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2.
AIDS Res Hum Retroviruses ; 29(5): 761-8, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23268562

RESUMO

Few data report the prevalence in actual clinical settings of lipodystrophy (LD), and in particular of facial lipoatrophy (LA), in HIV-infected patients treated with long-term antiretroviral therapy (ART). A French, multicenter, cross-sectional, observational study was conducted in HIV-infected patients on continuous ART for more than 12 months. The main objective was to assess the prevalence of facial LA in this population. Additional objectives were to make the same assessments for nonfacial LA and lipohypertrophy. The presence of LD signs, type, and severity was assessed by clinicians and compared with patient self-evaluations through two questionnaires. A total of 2,131 assessable patients had a median age of 46 years and a median time on ART of 10 years. Physicians diagnosed facial LA in 54% of patients and these subjects had received ART for a longer duration than those without LA. Thymidine analog usage was associated with an increased likelihood of facial LA, but 28% of patients recently treatment-initiated (1-5 years) were also affected. At other sites, LA and lipohypertrophy were diagnosed in 59% and 57% of cases, respectively. The concordance between physician and patient assessments was good for facial and buttocks LA. In this study, facial LA affects more than half of the subjects and is frequent even among the most recently treated patients. The prevalence of facial LA significantly increases with the duration of ART, with male gender, hepatitis C virus (HCV) coinfection, and non-African origin being independent risk factors. Lipohypertrophy is frequent and appears early after ART initiation.


Assuntos
Fármacos Anti-HIV/efeitos adversos , Síndrome de Lipodistrofia Associada ao HIV/epidemiologia , Qualidade de Vida , Adulto , Fármacos Anti-HIV/uso terapêutico , Face , Feminino , Síndrome de Lipodistrofia Associada ao HIV/diagnóstico , Síndrome de Lipodistrofia Associada ao HIV/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Inquéritos e Questionários
3.
Clin Drug Investig ; 32(7): 451-63, 2012 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-22594491

RESUMO

BACKGROUND AND OBJECTIVES: GRAZAX(®) (Phleum Pratense, 75,000 SQ-T/2,800 BAU, ALK, Denmark), an SQ-standardized grass allergy sublingual immunotherapy tablet for the desensitization of grass pollen-induced rhinoconjunctivitis, has been developed to facilitate patient access to specific immunotherapy (SIT), while minimizing the risk of serious treatment-related adverse events. As a minimum duration of 3 years is recommended for SIT treatment, the GRAAL trial aimed to assess the safety profile of GRAZAX(®) in real-world conditions during long-term treatment of patients with grass pollen-induced allergic rhinoconjunctivitis (ARC). METHODS: A multicentre, prospective, open-label, observational trial was conducted over three consecutive grass pollen seasons from November 2007 to October 2010 in France. A total of 130 physicians included 628 patients with previously documented ARC. Patients received one tablet daily (no up-titration) for at least 4 months before the expected start of the pollen season (pre-season), which was then maintained throughout the entire season (co-season). The primary endpoint was safety and tolerability (immediate, i.e. each year at first tablet administration, and long-term) after pre- and co-seasonal exposure to GRAZAX(®). RESULTS: Patients were treated for an average of 5.5 months per year. After administration of the first tablet, immediate tolerable reactions (defined as benign, local, of short duration [<30 minutes] and not requiring any symptomatic treatment) were experienced by 54.6%, 38.4% and 33.6% of the patients during the first, second and third years of treatment, respectively. Immediate intolerable reactions (required study discontinuation, symptomatic medication or lasted >30 minutes) occurred in 14 patients (2.2%) during GRAZAX(®) initiation, and one patient (0.3%) at treatment reintroduction during the second year. Adverse events considered to be related to GRAZAX(®) were reported by 46.2%, 14.4% and 1.8% of patients, during the first, second and third years of treatment, respectively. The most frequently reported adverse events were mild-to-moderate local events (at the oral and pharyngeal mucosa levels). These symptoms mainly occurred within the first month of treatment initiation and subsequent tablet reintroduction. CONCLUSION: Daily administration of GRAZAX(®) for three consecutive years was generally safe and well tolerated. An improvement in the incidence of adverse events related to treatment was observed at reintroduction of GRAZAX(®) and during the course of treatment. TRIAL REGISTRATION: http://clinicaltrials.gov (NCT01433510).


Assuntos
Alérgenos/uso terapêutico , Conjuntivite Alérgica/terapia , Dessensibilização Imunológica/métodos , Extratos Vegetais/uso terapêutico , Poaceae/imunologia , Rinite Alérgica Sazonal/terapia , Administração Sublingual , Adolescente , Adulto , Idoso , Alérgenos/administração & dosagem , Alérgenos/efeitos adversos , Distribuição de Qui-Quadrado , Conjuntivite Alérgica/diagnóstico , Conjuntivite Alérgica/imunologia , Dessensibilização Imunológica/efeitos adversos , Dessensibilização Imunológica/normas , Feminino , França , Humanos , Testes Intradérmicos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , Extratos Vegetais/administração & dosagem , Extratos Vegetais/efeitos adversos , Extratos Vegetais/normas , Estudos Prospectivos , Rinite Alérgica Sazonal/diagnóstico , Rinite Alérgica Sazonal/imunologia , Medição de Risco , Fatores de Risco , Estações do Ano , Comprimidos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
4.
Prim Care Respir J ; 19(4): 371-7, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20842324

RESUMO

AIM: To evaluate the impact of chronic bronchitis in patients identified among subjects at risk of chronic obstructive pulmonary disease (COPD) but currently free from any known chronic respiratory disorder, visiting a general practitioner for an acute respiratory episode. METHOD: A multicentre, cross-sectional survey carried out in primary care. RESULTS: Primary care practitioners (n = 772) examined 14,030 patients with acute cough (male: 56.9%, age 50.6 ± 16.5 years). Of these, 3,615 were at risk of COPD (> 40 years and tobacco use > 10 pack-years) and constituted the study population: 79.8% reported current symptoms of chronic bronchitis. Compared to patients without chronic bronchitis, they were older, more frequently exposed to occupational pollutants or to passive smoking, had more tobacco use (p < 0.001), reported dyspnoea > Grade 2 more frequently, and had poorer quality of life as assessed by the EuroQOL-5D questionnaire. CONCLUSIONS: In this survey, previously unrecognised chronic bronchitis was diagnosed in a high proportion of at-risk patients with acute respiratory episodes. Chronic bronchitis was associated with significantly poorer health status. Acute respiratory illness could be an appropriate opportunity for screening those patients at risk of COPD with lung function testing.


Assuntos
Bronquite/diagnóstico , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doenças Respiratórias/diagnóstico , Doença Aguda , Fatores Etários , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/estatística & dados numéricos , Atenção Primária à Saúde , Doença Pulmonar Obstrutiva Crônica/prevenção & controle , Qualidade de Vida , Fatores de Risco , Fumar/epidemiologia , Poluição por Fumaça de Tabaco/estatística & dados numéricos
5.
Appl Opt ; 48(31): G53-8, 2009 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-19881646

RESUMO

We present a theoretical study of the ambient refractive index sensing characteristics of long period gratings in bare and metal-coated D-shaped fibers. An equivalent rectangular core waveguide method based on the first-order perturbation theory has been used to study the modal behavior of the waveguide. Power coupling corresponding to dual resonance in both cases has been investigated, and an optimum metal thickness giving maximum sensitivity has been found to exist. The study shows that the dual resonances can be shifted to lower wavelengths by increasing (decreasing) the metal thickness (core to flat surface separation). Further, an optimum combination of metal thickness and core to flat surface separation, corresponding to maximum sensitivity, has been presented for different cladding modes and their relative performance has been discussed. It has been shown theoretically that detection of refractive index changes as small as 1.67x10(-7) RIU in the ambient region is possible using the optimized parameters. The study should find application in realizing highly sensitive biochemical sensors.

6.
Appl Opt ; 48(23): 4562-7, 2009 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-19668270

RESUMO

A novel biochemical sensor based on a submicrometer size, high core-cladding index difference, silica core Si-SiO(2) waveguide with a Bragg grating written in its cladding region is proposed and analyzed. Waveguide parameters are optimized to obtain maximum sensitivity, and for lower refractive index samples, an optimum core width is found to exist for both the TE and the TM mode configurations. Owing to the high index contrast at the Si-SiO(2) interface, the structure is much more sensitive while operating in the TM mode configuration, showing extremely high sensitivity [200-740 nm refractive index units (RIU)] for the ambient refractive indices between 1.33 and 1.63, which is of the order of most surface plasmon polariton (SPP) based biosensors. Further, unlike SPP based sensors, the proposed structure is free from any metallic layer or bulky prism and hence easy to realize. Owing to its simple structure and small dimensions, the proposed device could be easily integrated with planar lightwave circuits and could be used for lab-on-a-chip applications.


Assuntos
Técnicas Biossensoriais , Dispositivos Lab-On-A-Chip , Óptica e Fotônica , Dióxido de Silício/química , Silício/química , Desenho de Equipamento/instrumentação , Modelos Estatísticos , Fibras Ópticas , Refratometria , Ressonância de Plasmônio de Superfície
7.
Appl Opt ; 47(20): 3543-8, 2008 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-18617969

RESUMO

Specklegram in multimode fiber has successfully been used as a sensor for detecting mechanical disturbance. Speckles in a multimode pure silica grapefruit fiber are observed and compared to that of a step-index multimode fiber, showing different features between them. The sensitivities to external disturbance of two kinds of fiber were measured, based on single-multiple-single mode (SMS) fiber structure. Experimental results show that the grapefruit fiber shows higher sensitivity than does the step-index multimode fiber. The transmission spectrum of the grapefruit fiber was measured as well, showing some oscillation features that are significantly different from that of a step-index multimode fiber. The experiments may provide suggestions to understand the mechanisms of light propagation in grapefruit fibers.

8.
Appl Opt ; 44(30): 6402-11, 2005 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-16252652

RESUMO

The driving mechanism of a scanning mirror can cause significant impairment of expanded beam properties, which we investigated for several scanning waveforms. Engineering on the scanning waveform is then carried out by a scanned CO2 laser beam technique to enlarge the uniform heating region for stretching and sintering of silica fibers. Details of the derivation are given. A simple thermal model is presented to account for the relationship between the scanning beam profile and the taper shape. Fusion profiles are also compared for various scanning waveforms. The corresponding scanned beam power distributions are determined experimentally, which enables us to determine precise power density conditions for CO2 laser fusion.

9.
J Interv Cardiol ; 17(4): 245-52, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15318896

RESUMO

OBJECTIVES: Surgery remains the standard option to treat symptomatic or complicated aneurysms of the extracranial internal carotid arteries (EICA). When located more distally to the EICA, surgery appears to be very invasive and disabling. Endovascular treatment of high aneurysmal EICA has been poorly reported. We report our experience in this particular field. METHODS: We treated five EICA endovascularly, using covered stents and stentgrafts in four patients, two males and two females. One male was treated bilaterally. The average age was 59.2 years (39-80). Three patients were symptomatic (two transient ischemic attack and one stroke). Patients were followed by duplex scan, CT scan, or angio MR. RESULTS: Protecting devices were used in two cases. No in-hospital complication was observed. During follow-up (3.6 +/- 1.3 years), no adverse event was observed and all devices remained patent at duplex scan and angiography. One early endoleak was observed and treated with covered stent extension. No sign of in-stent stenosis was observed. All the aneurysmal sacs thrombosed. CONCLUSION: Covered stents and stentgrafts allow a less invasive approach to treat highly located internal carotid aneurysms. Larger series are needed to assess the role of covered stents in treating aneurysmal EICA as first choice.


Assuntos
Aneurisma Dissecante/terapia , Angioplastia com Balão , Dissecação da Artéria Carótida Interna/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do Tratamento
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