The physiological importance of glutathione and glutathione disulfide is evident from their implications in an array of medical conditions including diabetes, Parkinson's disease and cancer. As such ...the need for simple, rapid and cheap assays to aid clinical diagnostics and treatment is clear. These requirements are, in principle at least, ideally suited to electrochemical detection. Accordingly a large array of voltammetric methods ultimately aimed at making cheap and most likely disposable electrodes have been reported. This critical review analyses the context in which physiological glutathione measurement can be undertaken electrochemically and compares it to current assay approaches, while also covering the current literature for glutathione disulfide detection. The various characteristics and limitations of the methodologies are compared and contrasted, with the analytical parameters (matrix, pH, limit of detection,
etc.
) tabulated to aid comparison.
The electrochemical detection of glutathione is reviewed with the state of the art highlighted and issues for future research identified.
The aim of this study was to describe the prevalence and characteristics of drusen and pigmentary changes in a middle-aged population.
Retinal images from 500 individuals aged 18-54 years were ...included. The source of participants was two UK optometry practices. Retinal images were graded using the Wisconsin Age-Related Maculopathy Grading System. However, owing to the relatively young age of the population studied, a new category of drusen of smaller size (<31.5 μm) was introduced.
Drusen were identified within the central macular grid in 91.48% of all gradable eyes and in 444 subjects. Drusen sized <31.5 μm were present in 89.7% of eyes, drusen sized >31.5 μm and <63 μm were present in 45.9% of all eyes and drusen >63 μm and <125 μm were present in only 1.7% of eyes. No eye had drusen larger or equal to 125 μm. Very few eyes (1.2%) showed pigmentary changes within the grid. Drusen load increased with increasing age, P <0.001.
The frequency of drusen in a younger Caucasian population aged 18-54 years is high, with 91.48% of all gradable eyes having drusen. The most frequent drusen subtype was hard distinct drusen <31.5 μm. No druse greater or equal in size to 125 μm was seen. Pigmentary changes are rare.
A total of 298 environmental samples from 5 separate dairy powder factories (A–E) were analysed for the presence of
Escherichia coli. E. coli was isolated from 80 of these samples to obtain 359 ...isolates. These isolates were tested for the presence of 12 virulence genes associated with enteropathogenic
E. coli (EPEC), atypical EPEC, Shiga toxin (Stx)-producing
E. coli (STEC), enterotoxigenic
E. coli (ETEC), enteroinvasive
E. coli (EIEC) and enteroaggregative
E. coli (EAEC). A total of 4 isolates obtained from two different sampling points at Factory C were positive for the
astA gene, indicative of EAEC. A further 2 isolates from one sample from Factory C were positive for the presence of
eaeA and
escV genes, indicative of atypical EPEC. No virulence genes were detected in the remaining 353 isolates. While
E. coli was present within the environment of dairy powder processing factories the carriage of potential virulence genes was low.
BackgroundLocally, neurodevelopmental assessment of primary school aged children with social and communication difficulties involves collation of reports from the educational setting, then assessment ...by a paediatrician. Often, no formal diagnostic tool or face-to-face multi-professional assessment is carried out. For some children, this model of working can lead to a delay in conclusions due to complexities with that child. This pilot was a model for multi-professional working between a paediatrician and clinical psychologist using structured assessments for a group of children that presented diagnostic challenge.AimsTo pilot a neurodevelopmental clinical model of joint working between a paediatrician and psychologist. To collect data regarding clinician and patient experience, time from initial referral to diagnosis and identify the advantages and pitfalls of this method of working. To provide information for the MDT reviewing the pathway for Autistic Spectrum Disorder (ASD) diagnosis.MethodCases were selected by the paediatrician. Data collected included demographics, presenting problems, time from referral to receiving a final diagnosis, diagnostic outcome and experience feedback questionnaires. Diagnostic Interview for Social and Communication Disorders (DISCO) and Autism Diagnostic Observation Schedule (ADOS) assessments were carried out.ResultsThirteen children were enrolled in the pilot from 2017 to 2019 with a median age of nine years, four months. Eleven participants were male. Five of the children were given a final diagnosis of ASD. Other children received a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) or other cognitive or attachment difficulties. Six families completed feedback questionnaires. Most parents felt that the process helped their understanding of their child. Follow-up support was identified as an area for improvement. The clinicians found the process helpful, particularly with patients for whom there was disparity of opinion about that child.ConclusionThis model demonstrated positive patient experience, increased diagnostic accuracy and clinicians reported improved job satisfaction. It is likely to shorten initial referral to diagnosis time and offer a model of working that is closer to NICE guidance. Cost implications would need to be considered. Should this model of working be commissioned, areas for improvement would include follow up after diagnosis, and the robustness of the administration around the clinic.
To identify physiotherapists' familiarity with and experience using outcome measures (OMs) along the care continuum for patients undergoing total joint arthroplasty (TJA) of the hip and knee. Views ...on future use and barriers were also captured.
A stratified random sample of physiotherapists in one Canadian province completed a questionnaire about 19 standardized and clinically feasible OMs. Analyses included descriptive statistics and chi-square and McNemar tests to compare use of OMs for clinical decision making and program evaluation.
Of 694 physiotherapists surveyed, 298 (43%) responded. Of these, 172 (58%) treated TJA clients and completed the full questionnaire. A majority worked in public practice settings and >1 care phase (e.g., pre-op, acute, rehab). All physiotherapists reported using ≥1 OM and having greater experience using performance-based measures than patient-reported OMs. OMs were used more often for clinical decision making than for program evaluation. Dissatisfaction with available tools was evident from respondents' comments. Several barriers to using OMs were identified in varied clinical settings and care phases.
While physiotherapists use a variety of OMs along the TJA continuum, there remain challenges to routine use across clinical settings, care phases, and patient sub-groups.
CuO nanorod agglomerates were synthesised via a simple hydrothermal method in the presence of polyethylene glycol (PEG;
M
w 20,000). The chemical composition, size and morphology of the prepared CuO ...material was investigated by X-ray powder diffraction, voltammetry and transmission electron microscopy. A basal plane pyrolytic graphite electrode (bppg) was modified with the CuO nanorods and used to study the direct oxidation of glucose, fructose and sucrose in an alkaline medium (0.1
M NaOH). The CuO nanorod modified electrode was shown to have far larger analytical signals in the presence of carbohydrates than an electrode modified with CuO microparticles and gave a limit of detection for glucose of 1.2
×
10
−6
M which is comparable with the literature. As such it is a non-selective, non-enzymatic, total carbohydrate sensor. The CuO nanorod modified bppg electrode was also used for the detection of H
2O
2, it was shown that in this case it is preferential to look at the oxidation of the analyte due to interference of oxygen in the reductive window. A limit of detection of 2.2
×
10
−7
M was obtained for the sensing of hydrogen peroxide in an alkaline solution.
People with respiratory disease have increased risk of developing frailty, which is associated with worse health outcomes. There is growing evidence of the role of rehabilitation in managing frailty ...in people with respiratory disease. However, several challenges remain regarding optimal methods of identifying frailty and delivering rehabilitation for this population. The aims of this American Thoracic Society workshop were to outline key definitions and concepts around rehabilitation for people with respiratory disease and frailty, synthesize available evidence, and explore how programs may be adapted to align to the needs and experiences of this population. Across two half-day virtual workshops, 20 professionals from diverse disciplines, professions, and countries discussed key developments and identified opportunities for future research, with additional input via online correspondence. Participants highlighted a "frailty rehabilitation paradox" whereby pulmonary rehabilitation can effectively reduce frailty, but programs are challenging for some individuals with frailty to complete. Frailty should not limit access to rehabilitation; instead, the identification of frailty should prompt comprehensive assessment and tailored support, including onward referral for additional specialist input. Exercise prescriptions that explicitly consider symptom burden and comorbidities, integration of additional geriatric or palliative care expertise, and/or preemptive planning for disruptions to participation may support engagement and outcomes. To identify and measure frailty in people with respiratory disease, tools should be selected on the basis of sensitivity, specificity, responsiveness, and feasibility for their intended purpose. Research is required to expand understanding beyond the physical dimensions of frailty and to explore the merits and limitations of telerehabilitation or home-based pulmonary rehabilitation for people with chronic respiratory disease and frailty.
Coronavirus disease 2019 (COVID-19) can lead to ongoing symptoms such as breathlessness, fatigue and muscle pain, which can have a substantial impact on an individual. Exercise-based rehabilitation ...programmes have proven beneficial in many long-term conditions that share similar symptoms. These programmes have favourably influenced breathlessness, fatigue and pain, while also increasing functional capacity. Exercise-based rehabilitation may benefit those with ongoing symptoms following COVID-19. However, some precautions may be necessary prior to embarking on an exercise programme. Areas of concern include ongoing complex lung pathologies, such as fibrosis, cardiovascular abnormalities and fatigue, and concerns regarding post-exertional symptom exacerbation. This article addresses these concerns and proposes that an individually prescribed, symptom-titrated exercise-based intervention may be of value to individuals following infection with severe acute respiratory syndrome coronavirus 2.
Objective
Endocrine systems are disrupted in acute illness, and symptoms reported following coronavirus disease 2019 (COVID‐19) are similar to those found with clinical hormone deficiencies. We ...hypothesised that people with severe acute COVID‐19 and with post‐COVID symptoms have glucocorticoid and sex hormone deficiencies.
Design/Patients
Samples were obtained for analysis from two UK multicentre cohorts during hospitalisation with COVID‐19 (International Severe Acute Respiratory Infection Consortium/World Health Organisation WHO Clinical Characterization Protocol for Severe Emerging Infections in the UK study), and at follow‐up 5 months after hospitalisation (Post‐hospitalisation COVID‐19 study).
Measurements
Plasma steroids were quantified by liquid chromatography–mass spectrometry. Steroid concentrations were compared against disease severity (WHO ordinal scale) and validated symptom scores. Data are presented as geometric mean (SD).
Results
In the acute cohort (n = 239, 66.5% male), plasma cortisol concentration increased with disease severity (cortisol 753.3 1.6 vs. 429.2 1.7 nmol/L in fatal vs. least severe, p < .001). In males, testosterone concentrations decreased with severity (testosterone 1.2 2.2 vs. 6.9 1.9 nmol/L in fatal vs. least severe, p < .001). In the follow‐up cohort (n = 198, 62.1% male, 68.9% ongoing symptoms, 165 121–192 days postdischarge), plasma cortisol concentrations (275.6 1.5 nmol/L) did not differ with in‐hospital severity, perception of recovery, or patient‐reported symptoms. Male testosterone concentrations (12.6 1.5 nmol/L) were not related to in‐hospital severity, perception of recovery or symptom scores.
Conclusions
Circulating glucocorticoids in patients hospitalised with COVID‐19 reflect acute illness, with a marked rise in cortisol and fall in male testosterone. These findings are not observed 5 months from discharge. The lack of association between hormone concentrations and common post‐COVID symptoms suggests steroid insufficiency does not play a causal role in this condition.
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