Objective
To examine the relationship between maternal characteristics, serum biomarkers and preterm birth (PTB) by spontaneous and medically indicated subtypes.
Design
Population‐based cohort.
...Setting
California, United States of America.
Population
From a total population of 1 004 039 live singleton births in 2009 and 2010, 841 665 pregnancies with linked birth certificate and hospital discharge records were included.
Methods
Characteristics were compared for term and preterm deliveries by PTB subtype using logistic regression and odds ratios adjusted for maternal characteristics and obstetric factors present in final stepwise models and 95% confidence intervals. First‐trimester and second‐trimester serum marker levels were analysed in a subset of 125 202 pregnancies with available first‐trimester and second‐trimester serum biomarker results.
Main outcome measure
PTB by subtype.
Results
In fully adjusted models, ten characteristics and three serum biomarkers were associated with increased risk in each PTB subtype (Black race/ethnicity, pre‐existing hypertension with and without pre‐eclampsia, gestational hypertension with pre‐eclampsia, pre‐existing diabetes, anaemia, previous PTB, one or two or more previous caesarean section(s), interpregnancy interval ≥ 60 months, low first‐trimester pregnancy‐associated plasma protein A, high second‐trimester α‐fetoprotein, and high second‐trimester dimeric inhibin A). These risks occurred in 51.6–86.2% of all pregnancies ending in PTB depending on subtype. The highest risk observed was for medically indicated PTB <32 weeks in women with pre‐existing hypertension and pre‐eclampsia (adjusted odds ratio 89.7, 95% CI 27.3–111.2).
Conclusions
Our findings suggest a shared aetiology across PTB subtypes. These commonalities point to targets for further study and exploration of risk reduction strategies.
Tweetable
Findings suggest a shared aetiology across preterm birth subtypes. Patterns may inform risk reduction efforts.
Aims The purpose of this study was to describe the effect of histological grade on disease-specific survival in patients with chondrosarcoma. Patients and Methods A total of 343 patients with a ...chondrosarcoma were included. The histological grade was assessed on the initial biopsy and on the resection specimen. Where the histology showed a mixed grade, the highest grade was taken as the definitive grade. When only small focal areas showed higher grade, the final grade was considered as both. Results The concordance between the highest preoperative biopsy grading and the highest final grading of the resection specimen in total was only 43% (146/343). In 102 specimens (30%), a small number of cells or focal areas of higher grade were observed in contrast to the main histology. The disease-specific survival, stratified according to the predominant histological grade, showed greater variation than when stratified according to the highest grade seen in the resection specimen. Conclusion The diagnostic biopsy in chondrosarcoma is unreliable in assessing the definitive grade and the malignant potential of the tumour. When categorizing the grade of the resection specimen, the prognosis for local recurrence and disease-specific survival should be based on the highest grade seen, even when seen in only a few cells. Cite this article: Bone Joint J 2018;100-B:662-6.
Summary Aim The aim of our study was to assess the efficacy of pulmonary rehabilitation in addition to regular chest physiotherapy in non cystic fibrosis bronchiectasis. Methods Thirty patients with ...clinically significant bronchiectasis and limited exercise tolerance were randomized into either the control group receiving chest physiotherapy (8 weeks) or into the intervention group, receiving pulmonary rehabilitation in addition to chest physiotherapy (8 weeks). Both groups were encouraged to maintain their exercise program and or chest physiotherapy, following completion of the study. Results End of training ( 8 weeks ) No improvement in control group. In the intervention group, incremental shuttle walk test (ISWT) improved by 56.7 m ( p = 0.03), endurance walk test (EWT) by 193.3 m ( p = 0.01), Leicester Cough Questionnaire (LCQ) improved by 2.6units ( p < 0.001) and St. George's Respiratory Questionnaire (SGRQ) by 8units ( p < 0.001). At 20 weeks ( 12 weeks post end of training ) No improvement in control group. In the intervention group, ISWT improved by 80 m ( p = 0.04) and EWT by 247.5 m ( p = 0.003). LCQ improved by 4.4 units ( p < 0.001) and SGRQ by 4 units ( p < 0.001). Conclusion Pulmonary rehabilitation in addition to regular chest physiotherapy, improves exercise tolerance and health related quality of life in non cystic fibrosis bronchiectasis and the benefit was sustained at 12 weeks post end of pulmonary rehabilitation. Clinical trials regn no. NCT00868075.
Uniquely positioned as sentinel cells constantly exposed to the environment, pulmonary macrophages are vital for the maintenance of the lung lining. These cells are responsible for the clearance of ...xenobiotics, pathogen detection and clearance, and homeostatic functions such as surfactant recycling. Among the spectrum of phenotypes that may be expressed by macrophages in the lung, the pulmonary lipid-laden phenotype is less commonly studied in comparison to its circulatory counterpart, the atherosclerotic lesion-associated foam cell, or the acutely activated inflammatory macrophage. Herein, we propose that lipid-laden macrophage formation in the lung is governed by lipid acquisition, storage, metabolism, and export processes. The cellular balance of these four processes is critical to the maintenance of homeostasis and the prevention of aberrant signaling that may contribute to lung pathologies. This review aims to examine mechanisms and signaling pathways that are involved in lipid-laden macrophage formation and the potential consequences of this phenotype in the lung.
Health & Food Group, The New Zealand Institute for Plant and Food Research, Ltd., Hamilton, New Zealand
Submitted 2 September 2008
; accepted in final form 17 April 2009
Exercise-induced oxidative ...stress is instrumental in achieving the health benefits from regular exercise. Therefore, inappropriate use of fruit-derived products (commonly applied as prophalytic antioxidants) may counteract the positive effects of exercise. Using human exercise and cellular models we found that 1 ) blackcurrant supplementation suppressed exercise-induced oxidative stress, e.g., plasma carbonyls (0.9 ± 0.1 vs. 0.6 ± 0.1 nmol/mg protein, placebo vs. blackcurrant), and 2 ) preincubation of THP-1 cells with an anthocyanin-rich blackcurrant extract inhibited LPS-stimulated cytokine secretion TNF- (16,453 ± 322 vs. 10,941 ± 82 pg/ml, control vs. extract, P < 0.05) and IL-6 (476 ± 14 vs. 326 ± 32 pg/ml, control vs. extract, P < 0.05) and NF- B activation. In addition to its antioxidant and anti-inflammatory properties, we found that postexercise plasma collected after blackcurrant supplementation enhanced the differential temporal LPS-stimulated inflammatory response in THP-1 cells, resulting in an early suppression of TNF- (1,741 ± 32 vs. 1,312 ± 42 pg/ml, placebo vs. blackcurrant, P < 0.05) and IL-6 (44 ± 5 vs. 36 ± 3 pg/ml, placebo vs. blackcurrant, P < 0.05) secretion after 24 h. Furthermore, by using an oxidative stress cell model, we found that preincubation of THP-1 cells with hydrogen peroxide (H 2 O 2 ) prior to extract exposure caused a greater suppression of LPS-stimulated cytokine secretion after 24 h, which was not evident when cells were simultaneously incubated with H 2 O 2 and the extract. In summary, our findings support the concept that consumption of blackcurrant anthocyanins alleviate oxidative stress, and may, if given at the appropriate amount and time, complement the ability of exercise to enhance immune responsiveness to potential pathogens.
acute inflammation; fruit anthocyanins; moderate exercise
Address for reprint requests and other correspondence: S. Hurst, Health & Food Group, The New Zealand Institute for Plant and Food Research, Ltd., Private Bag 3123, East St., Hamilton. New Zealand (e-mail: rhurst{at}hortresearch.co.nz )
Reduced olfactory function (hyposmia) is one of the most common non-motor symptoms experienced by those living with Parkinson's disease (PD), however, the underlying pathology of the dysfunction is ...unclear. Recent evidence indicates that α-synuclein (α-syn) pathology accumulates in the anterior olfactory nucleus of the olfactory bulb years before the motor symptoms are present. It is well established that neuronal cells in the olfactory bulb are affected by α-syn, but the involvement of other non-neuronal cell types is unknown. The occurrence of intracellular α-syn inclusions were quantified in four non-neuronal cell types - microglia, pericytes, astrocytes and oligodendrocytes as well as neurons in the anterior olfactory nucleus of post-mortem human PD olfactory bulbs (n = 11) and normal olfactory bulbs (n = 11). In the anterior olfactory nucleus, α-syn inclusions were confirmed to be intracellular in three of the four non-neuronal cell types, where 7.78% of microglia, 3.14% of pericytes and 1.97% of astrocytes were affected. Neurons containing α-syn inclusions comprised 8.60% of the total neuron population. Oligodendrocytes did not contain α-syn. The data provides evidence that non-neuronal cells in the PD olfactory bulb contain α-syn inclusions, suggesting that they may play an important role in the progression of PD.
Parkinson's disease (PD) is a progressive, neurodegenerative disorder characterised by the abnormal accumulation of α-synuclein (α-syn) aggregates. Central to disease progression is the gradual ...spread of pathological α-syn. α-syn aggregation is closely linked to progressive neuron loss. As such, clearance of α-syn aggregates may slow the progression of PD and lead to less severe symptoms. Evidence is increasing that non-neuronal cells play a role in PD and other synucleinopathies such as Lewy body dementia and multiple system atrophy. Our previous work has shown that pericytes-vascular mural cells that regulate the blood-brain barrier-contain α-syn aggregates in human PD brains. Here, we demonstrate that pericytes efficiently internalise fibrillar α-syn irrespective of being in a monoculture or mixed neuronal cell culture. Pericytes cleave fibrillar α-syn aggregates (Fibrils, Ribbons, fibrils65, fibrils91 and fibrils110), with cleaved α-syn remaining present for up to 21 days. The number of α-syn aggregates/cell and average aggregate size depends on the type of strain, but differences disappear within 5 five hours of treatment. Our results highlight the role brain vasculature may play in reducing α-syn aggregate burden in PD.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
8.
We should stand by our surgical assistants Sakata, S.; Lonne, M. L. R.; Pappas, C. P. ...
Techniques in coloproctology,
09/2022, Letnik:
26, Številka:
9
Journal Article
Antibiotic allergy labels (AALs), reported by up to 25% of hospitalized patients, are a significant barrier to appropriate prescribing and a focus of antimicrobial stewardship (AMS) programmes.
A ...prospective audit of a pharmacist-led AMS penicillin allergy de-labelling ward round at Austin Health (Melbourne, Australia) was evaluated. Eligible inpatients with a documented penicillin allergy receiving an antibiotic were identified via an electronic medical report and then reviewed by a pharmacist-led AMS team. The audit outcomes evaluated were: (i) AMS post-prescription review recommendations; (ii) direct de-labelling; (iii) inpatient oral rechallenge referral; (iv) skin prick testing/intradermal testing referral; and (v) outpatient antibiotic allergy clinic assessment.
Across a 5 month period, 106 patients were identified from a real-time electronic prescribing antibiotic allergy report. The highest rate of penicillin allergy de-labelling was demonstrated in patients who were referred for an inpatient oral rechallenge with 95.2% (n = 21) successfully having their penicillin AAL removed. From the 22 patients with Type A reactions, 63.6% had their penicillin AAL removed. We demonstrated a significant decrease in the prescribing of restricted antibiotics (defined as third- or fourth-generation cephalosporins, fluoroquinolones, glycopeptides, carbapenems, piperacillin/tazobactam, lincosamides, linezolid or daptomycin) in patients reviewed (pre 42.5% versus post 17.9%, P = 0.0002).
A pharmacist-led AMS penicillin allergy de-labelling ward round reduced penicillin AALs and the prescribing of restricted antibiotics. This model could be implemented at other hospitals with existing AMS programmes.
Introduction
The social licence of the Australian thoroughbred (TB) industry relies on the general public's perception of how they manage the animal in their care.
Method
This study examines the ...horse, race and activity records for the 37,704 horses racing and training in Australia from 1 August 2017 to 31 July 2018. Three‐quarters (75%, n = 28,184) of TBs started in one of the 180, 933 race starts that occurred during the 2017–2018 Australian racing season.
Results
Horses participating in the 2017–2018 Australian racing season had a median age of 4 years, with geldings more likely to be aged 5 years and older. The majority of the TB racehorse population were geldings (51%, n = 19,210), with 44% (n = 16,617) females and only 5% (n = 1877) entire males. Horses aged 2 years were three times more likely to not start in a race in that year compared with older horses. At the end of the 2017–2018 racing season, 34% of the population had an inactive status recorded. Horses aged 2 years (median two starts) and 3 years (median five starts) had fewer starts than older horses (median seven starts). Eighty‐eight percent (n = 158,339) of race starts were over distances of 1700 metres or less. Race starts by horses aged 2 years (46%, 3264 of 7100) were more likely to have occurred at a metropolitan meeting compared with starts by older horses.
Conclusion
This study provides a national overview of the racing and training activities and TBs participating in the 2017–2018 Australian racing season.
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