HIV and employment MCGOLDRICK, C
Occupational medicine (Oxford),
06/2012, Letnik:
62, Številka:
4
Journal Article
Recenzirano
Odprti dostop
According to 2009 statistics, the human immunodeficiency virus (HIV) infected an estimated 86,500 individuals within the UK, although around one-quarter were unaware of their infection. In the ...majority of cases, it is now considered a long-term controllable but incurable infection. Indeed, most HIV-positive individuals are able to work. Employment is across most, if not all, workforce sectors and protection against workplace discrimination is provided by the Equality Act 2010. Issues including confidentiality, workplace adjustments, vaccinations and travel restrictions may be relevant to the occupational health of HIV-positive workers. There are special considerations concerning HIV-infected health care workers, including avoidance of performing exposure-prone procedures. Prevention of HIV acquisition in the workplace is relevant to a diverse range of occupational environments, and HIV post-exposure prophylaxis should be considered after potential HIV exposure incidents. If a worker contracts HIV by occupational means, financial help may be available.
Objective:
To assess the feasibility of a trial to investigate the effectiveness of virtual reality-mediated therapy compared to conventional physiotherapy in the motor rehabilitation of the arm ...following stroke, and to provide data for a power analysis to determine numbers for a future main trial.
Design:
Pilot randomized controlled trial.
Setting:
Clinical research facility.
Participants:
Eighteen people with a first stroke, 10 males and 8 females, 7 right and 2 left side most affected. Mean time since stroke 10.8 months.
Interventions:
Participants were randomized to a virtual reality group or a conventional arm therapy group for nine sessions over three weeks.
Main measures:
The upper limb Motricity Index and the Action Research Arm Test were completed at baseline, post intervention and six weeks follow-up.
Results:
Outcome data were obtained from 95% of participants at the end of treatment and at follow-up: one participant withdrew. Compliance was high; only two people reported side-effects from virtual reality exposure. Both groups demonstrated small (7–8 points on upper limb Motricity Index and 4 points on the Action Research Arm Test), but non-significant, changes to their arm impairment and activity levels.
Conclusion:
A randomized controlled trial of virtual reality-mediated therapy comparable to conventional therapy would be feasible, with some suggested improvements in recruitment and outcome measures. Seventy-eight participants (39 per group) would be required for a main trial.
A case of rifampicin-induced haemolysis Sykes, C. A.; Shepherd, J.; McGoldrick, C. ...
The international journal of tuberculosis and lung disease,
02/2019, Letnik:
23, Številka:
2
Journal Article
Recenzirano
We present a case of pulmonary tuberculosis treated with a rifampicin (RMP) containing regimen, which led to marked haemolysis and acute kidney injury. The patient was shown to have RMP-induced ...haemolysis on detailed immunological testing. RMP is described as a rare cause of drug-induced
haemolysis in the literature. However, it is a widely used drug and this complication may be severe. RMP-induced haemolysis precludes further treatment with the drug. Clinicians should consider this possibility and seek advice if patients on RMP develop haemolysis.
Unequal transmissions of spin waves along opposite directions provide useful functions for signal processing. So far, the realization of such nonreciprocal spin waves has been mostly limited at a ...gigahertz frequency in the coherent regime via microwave excitation. Here we show that, in a magnetic bilayer stack with chiral coupling, tunable nonreciprocal propagation can be realized in spin Hall effect-excited incoherent magnons, whose frequencies cover the spectrum from a few gigahertz up to terahertz. The sign of nonreciprocity is controlled by the magnetic orientations of the bilayer in a nonvolatile manner. The nonreciprocity is further verified by measurements of the magnon diffusion length, which is unequal along opposite transmission directions. Our findings enrich the knowledge on magnetic relaxation and diffusive transport and can lead to the design of a passive directional signal isolation device in the diffusive regime.
Summary We present a case of hypersensitivity to a breast implant in a 57-year old female with breast cancer and hypersensitivity to adhesive dressings. A mastectomy, axillary node clearance, ...latissimus dorsi flap and silicone implant-based reconstruction were performed. The mammary wound dehisced within three weeks and the implant required removal. No pus was present, and cultures were negative. Three years later, a further silicone implant was inserted. Within three weeks from insertion, the patient required readmission with serous discharge from the wound, flu-like symptoms, low-grade pyrexia and painful swelling at the operative site. The implant was removed. Capsule biopsies demonstrated a large lymphoid cell reaction, in keeping with a delayed hypersensitivity reaction. Patch testing to samples of the implant was positive.
Background
Collagenase clostridium histolyticum (CCH) is a Food and Drug Administration-approved treatment for adult patients with Dupuytren's contracture with a palpable cord that has been shown ...efficacious and safe in clinical trials.
Methods
This paper summarizes the most common post-marketing clinical adverse event (AE) reports received by the manufacturer of CCH and sponsor of the US Biologics License Application (Auxilium Pharmaceuticals, Malvern, PA, USA) during the first 12 months after drug approval and commercialization in the USA.
Results
Of the 115 AE reports describing 270 AEs voluntarily received from patients or health care providers after approximately 5,400 injections of CCH administered, the most common AEs involved local, nonserious reactions to treatment, including skin tears, peripheral edema, and contusion. There were few serious AEs observed (0.6% reporting rate per 1,000 injections), and two flexor tendon ruptures and one flexor pulley injury were reported.
Conclusions
Analysis of post-marketing AEs received for CCH in the first year post-approval supports the safety profile reported earlier during clinical development and did not reveal additional clinical risks or concerns about CCH.
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