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INTRODUCTION: Cardiopulmonary bypass is an essential component of cardiothoracic surgeries. However, significant complications such as systemic inflammatory response syndrome (SIRS) resulting from cardiopulmonary bypass (CPB) are a common occurrence due to contact between circulating blood and foreign surfaces that leads to platelet activation. It is suggested that different available CPB circuit coatings can potentially reduce platelet activation. However, there have been no published evidence-based reports confirming these claims. In addition, there is no well-established protocol for studying platelet activation biomarkers during CPB in vitro in a laboratory setting. METHODS: CPB was simulated in the laboratory using bovine blood in two different types of coated CPB circuits: Trillium® Biosurface by Medtronic, and XcoatingTM Surface by Terumo. Fresh bovine blood samples were collected and circulated through the CPB circuit following the standard protocol used in the operation rooms. Blood samples were then collected at 5 min, 30 min, and 55 min during the circulation. Blood plasmas were separated and subjected to enzyme-linked immunosorbent assay to measure most established platelet activation markers P-selectin, Platelet Factor 4 (PF4), Glycoprotein IIb/IIIa (GPIIb/IIIa), and ß-thromboglobulin (ß-TG) at different time points. RESULTS: The biomarker values at 30 min and 55 min were compared to the base values at 5 min for each type of CPB circuit. The results of the means from all measured biomarkers showed data measurements that indicated no significant variability within each coating. All collected data points fell within ±2 SD of the means, which was considered acceptable variations across technical replicates.⯠Conclusion: In this study, we were able to establish an in vitro protocol in the laboratory setting that is precise and reliable with minimum intra-variability. This established protocol will allow for future studies in which different coated CPB circuits can be compared for their effectiveness in blocking platelet activation during the CPB.
Subject(s)
Biomarkers , Cardiopulmonary Bypass , Coated Materials, Biocompatible , Platelet Activation , Cardiopulmonary Bypass/instrumentation , Cardiopulmonary Bypass/adverse effects , Platelet Activation/physiology , Animals , Biomarkers/blood , Cattle , Materials Testing/methodsABSTRACT
Ocular manifestations of rheumatic diseases are common and contribute significantly to the morbidity and reduced quality of life of affected patients. Knowledge of typical clinical manifestations is important for the rheumatologist in order to support the reference of patients with corresponding symptoms for ophthalmological consultation at an early stage of disease, or to initiate regular screening examinations (e.g. in patients with Behçet's syndrome). Conversely, a (possibly urgent) rheumatological assessment is crucial for certain ophthalmological diseases, in order not to overlook a (possibly fatal) systemic associated disease. Patients with rheumatic or inflammatory ocular diseases should always be informed by the treating physician about possible symptoms of other organ manifestations, in order to avoid a delayed diagnosis. "Classic" associations for uveitis are (HLA-B27-associated) spondyloarthritis and acute anterior uveitis, as well as retinal vasculitis with or without panuveitis and Behçet's syndrome. In patients with rheumatoid arthritis or ANCA-associated vasculitis, however, scleritis (with or without peripheral ulcerative keratitis) typically occurs, but a variety of other findings are also possible. Close interdisciplinary collaboration, particularly regarding therapeutic decisions, is crucial to ensuring a good prognosis for the patient.
Subject(s)
Eye Diseases , Rheumatic Diseases , Humans , Rheumatic Diseases/complications , Rheumatic Diseases/diagnosis , Eye Diseases/etiology , Eye Diseases/diagnosis , Eye Diseases/therapy , Adult , Diagnosis, Differential , Female , MaleABSTRACT
BACKGROUND: Pathophysiological changes in severely burned patients alter the pharmacokinetics (PK) of anti-infective agents, potentially leading to subtherapeutic concentrations at the target site. Albumin supplementation, to support fluid resuscitation, may affect pharmacokinetic properties by binding drugs. This study aimed to investigate the PK of piperacillin/tazobactam in burn patients admitted to the ICU before and after albumin substitution as total and unbound concentrations in plasma. PATIENTS AND METHODS: Patients admitted to the ICU and scheduled for 4.5 g piperacillin/tazobactam administration and 200 mL of 20% albumin substitution as part of clinical routine were included. Patients underwent IV microdialysis, and simultaneous arterial plasma sampling, at baseline and multiple timepoints after drug administration. PK analysis of total and unbound drug concentrations under steady-state conditions was performed before and after albumin supplementation. RESULTS: A total of seven patients with second- to third-degree burns involving 20%-60% of the total body surface were enrolled. Mean (SD) AUC0-8 (h·mg/L) of total piperacillin/tazobactam before and after albumin substitution were 402.1 (242)/53.2 (27) and 521.8 (363)/59.7 (32), respectively. Unbound mean AUC0-8 before and after albumin supplementation were 398.9 (204)/54.5 (25) and 456.4 (439)/64.5 (82), respectively. CONCLUSIONS: Albumin supplementation had little impact on the PK of piperacillin/tazobactam. After albumin supplementation, there was a numerical increase in mean AUC0-8 of total and unbound piperacillin/tazobactam, whereas similar Cmax values were observed. Future studies may investigate the effect of albumin supplementation on drugs with a higher plasma protein binding.
Subject(s)
Anti-Bacterial Agents , Burns , Humans , Anti-Bacterial Agents/therapeutic use , Piperacillin/pharmacokinetics , Penicillanic Acid/pharmacokinetics , Piperacillin, Tazobactam Drug Combination/pharmacokinetics , Burns/complications , Burns/drug therapy , Intensive Care UnitsABSTRACT
Perylene monoimide based electron acceptors have great properties for use in organic solar cells, like thermal stability, strong absorption, and simple synthesis. However, they typically exhibit low values for the dielectric permittivity. This hinders efficient exciton dissociation, limiting the achievable power conversion efficiencies. In this work, we present the synthesis and utilization of two new acceptor-donor-acceptor (A-D-A) molecules, comprising perylene monoimide as electron withdrawing A unit. Oligo ethylene glycol side chain modified carbazole (PMI-[C-OEG]) and fluorene (PMI-[F-OEG]) linkers were used as electron rich D units, respectively. The polar side chains are expected to increase the polarizability of the molecules and, thus, their permittivity according to the Clausius-Mossotti relationship. We found that the incorporation of glycol chains improved the dielectric properties of both materials in comparison to the reference compounds with alkyl chains. The permittivity increased by 18% from 3.17 to 3.75 for the carbazole-based non-fullerene acceptor PMI-[C-OEG] and by 12% from 3.10 to 3.47 for the fluorene-based acceptor PMI-[F-OEG]. The fabricated solar cells revealed power conversion efficiencies of 3.71 ± 0.20% (record 3.92%) with PMI-[C-OEG], and 1.21 ± 0.06% (record 1.51%) with PMI-[F-OEG]. Supplementary Information: The online version contains supplementary material available at 10.1007/s00706-022-02956-2.
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Cu3BiS3 thin films are fabricated via spin coating of precursor solutions containing copper and bismuth xanthates onto planar glass substrates or mesoporous metal oxide scaffolds followed by annealing at 300 °C to convert the metal xanthates into copper bismuth sulfide. Detailed insights into the film formation are gained from time-resolved simultaneous small and wide angle X-ray scattering measurements. The Cu3BiS3 films show a high absorption coefficient and a band gap of 1.55 eV, which makes them attractive for application in photovoltaic devices. Transient absorption spectroscopic measurements reveal that charge generation yields in mesoporous TiO2/Cu3BiS3 heterojunctions can be significantly improved by the introduction of an In2S3 interlayer, and long-lived charge carriers (t50% of 10 µs) are found.
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Organic solar cells have been continuously studied and developed through the last decades. A major step in their development was the introduction of fused-ring non-fullerene electron acceptors. Yet, beside their high efficiency, they suffer from complex synthesis and stability issues. Perylene-based non-fullerene acceptors, in contrast, can be prepared in only a few steps and display good photochemical and thermal stability. Herein, we introduce four monomeric perylene diimide acceptors obtained in a three-step synthesis. In these molecules, the semimetals silicon and germanium were added in the bay position, on one or both sides of the molecules, resulting in asymmetric and symmetric compounds with a red-shifted absorption compared to unsubstituted perylene diimide. Introducing two germanium atoms improved the crystallinity and charge carrier mobility in the blend with the conjugated polymer PM6. In addition, charge carrier separation is significantly influenced by the high crystallinity of this blend, as shown by transient absorption spectroscopy. As a result, the solar cells reached a power conversion efficiency of 5.38 %, which is one of the highest efficiencies of monomeric perylene diimide-based solar cells recorded to date.
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Biobased and biodegradable polymers (BBDs) such as poly(3-hydroxy-butyrate), PHB, and poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) are considered attractive alternatives to fossil-based plastic materials since they are more environmentally friendly. One major problem with these compounds is their high crystallinity and brittleness. In order to generate softer materials without using fossil-based plasticizers, the suitability of natural rubber (NR) as an impact modifier was investigated in PHBV blends. Mixtures with varying proportions of NR and PHBV were generated, and samples were prepared by mechanical mixing (roll mixer and/or internal mixer) and cured by radical C-C crosslinking. The obtained specimens were investigated with respect to their chemical and physical characteristics, applying a variety of different methods such as size exclusion chromatography, Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), thermal analysis, XRD, and mechanical testing. Our results clearly indicate that NR-PHBV blends exhibit excellent material characteristics including high elasticity and durability. Additionally, biodegradability was tested by applying heterologously produced and purified depolymerases. pH shift assays and morphology analyses of the surface of depolymerase-treated NR-PHBV through electron scanning microscopy confirmed the enzymatic degradation of PHBV. Altogether, we prove that NR is highly suitable to substitute fossil-based plasticizers; NR-PHBV blends are biodegradable and, hence, should be considered as interesting materials for a great number of applications.
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BACKGROUND: We previously reported excellent efficacy and improved safety aspects of rapid steroid withdrawal (RSWD) in the randomized controlled 1-year "Harmony" trial with 587 predominantly deceased-donor kidney transplant recipients randomized either to basiliximab or rabbit antithymocyte globulin induction therapy and compared with standard immunosuppressive therapy consisting of basiliximab, low tacrolimus once daily, mycophenolate mofetil and corticosteroids. METHODS: The 5-year post-trial follow-up (FU) data were obtained in an observational manner at a 3- and a 5-year visit only for those Harmony patients who consented to participate and covered clinical events that occurred from the second year onwards. RESULTS: Biopsy-proven acute rejection and death-censored graft loss rates remained low and independent of RSWD. Rapid steroid withdrawal was an independent positive factor for patient survival (adjusted hazard ratio 0.554, 95% confidence interval 0.314-0.976; P = .041).The reduced incidence of post-transplantation diabetes mellitus in RSWD patients during the original 1-year study period was not compensated by later incidences during FU. Incidences of other important outcome parameters such as opportunistic infections, malignancies, cardiovascular morbidity/risk factors, donor-specific antibody formation or kidney function did not differ during FU period. CONCLUSIONS: With all the limitations of a post-trial FU study, the Harmony FU data confirm excellent efficacy and beneficial safety aspects of RSWD under modern immunosuppressive therapy over the course of 5 years after kidney transplantation in an immunologically low-risk, elderly population of Caucasian kidney transplant recipients. Trial registration: Clinical trial registration number: Investigator Initiated Trial (NCT00724022, FU study DRKS00005786).
Subject(s)
Kidney Transplantation , Aged , Humans , Antibodies, Monoclonal , Basiliximab , Follow-Up Studies , Graft Rejection/drug therapy , Graft Rejection/etiology , Graft Rejection/prevention & control , Graft Survival , Immunosuppressive Agents/adverse effects , Kidney Transplantation/adverse effects , Mycophenolic Acid/therapeutic use , Steroids , Tacrolimus/adverse effectsABSTRACT
BACKGROUND: The current development of sensor technologies towards ever more cost-effective and powerful systems is steadily increasing the application of low-cost sensors in different horticultural sectors. In plant in vitro culture, as a fundamental technique for plant breeding and plant propagation, the majority of evaluation methods to describe the performance of these cultures are based on destructive approaches, limiting data to unique endpoint measurements. Therefore, a non-destructive phenotyping system capable of automated, continuous and objective quantification of in vitro plant traits is desirable. RESULTS: An automated low-cost multi-sensor system acquiring phenotypic data of plant in vitro cultures was developed and evaluated. Unique hardware and software components were selected to construct a xyz-scanning system with an adequate accuracy for consistent data acquisition. Relevant plant growth predictors, such as projected area of explants and average canopy height were determined employing multi-sensory imaging and various developmental processes could be monitored and documented. The validation of the RGB image segmentation pipeline using a random forest classifier revealed very strong correlation with manual pixel annotation. Depth imaging by a laser distance sensor of plant in vitro cultures enabled the description of the dynamic behavior of the average canopy height, the maximum plant height, but also the culture media height and volume. Projected plant area in depth data by RANSAC (random sample consensus) segmentation approach well matched the projected plant area by RGB image processing pipeline. In addition, a successful proof of concept for in situ spectral fluorescence monitoring was achieved and challenges of thermal imaging were documented. Potential use cases for the digital quantification of key performance parameters in research and commercial application are discussed. CONCLUSION: The technical realization of "Phenomenon" allows phenotyping of plant in vitro cultures under highly challenging conditions and enables multi-sensory monitoring through closed vessels, ensuring the aseptic status of the cultures. Automated sensor application in plant tissue culture promises great potential for a non-destructive growth analysis enhancing commercial propagation as well as enabling research with novel digital parameters recorded over time.
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OBJECTIVE: Several case reports have been published on the effect of janus kinase inhibitors (JAK-I) on juvenile idiopathic arthritis-associated uveitis (JIAU). Both tofacitinib and baricitinib have been described as therapeutically effective in JIAU. METHODS: We here present a case of a 24-years-old female with refractory course of JIAU receiving upadacitinib therapy. RESULTS: After failing multiple conventional and biologic disease-modifying antirheumatic drugs, the patient finally achieved clinical remission on upadacitinib monotherapy, despite a previously unsatisfactory clinical response of both arthritis and uveitis to tofacitinib monotherapy. CONCLUSION: This case suggests that switching JAK-I might be a successful strategy in the treatment of JIAU, despite previously incomplete response to other preparations.
Subject(s)
Antirheumatic Agents , Arthritis, Juvenile , Janus Kinase Inhibitors , Uveitis , Adult , Humans , Female , Young Adult , Arthritis, Juvenile/complications , Arthritis, Juvenile/diagnosis , Arthritis, Juvenile/drug therapy , Antirheumatic Agents/therapeutic use , Uveitis/diagnosis , Uveitis/drug therapy , Uveitis/etiology , Janus Kinase Inhibitors/therapeutic useABSTRACT
Adventitious root (AR) formation is the basis of vegetative propagation in rose, be it via stem cuttings or via stenting. During this process, wounding plays a pivotal role since cell reprogramming takes place at the tissue adjacent to the wound. We investigated the effects of wounding on AR formation on leafy single-node stem cuttings of the rose rootstock R. canina 'Pfänder' (codes R02-3 and R02-6) and the cut rose cultivar Rosa 'Tan09283' (Registration name 'Beluga'). Laser wounding treatments were based on the assisted removal of tissue layers located in the bark. The positioning of wounding was studied based on two marking directions: along the cutting base (strip pattern) and around the cutting base (ring pattern). Additionally, the effects of external supply of indole-butyric acid (IBA 1 mg L-1) on rooting were analyzed. Results showed that in order to remove specific tissue layers, the calculation of the laser energy density (J cm-2) in terms of cutting diameter was necessary. Interestingly, the application of energy densities from 2.5 J cm-2 up to approximately 8.5 J cm-2 were sufficient to expose the tissue layers of epidermis up to regions of phloem. Regarding AR formation for R. canina 'Pfänder', characterized by a low rooting response, an increase in the rooting percentage was registered when the laser treatment eliminated the tissue up to phloem proximities. Analysis of the nodal position showed that bud location was a preferential place for AR formation independently of wounding treatment. In case of Rosa 'Tan09283', laser treatments did not reduce its high rooting capacity, but an apparent reduction in rooting quality due to an investment in tissue healing was observed when wounding reached deeper layers such as parenchyma and sclerenchyma. Results also showed a strong AR formation directly from wounded regions in case of Rosa 'Tan09283' specifically when the wound was located below the axillary bud. In conclusion, wounding by assisted-elimination of layers by laser can induce positive effects on AR formation of single-node stem cuttings of the rose if energy applied is able to expose phloem proximities, a longitudinal orientation, and relative position to the axillary bud are considered.
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Since the addition of BaTiO3 in perovskite solar cells (PSCs) provides a more energetically favorable transport route for electrons, resulting in more efficient charge separation and electron extraction, in this work we experimentally prepared such a PSC and used a modeling approach to point out which simulation parameters have an influence on PSC characteristics and how they can be improved. We added a layer of BaTiO3 onto the TiO2 electron transport layer and prepared a PSC, which had an FTO/TiO2/BaTiO3/FAPbI3/spiro-OMeTAD/Au architecture with a power conversion efficiency (PCE) of 11%. Further, we used the simulation program SCAPS-1D to investigate and optimize the device parameters (thickness of the BaTiO3 and absorber layers, doping, and defect concentration) resulting in devices with PCEs reaching up to 15%, and even up to 20% if we assume an ideal structure with no interlayer defects. Our experimental findings and simulations in this paper highlight the promising interplay of multilayer TiO2/BaTiO3 ETLs for potential future applications in PSCs.
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Necessary advancements in the area of organic photovoltaic (OPV) devices include the upgrade of power conversion efficiencies (PCE) and stability. One answer to these demands lies in the research into new absorbers. Here, we focus on the development of new small molecule absorbers from the group of squaraines (SQs). These modular absorbers can be applied as donors in organic solar cells and have the ability to utilize a broad range of solar radiation if blended with suitable acceptors. In order to allow for the compatibility and favorable organization of donor and acceptor in the absorber layer, we intend to optimize the structure of the SQ by varying the groups attached to the squaric acid core. For that purpose, we accordingly developed a well-suited synthesis route. The novel alkyl- and benzyl-substituted aryl aminosquaraines were synthesized through an improved and eco-friendly procedure. Special emphasis was placed on optimizing the amination reaction to obtain initial precursors in the synthesis of squaraine, avoiding hitherto common catalytic processes. All SQ precursors and SQ products were completely described. The derived SQs were additionally characterized in thin-film configuration using cyclic voltammetry and UV-VIS spectroscopy and then processed to prepare self-standing bulk heterojunction (BHJ) thin films in conjunction with fullerene-based electron acceptors, which were characterized via profilometry. The comparison between SQ and BHJ solutions and thin films, using atomic force microscopy and UV-VIS spectroscopy, revealed differences in susceptibility for the organization and orientation of the constituting domains.
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A large proportion of patients with visual impairment secondary to non-infectious uveitis may require DMARDs. Although these are highly effective, some patients may require alternatives to the currently available immunomodulators due to an inadequate response or undesirable side effects. Janus Kinase Inhibitors (JAKi) are already approved for several autoimmune diseases in rheumatology, gastroenterology and dermatology. To date, JAKi have been studied in phase 3 trials in various types of uveitis. Mechanism of Action: JAKi work by inhibiting the phosphorylation of Janus kinases, which are transmembrane proteins. This blocks the activation of transcription factors, which in turn downregulates cytokine expression and inflammatory mediators. JAKi represent an extremely effective novel therapeutic approach in rheumatology, gastroenterology and dermatology. They have already been approved for the treatment of rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, ulcerative colitis and atopic eczema. In earlier comparative studies with conventional biologics, a better therapeutic response was reported in some cases. Several published case reports report reduced cortisone levels in patients with uveitis who had responded poorly to conventional and biological DMARDs. Approval studies are under way for JIA-associated and ANA-positive anterior uveitis. In summary, JAKi represent an innovative treatment option for patients with non-infectious uveitis in whom DMARDs are contraindicated or ineffective.
Subject(s)
Antirheumatic Agents , Arthritis, Psoriatic , Arthritis, Rheumatoid , Janus Kinase Inhibitors , Uveitis , Antirheumatic Agents/therapeutic use , Arthritis, Psoriatic/chemically induced , Arthritis, Psoriatic/drug therapy , Arthritis, Rheumatoid/drug therapy , Humans , Janus Kinase Inhibitors/pharmacology , Janus Kinase Inhibitors/therapeutic use , Uveitis/chemically induced , Uveitis/diagnosis , Uveitis/drug therapyABSTRACT
A perylene-based acceptor (PMI-FF-PMI), consisting of two perylene monoimide (PMI) units bridged with a dihydroindeno[1,2-b]fluorene molecule was developed as a potential non-fullerene acceptor (NFA) for organic solar cells (OSCs). The synthesized NFA was combined with the high-performance donor polymer D18 to fabricate efficient OSCs. With an effective bandgap of 2.02 eV, the D18:PMI-FF-PMI blend can be categorized as a wide-bandgap OSC and is an attractive candidate for application as a wide-bandgap sub-cell in all-organic triple-junction solar cell devices. Owing to their large effective bandgap, D18:PMI-FF-PMI solar cells are characterized by an extremely high open-circuit voltage (V OC) of 1.41 V, which to the best of our knowledge is the highest reported value for solution-processed OSCs so far. Despite the exceptionally high V OC of this blend, a comparatively large non-radiative voltage loss (ΔV non-rad OC) of 0.25 V was derived from a detailed voltage loss analysis. Measurements of the electroluminescence quantum yield (ELQY) of the solar cell reveal high ELQY values of â¼0.1%, which contradicts the ELQY values derived from the non-radiative voltage loss (ΔV non-rad OC = 0.25 V, ELQY = 0.0063%). This work should help to raise awareness that (especially for BHJ blends with small ΔHOMO or ΔLUMO offsets) the measured ELQY cannot be straightforwardly used to calculate the ΔV non-rad OC. To avoid any misinterpretation of the non-radiative voltage losses, the presented ELQY discrepancies for the D18:PMI-FF-PMI system should encourage OPV researchers to primarily rely on the ΔV non-rad OC values derived from the presented voltage loss analysis based on EQEPV and J-V measurements.
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A series of non-fullerene acceptors based on perylene monoimides coupled in the peri position through phenylene linkers were synthesized via Suzuki-coupling reactions. Various substitution patterns were investigated using density functional theory (DFT) calculations in combination with experimental data to elucidate the geometry and their optical and electrochemical properties. Further investigations of the bulk properties with grazing incidence wide angle X-ray scattering (GIWAXS) gave insight into the stacking behavior of the acceptor thin films. Electrochemical and morphological properties correlate with the photovoltaic performance of devices with the polymeric donor PBDB-T and a maximum efficiency of 3.17 % was reached. The study gives detailed information about structure-property relationships of perylene-linker-perylene compounds.
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With the aim of decreasing the number of experiments to obtain a perovskite solar cell (PSC) with maximum theoretical efficiency, in this paper, PSC performance was studied using the program solar cell capacitance simulator (SCAPS-1D). The PSC with the architecture ITO/TiO2/perovskite/spiro-MeOTAD/Au was investigated, while the selected perovskite was mixed cation Rb0.05Cs0.1FA0.85PbI3. The analysis was based on an experimentally prepared solar cell with a power conversion efficiency of ~7%. The PSC performance, verified by short-circuit current density (Jsc), open-circuit voltage (Voc), fill factor (FF) and power conversion efficiency (PCE), was studied by optimization of the simulation parameters responsible for improvement of the cell operation. The optimized parameters were absorber layer thickness, doping, defect concentration and the influence of the resistivity (the net effect of ohmic loss, Rs and the leakage current loss represented by the resistivity, Rshunt). The results of SCAPS-1D simulations estimated the theoretical power conversion efficiency of 15% for our material. We have showed that the main contribution to improvement of solar cell efficiency comes with lowering ohmic resistivity of the cell as well as doping and defect concentration, because their concentration is proportional to recombination rate.
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BACKGROUND: As a consequence of improved survival rates after burn injury occupational reintegration of burn survivors has gained increasing significance. We aimed to develop a precise patient questionnaire as a tool to evaluate factors contributing to occupational reintegration. MATERIAL AND METHODS: A questionnaire comprising 20 questions specifically evaluating occupational reintegration was developed under psychological supervision. The single-center questionnaire study was implemented in patients with burn injuries who were admitted to the 6bed burn intensive care unit (BICU) of the General Hospital of Vienna, Austria (2004-2013). The questionnaire was sent to burn survivors of working age (18-60 years) with an abbreviated burn severity index (ABSI) of 6 or greater, a total burn surface area (TBSA) of 15% or greater, and a BICU stay of at least 24â¯h. RESULTS: A total of 112 burn survivors met the inclusion criteria and were contacted by mail. Of the 112 patients 11 (10%) decided to participate in the study and 218/220 questions (99%) in 11 patients were answered. Out of 11 patients 7 (64%) reported successful return to work and 4 of 11 (36%) did not resume their occupation. Advanced age, longer BICU and hospital stays, higher TBSA, burn at work, lower education, and problems with esthetic appearance seemed to impair patients' return to their occupation. CONCLUSION: When implementing the questionnaire, severely burned patients with higher age, lower education, and longer hospital and BICU stay seemed at high risk for failed reintegration in their profession after burn injury.
Subject(s)
Intensive Care Units , Adolescent , Adult , Austria , Humans , Length of Stay , Middle Aged , Retrospective Studies , Surveys and Questionnaires , Young AdultABSTRACT
INTRODUCTION: Acute anterior uveitis (AAU), affecting up to 40% of patients with axial spondyloarthritis (axSpA), risks permanent visual deficits if not adequately treated. We report 2-year results from C-VIEW, the first study to prospectively investigate certolizumab pegol (CZP) on AAU in patients with active axSpA at high risk of recurrent AAU. PATIENTS AND METHODS: C-VIEW (NCT03020992) was a 104-week (96 weeks plus 8-week safety follow-up), open-label, multicenter study. Eligible patients had active axSpA, human leukocyte antigen-B27 (HLA-B27) positivity and a history of recurrent AAU (⩾2 AAU flares in total; ⩾1 in the year prior to baseline). Patients received CZP 400 mg at weeks 0, 2 and 4, then 200 mg every 2 weeks to week 96. The primary efficacy endpoint was the AAU flare event rate during 96 weeks' CZP versus 2 years pre-baseline. RESULTS: Of 115 enrolled patients, 89 initiated CZP (male: 63%; radiographic/non-radiographic axSpA: 85%/15%; mean disease duration: 9.1 years); 83 completed week 96. There was a significant 82% reduction in AAU flare event rate during CZP versus pre-baseline [rate ratio (95% confidence interval): 0.18 (0.12-0.28), p < 0.001]. One hundred percent and 59.6% of patients experienced ⩾1 and ⩾2 AAU flares pre-baseline, respectively, compared to 20.2% and 11.2% during treatment. Age, sex and axSpA population subgroup analyses were consistent with the primary analysis. There were substantial improvements in axSpA disease activity with no new safety signal identified. CONCLUSION: CZP treatment significantly reduced AAU flare event rate in patients with axSpA and a history of AAU, indicating CZP is a suitable treatment option for patients at risk of recurrent AAU. TRIAL REGISTRATION CLINICALTRIALSGOV: NCT03020992, URL: https://clinicaltrials.gov/ct2/show/NCT03020992.