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Mrklas KJ, Boyd JM, Shergill S, Merali S, Khan M, Nowell L, Goertzen A, Pfadenhauer LM, Paul K, Sibley KM, Swain L, Vis-Dunbar M, Hill MD, Raffin-Bouchal S, Tonelli M, Graham ID. Tools for assessing health research partnership outcomes and impacts: a systematic review. Health Res Policy Syst 2023; 21:3. [PMID: 36604697 PMCID: PMC9817421 DOI: 10.1186/s12961-022-00937-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 11/08/2022] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To identify and assess the globally available valid, reliable and acceptable tools for assessing health research partnership outcomes and impacts. METHODS We searched Ovid MEDLINE, Embase, CINAHL Plus and PsycINFO from origin to 2 June 2021, without limits, using an a priori strategy and registered protocol. We screened citations independently and in duplicate, resolving discrepancies by consensus and retaining studies involving health research partnerships, the development, use and/or assessment of tools to evaluate partnership outcomes and impacts, and reporting empirical psychometric evidence. Study, tool, psychometric and pragmatic characteristics were abstracted using a hybrid approach, then synthesized using descriptive statistics and thematic analysis. Study quality was assessed using the quality of survey studies in psychology (Q-SSP) checklist. RESULTS From 56 123 total citations, we screened 36 027 citations, assessed 2784 full-text papers, abstracted data from 48 studies and one companion report, and identified 58 tools. Most tools comprised surveys, questionnaires and scales. Studies used cross-sectional or mixed-method/embedded survey designs and employed quantitative and mixed methods. Both studies and tools were conceptually well grounded, focusing mainly on outcomes, then process, and less frequently on impact measurement. Multiple forms of empirical validity and reliability evidence was present for most tools; however, psychometric characteristics were inconsistently assessed and reported. We identified a subset of studies (22) and accompanying tools distinguished by their empirical psychometric, pragmatic and study quality characteristics. While our review demonstrated psychometric and pragmatic improvements over previous reviews, challenges related to health research partnership assessment and the nascency of partnership science persist. CONCLUSION This systematic review identified multiple tools demonstrating empirical psychometric evidence, pragmatic strength and moderate study quality. Increased attention to psychometric and pragmatic requirements in tool development, testing and reporting is key to advancing health research partnership assessment and partnership science. PROSPERO CRD42021137932.
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Affiliation(s)
- K. J. Mrklas
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
- Strategic Clinical Networks™, Provincial Clinical Excellence, Alberta Health Services, Calgary, AB Canada
| | - J. M. Boyd
- Knowledge Translation Program, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON Canada
| | - S. Shergill
- Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - S. Merali
- Faculty of Kinesiology, University of Calgary, Calgary, AB Canada
| | - M. Khan
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB Canada
| | - L. Nowell
- Faculty of Nursing, University of Calgary, Calgary, AB Canada
| | - A. Goertzen
- Faculty of Science, University of Alberta, Edmonton, AB Canada
| | - L. M. Pfadenhauer
- Institute for Medical Information Processing, Biometry, and Epidemiology–IBE, Ludwig-Maximilian Universität Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - K. Paul
- University of Calgary Summer Studentships Program, Calgary, AB Canada
| | - K. M. Sibley
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB Canada
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB Canada
| | - L. Swain
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
| | - M. Vis-Dunbar
- University of British Columbia - Okanagan, Kelowna, BC Canada
| | - M. D. Hill
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
- Departments of Clinical Neurosciences, Medicine and Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | | | - M. Tonelli
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
- Office of the Vice-President (Research), University of Calgary, Calgary, AB Canada
| | - I. D. Graham
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON Canada
- School of Epidemiology and Public Health & School of Nursing, University of Ottawa, Ottawa, ON Canada
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Hollederer A, Paul K. Health promotion among unemployed people – meta-analytic evidence. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.316] [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: 11/13/2022] Open
Abstract
Abstract
Background
It is well known that unemployment impairs health. However, less is known about health promotion among unemployed people and healthy coping strategies to deal with unemployment.
Methods
A random-effect meta-analysis was applied to statistically integrate quantitative controlled intervention studies among unemployed people.
Results
The meta-analysis included 34 eligible primary studies with 36 independent intervention samples. For mental health, the average meta-analytic effect sizes for the comparison of intervention group and comparison group was significant and of small size after the intervention d = 0.25; 95% CI [0.10, 0.39], and at follow-up, d = 0.13; 95% CI [0.04, 0.22]. For health behavior (measured as physical activity), the effects were also significant after the intervention, d = 0.30; 95% CI [0.12, 0.47] (no data available at follow-up). Effects on self-assessed physical health status were very small and not significant. However, when health improvement was the only goal of the respective intervention (in contrast to studies with multiple goals, e.g., health improvement plus re-employment), the effect on physical health was significant, too, d = 0.15; 95% CI [0.04, 0.25]. Moderator tests showed that intervention effects on mental health were significantly stronger when cognitive-behavioral methods were used (p < .05), while the use other kinds of stress-management techniques (p < .05), of methods to increase social support (p < .05), or of relaxation techniques (p < .07) did not improve the effectiveness of the intervention.
Conclusions
The present meta-analyses provided evidence that, on average, interventions aiming at improving unemployed people’s health do indeed improve participants’ health.
Key messages
• The present meta-analysis confirms that it is possible to promote unemployed people’ health. The moderator effects for type of intervention that were found here might be helpful for health promotion.
• The inclusion of cognitive-behavioral methods, appears to be a successful approach for health-oriented interventions with unemployed people.
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Affiliation(s)
- A Hollederer
- Faculty of Human Sciences, University Kassel , Kassel, Germany
| | - K Paul
- Faculty of Business, Economics and Law, Friedrich-Alexander-University of Erlangen-Nü , Nuremberg, Germany
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Paul K, Dorsch S, Naumann J, Hansmann T, Haberer T, Debus J, Klüter S. OC-0778 Towards MR-guided particle radiotherapy: Compatibility of an open MR scanner with an ion beamline. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02684-6] [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: 11/26/2022]
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Lindert J, Paul K, Lachman M, Ritz B, Seeman T. Discrimination impairs cognitive function in ageing men and women. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.794] [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: 11/14/2022] Open
Abstract
Abstract
Background
We sought to assess changes in episodic memory and executive functioning among men and women in the Midlife in the United States (MIDUS) cohort study; and to delineate variations in episodic memory and executive functioning by gender; and to determine the impact of discrimination on longitudinal changes in episodic memory and executive functioning.
Methods
We used data from the MIDUS study - a national probability sample of non-institutionalized, English speaking respondents aged 25-74 living in the 48 contiguous states of the United States. The initial wave in our study (1995) included 4963 non-institutionalized adults aged 32 to 84 (M = 55, SD = 12.4). Dependent variables are episodic memory and executive functioning, assessed with the Brief Test for Cognition. The independent variables were discrimination (lifetime and daily discrimination) variables. Furthermore, we investigated baseline cognition score, race/ethnicity (White, Hispanic, other), education (some college or more vs high school of less), whether or not living with partner, income (per 100% above Federal Poverty Level), unemployed (vs employed), retired (vs employed), physical health (self-reported), vigorous physical activity, depression (continuous scale), anxiety (continuous scale). To assess cognition changes we estimated adjusted linear regression models.
Results
Cross-sectional, work discrimination was associated with cognition in men and women. Longitudinally, adjusting for baseline cognition score, race/ethnicity, education, living situation, income, (un)employed, (not)retired, physical health, vigorous physical activity, depression, and anxiety, we found an association of family strain with cognition changes in high-income men, and an association of daily discrimination with cognition changes in men (Beta 0.01, P-value: 0.001).
Conclusions
Reducing discrimination might be an important measure to support cognitive function in ageing populations.
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Affiliation(s)
- J Lindert
- Department of Health and Social Work, University of Applied Sciences Emden/Leer, Emden/Leer, Germany
- Women`s Research Center, Brandeis University, Waltham, USA
| | - K Paul
- Department of Epidemiology, University of California at Los Angeles, Los Angeles, USA
| | - M Lachman
- The Heller School for Social Policy and Management, Brandeis University, Waltham, USA
| | - B Ritz
- Department of Epidemiology, University of California at Los Angeles, Los Angeles, USA
| | - T Seeman
- Division of Geriatrics, David Geffen School of Medicine, Los Angeles, USA
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Reding R, Chardot C, Paul K, Veyckemans F, Obbergh LV, Clety SCD, Detaille T, Clapuyt P, Saint-Martin C, Janssen M, Lerut J, Sokal E, Otte JB. Living-Related Liver Transplantation in Children at Saint-Luc University Clinics : A Seven Year Experience in 77 Recipients. Acta Chir Belg 2020. [DOI: 10.1080/00015458.2001.12098576] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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)
- R. Reding
- Pediatric Liver Transplant Program. Departments of Surgery, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - Chr. Chardot
- Pediatric Liver Transplant Program. Departments of Surgery, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - K. Paul
- Pediatric Liver Transplant Program. Departments of Surgery, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - F. Veyckemans
- Pediatric Liver Transplant Program. Departments of Anaesthesiology, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - L. Van Obbergh
- Pediatric Liver Transplant Program. Departments of Anaesthesiology, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - S. Clement De Clety
- Pediatric Liver Transplant Program. Departments of Intensive Care, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - Th. Detaille
- Pediatric Liver Transplant Program. Departments of Intensive Care, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - Ph. Clapuyt
- Pediatric Liver Transplant Program. Departments of Radiology, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - Chr. Saint-Martin
- Pediatric Liver Transplant Program. Departments of Radiology, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - M. Janssen
- Pediatric Liver Transplant Program. Departments of Surgery, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - J. Lerut
- Pediatric Liver Transplant Program. Departments of Surgery, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - E. Sokal
- Pediatric Liver Transplant Program. Departments of Pediatrics, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - J.-B. Otte
- Pediatric Liver Transplant Program. Departments of Surgery, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
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Nichols IS, Chiem E, Tahara Y, Anderson S, Trotter D, Whittaker D, Ghiani C, Colwell C, Paul K. 0426 Time Restricted Feeding Consolidates Sleep in the BACHD Mouse Model of Huntington’s Disease. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.423] [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
Introduction
Disturbances in the daily sleep-wake cycle are common in individuals with neurodegenerative disorders. Huntington’s disease (HD) is a genetic neurodegenerative disorder in which patients exhibit a variety of impairments that include, poor motor function, disrupted circadian rhythms, and sleep abnormalities such as difficulty initiating sleep at bedtime and more frequent nighttime arousals. In the BACHD mouse model time restricted feeding (TRF) has been successful at improving motor functions and circadian rhythms. The BACHD mouse model has a bacterial artificial chromosome that expresses the full-length human mutant huntingtin gene.
Methods
In order to determine the effects of TRF on sleep-wake architecture, EEG/EMG polysomnographic records were examined in mice between 3-4 months old bearing the BAC knock-in of a human genetic mutation of HD and WT litter mates, first during ad libitum (ad lib) feeding then during an 18 hour fasting protocol. TRF protocol consisted of 6 hours of food access limited between ZT15-ZT21 and 18 hours of fasting.
Results
A two-way ANOVA revealed that TRF significantly decreased the amount of total sleep (p=0.04) and NREM sleep (p=0.04) in the dark phase in both WT and BACHD mice. TRF did not significantly affect sleep in the light phase, however trends suggest that BACHD mice have more sleep in the light phase under TRF than ad lib.
Conclusion
This data suggests that TRF improves sleep by consolidating sleep to the light phase and wake to the dark phase. In conclusion, TRF may be a promising tool that can improve the negative effects of neurodegenerative diseases on sleep-wake processes.
Support
These experiments were supported by R01-NS078410 and UCLA start-up funds.
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Affiliation(s)
- I S Nichols
- University of California, Los Angeles, Los Angeles, CA
| | - E Chiem
- University of California, Los Angeles, Los Angeles, CA
| | - Y Tahara
- University of California, Los Angeles, Los Angeles, CA
| | - S Anderson
- University of California, Los Angeles, Los Angeles, CA
| | - D Trotter
- Morgan State University, Baltimore, MD
| | - D Whittaker
- University of California, Los Angeles, Los Angeles, CA
| | - C Ghiani
- University of California, Los Angeles, Los Angeles, CA
| | - C Colwell
- University of California, Los Angeles, Los Angeles, CA
| | - K Paul
- University of California, Los Angeles, Los Angeles, CA
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7
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Chiem E, Nichols I, Paul K. 0309 Stress Induced Nitric Oxide Synthase Activation in the Basal Forebrain is a Result of Sleep Loss. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.306] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
The mechanisms underlying the reciprocal relationship between stress and sleep are unclear. Nitric oxide, a diffusible signaling molecule, plays an important role in physiological stress responses and sleep. The medial septum (MS) and vertical diagonal band (VDB) are sleep regulatory regions of the basal forebrain whose cells express nitric oxide synthase (NOS). In this study, we examined the effects of sleep loss and restraint stress on NOS activation in the MS and VDB.
Methods
Adult male and female C57BL/J6 mice were randomly assigned to a control, total sleep deprivation (TSD), or restraint stress group. TSD was performed for 6h using gentle handling, and restraint was performed for 6h by immobilizing the mice in a plastic restraint device. Both procedures began at light onset in a 12:12 light:dark cycle. Immediately following the procedures, mice were sacrificed, and NADPH-diaphorase (NADPH-d) was measured in the MS and VDB to determine NOS activity.
Results
A multivariate ANOVA revealed main effects of TSD and restraint stress on NADPH-d in the MS (F(2,13) = 7.0921, p = 0.011) and VDB (F(2,13)=6.416, p = 0.014) in females. A post hoc analysis showed a significant difference between control and TSD (p = 0.011 (MS), p = 0.014 (VDB)), and between control and restraint (p = 0.032 (MS), p = 0.048 (VDB)), but no significant difference between TSD and restraint. There is a sex difference in NADPH-d in these regions (p < 0.005) that reverses direction following TSD and restraint stress.
Conclusion
Our findings provide evidence that NOS activity in the basal forebrain may underlie sex differences in stress responses. Since there is no significant difference between the TSD and restraint stress, this suggests that the effect of restraint stress on NOS activation is a result of sleep loss, and not due to induction of a stress mechanism.
Support
This study was partly funded by R01-NS078410 and UCLA start-up funds.
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Affiliation(s)
- E Chiem
- University of California, Los Angeles, Los Angeles, CA
| | - I Nichols
- University of California, Los Angeles, Los Angeles, CA
| | - K Paul
- University of California, Los Angeles, Los Angeles, CA
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Davis D, Tewolde T, Akinnawo F, Alema-Mensah E, Paul K, Clark K. Non-dipping and sleep outcomes in african-american non-standard shift workers. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.211] [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: 10/25/2022]
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9
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Nichols-Obande IS, Anderson S, Bush B, Gray C, Ehlen JC, Jones MI, Ananaba G, Okere CO, Brager A, Paul K. 0075 Nitrergic Neurons of the Dorsal Raphe Nucleus Encode Information About Stress Duration. Sleep 2018. [DOI: 10.1093/sleep/zsy061.074] [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: 11/15/2022] Open
Affiliation(s)
| | - S Anderson
- University of California- Los Angeles, Los Angeles, CA
| | - B Bush
- Morehouse School of Medicine, Atlanta, GA
| | - C Gray
- Morehouse School of Medicine, Atlanta, GA
| | - J C Ehlen
- Morehouse School of Medicine, Atlanta, GA
| | - M I Jones
- Clark Atlanta University, Atlanta, GA
| | - G Ananaba
- Clark Atlanta University, Atlanta, GA
| | - C O Okere
- Clark Atlanta University, Atlanta, GA
| | - A Brager
- Walter Reed Army Institute of Research, Silver Spring, MD
| | - K Paul
- University of California- Los Angeles, Los Angeles, CA
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Paul K, Sengupta R. TRENDS AND PATTERNS OF SELF-REPORTED ELDERLY MORBIDITY IN KERALA: FUTURE PROBLEMS AND POLICY PROSPECTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1627] [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: 11/12/2022] Open
Affiliation(s)
- K. Paul
- Tata Institute of Social Sciences, Mumbai, Mumbai, Maharashtra, India,
| | - R. Sengupta
- Jawaharlal Nehru University, Delhi, Delhi, India
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Eyre V, Lang CC, Smith K, Jolly K, Davis R, Hayward C, Wingham J, Abraham C, Green C, Warren FC, Britten N, Greaves CJ, Doherty P, Austin J, Van Lingen R, Singh S, Buckingham S, Paul K, Taylor RS, Dalal HM. Rehabilitation Enablement in Chronic Heart Failure-a facilitated self-care rehabilitation intervention in patients with heart failure with preserved ejection fraction (REACH-HFpEF) and their caregivers: rationale and protocol for a single-centre pilot randomised controlled trial. BMJ Open 2016; 6:e012853. [PMID: 27798024 PMCID: PMC5093626 DOI: 10.1136/bmjopen-2016-012853] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION The Rehabilitation EnAblement in CHronic Heart Failure in patients with Heart Failure (HF) with preserved ejection fraction (REACH-HFpEF) pilot trial is part of a research programme designed to develop and evaluate a facilitated, home-based, self-help rehabilitation intervention to improve self-care and quality of life (QoL) in heart failure patients and their caregivers. We will assess the feasibility of a definitive trial of the REACH-HF intervention in patients with HFpEF and their caregivers. The impact of the REACH-HF intervention on echocardiographic outcomes and bloodborne biomarkers will also be assessed. METHODS AND ANALYSIS A single-centre parallel two-group randomised controlled trial (RCT) with 1:1 individual allocation to the REACH-HF intervention plus usual care (intervention) or usual care alone (control) in 50 HFpEF patients and their caregivers. The REACH-HF intervention comprises a REACH-HF manual with supplementary tools, delivered by trained facilitators over 12 weeks. A mixed methods approach will be used to assess estimation of recruitment and retention rates; fidelity of REACH-HF manual delivery; identification of barriers to participation and adherence to the intervention and study protocol; feasibility of data collection and outcome burden. We will assess the variance in study outcomes to inform a definitive study sample size and assess methods for the collection of resource use and intervention delivery cost data to develop the cost-effectiveness analyses framework for any future trial. Patient outcomes collected at baseline, 4 and 6 months include QoL, psychological well-being, exercise capacity, physical activity and HF-related hospitalisation. Caregiver outcomes will also be assessed, and a substudy will evaluate impact of the REACH-HF manual on resting global cardiovascular function and bloodborne biomarkers in HFpEF patients. ETHICS AND DISSEMINATION The study is approved by the East of Scotland Research Ethics Service (Ref: 15/ES/0036). Findings will be disseminated via journals and presentations to clinicians, commissioners and service users. TRIAL REGISTRATION NUMBER ISRCTN78539530; Pre-results .
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Affiliation(s)
- V Eyre
- Peninsula Clinical Trials Unit, Plymouth University, Plymouth, UK
| | - C C Lang
- School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - K Smith
- School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
- School of Nursing & Midwifery, Dundee University, Dundee, UK
| | - K Jolly
- Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| | - R Davis
- Cardiology Department, Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - C Hayward
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - J Wingham
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
- Research, Development & Innovation, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - C Abraham
- Psychology Applied to Health Group, University of Exeter Medical School, Exeter, UK
| | - C Green
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - F C Warren
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - N Britten
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - C J Greaves
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - P Doherty
- Department of Health Sciences, University of York, York, UK
| | - J Austin
- Heart Failure Services and Cardiac Rehabilitation, Aneurin Bevan University Health Board, Nevill Hall Hospital, Abergavenny, UK
| | - R Van Lingen
- Cardiology Department, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - S Singh
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK
| | - S Buckingham
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - K Paul
- REACH-HF Patient and Public Involvement Group, c/o Research, Development & Innovation, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - R S Taylor
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - H M Dalal
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
- Research, Development & Innovation, Royal Cornwall Hospitals NHS Trust, Truro, UK
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Hős C, Champneys A, Paul K, McNeely M. Dynamic behaviour of direct spring loaded pressure relief valves: III valves in liquid service. J Loss Prev Process Ind 2016. [DOI: 10.1016/j.jlp.2016.03.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Paul K, Franke S, Nadal J, Schmid M, Yilmaz A, Kretzschmar D, Bärthlein B, Titze S, Koettgen A, Wolf G, Busch M. Inflammation, vitamin D and dendritic cell precursors in chronic kidney disease. Clin Exp Immunol 2016; 186:86-95. [PMID: 27414487 DOI: 10.1111/cei.12844] [Citation(s) in RCA: 4] [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] [Accepted: 07/05/2016] [Indexed: 01/14/2023] Open
Abstract
Decreased blood dendritic cell precursors (DCP) count is linked with atherosclerotic disease, while reduction of circulating DCP is also seen in patients with chronic kidney disease (CKD). As poor vitamin D status could be linked to a compromised innate immune response, we hypothesized that vitamin D status might be involved in the decrease in circulating DCP in CKD. Moreover, the potential role of inflammation was considered. Circulating myeloid (mDCP), plasmacytoid (pDCP) and total DCP (tDCP) were analysed using flow cytometry in 287 patients with CKD stage 3. Serum 25(OH)D and 1,25(OH)2D levels were measured using enzyme-linked immunosorbent assays (ELISA), interleukin (IL)-6, IL-10 and tumour necrosis factor (TNF)-α using cytometric bead array, C-reactive protein (CRP) using a high-sensitivity (hs) ELISA. Contrary to our hypothesis, there was no association between vitamin D levels and DCP, although their number was decreased significantly in CKD (P < 0·001). Instead, mDCP (r = -0·211) and tDCP (r = -0·188,) were associated slightly negatively with hsCRP but positively with the estimated glomerular filtration rate (eGFR, r = 0·314 for tDCP). According to multivariate linear regression, only higher hsCRP concentration and the presence of diabetes mellitus had a significant negative influence on DCP count (P < 0·03, respectively) but not vitamin D, age and eGFR. A significant impact of vitamin D on the reduction of circulating DCP in CKD 3 patients can be neglected. Instead, inflammation as a common phenomenon in CKD and diabetes mellitus had the main influence on the decrease in DCP. Thus, a potential role for DCP as a sensitive marker of inflammation and cardiovascular risk should be elucidated in future studies.
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Affiliation(s)
- K Paul
- Department of Internal Medicine III, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
| | - S Franke
- Department of Internal Medicine III, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
| | - J Nadal
- Institute of Medical Biometry, Informatics and Epidemiology at Rhenish Friedrich-Wilhelm University, Bonn, Germany
| | - M Schmid
- Institute of Medical Biometry, Informatics and Epidemiology at Rhenish Friedrich-Wilhelm University, Bonn, Germany
| | - A Yilmaz
- Department of Internal Medicine II, Division of Cardiology, Elisabeth Klinikum Schmalkalden GmbH, Schmalkalden, Germany
| | - D Kretzschmar
- Department of Internal Medicine I, Division of Cardiology and Intensive Care Medicine, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
| | - B Bärthlein
- Chair of Medical Informatics, University of Erlangen-Nürnberg, Erlangen, Germany
| | - S Titze
- Department of Nephrology and Hypertension, University of Erlangen-Nürnberg, Erlangen, Germany
| | - A Koettgen
- Department of Medicine IV, University Hospital Freiburg, Freiburg, Germany
| | - G Wolf
- Department of Internal Medicine III, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
| | - M Busch
- Department of Internal Medicine III, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
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Latimer M, Rudderham S, Harman K, Finley A, Dutcher L, Hutt-Macleod D, Paul K. Using Art as a Medium for First Nations Youth to Express Their Pain: A Two-Eyed Seeing Qualitative Study. Paediatr Child Health 2016. [DOI: 10.1093/pch/21.supp5.e94a] [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: 11/14/2022] Open
Abstract
Abstract
BACKGROUND: First Nations (FN) youth in Canada have the highest rates of pain-related conditions (ear, dental, headaches) yet may be least likely to be treated for them. Untreated pain has an arresting impact on growth and development and is detrimental to the achievement of life goals. In recent research conducted by the Aboriginal Children’s Hurt & Healing Initiative (ACHH), community participants reported that First Nation children are stoic and are reluctant to talk about their pain (Latimer & Rudderham, 2013). Clinicians are trained to assess pain based on overt signs of expression (cry, facial grimace, ability to describe) however if you do not present your pain this way it may reduce the chance of proper assessment and treatment.
OBJECTIVES: Using a Two-Eyed Seeing qualitative perspective (best of Indigenous and Western knowledge) the purpose of this research was to provide FN youth with the method of art making to determine how they express their pain.
DESIGN/METHODS: Youth from four FN communities, in three Maritime Provinces were invited to participate in art workshops facilitated by internationally renowned Mi’kmaq artist Alan Syliboy. The workshop began with a conversation circle about pain experiences and then proceeded to the art making. A FN documentary cinematographer captured the workshops and the results are documented in art and film. Three team members independently themed the data using thematic analysis and the inter-rater reliability was >85%.
RESULTS: 39 youth aged 10-18 years participated in 4 community-based conversation and art sessions. The themes for the sessions were themed using the four dimensions of the Medicine Wheel. While the overwhelming theme discussed in the conversation sessions was physical pain, when provided the nonverbal, art mode of expression, the youth painted emotional pain more frequently than physical, spiritual and mental pain. There was overlap between the four themes but 70% of the artwork prominently illustrated emotional pain with 54% overlapping with physical, 30% mental and 31% spiritual.
CONCLUSION: These results present a more complicated issue regarding the integration of the different types of pain, intertwined together. The finding that when asked-youth primarily discussed physical pain but given the opportunity, more frequently painted emotional pain may shed new light on the degree to which emotional pain is a factor for these youth. The artwork and accompanying narratives are powerful and have implications for understanding the complexity of assessing the different dimensions of pain in a culturally meaningful manner and for clinician education purposes. A sample of the artwork is attached.
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Kang S, Paul K, Hankosky ER, Cox CL, Gulley JM. D1 receptor-mediated inhibition of medial prefrontal cortex neurons is disrupted in adult rats exposed to amphetamine in adolescence. Neuroscience 2016; 324:40-9. [PMID: 26946269 DOI: 10.1016/j.neuroscience.2016.02.064] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 02/09/2016] [Accepted: 02/25/2016] [Indexed: 02/03/2023]
Abstract
Amphetamine (AMPH) exposure leads to changes in behavior and dopamine receptor function in the prefrontal cortex (PFC). Since dopamine plays an important role in regulating GABAergic transmission in the PFC, we investigated if AMPH exposure induces long-lasting changes in dopamine's ability to modulate inhibitory transmission in the PFC as well as whether the effects of AMPH differed depending on the age of exposure. Male Sprague-Dawley rats were given saline or 3 mg/kg AMPH (i.p.) repeatedly during adolescence or adulthood and following a withdrawal period of up to 5 weeks (Experiment 1) or up to 14 weeks (Experiment 2), they were sacrificed for in vitro whole-cell recordings in layer V/VI of the medial PFC. We found that in brain slices from either adolescent- or adult-exposed rats, there was an attenuation of dopamine-induced increases in inhibitory synaptic currents in pyramidal cells. These effects did not depend on age of exposure, were mediated at least partially by a reduced sensitivity of D1 receptors in AMPH-treated rats, and were associated with an enhanced behavioral response to the drug in a separate group of rats given an AMPH challenge following the longest withdrawal period. Together, these data reveal a prolonged effect of AMPH exposure on medial PFC function that persisted for up to 14 weeks in adolescent-exposed animals. These long-lasting neurophysiological changes may be a contributing mechanism to the behavioral consequences that have been observed in those with a history of amphetamine abuse.
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Affiliation(s)
- S Kang
- Neuroscience Program, University of Illinois, Urbana-Champaign, USA
| | - K Paul
- Neuroscience Program, University of Illinois, Urbana-Champaign, USA; Department of Molecular and Integrative Physiology, University of Illinois, Urbana-Champaign, USA; Beckman Institute for Advanced Science, University of Illinois, Urbana-Champaign, USA
| | - E R Hankosky
- Department of Psychology, University of Illinois, Urbana-Champaign, USA
| | - C L Cox
- Neuroscience Program, University of Illinois, Urbana-Champaign, USA; Department of Molecular and Integrative Physiology, University of Illinois, Urbana-Champaign, USA; Department of Pharmacology, University of Illinois, Urbana-Champaign, USA; Beckman Institute for Advanced Science, University of Illinois, Urbana-Champaign, USA.
| | - J M Gulley
- Neuroscience Program, University of Illinois, Urbana-Champaign, USA; Department of Psychology, University of Illinois, Urbana-Champaign, USA; Institute for Genomic Biology, University of Illinois, Urbana-Champaign, USA.
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Taylor RS, Hayward C, Eyre V, Austin J, Davies R, Doherty P, Jolly K, Wingham J, Van Lingen R, Abraham C, Green C, Warren FC, Britten N, Greaves CJ, Singh S, Buckingham S, Paul K, Dalal H. Clinical effectiveness and cost-effectiveness of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) facilitated self-care rehabilitation intervention in heart failure patients and caregivers: rationale and protocol for a multicentre randomised controlled trial. BMJ Open 2015; 5:e009994. [PMID: 26700291 PMCID: PMC4691763 DOI: 10.1136/bmjopen-2015-009994] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 09/30/2015] [Accepted: 10/05/2015] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) trial is part of a research programme designed to develop and evaluate a health professional facilitated, home-based, self-help rehabilitation intervention to improve self-care and health-related quality of life in people with heart failure and their caregivers. The trial will assess the clinical effectiveness and cost-effectiveness of the REACH-HF intervention in patients with systolic heart failure and impact on the outcomes of their caregivers. METHODS AND ANALYSIS A parallel two group randomised controlled trial with 1:1 individual allocation to the REACH-HF intervention plus usual care (intervention group) or usual care alone (control group) in 216 patients with systolic heart failure (ejection fraction <45%) and their caregivers. The intervention comprises a self-help manual delivered by specially trained facilitators over a 12-week period. The primary outcome measure is patients' disease-specific health-related quality of life measured using the Minnesota Living with Heart Failure questionnaire at 12 months' follow-up. Secondary outcomes include survival and heart failure related hospitalisation, blood biomarkers, psychological well-being, exercise capacity, physical activity, other measures of quality of life, patient safety and the quality of life, psychological well-being and perceived burden of caregivers at 4, 6 and 12 months' follow-up. A process evaluation will assess fidelity of intervention delivery and explore potential mediators and moderators of changes in health-related quality of life in intervention and control group patients. Qualitative studies will describe patient and caregiver experiences of the intervention. An economic evaluation will estimate the cost-effectiveness of the REACH-HF intervention plus usual care versus usual care alone in patients with systolic heart failure. ETHICS AND DISSEMINATION The study is approved by the North West-Lancaster Research Ethics Committee (ref 14/NW/1351). Findings will be disseminated via journals and presentations to publicise the research to clinicians, commissioners and service users. TRIAL REGISTRATION NUMBER ISRCTN86234930; Pre-results.
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Affiliation(s)
- R S Taylor
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - C Hayward
- Peninsula Clinical Trials Unit, Plymouth University, Plymouth, Devon, UK
| | - V Eyre
- Peninsula Clinical Trials Unit, Plymouth University, Plymouth, Devon, UK
| | - J Austin
- Heart Failure Services and Cardiac Rehabilitation, Aneurin Bevan University Health Board, Nevill Hall Hospital, Abergavenny, UK
| | - R Davies
- Cardiology Department, Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - P Doherty
- Department of Health Sciences, University of York, York, UK
| | - K Jolly
- Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| | - J Wingham
- Institute of Health Research, University of Exeter Medical School, Exeter, UK Department of Research, Development & Innovation, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - R Van Lingen
- Cardiology Department, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - C Abraham
- Psychology Applied to Health Group, University of Exeter Medical School, Exeter, UK
| | - C Green
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - F C Warren
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - N Britten
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - C J Greaves
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - S Singh
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK
| | - S Buckingham
- Department of Research, Development & Innovation, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - K Paul
- REACH-HF Patient and Public Involvement Group, c/o Research, Development & Innovation, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - H Dalal
- Institute of Health Research, University of Exeter Medical School, Exeter, UK Department of Research, Development & Innovation, Royal Cornwall Hospitals NHS Trust, Truro, UK
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Lindner T, Langner S, Paul K, Pohlmann A, Hadlich S, Niendorf T, Jünemann A, Guthoff RF, Stachs O. [Diffusion Weighted Magnetic Resonance Imaging and its Application in Ophthalmology]. Klin Monbl Augenheilkd 2015; 232:1386-91. [PMID: 26678901 DOI: 10.1055/s-0041-109021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The value of diffusion-weighted magnet resonance imaging (DWI-MRI) has been demonstrated for an ever growing range of clinical indications. DWI is sensitive to the diffusion of water molecules and probes their random displacement within tissue. DWI provides both qualitative and quantitative information on tissue characteristics, e.g. tissue cellularity. This review provides an overview of diffusion-weighted imaging and its emerging applications in ophthalmology. The basic physics and technical foundations of DWI are introduced. The emerging applications of DWI are surveyed, particularly in diseases of the eye, orbit and optical nerve.
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Affiliation(s)
- T Lindner
- Core Facility Multimodale Kleintierbildgebung, Universitätsmedizin Rostock
| | - S Langner
- Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsmedizin Greifswald
| | - K Paul
- Berlin Ultrahigh Field Facility (B. U. F. F.), Max-Delbrück-Zentrum für Molekulare Medizin in der Helmholtz-Gemeinschaft, Berlin
| | - A Pohlmann
- Berlin Ultrahigh Field Facility (B. U. F. F.), Max-Delbrück-Zentrum für Molekulare Medizin in der Helmholtz-Gemeinschaft, Berlin
| | - S Hadlich
- Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsmedizin Greifswald
| | - T Niendorf
- Berlin Ultrahigh Field Facility (B. U. F. F.), Max-Delbrück-Zentrum für Molekulare Medizin in der Helmholtz-Gemeinschaft, Berlin
| | - A Jünemann
- Universitätsaugenklinik, Universitätsmedizin Rostock
| | - R F Guthoff
- Universitätsaugenklinik, Universitätsmedizin Rostock
| | - O Stachs
- Universitätsaugenklinik, Universitätsmedizin Rostock
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Mefford HC, Zemel M, Geraghty E, Cook J, Clayton PT, Paul K, Plecko B, Mills PB, Nordli DR, Gospe SM. Intragenic deletions of ALDH7A1 in pyridoxine-dependent epilepsy caused by Alu-Alu recombination. Neurology 2015. [PMID: 26224730 DOI: 10.1212/wnl.0000000000001883] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the role of intragenic deletions of ALDH7A1 in patients with clinical and biochemical evidence of pyridoxine-dependent epilepsy but only a single identifiable mutation in ALDH7A1. METHODS We designed a custom oligonucleotide array with high-density probe coverage across the ALDH7A1 gene. We performed array comparative genomic hybridization in 6 patients with clinical and biochemical evidence of pyridoxine-dependent epilepsy but only a single detectable mutation in ALDH7A1 by sequence analysis. RESULTS We found partial deletions of ALDH7A1 in 5 of 6 patients. Breakpoint analysis reveals that the deletions are likely a result of Alu-Alu recombination in all cases. The density of Alu elements within introns of ALDH7A1 suggests susceptibility to recurrent rearrangement. CONCLUSION Patients with clinical pyridoxine-dependent epilepsy and a single identifiable mutation in ALDH7A1 warrant further investigation for copy number changes involving the ALHD7A1 gene.
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Affiliation(s)
- Heather C Mefford
- From the Department of Pediatrics, Division of Genetic Medicine (H.C.M., M.Z., E.G., J.C.), and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), University of Washington, Seattle; the Division of Genetic Medicine (H.C.M.), Seattle Children's Hospital, WA; the Centre for Translational Omics, Genetics, and Genomic Medicine (P.T.C., P.B.M.), UCL Institute of Child Health, London, UK; the Department of Pediatrics (K.P., B.P.), Division of Child Neurology, University Hospital Graz, Austria; the Division of Child Neurology (B.P.), University Children's Hospital Zurich, University of Zurich, Switzerland; the Departments of Pediatrics and Neurology (D.R.N.), Northwestern University Feinberg School of Medicine, Evanston, IL; the Departments of Pediatrics and Neurology (D.R.N.), Ann & Robert H. Lurie Children's Hospital of Chicago, IL; and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), Seattle Children's Hospital, WA.
| | - Matthew Zemel
- From the Department of Pediatrics, Division of Genetic Medicine (H.C.M., M.Z., E.G., J.C.), and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), University of Washington, Seattle; the Division of Genetic Medicine (H.C.M.), Seattle Children's Hospital, WA; the Centre for Translational Omics, Genetics, and Genomic Medicine (P.T.C., P.B.M.), UCL Institute of Child Health, London, UK; the Department of Pediatrics (K.P., B.P.), Division of Child Neurology, University Hospital Graz, Austria; the Division of Child Neurology (B.P.), University Children's Hospital Zurich, University of Zurich, Switzerland; the Departments of Pediatrics and Neurology (D.R.N.), Northwestern University Feinberg School of Medicine, Evanston, IL; the Departments of Pediatrics and Neurology (D.R.N.), Ann & Robert H. Lurie Children's Hospital of Chicago, IL; and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), Seattle Children's Hospital, WA
| | - Eileen Geraghty
- From the Department of Pediatrics, Division of Genetic Medicine (H.C.M., M.Z., E.G., J.C.), and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), University of Washington, Seattle; the Division of Genetic Medicine (H.C.M.), Seattle Children's Hospital, WA; the Centre for Translational Omics, Genetics, and Genomic Medicine (P.T.C., P.B.M.), UCL Institute of Child Health, London, UK; the Department of Pediatrics (K.P., B.P.), Division of Child Neurology, University Hospital Graz, Austria; the Division of Child Neurology (B.P.), University Children's Hospital Zurich, University of Zurich, Switzerland; the Departments of Pediatrics and Neurology (D.R.N.), Northwestern University Feinberg School of Medicine, Evanston, IL; the Departments of Pediatrics and Neurology (D.R.N.), Ann & Robert H. Lurie Children's Hospital of Chicago, IL; and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), Seattle Children's Hospital, WA
| | - Joseph Cook
- From the Department of Pediatrics, Division of Genetic Medicine (H.C.M., M.Z., E.G., J.C.), and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), University of Washington, Seattle; the Division of Genetic Medicine (H.C.M.), Seattle Children's Hospital, WA; the Centre for Translational Omics, Genetics, and Genomic Medicine (P.T.C., P.B.M.), UCL Institute of Child Health, London, UK; the Department of Pediatrics (K.P., B.P.), Division of Child Neurology, University Hospital Graz, Austria; the Division of Child Neurology (B.P.), University Children's Hospital Zurich, University of Zurich, Switzerland; the Departments of Pediatrics and Neurology (D.R.N.), Northwestern University Feinberg School of Medicine, Evanston, IL; the Departments of Pediatrics and Neurology (D.R.N.), Ann & Robert H. Lurie Children's Hospital of Chicago, IL; and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), Seattle Children's Hospital, WA
| | - Peter T Clayton
- From the Department of Pediatrics, Division of Genetic Medicine (H.C.M., M.Z., E.G., J.C.), and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), University of Washington, Seattle; the Division of Genetic Medicine (H.C.M.), Seattle Children's Hospital, WA; the Centre for Translational Omics, Genetics, and Genomic Medicine (P.T.C., P.B.M.), UCL Institute of Child Health, London, UK; the Department of Pediatrics (K.P., B.P.), Division of Child Neurology, University Hospital Graz, Austria; the Division of Child Neurology (B.P.), University Children's Hospital Zurich, University of Zurich, Switzerland; the Departments of Pediatrics and Neurology (D.R.N.), Northwestern University Feinberg School of Medicine, Evanston, IL; the Departments of Pediatrics and Neurology (D.R.N.), Ann & Robert H. Lurie Children's Hospital of Chicago, IL; and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), Seattle Children's Hospital, WA
| | - Karl Paul
- From the Department of Pediatrics, Division of Genetic Medicine (H.C.M., M.Z., E.G., J.C.), and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), University of Washington, Seattle; the Division of Genetic Medicine (H.C.M.), Seattle Children's Hospital, WA; the Centre for Translational Omics, Genetics, and Genomic Medicine (P.T.C., P.B.M.), UCL Institute of Child Health, London, UK; the Department of Pediatrics (K.P., B.P.), Division of Child Neurology, University Hospital Graz, Austria; the Division of Child Neurology (B.P.), University Children's Hospital Zurich, University of Zurich, Switzerland; the Departments of Pediatrics and Neurology (D.R.N.), Northwestern University Feinberg School of Medicine, Evanston, IL; the Departments of Pediatrics and Neurology (D.R.N.), Ann & Robert H. Lurie Children's Hospital of Chicago, IL; and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), Seattle Children's Hospital, WA
| | - Barbara Plecko
- From the Department of Pediatrics, Division of Genetic Medicine (H.C.M., M.Z., E.G., J.C.), and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), University of Washington, Seattle; the Division of Genetic Medicine (H.C.M.), Seattle Children's Hospital, WA; the Centre for Translational Omics, Genetics, and Genomic Medicine (P.T.C., P.B.M.), UCL Institute of Child Health, London, UK; the Department of Pediatrics (K.P., B.P.), Division of Child Neurology, University Hospital Graz, Austria; the Division of Child Neurology (B.P.), University Children's Hospital Zurich, University of Zurich, Switzerland; the Departments of Pediatrics and Neurology (D.R.N.), Northwestern University Feinberg School of Medicine, Evanston, IL; the Departments of Pediatrics and Neurology (D.R.N.), Ann & Robert H. Lurie Children's Hospital of Chicago, IL; and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), Seattle Children's Hospital, WA
| | - Philippa B Mills
- From the Department of Pediatrics, Division of Genetic Medicine (H.C.M., M.Z., E.G., J.C.), and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), University of Washington, Seattle; the Division of Genetic Medicine (H.C.M.), Seattle Children's Hospital, WA; the Centre for Translational Omics, Genetics, and Genomic Medicine (P.T.C., P.B.M.), UCL Institute of Child Health, London, UK; the Department of Pediatrics (K.P., B.P.), Division of Child Neurology, University Hospital Graz, Austria; the Division of Child Neurology (B.P.), University Children's Hospital Zurich, University of Zurich, Switzerland; the Departments of Pediatrics and Neurology (D.R.N.), Northwestern University Feinberg School of Medicine, Evanston, IL; the Departments of Pediatrics and Neurology (D.R.N.), Ann & Robert H. Lurie Children's Hospital of Chicago, IL; and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), Seattle Children's Hospital, WA
| | - Douglas R Nordli
- From the Department of Pediatrics, Division of Genetic Medicine (H.C.M., M.Z., E.G., J.C.), and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), University of Washington, Seattle; the Division of Genetic Medicine (H.C.M.), Seattle Children's Hospital, WA; the Centre for Translational Omics, Genetics, and Genomic Medicine (P.T.C., P.B.M.), UCL Institute of Child Health, London, UK; the Department of Pediatrics (K.P., B.P.), Division of Child Neurology, University Hospital Graz, Austria; the Division of Child Neurology (B.P.), University Children's Hospital Zurich, University of Zurich, Switzerland; the Departments of Pediatrics and Neurology (D.R.N.), Northwestern University Feinberg School of Medicine, Evanston, IL; the Departments of Pediatrics and Neurology (D.R.N.), Ann & Robert H. Lurie Children's Hospital of Chicago, IL; and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), Seattle Children's Hospital, WA
| | - Sidney M Gospe
- From the Department of Pediatrics, Division of Genetic Medicine (H.C.M., M.Z., E.G., J.C.), and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), University of Washington, Seattle; the Division of Genetic Medicine (H.C.M.), Seattle Children's Hospital, WA; the Centre for Translational Omics, Genetics, and Genomic Medicine (P.T.C., P.B.M.), UCL Institute of Child Health, London, UK; the Department of Pediatrics (K.P., B.P.), Division of Child Neurology, University Hospital Graz, Austria; the Division of Child Neurology (B.P.), University Children's Hospital Zurich, University of Zurich, Switzerland; the Departments of Pediatrics and Neurology (D.R.N.), Northwestern University Feinberg School of Medicine, Evanston, IL; the Departments of Pediatrics and Neurology (D.R.N.), Ann & Robert H. Lurie Children's Hospital of Chicago, IL; and the Departments of Neurology and Pediatrics, Division of Pediatric Neurology (S.M.G.), Seattle Children's Hospital, WA.
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Niendorf T, Paul K, Graessl A, Els A, Pohlmann A, Rieger J, Lindner T, Krueger PC, Hadlich S, Langner S, Stachs O. Ophthalmologische Bildgebung mit Ultrahochfeld-Magnetresonanztomografie: technische Innovationen und wegweisende Anwendungen. Klin Monbl Augenheilkd 2014; 231:1187-95. [DOI: 10.1055/s-0034-1383365] [Citation(s) in RCA: 3] [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: 10/24/2022]
Affiliation(s)
- T. Niendorf
- Berlin Ultrahigh Field Facility (B. U. F. F.), Max-Delbrück-Zentrum für Molekulare Medizin, Berlin
| | - K. Paul
- Berlin Ultrahigh Field Facility (B. U. F. F.), Max-Delbrück-Zentrum für Molekulare Medizin, Berlin
| | - A. Graessl
- Berlin Ultrahigh Field Facility (B. U. F. F.), Max-Delbrück-Zentrum für Molekulare Medizin, Berlin
| | - A. Els
- Berlin Ultrahigh Field Facility (B. U. F. F.), Max-Delbrück-Zentrum für Molekulare Medizin, Berlin
| | - A. Pohlmann
- Berlin Ultrahigh Field Facility (B. U. F. F.), Max-Delbrück-Zentrum für Molekulare Medizin, Berlin
| | - J. Rieger
- R&D Abteilung, MRI.TOOLS GmbH, Berlin
| | - T. Lindner
- Augenklinik und Poliklinik bzw. AG Präklinische Bildgebung, Universitätsmedizin Rostock
| | - P.-C. Krueger
- Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsmedizin Greifswald
| | - S. Hadlich
- Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsmedizin Greifswald
| | - S. Langner
- Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsmedizin Greifswald
| | - O. Stachs
- Augenklinik und Poliklinik bzw. AG Präklinische Bildgebung, Universitätsmedizin Rostock
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Jing J, Kielstein JT, Schultheiss UT, Sitter T, Titze SI, Schaeffner ES, McAdams-DeMarco M, Kronenberg F, Eckardt KU, Kottgen A, for the GCKD Study Investigators, Eckardt KU, Titze S, Prokosch HU, Barthlein B, Reis A, Ekici AB, Gefeller O, Hilgers KF, Hubner S, Avendano S, Becker-Grosspitsch D, Hauck N, Seuchter SA, Hausknecht B, Rittmeier M, Weigel A, Beck A, Ganslandt T, Knispel S, Dressel T, Malzer M, Floege J, Eitner F, Schlieper G, Findeisen K, Arweiler E, Ernst S, Unger M, Lipski S, Schaeffner E, Baid-Agrawal S, Petzold K, Schindler R, Kottgen A, Schultheiss U, Meder S, Mitsch E, Reinhard U, Walz G, Haller H, Lorenzen J, Kielstein JT, Otto P, Sommerer C, Follinger C, Zeier M, Wolf G, Busch M, Paul K, Dittrich L, Sitter T, Hilge R, Blank C, Wanner C, Krane V, Schmiedeke D, Toncar S, Cavitt D, Schonowsky K, Borner-Klein A, Kronenberg F, Raschenberger J, Kollerits B, Forer L, Schonherr S, Weissensteiner H, Oefner P, Gronwald W, Zacharias H, Schmid M. Prevalence and correlates of gout in a large cohort of patients with chronic kidney disease: the German Chronic Kidney Disease (GCKD) study. Nephrol Dial Transplant 2014; 30:613-21. [DOI: 10.1093/ndt/gfu352] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Hős C, Champneys A, Paul K, McNeely M. Dynamic behavior of direct spring loaded pressure relief valves in gas service: Model development, measurements and instability mechanisms. J Loss Prev Process Ind 2014. [DOI: 10.1016/j.jlp.2014.06.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [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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Plecko B, Paul K, Mills P, Clayton P, Paschke E, Maier O, Hasselmann O, Schmiedel G, Kanz S, Connolly M, Wolf N, Struys E, Stockler S, Abela L, Hofer D. Pyridoxine responsiveness in novel mutations of the PNPO gene. Neurology 2014; 82:1425-33. [PMID: 24658933 DOI: 10.1212/wnl.0000000000000344] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether patients with pyridoxine-responsive seizures but normal biomarkers for antiquitin deficiency and normal sequencing of the ALDH7A1 gene may have PNPO mutations. METHODS We sequenced the PNPO gene in 31 patients who fulfilled the above-mentioned criteria. RESULTS We were able to identify 11 patients carrying 3 novel mutations of the PNPO gene. In 6 families, a homozygous missense mutation p.Arg225His in exon 7 was identified, while 1 family was compound heterozygous for a novel missense mutation p.Arg141Cys in exon 5 and a deletion c.279_290del in exon 3. Pathogenicity of the respective mutations was proven by absence in 100 control alleles and expression studies in CHO-K1 cell lines. The response to pyridoxine was prompt in 4, delayed in 2, on EEG only in 2, and initially absent in another 2 patients. Two unrelated patients homozygous for the p.Arg225His mutation experienced status epilepticus when switched to pyridoxal 5'-phosphate (PLP). CONCLUSIONS This study challenges the paradigm of exclusive PLP responsiveness in patients with pyridoxal 5'-phosphate oxidase deficiency and underlines the importance of consecutive testing of pyridoxine and PLP in neonates with antiepileptic drug-resistant seizures. Patients with pyridoxine response but normal biomarkers for antiquitin deficiency should undergo PNPO mutation analysis.
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Affiliation(s)
- Barbara Plecko
- From the Department of Pediatrics (B.P., L.A.), Division of Child Neurology, University Hospital Zurich, Switzerland; the Department of Pediatrics (B.P.), Division of Neurology and Inborn Errors of Metabolism, Medical University Graz, Austria; radiz-"Rare Disease Initiative Zurich, Clinical Research Priority Program for Rare Diseases University of Zurich" (B.P., L.A.); CRC Clinical Research Center (B.P.), University Childrens' Hospital Zurich, Switzerland; the Laboratory of Metabolic Diseases (K.P., E.P., D.H.), Department of Pediatrics, University Hospital Graz, Austria; UCL Institute of Child Health (P.M., P.C.), Clinical and Molecular Genetics Unit, London, UK; Childrens Hospital St. Gallen (O.M., O.H.), Switzerland; the Department of Pediatrics (G.H.), Klinikum Esslingen; the Department of Pediatrics (S.K.), St. Marien Hospital, Landshut, Germany; the Division of Child Neurology (M.C.) and Division of Biochemical Diseases (S.S.), Department of Pediatrics, University of British Columbia, Vancouver, Canada; the Department of Pediatrics, Division of Child Neurology (N.W.), VU University Medical Center and Neuroscience Campus Amsterdam; and the Department of Clinical Chemistry (E.S.), Vrije Universiteit Amsterdam, the Netherlands
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Herrmann G, Hellwig D, Heuer HE, Heyder S, Köster H, Kröger K, Paul K, Mellies U, Schmitt A, Wagenseil D, Riethmueller J. 91 Sequential inhalative tobramycin–colistin-combination stabilizes patients with chronic Pseudomonas aeruginosa colonization. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60233-7] [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: 10/26/2022]
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Freihorst J, Paul K, Griese M. Seltene Lungenerkrankungen. Pädiatrische Pneumologie 2013. [PMCID: PMC7123953 DOI: 10.1007/978-3-642-34827-3_31] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sterl E, Paul K, Paschke E, Zschocke J, Brunner-Krainz M, Windisch E, Konstantopoulou V, Möslinger D, Karall D, Scholl-Bürgi S, Sperl W, Lagler F, Plecko B. Prevalence of tetrahydrobiopterine (BH4)-responsive alleles among Austrian patients with PAH deficiency: comprehensive results from molecular analysis in 147 patients. J Inherit Metab Dis 2013; 36:7-13. [PMID: 22526846 DOI: 10.1007/s10545-012-9485-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [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] [Received: 10/25/2011] [Revised: 03/28/2012] [Accepted: 03/30/2012] [Indexed: 10/28/2022]
Abstract
Phenylketonuria (PKU, MIM 261600) is an autosomal recessive disorder caused by mutations of the phenylalanine hydroxylase gene (PAH, GenBank U49897.1, RefSeq NM_000277). To date more than 560 variants of the PAH gene have been identified. In Europe there is regional distribution of specific mutations. Due to recent progress in chaperone therapy, the prevalence of BH4-responsive alleles gained therapeutic importance. Here we report the mutational spectrum of PAH deficiency in 147 unrelated Austrian families. Overall mutation detection rate was 98.6 %. There was a total of 62 disease-causing mutations, including five novel mutations IVS4 + 6T>A, p.H290Y, IVS8-2A>G, p.A322V and p.I421S. The five most prevalent mutations found in patients were p.R408W, IVS12 + 1G>A, p.R261Q, p.R158Q and IVS2 + 5G>C. Neonatal phenylalanine levels before treatment were available in 114/147 patients. Prediction of BH4-responsiveness in patients with full genotypes was exclusively made according to published data. Among the 133 patients needing dietary treatment, 28.4 % are expected to be BH4 "non-responsive", 4.5 % are highly likely BH4-responsive, 35.8 % are probably BH4-responsive while no interpretation was possible for 31.3 %. The mutation data reflect the population history of Austria and provide information on the likely proportion of Austrian PKU patients that may benefit from BH4-therapy.
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Affiliation(s)
- Elisabeth Sterl
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
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Griese M, Heinrich S, Ratjen F, Kabesch M, Paul K, Ballmann M, Rietschel E, Kappler M. Surfactant protein a in cystic fibrosis: supratrimeric structure and pulmonary outcome. PLoS One 2012; 7:e51050. [PMID: 23236429 PMCID: PMC3517609 DOI: 10.1371/journal.pone.0051050] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 10/29/2012] [Indexed: 01/21/2023] Open
Abstract
Background The state of oligomerization of surfactant associated protein-A (SP-A) monomers differs between individuals. This likely affects SP-A’s functional properties and could thereby influence clinical status in patients with lung diseases. In this study we focus on SP-A structure in cystic fibrosis (CF) compared to both healthy subjects and disease controls. Methods SP-A composition and function were assessed in both bronchoalveolar lavage (BAL) fluid and serum of 46 CF patients with mild disease, 25 patients with chronic bronchitis and 22 healthy subjects by gel chromatography and a functional agglutination assay. Relation of SP-A agglutination ability to disease severity of the subjects was explored. Results SP-A was present in seven major oligomeric forms with the majority of SP-A being structurally organized as complex oligomeric forms. More complex oligomeric forms were associated with better SP-A function with regard to its agglutination ability. These forms were more frequently observed in BAL than in serum, but there were no differences between disease groups. In CF patients, more complex forms of SP-A were associated with better lung function. Conclusions Organizational structure of SP-A affects its functional activity and is linked to disease severity in CF.
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Affiliation(s)
- Matthias Griese
- Dr. von Haunersches Kinderspital, University of Munich, Munich, Germany.
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Zima M, Tichavský P, Paul K, Krajča V. Robust removal of short-duration artifacts in long neonatal EEG recordings using wavelet-enhanced ICA and adaptive combining of tentative reconstructions. Physiol Meas 2012; 33:N39-49. [DOI: 10.1088/0967-3334/33/8/n39] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Gerla V, Radisavljevic Djordjevic V, Lhotska L, Krajca V, Paul K. 21. Analysis of newborn EEG recorded at 40th week of postconceptional age. Clin Neurophysiol 2012. [DOI: 10.1016/j.clinph.2011.10.033] [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: 10/14/2022]
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Thakur SK, Roy SK, Paul K, Khanam M, Khatun W, Sarker D. Effect of nutrition education on exclusive breastfeeding for nutritional outcome of low birth weight babies. Eur J Clin Nutr 2011; 66:376-81. [PMID: 22085870 DOI: 10.1038/ejcn.2011.182] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND/OBJECTIVES Low birth weight (LBW), defined as the body weight at birth of less than 2500 g, is a major public health problem in Bangladesh, where 37% of the babies are born with LBW. The objective of this study is to see the impact of nutrition education on growth of LBW babies with early initiation and exclusive breastfeeding compared to control group. SUBJECTS/METHODS A total of 184 LBW babies and their mothers who attended the Maternal Care and Health Training Institute and Dhaka Medical College Hospital were randomly allocated to either intervention or control group. Enrollment of the study population started in May 2008 and was completed in October 2008. Nutrition education was given to mothers twice weekly for 2 months, on initiation of breastfeeding within 1 h, exclusive breastfeeding and increasing their dietary intake. Nutritional status of LBW babies was assessed for length and weight every 2 weeks. Data were analyzed using SPSS/Window's version 12. Comparison of mean of data was done using standard Student's t-test. RESULTS Mean initial body weight and length of LBW babies were similar in both groups (2261±198 g vs 2241±244 g, P=0.535 and 43.0±1.3 cm vs 43.0±1.7 cm, P=0.77). Body weight and length of the LBW babies after 2 months increased significantly (3620±229 g vs 3315±301 g, P<0.001 and 50.2±1.3 cm vs 48.7±1.6 cm, P<0.001). It was found that the intervention group suffered less from respiratory illness compared with the control group (39% vs 66%, P<0.001). The rate of early initiation of breastfeeding was also significantly higher with nutrition intervention (59.8% vs 37.2%, P<0.001). Exclusive breastfeeding rate was significantly higher in intervention group (59.8% vs 37%, P=0.003). CONCLUSIONS The present study showed that weight and length gain of LBW babies significantly increased by breastfeeding and nutrition education. Therefore, nutrition education on breastfeeding proves to be a strong tool to reduce the high risk of malnutrition and mortality of the LBW babies.
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Affiliation(s)
- S K Thakur
- Department of Food and Nurtition, College of Home Economics, Dhaka, Bangladesh
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Gruber W, Orenstein DM, Braumann KM, Paul K, Hüls G. Effects of an exercise program in children with cystic fibrosis: are there differences between females and males? J Pediatr 2011; 158:71-6. [PMID: 20833400 DOI: 10.1016/j.jpeds.2010.07.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Revised: 06/29/2010] [Accepted: 07/21/2010] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the adaptive responses of an in-patient exercise program in children with cystic fibrosis (CF) and evaluate the effects of sex. STUDY DESIGN In total, 158 female and 186 male subjects with CF (age, 12 to 43 years) were studied during a 6-week rehabilitation course. A maximal incremental cycling test was used to determine exercise capacity and responses after 6 weeks of exercise training. Measures included lung function, peak oxygen uptake, peak workload, and peak heart rate. RESULTS Lung function values were lower in males (P < .05). Females had a lower aerobic capacity (P < .05) at the beginning and at the end of the exercise training program. Similar training effects (P > .05) were seen between sexes in peak oxygen uptake (mL/min, mL/kg/min) and peak heart rate (beats/min) but not in peak workload (Watts, W/kg). CONCLUSIONS The exercise program improved the fitness level similarly in females and males with CF. Basic physiological sex differences were still seen at the beginning and end of the training, despite the better lung function in females. Moreover, the finding suggested that fitness level and not lung function determined the response to training in CF, with those who were less fit at baseline having the largest response to training.
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Abstract
The aim of the present study was to assess the motor performance in preschool children with a reliable and valid test battery developed to identify motor dysfunction and normal motor development in children aged from 4 to 6 years. Several aspects of motor performance were examined in 29 preschool children with cystic fibrosis (CF) age range 4-6 years (mean 5.2 +/- 0.8 years), FEV(1) 97.2 +/- 15.3pred and compared to with 22 healthy children of the same age 5.5 +/- 0.8 years. All children performed the "Motoriktest fuer 4-6jaehrige Kinder" (MOT) assessing seven different aspects of motor performance. Compared to healthy children, test score "Motor Quotient" (MQ) as the mean of all test items was significantly higher (P < 0.05) in children with CF (108.1 +/- 16 vs. 93.5 +/- 17.9). In both groups, the MQ can be classified as normal. Children with CF scored higher in MOT subtests "Agility and Coordination" (P < 0.05) and "Balance" (P < 0.01) than healthy children but not in the other subtests. We speculate that chest physiotherapy in preschool children with CF may have an effect on motor performance in general and in some aspects of motor performance.
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Banz VM, Christen B, Paul K, Martinolli L, Candinas D, Zimmermann H, Exadaktylos AK. Gender, age and ethnic aspects of analgesia in acute abdominal pain: is analgesia even across the groups? Intern Med J 2010; 42:281-8. [PMID: 20492010 DOI: 10.1111/j.1445-5994.2010.02255.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Numerous studies have shown differences in pain perception between men and women, which may affect pain management strategies. AIM Our primary aim was to investigate whether there are gender-based differences in pain management in patients admitted to our emergency department with acute, non-specific abdominal pain (NSAP). Our secondary aim was to evaluate if other factors influence administration of analgesia for patients admitted with NSAP. METHODS From June 2007 to June 2008, we carried out a retrospective, gender-based, frequency-matched control study with 150 patients (75 consecutive men and 75 women) who presented with NSAP at our emergency department. Pain was documented using a numerical rating scale ('0' no pain, '10' most severe pain). A multinomial regression model was used to assess factors that might influence pain management. RESULTS No statistically significant difference was seen between men and women with respect to pain management (P= 0.085). Younger patients were, however, more likely to receive weaker (P= 0.011) and fewer analgesics (P < 0.001). Patients with previous abdominal surgery (P= 0.012), known chronic pain conditions (P= 0.029) or relevant comorbidities (P= 0.048) received stronger analgesia. Nationality (P= 0.244), employment status (P= 0.988), time of admission (P= 0.487) and known psychiatric illness (P= 0.579) did not influence pain management. CONCLUSIONS No statistically significant gender-dependent differences in pain management were observed. However, younger patients received less potent analgesic treatment. There is no reason for certain groups to receive suboptimal treatment, and greater efforts should be made to offer consistent treatment to all patients.
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Affiliation(s)
- V M Banz
- Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland.
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Hofer D, Paul K, Fantur K, Beck M, Roubergue A, Vellodi A, Poorthuis BJ, Michelakakis H, Plecko B, Paschke E. Phenotype determining alleles in GM1 gangliosidosis patients bearing novel GLB1 mutations. Clin Genet 2010; 78:236-46. [PMID: 20175788 DOI: 10.1111/j.1399-0004.2010.01379.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [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
GM1 gangliosidosis manifests with progressive psychomotor deterioration and dysostosis of infantile, juvenile, or adult onset, caused by alterations in the structural gene coding for lysosomal acid beta-galactosidase (GLB1). In addition, allelic variants of this gene can result in Morquio B disease (MBD), a phenotype with dysostosis multiplex and entire lack of neurologic involvement. More than 100 sequence alterations in the GLB1 gene have been identified so far, but only few could be proven to be predictive for one of the GM1 gangliosidosis subtypes or MBD. We performed genotype analyses in 16 GM1 gangliosidosis patients of all phenotypes and detected 28 different genetic lesions. Among these, p.I55FfsX16, p.W65X, p.F107L, p.H112P, p.C127Y, p.W161X, p.I181K, p.C230R, p.W273X, p.R299VfsX5, p.A301V, p.F357L, p.K359KfsX23, p.L389P, p.D448V, p.D448GfsX8, and the intronic mutation IVS6-8A>G have not been published so far. Due to their occurrence in homozygous patients, four mutations could be correlated to a distinct GM1 gangliosidosis phenotype. Furthermore, the missense mutations from heteroallelic patients and three artificial nonsense mutations were characterized by overexpression in COS-1 cells, and the subcellular localization of the mutant proteins in fibroblasts was assessed. The phenotype specificity of 10 alleles can be proposed on the basis of our results and previous data.
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Affiliation(s)
- D Hofer
- Department of Paediatrics, Medical University of Graz, Austria
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Hofer D, Paul K, Fantur K, Beck M, Bürger F, Caillaud C, Fumic K, Ledvinova J, Lugowska A, Michelakakis H, Radeva B, Ramaswami U, Plecko B, Paschke E. GM1 gangliosidosis and Morquio B disease: expression analysis of missense mutations affecting the catalytic site of acid beta-galactosidase. Hum Mutat 2009; 30:1214-21. [PMID: 19472408 DOI: 10.1002/humu.21031] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Alterations in GLB1, the gene coding for acid beta-D-galactosidase (beta-Gal), can result in GM1 gangliosidosis (GM1), a neurodegenerative disorder, or in Morquio B disease (MBD), a phenotype with dysostosis multiplex and normal central nervous system (CNS) function. While most MBD patients carry a common allele, c.817TG>CT (p.W273L), only few of the >100 mutations known in GM1 can be related to a certain phenotype. In 25 multiethnic patients with GM1 or MBD, 11 missense mutations were found as well as one novel insertion and a transversion causing aberrant gene products. Except c.602G>A (p.R201H) and two novel alleles, c.592G>T (p.D198Y) and c.1189C>G (p.P397A), all mutants resulted in significantly reduced beta-Gal activities (<10% of normal) upon expression in COS-1 cells. Although c.997T>C (p.Y333H) expressed 3% of normal activity, the mutant protein was localized in the lysosomal-endosomal compartment. A homozygous case presented with late infantile GM1, while a heterozygous, juvenile case carried p.Y333H together with p.R201H. This allele, recently found in homozygous MBD, gives rise to rough endoplasmic reticulum (RER)-located beta-Gal precursors. Thus, unlike classical MBD, the phenotype of heterozygotes carrying p.R201H may rather be determined by poorly active, properly transported products of the counter allele than by the mislocalized p.R201H precursors.
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Affiliation(s)
- Doris Hofer
- Department of Paediatrics, Medical University of Graz, Graz A-8036, Austria
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Petranek S, Patakova I, Krajca V, Paul K. PO31-FR-09 Automatic system for identification of sleep stages in preterm newborns. J Neurol Sci 2009. [DOI: 10.1016/s0022-510x(09)71227-4] [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: 10/20/2022]
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Abstract
INTRODUCTION Polysomnography (PSG) is one of the most important noninvasive methods for studying maturation of the child brain. Sleep in infants is significantly different from sleep in adults. This paper addresses the problem of computer analysis of neonatal polygraphic signals. METHODS We applied methods designed for differentiating three important neonatal behavioral states: quiet sleep, active sleep, and wakefulness. The proportion of these states is a significant indicator of the maturity of the newborn brain in clinical practice. In this study, we used data provided by the Institute for Care of Mother and Child, Prague (12 newborn infants of similar postconceptional age). The data were scored by an experienced physician to four states (wake, quiet sleep, active sleep, movement artifact). For accurate classification, it was necessary to determine the most informative features. We used a method based on power spectral density (PSD) applied to each EEG channel. We also used features derived from electrooculogram (EOG), electromyogram (EMG), ECG, and respiration [pneumogram (PNG)] signals. The most informative feature was the measure of regularity of respiration from the PNG signal. We designed an algorithm for interpreting these characteristics. This algorithm was based on Markov models. RESULTS The results of automatic detection of sleep states were compared to the "sleep profiles" determined visually. We evaluated both the success rate and the true positive rate of the classification, and statistically significant agreement of the two scorings was found. Two variants, for learning and for testing, were applied, namely learning from the data of all 12 newborns and tenfold cross-validation, and learning from the data of 11 newborns and testing on the data from the 12th newborn. We utilized information obtained from several biological signals (EEG, ECG, PNG, EMG, EOG) for our final classification. We reached the final success rate of 82.5%. The true positive rate was 81.8% and the false positive rate was 6.1%. DISCUSSION The most important step in the whole process is feature extraction and feature selection. In this process, we used visualization as an additional tool that helped us to decide which features to select. Proper selection of features may significantly influence the success rate of the classification. We made a visual comparison of the computed features with the manual scoring provided by the expert. A hidden Markov model was used for classification. The advantage of this model is that it determines the future behavior of the process by its present state. In this way, it preserves information about temporal development.
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Affiliation(s)
- V Gerla
- Gerstner Laboratory, Czech Technical University, Prague, Czech Republic.
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Kim S, Richter JW, Paul K, Plecko B, Paschke E, Kattner E. Scheinbares neonatales Entzugssyndrom als Ausdruck einer pyridoxinabhängigen Enzephalopathie – eine Kasuistik mit Videoaufzeichnung. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1223041] [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: 10/20/2022]
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Kleinert J, Kotanko P, Spada M, Pagliardini S, Paschke E, Paul K, Voigtländer T, Wallner M, Kramar R, Stummvoll HK, Schwarz C, Horn S, Holzer H, Födinger M, Sunder-Plassmann G. Anderson-Fabry disease: a case-finding study among male kidney transplant recipients in Austria. Transpl Int 2008; 22:287-92. [PMID: 18954370 DOI: 10.1111/j.1432-2277.2008.00791.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The diagnosis of Anderson-Fabry disease is often delayed or even missed. As severe renal manifestations are a hallmark of alfa-galactosidase A (AGAL) deficiency, we tested the hypothesis that Anderson-Fabry disease is under-recognized among male kidney transplant recipients. This nation-wide study in Austria enrolled 1306 patients (ca 65% of all kidney transplanted males) from 30 kidney centers. AGAL activity was determined from filter paper dried blood spots by a fluorescence assay. A positive screening test was defined by an AGAL activity below 1.5 nmol/h/ml. In patients with a positive blood spot-screening test, AGAL activity was re-examined in peripheral blood leukocytes. Genetic testing for mutations in the GLA gene was performed by sequencing to confirm the diagnosis of Anderson-Fabry disease. Two previously not recognized cases with Anderson-Fabry disease were identified. Our study is the first showing that a diagnosis of Anderson-Fabry disease can be missed even in patients who undergo kidney transplantation. Case-finding strategies may be considered a useful tool for diagnosis of this rare disease that may be somewhat more prevalent among kidney transplant recipients compared with dialysis populations.
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Affiliation(s)
- Julia Kleinert
- Division of Nephrology and Dialysis, Department of Medicine III, Medical University Vienna, Vienna, Austria
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Kluger G, Blank R, Paul K, Paschke E, Jansen E, Jakobs C, Wörle H, Plecko B. Pyridoxine-dependent epilepsy: normal outcome in a patient with late diagnosis after prolonged status epilepticus causing cortical blindness. Neuropediatrics 2008; 39:276-9. [PMID: 19294602 DOI: 10.1055/s-0029-1202833] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We report on a male proband with pyridoxine-dependent epilepsy (PDE) and neonatal seizure onset. At the age of 31 months, a prolonged status epilepticus led to severe neurological regression with cortical blindness, loss of speech and muscular hypotonia with slow recovery over the following 3 months. At 33 months of age pyridoxine therapy was initiated with excellent response and the boy remained seizure-free on pyridoxine monotherapy, except for two occasions with seizure recurrence 10 days after accidental pyridoxine withdrawal. alpha-aminoadipic semialdehyde dehydrogenase (antiquitin) deficiency was indicated by elevated pipecolic acid concentrations in plasma and alpha-aminoadipic semialdehyde excretion in urine. Molecular analysis of the antiquitin gene revealed a novel missense mutation c.57insA, while the mutation of the other allele remained unidentified so far. Despite the delay in diagnosis and prolonged status epilepticus, neuropsychological evaluations at the ages of 11 and 18 years demonstrated full-scale IQ of 93 and 92, respectively, with better verbal IQ (103 and 101) than performance IQ (85 and 82).
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Affiliation(s)
- G Kluger
- Klinik für Neuropädiatrie und Neurologische Rehabilitation, Epilepsiezentrum für Kinder und Jugendliche, BHZ Vogtareuth, Germany
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Geddes CGR, Bruhwiler DL, Cary JR, Mori WB, Vay JL, Martins SF, Katsouleas T, Cormier-Michel E, Fawley WM, Huang C, Wang X, Cowan B, Decyk VK, Esarey E, Fonseca RA, Lu W, Messmer P, Mullowney P, Nakamura K, Paul K, Plateau GR, Schroeder CB, Silva LO, Toth C, Tsung FS, Tzoufras M, Antonsen T, Vieira J, Leemans WP. Computational studies and optimization of wakefield accelerators. ACTA ACUST UNITED AC 2008. [DOI: 10.1088/1742-6596/125/1/012002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Tafel O, Latzin P, Paul K, Winter T, Woischnik M, Griese M. Surfactant proteins SP-B and SP-C and their precursors in bronchoalveolar lavages from children with acute and chronic inflammatory airway disease. BMC Pulm Med 2008; 8:6. [PMID: 18405368 PMCID: PMC2364613 DOI: 10.1186/1471-2466-8-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2007] [Accepted: 04/11/2008] [Indexed: 01/08/2023] Open
Abstract
Background The surfactant proteins B (SP-B) and C (SP-C) are important for the stability and function of the alveolar surfactant film. Their involvement and down-regulation in inflammatory processes has recently been proposed, but their level during neutrophilic human airway diseases are not yet known. Methods We used 1D-electrophoresis and Western blotting to determine the concentrations and molecular forms of SP-B and SP-C in bronchoalveolar lavage (BAL) fluid of children with different inflammatory airway diseases. 21 children with cystic fibrosis, 15 with chronic bronchitis and 14 with pneumonia were included and compared to 14 healthy control children. Results SP-B was detected in BAL of all 64 patients, whereas SP-C was found in BAL of all but 3 children; those three BAL fluids had more than 80% neutrophils, and in two patients, who were re-lavaged later, SP-C was then present and the neutrophil count was lower. SP-B was mainly present as a dimer, SP-C as a monomer. For both qualitative and quantitative measures of SP-C and SP-B, no significant differences were observed between the four evaluated patient groups. Conclusion Concentration or molecular form of SP-B and SP-C is not altered in BAL of children with different acute and chronic inflammatory lung diseases. We conclude that there is no down-regulation of SP-B and SP-C at the protein level in inflammatory processes of neutrophilic airway disease.
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Affiliation(s)
- Oliver Tafel
- Lung Research Group, Children's Hospital of Ludwig Maximilian University, Munich, Germany.
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Paul K. Aktueller Stand der Entgeltordnung und des Arbeitszeitgesetzes des öffentlichen Dienstes (TVÖD/TVL). ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073900] [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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Paul K, Manjula J, Deepa EP, Selvanayagam ZE, Ganesh KA, Subba Rao PV. Anti-Echis carinatus venom antibodies from chicken egg yolk: Isolation, purification and neutralization efficacy. Toxicon 2007; 50:893-900. [PMID: 17681579 DOI: 10.1016/j.toxicon.2007.06.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2006] [Revised: 07/26/2006] [Accepted: 06/21/2007] [Indexed: 11/26/2022]
Abstract
High titer antibodies (IgY) were raised in egg yolk of white leghorn chicken (Gallus gallus domesticus) by immunizing with the venom of Echis carinatus (Saw scaled viper or carpet viper), an Indian venomous snake belonging to the family Viperidae. The anti-snake venom antibodies (antivenom) were isolated from egg yolk by the water dilution method, enriched by 19% sodium sulfate precipitation and purified by immunoaffinity chromatography. A single, electrophoretically pure IgY band of 180-200 kDa was obtained on SDS-PAGE. Immunoblot analysis revealed not only the specific binding of the antivenom but also dose-dependent blocking of antivenom by venom proteins. In neutralization studies, a preincubated mixture of both affinity-purified (50 mg/kg body weight) as well as partially purified (210 mg/kg body weight) anti-E. carinatus IgY with 2 LD(50) dose of E. carinatus venom (2 x 6.65 mg/kg body weight) gave 100% protection in mice when administered subcutaneously.
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Affiliation(s)
- K Paul
- Vittal Mallya Scientific Research Foundation, PO Box 406, K.R. Road, Bangalore-560 004, India
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Davison AG, Monaghan M, Brown D, Eraut CD, O'Brien A, Paul K, Townsend J, Elston C, Ward L, Steeples S, Cubitt L. Hospital at home for chronic obstructive pulmonary disease: an integrated hospital and community based generic intermediate care service for prevention and early discharge. Chron Respir Dis 2007; 3:181-5. [PMID: 17190120 DOI: 10.1177/1479972306070074] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [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: 11/15/2022] Open
Abstract
Recent randomized controlled studies have reported success for hospital at home for prevention and early discharge of chronic obstructive pulmonary disease (COPD) patients using hospital based respiratory nurse specialists. This observational study reports results using an integrated hospital and community based generic intermediate care service. The length of care, readmission within 60 days and death within 60 days in the early discharge (9.37 days, 21.1%, 7%) and the prevention of admission (five to six days, 34.1%, 3.8%) are similar to previous studies. We suggest that this generic community model of service may allow hospital at home services for COPD to be introduced in more areas.
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Affiliation(s)
- A G Davison
- Southend Associated University Hospital, Westcliff on Sea, Essex, UK.
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Plecko B, Paul K, Paschke E, Stoeckler-Ipsiroglu S, Struys E, Jakobs C, Hartmann H, Luecke T, di Capua M, Korenke C, Hikel C, Reutershahn E, Freilinger M, Baumeister F, Bosch F, Erwa W. Biochemical and molecular characterization of 18 patients with pyridoxine-dependent epilepsy and mutations of the antiquitin (ALDH7A1) gene. Hum Mutat 2007; 28:19-26. [PMID: 17068770 DOI: 10.1002/humu.20433] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.5] [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: 11/07/2022]
Abstract
Patients with pyridoxine dependent epilepsy (PDE) present with early-onset seizures resistant to common anticonvulsants. According to the benefit of pyridoxine (vitamin B(6)) and recurrence of seizures on pyridoxine withdrawal, patients so far have been classified as having definite, probable, or possible PDE. Recently, PDE has been shown to be caused by a defect of alpha-amino adipic semialdehyde (AASA) dehydrogenase (antiquitin) in the cerebral lysine degradation pathway. The accumulating compound piperideine-6-carboxylic acid (P6C) was shown to inactivate pyridoxalphosphate (PLP) by a Knoevenagel condensation. Pipecolic acid (PA) and AASA are markedly elevated in urine, plasma, and cerebrospinal fluid (CSF) and thus can be used as biomarkers of the disease. We have investigated 18 patients with neonatal seizure onset, who have been classified as having definite (11), probable (four), or possible (three) PDE. All patients had elevated PA and AASA in plasma (and urine) while on treatment with individual dosages of pyridoxine. Within this cohort, molecular analysis identified 10 novel mutations (six missense mutations, one nonsense mutation, two splice site mutations) within highly conserved regions of the antiquitin gene. Seven mutations were located in exonic sequences and two in introns 7 and 17. Furthermore, a novel deletion of exon 7 was identified. Two of the 36 alleles investigated require further investigation. A known mutation (p.Glu399Gln) was found with marked prevalence, accounting for 12 out of 36 alleles (33%) within our cohort. Pyridoxine withdrawal is no longer needed to establish the diagnosis of "definite" PDE. Administration of pyridoxine in PDE may not only correct secondary PLP deficiency, but may also lead to a reduction of AASA (and P6C) as presumably toxic compounds.
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Affiliation(s)
- Barbara Plecko
- Department of Pediatrics, Medical University Graz, Graz, Austria.
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Hirche T, Jungblut S, Paul K, Stern M, Wagner TOF, Wiedemann B. Body Mass Index Perzentile korrelieren besser mit dem Ernährungsstatus und der Lungenfunktion von Patienten mit Cystischer Fibrose (CF) als konventionelle anthropometrische Indizes. Pneumologie 2007. [DOI: 10.1055/s-2007-973219] [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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Abstract
Lung inflammation plays a pivotal role in the pathogenesis of airway disease in cystic fibrosis (CF). An imbalance between pro- and anti-inflammatory mediators has been observed and a deficiency in the anti-inflammatory response has been proposed, but this concept remains controversial. In the present study, the concentrations of two anti-inflammatory mediators, lipoxin A (LxA4) and Clara cell protein 10 (CC-10), were assessed in bronchoalveolar lavage fluid (BALF) of CF patients with a wide range of endobronchial inflammation and disease controls with neutrophilic inflammation unrelated to CF. No differences were observed in LxA4 BALF concentrations between CF patients and controls with a similar degree of neutrophilic airway inflammation. Concentrations were also similar in CF patients with mild versus more severe airway inflammation. In contrast, CC-10 concentrations were lower in CF patients, but this decrease was limited to patients with more intense airway inflammation. The present data do not support the concept of a primary defect in anti-inflammatory mediators in cystic fibrosis lung disease. Although Clara cell protein concentrations were found to be reduced, these alterations appear to be secondary to neutrophilic airway inflammation rather than due to a primary deficiency.
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Affiliation(s)
- V Starosta
- Lung Research Group, Children's Hospital of Ludwig Maximilians University, Munich, Germany
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