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1.
J Invertebr Pathol ; 124: 44-50, 2015 Jan.
Article En | MEDLINE | ID: mdl-25450740

Propolis is a substance derived from antimicrobial plant resins that honey bees use in the construction of their nests. Propolis use in the hive is an important component of honey bee social immunity and confers a number of positive physiological benefits to bees. The benefits that bees derive from resins are mostly due to their antimicrobial properties, but it is unknown how the diversity of antimicrobial activities among resins might impact bee health. In our previous work, we found that resins from different North American Populus spp. differed in their ability to inhibit in vitro growth of the bee bacterial pathogen Paenibacillus larvae. The goal of our current work was to characterize the antimicrobial activity of propolis from 12 climatically diverse regions across the US against the bee pathogens P. larvae and Ascosphaera apis and compare the metabolite profiles among those samples using LC-MS-based metabolomic methods. Samples differed greatly in their ability to inhibit both bacterial and fungal growth in vitro, but propolis from Nevada, Texas, and California displayed high activity against both pathogens. Interestingly, propolis from Georgia, New York, Louisiana, and Minnesota were active against A. apis, but not very active against P. larvae. Metabolomic analysis of regional propolis samples revealed that each sample was compositionally distinct, and LC-FTMS profiles from each sample contained a unique number of shared and exclusive peaks. Propolis from Aspen, CO, Tuscon, AZ, and Raleigh, NC, contained relatively large numbers of exclusive peaks, which may indicate that these samples originated from relatively unique botanical sources. This is the first study to characterize how the diversity of bee preferred resinous plants in the US may affect bee health, and could guide future studies on the therapeutic potential of propolis for bees.


Anti-Infective Agents/pharmacology , Ascomycota/physiology , Bees/microbiology , Paenibacillus/physiology , Propolis/pharmacology , Animals , Ascomycota/drug effects , Geography , Host-Pathogen Interactions/drug effects , Larva/drug effects , Larva/physiology , Microbial Sensitivity Tests , Paenibacillus/drug effects
2.
Cogn Affect Behav Neurosci ; 14(1): 129-46, 2014 Mar.
Article En | MEDLINE | ID: mdl-24481850

Why is it that behaviors that rely on control, so striking in their diversity and flexibility, are also subject to such striking limitations? Typically, people cannot engage in more than a few-and usually only a single-control-demanding task at a time. This limitation was a defining element in the earliest conceptualizations of controlled processing; it remains one of the most widely accepted axioms of cognitive psychology, and is even the basis for some laws (e.g., against the use of mobile devices while driving). Remarkably, however, the source of this limitation is still not understood. Here, we examine one potential source of this limitation, in terms of a trade-off between the flexibility and efficiency of representation ("multiplexing") and the simultaneous engagement of different processing pathways ("multitasking"). We show that even a modest amount of multiplexing rapidly introduces cross-talk among processing pathways, thereby constraining the number that can be productively engaged at once. We propose that, given the large number of advantages of efficient coding, the human brain has favored this over the capacity for multitasking of control-demanding processes.


Decision Making , Executive Function , Models, Psychological , Computer Simulation , Humans , Stroop Test
3.
J Perinatol ; 33(10): 772-7, 2013 Oct.
Article En | MEDLINE | ID: mdl-23867959

OBJECTIVE: To test the hypothesis that single-nucleotide polymorphisms (SNPs) in Toll-like receptor (TLR) genes alter susceptibility to bacterial infections and modulate white blood cell (WBC) counts during infections in very low birth weight (VLBW) infants (birth weight <1500 g). STUDY DESIGN: VLBW infants recruited in a multicenter study were genotyped for nine functional TLR SNPs and associations between SNPs and infection rates examined. WBC counts obtained during infections were compared among infants with and without SNPs. RESULT: In our cohort (n=408), 90 infants developed bacterial infections. Presence of TLR4 (rs4986790 and rs4986791) variants were associated with Gram-negative (G-ve) infections. Female infants heterozygous for the X-linked IRAK1 (rs1059703) SNP had less G-ve infections. In regression models controlling for confounders, the TLR4 (rs4986790) SNP was associated with increased G-ve infections. The TLR5 (rs5744105) variant was associated with elevated WBC counts during infections. CONCLUSION: TLR genetic variants can contribute to increased risk of bacterial infections and altered immune responses in VLBW infants.


Genetic Predisposition to Disease/genetics , Gram-Negative Bacterial Infections/genetics , Infant, Premature, Diseases/genetics , Infant, Very Low Birth Weight/physiology , Polymorphism, Single Nucleotide/genetics , Toll-Like Receptors/genetics , Black or African American/genetics , Female , Genetic Variation , Gram-Negative Bacterial Infections/blood , Humans , Immunity, Innate/genetics , Infant, Newborn , Infant, Premature , Interleukin-1 Receptor-Associated Kinases/genetics , Leukocyte Count , Logistic Models , Male , Risk Factors , Toll-Like Receptor 4/genetics , Toll-Like Receptor 5/genetics , White People/genetics
4.
Front Neurosci ; 6: 106, 2012.
Article En | MEDLINE | ID: mdl-22822389

Recent studies have begun to elucidate the neural correlates of evidence accumulation in perceptual decision making, but few of them have used a combined modeling-electrophysiological approach to studying evidence accumulation. We introduce a multivariate approach to EEG analysis with which we can perform a comprehensive search for the neural correlate of dynamics predicted by accumulator models. We show that the dynamics of evidence accumulation are most strongly correlated with ramping of oscillatory power in the 4-9 Hz theta band over the course of a trial, although it also correlates with oscillatory power in other frequency bands. The rate of power decrease in the theta band correlates with individual differences in the parameters of drift diffusion models fitted to individuals' behavioral data.

5.
Toxicol Appl Pharmacol ; 257(1): 74-83, 2011 Nov 15.
Article En | MEDLINE | ID: mdl-21906609

Sunitinib, an oral tyrosine kinase inhibitor approved to treat advanced renal cell carcinoma and gastrointestinal stroma tumor, is associated with clinical cardiac toxicity. Although the precise mechanism of sunitinib cardiotoxicity is not known, both the key metabolic energy regulator, AMP-activated protein kinase (AMPK), and ribosomal S 6 kinase (RSK) have been hypothesized as causative, albeit based on rodent models. To study the mechanism of sunitinib-mediated cardiotoxicity in a human model, induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) having electrophysiological and contractile properties of native cardiac tissue were investigated. Sunitinib was cardiotoxic in a dose-dependent manner with an IC50 in the low micromolar range, observed by a loss of cellular ATP, an increase in oxidized glutathione, and induction of apoptosis in iPSC-CMs. Pretreatment of iPSC-CMs with AMPK activators AICAR or metformin, increased the phosphorylation of pAMPK-T172 and pACC-S79, but only marginally attenuated sunitinib mediated cell death. Furthermore, additional inhibitors of AMPK were not directly cytotoxic to iPSC-CMs up to 250 µM concentrations. Inhibition of RSK with a highly specific, irreversible, small molecule inhibitor (RSK-FMK-MEA) did not induce cytotoxicity in iPSC-CMs below 250 µM. Extensive electrophysiological analysis of sunitinib and RSK-FMK-MEA mediated conduction effects were performed. Taken together, these findings suggest that inhibition of AMPK and RSK are not a major component of sunitinib-induced cardiotoxicity. Although the exact mechanism of cardiotoxicity of sunitinib is not known, it is likely due to inhibition of multiple kinases simultaneously. These data highlight the utility of human iPSC-CMs in investigating the potential molecular mechanisms underlying drug-induced cardiotoxicity.


Indoles/toxicity , Induced Pluripotent Stem Cells/drug effects , Myocytes, Cardiac/drug effects , Pyrroles/toxicity , Receptor Protein-Tyrosine Kinases/antagonists & inhibitors , AMP-Activated Protein Kinase Kinases , Blotting, Western , Cell Survival/drug effects , Electrophysiological Phenomena/drug effects , Enzyme Activation/drug effects , Humans , Induced Pluripotent Stem Cells/physiology , Myocardial Contraction/drug effects , Myocytes, Cardiac/physiology , Protein Kinases/metabolism , Ribosomal Protein S6 Kinases, 90-kDa/antagonists & inhibitors , Ribosomal Protein S6 Kinases, 90-kDa/metabolism , Sunitinib
6.
Plant Cell ; 22(6): 1749-61, 2010 Jun.
Article En | MEDLINE | ID: mdl-20562234

Auxin is an essential phytohormone that regulates many aspects of plant development. To identify new genes that function in auxin signaling, we performed a genetic screen for Arabidopsis thaliana mutants with an alteration in the expression of the auxin-responsive reporter DR5rev:GFP (for green fluorescent protein). One of the mutants recovered in this screen, called weak auxin response1 (wxr1), has a defect in auxin response and exhibits a variety of auxin-related growth defects in the root. Polar auxin transport is reduced in wxr1 seedlings, resulting in auxin accumulation in the hypocotyl and cotyledons and a reduction in auxin levels in the root apex. In addition, the levels of the PIN auxin transport proteins are reduced in the wxr1 root. We also show that WXR1 is ROOT UV-B SENSITIVE2 (RUS2), a member of the broadly conserved DUF647 domain protein family found in diverse eukaryotic organisms. Our data indicate that RUS2/WXR1 is required for auxin transport and to maintain the normal levels of PIN proteins in the root.


Arabidopsis Proteins/metabolism , Arabidopsis/genetics , Indoleacetic Acids/metabolism , Plant Roots/metabolism , Arabidopsis/growth & development , Arabidopsis/metabolism , Arabidopsis Proteins/genetics , Gene Expression Regulation, Plant , Membrane Transport Proteins/metabolism , Molecular Sequence Data , Mutation , Phylogeny , Plant Growth Regulators/metabolism , Plant Roots/growth & development , RNA, Plant/genetics , Seedlings/growth & development
7.
Vaccine ; 28(2): 452-62, 2009 Dec 11.
Article En | MEDLINE | ID: mdl-19857448

In an effort to broaden the immune response induced by the RTS,S/AS02(A),vaccine, we have evaluated the immunogenicity of the RTS,S antigen when combined with MSP1(42) and with AMA1, antigens derived from the asexual blood stage. The objectives of this study were (i) to determine whether MSP1(42) and AMA1 vaccines formulated with the AS02(A) Adjuvant System were safe and immunogenic in the rhesus monkey model; (ii) to investigate whether MSP1(42) or AMA1 induced immune interference to each other, or to RTS,S, when added singly or in combinations at a single injection site; (iii) in the event of immune interference, to determine if this could be reduced when antigens were administered at separate sites. We found that MSP1(42) and AMA1 were safe and immunogenic, eliciting antibodies, and Th1 and Th2 responses using IFN-gamma and IL-5 as markers. When malaria antigens were delivered together in one formulation, MSP1(42) and RTS,S reduced AMA1-specific antibody responses as measured by ELISA however, only MSP1(42) lowered parasite growth inhibitory activity of anti-AMA1 antibodies as measured by in vitro growth inhibition assay. Unlike RTS,S, MSP1(42) significantly reduced AMA1 IFN-gamma and IL-5 responses. MSP1(42) suppression of AMA1 IFN-gamma responses was not seen in animals receiving RTS,S+AMA1+MSP1(42) suggesting that RTS,S restored IFN-gamma responses. Conversely, AMA1 had no effect on MSP1(42) antibody and IFN-gamma and IL-5 responses. Neither AMA1 alone or combined with MSP1(42) affected RTS,S antibody or IFN-gamma and IL-5 responses. Immune interference by MSP1(42) on AMA1 antibody responses was also evident when AMA1, MSP1(42) and RTS,S were administered concurrently at separate sites. These results suggest that immune interference may be complex and should be considered for the design of multi-antigen, multi-stage vaccines against malaria.


Antigens, Protozoan/immunology , Macaca mulatta/immunology , Malaria Vaccines/immunology , Membrane Proteins/immunology , Merozoite Surface Protein 1/immunology , Plasmodium falciparum/immunology , Protozoan Proteins/immunology , Animals , Malaria Vaccines/adverse effects , Merozoite Surface Protein 1/adverse effects
8.
Ultrasound Obstet Gynecol ; 34(1): 43-6, 2009 Jul.
Article En | MEDLINE | ID: mdl-19565536

OBJECTIVES: Preterm delivery is the leading cause of major perinatal morbidity and mortality associated with triplet pregnancies. The objective of this study was to evaluate the efficacy of ultrasound-indicated cervical cerclage in triplet pregnancies that are diagnosed with cervical shortening on biweekly transvaginal sonography (TVS). METHODS: A retrospective review of all triplets who were followed with biweekly TVS for measurement of cervical length was conducted. Cervical shortening was defined as cervical length

Cerclage, Cervical , Cervical Length Measurement/methods , Cervix Uteri/surgery , Obstetric Labor, Premature/prevention & control , Triplets , Adult , Birth Weight , Cervix Uteri/diagnostic imaging , Female , Gestational Age , Humans , Infant, Newborn , Infant, Very Low Birth Weight , Pregnancy , Pregnancy Outcome , Retrospective Studies , Risk Factors
9.
Proc Natl Acad Sci U S A ; 106(26): 10415-22, 2009 Jun 30.
Article En | MEDLINE | ID: mdl-19556548

InfoMax and FastICA are the independent component analysis algorithms most used and apparently most effective for brain fMRI. We show that this is linked to their ability to handle effectively sparse components rather than independent components as such. The mathematical design of better analysis tools for brain fMRI should thus emphasize other mathematical characteristics than independence.


Algorithms , Brain Mapping/methods , Magnetic Resonance Imaging/methods , Brain/diagnostic imaging , Brain/physiology , Computer Simulation , Humans , Image Interpretation, Computer-Assisted , Image Processing, Computer-Assisted , Radiography , Reproducibility of Results , Signal Processing, Computer-Assisted
10.
Clin Exp Immunol ; 155(3): 395-402, 2009 Mar.
Article En | MEDLINE | ID: mdl-19220830

In rheumatoid arthritis (RA) there are currently no good indicators to predict a clinical response to rituximab. The purpose of this study was to monitor and determine the role of peripheral blood cytokine profiling in differentiating between a good versus poor response to rituximab in RA. Blood samples were collected at baseline and at 3 months from 46 RA patients who were treated with rituximab. Responders are defined by the presence of three of four American College of Rheumatology criteria: >or=20% decrease in C-reactive protein, visual analogical score of disease activity, erythrocyte sedimentation rate and improvement of the disease activity score (28) (four values) by >or=1.2 obtained at 3 months. Twelve cytokines were measured from serum collected on days 0 and 90 by proteomic array, including interleukin-6 (IL-6), tumour necrosis factor-alpha, IL-1a, IL-1b, IL-2, IL-8, interferon-gamma, IL-4, IL-10, monocyte chemoattractant protein-1, epidermal growth factor and vascular growth factor. We showed that C-reactive protein and IL-6 levels decrease significantly at 3 months in the responder group compared with baseline. At day 90 we identified a cytokine profile which differentiates responders and non-responders. High serum levels of two proinflammatory cytokines, monocyte chemoattractant protein-1 and epidermal growth factor, were significantly higher in the responder group at day 90 compared with non-responders. However, we were not able to identify a baseline cytokine profile predictive of a good response at 3 months. These findings suggest that cytokine profiling by proteomic analysis may be a promising tool for monitoring rituximab and may help in the future to identify responder RA patients.


Antibodies, Monoclonal/therapeutic use , Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/drug therapy , Cytokines/blood , Protein Array Analysis , Aged , Antibodies, Monoclonal, Murine-Derived , Arthritis, Rheumatoid/immunology , Blood Sedimentation , C-Reactive Protein/analysis , Chemokine CCL2/blood , Epidermal Growth Factor/blood , Humans , Interleukin-6/immunology , Logistic Models , Middle Aged , Rituximab , Severity of Illness Index , Time Factors , Treatment Failure
13.
Clin Exp Immunol ; 153(2): 188-95, 2008 Aug.
Article En | MEDLINE | ID: mdl-18549443

In rheumatoid arthritis (RA) there are currently no useful indicators to predict a clinical response to tumour necrosis factor-alpha (TNF-alpha) blockade. The purpose of this study was to determine the role of peripheral blood cytokine profiling in differentiating between a good versus poor response to etanercept in RA. Peripheral blood samples were collected at baseline and at 3 months from 33 patients with active disease who were treated twice weekly by etanercept therapy. Responders are defined by the presence of three of four American College of Rheumatology criteria: > or =20% decrease in C-reactive protein (CRP), visual analogue score of disease activity, erythrocyte sedimentation rate and improvement of the disease activity score (28; four values) by > or =1.2 obtained at 3 months. Twelve cytokines were measured from serum collected on days 0 and 90 by proteomic array (protein biochip array, Investigator Evidence, Randox France), including interleukin (IL)-6, TNF-alpha, IL-1a, IL-1b, IL-2, IL-8, interferon-gamma, IL-4, IL-10, monocyte chemoattractant protein (MCP)-1, epidermal growth factor (EGF) and vascular endothelium growth factor. Our results showed that high serum levels of MCP-1 and EGF were associated with a response to etanercept. In addition, the increase of two combined parameters CRP and EGF was predictive of a response to etanercept treatment at 3 months (sensitivity: 87.5% and specificity: 75%, accuracy: 84.4%). These findings suggest that cytokine profiling by proteomic analysis before treatment initiation may help to identify a responder patient to TNF-alpha blocking agents in RA.


Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/drug therapy , Arthritis, Rheumatoid/immunology , Cytokines/genetics , Immunoglobulin G/therapeutic use , Receptors, Tumor Necrosis Factor/therapeutic use , Adult , Arthritis, Rheumatoid/blood , Biomarkers/blood , C-Reactive Protein/analysis , Epidermal Growth Factor/blood , Etanercept , Female , Gene Expression Profiling/methods , Humans , Logistic Models , Male , Middle Aged , Protein Array Analysis , Treatment Outcome
14.
Infect Immun ; 76(1): 229-38, 2008 Jan.
Article En | MEDLINE | ID: mdl-17954725

Several lines of evidence suggest that targeting pre-erythrocytic-stage parasites for malaria vaccine development can provide sterile immunity. The objectives of this study were (i) to evaluate preclinically the safety and immunogenicity of a new recombinant pre-erythrocytic-stage antigen, liver-stage antigen 1 (LSA1), in nonhuman primates; and (ii) to investigate the potential for immune interference between LSA1 and the leading malaria vaccine candidate, RTS,S, by comparing the immune responses after single-antigen vaccination to responses after simultaneous administration of both antigens at separate sites. Using a rhesus monkey model, we found that LSA1 formulated with the GlaxoSmithKline proprietary adjuvant system AS01B (LSA1/AS01B) was safe and immunogenic, inducing high titers of antigen-specific antibody and CD4+ T-cell responses, as monitored by the production of interleukin-2 and gamma interferon, using intracellular cytokine staining. RTS,S/AS01B vaccination was well tolerated and demonstrated robust antibody and moderate CD4+ T-cell responses to circumsporozoite protein (CSP) and HBsAg. Positive CD8+ T-cell responses to HBsAg were detected, whereas the responses to CSP and LSA1 were negligible. For both LSA1/AS01B and RTS,S/AS01B, no statistically significant differences were observed between individual and concurrent administration in the magnitude or duration of antibody and T-cell responses. Our results revealed that both pre-erythrocytic-stage antigens were safe and immunogenic, administered either separately or simultaneously to rhesus monkeys, and that no significant immune cross interference occurred with concurrent separate-site administration. The comparison of the profiles of immune responses induced by separate-site and single-site vaccinations with LSA1 and RTS,S warrants further investigation.


Adjuvants, Immunologic/pharmacology , Antigens, Protozoan/immunology , Lipid A/analogs & derivatives , Macaca mulatta/immunology , Malaria Vaccines/immunology , Malaria, Falciparum/prevention & control , Plasmodium falciparum/immunology , Saponins/pharmacology , Adjuvants, Immunologic/administration & dosage , Animals , Antibodies, Protozoan/blood , Antigens, Protozoan/administration & dosage , CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/immunology , Cytokines/metabolism , Lipid A/administration & dosage , Lipid A/pharmacology , Malaria Vaccines/administration & dosage , Malaria Vaccines/adverse effects , Saponins/administration & dosage , Time Factors
15.
Plant Biol (Stuttg) ; 8(3): 340-5, 2006 May.
Article En | MEDLINE | ID: mdl-16807826

Indole-3-acetic acid (IAA) is found in plants in both free and conjugated forms. Within the group of conjugated IAA there is a unique class of proteins and peptides where IAA is attached directly to the polypeptide structure as a prosthetic group. The first gene, IAP1, encoding for a protein with IAA as a prosthetic group, was cloned from bean (Phaseolus vulgaris). It was shown that the expression of IAP1 as a major IAA modified protein in bean seed (PvIAP1) was correlated to a developmental period of rapid growth during seed development. Moreover, this protein underwent rapid degradation during germination. Since further molecular analysis was difficult in bean, the IAP1 gene was transformed into Arabidopsis thaliana and Medicago truncatula. Expression of the bean IAP1 gene in both plant species under the control of its native promoter targeted protein expression to the seeds. In Arabidopsis no IAA was found to be attached to PvIAP1. These results show that there is specificity to protein modification by IAA and suggests that protein conjugation may be catalyzed by species specific enzymes. Furthermore, subcellular localization showed that in Arabidopsis PvIAP1 was predominantly associated with the microsomal fraction. In addition, a related protein and several smaller peptides that are conjugated to IAA were identified in Arabidopsis. Further research on this novel class of proteins from Arabidopsis will both advance our knowledge of IAA proteins and explore aspects of auxin homeostasis that were not fully revealed by studies of free IAA and lower molecular weight conjugates.


Arabidopsis/metabolism , Indoleacetic Acids/metabolism , Phaseolus/metabolism , Plant Growth Regulators/metabolism , Plant Proteins/metabolism , Arabidopsis/genetics , Homeostasis/physiology , Medicago truncatula/genetics , Medicago truncatula/metabolism , Phaseolus/genetics , Plants, Genetically Modified/metabolism
16.
J Sports Med Phys Fitness ; 45(3): 409-18, 2005 Sep.
Article En | MEDLINE | ID: mdl-16230994

AIM: To determine the reliability of monitoring penile transcutaneous oxygen (tpO2) during cycling, and to assess the influence of seat design and cycling position on tpO2. EXPERIMENTAL DESIGN: repeated measures analysis of the effects of seat design and riding position on tpO2 values. PARTICIPANTS: 31 male cyclists between the ages of 20 and 50 years participated. Subject inclusion criteria were: averaged=or>80 miles of road bicycling per week during the 2 months prior to enrollment in this study; no history of vascular disease, diabetes, or sexual dysfunction; and had an erection within 15 days prior to study. MEASURES: mean tpO2 values were calculated for seated and standing positions using 3 current bicycle seat designs. RESULTS: Test-retest reliability for seated cycling tpO2 values had an ICC (3,1) of 0.76 and mean absolute difference of 5.1 mmHg. Test-retest reliability for standing cycling tpO2 values had an ICC(3,1) of 0.88 and mean absolute difference of 7.23 mmHg. No interaction effect occurred between seat design and position. Seat design had no significant effect on tpO2 values. Seated cycling significantly reduced tpO2 levels compared with standing cycling (P<0.05). Mean percent decreases in tpO2 from standing to seated cycling were; Vetta 76%, Terry 73%, and Specialized 62%. CONCLUSION: The data suggest that penile tpO2 monitoring is reliable for use during cycling studies. None of the seats exhibited any significant ability to spare penile tpO2. The implications of decreased penile tpO2 over different time intervals on penile physiology remain to be investigated.


Bicycling/physiology , Blood Gas Monitoring, Transcutaneous/methods , Equipment Design , Penis/blood supply , Adult , Blood Gas Monitoring, Transcutaneous/instrumentation , Equipment Design/adverse effects , Heart Rate/physiology , Humans , Impotence, Vasculogenic/etiology , Impotence, Vasculogenic/prevention & control , Male , Middle Aged , Oxygen/analysis , Penis/physiopathology , Posture/physiology , Reproducibility of Results , Risk Assessment , Risk Factors
17.
Clin Exp Rheumatol ; 23(6): 795-800, 2005.
Article En | MEDLINE | ID: mdl-16396697

OBJECTIVE: To determine whether it may be successful to try another TNF-alpha antagonist (infliximab or etanercept) when one has failed due to non response or the development of side effects. METHODS: In a cohort of 282 patients with rheumatoid arthritis treated with infliximab or etanercept, we observed 38 patients who had received both agents. RESULTS: Twenty-four patients received infliximab first and 14 received etanercept first. Discontinuation was due to a lack of efficiency for 29 patients and to the occurence of an adverse effect for 9 patients. For 25 out of the 38 patients, the switch was a success according to the global physician's assessment 3 months after switching. This result was correlated to a significant decrease of DAS 28 measurements and CRP values (p < 0.05). The response after switching was recorded as a success for 18 out of the 24 patients who were treated with infliximab first, and for 12 out of the 14 patients who were treated with etanercept first. There was no statistical difference concerning the response after the switch between the two groups. Among the 29 patients who discontinued the first anti TNF-alpha treatment due to lack of efficiency, only 6 did not respond to the second anti TNF-alpha treatment. Only one out of the 9 patients who stopped a first anti TNF-alpha treatment after developing a side effect underwent an adverse event with the second anti TNF-alpha treatment. CONCLUSION: Our study suggests that switching between TNF-alpha antagonists seems to be relevant, regardless of which one was used first. It is legitimate to try to switch TNF-alpha blockers before contemplating other therapeutic strategies.


Antibodies, Monoclonal/administration & dosage , Antirheumatic Agents/administration & dosage , Arthritis, Rheumatoid/drug therapy , Immunoglobulin G/administration & dosage , Receptors, Tumor Necrosis Factor/administration & dosage , Adult , Aged , Antibodies, Monoclonal/adverse effects , Antirheumatic Agents/adverse effects , Cohort Studies , Etanercept , Female , Humans , Immunoglobulin G/adverse effects , Infliximab , Male , Middle Aged , Retrospective Studies , Treatment Outcome , Tumor Necrosis Factor-alpha/antagonists & inhibitors
18.
J Hum Hypertens ; 19(1): 33-45, 2005 Jan.
Article En | MEDLINE | ID: mdl-15372064

Sodium reduction is efficacious for primary prevention of hypertension, but the feasibility of achieving this effect is unclear. The objective of the paper is detailed analyses of adherence to and effects of the sodium reduction intervention among overweight adults in the Trials of Hypertension Prevention, Phase II. Sodium reduction (comprehensive education and counselling about how to reduce sodium intake) was tested vs no dietary intervention (usual care) for 36-48 months. A total of 956 white and 203 black adults, ages 30-54 years, with diastolic blood pressure 83-89 mmHg, systolic blood pressure (SBP) <140 mmHg, and body weight 110-165% of gender-specific standard weight were included in the study. At 36 months, urinary sodium excretion was 40.4 mmol/24 h (24.4%) lower in sodium reduction compared to usual care participants (P<0.0001), but only 21% of sodium reduction participants achieved the targeted level of sodium excretion below 80 mmol/24 h. Adherence was positively related to attendance at face-to-face contacts. Net decreases in SBP at 6, 18, and 36 months of 2.9 (P<0.001), 2.0 (P<0.001), and 1.3 (P=0.02) mmHg in sodium reduction vs usual care were associated with an overall 18% lower incidence of hypertension (P=0.048); were relatively unchanged by adjustment for ethnicity, gender, age, and baseline blood pressure, BMI, and sodium excretion; and were observed in both black and white men and women. From these beneficial but modest results with highly motivated and extensively counselled individuals, sodium reduction sufficient to favourably influence the population blood pressure distribution will be difficult to achieve without food supply changes.


Diet, Sodium-Restricted , Directive Counseling , Hypertension/prevention & control , Obesity/diet therapy , Adult , Angiotensins/genetics , Black People , Female , Follow-Up Studies , Genotype , Humans , Hypertension/etiology , Male , Middle Aged , Obesity/complications , Patient Compliance/ethnology , Sex Factors , Treatment Outcome , White People
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