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1.
J Geophys Res Atmos ; 124(6): 2932-2945, 2019 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-31218150

RESUMO

Several recent studies from both Greenland and Antarctica have reported significant changes in the water isotopic composition of near-surface snow between precipitation events. These changes have been linked to isotopic exchange with atmospheric water vapor and sublimation-induced fractionation, but the processes are poorly constrained by observations. Understanding and quantifying these processes are crucial to both the interpretation of ice core climate proxies and the formulation of isotope-enabled general circulation models. Here, we present continuous measurements of the water isotopic composition in surface snow and atmospheric vapor together with near-surface atmospheric turbulence and snow-air latent and sensible heat fluxes, obtained at the East Greenland Ice-Core Project drilling site in summer 2016. For two 4-day-long time periods, significant diurnal variations in atmospheric water isotopologues are observed. A model is developed to explore the impact of this variability on the surface snow isotopic composition. Our model suggests that the snow isotopic composition in the upper subcentimeter of the snow exhibits a diurnal variation with amplitudes in δ18O and δD of ~2.5‰ and ~13‰, respectively. As comparison, such changes correspond to 10-20% of the magnitude of seasonal changes in interior Greenland snow pack isotopes and of the change across a glacial-interglacial transition. Importantly, our observation and model results suggest, that sublimation-induced fractionation needs to be included in simulations of exchanges between the vapor and the snow surface on diurnal timescales during summer cloud-free conditions in northeast Greenland.

2.
Nature ; 554(7692): 351-355, 2018 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-29400700

RESUMO

The presence of large Northern Hemisphere ice sheets and reduced greenhouse gas concentrations during the Last Glacial Maximum fundamentally altered global ocean-atmosphere climate dynamics. Model simulations and palaeoclimate records suggest that glacial boundary conditions affected the El Niño-Southern Oscillation, a dominant source of short-term global climate variability. Yet little is known about changes in short-term climate variability at mid- to high latitudes. Here we use a high-resolution water isotope record from West Antarctica to demonstrate that interannual to decadal climate variability at high southern latitudes was almost twice as large at the Last Glacial Maximum as during the ensuing Holocene epoch (the past 11,700 years). Climate model simulations indicate that this increased variability reflects an increase in the teleconnection strength between the tropical Pacific and West Antarctica, owing to a shift in the mean location of tropical convection. This shift, in turn, can be attributed to the influence of topography and albedo of the North American ice sheets on atmospheric circulation. As the planet deglaciated, the largest and most abrupt decline in teleconnection strength occurred between approximately 16,000 years and 15,000 years ago, followed by a slower decline into the early Holocene.

3.
Vaccine ; 33(43): 5854-5860, 2015 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-26362099

RESUMO

BACKGROUND: Based on the success of vaccination with pneumococcal conjugate vaccines (PCVs) in children, recent studies have focused on PCVs in adults. Data from a randomized, double-blind study comparing the immunogenicity, tolerability, and safety of the 13-valent PCV (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23) in PPSV23-naive adults 60-64 years of age have been published. The same study also included a cohort of adults aged 18-49 years that received open-label PCV13. The purpose of this cohort was to examine the immunogenicity, safety, and tolerability of PCV13 in adult subjects 18-49 years of age compared with adults 60-64 years of age for whom PCV13 is approved. METHODS: Adults naive to PPSV23 were grouped by age into 2 cohorts: 18-49 years (n=899; further stratified by age into 3 subgroups 18-29, 30-39, and 40-49 years) and 60-64 years (n=417). All subjects received 1 dose of PCV13. In both age groups, immunogenicity was assessed by antipneumococcal opsonophagocytic activity (OPA) geometric mean titers (GMTs) and IgG geometric mean concentrations (GMCs) 1 month after vaccination. Safety and tolerability were evaluated. RESULTS: In adults aged 18-49 years, OPA GMTs and IgG GMCs were noninferior for all 13 serotypes and statistically significantly higher for all except 1 serotype (OPA GMT) and 5 serotypes (IgG GMCs) compared with adults 60-64 years. Immune responses were highest in the youngest age subgroup (18-29 years). Local reactions and systemic events were more common in adults 18-49 years compared with 60-64 years and were self-limited. CONCLUSION: Immune responses to PCV13 are robust in adults ≥18 years of age, with highest responses observed in the youngest subgroup. Based on its safety and immunologic profile, PCV13 may serve an important therapeutic role in younger adults, particularly those with underlying medical conditions who have an increased risk of serious pneumococcal infections.


Assuntos
Vacinas Pneumocócicas/efeitos adversos , Vacinas Pneumocócicas/imunologia , Adolescente , Adulto , Anticorpos Antibacterianos/sangue , Estudos de Coortes , Método Duplo-Cego , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Feminino , Humanos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Proteínas Opsonizantes/sangue , Fagocitose , Vacinas Pneumocócicas/administração & dosagem , Resultado do Tratamento , Adulto Jovem
4.
J Microsc ; 256(3): 231-6, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25228240

RESUMO

The presence of systematic noise in images in high-throughput microscopy experiments can significantly impact the accuracy of downstream results. Among the most common sources of systematic noise is non-homogeneous illumination across the image field. This often adds an unacceptable level of noise, obscures true quantitative differences and precludes biological experiments that rely on accurate fluorescence intensity measurements. In this paper, we seek to quantify the improvement in the quality of high-content screen readouts due to software-based illumination correction. We present a straightforward illumination correction pipeline that has been used by our group across many experiments. We test the pipeline on real-world high-throughput image sets and evaluate the performance of the pipeline at two levels: (a) Z'-factor to evaluate the effect of the image correction on a univariate readout, representative of a typical high-content screen, and (b) classification accuracy on phenotypic signatures derived from the images, representative of an experiment involving more complex data mining. We find that applying the proposed post-hoc correction method improves performance in both experiments, even when illumination correction has already been applied using software associated with the instrument. To facilitate the ready application and future development of illumination correction methods, we have made our complete test data sets as well as open-source image analysis pipelines publicly available. This software-based solution has the potential to improve outcomes for a wide-variety of image-based HTS experiments.


Assuntos
Ensaios de Triagem em Larga Escala/métodos , Iluminação/métodos , Microscopia/métodos , Estatística como Assunto/métodos , Ruído , Software
5.
Vaccine ; 30(43): 6163-74, 2012 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-22871351

RESUMO

Neisseria meningitidis is a leading cause of meningitis and septicaemia, but a broadly-protective vaccine against endemic serogroup B disease is not licensed and available. The conserved, outer-membrane lipoprotein factor H binding protein (fHBP, also known as LP2086) is expressed as one of two subfamily variants in virtually all meningococci. This study investigated the safety, tolerability, and immunogenicity of a recombinant-expressed bivalent fHBP (r-fHBP) vaccine in healthy adults. Participants (N=103) aged 18-25 years were recruited into three ascending dose level cohorts of 20, 60, and 200µg of a bivalent r-fHBP vaccine formulation and randomised to receive vaccine or placebo at 0, 1, and 6 months. The vaccine was well tolerated. Geometric mean titres (GMTs) for r-fHBP subfamily-specific IgG antibodies increased 19-168-fold from pre-vaccination to post-dose 2 in a dose level-dependent manner. In addition, robust serum bactericidal assay using human complement (hSBA) responses for strains expressing both homologous and heterologous fHBP variants were observed. After three vaccinations, 16-52% of the placebo group and 47-90%, 75-100%, and 88-100%, of the 20, 60, and 200µg dose levels, respectively, had seroprotective (≥ 1:4) hSBA titres against six serogroup B strains. The bivalent r-fHBP vaccine was well tolerated and induced robust bactericidal activity against six diverse serogroup B strains in young adults at the 60 and 200µg dose levels.


Assuntos
Antígenos de Bactérias/imunologia , Proteínas de Bactérias/imunologia , Infecções Meningocócicas/prevenção & controle , Vacinas Meningocócicas/imunologia , Adulto , Anticorpos Antibacterianos/sangue , Proteínas do Sistema Complemento/imunologia , Método Duplo-Cego , Feminino , Humanos , Imunoglobulina G/sangue , Masculino , Vacinas Meningocócicas/administração & dosagem , Vacinas Meningocócicas/efeitos adversos , Neisseria meningitidis Sorogrupo B/imunologia , Ensaios de Anticorpos Bactericidas Séricos , Vacinas Sintéticas/administração & dosagem , Vacinas Sintéticas/efeitos adversos , Vacinas Sintéticas/imunologia , Adulto Jovem
6.
J Appl Microbiol ; 110(4): 962-70, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21255210

RESUMO

AIMS: To investigate the prevalence and temporal patterns of antimicrobial resistance in wild rodents with no apparent exposure to antimicrobials. METHODS AND RESULTS: Two sympatric populations of bank voles and wood mice were trapped and individually monitored over a 2- year period for faecal carriage of antimicrobial-resistant Escherichia coli. High prevalences of ampicillin-, chloramphenicol-, tetracycline- and trimethoprim-resistant E. coli were observed. A markedly higher prevalence of antimicrobial-resistant E. coli was found in wood mice than in bank voles, with the prevalence in both increasing over time. Superimposed on this trend was a seasonal cycle with a peak prevalence of resistant E. coli in mice in early- to mid-summer and in voles in late summer and early autumn. CONCLUSIONS: These sympatric rodent species had no obvious contact with antimicrobials, and the difference in resistance profiles between rodent species and seasons suggests that factors present in their environment are unlikely to be drivers of such resistance. SIGNIFICANCE AND IMPACT OF THE STUDY: These findings suggest that rodents may represent a reservoir of antimicrobial-resistant bacteria, transmissible to livestock and man. Furthermore, such findings have implications for human and veterinary medicine regarding antimicrobial usage and subsequent selection of antimicrobial-resistant organisms.


Assuntos
Farmacorresistência Bacteriana , Escherichia coli/efeitos dos fármacos , Ampicilina/farmacologia , Animais , Antibacterianos/farmacologia , Arvicolinae/microbiologia , Fezes/microbiologia , Feminino , Masculino , Murinae/microbiologia , Estações do Ano , Simpatria
7.
Appl Environ Microbiol ; 76(21): 7318-21, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20851991

RESUMO

Campylobacter jejuni can be isolated from different animal hosts. Various studies have used multilocus sequence typing to look for associations between particular clones of C. jejuni and specific hosts. Here, we describe the isolation of a novel clone (sequence type 3704 [ST-3704]) of C. jejuni associated with the bank vole (Myodes glareolus).


Assuntos
Arvicolinae/microbiologia , Campylobacter jejuni/isolamento & purificação , Animais , Técnicas de Tipagem Bacteriana , Infecções por Campylobacter/microbiologia , Infecções por Campylobacter/veterinária , Campylobacter fetus/genética , Campylobacter fetus/isolamento & purificação , Campylobacter jejuni/genética , Campylobacter jejuni/fisiologia , Bovinos/microbiologia , Eletroforese em Gel de Campo Pulsado , Fezes/microbiologia , Dados de Sequência Molecular , Tipagem de Sequências Multilocus , Filogenia , Reação em Cadeia da Polimerase , Reino Unido
8.
Epidemiol Infect ; 137(11): 1574-82, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19327201

RESUMO

Shiga toxin-producing Escherichia coli (STEC) can cause serious disease in human beings. Ruminants are considered to be the main reservoir of human STEC infections. However, STEC have also been isolated from other domestic animals, wild mammals and birds. We describe a cross-sectional study of wild birds in northern England to determine the prevalence of E. coli-containing genes that encode Shiga toxins (stx1 and stx2) and intimin (eae), important virulence determinants of STEC associated with human disease. Multivariable logistic regression analysis identified unique risk factors for the occurrence of each virulence gene in wild bird populations. The results of our study indicate that while wild birds are unlikely to be direct sources of STEC infections, they do represent a potential reservoir of virulence genes. This, coupled with their ability to act as long-distance vectors of STEC, means that wild birds have the potential to influence the spread and evolution of STEC.


Assuntos
Adesinas Bacterianas/genética , Aves/microbiologia , Reservatórios de Doenças/veterinária , Proteínas de Escherichia coli/genética , Toxina Shiga I/genética , Toxina Shiga II/genética , Escherichia coli Shiga Toxigênica/genética , Animais , Estudos Transversais , Inglaterra/epidemiologia , Fezes/microbiologia , Razão de Chances , Vigilância da População , Fatores de Risco , Estações do Ano , Escherichia coli Shiga Toxigênica/isolamento & purificação , Fatores de Virulência/genética , Fatores de Virulência/isolamento & purificação
9.
Am J Transplant ; 7(2): 320-35, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17241112

RESUMO

A strategy for producing high-level hematopoietic chimerism after non-myeloablative conditioning has been established in the rhesus macaque. This strategy relies on hematopoietic stem cell transplantation after induction with a non-myeloablative dose of busulfan and blockade of the IL2-receptor in the setting of mTOR inhibition with sirolimus and combined CD28/CD154 costimulation blockade. Hematopoietic stem cells derived from bone marrow and leukopheresis products both were found to be successful in inducing high-level chimerism. Mean peripheral blood peak donor chimerism was 81% with a median chimerism duration of 145 days. Additional immune modulation strategies, such as pre-transplant CD8 depletion, donor-specific transfusion, recipient thymectomy or peritransplant deoxyspergualin treatment did not improve the level or durability of chimerism. Recipient immunologic assessment suggested that chimerism occurred amidst donor-specific down-regulation of alloreactive T cells, and the reappearance of vigorous T-mediated alloreactivity accompanied rejection of the transplants. Furthermore, viral reactivation constituted a significant transplant-related toxicity and may have negatively impacted the ability to achieve indefinite survival of transplanted stem cells. Nevertheless, this chimerism-induction regimen induced amongst the longest-lived stem cell chimerism reported to date for non-human primates and thus represents a platform upon which to evaluate emerging tolerance-induction strategies.


Assuntos
Quimerismo , Transplante de Células-Tronco Hematopoéticas/métodos , Terapia de Imunossupressão/métodos , Macaca mulatta/imunologia , Animais , Transplante de Medula Óssea/métodos , Bussulfano/farmacologia , Infecções por Citomegalovirus/complicações , Imunossupressores/farmacologia , Leucaférese/métodos , Macaca mulatta/genética , Receptores de Interleucina-2/antagonistas & inibidores , Sirolimo/farmacologia , Linfócitos T/imunologia , Tolerância ao Transplante
10.
Genes Immun ; 5(7): 553-61, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15318164

RESUMO

One potential benefit of DNA vaccines is the capacity to elicit antibody and T-cell responses against multiple antigens at the same time by mixing plasmids expressing different proteins. A possible negative effect of such mixing is interference among plasmids regarding immunogenicity. In preparation for a clinical trial, we assessed the immunogenicity of GMP-produced plasmids encoding five Plasmodium falciparum proteins, PfCSP, PfSSP2, PfEXP1, PfLSA1, and PfLSA3, given as a mixture, or alone. The mixture induced higher levels of antibodies against whole parasites than did the individual plasmids, but was associated with a decrease in antibodies to individual P. falciparum proteins. T-cell responses were in general decreased by administration of the mixture. Immune responses to individual plasmids and mixtures were generally higher in inbred mice than in outbreds. In inbred BALB/c and C57BL/6 mice, coadministration of a plasmid expressing murine granulocyte-macrophage colony-stimulating factor (mGM-CSF), increased antibody and T-cell responses, but in outbred CD-1 mice, coadministration of mGM-CSF was associated with a decrease in antibody responses. Such variability in data from studies in different strains of mice underscores the importance of genetic background on immune response and carefully considering the goals of any preclinical studies of vaccine mixtures planned for human trials.


Assuntos
Anticorpos Antiprotozoários/biossíntese , Fator Estimulador de Colônias de Granulócitos e Macrófagos/administração & dosagem , Plasmídeos/administração & dosagem , Plasmodium falciparum/imunologia , Engenharia de Proteínas/normas , Linfócitos T/efeitos dos fármacos , Vacinas de DNA/administração & dosagem , Animais , Feminino , Fator Estimulador de Colônias de Granulócitos e Macrófagos/biossíntese , Fator Estimulador de Colônias de Granulócitos e Macrófagos/genética , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Plasmídeos/síntese química , Plasmídeos/imunologia , Engenharia de Proteínas/métodos , Vacinas Protozoárias/administração & dosagem , Vacinas Protozoárias/genética , Vacinas Protozoárias/imunologia , Linfócitos T/imunologia , Vacinas de DNA/imunologia
11.
Int J Clin Pharmacol Ther ; 42(5): 253-9, 2004 May.
Artigo em Inglês | MEDLINE | ID: mdl-15176647

RESUMO

AIMS: To assess the safety, tolerability and pharmacokinetics of subcutaneous A6, an 8-amino acid peptide with anti-angiogenic properties, in healthy men. METHODS: Double-blind, placebo-controlled, parallel-group, dose-rising, phase I study of single and repeated doses. In the single dose phase, successive groups of 5 subjects received A6 15, 35, 75, 150, 300 mg, or placebo, as subcutaneous injections in the upper thigh. In the repeat dose phase, 2 groups of 6 subjects received repeat doses of A6 35 mg and 75 mg, or placebo, and 1 group of 5 subjects received 150 mg, or placebo, 12-hourly for 6 days (11 doses in total). In each group, 4 subjects received active treatment, the remainder placebo. Pharmacokinetics of A6 were assessed up to 24 h after single doses, for 12 h after the first of the repeated doses, and up to 24 h after the last of the repeated doses. MATERIALS: A6 for subcutaneous injection in phosphate buffer, pH 5.6-6.0. Phosphate-buffered saline was used as placebo. RESULTS: All dose regimens of A6 were safe and well-tolerated, both systemically and locally. Time to peak plasma concentration was similar (0.5-2.1 h) in all dosage groups. Cmax and AUC(0-inf) were linearly proportional to dose. Mean Cmax ranged from 454-10,333 ng/ml and mean AUC(0-inf) from 1,690-43,371 ng x h/ml after the 15 and 300 mg single doses, respectively. Terminal t(1/2) was 1.4-1.8 h, and there was no evidence of unexpected drug accumulation. Urinary excretion of unchanged A6 was 94.6% (SD 20.7) after the 300 mg single dose (0-24 h collection), and 78.4% (SD 13.0) after the 150 mg repeated dose (0-12 h collection). A6 did not trigger production of anti-A6 IgG antibodies within 14 days of the first dose. CONCLUSION: Single doses of A6 up to 300 mg, and repeated doses up to 150 mg, were well-tolerated and safe in healthy young men. A6 was rapidly absorbed; it was eliminated, mainly unchanged, in urine. Plasma concentrations were dose-proportional. A6 did not trigger an early immunogenic response.


Assuntos
Inibidores da Angiogênese/farmacocinética , Oligopeptídeos/farmacocinética , Fragmentos de Peptídeos/farmacocinética , Ativador de Plasminogênio Tipo Uroquinase/farmacocinética , Adolescente , Adulto , Inibidores da Angiogênese/efeitos adversos , Inibidores da Angiogênese/sangue , Inibidores da Angiogênese/urina , Área Sob a Curva , Método Duplo-Cego , Humanos , Injeções Subcutâneas , Masculino , Pessoa de Meia-Idade , Oligopeptídeos/efeitos adversos , Oligopeptídeos/sangue , Oligopeptídeos/urina , Fragmentos de Peptídeos/efeitos adversos , Fragmentos de Peptídeos/sangue , Fragmentos de Peptídeos/urina , Ativador de Plasminogênio Tipo Uroquinase/efeitos adversos , Ativador de Plasminogênio Tipo Uroquinase/sangue , Ativador de Plasminogênio Tipo Uroquinase/urina
12.
J Parasitol ; 89(3): 602-3, 2003 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12880263

RESUMO

We evaluated the effect of using Medium 199 alone and Medium 199 supplemented with 5% normal mouse serum, 5% fetal calf serum, 5% bovine serum albumin or 5% Albumax on Plasmodium yoelii sporozoite yield from infected mosquitoes and infectivity in BALB/c mice. The sporozoites yield, as well as their infectivity, was statistically lower (P = 0.0031) when unsupplemented Medium 199 was used to separate sporozoites from infected mosquitoes. Although Medium 199 supplemented with Albumax led to lower sporozoite yield (P < 0.0009), infectivity of the sporozoites was similar to those obtained with the other medium supplements. Because normal mouse serum supports good sporozoite infections and is also the supplement that can be used repeatedly in mice during multiple sporozoite injections without inducing anaphylaxis, we selected it to evaluate the infectivity of P. yoelii sporozoites in different strains of mice. After injecting mice with serial dilutions of sporozoites and detecting patent infections, we determined that the infective dose 50 (ID50) for BALB/c, C57Bl/6, A/J, and B10BR mice ranged between 4.9 and 10.6 sporozoites. The ID50 obtained for CD-1 mice (147 sporozoites) was significantly higher.


Assuntos
Modelos Animais de Doenças , Malária/parasitologia , Camundongos/parasitologia , Plasmodium yoelii/patogenicidade , Doenças dos Roedores/parasitologia , Animais , Intervalos de Confiança , Culicidae/parasitologia , Meios de Cultura , Insetos Vetores/parasitologia , Camundongos/classificação , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL
13.
J Magn Reson Imaging ; 14(6): 685-92, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11747024

RESUMO

In this study we assessed the use of a steady state free precession (SSFP) cine sequence in a series of radially orientated long axis slices for the measurement of left ventricular volumes and mass. We validated the radial long axis approach in phantoms and ex vivo porcine hearts and applied it to normal volunteers and patients using the SSFP and turbo gradient-echo (TGE) sequences. High quality images were obtained for analysis, and the measured volumes with radial long axis SSFP sequence correlated well with short axis TGE and SSFP volumes (r > 0.98). The best interobserver agreement for left ventricular volumes was obtained using SSFP in the long axis radial orientation (variability < 2.3%). We conclude that this combination of sequence and scan orientation has intrinsic advantages for image analysis due to the improved contrast and the avoidance of errors associated with the basal slice in the short axis orientation.


Assuntos
Volume Cardíaco , Imagem Cinética por Ressonância Magnética/métodos , Função Ventricular Esquerda/fisiologia , Animais , Humanos , Imagem Cinética por Ressonância Magnética/instrumentação , Variações Dependentes do Observador , Imagens de Fantasmas , Suínos
14.
Clin Infect Dis ; 33(12): 1990-7, 2001 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-11712091

RESUMO

Malaria causes illness or death in unprotected travelers. Primaquine prevents malaria by attacking liver-stage parasites, a property distinguishing it from most chemoprophylactics and obviating 4-week postexposure dosing. A daily adult regimen of 30 mg primaquine prevented malaria caused by Plasmodium falciparum and P. vivax for 20 weeks in 95 of 97 glucose-6-phosphate dehydrogenase (G6PD)-normal Javanese transmigrants in Papua, Indonesia. In comparison, 37 of 149 subjects taking placebo in a parallel trial became parasitemic. The protective efficacy of primaquine against malaria was 93% (95% confidence interval [CI] 71%-98%); against P. falciparum it was 88% (95% CI 48%-97%), and >92% for P. vivax (95% CI >37%-99%). Primaquine was as well tolerated as placebo. Mild methemoglobinemia (mean of 3.4%) returned to normal within 2 weeks. Blood chemistry and hematological parameters revealed no evidence of toxicity. Good safety, tolerance, and efficacy, along with key advantages in dosing requirements, make primaquine an excellent drug for preventing malaria in nonpregnant, G6PD-normal travelers.


Assuntos
Antimaláricos/uso terapêutico , Malária Falciparum/prevenção & controle , Primaquina/uso terapêutico , Adolescente , Adulto , Animais , Atovaquona , Quimioprevenção , Criança , Combinação de Medicamentos , Feminino , Humanos , Indonésia , Malária Falciparum/sangue , Masculino , Metemoglobinemia/metabolismo , Pessoa de Meia-Idade , Naftoquinonas/uso terapêutico , Cooperação do Paciente , Plasmodium falciparum/efeitos dos fármacos , Proguanil/uso terapêutico , Resultado do Tratamento
16.
J Magn Reson Imaging ; 14(3): 230-6, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11536399

RESUMO

Steady-state free precession imaging is a promising technique for cardiac magnetic resonance imaging (MRI), as it provides improved blood/myocardial contrast in shorter acquisition times compared with conventional gradient-echo acquisition. The better contrast could improve observer agreement and automatic detection of cardiac contours for volumetric assessment of the ventricles, but measurements might differ from those obtained using conventional methods. We compared volumetric measurements, observer variabilities, and automatic contour detection between a steady-state free precession imaging sequence (BFFE = balanced fast field echo) and segmented k-space gradient-echo acquisition (TFE = turbo field echo) in 41 subjects. With BFFE, significantly higher end-diastolic and end-systolic volumes and lower wall thickness, ventricular mass, ejection fraction, and wall motion were observed (P < 0.0001), while interobserver variabilities were lower and automatic contour detection of endocardial contours was more successful. We conclude that the improved image quality of BFFE reduces the observer-dependence of volumetric measurements of the left ventricle (LV) but results in significantly different values in comparison to TFE measurements.


Assuntos
Coração/anatomia & histologia , Imageamento por Ressonância Magnética/métodos , Miocárdio/patologia , Adulto , Idoso , Automação , Feminino , Humanos , Aumento da Imagem , Masculino , Pessoa de Meia-Idade
17.
Proc Natl Acad Sci U S A ; 98(19): 10817-22, 2001 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-11526203

RESUMO

We assessed immunogenicity of a malaria DNA vaccine administered by needle i.m. or needleless jet injection [i.m. or i.m./intradermally (i.d.)] in 14 volunteers. Antigen-specific IFN-gamma responses were detected by enzyme-linked immunospot (ELISPOT) assays in all subjects to multiple 9- to 23-aa peptides containing class I and/or class II restricted epitopes, and were dependent on both CD8(+) and CD4(+) T cells. Overall, frequency of response was significantly greater after i.m. jet injection. CD8(+)-dependent cytotoxic T lymphocytes (CTL) were detected in 8/14 volunteers. Demonstration in humans of elicitation of the class I restricted IFN-gamma responses we believe necessary for protection against the liver stage of malaria parasites brings us closer to an effective malaria vaccine.


Assuntos
Linfócitos T CD4-Positivos/imunologia , DNA de Protozoário/imunologia , Vacinas Antimaláricas/imunologia , Plasmodium falciparum/imunologia , Proteínas de Protozoários/genética , Linfócitos T Citotóxicos/imunologia , Vacinas de DNA/imunologia , Adolescente , Adulto , Sequência de Aminoácidos , Animais , Antígenos de Protozoários/imunologia , Humanos , Interferon gama/biossíntese , Interleucina-4/análise , Vacinas Antimaláricas/administração & dosagem , Malária Falciparum/imunologia , Malária Falciparum/prevenção & controle , Dados de Sequência Molecular , Subpopulações de Linfócitos T/imunologia , Vacinas de DNA/administração & dosagem
18.
Am J Trop Med Hyg ; 64(5-6): 223-8, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11463107

RESUMO

Combination therapy is one method of overcoming the global challenge of drug-resistant Plasmodium falciparum malaria. We conducted a hospital-based 28-day in vivo test comparing chloroquine/doxycycline to chloroquine or doxycycline alone for treating P. falciparum and Plasmodium vivax malaria in Irian Jaya, Indonesia. Eighty-nine patients with uncomplicated falciparum malaria were randomized to standard dose chloroquine (n = 30), doxycycline (100 mg every 12 hours [7 days], n = 20), or chloroquine with doxycycline (n = 39); corresponding numbers for vivax malaria (n = 63) were 23, 16, 24. Endpoints were parasite sensitivity (S) or resistance (RI/RII/RIII). Of the 105 evaluable patients, chloroquine/doxycycline cured (S) 20/22 (90.9% [95% CI 78.9-100%]) patients with P. falciparum malaria; 2/22 (9.1% [0-21%]) were RIII resistant. Doxycycline cured 11/17 (64.7% [42.0-87.4%]) patients, and chloroquine 4/20 (20% [2.5-37.5%]). Against P. vivax, chloroquine/doxycycline cured (S) 12/17 (70.6% [48.9-92.2%]) patients, doxycycline 4/12 (33.3% [6.6-59.9%]), and chloroquine 5/17 (29.4% [7.7-51.1%]). Chloroquine/doxycycline was effective against P. falciparum but only modestly effective against P. vivax. These findings support the use of chloroquine/doxycycline as an inexpensive alternative to mefloquine for treating chloroquine-resistant P. falciparum but not chloroquine-resistant P. vivax in this setting.


Assuntos
Antimaláricos/uso terapêutico , Cloroquina/uso terapêutico , Doxiciclina/uso terapêutico , Malária/tratamento farmacológico , Plasmodium falciparum/isolamento & purificação , Plasmodium vivax/isolamento & purificação , Adulto , Animais , Antimaláricos/administração & dosagem , Antimaláricos/sangue , Cloroquina/administração & dosagem , Cloroquina/sangue , Doxiciclina/administração & dosagem , Quimioterapia Combinada , Feminino , Humanos , Indonésia , Malária/parasitologia , Masculino , Resultado do Tratamento
19.
Ann Emerg Med ; 38(1): 79-82, 2001 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-11423817

RESUMO

A 36-year-old man captured a timber rattlesnake and was accidentally envenomated in the thumb by the severed head. At a local emergency department, hypotension and confusion developed. Facial and glossal edema were also observed. Oxygen was delivered by face mask, and crystalloids and dopamine were administered. Respiratory distress developed with progressive hypoxemia. Intubation was unsuccessful because of massive glossal and epiglottic (laryngeal) edema, and an emergency cricothyrotomy was performed. High-dose antivenom therapy was administered, and mechanical ventilation was started. Recovery was rapid, and the patient was discharged from the hospital a week later. This is the first report of life-threatening upper airway edema caused by snake envenomation not in the vicinity of the head or neck.


Assuntos
Obstrução das Vias Respiratórias/etiologia , Crotalus , Edema/etiologia , Tratamento de Emergência/métodos , Doenças da Laringe/etiologia , Insuficiência Respiratória/etiologia , Mordeduras de Serpentes/complicações , Polegar/lesões , Doenças da Língua/etiologia , Adulto , Obstrução das Vias Respiratórias/terapia , Animais , Antivenenos/uso terapêutico , Cardiotônicos/uso terapêutico , Venenos de Crotalídeos , Soluções Cristaloides , Dopamina/uso terapêutico , Edema/terapia , Humanos , Soluções Isotônicas , Doenças da Laringe/terapia , Masculino , Oxigenoterapia , Substitutos do Plasma/uso terapêutico , Respiração Artificial , Insuficiência Respiratória/terapia , Mordeduras de Serpentes/terapia , Doenças da Língua/terapia
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