المؤلفون: Onyema Ogbuagu, Peter J Ruane, Daniel Podzamczer, Laura C Salazar, Keith Henry, David M Asmuth, David Wohl, Richard Gilson, Yongwu Shao, Ramin Ebrahimi, Stephanie Cox, Alexander Kintu, Christoph Carter, Moupali Das, Jared M Baeten, Diana M Brainard, Gary Whitlock, Jason M Brunetta, Gitte Kronborg, Christoph D Spinner, Andrea Antinori, Vanessa Apea, David Asmuth, Ann Avery, Paul Benson, Colm Bergin, Mezgebe Berhe, Indira Brar, Cynthia Brinson, Jason Brunetta, Jeffrey Burack, Thomas Campbell, Michelle Cespedes, Amanda Clarke, Megan Coleman, Josep Coll, Manuel Crespo Casal, Catherine Creticos, Gordon Crofoot, Frederick Cruickshank, Eric Cua, Eric Daar, Joseph de Wet, Edwin DeJesus, Jorge Del Romero Guerrero, William Dinges, Susanne Doblecki-Lewis, Taylor Donovan, Olamide Dosekun, Jason Flamm, Joel Gallant, Jan Gerstoft, Jay Gladstein, Robert Grant, Robert Grossberg, Bernhard Haas, Jason Halperin, W. David Hardy, Charles Hare, Shawn Hassler, Richard Hengel, William Henry, Theo Hodge, Sybil Hosek, Christopher Hurt, Michelle Iandiorio, Heiko Jessen, Stephen Kegg, Gabriele Knecht, Ivanka Krznaric, Anthony LaMarca, Carsten Schade Larsen, Olav Ditlevsen Larsen, Adriano Lazzarin, Clifford Leen, Christopher Lucasti, Patrick Mallon, Sharon Mannheimer, Martin Markowitz, Claudia Martorell, Kenneth Mayer, Anthony Mills, Jean-Michel Molina, Sheldon Morris, Karam Mounzer, Nneka Nwokolo, Olayemi Osiyemi, Andrew Petroll, Patrick Philibert, John Phoenix, Gilles Pialoux, Frank Post, Maria Prins, Moti Ramgopal, Bruce Rashbaum, Iain Reeves, Gary Richmond, Armin Rieger, Peter Ruane, Laura Salazar, Anthony Scarsella, Gabriel Schembri, Mia Scott, Peter Shalit, Gary Sinclair, Magdalena Sobieszczyk, Christoph Spinner, Jeffrey Stephens, Jason Szabo, Stephen Taylor, Melanie Thompson, Cecile Tremblay, Benoit Trottier, Gene Voskuhl, Barbara Wade, Kimberly Workowski, Sigal Yawetz, Benjamin Young

المساهمون: Infectious diseases, AII - Infectious diseases, APH - Global Health

المصدر: The Lancet HIV, 8(7), e397-e407. Elsevier Limited
DISCOVER study team 2021, ' Long-term safety and efficacy of emtricitabine and tenofovir alafenamide vs emtricitabine and tenofovir disoproxil fumarate for HIV-1 pre-exposure prophylaxis : week 96 results from a randomised, double-blind, placebo-controlled, phase 3 trial ', The Lancet HIV, vol. 8, no. 7, pp. e397-e407 . https://doi.org/10.1016/S2352-3018Test(21)00071-0

مصطلحات موضوعية: Adult, Male, 0301 basic medicine, medicine.medical_specialty, Anti-HIV Agents, Epidemiology, Immunology, Organophosphonates, HIV Infections, Emtricitabine, Placebo, Tenofovir alafenamide, law.invention, Young Adult, 03 medical and health sciences, Pre-exposure prophylaxis, 0302 clinical medicine, Pharmacotherapy, Double-Blind Method, Randomized controlled trial, law, Virology, Internal medicine, medicine, Humans, 030212 general & internal medicine, Tenofovir, Aged, Alanine, business.industry, Adenine, Incidence (epidemiology), virus diseases, Middle Aged, 030112 virology, Clinical trial, Treatment Outcome, Infectious Diseases, HIV-1, Drug Therapy, Combination, Female, Pre-Exposure Prophylaxis, business, Follow-Up Studies, medicine.drug

الوصف: Summary Background In DISCOVER, a multinational, randomised controlled trial, emtricitabine and tenofovir alafenamide compared with emtricitabine and tenofovir disoproxil fumarate showed non-inferior efficacy for HIV prevention and improved bone mineral density and renal safety biomarkers at week 48. We report outcomes analysed after all participants had completed 96 weeks of follow-up. Methods This study is an ongoing, randomised, double-blind, multicentre, active-controlled, phase 3, non-inferiority trial done at 94 community, public health, and hospital-associated clinics located in Europe and North America. Adult cisgender men and transgender women who have sex with men, both with a high risk of acquiring HIV as determined by self-reported sexual behaviour or recent sexually transmitted infections, were randomly assigned (1:1) to receive either emtricitabine and tenofovir alafenamide (200/25 mg) tablets daily, with matched placebo tablets (emtricitabine and tenofovir alafenamide group), or emtricitabine and tenofovir disoproxil fumarate (200/300 mg) tablets daily, with matched placebo tablets (emtricitabine and tenofovir disoproxil fumarate group). The primary efficacy outcome was incident HIV infection. Incidence of HIV-1 infection per 100 person-years was assessed when the last participant had completed 96 weeks of follow-up. This trial is registered with ClinicalTrials.gov , number NCT02842086 . Findings Between Sept 13, 2016, and June 30, 2017, 5387 participants were randomly assigned to receive emtricitabine and tenofovir alafenamide (n=2694) or emtricitabine and tenofovir disoproxil fumarate (n=2693), contributing 10 081 person-years of follow-up. At 96 weeks of follow-up, there were eight HIV infections in participants who had received emtricitabine and tenofovir alafenamide (0·16 infections per 100 person-years [95% CI 0·07–0·31]) and 15 in participants who had received emtricitabine and tenofovir disoproxil fumarate (0·30 infections per 100 person-years [0·17–0·49]). Emtricitabine and tenofovir alafenamide maintained its non-inferiority to emtricitabine and tenofovir disoproxil fumarate for HIV prevention (IRR 0·54 [95% CI 0·23–1·26]). Approximately 78–82% of participants reported taking study medication more than 95% of the time across all study visits. Rates of sexually transmitted infections remained high and similar across groups (21 cases per 100 person-years for rectal gonorrhoea and 28 cases per 100 person-years for rectal chlamydia). Emtricitabine and tenofovir alafenamide continued to show superiority over emtricitabine and tenofovir disoproxil fumarate in all but one of the six prespecified bone mineral density and renal biomarkers. There was more weight gain among participants who had received emtricitabine and tenofovir alafenamide (median weight gain 1·7 kg vs 0·5 kg, p Interpretation Emtricitabine and tenofovir alafenamide is safe and effective for longer-term pre-exposure prophylaxis in cisgender men and transgender women who have sex with men. Funding Gilead Sciences.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::303b5922ad83d78a448781b8c096428cTest
https://doi.org/10.1016/s2352-3018Test(21)00071-0

المؤلفون: Michael Hertl, Luca Scarsella, Rüdiger Eming, Dario Didona, Hazem A. Juratli

المصدر: European Journal of Dermatology. 30:229-242

مصطلحات موضوعية: medicine.medical_specialty, Paraneoplastic Syndromes, Dermatology, Dermatomyositis, Autoimmune Diseases, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Pathognomonic, medicine, Humans, Myopathy, Autoantibodies, 030203 arthritis & rheumatology, Skin manifestations, Myositis, business.industry, Autoantibody, Heliotrope rash, Prognosis, medicine.disease, Pityriasis rubra pilaris, medicine.symptom, Skin lesion, business

الوصف: Dermatomyositis belongs to a group of rare autoimmune diseases characterized by a variable degree of skin symptoms and myopathy. The clinically diagnostic hallmarks of dermatomyositis are heliotrope rash, Gottron's papules and weakness of the proximal muscles. Along with pathognomonic, characteristic, and compatible cutaneous features, several uncommon and rare skin manifestations have been reported. In addition, new skin lesions have been described in dermatomyositis patients. Furthermore, rare clinical subtypes of dermatomyositis have been reported in the literature, including Wong-type dermatomyositis, characterised by the coexistence of dermatomyositis and pityriasis rubra pilaris with hyperkeratotic, erythematous, follicular confluent papules on the back of the hands along the bony prominences. In addition, plenty of autoantibody subsets have been recently described that are related to distinct clinical features and systemic involvement, such as anti-MDA5 autoantibodies. We reviewed the English- and German-language scientific literature using the key words "dermatomyositis", "autoantibodies", and "clinical features", alone or in combination, focusing on particular cutaneous symptoms and their association with defined autoantibody profiles. Furthermore, we focused on rare subtypes of dermatomyositis, unusual clinical features, and recently described skin lesions.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::740ce685fbd75b067568c5a4dcbbc373Test
https://doi.org/10.1684/ejd.2020.3761Test

المؤلفون: Jean-Michel Molina, Kathleen Squires, Paul E Sax, Pedro Cahn, Johan Lombaard, Edwin DeJesus, Ming-Tain Lai, Anthony Rodgers, Lisa Lupinacci, Sushma Kumar, Peter Sklar, George J Hanna, Carey Hwang, Elizabeth Anne Martin, Debbie P. Hagins, Olayemi O. Osiyemi, David James Prelutsky, Moti N. Ramgopal, Anthony John Scarsella, Robin Dretler, Christopher J. Bettacchi, James Sims, Patrick G. Clay, Nicholaos C. Bellos, Melanie A. Thompson, Jose Montero, Cheryl K. McDonald, Catherine Creticos, David Shamblaw, Miguel Mogyoros, Antonio E. Terrelonge, Martin Valdes, Karen T. Tashima, William J. Robbins, Franco Antonio Felizarta, Richard A. Elion, Jihad Slim, Sandra S. Win, Sujata N. Lalla-Reddy, Peter Jerome Ruane, Anthony Mills, Jerry L. Cade, Craig A. Dietz, David Scott Rubin, Cynthia Mayer, Juan Carlos Rondon, Paul P. Cook, Eric Daar, Princy N. Kumar, Susan Swindells, Jose Guillermo Castro, Ivan Melendez-Rivera, Javier O. Morales-Ramirez, Lizette Santiago, Jorge L. Santana-Bagur, Marcelo Martins, Pedro Enrique Cahn, Gustavo D. Lopardo, Norma Porteiro, Mark Theo Bloch, David Alfred Baker, Norman Roth, Richard James Moore, Robert James Finlayson, James McMahon, Armin Rieger, Alexander Zoufaly, Sylvia Hartl, Robert Zangerle, Fiona Smaill, Sharon L. Walmsley, Brian Conway, Anita Rachlis, Graham H.R. Smith, Carlos Perez, Alejandro Afani, Maria Isabel Campos, Carolina Eugenia Chahin, Marcelo Wolff Reyes, Jan Gerstoft, Nina Weis, Alex Lund Laursen, Yazdan Yazdanpanah, Laurent Cotte, Francois Raffi, Philippe Morlat, Pierre-Marie Girard, Christine Katlama, Juergen K. Rockstroh, Keikawus Arasteh, Stefan Esser, Albrecht Stoehr, Hans-Juergen Stellbrink, Matthias Stoll, Dirk Schuermann, Gerd Faetkenheuer, Johannes Bogner, Thomas Lutz, Axel Baumgarten, Hans Jaeger, Andrea Gori, Gabriel Coltan, Felicia Constandis, Simona Manuela Erscoiu, Liviu-Jany Prisacariu, Sorin Rugina, Adrian Streinu-Cercel, Vadim Valentinovich Pokrovsky, Natalia V. Zakharova, Andrey Anatolyevich Shuldyakov, Elena Pavlovna Ryamova, Valeriy Viktorovich Kulagin, Olga Aleksandrovna Tsybakova, Elena Orlova-Morozova, Firaya Nagimova, Evgeniy Voronin, Tatyana Evgenyevna Shimonova, Oleg Anatolyevich Kozyrev, Catherine Orrell, Johannes Jurgens Lombaard, Marleen de Jager, Joaquin Portilla Segorb, Josep Mallolas, Maria Jesus Perez Elias, Josep M. Gatell, Jose Ramon Arribas Lopez, Eugenia Negredo Puigmal, Daniel Podzamczer Palter, Federico Pulido Ortega, Jesus Troya Garcia, Ignacio De los Santos Gil, Juan Berenguer Berenguer, Ian G. Williams, Margaret A. Johnson, Gabriel Schembri, Amanda Clarke, Mark Gompels, Julie Meriel Fox, Steven John Taylor, David Harold Dockrell, Stephen Kegg

المصدر: The Lancet HIV. 7:e16-e26

مصطلحات موضوعية: Adult, Male, 0301 basic medicine, medicine.medical_specialty, Anti-HIV Agents, Pyridones, Epidemiology, Immunology, Phases of clinical research, HIV Infections, Emtricitabine, law.invention, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Randomized controlled trial, Abacavir, law, Virology, Internal medicine, medicine, Humans, 030212 general & internal medicine, Darunavir, Ritonavir, Reverse-transcriptase inhibitor, business.industry, Lamivudine, Middle Aged, Triazoles, 030112 virology, Infectious Diseases, HIV-1, Female, business, medicine.drug

الوصف: Doravirine is a novel, non-nucleoside reverse transcriptase inhibitor that has shown non-inferior efficacy to ritonavir-boosted darunavir, with a superior lipid profile, in adults with HIV who were treatment naive at week 48 in the phase 3 DRIVE-FORWARD trial. Here we present the 96-week data for the study.This randomised, controlled, double-blind, multicentre, non-inferiority, phase 3 study was undertaken at 125 clinical centres in 15 countries. Eligible participants were adults (aged ≥18 years) infected with HIV-1 who were naive to antiretroviral therapy, with a plasma HIV-1 RNA concentration of 1000 copies per mL or higher at screening, and no known resistance to any of the study drugs. Participants were randomly assigned (1:1) using an interactive voice and web response system, stratified by baseline HIV-1 RNA concentration and background nucleoside reverse transcriptase inhibitor therapy, to doravirine (100 mg per day) or ritonavir-boosted darunavir (100 mg ritonavir and 800 mg darunavir per day), both with investigator-selected nucleoside reverse transcriptase inhibitors: emtricitabine and tenofovir disoproxil fumarate or abacavir and lamivudine. Participants and investigators were masked to treatment assignment until week 96. The primary efficacy endpoint was the proportion of participants who had a plasma HIV-1 RNA concentration of less than 50 copies per mL at week 48, which has been reported previously. Here we report the key secondary efficacy endpoint of the proportion of participants who achieved this concentration by week 96, assessed in all participants who received at least one dose of any study drug, regardless of whether it was their randomly assigned treatment. We used a US Food and Drug Administration snapshot approach and a margin of 10 percentage points to define the non-inferiority of doravirine to ritonavir-boosted darunavir at 96 weeks. Key safety endpoints were change in fasting serum lipid concentrations, the incidence of adverse events, and time to discontinuation due to an adverse event, assessed in all participants who received at least one dose of any study medication. This study is registered with ClinicalTrials.gov, NCT02275780, and is closed to accrual.Between Dec 1, 2014, and Oct 20, 2015, 1027 individuals were screened, of whom 769 participants were randomly assigned to doravirine (n=385) or ritonavir-boosted darunavir (n=384), and 383 in both groups were given at least one dose of their allocated treatment. Most participants were male (645 [84%] of 766) and white (560 [73%]), with a mean age of 35·2 years (SD 10·6). 292 participants in the doravirine group and 273 in the darunavir group completed 96 weeks of treatment. At week 96, a higher proportion of the doravirine group (277 [73%] of 383) achieved an HIV-1 RNA concentration of less than 50 copies per mL than did of the darunavir group (248 [66%] of 383; difference 7·1%, 95% CI 0·5-13·7). Responses were similar regardless of baseline characteristics. Treatment-emergent resistance to any study drug occurred in two (1%) of 383 participants in the doravirine group and one (1%) of 383 in the ritonavir-boosted darunavir group. Significant differences were seen between treatment groups in mean changes from baseline in LDL cholesterol (-14·6 mg/dL, 95% CI -18·2 to -11·0) and non-HDL cholesterol (-18·4 mg/dL, -22·5 to -14·3). Frequencies of adverse events were similar between groups. No significant treatment difference (log-rank nominal p=0·063) through week 96 was observed in time to discontinuation due to an adverse event. The most common adverse events (week 0-96) were diarrhoea (65 [17%] in the doravirine group vs 91 [24%] in the ritonavir-boosted darunavir group), nausea (45 [12%] vs 52 [14%]), headache (57 [15%] vs 46 [12%]), and upper respiratory tract infection (51 [13%] vs 30 [8%]). Two participants, one in each group, died during treatment; neither death was considered to be related to study medication.These results through 96 weeks support the efficacy and safety results reported previously for doravirine at 48 weeks, supporting the use of doravirine for the long-term treatment of adults with previously untreated HIV-1 infection.Merck.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8680b3078cd4f9be32d8a00724f02a77Test
https://doi.org/10.1016/s2352-3018Test(19)30336-4

المؤلفون: Monica Scarsella, Dolora Wisco, Meghan Purohit, Ken Uchino, Karlo Toljan

المصدر: Stroke. 52

مصطلحات موضوعية: Advanced and Specialized Nursing, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Arterial stenosis, Magnetic resonance imaging, Posterior reversible encephalopathy syndrome, medicine.disease, Cerebrovascular Circulation, Internal medicine, Angiography, medicine, Cardiology, Vasogenic cerebral edema, Neurology (clinical), Cardiology and Cardiovascular Medicine, business

الوصف: Objectives: Posterior Reversible Encephalopathy Syndrome (PRES) is characterized as reversible vasogenic cerebral edema in a posterior-dominant distribution. Some patients with PRES have diffusion-weighted imaging (DWI) changes on MRI, as well as transient arterial stenosis. We examined the association between arterial stenosis and presence of hemorrhage and MRI-DWI changes in PRES. Methods: We retrospectively identified patients with PRES in electronic health records at a single health system from January 2008 to December 2018. We included patients age 18 years or older with clinical and radiographic evidence of PRES and arterial imaging (CT or MR angiography or digital subtraction angiogram). Any arterial stenosis was noted, with reversibility determined by repeat imaging. Patient characteristics, disease presentation, hospital lengths of stay and discharge dispositions, as well as imaging findings were collected and statistical analysis was used. Results: Of 281 patients with PRES, 169 had arterial imaging. Thirty-two (18.9%) had arterial stenosis and 60% had resolved arterial stenosis on follow-up imaging. Patients with arterial stenosis were younger compared to those without (47 v 55 years, p =0.03), however they did not differ in symptoms of presentation or comorbid conditions. Of note, arterial stenosis was associated with intracerebral hemorrhage[34% with stenosis and 18% without stenosis, p=0.05). However, the presence of MRI DWI lesions did not correlate with arterial stenosis [14/32 (44%) with stenosis, 49/137 (36%) without stenosis, p=0.42]. Among 97 patients with follow-up MRI, the presence of arterial stenosis was not associated with greater FLAIR reversibility. Furthermore, hospital length of stay or discharge disposition was not associated with arterial stenosis in PRES. Conclusions: Arterial stenoses are found in 19% of PRES patients, and most are reversed on follow-up imaging. They are also associated with hemorrhagic PRES, but not with MRI-DWI lesions or degree of FLAIR reversibility.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::47990cb64687915fd5b960da5f775d78Test
https://doi.org/10.1161/str.52.suppl_1.p570Test

المؤلفون: Meghan Purohit, Ken Uchino, Monica Scarsella, Karlo Toljan, Dolora Wisco

المصدر: Stroke. 52

مصطلحات موضوعية: Advanced and Specialized Nursing, medicine.medical_specialty, business.industry, Posterior reversible encephalopathy syndrome, medicine.disease, Cerebrovascular Circulation, Reversible cerebral vasoconstriction syndrome, Pathophysiology, Internal medicine, medicine, Cardiology, Neurology (clinical), medicine.symptom, Cardiology and Cardiovascular Medicine, business, Stroke, Vasoconstriction

الوصف: Introduction: Posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS) might represent a pathophysiological spectrum. They are commonly diagnosed separately, based on prominent clinical features. We aimed to compare clinical and radiographic findings of PRES and RCVS. Methods: We performed a retrospective study of adult patients admitted to a tertiary medical center from February 2008 until February 2018 and were diagnosed with PRES or RCVS. Patient demographics, risk factors, clinical features, imaging, and outcomes were compared. Appropriate statistical tests were used to compare the variables and significant findings are reported. Results: There were 281 PRES and 98 RCVS cases meeting diagnostic criteria. Seizures, encephalopathy, and hypertension were more common with PRES, whereas headache was more common with RCVS (p Conclusion: PRES and RCVS share common clinical characteristics and might represent a pathophysiological spectrum, though distinct clinical features were noted in our retrospective analysis.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::481879c025439af7bcaa8e93e265c3a7Test
https://doi.org/10.1161/str.52.suppl_1.p578Test

المؤلفون: Stefan Mühlenbein, Thomas Schmidt, Michael Hertl, Farzan Solimani, Rüdiger Eming, Robert Pollmann, Milad Fehresti, Lily Holiangu, Vera Korff, Dario Didona, Luca Scarsella, Josquin Pieper, Hazem A. Juratli, Cassian Sitaru, Manuel Göbel

المصدر: Frontiers in Immunology, Vol 12 (2021)
Frontiers in Immunology

مصطلحات موضوعية: 0301 basic medicine, lcsh:Immunologic diseases. Allergy, Pemphigoid, Enzyme-Linked Immunospot Assay, pemphigoid, Dystonin, T cell, Immunology, BP180, T cells, medicine.disease_cause, Peripheral blood mononuclear cell, Autoantigens, Autoimmunity, Cohort Studies, Ointments, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Pemphigoid, Bullous, medicine, Immunology and Allergy, Humans, Glucocorticoids, Original Research, Aged, Autoantibodies, Clobetasol, integumentary system, business.industry, ELISPOT, autoimmunity, Autoantibody, T helper cell, T-Lymphocytes, Helper-Inducer, Non-Fibrillar Collagens, pruritus, medicine.disease, 030104 developmental biology, medicine.anatomical_structure, ELISpot assay, Immunoglobulin G, Cytokines, Th17 Cells, Bullous pemphigoid, business, lcsh:RC581-607

الوصف: Bullous pemphigoid (BP) is a prototypic autoimmune disorder of the elderly, characterized by serum IgG autoantibodies, namely anti-BP180 and anti-BP230, directed against components of the basal membrane zone that lead to sub-epidermal loss of adhesion. Pruritus may be indicative of a pre-clinical stage of BP, since a subset of these patients shows serum IgG autoantibodies against BP230 and/or BP180 while chronic pruritus is increasingly common in the elderly population and is associated with a variety of dermatoses. Clinical and experimental evidence further suggests that pruritus of the elderly may be linked to autoimmunity with loss of self-tolerance against cutaneous autoantigens. Thus, the objective of this study was to determine autoreactive T cell responses against BP180 in elderly patients in comparison to patients with BP. A total of 22 elderly patients with pruritic disorders, 34 patients with bullous or non-bullous BP and 34 age-matched healthy controls were included in this study. The level of anti-BP180 and anti-BP230 IgG serum autoantibodies, Bullous Pemphigoid Disease Area Index (BPDAI), and pruritus severity were assessed for all patients and controls. For characterization of the autoreactive T cell response, peripheral blood mononuclear cells were stimulated ex vivo with recombinant BP180 proteins (NH2- and COOH-terminal domains) and the frequencies of BP180-specific T cells producing interferon-γ, interleukin (IL)-5 or IL-17 were subsequently determined by ELISpot assay. Patients with BP showed a mixed Th1/Th2 response against BP180 while autoreactive Th1 cells were identified in a minor subset of elderly patients with pruritic disorders. Furthermore, our T cell characterization revealed that therapeutic application of topical clobetasol propionate ointment in BP patients significantly reduced peripheral blood BP180-specific T cells, along with clinically improved symptoms, strongly suggesting a systemic immunosuppressive effect of this treatment.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::633503a1965bf558d2473cbd9b5c0e11Test
https://www.frontiersin.org/articles/10.3389/fimmu.2021.569287/fullTest

المؤلفون: Naresh Mullaguri, Karlo Toljan, Ken Uchino, Monica Scarsella, Meghan Purohit, Dolora Wisco

المصدر: Stroke. 52

مصطلحات موضوعية: Advanced and Specialized Nursing, medicine.medical_specialty, business.industry, Internal medicine, Cardiology, Medicine, Posterior reversible encephalopathy syndrome, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, medicine.disease, Reversible cerebral vasoconstriction syndrome

الوصف: Introduction: Posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS) are diagnoses that have a clinical and radiographic overlap. One particular overlap includes the presence of hemorrhage, which we studied in each population to determine its effect on outcomes. Objective: To compare characteristics and outcomes of hemorrhagic PRES and hemorrhagic RCVS populations. Methods: We conducted a review of the electronic health record at a single tertiary center from January 2008 to December 2018. Inclusion criteria were 18 years or older with clinical and radiographic evidence of PRES or RCVS. Patient demographics, presenting symptoms, imaging findings, and outcomes were compared between PRES and RCVS groups. Poor outcome was defined as discharge to skilled nursing facility or death. Analysis was performed using Pearson’s Chi-Square test. Results: Among 281 PRES and 98 RCVS cases, intracranial hemorrhage was seen on imaging in 51 PRES cases (18%) and 34 RCVS cases (35%). Headache was present in all patients with hemorrhagic RCVS but only seen in 40% of hemorrhagic PRES. Use of antidepressants or drugs of abuse was more frequent with hemorrhagic RCVS (53%) as compared to hemorrhagic PRES (7%, p Conclusion: Hemorrhage in PRES and RCVS is associated with more clinical deficits at presentation and longer hospital stays. Underlying vasoconstriction is frequent and associated with hemorrhagic PRES.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::bacd8f9dc9b7b860dba5d688360e6199Test
https://doi.org/10.1161/str.52.suppl_1.p460Test

المؤلفون: Alex Alongi, David W. Dougherty, Stephanie Buia Amport, Lauren M. Hamel, Chintan Pandya, Elizabeth Scarsella, Tammy Clarke

المصدر: J Oncol Pract

مصطلحات موضوعية: Patient Transfer, Quality management, MEDLINE, Nurse's Role, 03 medical and health sciences, Patient safety, 0302 clinical medicine, Neoplasms, medicine, Electronic Health Records, Humans, Transitional care, 030212 general & internal medicine, Patient transfer, Health communication, Quality of Health Care, Oncology (nursing), business.industry, Health Policy, Patient Handoff, Electronic medical record, Transitional Care, medicine.disease, Quality Improvement, Health Communication, Oncology, Health Care Surveys, 030220 oncology & carcinogenesis, Quality in Action, Interdisciplinary Communication, Medical emergency, business, Delivery of Health Care

الوصف: PURPOSE: Ineffective handoffs contribute to gaps in patient care and medication errors, which jeopardize patient safety and lead to poor-quality care. The project aims are to develop and implement a standardized handoff process using an electronic medical record (EMR)–based tool to ensure optimal communication of treatment-related information for patients receiving cancer treatment between oncology nurses. METHODS: A multidisciplinary team convened to develop a standard and safe treatment handoff process. The intervention was developed over a series of phases using Plan-Do-Study-Act methodology, including current workflow process mapping; identifying gaps, limitations, and potential causes of ineffective handoffs; and prioritizing these using a Pareto chart. An EMR-based tool incorporating a standardized treatment handoff process was developed. Study outcomes included proportion of handoff-related medication errors, tool utilization, handoff completion, patient waiting time, and nurse satisfaction with tool. All outcomes were evaluated before and after the intervention over a 1-year period. RESULTS: The proportion of medication errors as a result of ineffective handoffs was reduced from 10 of 17 (60%) pre-intervention to 11 of 34 (32%) postintervention ( P = .07). The EMR-based handoff tool was used in 9,274 of 10,910 (85%) patient treatment visits, and the handoff completion rate increased from 32% pre-intervention to 86% postintervention. Patient waiting time showed an average reduction of 2 minutes/patient/month. A majority of nurses reported that the new tool conveyed necessary information (85% of nurses) and was effective in preventing errors (81% of nurses). CONCLUSION: Multidisciplinary stakeholders guided the development and implementation of a standard handoff process and an EMR-based tool to optimize communication between nurses during patient transition. The intervention was associated with a reduction in the proportion of medication errors as the result of ineffective handoffs. In addition, the intervention improved communication between nurses.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b7fec150a909ac7fea74ce86980d7c88Test
https://doi.org/10.1200/jop.18.00245Test

المؤلفون: Marta Ciofi Degli Atti, Alberto Villani, Eva Piano Mortari, Annapaola Santoro, Christian Albano, Massimiliano Raponi, Rossana Scutari, Sara Terreri, Salvatore Zaffina, Cristina Russo, Vincenzo Camisa, Marco Scarsella, Claudia Alteri, Franco Locatelli, Rita Carsetti, Nicola Magnavita, Rita Brugaletta, Giulia Linardos, Carlo Federico Perno, Maria Vinci, Luna Colagrossi, Gloria Deriu, Caterina Rizzo

المصدر: SSRN Electronic Journal.

مصطلحات موضوعية: History, Saliva, Polymers and Plastics, biology, business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Industrial and Manufacturing Engineering, Vaccination, medicine.anatomical_structure, Antigen, Immunity, Immunology, biology.protein, Medicine, Waning immunity, Business and International Management, Antibody, business, B cell

الوصف: Background: Breakthrough infections in fully vaccinated HCWs are considered a marker of waning immunity. Serum antibodies represent the most visible and measurable outcome of vaccine-induced B-cell memory. When antibodies decline, memory B cells are expected to persist and perform their function, thus preventing clinical disease. We investigated whether BNT162b2 mRNA vaccine induces durable and in vivo functional B-cell memory against SARS-CoV-2 3, 6 and 9 months after the second dose. Methods: We assessed the duration of SARS-CoV-2 vaccine-induced immunity by measuring specific antibodies and memory B cells 3, 6 and 9 months after vaccination. In fully vaccinated HCWs with breakthrough SARS-CoV-2 infections, we evaluated the humoral and mucosal response of vaccine-induced memory B cells. Findings: Whereas specific serum antibodies decline, anti-Spike memory B cells continue to increase until 9 months after the last vaccine dose. HCWs with breakthrough infections had no signs of waning immunity on the day of the first positive swab. In 3-4 days, memory B cells responded to SARS-CoV-2 infection by producing high levels of specific antibodies in the serum. In the saliva, anti-Spike IgA also rapidly increased in response to the infection. Antibodies to the viral nucleoprotein were produced with the slow kinetics typical of the response to a novel antigen. Interpretation: SARS-CoV-2 specific antibodies physiologically decline months after vaccination. By contrast, memory B cells persist and increase over time. Parenteral administered vaccines do not generate mucosal immunity and serum antibodies reach mucosal sites in small amounts by transudation. In HCWs with SARS-CoV-2 breakthrough infections, memory B cells react by rapidly differentiating into antibody-producing cells and generating IgA for protection of mucosal sites. Funding Information: Italian Ministry of Health COVID-2020-12371817 grant and Ricerca Corrente 2021 “5 per mille”. Declaration of Interests: All authors declare no competing interests. Ethics Approval Statement: Ethics Committee of Bambino Gesu Children Hospital, Rome, Italy, Ethical approved the study. The study was performed in accordance with the Good Clinical Practice guidelines, the International Conference on Harmonization guidelines, and the most recent version of the Declaration of Helsinki.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::b34ac77ed7d7ce0c44aca21f3cbb4d47Test
https://doi.org/10.2139/ssrn.3956432Test

المؤلفون: Antonella Paladini, Roberto Casale, Zaira Symeonidou, Fabrizio Micheli, Paolo Scarsella, Sofia Ferfeli

مصطلحات موضوعية: Psychotherapist, phenylalanine, Metalloporphyrins, Pain medicine, media_common.quotation_subject, Pain relief, Food for pain, Food for medical purposes, Selenium, Nutraceutical, carnitine), Perception, medicine, Fatty acids (resolvines, Amino acids (tryptophan, Magnesium, media_common, PEA), Vitamins, business.industry, Perspective (graphical), Chronic pain, medicine.disease, Anesthesiology and Pain Medicine, Narrative review, Neurology (clinical), business

الوصف: The present paper focuses on the possible contribution of food compounds to alleviate symptomatic pains. Chronic pain can more easily be linked to anticipatory signals such as thirst and hunger than it is to sensory perceptions as its chronicity makes it fall under the behavioural category rather than it does senses. In fact, pain often negatively affects one’s normal feeding behavioural patterns, both directly and indirectly, as it is associated with pain or because of its prostrating effects. Several nutraceuticals and Foods for Special Medical Purposes (FSMPs) are reported to have significant pain relief efficacy with multiple antioxidant and anti-inflammatory properties. Apart from the aforementioned properties, amino acids, fatty acids, trace elements and vitamins may have a role in the modulation of pain signals to and within the nervous system. In our opinion, this review could be of great interest to clinicians, as it offers a complementary perspective in the management of pain. Trials with well-defined patient and symptoms selection and a robust pharmacological design are pivotal points to let these promising compounds become better accepted by the medical community.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::86b8eb56904c8a49eba4f62c42ec2d1dTest
http://hdl.handle.net/11697/159522Test