11 research outputs found
Deferasirox (Exjade®) significantly improves cardiac T2* in heavily iron-overloaded patients with β-thalassemia major
No full textNoninvasive measurement of tissue iron levels can be assessed using T2* magnetic resonance imaging (MRI) to identify and monitor patients with iron overload. This study monitored cardiac siderosis using T2* MRI in a cohort of 19 heavily iron-overloaded patients with β-thalassemia major receiving iron chelation therapy with deferasirox over an 18-month period. Overall, deferasirox therapy significantly improved mean ± standard deviation cardiac T2* from a baseline of 17.2±10.8 to 21.5±12.8 ms (+25.0percent; P=0.02). A concomitant reduction in median serum ferritin from a baseline of 5,497 to 4,235 ng-mL (-23.0percent; P=0.001), and mean liver iron concentration from 24.2±9.0 to 17.6± 12.9 mg Fe-g dry weight (-27.1percent; P=0.01) was also seen. Improvements were seen in patients with various degrees of cardiac siderosis, including those patients with a baseline cardiac T2* of 10 ms, indicative of high cardiac iron burden. These findings therefore support previous observations that deferasirox is effective in the removal of myocardial iron with concomitant reduction in total body iron. © The Author(s) 2009.Anderson LJ, 2006, ACTA HAEMATOL-BASEL, V115, P106, DOI 10.1159-000089475; Anderson LJ, 2001, EUR HEART J, V22, P2171, DOI 10.1053-euhj.2001.2822; Borgna-Pignatti C, 2004, HAEMATOLOGICA, V89, P1187; BRITTENHAM GM, 1994, NEW ENGL J MED, V331, P567, DOI 10.1056-NEJM199409013310902; Cappellini MD, 2006, BLOOD, V107, P3455, DOI 10.1182-blood-2005-08-3430; Daar S, 2009, HAEMATOL-HEMATOL J, V94, P140, DOI 10.3324-haematol.13845; ELEFTHERIOU P, 2006, HAEMATOLOGICA S1, V91, P999; Garbowski M, 2008, BLOOD, V112, P116; Kolnagou A, 2006, HEMOGLOBIN, V30, P219, DOI 10.1080-03630260600642542; Noetzli LJ, 2008, BLOOD, V112, P2973, DOI 10.1182-blood-2008-04-148767; PENNELL D, 2008, BLOOD, V112, P3874; Pennell DJ, 2008, BLOOD, V112, P3873; Porter J, 2008, EUR J HAEMATOL, V80, P168, DOI 10.1111-j.1600-0609.2007.00985.x; St Pierre TG, 2005, BLOOD, V105, P855, DOI 10.1182-blood-2004-01-0177; Taher A, 2009, EUR J HAEMATOL, V82, P458, DOI 10.1111-j.1600-0609.2009.01228.x; Vichinsky E, 2007, BRIT J HAEMATOL, V136, P501, DOI 10.1111-j.1365-2141.2006.06455.x; Westwood M, 2003, J MAGN RESON IMAGING, V18, P33, DOI 10.1002-jmri.10332; Wood JC, 2004, BLOOD, V104, p111A; Wood JC, 2008, BLOOD, V112, P3882; Wood JC, 2006, TRANSL RES, V148, P272, DOI 10.1016-j.trsl.2006.05.005; ZURLO MG, 1989, LANCET, V2, P2719222
Reduction in labile plasma iron during treatment with deferasirox, a once-daily oral iron chelator, in heavily iron-overloaded patients with β-thalassaemia
No full textThis subgroup analysis evaluated the effect of once-daily oral deferasirox on labile plasma iron (LPI) levels in patients from the prospective, 1-yr, multicentre ESCALATOR study. Mean baseline liver iron concentration and median serum ferritin levels were 28.6 ± 10.3 mg Fe-g dry weight and 6334 ng-mL respectively, indicating high iron burden despite prior chelation therapy. Baseline LPI levels (0.98 ± 0.82 μmol-L) decreased significantly to 0.12 ± 0.16 μmol-L, 2 h after first deferasirox dose (P = 0.0006). Reductions from pre- to post-deferasirox administration were also observed at all other time points. Compared to baseline, there was a significant reduction in preadministration LPI that reached the normal range at week 4 and throughout the remainder of the study (P ≤ 0.02). Pharmacokinetic analysis demonstrated an inverse relationship between preadministration LPI levels and trough deferasirox plasma concentrations. Once-daily dosing with deferasirox ≥20 mg-kg-d provided sustained reduction in LPI levels in these heavily iron-overloaded patients, suggesting 24-h protection from LPI. Deferasirox may therefore reduce unregulated tissue iron loading and prevent further end-organ damage. © 2009 Blackwell Munksgaard.ALREFAIE FN, 1995, BRIT J HAEMATOL, V89, P403, DOI 10.1111-j.1365-2141.1995.tb03318.x; Breuer W, 2000, TRANSFUS SCI, V23, P185, DOI 10.1016-S0955-3886(00)00087-4; Cabantchik ZI, 2005, BEST PRACT RES CL HA, V18, P277, DOI 10.1016-j.beha.2004.10.003; Esposito BP, 2003, BLOOD, V102, P2670, DOI 10.1182-blood-2003-03-0807; HERSHKO C, 1978, BRIT J HAEMATOL, V40, P255, DOI 10.1111-j.1365-2141.1978.tb03662.x; Nisbet-Brown E, 2003, LANCET, V361, P1597, DOI 10.1016-S0140-6736(03)13309-0; OLIVIERI NF, 1994, NEW ENGL J MED, V331, P574, DOI 10.1056-NEJM199409013310903; Olivieri NF, 1997, BLOOD, V89, P739; Piga A, 2006, HAEMATOL-HEMATOL J, V91, P873; Porter JB, 2001, SEMIN HEMATOL, V38, P63, DOI 10.1053-shem.2001.2014537353
Association between cardiac T2* magnetic resonance imaging values and endocrine function tests in patients with β-thalassemia major
No full text[No abstract available]Carpenter JP, 2011, CIRCULATION, V123, P1519, DOI 10.1161-CIRCULATIONAHA.110.007641; Kirk P, 2009, CIRCULATION, V120, P1961, DOI 10.1161-CIRCULATIONAHA.109.874487; Kirk P, 2010, J MAGN RESON IMAGING, V32, P315, DOI 10.1002-jmri.22245; Modell B, 2008, J CARDIOVASC MAGN R, V10, DOI 10.1186-1532-429X-10-42; Pennell DJ, 2013, CIRCULATION, V128, P281, DOI 10.1161-CIR.0b013e31829b2be6; Taher A.T., 2009, HEMOGLOBIN S1, V33, pS46; Westwood M, 2003, J MAGN RESON IMAGING, V18, P33, DOI 10.1002-jmri.10332; Wood JC, 2011, HEMATOL-AM SOC HEMAT, P443, DOI 10.1182-asheducation-2011.1.4430
A Bibliometric Analysis of Ophthalmology Resident Research Productivity in the United States
No full textAbstract
Background The extent and impact of ophthalmology resident scholarly output is not well known. The authors aim to quantify scholarly activity of ophthalmology residents during residency and assess what factors may be associated with greater research productivity of these residents.
Material and Methods Ophthalmology residents who graduated in 2021 were identified from their respective program Web sites. Bibliometric data published by these residents between the beginning of their postgraduate year 2 (July 1, 2018) until 3 months after graduation (September 30, 2021) were captured through searches via PubMed, Scopus, and Google Scholar. The association of the following factors with greater research productivity numbers was analyzed: residency tier, medical school rank, sex, doctorate degree, type of medical degree, and international medical graduate status.
Results We found 418 ophthalmology residents from 98 residency programs. These residents published a mean (±standard deviation [SD]) number of 2.68 ± 3.81 peer-reviewed publications, 2.39 ± 3.40 ophthalmology-related publications, and 1.18 ± 1.96 first-author publications each. The mean (±SD) Hirsch index (h-index) for this cohort was 0.79 ± 1.17. Upon multivariate analysis, we discovered significant correlations between both residency tier and medical school rank and all bibliometric variables assessed. Pairwise comparisons revealed that residents from higher tier programs had greater research productivity numbers than those from lower tier programs.
Conclusion We obtained bibliometric standards for ophthalmology residents on a national scale. Residents who graduated from higher-ranked residency programs and medical schools possessed higher h-indices and published more peer-reviewed publications, ophthalmology-related articles, and first-author publications
Iron overload in thalassemia and sickle cell disease
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Dissection of genetic associations with language-related traits in population-based cohorts
No full textThe author was supported by the Wellcome Trust [076566/Z/05/Z]; [075491/Z/04] and the Medical Research Council [G0800523/86473].Recent advances in the field of language-related disorders have led to the identification of candidate genes for specific language impairment (SLI) and dyslexia. Replication studies have been conducted in independent samples including population-based cohorts, which can be characterised for a large number of relevant cognitive measures. The availability of a wide range of phenotypes allows us to not only identify the most suitable traits for replication of genetic association but also to refine the associated cognitive trait. In addition, it is possible to test for pleiotropic effects across multiple phenotypes which could explain the extensive comorbidity observed across SLI, dyslexia and other neurodevelopmental disorders. The availability of genome-wide genotype data for such cohorts will facilitate this kind of analysis but important issues, such as multiple test corrections, have to be taken into account considering that small effect sizes are expected to underlie such associations.Peer reviewe
Peer support for people with severe mental illness versus usual care in high-, middle- A nd low-income countries: Study protocol for a pragmatic, multicentre, randomised controlled trial (UPSIDES-RCT)
No full text© 2020 The Author(s). Background: Peer support is an established intervention involving a person recovering from mental illness supporting others with mental illness. Peer support is an under-used resource in global mental health. Building upon comprehensive formative research, this study will rigorously evaluate the impact of peer support at multiple levels, including service user outcomes (psychosocial and clinical), peer support worker outcomes (work role and empowerment), service outcomes (cost-effectiveness and return on investment), and implementation outcomes (adoption, sustainability and organisational change). Methods: UPSIDES-RCT is a pragmatic, parallel-group, multicentre, randomised controlled trial assessing the effectiveness of using peer support in developing empowering mental health services (UPSIDES) at four measurement points over 1 year (baseline, 4-, 8- A nd 12-month follow-up), with embedded process evaluation and cost-effectiveness analysis. Research will take place in a range of high-, middle- A nd low-income countries (Germany, UK, Israel, India, Uganda and Tanzania). The primary outcome is social inclusion of service users with severe mental illness (N = 558; N = 93 per site) at 8-month follow-up, measured with the Social Inclusion Scale. Secondary outcomes include empowerment (using the Empowerment Scale), hope (using the HOPE scale), recovery (using Stages of Recovery) and health and social functioning (using the Health of the Nations Outcome Scales). Mixed-methods process evaluation will investigate mediators and moderators of effect and the implementation experiences of four UPSIDES stakeholder groups (service users, peer support workers, mental health workers and policy makers). A cost-effectiveness analysis examining cost-utility and health budget impact will estimate the value for money of UPSIDES peer support. Discussion: The UPSIDES-RCT will explore the essential components necessary to create a peer support model in mental health care, while providing the evidence required to sustain and eventually scale-up the intervention in different cultural, organisational and resource settings. By actively involving and empowering service users, UPSIDES will move mental health systems toward a recovery orientation, emphasising user-centredness, community participation and the realisation of mental health as a human right
The fate of carbon in a mature forest under carbon dioxide enrichment
No full textAtmospheric carbon dioxide enrichment (eCO2) can enhance plant carbon uptake and growth1 5, thereby providing an important negative feedback to climate change by slowing the rate of increase of the atmospheric CO2 concentration6. Although evidence gathered from young aggrading forests has generally indicated a strong CO2 fertilization effect on biomass growth3 5, it is unclear whether mature forests respond to eCO2 in a similar way. In mature trees and forest stands7 10, photosynthetic uptake has been found to increase under eCO2 without any apparent accompanying growth response, leaving the fate of additional carbon fixed under eCO2 unclear4,5,7 11. Here using data from the first ecosystem-scale Free-Air CO2 Enrichment (FACE) experiment in a mature forest, we constructed a comprehensive ecosystem carbon budget to track the fate of carbon as the forest responded to four years of eCO2 exposure. We show that, although the eCO2 treatment of +150 parts per million (+38 per cent) above ambient levels induced a 12 per cent (+247 grams of carbon per square metre per year) increase in carbon uptake through gross primary production, this additional carbon uptake did not lead to increased carbon sequestration at the ecosystem level. Instead, the majority of the extra carbon was emitted back into the atmosphere via several respiratory fluxes, with increased soil respiration alone accounting for half of the total uptake surplus. Our results call into question the predominant thinking that the capacity of forests to act as carbon sinks will be generally enhanced under eCO2, and challenge the efficacy of climate mitigation strategies that rely on ubiquitous CO2 fertilization as a driver of increased carbon sinks in global forests. © 2020, The Author(s), under exclusive licence to Springer Nature Limited
Author Correction: Multi-ancestry genome-wide association analyses improve resolution of genes and pathways influencing lung function and chronic obstructive pulmonary disease risk
No full textCorrection to: Nature Genetics, published online 13 March 2023. In the version of the article initially published, the sample sizes in the main text and Supplementary Tables 1 and 2 were incorrect. In the abstract, the last paragraph of the Introduction, the first paragraph of the Results, the top box in Figure 1a and the Supplementary Information, the total sample size has been corrected from 580,869 to 588,452 participants and the size of the European cohort from 468,062 to 475,645. Some of the effect sizes in Supplementary Table 14 (columns W, Z, AC, AF) had the wrong sign. There was also an error in Supplementary Table 3 where the sample size instead of the variant count was shown for EXCEED. The errors do not affect the conclusions of the study. Additionally, two acknowledgments for use of INTERVAL pQTL and Lung eQTL consortium data were omitted from the Supplementary Information. These errors have been corrected in the Supplementary Information and HTML and PDF versions of the article
