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161O RESILIENT part 2: A randomized, open-label phase III study of liposomal irinotecan versus topotecan in adults with relapsed small cell lung cancer (SCLC). J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00415-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Integrating wearables and modelling for monitoring rehabilitation following total knee joint replacement. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 225:107063. [PMID: 35994872 DOI: 10.1016/j.cmpb.2022.107063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/24/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Wearable inertial devices integrated with modelling and cloud computing have been widely adopted in the sports sector, however, their use in the health and medical field has yet to be fully realised. To date, there have been no reported studies concerning the use of wearables as a surrogate tool to monitor knee joint loading during recovery following a total knee joint replacement. The objective of this study is to firstly evaluate if peak tibial acceleration from wearables during gait is a good surrogate metric for computer modelling predicted functional knee loading; and secondly evaluate if traditional clinical patient related outcomes measures are consistent with wearable predictions. METHODS Following ethical approval, four healthy participants were used to establish the relationship between computer modelling predicted knee joint loading and wearable measured tibial acceleration. Following this, ten patients who had total knee joint replacements were then followed during their 6-week rehabilitation. Gait analysis, wearable acceleration, computer models of knee joint loading, and patient related outcomes measures including the Oxford knee score and range of motion were recorded. RESULTS A linear correlation (R2 of 0.7-0.97) was observed between peak tibial acceleration (from wearables) and musculoskeletal model predicted knee joint loading during gait in healthy participants first. Whilst patient related outcome measures (Oxford knee score and patient range of motion) were observed to improve consistently during rehabilitation, this was not consistent with all patient's tibial acceleration. Only those patients that exhibited increasing peak tibial acceleration over 6-weeks rehabilitation were positively correlated with the Oxford knee score (R2 of 0.51 to 0.97). Wearable predicted tibial acceleration revealed three patients with a consistent knee loading, five patients with improving knee loading, and two patients with declining knee loading during recovery. Hence, 20% of patients did not present with satisfactory joint loading following total knee joint replacement and this was not detected with current patient related outcome measures. CONCLUSIONS The use of inertial measurement units or wearables in this study provided additional insight into patients who were not exhibiting functional improvements in joint loading, and offers clinicians an 'off-site' early warning metric to identify potential complications during recovery and provide the opportunity for early intervention. This study has important implications for improving patient outcomes, equity, and for those who live in rural regions.
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Modified urine typing to enhance clinical management in kidney transplant patients with unknown donor human leukocyte antigen typing: abridged secondary publication. Hong Kong Med J 2022; 28 Suppl 1:31-34. [PMID: 35260514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
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Hydrogen recombination scaling experiments at CNL’s hydrogen safety test facility. NUCLEAR ENGINEERING AND DESIGN 2021. [DOI: 10.1016/j.nucengdes.2021.111152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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061 Absence of Adrb2 minimally affects UV-induced immunosuppression and skin cancer development. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rapid muscle volume prediction using anthropometric measurements and population-derived statistical models. Biomech Model Mechanobiol 2019; 19:1239-1249. [PMID: 31667655 DOI: 10.1007/s10237-019-01243-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 10/21/2019] [Indexed: 12/01/2022]
Abstract
Knowledge of subject-specific muscle volumes may be used as surrogates for evaluating muscle strength and power generated by 'fat-free' muscle mass. This study presents population-based statistical learning approaches for predicting 'fat-free' muscle volume from known anthropometric measurements. Using computed tomography (CT) imaging data to obtain lower-limb muscle volumes from 50 men and women, this study evaluated six statistical learning methods for predicting muscle volumes from anthropometric measurements: (i) stepwise regression, (ii) linear support vector machine (SVM), (iii) 2nd-order polynomial SVM, (iv) linear partial least squares regression (PLSR), (v) quadratic PLSR, and (vi) 3rd-order spline fit PLSR. These techniques have successfully been demonstrated in bioengineering applications and freely available in open-source toolkits. Analysis revealed that separating a general population into sexes and/or cohorts based on adipose level may improve prediction accuracies. The most important measures that statistically influence muscle volume predictions were shank girth, followed by sex and finally leg length, as identified using stepwise regression. SVM learning predicted muscle volume with an accuracy of 85 ± 4% when using linear interpolation, but performed poorly with an accuracy of 59 ± 6% using polynomial interpolation. The simpler linear PLSR exhibited muscle volume prediction accuracy of 87 ± 2%, while quadratic PLSR was slightly reduced at 82 ± 3%. For the spline fit PLSR, high accuracy was observed on the training data set (~ 99%) but over-fitting (a drawback of high-interpolation methods) resulted in erroneous predictions on testing data, and hence, the model was deemed unsuitable. In conclusion, use of linear PLSR models with variables of sex, leg length, and shank girth is a useful tool for predicting 'fat-free' muscle volume.
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The use of oral capecitabine with irinotecan and cetuximab (mCAPIRI-C) among colorectal cancer patients with unresectable liver-only metastases. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Awareness of the cancer and non-cancer related harms of continued smoking in cancer survivors. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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MA18.07 Awareness of the Harms of Continued Smoking Among Lung Cancer (LC) Survivors. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Randomized clinical trial of the effects of azithromycin use in the treatment of peri-implantitis. Aust Dent J 2018; 63:374-381. [PMID: 29679488 DOI: 10.1111/adj.12614] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND The aim of this clinical trial was to establish a proof of concept that the adjunctive use of systemic azithromycin (AZM) in conjunction with mechanical debridement has an increased benefit in reducing soft tissue inflammation in the treatment of peri-implantitis. METHODS In a randomized, double-blind, clinical trial, the treatment group (nine patients) received AZM as well as mechanical debridement in a single course of treatment, whereas the control group (eight patients) received a placebo and mechanical debridement. The primary outcome variables studied were bleeding on probing, suppuration, pocket probing depth and gingival recession. The secondary variables studied were gingival index, plaque index, microbiological and interleukin-1β status. The observation period was 6 months. RESULTS Over the 6 months' observation period, the treatment patients showed a consistently greater reduction of gingival inflammation and an improvement in soft tissue healing than the control patients. CONCLUSIONS The adjunctive use of a single course of systemic azithromycin can assist in the control of peri-implant mucositis in the treatment of peri-implantitis.
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Cancer patient attitudes and preferences towards smoking status assessment. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx388.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cancer patient interest and perceptions of lifestyle behavior programs. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx388.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Risk in the "Red Zone": Outcomes for Children Admitted to Ebola Holding Units in Sierra Leone Without Ebola Virus Disease. Clin Infect Dis 2017; 65:162-165. [PMID: 28369236 PMCID: PMC5693324 DOI: 10.1093/cid/cix223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/10/2017] [Indexed: 11/13/2022] Open
Abstract
We collected data on 1054 children admitted to Ebola Holding Units in Sierra Leone and describe outcomes of 697/1054 children testing negative for Ebola virus disease (EVD) and accompanying caregivers. Case-fatality was 9%; 3/630 (0.5%) children discharged testing negative were readmitted EVD-positive. Nosocomial EVD transmission risk may be lower than feared.
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125: Genetic Diversity of Epstein-Barr Virus Latent Gene EBNA-1 Among Transplant Patients and Patients with Infectious Mononucleosis. Paediatr Child Health 2015. [DOI: 10.1093/pch/20.5.e79a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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The latencies of prosaccades are prolonged by both executed and planned (but not executed) prior antisaccades. J Vis 2014. [DOI: 10.1167/14.10.97] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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P01.40. A new approach for quantifying chemosensitizing effects from herb-drug combinations: assessment of Tripterygium Wilfordii-Docetaxel in prostate cancer. Altern Ther Health Med 2012. [PMCID: PMC3373940 DOI: 10.1186/1472-6882-12-s1-p40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Imaging manifestations in Proteus syndrome: an unusual multisystem developmental disorder. Br J Radiol 2012; 85:e793-9. [PMID: 22514103 DOI: 10.1259/bjr/92343528] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
In this review we use images from an 11-year-old male to describe Proteus syndrome, a complex disorder with multisystem involvement and great clinical variability. Our aim is to enhance recognition of the typical imaging findings, which can aid diagnosis of this rare condition.
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Discriminative value of FRAX for fracture prediction in a cohort of Chinese postmenopausal women. Osteoporos Int 2012; 23:871-8. [PMID: 21562875 DOI: 10.1007/s00198-011-1647-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2010] [Accepted: 02/24/2011] [Indexed: 10/18/2022]
Abstract
UNLABELLED We followed 2,266 postmenopausal Chinese women for 4.5 years to determine which model best predicts osteoporotic fracture. A model that contains ethnic-specific risk factors, some of which reflect frailty, performed as well as or better than the well-established FRAX model. INTRODUCTION Clinical risk assessment, with or without T-score, can predict fractures in Chinese postmenopausal women although it is unknown which combination of clinical risk factors is most effective. This prospective study sought to compare the accuracy for fracture prediction using various models including FRAX, our ethnic-specific clinical risk factors (CRF) and other simple models. METHODS This study is part of the Hong Kong Osteoporosis Study. A total of 2,266 treatment naïve postmenopausal women underwent clinical risk factor and bone mineral density assessment. Subjects were followed up for outcome of major osteoporotic fracture and receiver operating characteristic (ROC) curves for different models were compared. The percentage of subjects in different quartiles of risk according to various models who actually fractured was also compared. RESULTS The mean age at baseline was 62.1 ± 8.5 years and mean follow-up time was 4.5 ± 2.8 years. A total of 106 new major osteoporotic fractures were reported, of which 21 were hip fractures. Ethnic-specific CRF with T-score performed better than FRAX with T-score (based on both Chinese normative and National Health and Nutrition Examination Survey (NHANES) databases) in terms of AUC comparison for prediction of major osteoporotic fracture. The two models were similar in hip fracture prediction. The ethnic-specific CRF model had a 10% higher sensitivity than FRAX at a specificity of 0.8 or above. CONCLUSION CRF related to frailty and differences in lifestyle between populations are likely to be important in fracture prediction. Further work is required to determine which and how CRF can be applied to develop a fracture prediction model in our population.
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Repeatability of Vicon Motion Analysis System for Upper Limb Kinematic Measurement During Fencing Lunge Action. Hong Kong Physiother J 2011. [DOI: 10.1016/j.hkpj.2011.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Integrative health coaching for patients with type 2 diabetes: a randomized clinical trial. DIABETES EDUCATOR 2010; 36:629-39. [PMID: 20534872 DOI: 10.1177/0145721710371523] [Citation(s) in RCA: 200] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the effectiveness of integrative health (IH) coaching on psychosocial factors, behavior change, and glycemic control in patients with type 2 diabetes. METHODS Fifty-six patients with type 2 diabetes were randomized to either 6 months of IH coaching or usual care (control group). Coaching was conducted by telephone for fourteen 30-minute sessions. Patients were guided in creating an individualized vision of health, and goals were self-chosen to align with personal values. The coaching agenda, discussion topics, and goals were those of the patient, not the provider. Preintervention and postintervention assessments measured medication adherence, exercise frequency, patient engagement, psychosocial variables, and A1C. RESULTS Perceived barriers to medication adherence decreased, while patient activation, perceived social support, and benefit finding all increased in the IH coaching group compared with those in the control group. Improvements in the coaching group alone were also observed for self-reported adherence, exercise frequency, stress, and perceived health status. Coaching participants with elevated baseline A1C (>/=7%) significantly reduced their A1C. CONCLUSIONS A coaching intervention focused on patients' values and sense of purpose may provide added benefit to traditional diabetes education programs. Fundamentals of IH coaching may be applied by diabetes educators to improve patient self-efficacy, accountability, and clinical outcomes.
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Virtual model analysis as an alternative approach to plaster model analysis: reliability and validity. Eur J Orthod 2010; 32:589-95. [DOI: 10.1093/ejo/cjp159] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Rare but Relevant Kidney DisordersSeizures, sensorineural deafness, ataxia, mental retardation, and electrolyte imbalance (SeSAME syndrome) caused by mutations in KCNJ10. Proc Natl Acad Sci U S A 106: 5842–5847, 2009Epilepsy, ataxia, sensorineural deafness, tubulopathy, and KCNJ10 mutations. N Engl J Med 360: 1960–1970, 2009A missense mutation in the Kv1.1 voltage-gated potassium channel-encoding gene KCNA1 is linked to human autosomal dominant hypomagnesemia. J Clin Invest 119: 936–942, 2009Idiopathic retroperitoneal fibrosis: Prospective evaluation of incidence and clinicoradiologic presentation. Medicine 88: 193–201, 2009Retroperitoneal fibrosis: The clinical, laboratory, and radiographic presentation. Medicine 88: 202–207, 2009Thrombomodulin mutations in atypical hemolytic-uremic syndrome. N Engl J Med 361: 345–357, 2009. Clin J Am Soc Nephrol 2009. [DOI: 10.2215/cjn.06710909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Rare but Relevant Kidney Disorders. Clin J Am Soc Nephrol 2009. [DOI: 10.2215/01.cjn.0000927052.57897.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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BT08�OBESITY AND ACUTE CHOLECYSTITIS. ANZ J Surg 2009. [DOI: 10.1111/j.1445-2197.2009.04912_8.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Differential impact of anti-diabetic treatments on pancreatic cancer cell growth in cell culture conditions mimicking different stages in the natural history of diabetes mellitus type. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Insecticide-treated bednets for the prevention of Plasmodium falciparum malaria in Cambodia: a cluster-randomized trial. Trop Med Int Health 2006; 11:1166-77. [PMID: 16903880 DOI: 10.1111/j.1365-3156.2006.01673.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To validate and quantify the impact of insecticide-treated bednets (ITN) on malaria morbidity and mortality in Cambodia. METHODS A paired, cluster-randomized trial of ITN was conducted in Rattanakiri, North East Cambodia. Thirty-four villages with a total population of 10,726 were randomized to receive deltamethrin-impregnated bednets or to control (no net provision). Cross-sectional surveys measured Plasmodium falciparum prevalence at baseline and 10 months after ITN distribution. Village malaria volunteers in control and intervention villages treated dipstick-positive P. falciparum cases with artesunate and mefloquine. The resulting passive surveillance data were used as an estimate of the incidence of clinical P. falciparum infections. RESULTS There was a protective efficacy of 28% in P. falciparum incidence (adjusted rate ratio 0.72, 95% CI 0.47-1.08) and 9% in P. falciparum prevalence (adjusted prevalence ratio 0.91, 95% CI 0.65-1.28) in ITN relative to control villages; however, neither of these estimates reached statistical significance. Individual-level analysis indicated a greater reduction in P. falciparum prevalence among under 5-year-olds (adjusted OR = 0.63, 95% CI 0.26-1.53) compared to older individuals (interaction P = 0.042). The protective efficacy of 35% (95% CI -28, 67%) with respect to clinical P. falciparum incidence in under 5-year-olds was more pronounced than the corresponding estimates for prevalence but was again not significant. CONCLUSIONS Lack of statistical significance in the results is likely to be due to a lack of power. The analysis provides further evidence for ITN effectiveness in South East Asia, particularly among individuals under 5 years of age.
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Cumulative spinal loading exposure methods for manual material handling tasks. Part 1: is cumulative spinal loading associated with lower back disorders? THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2006. [DOI: 10.1080/14639220500111392] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Cumulative spinal loading exposure methods for manual material handling tasks. Part 2: methodological issues and applicability for use in epidemiological studies. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2006. [DOI: 10.1080/14639220500111459] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Effects of Cyclosporine and Tacrolimus on the Pharmacokinetics of Mycophenolic Acid in Renal Transplant Recipients. Int J Organ Transplant Med 2005. [DOI: 10.1016/s1561-5413(09)60213-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
Geleophysic dysplasia is an autosomal recessive short-limbed, dysmorphic syndrome. The condition is frequently associated with cardiac valvular disease, which may result in secondary hypertrophy and cardiac failure. We describe two distantly related Pakistani children with classical features of geleophysic dysplasia. Pulmonary stenosis was recognized in both within a few months of birth. The younger child shows no signs of cardiac decompensation at the age of 7 years whilst her older cousin has developed a significant pulmonary gradient requiring surgical intervention in the second decade of life. The natural history of his disorder highlights that the cardiac involvement seen in apparently stable forms of geleophysic dysplasia is frequently progressive.
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Fake antimalarials in Southeast Asia are a major impediment to malaria control: multinational cross-sectional survey on the prevalence of fake antimalarials. Trop Med Int Health 2005; 9:1241-6. [PMID: 15598255 DOI: 10.1111/j.1365-3156.2004.01342.x] [Citation(s) in RCA: 177] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the prevalence of counterfeit antimalarial drugs in Southeast (SE) Asia. DESIGN Cross-sectional survey. SETTING Pharmacies and shops selling antimalarial drugs in Myanmar (Burma), Lao PDR, Vietnam, Cambodia and Thailand. MAIN OUTCOME MEASURES Proportion of artemisinin derivatives or mefloquine containing drugs of substandard quality. RESULTS Of the 188 tablet packs purchased which were labelled as 'artesunate' 53% did not contain any artesunate. All counterfeit artesunate tablets were labelled as manufactured by 'Guilin Pharma', and refinements of the fake blisterpacks made them often hard to distinguish from their genuine counterparts. No other artemisinin derivatives were found to be counterfeited. Of the 44 mefloquine samples, 9% contained <10% of the expected amount of active ingredient. CONCLUSIONS An alarmingly high proportion of antimalarial drugs bought in pharmacies and shops in mainland SE Asia are counterfeit, and the problem has increased significantly compared with our previous survey in 1999-2000. This is a serious threat to public health in the region.
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Primary immunosuppression with tacrolimus and low-dose mycophenolate mofetil in renal transplant recipients. Transplant Proc 2004; 36:2084-6. [PMID: 15518754 DOI: 10.1016/j.transproceed.2004.08.110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Both tacrolimus and mycophenolate mofetil (MMF) are potent immunosuppressive agents used in combination for prevention of acute rejection in renal transplantation. We studied the efficacy and safety of tacrolimus/MMF-based primary immunosuppression as well as their pharmacokinetics (PK) in Chinese renal transplant recipients. Oral tacrolimus was initiated at about 0.2 mg/kg/d, dose which was adjusted to achieve target trough levels of 10 to 20 ng/mL at 3 months and 5 to 10 ng/mL thereafter. The patients also received MMF (0.5 g bid) and prednisolone. PK profiles were studied at 1 week, and 1, 3, and 6 months posttransplant. Blood samples were taken at 0 (predose), 20, 40, 60, 75, and 90 minutes and 2, 4, 6, 8, 10, and 12 hours postdose for each profile. Plasma MPA and whole blood tacrolimus levels were determined by HPLC and EMIT methods respectively. Eight patients were studied with mean follow-up of 16.1 +/- 2.4 months. One patient (12.5%) experienced a borderline acute rejection episode. Both 1-year graft and patient survival rates were 100%. Posttransplant diabetes, diarrhea, and hand tremor occurred in 12.5%, 12.5%, and 37.5%, respectively. No patient had an opportunistic infection. Tacrolimus trough concentrations showed a fair correlation with AUC(0-12h) (R(2) = 0.587). Mean MPA AUC values at 1, 3, and 6 months were 40.5 +/- 9.4, 44.4 +/- 17.3, and 57.2 +/- 20.7 mug*h/mL, respectively (P = .0486, n = 7). In conclusion, primary immunosuppression with tacrolimus, low-dose MMF (0.5 g bid), and prednisolone is effective and safe with adequate systemic MPA exposure in renal transplant recipients.
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Association between knee cartilage volume and bone mineral density in older adults without osteoarthritis. Rheumatology (Oxford) 2004; 43:765-9. [PMID: 15039496 DOI: 10.1093/rheumatology/keh171] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Studies have suggested an inverse association between osteoarthritis (OA) and osteoporosis, based on the presence of osteophytes rather than joint space narrowing (JSN), an indirect measure of joint cartilage. We conducted a cross-sectional study to determine the relationship between knee cartilage volume, a direct measure of joint cartilage, and bone mineral density (BMD) in an adult population. METHODS 86 adults aged 55.1+/-10.4 years (50% females) had total BMD and bone mineral content (BMC) measured using dual X-ray absorptiometry. Site-specific BMD was performed on men in the study. Tibial and patella cartilage volumes were determined by processing images acquired in the sagittal plane using T(1)-weighted fat saturation magnetic resonance on an independent work station. RESULTS Tibial knee cartilage volume was positively associated with total body BMD in both men and women after adjusting for age, BMI, tibial bone area and physical activity. In men, tibial cartilage volume was positively associated with proximal femur BMD, but not lumbar spine BMD. No relationship was seen between patellar cartilage volume and BMD at any region. CONCLUSIONS We have shown a positive association between tibial cartilage volume and total BMD in men and women, but no such association with patellar cartilage volume. The mechanism for this is unclear but may represent a common environmental or genetic component. This study also highlights the need to examine the osteophyte and joint cartilage separately when investigating factors affecting the joint in health and disease since each feature is likely to reflect different aspects of the pathogenic process in OA.
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A participatory approach to the study of lifting demands and musculoskeletal symptoms among Hong Kong workers. Occup Environ Med 2003; 60:730-8. [PMID: 14504360 PMCID: PMC1740400 DOI: 10.1136/oem.60.10.730] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To investigate the use of a worker based methodology to assess the physical stresses of lifting tasks on effort expended, and to associate this loading with musculoskeletal outcomes (MO). METHODS A cross sectional study was conducted on 217 male manual handling workers from the Hong Kong area. The effects of four lifting variables (weight of load, horizontal distance, twisting angle, and vertical travel distance) on effort were examined using a linguistic approach (that is, characterising variables in descriptors such as "heavy" for weight of load). The numerical interpretations of linguistic descriptors were established. In addition, the associations between on the job effort and MO were investigated for 10 body regions including the spine, and both upper and lower extremities. RESULTS MO were prevalent in multiple body regions (range 12-58%); effort was significantly associated with MO in 8 of 10 body regions (odds ratios with age adjusted ranged from 1.31 for low back to 1.71 for elbows and forearm). The lifting task variables had significant effects on effort, with the weight of load having twice the effect of other variables; each linguistic descriptor was better described by a range of numerical values rather than a single numerical value. CONCLUSIONS The participatory worker based approach on musculoskeletal outcomes is a promising methodology. Further testing of this approach is recommended.
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Effect of mycophenolate mofetil on progression of chronic allograft nephropathy. Transplant Proc 2003; 35:176-8. [PMID: 12591355 DOI: 10.1016/s0041-1345(02)03848-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
OBJECTIVES To understand the factors that influence joint cartilage in health and disease as they are important for the prevention and management of osteoarthritis. METHODS We conducted a cross-sectional study to determine factors influencing knee cartilage volume in 45 males aged (mean+/-S.D.) 52.5+/-13.2 yr. RESULTS Total and medial tibial volumes were inversely associated with age, body mass index (BMI) and amount of physical activity and positively associated with total bone content. BMI explained the largest amount of the variation in tibial cartilage volume (18.7%). There were similar findings at the lateral tibial cartilage, but for age and total bone content this did not reach statistical significance. There was a positive association with serum testosterone at all tibial cartilage sites, but this only reached statistical significance for medial tibial cartilage, where serum testosterone explained up to 8% of the variation in cartilage volume. CONCLUSIONS Modifiable risk factors of osteoarthritis also appear to be significant determinants of tibial cartilage volume. Serum testosterone may provide one possible explanation for gender differences in tibial cartilage volume and prevalence of tibiofemoral osteoarthritis. The proposed link between osteoarthritis and knee cartilage volume and the effect of testosterone will need to be confirmed in longitudinal studies.
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Steroid reduction in renal transplant recipients. Transplant Proc 2003; 35:221-2. [PMID: 12591372 DOI: 10.1016/s0041-1345(02)03909-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abstract
The workshop considered six related questions about periodontal changes seen in HIV infection. 1) To what extent are specific periodontal changes associated with HIV? 2) Are conventional periodontal diseases modified by HIV infection? The changes associated with HIV appear to be modified presentations of conventional diseases. Research should identify initiation and progression factors for necrotizing diseases. 3) What is the role of geography and transmission groups? These questions cannot be answered without greater standardisation of research methods. 4) Has the epidemiology of these changes changed with the advent of new therapies? The data required to answer this question should be available soon but this question is irrelevant to the vast majority of people with HIV. 5) What pathogens are involved in periodontal changes seen in HIV infection? The role of Candida spp. and other potential pathogens requires further investigation. 6) What management protocols are suitable for the periodontal diseases? The significance of periodontal diseases among people with HIV in developing countries is not known. Further research is needed of the effectiveness of interventions especially necrotizing disease in developing countries. The quality of research of these diseases would be enhanced by standardized approaches. A list of relevant variables might prevent their omission from studies.
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Abstract
UNLABELLED This work was presented as a poster at the Institute of Health Research Conference 2000: Health of Children and Young People: Research Perspectives. University of Bradford 15th of September 2000. AIMS The aim of this survey was to determine the prevalence and aetiology of visual impairment in school children in Bradford. METHODS The case notes of school children with predominantly uncomplicated visual impairment were reviewed. Data including age, sex, race and information on visual diagnosis, heredity, degree of visual impairment and additional morbidity were collected. RESULTS Seventy-two children between the ages of 5 and 16 years were included in this survey. The male: female ratio was 2.1: 1. Twenty-one children were Caucasian, 42 were of Pakistani and nine of other racial origin. The most common diagnoses were congenital nystagmus (19), ocular albinism (6), myopia (4), cataract (4) and microphthalmia (4). Twenty-five children had a genetically linked visual diagnosis and 31 had a family history of the same visual disorder. CONCLUSIONS This survey showed similar causes of visual impairment as described in other studies on children with uncomplicated visual impairment and confirmed the previously described preponderance of boys. The proportion of Pakistani children in our study population was significantly higher than that in the general Bradford population, indicating a higher prevalence of visual impairment in this group. Children of Pakistani origin were significantly more likely to have genetically linked visual disease and a positive family history of the same visual disorder than children of Caucasian origin. This is probably due to genetic factors and a higher proportion of consanguineous marriages in this population. Information about the prevalence and causes of visual impairment is important for adequate provision of special services and for developing preventive strategies.
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Effects of calcitriol or calcium on bone mineral density, bone turnover, and fractures in men with primary osteoporosis: a two-year randomized, double blind, double placebo study. J Clin Endocrinol Metab 2001; 86:4098-103. [PMID: 11549632 DOI: 10.1210/jcem.86.9.7847] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Osteoporosis in men is an emerging public health problem. As calcitriol reduces the rate of vertebral fractures in osteoporotic postmenopausal women, we conducted a prospective study of this treatment in men with primary osteoporosis. Our study was a 2-yr, randomized, double masked, double placebo-controlled trial of calcitriol (0.25 microg twice daily) or calcium (500 mg twice daily) in 41 men with primary osteoporosis and at least 1 baseline fragility fracture. Thirty-three men (85%) completed the study. There were no differences in baseline characteristics. Spinal and femoral neck bone mineral densities at 2 yr were unchanged in both groups. Serum osteocalcin decreased in both groups by 30% (P < 0.05), whereas urine N-telopeptide cross-links decreased only in the calcium group by 30% (P < 0.05). After 2 yr, fractional calcium absorption increased by 34% (P < 0.01) in the calcitriol group. Nineteen incident fragility fractures occurred (14 vertebral and 5 nonvertebral) in 7 men. Over 2 yr, the number of men with vertebral fractures (6 vs. 1; P = 0.097) was similar in both groups. In conclusion, the efficacy of calcitriol remains unproven as a single agent for the treatment of osteoporosis in men.
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Impact of OKT3 and polyclonal antibodies on symptomatic CMV infection in renal transplant recipients. Transplant Proc 2000; 32:1928-9. [PMID: 11120005 DOI: 10.1016/s0041-1345(00)01497-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Efficacy and safety of mycophenolate mofetil in different dosages in Asian renal allograft recipients. Transplant Proc 2000; 32:1755-6. [PMID: 11119921 DOI: 10.1016/s0041-1345(00)01389-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
PURPOSE To explore the current trends and development of nursing education in China. Nursing education in China has developed rapidly in alignment with economic growth of this vast country. DESIGN Descriptive, using 345 manuscript abstracts from various regions of China, submitted for the 1996 Sino-Hong Kong Educational Conference. METHODS Content analysis of manuscript abstracts was done to describe the trends. Codes were determined after several rounds of independent analysis. FINDINGS Development of nursing education in China appears in line with global trends. The preparation of a pragmatic nurse was emphasized by nurse educators who also advocate total patient care and the integration of traditional Chinese medicine in nursing education. Areas seldom mentioned, however, were student-centered approaches to learning, advanced practice, and the evaluation of educational processes and outcomes. CONCLUSIONS Nurse educators in mainland China appear aware of the dynamics and challenges in health care, and the need for preparing a new generation of nurses to face these challenges. Educators in China need to adopt new approaches in teaching and learning to prepare nurses to function in a wide range of health care settings, and to monitor and evaluate educational outcomes.
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Abstract
The objective of this study was to determine the prevalence, clinical spectrum, and outcome of paediatric HIV infection in 281 consecutive children admitted to hospital in rural South Africa between October 1996 and January 1997. HIV infection was defined as two positive ELISAs in those aged > 12 months; a positive ELISA plus a positive IgG3 in those aged 6-12 months; and a positive ELISA plus positive p24 antigen or PCR in those aged 0-5 months. In all, 72 (26 per cent) children were HIV infected. Age-specific HIV prevalence was at least 25 per cent in all 1-5 year age groups. HIV-infected children were more likely to have been previously admitted (46 per cent vs. 23 per cent; p = 0.0002), and were more likely to have severe malnutrition (52 per cent vs. 17 per cent; p < 0.0001). Both HIV-infected and HIV-uninfected most frequently presented with diarrhoeal disease (51 per cent vs. 32 per cent), acute respiratory infection (13 per cent vs. 23 per cent), and malnutrition (18 per cent vs. 11 per cent). Satisfactory response to antibiotic therapy was less likely among the HIV-infected (56 per cent vs. 73 per cent; p = 0.02), and mortality was higher among the HIV-infected (21 per cent vs. 7 per cent; p = 0.005). It is concluded that HIV-infected children present with disease syndromes common to this setting, but do so more frequently and with worse outcome than their uninfected counterparts. The high burden of paediatric HIV disease in this setting poses a substantial challenge for health resources.
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