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Nwaneri D, Ifebi E, Oviawe OO, Roberts R, Parker R, Rich E, Yoder A, Kempeneer J, Ibadin M. Effects of Integrated Vector Management in the Control of Malaria Infection: An Intervention Study in a Malaria Endemic Community in Nigeria. West Afr J Med 2023; 40:44-54. [PMID: 36716288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND/AIM Malaria is a vector borne disease with high morbidity and mortality in endemic regions. In view to eliminating the disease, integrated vector and environmental hygiene practices have been advocated. There is paucity of studies on the effect of vector control measures on asymptomatic malaria infection which has been observed to be a reflection of malaria transmission. METHODS Longitudinal community-based intervention study carried out from October to December 2017. Study participants were 477 individuals living in 100 households selected by snow-balling sampling methods. Pre-intervention period included training of all heads of households on vector control methods. During the intervention period, each household received waste bins, two long lasting insecticide bed nets and had wire screen on their doors and windows; every household member was screened for malaria (antigen) using the pf rapid diagnostic test kits. Each household were monitored to ensure they comply with the environmental hygiene practices they were taught. Post-intervention malaria infection was obtained at 8 week being end of the intervention period. RESULTS Of the 100 households selected, 54.0% were from the lower social class, 45.0% middle class and only 1.0% upper class. Mean age [±] of the heads of the households was 37.1 ± 11.0 (range 16-68) years. There were 477 individuals recruited in the study from the 100 households; 234 (49.0%) females and 243 (51.0%) males; median age was 20.0 (range 1-100) years. Prevalence of malaria infection using mRDT during pre-intervention was 16.8% and an incidence of 1.3% post-intervention. There was 92.0% reduction in asymptomatic malaria infection showing marked reduction in malaria transmission in the study locale. CONCLUSION Some integrated vector control measures such as use of insecticide-treated net and sanitation were found effective methods for reducing malaria infection and transmission in endemic region.
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Affiliation(s)
- D Nwaneri
- Development of Child Health, University of Benin Teaching Hospital, P.M.B 1154, Benin City, Edo State, Nigeria
| | - E Ifebi
- Accident and Emergency Medicine, University of Benin Teaching Hospital, P.M.B 1154, Benin City, Edo State, Nigeria
| | - O O Oviawe
- Accident and Emergency Medicine, University of Benin Teaching Hospital, P.M.B 1154, Benin City, Edo State, Nigeria
| | - R Roberts
- Development Africa, Lagos, Dupe Oguntade St., Lekki Phase 1, Lagos State, Nigeria
| | - R Parker
- Development Africa, Lagos, Dupe Oguntade St., Lekki Phase 1, Lagos State, Nigeria
| | - E Rich
- Development Africa, Lagos, Dupe Oguntade St., Lekki Phase 1, Lagos State, Nigeria
| | - A Yoder
- Development Africa, Lagos, Dupe Oguntade St., Lekki Phase 1, Lagos State, Nigeria
| | - J Kempeneer
- Development Africa, Lagos, Dupe Oguntade St., Lekki Phase 1, Lagos State, Nigeria
| | - M Ibadin
- Development of Child Health, University of Benin Teaching Hospital, P.M.B 1154, Benin City, Edo State, Nigeria
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Adebiyi B, Goldschmidt T, Benjamin F, Sonn I, Rich E, Roman N. Enablers and barriers to effective parenting within the first 1000 days of life. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The first 1000 days is the period between conception and a child’s second birthday. Globally, research on parenting is in an advanced stage, but parenting research focusing specifically on parenting in this developmental phase is limited in South Africa. Therefore, this study explores the enablers and barriers to effective parenting within the first 1000 days through the lens of parents and caregivers in low socio-economic communities.
Methods
This study was conducted in low socio-economic communities of South Africa. An exploratory qualitative research design explored the enablers and barriers to effective parenting within the first 1000 days of life. Thirty participants were purposively selected and interviewed in this study. A semi-structured interview schedule was used for all interviews. The data were analysed using inductive thematic analysis.
Results
Two main categories emerged (effective parenting enablers and effective parenting barriers) during the data analysis. The main enablers of effective parenting within the first 1000 days of life include a support system, healthy behaviours/environment, job opportunities, religion, information/knowledge, and professional assistance. On the other hand, the main barriers to effective parenting were low socio-economic circumstances, environmental circumstances, lack of partner’s support, the negative impact of technology, and lack of access to services.
Conclusions
Enablers that need to be promoted for effective parenting range from support systems to professional assistance for parents. Also, barriers that need to be removed for effective parenting range from low socio-economic circumstances to a lack of partner’s support for parents. This is because effective parenting is vital in improving developmental outcomes for children within the first 1000 days of life. Therefore, there is a need to develop policies and interventions to promote effective parenting within the first 1000 days in the communities.
Key messages
• Effective parenting is vital in improving developmental outcomes for children within the first 1000 days of life.
• There is a need to develop policies and interventions to promote effective parenting within the first 1000 days in low socio-economic communities.
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Affiliation(s)
- B Adebiyi
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape , Cape Town, South Africa
| | - T Goldschmidt
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape , Cape Town, South Africa
| | - F Benjamin
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape , Cape Town, South Africa
| | - I Sonn
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape , Cape Town, South Africa
| | - E Rich
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape , Cape Town, South Africa
| | - N Roman
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape , Cape Town, South Africa
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Hyder S, Rich E, Misra J. P.159 A quality improvement project looking at the use of tea trolley teaching on a busy labour ward. Int J Obstet Anesth 2022. [DOI: 10.1016/j.ijoa.2022.103455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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O'Malley A, Rich E, Shang L, Niedzwiecki M, Rose T, Ghosh A, Peikes D, Poznyak D. MEASURING SAFETY, QUALITY, AND VALUE. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
| | - E. Rich
- Mathematica Washington DC USA
| | - L. Shang
- Mathematica Policy Researcher Princeton NJ USA
| | | | - T. Rose
- Mathematica Policy Research Ann Arbor MI USA
| | - A. Ghosh
- Mathematica Policy Research Princeton NJ USA
| | - D. Peikes
- Mathematica Policy Research Princeton NJ USA
| | - D. Poznyak
- Mathematica Policy Research Princeton NJ USA
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Hoa S, Troyanov Y, Fritzler MJ, Targoff IN, Chartrand S, Mansour AM, Rich E, Boudabbouz H, Bourré-Tessier J, Albert M, Goulet JR, Landry M, Senécal JL. Describing and expanding the clinical phenotype of anti-MDA5-associated rapidly progressive interstitial lung disease: case series of nine Canadian patients and literature review. Scand J Rheumatol 2017; 47:210-224. [DOI: 10.1080/03009742.2017.1334814] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S Hoa
- Division of Rheumatology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Y Troyanov
- Division of Rheumatology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Division of Rheumatology, Sacré-Coeur Hospital, Montreal, QC, Canada
| | - MJ Fritzler
- Faculty of Medicine and Mitogen Advanced Diagnostics Laboratory, University of Calgary, Calgary, AB, Canada
| | - IN Targoff
- Department of Medicine, University of Oklahoma, Oklahoma City, OK, USA
| | - S Chartrand
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Division of Rheumatology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada
| | - AM Mansour
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Research Center, Sacré-Coeur Hospital Research Center, Montreal, QC, Canada
| | - E Rich
- Division of Rheumatology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - H Boudabbouz
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Division of Rheumatology, Cité-de-la-Santé Hospital, Laval, QC, Canada
| | - J Bourré-Tessier
- Division of Rheumatology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - M Albert
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Research Center, Sacré-Coeur Hospital Research Center, Montreal, QC, Canada
| | - JR Goulet
- Division of Rheumatology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - M Landry
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Division of Rheumatology, Sacré-Coeur Hospital, Montreal, QC, Canada
| | - JL Senécal
- Division of Rheumatology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
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Rich E, Noguère G, Jean CDS, Tudora A. Generalization of the SPRT Method for the Modeling of the Neutron Cross Sections in the Unresolved Resonance Range. NUCL SCI ENG 2017. [DOI: 10.13182/nse162-76] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- E. Rich
- Commissariat à l’Energie Atomique, DEN Cadarache, F-13108 Saint-Paul-Lez-Durance, France
| | - Gilles Noguère
- Commissariat à l’Energie Atomique, DEN Cadarache, F-13108 Saint-Paul-Lez-Durance, France
| | - C. De Saint Jean
- Commissariat à l’Energie Atomique, DEN Cadarache, F-13108 Saint-Paul-Lez-Durance, France
| | - A. Tudora
- Bucarest University, Bucarest-Mêgurele, POB MG-11 R-76900, Romania
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Affiliation(s)
- E. Rich
- Commissariat à l’Energie Atomique, Direction de l’Energie Nucléaire, Cadarache, F-13108 Saint Paul Les Durance, France
| | - A. Tudora
- Bucharest University, Faculty of Physics, Bucharest-Magurele, P.O. Box MG-11, R-76900 Romania
| | - G. Noguere
- Commissariat à l’Energie Atomique, Direction de l’Energie Nucléaire, Cadarache, F-13108 Saint Paul Les Durance, France
| | - J. Tommasi
- Commissariat à l’Energie Atomique, Direction de l’Energie Nucléaire, Cadarache, F-13108 Saint Paul Les Durance, France
| | - J.-F. Lebrat
- Commissariat à l’Energie Atomique, Direction de l’Energie Nucléaire, Cadarache, F-13108 Saint Paul Les Durance, France
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Nath A, Wang F, Lenkala D, LaCroix B, Glavin N, Kipping-Johnson K, Geeleher P, Rich E, Thirman M, Godley L, Raca G, Larson R, Huang R. ID: 26: EXPLORING THE LONGITUDINAL TRANSCRIPTOMIC LANDSCAPE OF TYROSINE KINASE INHIBITOR TREATMENT RESPONSE IN CHRONIC MYELOID LEUKEMIA PATIENTS. J Investig Med 2016. [DOI: 10.1136/jim-2016-000120.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The interpretation and implementation of large-scale genetic profiles into clinical practice remains a challenge despite substantial growth in our understanding of genetic contributors to drug response. Most current omic studies focus on identifying genetic features that are distinct between normal and tumor samples, but fail to capture the dynamics of association between omic profiles, treatment response and disease progression over time. The focus of this research is to analyze the longitudinal transcriptomic profile of chronic myeloid leukemia patients (CML) in context of tyrosine kinase inhibitor (TKI) treatment and clinical status. The main objectives were to compare a series of post-TKI treatment transcriptome profiles to their baseline levels, and characterize the impact of TKI treatment and CML disease status on the individual's transcriptome over time. Our ultimate goal is to develop TKI response predictors using the longitudinal expression data collected over the treatment course.Peripheral blood samples, buccal swabs and detailed clinical data were collected from each study participant (screened for BCR-ABL1 translocation) for a period of 6 months, in addition to pre-therapy baseline. RNA was extracted from granulocytes isolated from peripheral blood samples, and profiled using RNA sequencing. RNAseq profiles over TKI treatment course were compared to baseline, as well as against hematologic response (complete blood count), cytogenetic response (FISH), and clinical disease progression.We investigated dynamic trends in RNAseq profiles associated TKI response, as well as with the clinical status of the patient over time. We identified genetic features that were either 1) Differentially expressed between baseline and post-TKI time points; 2) Showed non-random spikes in expression levels at specific time points; 3) Associated with hematological and clinical phenotypes, including white blood cell count, percentage granulocytes and percentage cells with BCR-ABL1 translocation; 4) Demonstrated highly correlated patterns of expression over time. Through clustering and enrichment analysis of the selected transcripts, we identified several pathways and molecular features associated with TKI-response, and altered disease state. Of note, we found mTOR signaling, and pro-apoptotic pathways to be significantly altered between baseline and TKI-responding individuals. In addition, we observed significant changes in transcription regulatory network of several transcription factors, notably AP-1, over the treatment time course.To our knowledge, this is the first study to establish the utility of comprehensive longitudinal multiple transcriptome profile analysis of TKI-response in CML. We believe this study will pave way for future large-scale longitudinal omic profiling of CML and other cancer-types.
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Foley M, Harris R, Rich E, Rapca A, Bergin M, Norman I, Van Hout MC. The availability of over-the-counter codeine medicines across the European Union. Public Health 2015. [PMID: 26215740 DOI: 10.1016/j.puhe.2015.06.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- M Foley
- School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland.
| | - R Harris
- H.I. Weldricks Ltd, Doncaster, United Kingdom
| | - E Rich
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - A Rapca
- H.I. Weldricks Ltd, Doncaster, United Kingdom
| | - M Bergin
- School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - I Norman
- Kings College London, Florence Nightingale School of Nursing & Midwifery, London, United Kingdom
| | - M C Van Hout
- School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
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Robidoux A, Rich E, Bureau N, Mader S, Laperrière D, Bail M, Tremblay N, Patenaude M, Turgeon J. A prospective pilot study investigating the musculoskeletal pain in postmenopausal breast cancer patients receiving aromatase inhibitor therapy. Curr Oncol 2011; 18:285-94. [PMID: 22184490 PMCID: PMC3224030 DOI: 10.3747/co.v18i6.909] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Although arthralgia is a known adverse effect of aromatase inhibitor (ai) treatment in postmenopausal breast cancer patients, few studies have carried out a comprehensive evaluation of the nature, onset, and incidence of musculoskeletal (msk) pain in these patients. We therefore used a pilot study to identify conditions or markers predictive of pain. METHODS For 24 weeks, we monitored 30 eligible postmenopausal women starting ai therapy. Pre-existing and incident msk conditions and pain were assessed clinically and with ultrasonography of the hands and wrists. In addition, patient questionnaires were used to assess pain before and during ai therapy. Biochemical markers were measured at baseline and at regular intervals after anastrozole therapy began. Gene profiling studies were carried out before and 48 hours after the initial ai administration. RESULTS Over the 24-week study period, 20 participants (67%) showed no pain symptoms; 5 (17%) experienced low or moderate pain at baseline, which did not increase with ai treatment; and during therapy, 5 (17%) showed exacerbation of pain attributable to osteoarthritis of the hand and to finger flexor tenosynovitis. Although all 30 participants had some degree of msk conditions before anastrozole therapy started, the pre-existing conditions did not necessarily predispose the women to increased pain during anastrozole treatment. Higher levels of urinary N-telopeptides of type i collagen were associated with the groups presenting pain, suggesting a higher extent of pre-existing bone resorption, without significant evolution over the 24-week treatment period. Slightly higher levels of 1,25(OH)(2) vitamin D(3) were observed at baseline in patients with pain increase, but did not significantly change during treatment; however, average levels of 25(OH) vitamin D(3) increased, likely because of supplementation. Although biochemical markers did not discriminate efficiently between pain groups, a signature of 166 genes in peripheral blood mononuclear cells was identified that could stratify patients into the various groups observed in this pilot study. The gene signature was enriched in components of inflammatory signalling and chemokine expression, of antitumoural immunity pathways, and of metabolic response to hormones and xenobiotics, although no clinically significant association could be made in the present study, considering the small number of patients. Nevertheless, the observed trend suggests the feasibility of developing surrogate predictive markers of msk pain. Patient compliance was high in this study and was not affected by pain exacerbation. CONCLUSIONS Baseline msk assessment showed pre-existing causes for pain in most of the study patients before initiation of the ai. Exacerbation of existing osteoarthritis pain and tenosynovial symptoms was the primary cause of pain increase. Musculoskeletal pain assessment at baseline and prompt treatment of pain symptoms may help to optimize adherence to ai therapy. The value of routinely assessing inflammatory markers such as C-reactive protein and erythrocyte sedimentation rate was not supported by our pilot study. Gene expression profiles in peripheral blood mononuclear cells may be further explored in larger-scale studies as stratification markers to identify patients at risk of developing arthralgia.
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Affiliation(s)
- A. Robidoux
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, QC
| | - E. Rich
- Department of Medicine, Centre hospitalier de l’Université de Montréal, Montreal, QC
| | - N.J. Bureau
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, QC
- Radiology Department, Université de Montréal, Montreal, QC
| | - S. Mader
- Institute for Research in Immunology and Cancer, Université de Montréal, Montreal, QC
- Biochemistry Department, Université de Montréal, Montreal, QC
| | - D. Laperrière
- Institute for Research in Immunology and Cancer, Université de Montréal, Montreal, QC
| | - M. Bail
- Institute for Research in Immunology and Cancer, Université de Montréal, Montreal, QC
| | - N. Tremblay
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, QC
| | - M. Patenaude
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, QC
| | - J. Turgeon
- Faculty of Pharmacy, Université de Montréal, Montreal, QC
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Tedeschi L, Nicholson C, Rich E. Using System Dynamics modelling approach to develop management tools for animal production with emphasis on small ruminants. Small Rumin Res 2011. [DOI: 10.1016/j.smallrumres.2011.03.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Arai S, Meagher R, Swearingen M, Myint H, Rich E, Martinson J, Klingemann H. Infusion of the allogeneic cell line NK-92 in patients with advanced renal cell cancer or melanoma: a phase I trial. Cytotherapy 2009; 10:625-32. [PMID: 18836917 DOI: 10.1080/14653240802301872] [Citation(s) in RCA: 286] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Renal cell cancer and malignant melanoma are two types of cancer that are responsive to immunotherapy. In this phase I dose-escalation study, the feasibility of large-scale expansion and safety of administering ex vivo-expanded NK-92 cells as allogeneic cellular immunotherapy in patients with refractory renal cell cancer and melanoma were determined. METHODS Twelve patients (aged 31-74 years) were enrolled, three per cohort at cell dose levels of 1x10(8)/m(2), 3x10(8)/m(2), 1x10(9)/m(2) and 3x10(9)/m(2). One treatment course consisted of three infusions. Eleven patients had refractory metastatic renal cell cancer; one patient had refractory metastatic melanoma. RESULTS The NK-92 cells were expanded in X-Vivo 10 serum-free media supplemented with 500 U/mL Proleukin recombinant human interleukin-2 (rhIL-2), amino acids and 2.5% human AB plasma. Final yields of approximately 1x10(9) cells/culture bag (218-250xexpansion) over 15-17 days were achievable with >or=80% viability. Infusional toxicities of NK-92 were generally mild, with only one grade 3 fever and one grade 4 hypoglycemic episode. All toxicities were transient, resolved and did not require discontinuation of treatment. One patient was alive with disease at 4 years post-NK-92 infusion. The one metastatic melanoma patient had a minor response during the study period. One other patient exhibited a mixed response. DISCUSSION This study establishes the feasibility of large-scale expansion and safety of administering NK-92 cells as allogeneic cellular immunotherapy in advanced cancer patients and serves as a platform for future study of this novel natural killer (NK)-cell based therapy.
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Affiliation(s)
- S Arai
- Rush University Medical Center, Chicago, Illinois, USA.
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Sandfort TGM, Nel J, Rich E, Reddy V, Yi H. HIV testing and self-reported HIV status in South African men who have sex with men: results from a community-based survey. Sex Transm Infect 2009; 84:425-9. [PMID: 19028940 DOI: 10.1136/sti.2008.031500] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To investigate the characteristics of South African men who have sex with men (MSM) who (1) have been tested for HIV and (2) are HIV positive. METHODS Data were collected from 1045 MSM in community surveys using questionnaires that were administered either face-to-face, by mail or on the internet. The mean age of the men was 29.9 years. The race distribution was 35.3% black, 17.0% coloured, 5.3% Indian and 41.1% white. RESULTS The proportion of MSM tested for HIV was 69.7%; having been tested was independently associated with being older, being more open about one's homosexuality and being homosexually instead of bisexually attracted; black MSM, students and MSM living in KwaZulu-Natal were less likely to have been tested. Of the 728 MSM who had been tested, 14.1% (n = 103) reported to be HIV positive (9.9% of the total sample). Being HIV positive is independently associated with two factors: men who were positive were more likely to have a lower level of education and to know other people who had HIV/AIDS; race was not independently associated with HIV status among those who had been tested. CONCLUSIONS The likelihood of having been tested for HIV seems to decrease with increasing social vulnerability. Racially, the distribution of HIV among MSM seems to differ from that of the general South African population, suggesting that while intertwined with the heterosexual epidemic there is also an epidemic among South African MSM with specific dynamics. These findings suggest that in-depth research is urgently needed to address the lack of understanding of HIV testing practices and HIV prevalence in South African MSM.
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Affiliation(s)
- T G M Sandfort
- HIV Center for Clinical and Behavioral Studies, NYSPI, 1051 Riverside Drive, Unit 15, New York, NY 11101, USA.
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O'Donnell P, Swanson K, Josephson M, Artz A, Rich E, Stock W, van Besien K. BK Virus Infection is Associated with Hematuria and Renal Impairment in Recipients of Allogeneic Hematopoetic Stem Cell Transplants. Biol Blood Marrow Transplant 2009. [DOI: 10.1016/j.bbmt.2008.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pollyea DA, Artz AS, Stock W, Daugherty C, Godley L, Odenike OM, Rich E, Smith SM, Zimmerman T, Zhang Y, Huo D, Larson R, van Besien K. Outcomes of patients with AML and MDS who relapse or progress after reduced intensity allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2007; 40:1027-32. [PMID: 17846595 DOI: 10.1038/sj.bmt.1705852] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We describe treatment, outcomes and prognostic factors for patients who relapse following transplantation with a reduced intensity conditioning regimen. Seventy consecutive patients with high-risk myeloid malignancies underwent transplant and 25 (36%) relapsed, a median of 120 days later. The median percentage of bone marrow blasts at relapse was 24, the median donor chimerism was 73% and new karyotypic abnormalities occurred in 8 out of 20 (40%) evaluable patients. Twenty-one patients (84%) received aggressive treatment for relapse, including chemotherapy (60%), second hematopoietic cell transplantation (HCT; 52%) and/or donor lymphocyte infusion (DLI; 12%). Thirteen achieved a complete response (CR) and four remain in CR. Median overall survival (OS) after relapse was 6 months (95% confidence interval=2.7-9.9 months), and actuarial 1 year OS was 24%. Most deaths were due to disease progression (17/20, 85%). We did not observe an advantage for cellular therapy (DLI or second transplant) compared to chemotherapy. Salvage therapy for relapse after reduced intensity HCT is feasible, associated with low treatment-related mortality, and may result in prolonged survival in select patients. Studies exploring the optimal treatment for relapse following reduced intensity HCT are warranted.
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Affiliation(s)
- D A Pollyea
- Department of Internal Medicine, University of Chicago Hospitals, Chicago, IL 60637, USA
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Michaelis L, Lin S, Joseph L, Artz AS, Kline J, Pollyea D, Stock W, Rich E, Collins-Jones D, Casey B, Del Cerro P, van Besien K. Chimerism does not predict for outcome after alemtuzumab based conditioning. Bone Marrow Transplant 2007; 40:181. [PMID: 17502895 DOI: 10.1038/sj.bmt.1705707] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Artz A, Wickrema A, Stock W, Daugherty C, Godley L, Kocherginsky M, Odenike O, Pollyea D, Rich E, Ulsazek J, Larson R, van Besien K. 223: C-reactive protein (CRP) may predict transplant-related mortality after allogeneic hematopoietic cell transplant (HCT). Biol Blood Marrow Transplant 2007. [DOI: 10.1016/j.bbmt.2006.12.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fortier S, Tryggestad E, Rich E, Beaumel D, Becheva E, Blumenfeld Y, Delaunay F, Drouart A, Fomichev A, Frascaria N, Gales S, Gaudefroy L, Gillibert A, Guillot J, Hammache F, Kemper KW, Khan E, Lapoux V, Lima V, Nalpas L, Obertelli A, Pollacco EC, Skaza F, Pramanik UD, Roussel-Chomaz P, Santonocito D, Scarpaci JA, Sorlin O, Stepantsov SV, Ter Akopian GM, Wolski R. Search for resonances in 4n, 7H and 9He via transfer reactions. ACTA ACUST UNITED AC 2007. [DOI: 10.1063/1.2746575] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bernatsky S, Clarke A, Pope J, Hanly JG, Smith CD, Peschken C, Rich E, Boire G, Fortin PR. Malignancy prevalence in the first-degree relatives of persons with systemic lupus erythematous: a pilot study. Lupus 2006; 15:695-6. [PMID: 17120599 DOI: 10.1177/0961203306072424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Gaudefroy L, Sorlin O, Beaumel D, Blumenfeld Y, Dombrádi Z, Fortier S, Franchoo S, Gélin M, Gibelin J, Grévy S, Hammache F, Ibrahim F, Kemper KW, Kratz KL, Lukyanov SM, Monrozeau C, Nalpas L, Nowacki F, Ostrowski AN, Otsuka T, Penionzhkevich YE, Piekarewicz J, Pollacco EC, Roussel-Chomaz P, Rich E, Scarpaci JA, St Laurent MG, Sohler D, Stanoiu M, Suzuki T, Tryggestad E, Verney D. Reduction of the spin-orbit splittings at the n = 28 shell closure. Phys Rev Lett 2006; 97:092501. [PMID: 17026356 DOI: 10.1103/physrevlett.97.092501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2006] [Indexed: 05/12/2023]
Abstract
The N = 28 shell closure has been investigated via the 46Ar(d,p)47Ar transfer reaction in inverse kinematics. Energies and spectroscopic factors of the neutron p(3/2), p(1/2), and f(5/2) states in 47Ar were determined and compared to those of the 49Ca isotone. We deduced a reduction of the N = 28 gap by 330(90) keV and spin-orbit weakenings of approximately 10(2) and 45(10)% for the f and p states, respectively. Such large variations for the f and p spin-orbit splittings could be accounted for by the proton-neutron tensor force and by the density dependence of the spin-orbit interaction, respectively. This contrasts with the picture of the spin-orbit interaction as a surface term only.
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Affiliation(s)
- L Gaudefroy
- IPN, IN2P3-CNRS,F- 91406 Orsay Cedex, France
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Kline J, Pollyea DA, Stock W, Artz A, Rich E, Godley L, Zimmerman T, Thompson K, Pursell K, Larson RA, van Besien K. Pre-transplant ganciclovir and post transplant high-dose valacyclovir reduce CMV infections after alemtuzumab-based conditioning. Bone Marrow Transplant 2006; 37:307-10. [PMID: 16400339 DOI: 10.1038/sj.bmt.1705249] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Alemtuzumab (Campath-1H)-based conditioning regimens are effective in preventing GVHD, but are associated with very high rates of cytomegalovirus (CMV) infection, a major limitation to their use. We evaluated 85 patients receiving conditioning with fludarabine 30 mg/m2/day (day -7 to day -3), alemtuzumab 20 mg/day (day -7 to day -3), and melphalan 140 mg/m2 on day -2. The initial patients received post transplant CMV prophylaxis with high-dose acyclovir. A very high incidence of CMV viremia was observed as has been commonly reported after alemtuzumab-based conditioning. Sixty-seven subsequent patients received pre-transplant ganciclovir and high-dose valacyclovir after engraftment. The cumulative incidence of CMV infection in the valacyclovir cohort was 29%. This compared favorably to the cumulative incidence of 53% in patients receiving only acyclovir (P = 0.004) and to literature data. CMV prophylaxis with pre-transplant ganciclovir and high-dose valacyclovir after engraftment appears effective in preventing the excessive incidence of CMV infection after alemtuzumab-based conditioning regimens.
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Affiliation(s)
- J Kline
- Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA
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22
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Michaelis L, Lin S, Joseph L, Artz A, Kline J, Pollea D, Stock W, Rich E, Jones D, Casey B, Del Cerro P, Van Besien K. The relationship of day 30 and day 100 donor chimerism to clinical outcomes following reduced-intensity allogeneic transplantation for hematologic malignancies. Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kline J, Pollyea D, Artz A, Stock W, Rich E, Godley L, Zimmerman T, van Besien K. Ganciclovir and high-dose valacyclovir reduce cytomegalovirus reactivation in patients receiving allogeneic stem cell transplantation with Campath-1H–based conditioning regimens. Biol Blood Marrow Transplant 2005. [DOI: 10.1016/j.bbmt.2004.12.277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Newman J, Zillioux E, Rich E, Liang L, Newman C. Historical and other patterns of monomethyl and inorganic mercury in the Florida panther (Puma concolor coryi). Arch Environ Contam Toxicol 2005; 48:75-80. [PMID: 15657808 DOI: 10.1007/s00244-003-0130-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2003] [Accepted: 06/23/2004] [Indexed: 05/24/2023]
Abstract
Since the late 1980s, elevated levels of mercury have been reported in the tissues of the Florida panther (Puma concolor coryi) from the Florida Everglades. The extent, degree, and length of time of mercury contamination in the Florida panther are unknown. The objective of this study was to determine the historical and other patterns of monomethyl and inorganic mercury in the Florida panther by analysis of mercury in panther hair from museum collections. In addition, this study evaluated the effects of preservation of skins on mercury concentrations in hair and the representativeness of museum collections for evaluating historical trends of contamination in the Florida panther. Hair from 42 Florida panther specimens collected from 1896 to 1995 was analyzed for both monomethyl and inorganic mercury. Monomethyl mercury (MMHg) and inorganic mercury (IHg) were found in all specimens. Monomethyl mercury in hair from untanned skins was significantly higher than MMHg in hair from tanned skins. For untanned specimens, the mean MMHg concentration in hair was 1.62 +/- 1.87 mug/g (range 0.11 to 6.68 mug/g, n = 16). Monomethyl mercury accounted for 88% of the total mercury in untanned Florida panther hair. No sexual or geographical differences were found. Although MMHg is generally stable in hair, the tanning process appears to reduce the amount of MMHg in hair. In addition, exogenous IHg contamination of the panther hair was found in museum specimens, especially in older specimens. The implication of these and other factors in interpreting results of museum studies is discussed. The presence of MMHg in panther hair since the 1890s indicates long-term and widespread exposure of the Florida panther to mercury. Levels of MMHg are significantly greater in the 1990s than the 1890s. When combined with field studies of mercury in the Florida panther, considerable individual variability is observed, reflecting short-term changes in exposure of individual panthers to mercury. Although museum specimens showed a significant increase in MMHg over the last 100 years, they did not show the magnitude of increase that field populations of Florida panthers did. A number of Florida panthers appeared to be at risk from mercury over their lifetimes, especially individuals from the early 1990s.
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Affiliation(s)
- J Newman
- Pandion Systems, Inc., Gainesville, FL 32606-4482, USA.
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25
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Korn JH, Mayes M, Matucci Cerinic M, Rainisio M, Pope J, Hachulla E, Rich E, Carpentier P, Molitor J, Seibold JR, Hsu V, Guillevin L, Chatterjee S, Peter HH, Coppock J, Herrick A, Merkel PA, Simms R, Denton CP, Furst D, Nguyen N, Gaitonde M, Black C. Digital ulcers in systemic sclerosis: Prevention by treatment with bosentan, an oral endothelin receptor antagonist. ACTA ACUST UNITED AC 2004; 50:3985-93. [PMID: 15593188 DOI: 10.1002/art.20676] [Citation(s) in RCA: 445] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Recurrent digital ulcers are a manifestation of vascular disease in patients with systemic sclerosis (SSc; scleroderma) and lead to pain, impaired function, and tissue loss. We investigated whether treatment with the endothelin receptor antagonist, bosentan, decreased the development of new digital ulcers in patients with SSc. METHODS This was a randomized, prospective, placebo-controlled, double-blind study of 122 patients at 17 centers in Europe and North America, evaluating the effect of treatment on prevention of digital ulcers. The primary outcome variable was the number of new digital ulcers developing during the 16-week study period. Secondary assessments included healing of existing digital ulcers and evaluation of hand function using the Scleroderma Health Assessment Questionnaire. RESULTS Patients receiving bosentan had a 48% reduction in the mean number of new ulcers during the treatment period (1.4 versus 2.7 new ulcers; P = 0.0083). Patients who had digital ulcers at the time of entry in the study were at higher risk for the development of new ulcers; in this subgroup the mean number of new ulcers was reduced from 3.6 to 1.8 (P = 0.0075). In patients receiving bosentan, a statistically significant improvement in hand function was observed. There was no difference between treatment groups in the healing of existing ulcers. Serum transaminase levels were elevated to >3-fold the upper limit of normal in bosentan-treated patients; this elevation is comparable with that observed in previous studies of this agent. Other side effects were similar in the 2 treatment groups. CONCLUSION Endothelins may play an important role in the pathogenesis of vascular disease in patients with SSc. Treatment with the endothelin receptor antagonist bosentan may be effective in preventing new digital ulcers and improving hand function in patients with SSc.
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Affiliation(s)
- J H Korn
- Boston University School of Medicine, Boston, MA 02118, USA.
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26
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Dobkin PL, Da Costa D, Fortin PR, Edworthy S, Barr S, Esdaile JM, Senécal JL, Goulet JR, Choquette D, Rich E, Beaulieu A, Cividino A, Ensworth S, Smith D, Zummer M, Gladman D, Clarke AE. Living with lupus: a prospective pan-Canadian study. J Rheumatol 2001; 28:2442-8. [PMID: 11708416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
OBJECTIVE To portray life with lupus for women affected by this disease and to identify predictors of fatigue, a common symptom that compromises patients' quality of life. METHODS A sample of 120 female patients (mean age 42.5 yrs) with systemic lupus erythematosus (SLE) from 9 rheumatology clinics across Canada were followed prospectively for 15 months. Assessments of psychosocial functioning took place at baseline, and at 3, 9, and 15 months. Physician examinations were conducted at baseline and 15 months. RESULTS Significant time effects were found for: global psychological distress (p < 0.001), stress (p < 0.01), emotion-oriented coping (p < 0.001), physical health status (p < 0.001), and fatigue (p < 0.001), indicating that patients improved from baseline to 15 months. Disease activity worsened for 40.3%, improved for 50.8%, and remained the same for 8.8% of the patients from baseline to 15 months. Controlling for baseline disease activity and fatigue, and considering sleep problems, decreases in stress and depression predicted less fatigue at 15 months (p < 0.001; adjusted R2 = 0.43). CONCLUSION Despite fluctuations in disease activity, patients with SLE, as a group, cope adequately with their disease over time. There is, nonetheless, a subset of patients (about 40%) who remain distressed and who may benefit from psychosocial interventions.
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Affiliation(s)
- P L Dobkin
- Division of Clinical Epidemiology, Montreal General Hospital Research Institute, Quebec, Canada.
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Lonzetti LS, Joyal F, Raynauld JP, Roussin A, Goulet JR, Rich E, Choquette D, Raymond Y, Senécal JL. Updating the American College of Rheumatology preliminary classification criteria for systemic sclerosis: addition of severe nailfold capillaroscopy abnormalities markedly increases the sensitivity for limited scleroderma. Arthritis Rheum 2001; 44:735-6. [PMID: 11263791 DOI: 10.1002/1529-0131(200103)44:3<735::aid-anr125>3.0.co;2-f] [Citation(s) in RCA: 158] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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28
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Kalunian KC, Moreland LW, Klashman DJ, Brion PH, Concoff AL, Myers S, Singh R, Ike RW, Seeger LL, Rich E, Skovron ML. Visually-guided irrigation in patients with early knee osteoarthritis: a multicenter randomized, controlled trial. Osteoarthritis Cartilage 2000; 8:412-8. [PMID: 11069725 DOI: 10.1053/joca.1999.0316] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine if visually-guided arthroscopic irrigation is an effective therapeutic intervention in patients with early knee osteoarthritis. DESIGN Ninety patients with knee osteoarthritis were randomized in a double-blind fashion to receive either arthroscopic irrigation with 3000 ml of saline (treatment group) or the minimal amount of irrigation (250 ml) required to perform arthroscopy (placebo group). The primary outcome variable was aggregate WOMAC score. RESULTS The study did not demonstrate an effect of irrigation on arthritis severity as measured by aggregate WOMAC scores, the primary outcome variable; the mean change in aggregate WOMAC score at 12 months was 15.5 (95% CI 7.7, 23.4) for the full irrigation group compared to 8.9 (95% CI 4.9, 13.0) for the minimal irrigation group (P=0.10). Full irrigation did have a statistically significant effect on patients' self-reported pain as measured by the WOMAC pain subscale and by a visual analog scale (VAS) (the secondary outcome variables). Mean change in WOMAC pain scores decreased by 4.2 (95% CI -0.9, 9.4) for the full irrigation group compared with a mean decrease of 2.3 (95% CI -0.1, 4.7) in the minimal irrigation group (P=0.04). Mean VAS pain scores decreased by 1.47 (95% CI -1.2, 4.1) in the full irrigation group compared to a mean decrease of 0.12 (95% CI 0.0, 0.3) in the minimal irrigation group (P=0.02). A hypothesis-generating post-hoc analysis of the effect of positively birefrigent intraarticular crystals showed that patients with and without intraarticular crystals had statistically significant improvements in pain assessments and aggregate WOMAC scores at 12 months; patients with crystals had statistically greater improvements in pain. CONCLUSIONS Visually-guided arthroscopic irrigation may be a useful therapeutic option for relief of pain in a subset of patients with knee OA, particularly in those who have occult intraarticular crystals.
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Affiliation(s)
- K C Kalunian
- Division of Rheumatology, UCLA School of Medicine, University of California, Los Angeles, CA 90095, USA.
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29
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Vanham G, Penne L, Allemeersch H, Kestens L, Willems B, van der Groen G, Jeang KT, Toossi Z, Rich E. Modeling HIV transfer between dendritic cells and T cells: importance of HIV phenotype, dendritic cell-T cell contact and T-cell activation. AIDS 2000; 14:2299-311. [PMID: 11089618 DOI: 10.1097/00002030-200010200-00011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To study the requirements for HIV transfer between dendritic cells (DC) and CD4 T cells, using an in vitro model, combined with flow cytometry. METHODS Immature DC and macrophages (MA) were generated from monocytes. After infection, DC or MA were cultured alone or with purified CD4 T cells. Intracellular HIV was measured, using (1) the monocyte (MO)-tropic AD8 HIV, endowed with enhanced green fluorescent protein (EGFP); and (2) intracellular staining of laboratory HIV strains and clones from primary isolates. RESULTS (1) Clone AD8-EGFP infected DC and MA with equal efficiency, but the virus was preferentially transferred from DC to autologous T cells. (2) DC were more productively infected with R5/NSI, as compared to X4/SI, HIV, but both HIV phenotypes were easily transmitted to autologous T4 cells. (3) HIV-infected DC transferred the virus to T cells across a semi-permeable membrane, if the T cells were in contact with non-infected DC. (4) Co-culture of T cells with autologous non-infected DC induced T-cell activation. HIV-infected DC selectively increased HLA-DR on T cells and HLA-DR (+) T cells were preferential targets for HIV transfer. (5) Resting Ba-L-infected CD4 T cells were able to transmit the virus 'inversely' to co-cultured DC. CONCLUSION HIV transfer between monocyte-derived dendritic cells and autologous CD4 T cells was directly demonstrated using flow cytometry. The transfer proceeded in both directions, depended on cellular contact and was associated with partial T-cell activation. This model, representing relevant in vivo targets of HIV, is useful to further investigate interactions between HIV, DC and T cells, without the need for primary ex vivo DC.
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Affiliation(s)
- G Vanham
- Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium.
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30
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Da Costa D, Dobkin PL, Fitzcharles MA, Fortin PR, Beaulieu A, Zummer M, Senécal JL, Goulet JR, Rich E, Choquette D, Clarke AE. Determinants of health status in fibromyalgia: a comparative study with systemic lupus erythematosus. J Rheumatol 2000; 27:365-72. [PMID: 10685798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
OBJECTIVE To compare perceived health status in women with fibromyalgia (FM) and systemic lupus erythematosus (SLE) using the Medical Outcomes Study (MOS) Short Form Health Survey (SF-36); and to identify determinants of physical and mental health in each patient group. METHODS A cross sectional study of 46 women with FM (mean age 48.13 yrs, SD 9.40) and 59 women with SLE (mean age 42.36 yrs, SD 11.31). Patients with FM were recruited from a rheumatology clinic and a rheumatology practice, while patients with SLE were recruited from 4 rheumatology clinics. Clinical examination determined disease activity (by Systemic Lupus Activity Measure) in SLE and a tender point count was used for FM. Patients completed questionnaires assessing health status (SF-36), stress (Hassles), social support (Social Support Questionnaire 6), and coping (Coping Inventory for Stressful Situations). RESULTS Patients with FM reported more impairment on the following SF-36 subscales: physical function (p < 0.001), role physical (p < 0.001), bodily pain (p < 0.001), and vitality (p < 0.001). Physical component summary scores were also significantly lower (p < 0.001) for the FM group. Four hierarchical regression analyses were computed to determine factors related to physical and mental health in each patient group, with the following variables in the equation: age, income, disease activity (Step 1), hassles (Step 2), emotional and task coping, and social support (Step 3). Better physical health in FM was related to higher income (R2 = 0.17, p < 0.05). In the SLE group, better physical health was associated with younger age, less disease activity, and lower hassles (R2 = 0.37, p < 0.0001). Worse mental health among women with FM was associated with more hassles, more emotional coping, and less satisfaction with social support (R2 = 0.64, p < 0.0001), while lower income, higher hassles, and more emotional coping were linked to worse mental health in SLE (R2 = 0.46, p < 0.0001). CONCLUSION Health related quality of life (HRQL) is impaired among women with FM and SLE, with FM patients reporting greater impairment along several dimensions. Enhancing the HRQL of patients with FM and SLE requires targeting specific modifiable psychosocial factors.
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Affiliation(s)
- D Da Costa
- Division of Clinical Epidemiology, The Montreal General Hospital, Quebec, Canada.
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31
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Dobkin PL, Da Costa D, Dritsa M, Fortin PR, Senécal JL, Goulet JR, Choquette D, Rich E, Beaulieu A, Cividino A, Edworthy S, Barr S, Ensworth S, Esdaile JM, Gladman D, Smith D, Zummer M, Clarke AE. Quality of life in systemic lupus erythematosus patients during more and less active disease states: differential contributors to mental and physical health. Arthritis Care Res 1999; 12:401-10. [PMID: 11081011 DOI: 10.1002/1529-0131(199912)12:6<401::aid-art8>3.0.co;2-f] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To identify determinants of mental and physical health as a function of disease state in patients with systemic lupus erythematosus (SLE). METHODS A sample of 129 SLE patients (mean age 42.01 years; SD 11.09) was recruited from 9 immunology/rheumatology clinics across Canada. Patients completed questionnaires assessing psychological distress, social support, coping, stress, and health-related quality of life. Physicians rated disease activity (using the revised Systemic Lupus Activity Measure; SLAM-R) and damage (using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index). Mental and physical health composite scores were derived from the Medical Outcomes Study Short Form 36. Patients were subdivided into more active (SLAM-R > or = 10; n = 38) or less active disease states (n = 91). RESULTS Better mental health was predicted by more education and less emotion-oriented coping in the patients in a more active disease state (P = 0.0001; R2 = 0.46). Better mental health was predicted by less stress, less emotion-oriented coping and more task-oriented coping in patients during a less active disease state (P = 0.0001; R2 = 0.45). Better physical health was predicted by more emotion-oriented coping in patients in a more active disease state (P = 0.04; R2 = 0.11). Better physical health was predicted by less stress and younger age in patients during a less active disease state (P = 0.0001; R2 = 0.20). CONCLUSION The positive association between emotion-oriented coping and better physical health in patients during a more active disease state suggests that this style of coping may be more adaptive in situations that are considered uncontrollable (e.g., SLE flare). Predictors of mental health were similar to those found in the literature, especially for SLE patients in a less active disease state.
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Affiliation(s)
- P L Dobkin
- Division of Clinical Epidemiology, Montreal General Hospital Research Institute, Quebec, Canada
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Abstract
This article presents a brief review of the most current therapies that are used for the relief of the symptoms related to osteoarthritis. The agents used either systematically or locally are described, providing the rationale for their usage in the treatment of osteoarthritis. Moreover, new therapies that have reached clinical evaluations and that can possibly reduce or stop the progression of the disease--namely the inhibitors of metalloproteases--are presented. Overall, it is obvious that significant progress has been made toward the development of new therapeutic agents to reduce the symptoms as well as the structural changes of the disease.
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Affiliation(s)
- J P Pelletier
- Osteoarthritis Research Unit, Centre Hospitalier de l'Universit de Montreal (CHUM), Hopital Notre-Dame, 1560 Sherbrooke St. E., Montreal, Quebec, H2L 4M1, Canada
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Rich E, Moreland LW, Alarcón GS. Paucity of radiographic progression in rheumatoid arthritis treated with methotrexate as the first disease modifying antirheumatic drug. J Rheumatol 1999; 26:259-61. [PMID: 9972955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
OBJECTIVE To determine disease progression in patients with rheumatoid arthritis (RA) using methotrexate (MTX) as the first disease modifying antirheumatic drug (DMARD). METHODS Patients with RA treated with MTX as their first DMARD and in whom hand/wrist radiographs prior to MTX administration had been obtained and who had received MTX for at least 10 months were evaluated radiographically for disease progression. Coded radiographs were read for erosions by 2 experienced readers using the modified method of Sharp. Erosion scores and rate of progression (per month) were calculated. RESULTS Of 24 patients studied, baseline radiographs showed erosions (one or more) in 11 and none in 13. Patients with and without erosions at baseline had comparable demographic and clinical features, although patients with erosions had longer disease duration and higher rheumatoid factor positivity than those without erosions (statistically nonsignificant, however). Half of all patients showed no progression; 73% of those patients with erosions at baseline but only 31% of those without erosions at baseline progressed (p = 0.049); progression rates were 0.017 (+/-0.033) and 0.049 (+/-0.078) for the 2 groups (p = 0.040). CONCLUSION Patients with RA starting MTX before erosions have occurred are less likely to develop them; these patients also experienced a lesser degree of disease progression than patients who started MTX with erosions already present.
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Affiliation(s)
- E Rich
- Department of Medicine, University of Alabama at Birmingham, 35294, USA
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Cellier M, Shustik C, Dalton W, Rich E, Hu J, Malo D, Schurr E, Gros P. Expression of the human NRAMP1 gene in professional primary phagocytes: studies in blood cells and in HL-60 promyelocytic leukemia. J Leukoc Biol 1997; 61:96-105. [PMID: 9000542 DOI: 10.1002/jlb.61.1.96] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
In the mouse, mutations at the natural resistance-associated macrophage protein 1 (Nramp1) gene abrogate resistance to infection with antigenically unrelated intracellular parasites such as Mycobacterium, Salmonella, and Leishmania. Nramp1 expression is restricted to reticuloendothelial organs and peripheral blood leukocytes, where the protein may function as a membrane transporter of an as yet to be identified substrate. To identify the human blood cell type(s) expressing NRAMP1 mRNA and determine how Nramp1 expression is regulated in these cells, we have examined separated populations of peripheral blood leukocytes and in vitro cell lines. We observed that polymorphonuclear leukocytes (PMN) are the major site of NRAMP1 expression, followed to a lesser degree by monocytes (MN). Migration of MN to tissues (alveolar macrophages) or maturation in vitro (long-term culture) was associated with a higher level of NRAMP1 expression compared with blood MN. Northern analyses of RNA from model cultured cells showed absence of NRAMP1 expression in transformed cell lines from either erythroid or lymphoid T or B lineages as well as progenitors of the monocyte/macrophage pathway (KG1, U937, THP1), and the HL-60 promyelocytic leukemia. Induction of differentiation of HL-60 cells toward either the monocyte/macrophage (vitamin D3, phorbol ester) or the granulocyte pathways (DMF, DMSO), as measured by induction of IL8-Rb, c-FMS, and CD14 marker gene expression, was concomitant with a strong induction of NRAMP1 expression. These results suggest that NRAMP1 expression is specific to the myeloid lineage and is acquired during the maturation of PMN and MN. The possibility that NRAMP1 may be a component of the phagosomal/endosomal apparatus common to PMN and MN is discussed.
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Affiliation(s)
- M Cellier
- Department of Biochemistry, McGill University, Montreal, Canada
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Newland JA, Rich E. Nurse-managed primary care center. Nurs Clin North Am 1996; 31:471-86. [PMID: 8751781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The authors look at many aspects of a nurse-managed primary care center within an academic institution, as administrators and practicing clinicians. This article presents the history of the development of the center, the profile of clients and services, the education and preparation for the role of nurse practitioner and scope of practice, reimbursement, legal issues such as collaborative practice and barriers to practice, and risk management. Problems faced by many nurse-managed centers are addressed, especially the need for flexibility, with personal accounts of how they have been dealt with at this center. An evaluation of the center and its practice model is offered.
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Affiliation(s)
- J A Newland
- University Health Care Unit, Pace University, Pleasantville, New York, USA
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Rich E, Hook EW, Alarcón GS, Moreland LW. Reactive arthritis in patients attending an urban sexually transmitted diseases clinic. Arthritis Rheum 1996; 39:1172-7. [PMID: 8670327 DOI: 10.1002/art.1780390715] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To assess the prevalence, clinical manifestations, associated genital infections, and HLA associations of reactive arthritis (ReA) among patients attending an urban sexually transmitted diseases (STD) clinic. METHODS Using a standardized questionnaire, 271 consecutive adults, primarily black, with possible or proven Chlamydia trachomatis genital infection were screened for symptoms of ReA. A followup questionnaire was administered 6 weeks later by mail. Patients who reported at least 1 symptom were evaluated by a rheumatologist. HLA-B typing was performed on patients with objective ReA features. RESULTS Nine of 217 patients (4.1%) with genital infection/inflammation had objective ReA features. Chlamydial or nongonococcal STD syndromes were diagnosed in 8 of these 9 patients (88%). Genital infection/inflammation was asymptomatic in 78% of patients with ReA features. HLA-B27 or other B7-cross-reactive group antigens were not associated with the occurrence of ReA. CONCLUSION Nongonococcal genital infections, often asymptomatic, can trigger a relatively mild ReA in a larger number of exposed patients than previously thought, irrespective of the individual's HLA status.
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Affiliation(s)
- E Rich
- University of Alabama at Birmingham, USA
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Lang T, Berquist W, Rich E, Cox K, De Vries P, Cahill J, Baker E, Gish R. Treatment of recurrent pancreatitis by endoscopic drainage of a duodenal duplication. J Pediatr Gastroenterol Nutr 1994; 18:494-6. [PMID: 8071789 DOI: 10.1097/00005176-199405000-00018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- T Lang
- Department of Pediatrics, California Pacific Medical Center, San Francisco 94115
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Rich E, Schmalz G, Syndikus S. [Clinical comparison of different cervical fillings after one year]. Dtsch Zahnarztl Z 1990; 45:292-6. [PMID: 2269112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Cervical lesions in 38 patients were restored using composite resins (n = 57), the "sandwich-technique" (n = 64) or glassionomercement (n = 66). Immediately following insertion and 4, 8, and 12 months later, the restorations were examined clinically and in the SEM. Two composite fillings and one filling each of the two other types of restoration were lost. After one year the quality of the dentinal margins of the composite restorations was statistically (p less than 0.05) inferior to the two other methods. Margin quality in enamel was rated superior (p less than 0.05) with glassionomercement as against the other materials. Clinically, the composite filling yielded poorer results regarding marginal integrity and discoloration, although in general they showed superior esthetics. In restoring cervical lesions the use of glassionomercements or the "sandwich-technique" has definite advantages over composite fillings. For the evaluation of new restorative materials and techniques, SEM should be used in addition to clinical examinations.
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Affiliation(s)
- E Rich
- Poliklinik für Zahnerhaltung und Parodontologie, Universität Regensburg
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Martinez J, Rich E, Barsigian C. Transglutaminase-mediated cross-linking of fibrinogen by human umbilical vein endothelial cells. J Biol Chem 1989; 264:20502-8. [PMID: 2573600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The interaction of endothelial cells with soluble or substrate-immobilized 125I-labeled fibrinogen (125I-FGN) was analyzed. Binding experiments involved incubation of 125I-FGN with cell suspensions at 4 degrees C. Bound ligand was quantitated by centrifugation of cells through silicone oil followed by scintillation analysis of the cell pellet. Calcium-dependent binding of 125I-FGN reached a maximum after 3 h and represented about 60% of the total. Half-maximal saturation occurred at 60 nM, and about 9 x 10(4) molecules were bound/cell at saturation (approximately 100 nM). Calcium-dependent binding was completely inhibited by unlabeled fibrinogen, partially inhibited by a monoclonal antibody (7E3) against glycoprotein IIb-IIIa, but not inhibited by fibrinogen fragments D or E, an anti-glycoprotein IIIa polyclonal antibody, or the Arg-Gly-Asp-Ser tetrapeptide. In contrast, the Arg-Gly-Asp-Ser tetrapeptide as well as the monoclonal antibody 7E3 markedly inhibited attachment of endothelial cells to substrate-immobilized fibrinogen, whereas fragment D or E did not. Both in suspension and monolayer, the 125I-FGN underwent cross-linking involving principally the A alpha chain. The transglutaminase inhibitors putrescine, histamine, and cystamine interfered with 125I-FGN binding and cross-linking by suspended cells. Since cross-linking in suspension was limited to bound 125I-FGN and since transglutaminase activity was not detectable in the binding buffer, cross-linking may have been mediated by a cell-associated transglutaminase.
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Affiliation(s)
- J Martinez
- Cardeza Foundation for Hematologic Research, Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania 19107
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Abstract
Medicare regulations and the guidelines of the Joint Commission on Accreditation of Healthcare Organizations require assessment of the appropriateness of transfusions by a hospital committee. A set of criteria maps for component transfusion review by nurses or technical personnel was designed, tested, and modified. The algorithms were based on written guidelines developed by a group of physicians. In the first part of the study, 196 medical records of patients from medical and surgical diagnosis-related groups with the highest utilization of blood (Group I) were screened. Forty patients were excluded because of a preexisting transfusion protocol. Of the remaining 156 patients, 146 (94%) received red cell transfusions, of which 96 percent were indicated, 1 percent not indicated, and 3 percent controversial. Thirty-five patients (22%) received fresh-frozen plasma transfusions, of which 69 percent were indicated, 11 percent not indicated, 17 percent controversial, and 6 percent indeterminate. In the second part of the study, medical records were screened from 99 randomly selected patients who had received red cell transfusions (Group II), and the results were similar to those in Group I. Physician review was necessary in 20 percent of the transfused patients screened with the criteria maps. It is concluded that algorithms for transfusion review can be developed and used easily to fulfill regulatory and accreditation requirements and to plan focused educational programs.
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Affiliation(s)
- C Coffin
- Department of Pathology, St. Paul-Ramsey Medical Center, Minnesota
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Fellin FM, Barsigian C, Rich E, Martinez J. Binding and cross-linking of rabbit fibronectin by rabbit hepatocytes in suspension. J Biol Chem 1988; 263:1791-7. [PMID: 3123479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Fibronectin purified from rabbit plasma was radioiodinated, and its interaction with rabbit hepatocytes in suspension was studied. Iodinated fibronectin interacted in a time-dependent fashion reaching plateau at 3 h. The interaction was greater in the presence of calcium than in the presence of magnesium or EDTA. Saturation occurred at about 140 nM fibronectin with about 1,400,000 molecules bound per cell. The interaction could be inhibited by unlabeled fibronectin or fibrinogen but not by the tetrapeptide Arg-Gly-Asp-Ser or by albumin, transferrin, or fetuin. About 50% of the bound iodinated fibronectin was incorporated, in a calcium-dependent fashion, into cross-linked high molecular weight complexes at the cell surface through a mechanism consistent with a cellular transglutaminase-mediated reaction. Iodinated fibronectin which could be displaced from the cell was monomeric in nature, while the cell-associated material remained in high molecular weight complexes. The role of the interaction is currently under investigation, but it is possible that the binding may promote cellular adhesion or facilitate intercellular interaction.
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Affiliation(s)
- F M Fellin
- Cardeza Foundation for Hematologic Research, Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania 19107
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Rich E. Vaginal bleeding in the first and second trimesters of pregnancy. Nurse Pract 1980; 5:10-1, 13, 15-6, passim. [PMID: 7454156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Picciolo GL, Chappelle EW, Rich E. A simple method for the mass culture of microorganisms with reference to photobacteria. Appl Microbiol 1968; 16:954-5. [PMID: 4874458 PMCID: PMC547563 DOI: 10.1128/am.16.6.954-955.1968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Crawford AM, Rich E. A clean room complex for microbial contamination control. Contam Control 1968; 7:14-6. [PMID: 4231731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Abstract
Firefly luciferase exposed to a temperature of 135 degrees C for 36 hours re tained up to 40 percent of its original activity. Prerequisites for heat stability were the use of a molecular sieve (Seph adex G-25 or Biogel P-300) and a high vacuum (5 x 10(-4) mm-Hg). These studies present a possible solution to the problem of sterilization for exobiologi cal experiments.
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