 year, infants born to women who used more substances had a lower weight, shorter length and smaller head circumference. Education was positively associated with all infant outcomes at birth and 1 year. MUAC was positively associated with infant BWZ, and weight and length at 1 year. Income was negatively associated with BWZ, but positively associated with all 1-year outcomes. CONCLUSION: Substance use during pregnancy affects infant outcomes at birth and 1 year of age. The addictive properties of substance use make cessation difficult, so prevention strategies should be implemented long before pregnancy. Higher maternal education, associated with better infant outcomes at birth and 1 year and acting as a countermeasure to substance use, is of paramount importance.


Asunto(s)
Mortinato , Trastornos Relacionados con Sustancias , Peso al Nacer , Femenino , Humanos , Lactante , Recién Nacido , Embarazo , Resultado del Embarazo/epidemiología , Fumar/efectos adversos , Fumar/epidemiología , Sudáfrica/epidemiología , Trastornos Relacionados con Sustancias/epidemiología
15.
Front Health Serv ; 2: 1024541, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36925803

RESUMEN

Background: Sickle Cell Disease (SCD) is a progressive genetic disease that causes organ damage and reduces longevity. Hydroxyurea is an underutilized evidence-based medication that reduces complications and improves survival in SCD. In a multi-site clinical trial, part of the NIH-funded Sickle Cell Disease Implementation Consortium (SCDIC), we evaluate the implementation of a multi-level and multi-component mobile health (mHealth) patient and provider intervention to target the determinants and context of low hydroxyurea use. Given the complexity of the intervention and contextual variability in its implementation, we combined different behavioral and implementation theories, models, and frameworks to facilitate the evaluation of the intervention implementation. In this report, we describe engagement with stakeholders, planning of the implementation process, and final analytical plan to evaluate the implementation outcomes. Methods: During 19 meetings, a 16-member multidisciplinary SCDIC implementation team created, conceived, and implemented a project that utilized Intervention Mapping to guide designing an intervention and its evaluation plan. The process included five steps: (1) needs assessment of low hydroxyurea utilization, (2) conceptual framework development, (3) intervention design process, (4) selection of models and frameworks, and (5) designing evaluation of the intervention implementation. Results: Behavioral theories guided the needs assessment and the design of the multi-level mHealth intervention. In designing the evaluation approach, we combined two implementation frameworks to best account for the contextual complexity at the organizational, provider, and patient levels: (1) the Consolidated Framework for Implementation Research (CFIR) that details barriers and facilitators to implementing the mHealth intervention at multiple levels (users, organization, intervention characteristics, broader community), and (2) the Technology Acceptance Model (TAM), a conceptual model specific for explaining the intent to use new information technology (including mHealth). The Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM) framework was used to measure the outcomes. Discussion: Our research project can serve as a case study of a potential approach to combining different models/frameworks to help organize and plan the evaluation of interventions to increase medication adherence. The description of our process may serve as a blueprint for future studies developing and testing new strategies to foster evidence-based treatments for individuals living with SCD.

16.
Clin Transplant ; 25(2): 222-7, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-20201951

RESUMEN

Mycophenolate mofetil (MMF) is used to treat acute and chronic graft versus host disease (GvHD). There is scant evidence in the literature about mycophenolic acid (MPA) trough level monitoring in GvHD. We therefore reviewed 32 patients treated with MMF for acute (n = 19) or chronic GvHD (n = 13). Twelve (63%) of 19 patients with acute GvHD and nine (69%) of 13 with chronic GvHD showed a good response. In all 21 patients who responded to MMF, their mean total MPA levels were therapeutic (1-3.5 mg/L), whereas five of 11 patients who did not respond had sub-therapeutic mean MPA levels (p = 0.002). Sixteen (66%) of 24 steroid refractory or dependent patients responded to MMF. Associations between the mean total MPA level for each patient and the corresponding mean serum albumin concentration showed therapeutic mean total MPA levels for all 23 patients with mean albumin ≥ 31 g/L but sub-therapeutic mean total MPA levels in five of nine patients with mean albumin <31 g/L (p = 0.0006). In conclusion, MMF is efficacious in steroid refractory and dependent acute or chronic GvHD with statistically significant correlation between therapeutic plasma total MPA trough levels and clinical response. Serum albumin levels should be taken into account when considering MMF dose adjustments.


Asunto(s)
Albúminas/análisis , Antibióticos Antineoplásicos/farmacocinética , Monitoreo de Drogas , Enfermedad Injerto contra Huésped/prevención & control , Ácido Micofenólico/farmacocinética , Enfermedad Aguda , Adolescente , Adulto , Antibióticos Antineoplásicos/sangre , Área Bajo la Curva , Enfermedad Crónica , Femenino , Supervivencia de Injerto , Trasplante de Células Madre Hematopoyéticas , Humanos , Masculino , Persona de Mediana Edad , Ácido Micofenólico/sangre , Distribución Tisular , Resultado del Tratamiento , Adulto Joven
17.
Australas Phys Eng Sci Med ; 34(3): 345-50, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-21691851

RESUMEN

While clonogenic assays are extensively used in radiobiology, there is no widely accepted procedure for choosing the composition of the cell culture media. Cell line suppliers recommend a specific culture medium for each cell line, however a researcher will frequently customize this aspect of the protocol by supplementing the recommended support medium with additives. For example, many researchers add antibiotics, in order to avoid contamination of cells and the consequent loss of data, with little discussion of the influence of the antibiotics on the clonogenic survival of the cells. It is assumed that the effect of any variables in the growth medium on cell survival is taken into consideration by comparing the survival fraction relative to that of controls grown under the same conditions. In the search for better cancer treatment, the effect of various stressors on clonogenic cell survival is under investigation. This study seeks to identify and test potential stressors commonly introduced into the cell culture medium, which may confound the response to radiation.


Asunto(s)
Supervivencia Celular , Radiobiología/métodos , Ensayo de Tumor de Célula Madre , Proliferación Celular/efectos de los fármacos , Proliferación Celular/efectos de la radiación , Supervivencia Celular/efectos de los fármacos , Supervivencia Celular/efectos de la radiación , Medio de Cultivo Libre de Suero/química , Humanos , Neoplasias Pulmonares/radioterapia , Melanoma/radioterapia , Fármacos Sensibilizantes a Radiaciones/química , Células Tumorales Cultivadas/efectos de la radiación , Ensayo de Tumor de Célula Madre/métodos , Ensayo de Tumor de Célula Madre/normas , Ensayo de Tumor de Célula Madre/estadística & datos numéricos
18.
J Exp Med ; 130(3): 519-41, 1969 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-4185248

RESUMEN

Immunoglobulin heavy chain genes were found in wild mice (Mus musculus) that could best be explained as recombinants of immunoglobulin genotypes. In wild mice from Kitty Hawk, N. C., two new heavy chain linkage groups, G(3,5,7,8)H(9,11)F(f)A(-) and G(3,5,8)H(9,11)F(f)A(-), were found, each of which genetically controls both the 3 and 5 distinct immunoglobulin determinants. In inbred strains the 3 and 5 determinants are found independently. The new heavy chain allotype G(3,5,7,8)H(9,11)F(f)A(-) probably arose from a homologous (intragenic) cross-over between G(3,8)H(9,11)F(f)A(-) and G(5,7,8)H(9,11)F(f)A(14) heavy chain linkage groups. It was suggested that genes controlling G(3,8)G(5,7,8), G(3,5,8), and G(3,5,7,8) are alleles. Another homozygous wild mouse (Kyushu, Japan) showed a new heavy chain allotype, (2)G(1,6,7,8)H(9,16)F(s)A(15). The 2 and G(1,6,7,8) determinants are also separated in inbred strains. The 2 determinant in inbred mice is not on the gammaF, gammaH, or gammaA heavy chain and is probably on a gammaG or gammaG-like immunoglobulin heavy chain. Papain digestion of serum from the Kyushu mouse showed two electrophoretically different Fc fragments, one carrying the G(1,6,7,8) and the other the 2 determinant. The new heavy chain allotype, (2)G(1,6,7,8)H(9,16)F(s)A(15), of the Kyushu wild mouse probably arose from a nonhomologous (unequal) cross over between (2)G(-)H(9,16)F(s)A(15) and G(1,6,7,8)H(9,11)F(f)A(12,13,14) heavy chain linkage groups. The linkage group of the Kyushu wild mouse has at least five heavy chain genes, while that of the inbred mice has four.


Asunto(s)
Intercambio Genético , Genes , Ratones , gammaglobulinas/análisis , Animales , Anticuerpos Antiidiotipos/análisis , Sangre , Análisis Químico de la Sangre , Cruzamiento , Genotipo , Sueros Inmunes/análisis , Inmunodifusión , Inmunoelectroforesis , Papaína/metabolismo , Fenotipo
19.
J Exp Med ; 144(6): 1554-67, 1976 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-1003103

RESUMEN

The intraperitoneal injection of pristane (2,6,10,14-tetramethylpentadecane) produces an environment conductive to primary plasmacytoma growth in as few as 3 days. After pristane injection, the total free peritoneal cell population increases from a normal value of 1.55 X 10(6) to 5.28 X 10(6) and remains at this elevated level for at least 50 days. The adherent peritoneal cell population, composed of both mononuclear cells and polymorphonuclear leukocytes, is the primary source of this increase. In the pristane-conditioned peritoneum, these cells rapidly form a chronic granuloma on the peritoneal connective tissues. Daily subcutaneous treatment of mice with 0.5 mg of hydrocortisone beginning simultaneously with pristane injection prevents the increase in the peritoneal cell population, granuloma formation, d the production of a conditoned environment. In mice treated with hydrocortisone beginning 3 days after pristane injection, however, neither the peritoneal cell increase nor the production of a conditioned environment is prevented. The intraperitoneal injection of thioglycolate medium at 4-day intervals produces an elevation of the free adherent peritoneal cell population similar to pristane, but does not produce a granuloma or a conditioned environment. The intraperitoneal transfer of thioglycolate-induced adherent peritonel cells to mice treated with pristane and hydrocortisone simultaneously restores the production of a conditioned environment. These findings indicate that the adherent peritoneal cell population is responsible for the conditioning effect, and that the establishment of a resident population of these cells is necessary to produce conditioning.


Asunto(s)
Alcanos/farmacología , Hidrocortisona/farmacología , Plasmacitoma/patología , Animales , Líquido Ascítico/citología , Adhesión Celular/efectos de los fármacos , Granuloma/inducido químicamente , Ratones , Ratones Endogámicos BALB C , Trasplante de Neoplasias , Neoplasias Experimentales/patología , Cavidad Peritoneal/citología , Tioglicolatos , Factores de Tiempo
20.
J Exp Med ; 132(4): 737-51, 1970 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-4101363

RESUMEN

Eight IgA myeloma proteins derived from independently induced plasma-cytomas in genetically similar inbred BALB/c mice are functionally related by their binding of phosphoryl choline-containing antigens (Pneumococcus C polysaccharide or Lactobacillus antigen). Each protein resembles a single species of immunoglobulin in antibody. The proteins are characterized by highly sensitive myeloma-specific antisera prepared by immunizing mice of other inbred strains with the BALB/c myeloma proteins. Individual or myeloma-specific determinants located on Fab fragments were found on three of the proteins that were unique for that protein and did not react with any other IgA protein among over 70 tested. Remarkably, five of the proteins shared two common myeloma-specific determinants which were specific for this group of five proteins. These results suggest that the five functionally and genetically related proteins sharing the same myeloma-specific determinants might also be structurally similar.


Asunto(s)
Reacciones Antígeno-Anticuerpo , Antígenos , Inmunoglobulina G/análisis , Ratones/inmunología , Proteínas de Neoplasias/análisis , Neoplasias Experimentales/inmunología , Plasmacitoma/inmunología , Animales , Colina , Epítopos , Sueros Inmunes , Inmunodifusión , Inmunoglobulinas , Endogamia , Lactobacillus acidophilus/inmunología , Polisacáridos Bacterianos , Especificidad de la Especie , Streptococcus pneumoniae/inmunología
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