2,876 research outputs found
Determine TB-LAM lateral flow urine antigen assay for HIV-associated tuberculosis: recommendations on the design and reporting of clinical studies.
No full textDetection of the Mycobacterium tuberculosis cell wall antigen lipoarabinomannan (LAM) in urine permits diagnoses of tuberculosis (TB) to be made in HIV-infected patients with advanced immunodeficiency. This can be achieved at the point-of-care within just 30 minutes using the Determine TB-LAM, which is a commercially available, lateral-flow urine 'strip test' assay. The assay has been shown to have useful diagnostic accuracy in patients enrolling in antiretroviral treatment services or in HIV-infected patients requiring admission to hospital medical wards in sub-Saharan Africa. Such patients have high mortality risk and have most to gain from rapid diagnosis of TB and immediate initiation of treatment. However, few studies using this assay have yet been reported and many questions remain concerning the correct use of the assay, interpretation of results, the role of the assay as an add-on test within existing diagnostic algorithms and the types of further studies needed. In this paper we address a series of questions with the aim of informing the design, conduct and interpretation of future studies. Specifically, we clarify which clinical populations are most likely to derive benefit from use of this assay and how patients enrolled in such studies might best be characterised. We describe the importance of employing a rigorous microbiological diagnostic reference standard in studies of diagnostic accuracy and discuss issues surrounding the specificity of the assay in different geographical areas and potential cross-reactivity with non-tuberculous mycobacteria and other organisms. We highlight the importance of careful procedures for urine collection and storage and the critical issue of how to read and interpret the test strips. Finally, we consider how the assay could be used in combination with other assays and outline the types of studies that are required to build the evidence base concerning its use
Extrapulmonary presentation of asymptomatic pulmonary lymphangioleiomyomatosis
No full textLymphangioleiomyomatosis (LAM) is a rare parenchymal lung disease, which affects young women of childbearing age and is characterized pathologically by proliferation of interstitial smooth muscle and formation of cysts in the lung. While LAM is usually predominantly a respiratory disorder, it can also initially involve other extrapulmonary organs. We report the case of a 35-year-old Chinese woman, who presented with a 4-week history of left thigh swelling which was found to be secondary to compression of pelvic veins by a mass lesion. The latter was found histologically to show LAM. Despite the patient being asymptomatic and displaying normal lung function, a thoracic high resolution CT scan showed typical features of early LAM. This case further illustrates that LAM can have multisystem involvement, and demonstrates the importance of being aware of the diagnosis in cases presenting with extrapulmonary manifestation, in order that patients are diagnosed and managed appropriately.link_to_subscribed_fulltex
An increased MRP8/14 expression and adhesion, but a decreased migration towards proinflammatory chemokines of type 1 diabetes monocytes
No full textDe novo combination therapy with lamivudine and adefovir dipivoxil in chronic hepatitis B patients
No full textAIM: To investigate the appropriate time for combination therapy in HBeAg positive chronic hepatitis B (CHB) patients with decompensated cirrhosis. METHODS: Thirty HBeAg positive CHB patients with decompensated cirrhosis were enrolled in the study. All of the patients were given 48 wk combination therapy with lamivudine (LAM) and adefovir dipivoxil (ADV). Briefly, 10 patients were given the de novo combination therapy with LAM and ADV, whereas the other 20 patients received ADV in addition to LAM after hepatitis B virus (HBV) genetic mutation. RESULTS: Serum alanine aminotransferase and total bilirubin were both improved in the two groups at 4, 12, 24 and 48 wk after treatment. Serum albumin was also improved at 24 and 48 wk after combination therapy in both groups. The serum HBV DNA level was still detectable in every patient in the two groups at 4 and 12 wk after combination treatment. However, in the de novo combination group, serum HBV DNA levels in 4 (40%) and 9 (90%) patients was decreased to below 1x10(3) copies/mL at 24 and 48 wk after the combination treatment, respectively. In parallel, serum HBV DNA levels in 2 (20%) and 8 (40%) patients in the add-on combination group became undetectable at 24 and 48 wk after combination treatment, respectively. Furthermore, 6 (60%) patients in the de novo combination group achieved HBeAg seroconversion after 48 wk treatment, whereas only 4 (20%) patients in the add-on combination group achieved seroconversion. Child-Pugh score of patients in the de novo combination group was better than that of patients in the add-on combination group after 48 wk treatment. Moreover, patients in the de novo combination group had a significantly decreased serum creatinine level and elevated red blood cell counts. CONCLUSION: De novo combination therapy with LAM and ADV was better than add-on combination therapy in terms of Child-Pugh score, virus inhibition and renal function. (C) 2011 Baishideng. All rights reserved.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000298004000009&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701Gastroenterology & HepatologySCI(E)PubMed中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)5ARTICLE434804-48091
Synthesis, characterization of pyrazino-phenanthroline derivatives and study of their aggregation properties
No full textNew pyrazinopyraine-phananthroline derivatives with various lengths of oligoether and alkyl substituents and the corresponding pyrazino-phenanthroline derivatives were synthesized for comparison to their photophysical, electrochemical and thermal properties by UV-vis absorption spectroscopy, emission spectroscopy, cyclic voltammetry, DFT and TDDFT calculations. These derivatives were employed to study molecular self-assembly and kinetic factors in the processes. Furthermore, the newly developed compounds with pyrazinopyraine-phananthroline and pyrazino- phenanthroline moieties were applied in coordination with Re(I) metal ion. The photophysical and electrochemical properties of the Re(I) complexes were investigated.
The pyrazinopyraine-phananthroline derivatives showed similar photophysical and electrochemical properties and exhibited bathochromic shifts in the absorption and emission spectra with smaller optical bandgaps than compounds with pyraino bridges. The compounds with pyrazinopyraine bridges showed a positive solvatochromism in charging the polarity of solvents implying the excited states being more polar than the ground states. In the solution of chloroform, pyrazinopyrazine-phenanthroline derivatives were not stable and could be photo-excited under UV light changing color from yellow to amber. From the DFT and TDDFT calculations, the computational results agreed with the experimental results. For the molecular self-assembly, fabrication of nano- or micro-structures of the derivatives was performed by the mixing with acetone and pure water. Various micro-structures were obtained based on differences in molecular geometries. These micro-structures were controlled and modified by changing kinetic factors such as changing solvent ratios and solvent compositions. These self-assembled structures can be potentially applied to develop organic semiconductors and photonic devices.
The new phenanthroline-containing Re(I) complexes displayed unique photophysical and electrochemical properties. Bathochromic shifts in the absorption and emission spectra were identified upon coordination with Re(I) metal ion. The experimental absorption results agreed with the TTDFT calculations with two electron excitations for the complexes. The Re(I) complexes showed weak quantum yields compared with their parent ligands due to self-quenching processes through non-radiative pathways.published_or_final_versionChemistryMasterMaster of Philosoph
Sulfur forming an isoelectronic center in zinc telluride thin films
No full textZnTe1-xSx epitaxial layers grown on GaAs by molecular-beam epitaxy were studied by photoluminescence (PL) as a function of temperatures, excitation powers, and hydrostatic pressures. A sulfur-related emission peak, labeled as P-2, is identified as a deep-level emission by hydrostatic-pressure PL measurement. This indicates that sulfur atoms form isoelectronic centers in a ZnTe matrix. The results qualitatively agree with the theoretical prediction and show experimental evidence of isoelectronic S in ZnTe. A model is proposed to explain the emission mechanisms in the ZnTe1-xSx system with small x values
Supplemental Material, AD-short - Dealing With Death Taboo: Discussion of Do-Not-Resuscitate Directives With Chinese Patients With Noncancer Life-Limiting Illnesses
No full textSupplemental Material, AD-short for Dealing With Death Taboo: Discussion of Do-Not-Resuscitate Directives With Chinese Patients With Noncancer Life-Limiting Illnesses by Hon-Wai Benjamin Cheng, Pui-Shan Karen Shek, Ching-Wah Man, Oi-Man Chan, Chun-Hung Chan, Kit-Man Lai, Suk-Ching Cheng, Koon-Sim Fung, WK Lui, Carman Lam, Yuen-Kwan Ng, Wan-To Wong, and Cherry Wong in American Journal of Hospice and Palliative Medicine®</p
Supplemental Material, AD-long - Dealing With Death Taboo: Discussion of Do-Not-Resuscitate Directives With Chinese Patients With Noncancer Life-Limiting Illnesses
No full textSupplemental Material, AD-long for Dealing With Death Taboo: Discussion of Do-Not-Resuscitate Directives With Chinese Patients With Noncancer Life-Limiting Illnesses by Hon-Wai Benjamin Cheng, Pui-Shan Karen Shek, Ching-Wah Man, Oi-Man Chan, Chun-Hung Chan, Kit-Man Lai, Suk-Ching Cheng, Koon-Sim Fung, WK Lui, Carman Lam, Yuen-Kwan Ng, Wan-To Wong, and Cherry Wong in American Journal of Hospice and Palliative Medicine®</p
Behavior during transition differs for cows diagnosed with claw horn lesions in mid lactation
No full textClaw horn lesions, including sole hemorrhages and sole ulcers, are a major cause of lameness in dairy cattle. These lesions often develop in the weeks around calving and become visible 8 to 12 wk later. The aim was to determine whether cows that are diagnosed with claw horn lesions several weeks after calving behave differently during the calving period when the lesions are thought to first develop. The claws of 26 multiparous Holstein dairy cows were scored for sole hemorrhage severity and presence of sole ulcers 2 wk before calving, 3 wk after calving, and every 4 wk thereafter until 15 wk after calving. Of the 26 cows, 13 cows had no or low lesion scores up to 15 wk and 13 cows had at least 1 new severe lesion or sole ulcer diagnosed between 7 and 15 wk after calving. Behavior (dry matter intake, feeding time and rate, number and size of meals, standing time, number and duration of standing bouts, location of standing, and displacements at the feed bunk) was recorded from 2 wk before calving to 3 wk after calving. Behavior during the 2 wk before calving, first 24h after calving, 1 wk after calving, and 2 to 3 wk after calving was compared between cows with and without lesions in mid lactation. Multivariate regression was used to determine the predictive value of each behavior and combination of behaviors on lesion diagnosis. Cows diagnosed with lesions in mid lactation spent more time standing than cows without lesions during the 2 wk before (832+/-29 vs. 711+/-29 min/d) and 24 h after (935+/-46 vs. 693+/-46 min/d) calving. These differences were driven by an increase in the time spent perching with front feet in the stall (241+/-22 vs. 147+/-22 min/d at 2 wk before calving) and an increase in standing bout duration (101+/-10 vs. 56+/-10 min/bout at 24 h after calving). Compared with cows without lesions, cows with lesions consumed feed at a faster rate (86+/-3 vs. 77+/-3 g/min) during the 2 wk before calving and consumed more feed (17.9+/-0.9 vs. 12.3+/-0.9 kg/d) during the 24 h after calving. The number of displacements at the feeder was not different between groups. These results indicate that a combination of feeding and standing behavior during the transition can serve as early indicators of claw horn lesions in mid lactation
The anatomical components of urinary continence.
No full textBACKGROUND: The levator ani muscle (LAM) plays an important role in urinary continence, but the anatomical relationship between this pelvic floor muscle and the external urethral sphincter (EUS) remains incompletely understood. OBJECTIVE: To investigate the topographical relationship between the EUS and the LAM. DESIGN, SETTING, AND PARTICIPANTS: Serially sectioned and histochemically stained foetal pelves from eleven females and nine males (10-27 wk of gestation) were studied. Three foetal pelves (two female, 12 and 18 wk of gestation; one male, 12 wk of gestation) and three adult pelves (two females, 54 and 85 yr; one male, 75 yr) were stained immunohistochemically for the presence of striated and smooth muscle tissue. Three-dimensional reconstructions were prepared. MEASUREMENTS: Anatomy of the LAM and urethral sphincter components was evaluated qualitatively. RESULTS AND LIMITATIONS: The EUS has no direct bony attachment. In female foetuses, the inferior part of the EUS is firmly attached to the LAM by a tendinous connection. Contraction of this part of the EUS produces a force on the urethra in a posteroinferior direction. Contraction of the LAM compresses the rectum and moves the rectovaginal complex anteriorly and superiorly towards the urethra in a plane that lies parallel to, but superior of, that of the EUS. Simultaneous contraction of the LAM and EUS causes an anteriorly convex bend in the midurethra, which closes the midurethral lumen. A similar attachment of the EUS to the LAM is absent in the male. Our study is limited due to the absence of young adult study specimens. CONCLUSIONS: The EUS in females is anchored to the levator ani muscle via a tendinous connection. Because of this attachment to the LAM, proper function of the EUS is dependent on the integrity of the LAM and its attachment to the pelvic wall
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