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Lisiecki J, Buta M, Taylor S, Tait M, Farina N, Levin J, Schulz J, Sangji N, Friedstat J, Hemmila M, Wang S, Levi B, Goverman J. Efficacy of Mepliex ® Ag Versus Xeroform ® As A Split-Thickness Skin Graft Donor Site Dressing: Bad Habits Die Hard. Ann Burns Fire Disasters 2023; 36:243-250. [PMID: 38680433 PMCID: PMC11041881] [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] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 03/01/2022] [Indexed: 05/01/2024]
Abstract
Autografting with split-thickness skin grafts (STSG) remains an essential procedure in burn and reconstructive surgery. The process of harvesting STSG, however, leaves behind a donor site, an exposed area of partial-thickness dermis left to heal by secondary intention. There has yet to be a consensus amongst surgeons regarding optimal management of the donor site. The ideal donor site dressing is one that allows for expeditious healing while minimizing pain and infection. Despite numerous studies demonstrating the superiority of moist wound healing, many surgeons continue to treat STSG donor sites dry, with petroleum-based gauze. In this study, two burn centers performed a retrospective review of burn patients whose STSG donor sites were treated with either Xeroform® or Mepilex® Ag dressings. Infections were documented and in a subgroup analysis of patients, postoperative pain scores were noted and total opiate usage during hospitalization was calculated. Analysis revealed an overall infection rate of 1.2% in the Mepilex® Ag group and 11.4% in the Xeroform® group (p<0.0001). Patients with Xeroform® donor site dressings had increased odds of donor site infection (OR=10.8, p=0.002). In subgroup analysis, there were no significant differences in maximum pain scores between Mepilex® Ag and Xeroform® groups, nor were there differences in opiate usage. STSG donor sites dressed with silver foam dressings have a lower rate of donor site infection relative to those dressed with petroleum-based gauze. Moist donor site dressings such as foam dressings (including Mepilex® Ag) should be the standard of care in STSG donor site wound care.
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Affiliation(s)
- J.L. Lisiecki
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - M.R. Buta
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - S. Taylor
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - M. Tait
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - N. Farina
- Department of Pharmacy Services, University of Michigan Health System, Ann Arbor, MI, USA
| | - J. Levin
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - J. Schulz
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - N. Sangji
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - J. Friedstat
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - M.R. Hemmila
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - S. Wang
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - B. Levi
- Department of Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - J. Goverman
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
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Vermunt L, Sutphen C, Dicks E, de Leeuw DM, Allegri R, Berman SB, Cash DM, Chhatwal JP, Cruchaga C, Day G, Ewers M, Farlow M, Fox NC, Ghetti B, Graff-Radford N, Hassenstab J, Jucker M, Karch CM, Kuhle J, Laske C, Levin J, Masters CL, McDade E, Mori H, Morris JC, Perrin RJ, Preische O, Schofield PR, Suárez-Calvet M, Xiong C, Scheltens P, Teunissen CE, Visser PJ, Bateman RJ, Benzinger TLS, Fagan AM, Gordon BA, Tijms BM. Axonal damage and astrocytosis are biological correlates of grey matter network integrity loss: a cohort study in autosomal dominant Alzheimer disease. medRxiv 2023:2023.03.21.23287468. [PMID: 37016671 PMCID: PMC10071836 DOI: 10.1101/2023.03.21.23287468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Brain development and maturation leads to grey matter networks that can be measured using magnetic resonance imaging. Network integrity is an indicator of information processing capacity which declines in neurodegenerative disorders such as Alzheimer disease (AD). The biological mechanisms causing this loss of network integrity remain unknown. Cerebrospinal fluid (CSF) protein biomarkers are available for studying diverse pathological mechanisms in humans and can provide insight into decline. We investigated the relationships between 10 CSF proteins and network integrity in mutation carriers (N=219) and noncarriers (N=136) of the Dominantly Inherited Alzheimer Network Observational study. Abnormalities in Aβ, Tau, synaptic (SNAP-25, neurogranin) and neuronal calcium-sensor protein (VILIP-1) preceded grey matter network disruptions by several years, while inflammation related (YKL-40) and axonal injury (NfL) abnormalities co-occurred and correlated with network integrity. This suggests that axonal loss and inflammation play a role in structural grey matter network changes. Key points Abnormal levels of fluid markers for neuronal damage and inflammatory processes in CSF are associated with grey matter network disruptions.The strongest association was with NfL, suggesting that axonal loss may contribute to disrupted network organization as observed in AD.Tracking biomarker trajectories over the disease course, changes in CSF biomarkers generally precede changes in brain networks by several years.
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Levin J, Döhrmann S, Dedeic N, Almaguer A, Zuill D, Abelovski E, Grewal R, Fortier J, Zhao Q, Hernandez M, Amundson K, Moniz M, Chen H, Panickar D, Lam T, Brady T, Borchardt A, Cole J, Tari L. 45P Discovery of CBO-212, a first-in-class drug Fc-conjugate (DFC), targeting CD73 in cancer. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101011] [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: 03/11/2023] Open
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Walendzik A, Wasem J, Wagemann O, Levin J, Schall A, Tesky V, Pantel J, Hüer T. (Zugang zur) Diagnostik und Therapie demenzieller Erkrankungen bei
Menschen mit einem Down-Syndrom (DS-Demenz). Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753611] [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: 12/12/2022]
Affiliation(s)
- A Walendzik
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - J Wasem
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
| | - O Wagemann
- Universität München, Ambulanz für Alzheimer bei
Downsyndrom, LMU, München, Deutschland
| | - J Levin
- Universität München, Ambulanz für Alzheimer bei
Downsyndrom, LMU, München, Deutschland
| | - A Schall
- Universität Frankfurt, Institut für Allgemeinmedizin,
Frankfurt, Deutschland
| | - V Tesky
- Universität Frankfurt, Institut für Allgemeinmedizin,
Frankfurt, Deutschland
| | - J Pantel
- Universität Frankfurt, Institut für Allgemeinmedizin,
Frankfurt, Deutschland
| | - T Hüer
- Universität Duisburg-Essen, Lehrstuhl für
Medizinmanagement, Essen, Deutschland
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Koeglsperger T, Alesch F, Buhmann C, Kinfe T, Rumpf J, Schnitzler A, Steiger B, Weiss D, Witt K, Mehrkens J, Levin J. P 51 Evaluation of a Visual-Analog Scale (VAS) for Remote DBS Programming (The REMOTE-Trial). Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2022.01.082] [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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Zsom A, Tsekhan S, Hamid T, Levin J, Truccolo W, LaFrance WC, Blum AS, Li P, Wahed LA, Shaikh MA, Sharma G, Ranieri R, Zhang L. Ictal autonomic activity recorded via wearable-sensors plus machine learning can discriminate epileptic and psychogenic nonepileptic seizures. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:3502-3506. [PMID: 31946633 DOI: 10.1109/embc.2019.8857552] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Differentiating epileptic seizures (ES) and psychogenic nonepileptic seizures (PNES) is commonly based on electroencephalogram and concurrent video recordings (vEEG). Here, we demonstrate that these two types of seizures can be discriminated based on signals related to autonomic nervous system activity recorded via wearable sensors. We used Empatica E4 Wristband sensors worn on both arms in vEEG confirmed seizures, and machine learning methods to train classifiers, specifically, extreme gradient boosting (XGBoost). Classification performance achieved a predictive accuracy of 78 ± 1.5% on previously unseen data for whether a seizure was epileptic or psychogenic, which is 6 standard deviations above the baseline of 68% accuracy. Our dataset contained altogether 35 seizures from 18 patients out of which 8 patients had 13 convulsive seizures. Prediction of seizure type was based on simple features derived from the segments of autonomic activity measurements (electrodermal activity, body temperature, blood volume pulse, and heart rate) and forearm acceleration. Features related to heart rate and electrodermal activity were ranked as the top predictors in XGBoost classifiers. We found that patients with PNES had a higher ictal heart rate and electrodermal activity than patients with ES. In contrast to existing published studies of mainly convulsive seizures, our classifier focuses on autonomic signals to differentiate convulsive or nonconvulsive semiology ES from PNES. Our results show that autonomic activity recorded via wearable sensors provides promising signals for detection and discrimination of psychogenic and epileptic seizures, but more work is necessary to improve the predictive power of the model.
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Grosch M, Schöberl F, Levin J, Bötzel K, Dieterich M, Zwergal A. FV16 [18F]FDG-PET imaging of supraspinal locomotor control in Parkinson’s disease. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.106] [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: 10/24/2022]
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Birungi C, Ssembajjwe W, Salisbury TT, Levin J, Nakasujja N, Mpango RS, Abbo C, Seedat S, Araya R, Musisi S, Gadow KD, Patel V, Kinyanda E. Substance use among HIV-infected adolescents in Uganda: rates and association with potential risks and outcome factors. AIDS Care 2020; 33:137-147. [PMID: 32005076 DOI: 10.1080/09540121.2020.1717419] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This article sets out to investigate alcohol and substance use (ASU) among adolescents living with HIV (ALWH) in the sub-Saharan African setting of Uganda. A cross-sectional analysis of the records of 479 adolescents (aged between 12and 17 years) attending the study, "Mental health among HIV infected CHildren and Adolescents in KAmpala and Masaka, Uganda (the CHAKA study)" was undertaken. ASU was assessed through both youth self-report and caregiver report using the Diagnostic and Statistical Manual of Mental Disorders-5 referenced instruments, the Youth Inventory-4R and the Child and Adolescent Symptom Inventory-5 (CASI-5). Rates and association with potential risk and outcome factors were investigated using logistic regression models. The rate of ASU was 29/484 (5.9%) with the most frequently reported ASU being alcohol 22/484 (4.3%) and marijuana 10/484 (2.1%). Functional impairment secondary to ASU was reported by 10/484 (2.1%) of the youth. ASU was significantly associated with urban residence, caregiver psychological distress and the psychiatric diagnosis of post-traumatic stress disorder. On associations with negative outcomes, ASU was significantly associated with only "ever had sex". Health care for ALWH in sub-Saharan Africa should include ASU prevention and management strategies.
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Affiliation(s)
- C Birungi
- Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda.,Mental Health Section, MRC/UVRI & LSHTM Uganda Research Unit/Senior Wellcome Trust Fellowship, Entebbe, Uganda
| | - W Ssembajjwe
- Mental Health Section, MRC/UVRI & LSHTM Uganda Research Unit/Senior Wellcome Trust Fellowship, Entebbe, Uganda.,Statistical and Data Management Section, MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
| | - T T Salisbury
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J Levin
- School of Public HealthFaculty of Health Sciences, University of the Witwatersrand, Jannesburg, South Africa
| | - N Nakasujja
- Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda
| | - R S Mpango
- Mental Health Section, MRC/UVRI & LSHTM Uganda Research Unit/Senior Wellcome Trust Fellowship, Entebbe, Uganda.,Butabika National Referral Hospital, Kampala, Uganda
| | - C Abbo
- Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda
| | - S Seedat
- Department of Psychiatry, Stellenbosch University, Matieland, South Africa
| | - R Araya
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S Musisi
- Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda
| | - K D Gadow
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - V Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - E Kinyanda
- Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda.,Mental Health Section, MRC/UVRI & LSHTM Uganda Research Unit/Senior Wellcome Trust Fellowship, Entebbe, Uganda
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9
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Nübling G, Loosli SV, Wlasich E, Prix C, Schönecker S, Freudelsperger L, Smrzka N, Strydom AM, Zaman SH, Benejam B, Missios J, Meister R, Danek A, Levin J. Eine deutsche Fassung der Cambridge Examination for Mental Disorders of Older People with Down’s Syndrome and Others with Intellectual Disabilities. Z Gerontol Geriatr 2019; 53:546-551. [DOI: 10.1007/s00391-019-01591-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 07/16/2019] [Indexed: 02/04/2023]
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10
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Hechtfischer U, Levin J, Lange M, Knoll L, Schwalm D, Wester R, Wolf A, Zajfman D. Near-threshold photodissociation of cool OH + to O + H + and O + + H. J Chem Phys 2019; 151:044303. [DOI: 10.1063/1.5098321] [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: 11/14/2022] Open
Affiliation(s)
- U. Hechtfischer
- Max-Planck-Institut für Kernphysik, 69029 Heidelberg, Germany
| | - J. Levin
- Max-Planck-Institut für Kernphysik, 69029 Heidelberg, Germany
| | - M. Lange
- Max-Planck-Institut für Kernphysik, 69029 Heidelberg, Germany
| | - L. Knoll
- Max-Planck-Institut für Kernphysik, 69029 Heidelberg, Germany
| | - D. Schwalm
- Max-Planck-Institut für Kernphysik, 69029 Heidelberg, Germany
| | - R. Wester
- Max-Planck-Institut für Kernphysik, 69029 Heidelberg, Germany
| | - A. Wolf
- Max-Planck-Institut für Kernphysik, 69029 Heidelberg, Germany
| | - D. Zajfman
- Weizmann Institute of Science, Rehovot 76100, Israel
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11
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Friedstat JS, Stockley O, Chang K, Levin J, Sangji N, Sheridan R, Schulz JT, Kasis L, Ryan CM, Goverman J, Schneider JC. 310 Evaluation of Patient Reported Outcomes Before and After Burn Reconstruction. J Burn Care Res 2019. [DOI: 10.1093/jbcr/irz013.224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- J S Friedstat
- Massachusetts General Hospital, Boston, MA; Spaulding Rehabilitation Hospital, Boston, MA; Massachusetts General Hospital, Boston, MA; Boston University, Boston, MA; Spaulding Rehabiliation Hospital, Boston, MA
| | - O Stockley
- Massachusetts General Hospital, Boston, MA; Spaulding Rehabilitation Hospital, Boston, MA; Massachusetts General Hospital, Boston, MA; Boston University, Boston, MA; Spaulding Rehabiliation Hospital, Boston, MA
| | - K Chang
- Massachusetts General Hospital, Boston, MA; Spaulding Rehabilitation Hospital, Boston, MA; Massachusetts General Hospital, Boston, MA; Boston University, Boston, MA; Spaulding Rehabiliation Hospital, Boston, MA
| | - J Levin
- Massachusetts General Hospital, Boston, MA; Spaulding Rehabilitation Hospital, Boston, MA; Massachusetts General Hospital, Boston, MA; Boston University, Boston, MA; Spaulding Rehabiliation Hospital, Boston, MA
| | - N Sangji
- Massachusetts General Hospital, Boston, MA; Spaulding Rehabilitation Hospital, Boston, MA; Massachusetts General Hospital, Boston, MA; Boston University, Boston, MA; Spaulding Rehabiliation Hospital, Boston, MA
| | - R Sheridan
- Massachusetts General Hospital, Boston, MA; Spaulding Rehabilitation Hospital, Boston, MA; Massachusetts General Hospital, Boston, MA; Boston University, Boston, MA; Spaulding Rehabiliation Hospital, Boston, MA
| | - J T Schulz
- Massachusetts General Hospital, Boston, MA; Spaulding Rehabilitation Hospital, Boston, MA; Massachusetts General Hospital, Boston, MA; Boston University, Boston, MA; Spaulding Rehabiliation Hospital, Boston, MA
| | - L Kasis
- Massachusetts General Hospital, Boston, MA; Spaulding Rehabilitation Hospital, Boston, MA; Massachusetts General Hospital, Boston, MA; Boston University, Boston, MA; Spaulding Rehabiliation Hospital, Boston, MA
| | - C M Ryan
- Massachusetts General Hospital, Boston, MA; Spaulding Rehabilitation Hospital, Boston, MA; Massachusetts General Hospital, Boston, MA; Boston University, Boston, MA; Spaulding Rehabiliation Hospital, Boston, MA
| | - J Goverman
- Massachusetts General Hospital, Boston, MA; Spaulding Rehabilitation Hospital, Boston, MA; Massachusetts General Hospital, Boston, MA; Boston University, Boston, MA; Spaulding Rehabiliation Hospital, Boston, MA
| | - J C Schneider
- Massachusetts General Hospital, Boston, MA; Spaulding Rehabilitation Hospital, Boston, MA; Massachusetts General Hospital, Boston, MA; Boston University, Boston, MA; Spaulding Rehabiliation Hospital, Boston, MA
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12
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Spies G, Denckla CA, Mall S, Levin J, Seedat S, Nakasujja N, Kinyanda E. The relationship between cognitive change and physical health and behavioural outcomes in a Ugandan cohort of adults living with HIV - a longitudinal study. AIDS Care 2018; 31:803-808. [PMID: 30421989 DOI: 10.1080/09540121.2018.1545987] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 01/30/2023]
Abstract
We investigated changes in cognitive function and physical health and behavioural outcomes (HIV disease progression, health-seeking behaviour, adherence to HIV medications and risky sexual behaviour) at baseline and 12 months later among 1126 Ugandan adults living with HIV. Overall, cognitive function improved from baseline to follow-up, except for gait speed, which was slower at follow-up compared to baseline. There were improvements in physical health and behavioural outcomes by follow-up, with greater improvements among individuals on ART compared to those not on ART. Change in gait speed over time significantly predicted risky sexual behaviours at follow-up. This is the first study to investigate the longitudinal relationships between cognitive function and health outcomes among Ugandan adults living with HIV and provide insights into the possible links between cognitive function and negative clinical and behavioural health outcomes in people living with HIV.
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Affiliation(s)
- G Spies
- a Department of Psychiatry, Faculty of Medicine and Health Sciences , Stellenbosch University , Cape Town , South Africa
| | - C A Denckla
- b Department of Epidemiology , Harvard T. H. Chan School of Public Health , Cambridge , MA , USA
| | - S Mall
- c Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - J Levin
- c Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,d Statistical Section , MRC/UVRI Uganda Research Unit on AIDS , Entebbe , Uganda
| | - S Seedat
- a Department of Psychiatry, Faculty of Medicine and Health Sciences , Stellenbosch University , Cape Town , South Africa
| | - N Nakasujja
- e Department of Psychiatry , Makerere University , Kampala , Uganda
| | - E Kinyanda
- e Department of Psychiatry , Makerere University , Kampala , Uganda.,f Mental Health Project, MRC/LSHTM/UVRI and Senior Wellcome Trust Fellow , Uganda
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Abstract
SummaryClotting enzyme activity was detected in lysates prepared from the coelomocytes of Asterias forbesi following incubation with endotoxin-activated Limulus amebocyte lysate. This activity was not detected in the cell-free coelomic fluid. The enzymatic activity from the sea star lysate hydrolyzed the synthetic substrate S2222 but not S2238 or S2251, and polymerized partially purified Limulus clottable protein. The clotting enzyme activity was not detected following treatment of the sea star cell lysate with endotoxin or with the clotting enzyme from Limulus lysate. The enzymatic activity, generated in sea star cell lysate by the activated Limulus lysate, was inhibited by the addition of benzamidine; and its effect was suppressed with rabbit anti-sera directed against Asterias whole cell lysate, but not with anti-sera directed against the previously reported Sea Star Factor.
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Affiliation(s)
- J A Marcum
- The Department of Medicine, Harvard Medical School, Boston, MA, and Department of Biology, MIT, Cambridge, MA
- The Marine Biological Laboratory, Woods Hole, MA, U.S.A
| | - J Levin
- The Departments of Laboratory Medicine and Medicine, University of California School of Medicine, San Francisco, CA
- The Marine Biological Laboratory, Woods Hole, MA, U.S.A
| | - R A Prendergast
- The Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, U.S.A
- The Marine Biological Laboratory, Woods Hole, MA, U.S.A
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Abstract
SummaryWhen blood is withdrawn from Limulus, the horseshoe crab, a cellular clot composed of amebocytes quickly forms. Amebocytes are the only type of cell in Limulus blood. During coagulation, Limulus amebocytes undergo morphological changes that are strikingly similar to those seen when mammalian platelets undergo aggregation and viscous metamorphosis. The clottable protein in Limulus blood is derived entirely from amebocytes, and gelation does not require extracellular factors. Cell free Limulus plasma is incoagulable. The cellular localization of clottable protein in Limulus blood provides a precedent for the presence of fibrinogen in mammalian platelets.The clottable protein in lysates of amebocytes has a spectral absorption pattern with a maximum at 270-275 mμ, appears to have a low sedimentation coefficient, is stable at –20° C for 1 week, and is destroyed by heating at 56° C for 30 min. The protein gels upon exposure to endotoxin; and the rate of gelation is related to the concentration of endotoxin but is independent of the concentration of protein in the range tested. The kinetics of this reaction are consistent with the concept that an enzymatic system mediates the conversion of the cellular protein into a gel by endotoxin. Increase in light scattering during the reaction detects as little as 0.004 μg of E. coli endotoxin/ml. This conversion will perhaps provide insight into one of the biological activities of endotoxins.
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Abstract
SummaryThe role of intravascular coagulation in the production of the generalized Shwartzman phenomenon has been evaluated. The administration of endotoxin to animals prepared with Thorotrast results in activation of the coagulation mechanism with the resultant deposition of fibrinoid material in the renal glomeruli. Anticoagulation prevents alterations in the state of the coagulation system and inhibits development of the renal lesions. Platelets are not primarily involved. Platelet antiserum produces similar lesions in animals prepared with Thorotrast, but appears to do so in a manner which does not significantly involve intravascular coagulation.The production of adrenal cortical hemorrhage, comparable to that seen in the Waterhouse-Friderichsen syndrome, following the administration of endotoxin to animals that had previously received ACTH does not require intravascular coagulation and may not be a manifestation of the generalized Shwartzman phenomenon.
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Brown DJ, Hickey S, Levin J, Chang K, Sheridan R, Ryan C, Friedstat J, Schulz J, Goverman J. 532 The Use of Topical Steroids for the Treatment of Burn-Related Hypertrophic Granulation Tissue and Unstable Scar. J Burn Care Res 2018. [DOI: 10.1093/jbcr/iry006.455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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)
- D J Brown
- Sumner M. Redstone Burn Center - Massachusetts General Hospital, Boston, MA
| | - S Hickey
- Sumner M. Redstone Burn Center - Massachusetts General Hospital, Boston, MA
| | - J Levin
- Sumner M. Redstone Burn Center - Massachusetts General Hospital, Boston, MA
| | - K Chang
- Sumner M. Redstone Burn Center - Massachusetts General Hospital, Boston, MA
| | - R Sheridan
- Sumner M. Redstone Burn Center - Massachusetts General Hospital, Boston, MA
| | - C Ryan
- Sumner M. Redstone Burn Center - Massachusetts General Hospital, Boston, MA
| | - J Friedstat
- Sumner M. Redstone Burn Center - Massachusetts General Hospital, Boston, MA
| | - J Schulz
- Sumner M. Redstone Burn Center - Massachusetts General Hospital, Boston, MA
| | - J Goverman
- Sumner M. Redstone Burn Center - Massachusetts General Hospital, Boston, MA
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Schönecker S, Prix C, Raiser T, Ackl N, Wlasich E, Stenglein-Krapf G, Mille E, Brendel M, Sabri O, Patt M, Barthel H, Bartenstein P, Levin J, Rominger A, Danek A. [Amyloid positron-emission-tomography with [ 18 F]-florbetaben in the diagnostic workup of dementia patients]. Nervenarzt 2017; 88:156-161. [PMID: 27913818 DOI: 10.1007/s00115-016-0249-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND To this day the definite diagnosis of Alzheimer's disease still relies on post-mortem histopathological detection of neurofibrillary tangles and beta-amyloid deposits. Amyloid positron emission tomography (PET) is a new diagnostic tool that enables the in vivo quantification of pathological beta-amyloid deposits. The aim of the current study was to evaluate to what extent 18F-florbetaben-PET (FBB-PET) influences the diagnosis of patients with dementia. MATERIAL AND METHODS Imaging with FBB-PET was performed on 33 patients from our outpatient department for cognitive neurology. Beforehand all patients underwent a comprehensive clinical, neuropsychiatric and laboratory examination as well as imaging by means of magnetic resonance imaging (MRI) and fluorodeoxyglucose-PET. The working diagnoses before and after FBB-PET imaging were compared. RESULTS 17 out of 33 patients were scored as FBB-PET positive. In four cases the initial diagnosis had to be changed to Alzheimer's disease (three cases) and cerebral amyloid angiopathy (one case) due to the positive FBB-PET scan. 16 patients showed a negative FBB-PET scan. In three patients the initial diagnosis of Alzheimer's disease could be ruled out due to the negative FBB-PET scan. Overall, in 7 out of 33 examined patients the initial diagnosis had to be changed because of the findings of the FBB-PET scan. In 24 patients the initial diagnosis was confirmed by the results of the FBB-PET scan. CONCLUSION Amyloid-PET is currently no standard procedure in the diagnosis of dementia; however, it can be a helpful additional diagnostic tool when used according to the "Appropriate Use Criteria" and the S3 guidelines on dementia in cases of unclear clinical presentation, atypically early age of onset as well as in patients with persistent or progressive unexplained mild cognitive impairment. By facilitating early diagnosis amyloid-PET imaging allows patient selection for therapeutic drug trials.
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Affiliation(s)
- S Schönecker
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, München, Deutschland.
| | - C Prix
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, München, Deutschland
| | - T Raiser
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), München, Deutschland
| | - N Ackl
- Memory Clinic, Psychiatrische Dienste Thurgau, Münsterlingen, Schweiz
| | - E Wlasich
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, München, Deutschland
| | - G Stenglein-Krapf
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, München, Deutschland
| | - E Mille
- Klinik und Poliklinik für Nuklearmedizin, Ludwig-Maximilians-Universität, München, Deutschland
| | - M Brendel
- Klinik und Poliklinik für Nuklearmedizin, Ludwig-Maximilians-Universität, München, Deutschland
| | - O Sabri
- Klinik und Poliklinik für Nuklearmedizin, Universität Leipzig, Leipzig, Deutschland
| | - M Patt
- Klinik und Poliklinik für Nuklearmedizin, Universität Leipzig, Leipzig, Deutschland
| | - H Barthel
- Klinik und Poliklinik für Nuklearmedizin, Universität Leipzig, Leipzig, Deutschland
| | - P Bartenstein
- Klinik und Poliklinik für Nuklearmedizin, Ludwig-Maximilians-Universität, München, Deutschland.,Munich Cluster Syst Neurol SyNergy, München, Deutschland
| | - J Levin
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, München, Deutschland.,Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), München, Deutschland
| | - A Rominger
- Klinik und Poliklinik für Nuklearmedizin, Ludwig-Maximilians-Universität, München, Deutschland.,Munich Cluster Syst Neurol SyNergy, München, Deutschland
| | - A Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, München, Deutschland
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18
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Abstract
BACKGROUND Frontotemporal lobar degeneration (FTLD) includes a spectrum of heterogeneous clinical and neuropathological diseases. In a strict sense this includes the behavioral variant of frontotemporal dementia (bvFTD) and primary progressive aphasia (PPA) and both variants can be associated with amyotrophic lateral sclerosis (FTD-ALS). In a broader sense FTLD also includes progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). In recent years the strong genetic component of FTLD has become increasingly clear. OBJECTIVE The association between clinical presentation, neuropathology, genetics and pathophysiological mechanisms of FTLD are presented. RESULTS The diagnostic criteria and tools for the clinical differential diagnosis of FTLD are presented. At autopsy patients show neuronal and glial inclusions of Tau, TDP-43 or FUS. While Tau pathology is often associated with extrapyramidal symptoms, patients with TDP-43 and FUS inclusions often also show signs of ALS. Pathogenic mutations directly increase the aggregation propensity of these proteins or impair protein degradation through autophagy or the proteasome. Pathogenic mutations in most FTLD genes trigger cytoplasmic missorting and aggregation of the RNA-binding protein TDP-43 and thus lead to a nuclear loss of TDP-43 function. Microgliosis and mutations in GRN and TREM2 suggest an important role of neuroinflammation in FTLD. CONCLUSION There is still no causal therapy for FTLD but preclinical studies focusing on pathogenic mutations in C9orf72, GRN and Tau may lead to clinical trials soon; therefore, establishing large well characterized patient cohorts is crucial for trial readiness.
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Affiliation(s)
- K Bürger
- Institut für Schlaganfall und Demenzforschung, Klinikum der Universität München, Ludwig-Maximilians-Universität München, München, Deutschland
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Feodor-Lynen-Str. 17, 81377, München, Deutschland
| | - T Arzberger
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Feodor-Lynen-Str. 17, 81377, München, Deutschland
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, Ludwig-Maximilians-Universität München, München, Deutschland
- Zentrum für Neuropathologie und Prionforschung, Ludwig-Maximilians-Universität München, München, Deutschland
| | - J Stephan
- Institut für Schlaganfall und Demenzforschung, Klinikum der Universität München, Ludwig-Maximilians-Universität München, München, Deutschland
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, Ludwig-Maximilians-Universität München, München, Deutschland
| | - J Levin
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Feodor-Lynen-Str. 17, 81377, München, Deutschland
- Neurologische Klinik und Poliklinik, Klinikum der Universität München, Ludwig-Maximilians-Universität München, München, Deutschland
| | - D Edbauer
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Feodor-Lynen-Str. 17, 81377, München, Deutschland.
- Munich Cluster of Systems Neurology (SyNergy), Ludwig-Maximilians-Universität München, München, Deutschland.
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19
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Abstract
Bacterial endotoxin, a major modulator of morbidity and mortality during bacterial sepsis, has affinity for cations. Binding of certain cations to LPS can cause alterations of LPS size and ultrastructure, and can affect LPS biological potency. Although the addition of iron to LPS has been shown previously to result in decreased LPSmediated lethality in mice, it is not certain whether this represents a direct effect of iron on LPS biological activity. To examine this possibility, we measured binding of ferrous or ferric iron to Escherichia coli LPS in vitro. 1.5-2 moles of iron (regardless of oxidation state) was shown to bind per mole LPS. Binding of iron to LPS produced a dose-dependent decrease in two measures of LPS biological activity, activation of Limulus amebocyte lysate (which decreased to 10% of control when LPS was saturated with Fe) and stimulation of endothelial cell procoagulant activity (which decreased to 1-10% of control when LPS was saturated with Fe).
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Affiliation(s)
| | | | | | - F.A. Arellano
- Department of Laboratory Medicine, University of California School of Medicine and Veterans Affairs Medical Center, San Francisco, California, USA
| | - J. Levin
- Department of Laboratory Medicine, University of California School of Medicine and Veterans Affairs Medical Center, San Francisco, California, USA
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20
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Kaca W, Roth R, Ziolkowski A, Levin J. Human hemoglobin increases the biological activity of bacterial lipopolysaccharides in activation of Limulus amebocyte lysate and stimulation of tissue factor production by endothelial cells in vitro. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/096805199400100406] [Citation(s) in RCA: 23] [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: 11/16/2022]
Abstract
Previous studies have demonstrated that hemoglobin (Hb) and bacterial endotoxin (lipopolysaccharide, LPS) form stable complexes and result in disaggregation of macromolecular LPS. To examine the effect of complex formation on LPS biological activity, we investigated the ability of Hb to alter LPS-induced activation of the coagulation cascade of Limulus amebocyte lysate (LAL) and expression of tissue factor from human endothelial cells. Both native HbAo and derivatized (covalently cross-linked) hemoglobin resulted in prominent enhancement of LAL activation and endothelial cell tissue factor production by Proteus mirabilis LPS. No substantial differences were observed between the enhancement effect of Hb on P. mirabilis smooth and rough LPS, indicating a dominant role for the lipid A component of LPS. Rough (Re) Salmonella min nesota 595 LPS also demonstrated both enhanced activation of LAL and stimulation of endothelial cell tissue factor in the presence of Hb. In contrast, neither lipid A nor singly dephosphorylated or partially deacylated Re LPS manifested significant enhancement of LAL activation by Hb, and partially deacylated Re LPS showed no enhancement of endothelial cell tissue factor by Hb. These results suggest that the Kdo moieties, as well as the phosphate residues and fatty acyl moieties of lipid A, may be involved in the interaction of Hb with LPS. Comparison of Hb with other endotoxin binding proteins for ability to cause enhancement of LPS biological activity demonstrated more prominent enhancement with lipopolysaccharide binding protein (LBP) than that observed with Hb, lesser enhancement with albumin, and no enhancement effect with IgG or transferrin.
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Affiliation(s)
- W. Kaca
- Department of Laboratory Medicine, University of California School of Medicine and the Veterans Administration Medical Center, San Francisco, CA, USA, Institute of Microbiology and Immunology, University of Lodz, Lodz, Poland
| | - R.I. Roth
- Department of Laboratory Medicine, University of California School of Medicine and the Veterans Administration Medical Center, San Francisco, CA, USA, Institute of Microbiology and Immunology, University of Lodz, Lodz, Poland
| | - A. Ziolkowski
- Department of Laboratory Medicine, University of California School of Medicine and the Veterans Administration Medical Center, San Francisco, CA, USA, Institute of Microbiology and Immunology, University of Lodz, Lodz, Poland
| | - J. Levin
- Department of Laboratory Medicine, University of California School of Medicine and the Veterans Administration Medical Center, San Francisco, CA, USA, Institute of Microbiology and Immunology, University of Lodz, Lodz, Poland
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21
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Abstract
A multitrait-multimethod matrix of four personality constructs, social desirability, neuroticism, extraversion, and masculinity-femininity, measured by three instruments, Comrey Personality Scales, Eysenck Personality Scales, and MMPI, were analyzed by classical factor analysis and smallest space analysis. The results of both procedures showed excellent agreement, giving four clearly defined orthogonal factors as well as four clearly separated regions in space for the personality constructs, confirming the convergent and discriminant validity of the data obtained in a previous study. The results are attributed in part to the special testing instructions designed to minimize faking and social desirability responding.
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22
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Schönecker S, Brendel M, van der Zee J, van Broeckhoven C, Rominger A, Danek A, Levin J. [A Pair of Siblings with Frontotemporal Dementia and Amyotrophic Lateral Sclerosis and a Novel Thr462Lysfs Mutation in the TBK1 Gene]. Fortschr Neurol Psychiatr 2016; 84:494-8. [PMID: 27570907 DOI: 10.1055/s-0042-110653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We report on a pair of siblings with frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) and a novel Thr462Lysfs mutation in the TANK-binding kinase 1 (TBK1) gene identified through the European Early-Onset Dementia Consortium. The patients presented at the age of 77 and 75 years and displayed dementia and bulbar symptoms as well as progressive paresis. After a progressive course, both of them died only a few months after diagnosis. Most recently, TBK1 mutations were identified in patients with FTD and ALS. A loss of expression of the mutant allele, leading to 50 % reduced TBK1 protein levels, seems to be causative. The occurrence of TBK1 mutations in FTD and ALS underlines the fact that FTD and ALS are part of the same disease spectrum. For future therapeutic trials, characterization of TBK1 mutation carriers in presymptomatic cohorts, such as the genetic frontotemporal dementia initiative (GENFI), is of great importance.
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Affiliation(s)
- S Schönecker
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, München
| | - M Brendel
- Klinik und Poliklinik für Nuklearmedizin, Ludwig-Maximilians-Universität, München
| | | | | | - A Rominger
- Klinik und Poliklinik für Nuklearmedizin, Ludwig-Maximilians-Universität, München
| | - A Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, München
| | - J Levin
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, München
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23
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Küpper C, Levin J, Klopstock T. Eisen im alternden Gehirn. Akt Neurol 2016. [DOI: 10.1055/s-0035-1565121] [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: 10/22/2022]
Affiliation(s)
- C. Küpper
- Neurologische Klinik und Poliklinik, Standort Innenstadt, Friedrich-Baur-Institut, Klinikum der Universität München
| | - J. Levin
- Neurologische Klinik und Poliklinik, Standort Großhadern, Klinikum der Universität München
| | - T. Klopstock
- Neurologische Klinik und Poliklinik, Standort Innenstadt, Friedrich-Baur-Institut, Klinikum der Universität München
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24
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Levin J, Danek A. Oligoclonal bands in hereditary diffuse leukencephalopathy with spheroids. Eur J Neurol 2015; 22:e48. [DOI: 10.1111/ene.12644] [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] [Received: 11/04/2014] [Accepted: 11/12/2014] [Indexed: 11/30/2022]
Affiliation(s)
- J. Levin
- Department of Neurology; Ludwig-Maximilians-Universität München; Munich Germany
| | - A. Danek
- Department of Neurology; Ludwig-Maximilians-Universität München; Munich Germany
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25
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Snyman JR, Potter PC, Groenewald M, Levin J. Effect of betamethasone-loratadine combination therapy on severe exacerbations of allergic rhinitis : a randomised, controlled trial. Clin Drug Investig 2012; 24:265-74. [PMID: 17503888 DOI: 10.2165/00044011-200424050-00003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Corticosteroids are effective in controlling the inflammatory component of allergic rhinitis; however, evidence for the clinical efficacy of systemic corticosteroids in this disease is sparse. It is further common practice to combine oral corticosteroids with antihistamines in the treatment of acute exacerbations of allergic rhinitis. The aim of this study was to investigate the effect of low-dose oral betamethasone alone and in combination with loratadine in a group of patients with allergic rhinitis with clinically significant obstruction. METHODS In this parallel, double-blind, active controlled multicentre study, 299 patients with severe allergic rhinitis were randomly allocated to either betamethasone 1.0mg or betamethasone 1.0mg plus loratadine 10mg or betamethasone 0.5mg plus loratadine 10mg or loratadine 10mg alone for 5-7 days. Total symptom scores, nasal obstruction, and doctor and patient perception of improvement were measured as markers of disease severity. RESULTS Although not statistically significant, both betamethasone 1.0mg regimens resulted in a total symptom score difference of at least 1 or more from loratadine (i.e. mean [SD] change in total symptom score of 4.10 [3.10] and 4.40 [3.62] vs 3.10 [3.30], respectively, for betamethasone 1.0 mg plus loratadine, betamethasone 1.0 mg and loratadine). All corticosteroid-containing regimens were significantly better than loratadine alone with regard to the patients' (p < 0.013) and doctors' (p < 0.009) perceptions of improvement. They significantly favoured loratadine in combination with betamethasone over single-drug therapy (i.e. odds ratio: investigator ratings 0.49, 0.36 and 0.45, and patient ratings 0.47, 0.40 and 0.43, respectively, for 0.5 mg and 1.0 mg betamethasone plus loratadine and betamethasone 1.0 mg alone vs loratadine alone). Betamethasone 1.0mg plus loratadine also resulted in significant reduction of the relapse rate compared with the other therapies. CONCLUSIONS This study demonstrated the benefit of a short course of a systemic low dosage of corticosteroids with and without antihistamine therapy during acute severe exacerbations of allergic rhinitis. Combination treatment with betamethasone 1.0mg and loratadine 10mg was significantly better in relieving symptoms of hayfever as experienced by patients. This was the first study to give evidence of benefit of systemic low-dose corticosteroids with and without an antihistamine in patients with acute exacerbations of allergic rhinitis.
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Affiliation(s)
- J R Snyman
- Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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26
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Kubny C, Bulst S, Levin J, Krause S, Schoser B, Giese A, Walter M, Schessl J. G.P.123 Identification of molecular effects of FHL1 mutations on protein assembly in reducing body myopathy. Neuromuscul Disord 2012. [DOI: 10.1016/j.nmd.2012.06.329] [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: 10/28/2022]
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27
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Yoshida M, Roth RI, Grunfeld C, Feingold KR, Levin J. Pharmacokinetics, biological effects, and distribution of (1-->3)-beta-D-glucan in blood and organs in rabbits. Mediators Inflamm 2012; 6:279-83. [PMID: 18472859 PMCID: PMC2365862 DOI: 10.1080/09629359791622] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The pharmacokinetics, biological effects and distribution in blood and organs of 125I-labeled (1→3)-β-D-glucan purified from Candida albicans were analyzed in rabbits during the 24-h period following an intravenous administration.The intravascular half-life of (1→3)-β- D-glucan was 1.8 min in the low-dose group (9.3 μg/kg) and 1.4 min in the high-dose group (222 μg/kg), and the mean (±SD) total body clearance was 1.12 ± 0.30 and 1.17 ± 0.16 ml/min, respectively. The rabbits remained well and (1→3)-β-D-glucan failed to alter blood cell counts. Less than 3% of the 125I-(1→3)-β-D-glucan was initially associated with the cellular compartment, and this value decreased further during the 2-h period following administration
(P = 0.0001). Over 97% of 125I-(1→3)-β-D-glucan was associated with cell-free plasma, and the majority in plasma appeared to be present in the unbound form (not associated with lipoproteins or plasma proteins). The liver contained more than 80% of the 125I-(1→3)-β-D-glucan detected in the six major organs analyzed.
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Affiliation(s)
- M Yoshida
- Fourth Depar tmentof Internal Medicine Teikyo University School of Medicine 74 Mizonokuchi Takatsu-ku Kawasaki City 213 Japan
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28
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Kiwuwa-Muyingo S, Walker AS, Oja H, Levin J, Miiro G, Katabira E, Kityo C, Hakim J, Todd J. The impact of first year adherence to antiretroviral therapy on long-term clinical and immunological outcomes in the DART trial in Uganda and Zimbabwe. Trop Med Int Health 2012; 17:584-94. [DOI: 10.1111/j.1365-3156.2012.02974.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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29
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Levin J, Singh A, Feddersen B, Mehrkens JH, Bötzel K. Zeitverlauf dystoner Symptome nach Abschalten des Globus pallidus Stimulators bei zervikaler Dystonie. KLIN NEUROPHYSIOL 2012. [DOI: 10.1055/s-0032-1301636] [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: 10/28/2022]
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30
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Hesketh PJ, Moiseyenko V, Rosati G, Makhson A, Levin J, Russo MW. Phase III study of single-dose casopitant in combination with ondansetron and dexamethasone for the prevention of oxaliplatin-induced nausea and vomiting. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9019] [Citation(s) in RCA: 1] [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: 11/20/2022] Open
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31
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Schmidt F, Giese A, Levin J, Bötzel K. Elektrophysiologische Charakterisierung von α-Synuclein-Oligomeren. KLIN NEUROPHYSIOL 2011. [DOI: 10.1055/s-0031-1272680] [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: 10/18/2022]
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32
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Kratochwill T, Alden K, Demuth D, Dawson D, Panicucci C, Arntson P, McMurray N, Hempstead J, Levin J. A further consideration in the application of an analysis-of-variance model for the intrasubject replication design. J Appl Behav Anal 2010; 7:629-33. [PMID: 16795482 PMCID: PMC1311679 DOI: 10.1901/jaba.1974.7-629] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
It is argued that the analysis-of-variance model is inappropriate for assessing treatment effects in single-subject designs. In particular, such designs are demonstrated to violate the crucial assumption concerning the statistical independence of observations. Alternative methods of data analysis are suggested.
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Abstract
The intercorrelation matrix between the scales of the California Psychological Inventory, given in the manual, was factor analyzed. Three factors were extracted and rotated by varimax. The matrix was rescaled, first normalizing the rows, then standardizing the columns to a mean sum of squares of one. Unity was used as a cut-off point for determination of salient loadings. The first two factors were similar to the results reported in a previous Study by Nichols and Schnell. The third factor was interpreted as an independence-dependence dimension.
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Affiliation(s)
- J Levin
- Tel Aviv University, Dept. of Psychology, Ramat Aviv, Israel
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34
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Namakoola I, Wakeham K, Parkes-Ratanshi R, Levin J, Mugagga T, Seymour C, Kissa J, Kamali A, Lalloo DG. Use of nail and oral pigmentation to determine ART eligibility among HIV-infected Ugandan adults. Trop Med Int Health 2010; 15:259-62. [PMID: 20409288 DOI: 10.1111/j.1365-3156.2009.02448.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the use of grey/distal banded nails as an indicator of advanced immunosuppression, and thus eligibility for ART, in resource poor settings. METHODS We tested whether grey/distal banded nails and/or oral pigmentation could be used to identify patients with low CD4 cell counts at two cut-offs: <200 and <350 cells/microl in ART naive adults. RESULTS Four hundred and three nail and oral cavities were photographed and assessed. Grey/distal banded nails and/or oral pigmentation were significantly associated with a CD4 cell count <200 cells/microl (P < 0.001), with a sensitivity of 66%, a specificity of 50% and a negative predictive value of 77%. However, there was no association when a CD4 cell count cut-off of <350 cells/microl was used. Inter-observer agreement (k 0.46) was fair/moderate. CONCLUSIONS While grey/distal banded nails and/or oral pigmentation are associated with low CD4 counts, the sensitivity and kappa score are too low for this method to be recommended as a tool to guide ART initiation; large number of individuals eligible for ART would be missed.
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Affiliation(s)
- I Namakoola
- MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.
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35
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Chang B, Levin J, Thompson WA, Fairbrother WG. High-throughput binding analysis determines the binding specificity of ASF/SF2 on alternatively spliced human pre-mRNAs. Comb Chem High Throughput Screen 2010; 13:242-52. [PMID: 20015017 PMCID: PMC3427726 DOI: 10.2174/138620710790980522] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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] [Received: 05/01/2009] [Accepted: 08/13/2009] [Indexed: 11/22/2022]
Abstract
High-throughput immunoprecipitation studies of transcription factors and splicing factors have revolutionized the fields of transcription and splicing. Recent location studies on Nova1/2 and Fox2 have identified a set of cellular targets of these splicing factors. One problem with identifying binding sites for splicing factors arises from the transient role of RNA in gene expression. The primary role of most splicing factors is to bind pre-mRNA co-transcriptionally and participate in the extremely rapid process of splice site selection and catalysis. Pre-mRNA is a labile species with a steady state level that is three orders of magnitude less abundant than mRNA. As many splicing factors also bind mRNA to some degree, these substrates tend to dominate the output of location studies. Here we present an in-vitro method for screening RNA protein interactions that circumvents these problems. We screen approximately 4000 alternatively spliced exons and the entire Hepatitis C genome for binding of ASF/SF2, the only splicing factor demonstrated to function as an oncogene. From the pre-mRNA sequences returned in this screen we discovered physiologically relevant ASF recognition element motifs. ASF binds two motifs: a C-rich and a purine rich motif. Comparisons with similar data derived from the hnRNP protein PTB reveals little overlap between strong PTB and ASF/SF2 sites. We illustrate how this method could be employed to screen disease alleles with the set of small molecules that have been shown to alter splicing in search for therapies for splicing diseases.
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Affiliation(s)
- B Chang
- Department of Molecular and Cell Biology and Biochemistry, Brown University, Providence, Rhode Island 02912, USA
| | - J Levin
- Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510 USA
| | - WA Thompson
- Division of Applied Math, Brown University, Providence, Rhode Island 02912, USA
- Center for Computational Molecular Biology, Brown University, Providence, Rhode Island 02912, USA
| | - WG Fairbrother
- Department of Molecular and Cell Biology and Biochemistry, Brown University, Providence, Rhode Island 02912, USA
- Center for Computational Molecular Biology, Brown University, Providence, Rhode Island 02912, USA
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Appleton CC, Mosala TI, Levin J, Olsen A. Geohelminth infection and re-infection after chemotherapy among slum-dwelling children in Durban, South Africa. Ann Trop Med Parasitol 2010; 103:249-61. [PMID: 19341539 DOI: 10.1179/136485909x398212] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The prevalences and intensities of Ascaris lumbricoides, Trichuris trichiura and hookworm (probably Necator americanus) infection were measured in the young children (aged 2-10 years) living in 10 urban slums in Durban, South Africa. Re-infection was assessed at 4-6 and 12 months post-treatment. The baseline prevalences of A. lumbricoides and T. trichiura were 81.7%-96.3% and 54.5%-86.2%, respectively, and the corresponding geometric mean intensities were 960 and 91 eggs/g faeces. Most (85%) of the children found infected with A. lumbricoides and 23% of those found infected with T. trichiura had moderate-heavy infections. A few of the children investigated had intensities of Ascaris and Trichuris infection that were considerably higher than those previously recorded in South Africa. The baseline prevalences of hookworm infection (0%-20% in individual slums, with a mean of 4.7%) and intensities of such infection (geometric mean=17 eggs/g) were relatively low. Albendazole proved very effective against A. lumbricoides and hookworm but less so against T. trichiura. Re-infection by A. lumbricoides and T. trichiura reached pre-treatment prevalences by 4-6 months post-treatment in some of the slums and by 12 months in all the other slums. By 12 months post-treatment, the intensities of A. lumbricoides infection had reached their pre-treatment levels while those of T. trichiura infection were higher than at baseline. Approximately 50% of children had moderate-heavy T. trichiura infections at 12 months post-treatment compared with approximately 23% at baseline. Hookworm infections did not re-appear after treatment. The results show clearly that urban slums should be included in any future helminth-control programmes in South Africa.
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Affiliation(s)
- C C Appleton
- School of Biological and Conservation Sciences, Westville Campus, University of KwaZulu-Natal, Durban 4000, South Africa.
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Mugyenyi P, Walker AS, Hakim J, Munderi P, Gibb DM, Kityo C, Reid A, Grosskurth H, Darbyshire JH, Ssali F, Bray D, Katabira E, Babiker AG, Gilks CF, Grosskurth H, Munderi P, Kabuye G, Nsibambi D, Kasirye R, Zalwango E, Nakazibwe M, Kikaire B, Nassuna G, Massa R, Fadhiru K, Namyalo M, Zalwango A, Generous L, Khauka P, Rutikarayo N, Nakahima W, Mugisha A, Todd J, Levin J, Muyingo S, Ruberantwari A, Kaleebu P, Yirrell D, Ndembi N, Lyagoba F, Hughes P, Aber M, Lara AM, Foster S, Amurwon J, Wakholi BN, Whitworth J, Wangati K, Amuron B, Kajungu D, Nakiyingi J, Omony W, Fadhiru K, Nsibambi D, Khauka P, Mugyenyi P, Kityo C, Ssali F, Tumukunde D, Otim T, Kabanda J, Musana H, Akao J, Kyomugisha H, Byamukama A, Sabiiti J, Komugyena J, Wavamunno P, Mukiibi S, Drasiku A, Byaruhanga R, Labeja O, Katundu P, Tugume S, Awio P, Namazzi A, Bakeinyaga GT, Katabira H, Abaine D, Tukamushaba J, Anywar W, Ojiambo W, Angweng E, Murungi S, Haguma W, Atwiine S, Kigozi J, Namale L, Mukose A, Mulindwa G, Atwiine D, Muhwezi A, Nimwesiga E, Barungi G, Takubwa J, Murungi S, Mwebesa D, Kagina G, Mulindwa M, Ahimbisibwe F, Mwesigwa P, Akuma S, Zawedde C, Nyiraguhirwa D, Tumusiime C, Bagaya L, Namara W, Kigozi J, Karungi J, Kankunda R, Enzama R, Latif A, Hakim J, Robertson V, Reid A, Chidziva E, Bulaya-Tembo R, Musoro G, Taziwa F, Chimbetete C, Chakonza L, Mawora A, Muvirimi C, Tinago G, Svovanapasis P, Simango M, Chirema O, Machingura J, Mutsai S, Phiri M, Bafana T, Chirara M, Muchabaiwa L, Muzambi M, Mutowo J, Chivhunga T, Chigwedere E, Pascoe M, Warambwa C, Zengeza E, Mapinge F, Makota S, Jamu A, Ngorima N, Chirairo H, Chitsungo S, Chimanzi J, Maweni C, Warara R, Matongo M, Mudzingwa S, Jangano M, Moyo K, Vere L, Mdege N, Machingura I, Katabira E, Ronald A, Kambungu A, Lutwama F, Mambule I, Nanfuka A, Walusimbi J, Nabankema E, Nalumenya R, Namuli T, Kulume R, Namata I, Nyachwo L, Florence A, Kusiima A, Lubwama E, Nairuba R, Oketta F, Buluma E, Waita R, Ojiambo H, Sadik F, Wanyama J, Nabongo P, Oyugi J, Sematala F, Muganzi A, Twijukye C, Byakwaga H, Ochai R, Muhweezi D, Coutinho A, Etukoit B, Gilks C, Boocock K, Puddephatt C, Grundy C, Bohannon J, Winogron D, Gibb DM, Burke A, Bray D, Babiker A, Walker AS, Wilkes H, Rauchenberger M, Sheehan S, Spencer-Drake C, Taylor K, Spyer M, Ferrier A, Naidoo B, Dunn D, Goodall R, Darbyshire JH, Peto L, Nanfuka R, Mufuka-Kapuya C, Kaleebu P, Pillay D, Robertson V, Yirrell D, Tugume S, Chirara M, Katundu P, Ndembi N, Lyagoba F, Dunn D, Goodall R, McCormick A, Lara AM, Foster S, Amurwon J, Wakholi BN, Kigozi J, Muchabaiwa L, Muzambi M, Weller I, Babiker A, Bahendeka S, Bassett M, Wapakhabulo AC, Darbyshire JH, Gazzard B, Gilks C, Grosskurth H, Hakim J, Latif A, Mapuchere C, Mugurungi O, Mugyenyi P, Burke C, Jones S, Newland C, Pearce G, Rahim S, Rooney J, Smith M, Snowden W, Steens JM, Breckenridge A, McLaren A, Hill C, Matenga J, Pozniak A, Serwadda D, Peto T, Palfreeman A, Borok M, Katabira E. Routine versus clinically driven laboratory monitoring of HIV antiretroviral therapy in Africa (DART): a randomised non-inferiority trial. Lancet 2010; 375:123-31. [PMID: 20004464 PMCID: PMC2805723 DOI: 10.1016/s0140-6736(09)62067-5] [Citation(s) in RCA: 220] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND HIV antiretroviral therapy (ART) is often managed without routine laboratory monitoring in Africa; however, the effect of this approach is unknown. This trial investigated whether routine toxicity and efficacy monitoring of HIV-infected patients receiving ART had an important long-term effect on clinical outcomes in Africa. METHODS In this open, non-inferiority trial in three centres in Uganda and one in Zimbabwe, 3321 symptomatic, ART-naive, HIV-infected adults with CD4 counts less than 200 cells per microL starting ART were randomly assigned to laboratory and clinical monitoring (LCM; n=1659) or clinically driven monitoring (CDM; n=1662) by a computer-generated list. Haematology, biochemistry, and CD4-cell counts were done every 12 weeks. In the LCM group, results were available to clinicians; in the CDM group, results (apart from CD4-cell count) could be requested if clinically indicated and grade 4 toxicities were available. Participants switched to second-line ART after new or recurrent WHO stage 4 events in both groups, or CD4 count less than 100 cells per microL (LCM only). Co-primary endpoints were new WHO stage 4 HIV events or death, and serious adverse events. Non-inferiority was defined as the upper 95% confidence limit for the hazard ratio (HR) for new WHO stage 4 events or death being no greater than 1.18. Analyses were by intention to treat. This study is registered, number ISRCTN13968779. FINDINGS Two participants assigned to CDM and three to LCM were excluded from analyses. 5-year survival was 87% (95% CI 85-88) in the CDM group and 90% (88-91) in the LCM group, and 122 (7%) and 112 (7%) participants, respectively, were lost to follow-up over median 4.9 years' follow-up. 459 (28%) participants receiving CDM versus 356 (21%) LCM had a new WHO stage 4 event or died (6.94 [95% CI 6.33-7.60] vs 5.24 [4.72-5.81] per 100 person-years; absolute difference 1.70 per 100 person-years [0.87-2.54]; HR 1.31 [1.14-1.51]; p=0.0001). Differences in disease progression occurred from the third year on ART, whereas higher rates of switch to second-line treatment occurred in LCM from the second year. 283 (17%) participants receiving CDM versus 260 (16%) LCM had a new serious adverse event (HR 1.12 [0.94-1.32]; p=0.19), with anaemia the most common (76 vs 61 cases). INTERPRETATION ART can be delivered safely without routine laboratory monitoring for toxic effects, but differences in disease progression suggest a role for monitoring of CD4-cell count from the second year of ART to guide the switch to second-line treatment. FUNDING UK Medical Research Council, the UK Department for International Development, the Rockefeller Foundation, GlaxoSmithKline, Gilead Sciences, Boehringer-Ingelheim, and Abbott Laboratories.
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Henn MR, Boutwell C, Lennon N, Power K, Malboeuf C, Charlebois P, Gladden A, Levin J, Casali M, Philips L, Berlin A, Berical A, Erlich R, Anderson S, Streeck H, Kemper M, Ryan E, Wang Y, Green L, Axten K, Brumme Z, Brumme C, Russ C, Rosenberg E, Jessen H, Altfeld M, Nusbaum C, Walker B, Birren B, Allen TM. P09-20 LB. Ultra-deep sequencing of full-length HIV-1 genomes identifies rapid viral evolution during acute infection. Retrovirology 2009. [PMCID: PMC2767916 DOI: 10.1186/1742-4690-6-s3-p400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Njai HF, Tomusange K, Sokolik-Wolak B, Montefiori D, Balla S, Vanham G, Levin J, Maher D, Kamali A, Grosskurth H, Pala P, Kaleebu P. P04-11. Prevalence of neutralizing antibody responses in chronic clades A and D human immunodeficiency virus type 1 (HIV-1) infections. Retrovirology 2009. [PMCID: PMC2767903 DOI: 10.1186/1742-4690-6-s3-p39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Templeton AK, Dominguez N, Lu R, Vidal G, Levin J, Sestak A, Kelly J, Kaufman K, Bruner G, Gaffney P, Harley J, James J, Guthridge J, Poole B. IRF5 Genetic Risk Haplotype Influences Host B Cell Gene Responses to Epstein-Barr Virus (EBV) (49.14). The Journal of Immunology 2009. [DOI: 10.4049/jimmunol.182.supp.49.14] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Both gene and environment interactions play keyroles in the development of systemic lupus erythematosus (SLE). We examined effects of the IRF5 lupus risk haplotype upon the host's B cell response to the binding or infection with EBV, a suspected environmental trigger for SLE. Whole genome microarray expression profile data was collected from cells exposed to EBV for 16 hours. Analysis of gene expression by gene set enrichment analysis revealed that key differences in expression between SLE patients and controls (or individuals carrying the IRF5 risk and non-risk haplotype) were in a subset of interferon response genes. Patients with the IRF5 risk haplotype have a heightened interferon signature under all experimental conditions; whereas, the patients with the IRF5 protective haplotype have a B cell interferon signature similar to that of unrelated, matched controls. Overexpression of interferon pathway genes in B cells following viral exposure in control individuals carrying the IRF5 risk haplotype suggests that the IRF5 risk alleles alone can modulate ones biological response to the environmental insult. Patients carrying either the IRF5 risk or non-risk alleles appear to already be predisposed to having a higher interferon signature even without exposure to virus, suggesting that other genetic factors are also influencing the interferon response, independent of virus. Support by NIH (AI007633 and AI31584).
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Affiliation(s)
| | - N Dominguez
- 1Oklahoma Medical Research Foundation, Oklahoma City, OK
| | - R Lu
- 1Oklahoma Medical Research Foundation, Oklahoma City, OK
| | - G Vidal
- 1Oklahoma Medical Research Foundation, Oklahoma City, OK
| | - J Levin
- 1Oklahoma Medical Research Foundation, Oklahoma City, OK
| | - A Sestak
- 1Oklahoma Medical Research Foundation, Oklahoma City, OK
| | - J Kelly
- 1Oklahoma Medical Research Foundation, Oklahoma City, OK
| | - K Kaufman
- 1Oklahoma Medical Research Foundation, Oklahoma City, OK
| | - G Bruner
- 1Oklahoma Medical Research Foundation, Oklahoma City, OK
| | - P Gaffney
- 1Oklahoma Medical Research Foundation, Oklahoma City, OK
| | - J Harley
- 1Oklahoma Medical Research Foundation, Oklahoma City, OK
| | - J James
- 1Oklahoma Medical Research Foundation, Oklahoma City, OK
| | - J Guthridge
- 1Oklahoma Medical Research Foundation, Oklahoma City, OK
| | - B Poole
- 2Brigham Young University, Provo, UT
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Levin J, Meszaros I, Valkovic P, Bötzel K. Der Einfluss von Augenbewegungen auf Körperschwankungen. KLIN NEUROPHYSIOL 2009. [DOI: 10.1055/s-0029-1216154] [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: 10/21/2022]
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Levin J, Krafczyk S, Valkovič P, Eggert T, Claassen J, Bötzel K. 22. Objective measurement of muscle rigidity in parkinsonian patients treated with subthalamic stimulation. Clin Neurophysiol 2009. [DOI: 10.1016/j.clinph.2008.07.023] [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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Mer M, Ezekiel L, Naicker S, Richards G, Levin J. Outcome of ICU patients requiring dialysis in an African institution. Crit Care 2009. [PMCID: PMC4084144 DOI: 10.1186/cc7422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Levin J, Högen T, Bötzel K, Kostka M, Kretzschmar H, Giese A. Properties of iron-induced alpha-synuclein oligomers determined on a single particle level. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086604] [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: 10/21/2022]
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Anneser J, Levin J, Lorenzl S. Erhöhte Konzentrationen von Homocystein und Methylmalonsäure im Serum von Patienten mit amyotropher Lateralsklerose. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086657] [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: 10/21/2022]
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Jewkes R, Nduna M, Levin J, Jama N, Dunkle K, Puren A, Duvvury N. Impact of stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. BMJ 2008; 337:a506. [PMID: 18687720 PMCID: PMC2505093 DOI: 10.1136/bmj.a506] [Citation(s) in RCA: 504] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the impact of Stepping Stones, a HIV prevention programme, on incidence of HIV and herpes simplex type 2 (HSV-2) and sexual behaviour. DESIGN Cluster randomised controlled trial. SETTING 70 villages (clusters) in the Eastern Cape province of South Africa. PARTICIPANTS 1360 men and 1416 women aged 15-26 years, who were mostly attending schools. INTERVENTION Stepping Stones, a 50 hour programme, aims to improve sexual health by using participatory learning approaches to build knowledge, risk awareness, and communication skills and to stimulate critical reflection. Villages were randomised to receive either this or a three hour intervention on HIV and safer sex. Interviewers administered questionnaires at baseline and 12 and 24 months and blood was tested for HIV and HSV-2. PRIMARY OUTCOME MEASURE incidence of HIV. Other outcomes: incidence of HSV-2, unwanted pregnancy, reported sexual practices, depression, and substance misuse. RESULTS There was no evidence that Stepping Stones lowered the incidence of HIV (adjusted incidence rate ratio 0.95, 95% confidence interval 0.67 to 1.35). The programme was associated with a reduction of about 33% in the incidence of HSV-2 (0.67, 0.46 to 0.97; P=0.036)-that is, Stepping Stones reduced the number of new HSV-2 infections over a two year period by 34.9 (1.6 to 68.2) per 1000 people exposed. Stepping Stones significantly improved a number of reported risk behaviours in men, with a lower proportion of men reporting perpetration of intimate partner violence across two years of follow-up and less transactional sex and problem drinking at 12 months. In women desired behaviour changes were not reported and those in the Stepping Stones programme reported more transactional sex at 12 months. CONCLUSION Stepping Stones did not reduce incidence of HIV but had an impact on several risk factors for HIV-notably, HSV-2 and perpetration of intimate partner violence. TRIAL REGISTRATION Clinical Trials NCT00332878.
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Affiliation(s)
- Rachel Jewkes
- Gender and Health Research Unit, Medical Research Council, Private Bag X385, Pretoria 0001, South Africa.
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Aziz Z, Arpornwirat W, Herrstedt J, Camlett I, Piontek T, Ranganathan S, Schnyder J, Bandekar RR, Levin J, Shaharyar A. Phase III results for the novel neurokinin-1 (NK-1) receptor antagonist, casopitant: 3-day IV/oral dosing regimen for chemotherapy-induced nausea and vomiting (CINV) in patients (Pts) receiving moderately emetogenic chemotherapy (MEC). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.20512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Herrstedt J, Arpornwirat W, Albert I, Hansen V, Bandekar R, Levin J, Grunberg S. Safety and efficacy of the novel antiemetic neurokinin-1 (NK-1) receptor antagonist, casopitant, in women with breast cancer (BC) receiving moderately emetogenic chemotherapy (MEC) – subgroup analysis from a randomized, double-blind, placebo-controlled phase II trial. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70808-5] [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: 10/22/2022] Open
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Bötzel K, Claassen J, Crispin A, Krafczyk S, Levin J. Ballistic Movements are less impaired in Parkinson's Disease than Controlled Movements. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1072908] [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: 10/21/2022]
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50
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Levin J, Krafczyk S, Valkoviè P, Eggert T, Claassen J, Bötzel K. Objective measurement of muscle rigidity in parkinsonian patients treated with subthalamic stimulation. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1072817] [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: 10/21/2022]
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