27 research outputs found
[Ongoing breastfeeding with breast abscess]
No full textMastitis puerperalis can frequently be complicated by a breast abscess. Immediate diagnosis and treatment are crucial if breastfeeding is to be continued and for the prevention of further complications. Somatic and psychological interventions are of importance for recovery. Specialised nurses and midwives have an important impact on the promotion of well-being of affected mothers
Certolizumab treatment during late pregnancy in patients with rheumatic diseases: Low drug levels in cord blood but possible risk for maternal infections. A case series of 13 patients
No full textOBJECTIVE
Due to reduction of immune-suppressive drugs, patients with rheumatic diseases can experience an increase in disease activity during pregnancy. In such cases, TNF-inhibitors may be prescribed. However, monoclonal antibodies with the Fc moiety are actively transported across the placenta, resulting in therapeutic drug levels in the newborn. As certolizumab (CZP) lacks the Fc moiety, it may bear a lower risk for the child.
METHOD
We report a case series of thirteen patients (5 with rheumatoid arthritis and 8 with spondyloarthritis) treated with CZP during late pregnancy to control disease activity.
RESULT
CZP measured in cord blood of eleven infants ranged between undetectable levels and 1μg/mL whereas the median CZP level of maternal plasma was 32.97μg/mL. Three women developed an infection during the third trimester, of whom one had a severe infection and one had an infection that resulted in a pre-term delivery. During the postpartum period, 6 patients remained on CZP while breastfeeding. CZP levels in the breast milk of two breastfeeding patients were undetectable.
CONCLUSION
The lack of the active transplacental transfer of CZP gives the possibility to treat inflammatory arthritis during late gestation without potential harm to the newborn. However, in pregnant women treated with TNF-inhibitors and prednisone, attention should be given to the increased susceptibility to infections, which might cause prematurity. CZP treatment can be continued while breastfeeding
Rituximab and Canakinumab Use During Lactation: No Detectable Serum Levels in Breastfed Infants.
No full textINTRODUCTION
In breastfeeding patients with chronic inflammatory rheumatic diseases, a postpartum flare may require the use of biologics. However, data on the safety of biologics during lactation are scarce, potentially impeding the decision-making process.
CASE SERIES
We report two cases of women in whom treatment with a monoclonal IgG antibody (rituximab or canakinumab) was indicated during the lactation period. In both cases, breastfeeding was continued, and drug levels in the mother's serum, in serial breast milk samples and in the infant's serum were measured. Both rituximab and canakinumab showed minimal drug concentrations in breast milk and no detectable levels in the infants' sera.
CONCLUSION
The lack of detectable levels of rituximab and canakinumab in the sera of breastfed infants reflects the poor oral bioavailability of these biologics and helps to promote their use in breastfeeding patients
Risk for adverse pregnancy outcome in axial spondyloarthritis and rheumatoid arthritis: disease activity matters.
No full textObjective
To analyse pregnancy outcome and delivery mode in patients with RA and axial spondyloarthritis (axSpA) in relation to disease activity and anti-rheumatic drugs.
Methods
Patients with RA and axSpA were compared with age-matched healthy controls (HCs) with respect to pregnancy outcome and delivery mode. Disease activity (DAS28, ASDAS, CRP) and medication use of patients was assessed once at each trimester. ORs with 95% CI were calculated with univariate and multivariate regression models.
Results
We analysed 244 pregnancies, of which 96 occurred in patients with RA, 78 in patients with axSpA and 70 in HCs. The adjusted analysis showed that pregnant women with RA and axSpA had a higher risk of pregnancy complications (gestational diabetes, preeclampsia, infection, preterm premature rupture of membranes), small for gestational age infants and preterm deliveries (all P < 0.05). Active disease was a predictor for preterm delivery in both RA [odds ratio (OR) = 3.9, 95% CI: 1.25, 12.15] and axSpA (OR = 13.8, 95% CI: 1.33, 143.94). Regarding delivery mode, most patients had vaginal deliveries. However, women with RA revealed an increased risk of caesarean section compared with HC (P < 0.05), which was not seen in patients with axSpA.
Conclusion
Our findings show that disease activity of RA and axSpA during pregnancy influences pregnancy outcome. To allow for successful pregnancy a treatment strategy that targets inactive disease beyond conception should be followed
BEEYOND - Foundation of the Company & Market Entry
No full textThis bachelor thesis depicts the author's journey over the last months, from the discovery of a business idea inspired by an innovative blockchain application over the creation of a solid concept in the form of a business plan to the development & implementation on a strategic as well as functional level. By applying his theoretical knowledge acquired in the Major "International Entrepreneurship", the author gained the necessary skillset to establish the company, develop the market entry strategy and begin with its practical implementation
miR-125b controls apoptosis and temozolomide resistance by targeting TNFAIP3 and NKIRAS2 in glioblastomas.
No full textDiffusely infiltrating gliomas are among the most prognostically discouraging neoplasia in human. Temozolomide (TMZ) in combination with radiotherapy is currently used for the treatment of glioblastoma (GBM) patients, but less than half of the patients respond to therapy and chemoresistance develops rapidly. Epigenetic silencing of the O(6)-methylguanine-DNA methyltransferase (MGMT) has been associated with longer survival in GBM patients treated with TMZ, but nuclear factor κB (NF-κB)-mediated survival signaling and TP53 mutations contribute significantly to TMZ resistance. Enhanced NF-κB is in part owing to downregulation of negative regulators of NF-κB activity, including Tumor necrosis factor alpha-induced protein 3 (TNFAIP3) and NF-κB inhibitor interacting RAS-like 2 (NKIRAS2). Here we provide a novel mechanism independent of TP53 and MGMT by which oncogenic miR-125b confers TMZ resistance by targeting TNFAIP3 and NKIRAS2. GBM cells overexpressing miR-125b showed increased NF-κB activity and upregulation of anti-apoptotic and cell cycle genes. This was significantly associated with resistance of GBM cells to TNFα- and TNF-related inducing ligand-induced apoptosis as well as resistance to TMZ. Conversely, overexpression of anti-miR-125b resulted in cell cycle arrest, increased apoptosis and increased sensitivity to TMZ, indicating that endogenous miR-125b is sufficient to control these processes. GBM cells overexpressing TNFAIP3 and NKIRAS2 were refractory to miR-125b-induced apoptosis resistance as well as TMZ resistance, indicating that both genes are relevant targets of miR-125b. In GBM tissues, high miR-125b expression was significantly correlated with nuclear NF-κB confirming that miR-125b is implicated in NF-κB signaling. Most remarkably, miR-125b overexpression was clearly associated with shorter overall survival of patients treated with TMZ, suggesting that this microRNA is an important predictor of response to therapy
Quick scan alternatieve veiligheidsmaatregelen
No full textDijken en duinen beschermen Nederland tegen overstroming vanuit de rivieren en de zee. Zeespiegelstijging en meer en extremere stormen als gevolg van de klimaatverandering noodzaken tot het treffen van aanvullende maatregelen. Nog meer bepalend is de achterstand in het beschermingsniveau tegen overstromingen door de toenemende omvang en waardegroei van het te beschermen goed en toegenomen bevolking. De huidige normen lijken niet meer adequaat te zijn. Om te komen tot een nieuwe veiligheidsbenadering moet verder worden gekeken dan de reguliere veiligheidsmaatregelen. Vandaar dat verschillende alternatieve veiligheidsmaatregelen in deze voorliggende quick scan nader worden bekeken. Onder alternatieve maatregelen worden verstaan alle maatregelen anders dan de traditionele versterking en verhoging van de (hoofd)waterkeringen. Alternatieve maatregelen kunnen zowel nieuwe als reeds bestaande - maar nog niet regulier toegepaste - maatregelen zijn. Deze quick scan brengt in kaart welke informatie er beschikbaar is over de alternatieve veiligheidsmaatregelen, waar de informatie gevonden kan worden en welke personen en organisaties kennis hebben over of betrokken zijn bij de maatregelen. De quick scan maakt tevens inzichtelijk waar informatie ontbreekt. Dit is vastgelegd in een factsheet per maatregel. Van alle maatregelen is een inschatting gemaakt van de kansrijkheid, gebaseerd op een (globale) beoordeling van de effectiviteit en haalbaarheid van de betreffende maatregel. Bij de beoordeling van de kansrijkheid zijn relevante kanttekeningen (aannames, orde groottes, onzekerheden) geplaatst. Geconcludeerd kan worden dat alle maatregelen die genoemd worden in deze quick scan waardevol zijn om serieus in overweging te nemen bij verdere verkenning van de nieuwe waterveiligheidsstrategie. In aanvulling daarop kan worden opgemerkt dat, gegeven de opzet van deze quick scan en de gehanteerde uitgangspunten, de beoordeling van de kansrijkheid met name gericht is op de korte termijn. Maatregelen die pas na een lange procedure of vanwege hun omvang pas op lange termijn kunnen worden toegepast, scoren op basis van deze uitgangspunten minder goed. Het is denkbaar dat dergelijke maatregelen (als ze bijvoorbeeld kosteneffectief blijken te zijn) wel goed binnen een lange termijn-strategie passen. Ten slotte dient opgemerkt te worden dat in deze quick scan niet gekeken is naar het combineren van afzonderlijke maatregelen. Aanbevolen wordt om de wisselwerking met andere maatregelen te betrekken bij toekomstige afweging voor het toepassen van één of meer maatregelen
Practical Relativistic Bit Commitment
No full textBit commitment is a fundamental cryptographic primitive in which Alice wishes to commit a secret bit to Bob. Perfectly secure bit commitment between two mistrustful parties is impossible through an asynchronous exchange of quantum information. Perfect security is, however, possible when Alice and Bob each split into several agents exchanging classical information at times and locations suitably chosen to satisfy specific relativistic constraints. In this Letter we first revisit a previously proposed scheme [C. Crépeau et al., Lect. Notes Comput. Sci. 7073, 407 (2011)] that realizes bit commitment using only classical communication. We prove that the protocol is secure against quantum adversaries for a duration limited by the light-speed communication time between the locations of the agents. We then propose a novel multiround scheme based on finite-field arithmetic that extends the commitment time beyond this limit, and we prove its security against classical attacks. Finally, we present an implementation of these protocols using dedicated hardware and we demonstrate a 2 ms-long bit commitment over a distance of 131 km. By positioning the agents on antipodal points on the surface of Earth, the commitment time could possibly be extended to 212 ms.</p
Colonisation of newly-opened habitat by a pioneer species, Alvinella pompejana (Polychaeta: Alvinellidae), at East Pacific Rise vent sites
No full textAuthor Posting. © Inter-Research, 2005. This article is posted here by permission of Inter-Research for personal use, not for redistribution. The definitive version was published in Marine Ecology Progress Series 302 (2005): 147-157, doi:10.3354/meps302147.Animal communities on the walls of deep-sea hydrothermal chimneys are distributed in mosaics of patches that may evolve as local environmental conditions change and biological interactions develop. Alvinella pompejana Desbruyères et Laubier, 1980 is one of the first metazoan colonisers of new surfaces created by mineral precipitation, and therefore may be particularly important in community establishment in active parts of smokers. Here our goal was to investigate the colonisation mechanisms of A. pompejana in new patches and determine whether these mechanisms may influence population structure and reproductive patterns in this species. We deployed a series of TRAC (Titanium Ring for Alvinellid Colonisation) devices at East Pacific Rise (EPR) vent sites to compare the size and stage (i.e. reproductive maturity) distribution of A. pompejana individuals between recently colonised patches (TRACs) and established patches (grabbed by submersible). TRACs deployed for short time periods (11 d to 1 mo) were generally colonised by smaller individuals than those found in background populations or in TRACs deployed for longer time periods (>1 mo). Colonists into new patches were a mix of juveniles and individuals that were sexually mature but non-reproductive (i.e. not producing gametes), whereas background population and older patches harboured a mixture of individuals at different stages including reproductive females. Although some individuals may have recruited on TRACs as larvae, the major colonisation process involved was probably immigration of post-larval stages. In long-term TRAC, reproductive females were not reproductively synchronised. In this dynamic environment, reproduction would be triggered by the disturbance/migration processes, explaining the heterogeneity observed in reproductive patterns.The research
was funded by INSU, CNRS, IFREMER, Dorsales and NSF
grant OCE-9712233 to L.S.M
