112 research outputs found
Lymphocytes and liver fibrosis in HIV & HCV coinfection
No full textCoinfection with HIV has an important impact on immunity against hepatitis C virus (HCV). In the present dissertation, phenotypes of lymphocytes derived from the peripheral blood of HCV-infected patients were studied into detail, with special attention to changes in phenotype of lymphocytes associated with HIV-coinfection and liver fibrosis. HCV-infection was associated with increased apoptosis of T lymphocytes in comparison to healthy controls. HCV-infection was also associated with increased cell activation and exhaustion of T lymphocytes and this was correlated to the level of HCV-viraemia, suggesting that HCV directly causes non-specific T cell activation and exhaustion in the periphery. T lymphocyte apoptosis, activation and exhaustion were independent of liver fibrosis. Together these findings suggest that, if left untreated, HCV might on long term contribute to dysfunction of T lymphocytes through non-specific immune activation, even in the absence of liver fibrosis. Coinfection with HIV was associated with even higher levels of peripheral T lymphocyte activation than HCV monoinfection. Natural killer (NK) cells are a type of lymphocytes belonging to the innate immune system. Of the NK cell subsets, the CD56dim NK cells have generally been considered as the primarily cytotoxic subset, whereas CD56bright NK cells are thought to merely exert cytokine-producing activity. Surprisingly, Feuth et al demonstrate that CD56bright NK cells typically display high levels of the cytotoxic molecule FasL on their surface. Furthermore, chronic infection with HCV is associated with upregulation of FasL as well as with the cytotoxic molecules granzyme B and perforin. Liver fibrosis has traditionally been diagnosed by liver biopsy, an invasive method with rare but severe complications. Transient elastography has recently been implemented as an non-invasive measurement for liver fibrosis. A retrospective analysis, presented in this dissertation, demonstrated that transient elastography has major clinical impact on clinical decision-making concerning treatment and follow-up of patients with viral hepatitis. Lastly, the CD4/CD8 T cell ratio was identified as an alternative non-invasive marker for liver fibrosis in HCV monoinfection. If this finding is to be confirmed in larger studies, the marker might be of value especially in settings where transient elastography is not available. Altogether, the studies presented in this dissertation shed new light on regulation of innate and adaptive immunity in HCV monoinfection and HIV-HCV coinfection and identify CD4/CD8 T cell ratio as a promising non-invasive marker of liver fibrosis in HCV monoinfection
Guideline implementation results in a decrease of pressure ulcer incidence in critically ill patients
No full textObjective: To describe the short-term and long-term effects ofa hospital-wide pressure ulcer prevention and treatment guidelineon both the incidence and the time to the onset of pressure ulcersin critically ill patients.Design: Prospective cohort study.Setting: Adult intensive care department of a university medicalcenter.Patients: Critically ill patients (n ? 399).Interventions: A guideline for pressure ulcer care was implementedon all intensive care units. The attention of nurses fortimely transfer to a specific pressure-reducing device was animportant part of this guideline.Measurements and Main Results: Patient characteristics, demographics,pressure ulcer risk profile at admission, daily pressureulcer grading, and type of mattress were determined todescribe the short-term and long-term effects 3 and 12 monthsafter the implementation. The incidence density of pressure ulcersgrade II–IV decreased from 54 per 1000 patient days at baselineto 32 per 1000 days (p ? .001) 12 months after the implementation.The median pressure ulcer-free time increased from 12 daysto 19 days (hazard rate ratio, 0.58; p ? .02). After adjustment fordifferences in risk factors in a Cox proportional hazard model, thenumber of preventive transfers to special mattresses was thestrongest indicator for the decreased risk of pressure ulcers(hazard rate ratio, 0.22; p < .001). The number needed to treat toprevent one pressure ulcer during the first 9 days was six.Conclusions: The implementation of a guideline for pressureulcer care resulted in a significant and sustained decrease inthe development of grade II–IV pressure ulcers in critically illpatients. Timely transfer to a specific mattress (i.e., transferbefore the occurrence of a pressure ulcer) was the mainindicator for a decrease in pressure ulcer development
The shroud in Omeros and Catullus 64: Derek Walcott as poeta novus
No full textNWOClassics and Classical Civilizatio
Interactions between sleep, inflammation, immunity and infections: A narrative review
No full textBackground: Over the past decades, it has become increasingly evident thatsleep disturbance contributes to inflammation‐mediated disease, includingdepression, mainly through activation of the innate immune system and to anincreased risk of infections.Methods: A comprehensive literature search was performed in PubMed toidentify relevant research findings in the field of immunity, inflammation andinfections, with a focus on translational research findings from the past5 years.Results: Physiological sleep is characterized by a dynamic interplay betweenthe immune system and sleep architecture, marked by increased innateimmunity and T helper 1 (Th1) ‐mediated inflammation in the early phase,transitioning to a T helper 2 (Th2) response dominating in late sleep. Chronicsleep disturbances are associated with enhanced inflammation and an elevatedrisk of infections, while other inflammatory diseases may also be affected.Conversely, inflammation in response to infection can also disrupt sleep pat-terns and architecture. This narrative review summarizes current data on thecomplex relationships between sleep, immunity, inflammation and infections,while highlighting translational aspects. The bidirectional nature of these in-teractions are addressed within specific conditions such as sleep apnea, HIV,and other infections. Furthermore, technical developments with the potentialto accelerate our understanding of these interactions are identified, includingadvances in wearable devices, artificial intelligence, and omics technology. Byintegrating these tools, novel biomarkers and therapeutic targets for sleep‐related immune dysregulation may be identified.Conclusion: The review underscores the importance of understanding andaddressing immune imbalance related to sleep disturbances to improve diseaseoutcomes.K E Y W O R D Scytokines, immunity, infections, inflammation, interleukin‐1, long‐COVID, parasiticinfections, sleep, sleep apnea, TNF, viral infectionsImmun </p
Transition zone prostate cancer: detection and localization with 3-T multiparametric MR imaging
No full textContains fulltext :
117880.pdf (Publisher’s version ) (Open Access)PURPOSE: To retrospectively compare transition zone (TZ) cancer detection and localization accuracy of 3-T T2-weighted magnetic resonance (MR) imaging with that of multiparametric (MP) MR imaging, with radical prostatectomy specimens as the reference standard. MATERIALS AND METHODS: The informed consent requirement was waived by the institutional review board. Inclusion criteria were radical prostatectomy specimen TZ cancer larger than 0.5 cm(3) and 3-T endorectal presurgery MP MR imaging (T2-weighted imaging, diffusion-weighted [DW] imaging apparent diffusion coefficient [ADC] maps [b .05). CONCLUSION: Use of 3-T MP MR imaging, consisting of T2-weighted imaging, DW imaging ADC maps (b values, 50, 500, and 800 sec/mm(2)), and DCE MR imaging may not improve TZ cancer detection and localization accuracy compared with T2-weighted imaging. SUPPLEMENTAL MATERIAL: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120281/-/DC1
The poet and the underworld: metaliterary katabasis in Eavan Boland's 'The Journey', Derek Walcott's Omeros, and Gloria Naylor's Linden Hills
No full textThis thesis compares the uses of the classical underworld descent, or katabasis, in three contemporary English-language authors, women and/or Black writers, as an instrument to express their poetics. It focuses on one central text from each author, contextualizing its use of katabasis within the author's larger oeuvre. For this analysis, use has been made of Conceptual Metaphor Theory and cognitive theory of allegory, theories of metaliterature and intertextuality, and transgeneric narratology. Katabasis has proven to hold a central position in the oeuvre of all three authors, albeit in very different ways. In the work of Boland and Naylor, the motif is omni-present. Boland maps katabasis onto the moment of poetic creativity, in which access to the female underworld is attempted, but nevertheless remains barred. Naylor's work combines the various regions of Dante's afterlife with western esotericism, offering a somewhat happier prospect for women and writing. For Walcott, on the other hand, katabasis is omni-present in his magnum opus Omeros only, and is applied as a final reckoning with his literary critics. Thus, for all three authors katabasis has proven to be used as an instrument to appropriate the western literary canon and to define their poetics.</p
The poet and the underworld: metaliterary katabasis in Eavan Boland's 'The Journey', Derek Walcott's Omeros, and Gloria Naylor's Linden Hills
No full textThis thesis compares the uses of the classical underworld descent, or katabasis, in three contemporary English-language authors, women and/or Black writers, as an instrument to express their poetics. It focuses on one central text from each author, contextualizing its use of katabasis within the author's larger oeuvre. For this analysis, use has been made of Conceptual Metaphor Theory and cognitive theory of allegory, theories of metaliterature and intertextuality, and transgeneric narratology. Katabasis has proven to hold a central position in the oeuvre of all three authors, albeit in very different ways. In the work of Boland and Naylor, the motif is omni-present. Boland maps katabasis onto the moment of poetic creativity, in which access to the female underworld is attempted, but nevertheless remains barred. Naylor's work combines the various regions of Dante's afterlife with western esotericism, offering a somewhat happier prospect for women and writing. For Walcott, on the other hand, katabasis is omni-present in his magnum opus Omeros only, and is applied as a final reckoning with his literary critics. Thus, for all three authors katabasis has proven to be used as an instrument to appropriate the western literary canon and to define their poetics.NWOModern and Contemporary Studie
Op deugdelijke grondslag. Een explorerende studie naar de private forensische accountancy
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