Academic literature on the topic '949.522 007 4'

ABSTRACTFaecal egg counts, haematocrits, erythrocyte potassium contents and serum iron concentrations were determined in 1005, 3- to 5-month-old Merino lambs infected with a single dose of 11 000 Haemonchus contortus larvae. Live-weight gain and wool growth also were recorded. Lambs were infected in six different groups over a 3-year period. When infections were terminated after 5 weeks, faecal egg counts in the six infected groups had reached a peak of 5170 to 20 339 eggs per g (average 12 909), haematocrits had declined to between 196 and 309 ml/1 (average 233), erythrocyte potassium contents had risen to between 16·7 and 37·5 mequiv. per 1 (average 31·5) and serum iron concentrations, in some cases following an erratic course, had dropped to between 0·512 and 1·546 mg/1 (average 0·946).Of the three haematological parameters, haematocrit correlated best with faecal egg count (r = 0·7 in four of six infected groups). However, in two groups with low faecal egg counts this correlation was much lower (r = 0·3). Erythrocyte potassium concentration and serum iron concentration significantly correlated with variability of haematocrit not accounted for by faecal egg count, suggesting that both erythropoiesis and iron availability influence the degree of anaemia.The effect of H. contortus infection on productivity of lambs was best predicted by haematocrits: for each further 0·01 proportional decrease in haematocrit, a 0·03 reduction of live-weight gain over a 9-week post-infection period, a 0·007 reduction in clean wool growth and a 0·004 reduction in fibre diameter over a 4- to 9-week period were observed. Some evidence was obtained indicating a tolerance level of anaemia at approximately 280 ml/1 packed cell volume.

Abstract Introduction: Although sleep disturbances, anxiety, and sadness are some of the most common symptoms in patients with chronic anemia, there is little knowledge about sleep structures in patients with chronic anemia such as thalassemia. The aim of this study is to investigate sleep structure in patients with beta-thalassemia minor. Methods: Seventeen drug free subjects with beta-thalassemia minor and age-matched healthy subjects were enrolled in the study. The patients were diagnosed by complete blood count including reticulocyte count and hemoglobin electrophoresis. In addition, blood smear, erythrocyte sedimentation rate, serum level of urea, creatinine, indirect bilirubin, lactate dehydrogenase, ferritin, folate, vitamin B12, and thyroid hormones were determined. The other causes of anemia were ruled out. Subjects also were screened for excessive daytime sleepiness with the Epworth sleepiness scale, and for insomnia using insomnia severity index. All subjects slept in laboratory for two consecutive nights. First night served as adjustment nights. The second night results were used for analysis. Their sleep patterns were compared with healthy normal controls. Sleep was recorded and scored according to the criteria of Rechtschafffen and Kales. Results: Four female and thirteen male patients (mean age, 26.1 ± 5.9 years) completed both nights of sleep recordings. In patients groups, one patient complained snoring and daytime sleepiness. Nine of them complained daytime weakness. Ten patients were anemic (Hb < 13,2 g/dL for men, <11,7 g/dL for women). In polysomnographic investigation, the patients with β-thalassemia minor showed increased total sleep time, sleep period time, PLM index and the increased percentage of REM sleep. The percentage of stage 4, and REM latency are decreased. Sleep fragmentation and periodic leg movement syndrome (PLMS) have been reported. Conclusion: The disturbances of sleep continuity was prominent finding in this polysomnographic study. They also showed decreased REM latency and the increased percentage of REM sleep, although they didn’t have major depressive disorders. Polysomnographic variables in patients with beta-thalassemia minor Polysomnographic variables Thalassemia (n: 17) Normal Controls (n: 17) Results (P value) NS: not sinificant, REM: rapid eye movement, PLM: periodic leg movement Sleep effiency 90.8±4.6 93.7±2.1 NS Total time in bed (min) 467.6±60.1 415.1±51.1 .008 Total sleep time (min) 425.8.4±65.1 388.5±49.2 .031 Sleep period time (min) 453.2.4±62.0 404.4±52.2 .012 Sleep latency (min) 9.9±9.0 8.2±5.2 NS Percentage of stage 1 (SPT) 2.5±1.0 1.8±1.1 NS Percentage of stage 2 (SPT) 61.9±6.9 64.1±7.3 NS Percentage of stage 3 (SPT) 4.8±1.9 6.5±2.4 NS Percentage of stage 4 (SPT) 8.0±6.4 12.2±6.1 .022 Percentage of stage REM (SPT) 16.3±3.8 12.5±3.4 .006 REM latency 67.9±25.0 96.8±32.5 .016 PLM index 7.4 ± 5.7 0.0 .000

Abstract Three chimpanzees experimentally infected with human immunodeficiency virus (HIV) developed significant chronic thrombocytopenia after 5, 4, and 2 years, with peripheral platelet counts averaging 64 ± 19 × 103/μL (P = .004 compared with 228 ± 92 × 103/μL in 44 normal control animals), mean platelet volumes of 11.2 ± 1.8 fL (P &gt; .5 compared with 10.9 ± 0.7 fL in normal controls), endogenous thrombopoietin (TPO) levels of 926 ± 364 pg/mL (P &lt; .001 compared with 324 ± 256 pg/mL in normal controls), uniformly elevated platelet anti-glycoprotein (GP) IIIa49-66 antibodies, and corresponding viral loads of 534, 260, and 15 × 103 RNA viral copies/mL. Pegylated recombinant human megakaryocyte growth and development factor (PEG-rHuMGDF) was administered subcutaneously (25 μg/kg twice weekly for 3 doses) to determine the effects of stimulating platelet production on peripheral platelet concentrations in this cohort of thrombocytopenic HIV-infected chimpanzees. PEG-rHuMGDF therapy increased (1) peripheral platelet counts 10-fold (from 64 ± 19 to 599 ± 260 × 103 platelets/μL;P = .02); (2) marrow megakaryocyte numbers 30-fold (from 11.7 ± 6.5 × 106/kg to 353 ± 255 × 106/kg;P = .04); (3) marrow megakaryocyte progenitor cells fourfold (from a mean of 3.6 ± 0.6 to 14.1 × 103 CFU-Meg/1,000 CD34+ marrow cells); and (4) serum levels of Mpl ligand from 926 ± 364 pg/mL (endogenous TPO) to predosing trough levels of 1,840 ± 353 pg/mL PEG-rHuMGDF (P = .02). The peripheral neutrophil counts were also transiently increased from 5.2 ± 2.6 × 103/μL to 9.9 ± 5.0 × 103/μL (P= .01), but neither the erythrocyte counts nor the reticulocyte counts were altered significantly (P &gt; .1). The serum levels of antiplatelet GPIIIa49-66 antibodies exhibited reciprocal reductions during periods of thrombocytosis (P &lt; .07). PEG-rHuMGDF therapy did not increase viral loads significantly (395, 189, and 53 × 103 RNA viral copies/mL; P &gt; .5 compared with baseline values). The striking increase in peripheral platelet counts produced by PEG-rHuMGDF therapy implies that thrombocytopenia in HIV-infected chimpanzees is attributable to insufficient compensatory expansion in platelet production resulting from HIV-impaired delivery of platelets despite stimulated megakaryocytopoiesis. These data suggest that PEG-rHuMGDF therapy may similarly correct peripheral platelet counts in thrombocytopenic HIV-infected patients.

Three chimpanzees experimentally infected with human immunodeficiency virus (HIV) developed significant chronic thrombocytopenia after 5, 4, and 2 years, with peripheral platelet counts averaging 64 ± 19 × 103/μL (P = .004 compared with 228 ± 92 × 103/μL in 44 normal control animals), mean platelet volumes of 11.2 ± 1.8 fL (P > .5 compared with 10.9 ± 0.7 fL in normal controls), endogenous thrombopoietin (TPO) levels of 926 ± 364 pg/mL (P < .001 compared with 324 ± 256 pg/mL in normal controls), uniformly elevated platelet anti-glycoprotein (GP) IIIa49-66 antibodies, and corresponding viral loads of 534, 260, and 15 × 103 RNA viral copies/mL. Pegylated recombinant human megakaryocyte growth and development factor (PEG-rHuMGDF) was administered subcutaneously (25 μg/kg twice weekly for 3 doses) to determine the effects of stimulating platelet production on peripheral platelet concentrations in this cohort of thrombocytopenic HIV-infected chimpanzees. PEG-rHuMGDF therapy increased (1) peripheral platelet counts 10-fold (from 64 ± 19 to 599 ± 260 × 103 platelets/μL;P = .02); (2) marrow megakaryocyte numbers 30-fold (from 11.7 ± 6.5 × 106/kg to 353 ± 255 × 106/kg;P = .04); (3) marrow megakaryocyte progenitor cells fourfold (from a mean of 3.6 ± 0.6 to 14.1 × 103 CFU-Meg/1,000 CD34+ marrow cells); and (4) serum levels of Mpl ligand from 926 ± 364 pg/mL (endogenous TPO) to predosing trough levels of 1,840 ± 353 pg/mL PEG-rHuMGDF (P = .02). The peripheral neutrophil counts were also transiently increased from 5.2 ± 2.6 × 103/μL to 9.9 ± 5.0 × 103/μL (P= .01), but neither the erythrocyte counts nor the reticulocyte counts were altered significantly (P > .1). The serum levels of antiplatelet GPIIIa49-66 antibodies exhibited reciprocal reductions during periods of thrombocytosis (P < .07). PEG-rHuMGDF therapy did not increase viral loads significantly (395, 189, and 53 × 103 RNA viral copies/mL; P > .5 compared with baseline values). The striking increase in peripheral platelet counts produced by PEG-rHuMGDF therapy implies that thrombocytopenia in HIV-infected chimpanzees is attributable to insufficient compensatory expansion in platelet production resulting from HIV-impaired delivery of platelets despite stimulated megakaryocytopoiesis. These data suggest that PEG-rHuMGDF therapy may similarly correct peripheral platelet counts in thrombocytopenic HIV-infected patients.

<p class="Pa7"><strong>Objective: </strong>Assess the relationship of self-reported sleep quality and possible sleep disorders with disability in a racially diverse sample of community-dwelling older adults.</p><p class="Pa7"><strong>Methods: </strong>Participants included 943 non-demented older African Americans (n=452) and Whites (n=491) from two cohort studies, the Minority Aging Research Study (MARS) and the Rush Memory and Aging Project (MAP). Participants completed a 32-item questionnaire assessing sleep quality and the possible presence of three sleep disorders (sleep apnea, restless leg syndrome [RLS] and REM behavior disorder [RBD]). Disability was assessed with scales that quantified the ability to perform instru­mental activities of daily living (IADL), basic activities of daily living (ADL), and physical mobility activities.</p><p class="Pa7"><strong>Results: </strong>More than half of the participants reported impaired sleep quality (51%), or the possible presence of at least one sleep disorder (57%; sleep apnea 44%, RLS 25% and RBD 7%). Sleep quality was rated poorer in African Americans, those with advancing age and fewer years of educa­tion (all P&lt;.05). Only sleep apnea risk was associated with age (P&lt;.02). In logistic regression models adjusted for age, sex, years of education, and race, both sleep quality and disorders were associated with disability (sleep quality with mobility disabil­ity (P&lt;.001), sleep apnea risk with mobility disability and IADL disability (all P&lt;.001) and RLS symptoms with mobility disability (P&lt;.01).</p><p class="Pa7"><strong>Conclusions: </strong>Results indicate that self-assessed impaired sleep is common in old age and is associated with disability. <em></em></p><p class="Pa7"><em>Ethn Dis.</em>2016;26(4):521-528; doi:10.18865/ ed.26.4.521</p><strong></strong>

Abstract Abstract 4037 Background: Cardiac and pulmonary events are common comorbidities in patients (pts) with multiple myeloma (MM) that typically affect older adults (Robin J, et al. J Med Case Rep. 2008) and are aggravated by chronic anemia and cardiotoxicity of anti-MM agents such as anthracyclines and hematopoietic stem cell transplantation (Chow AW, et al. Intern Med J. 2012). Pts with MM are also predisposed to pulmonary infections, with pneumonia being one of the most common causes of death (Augustson BM, et al. J Clin Oncol.2005). The following abstract summarizes details of the cardiac and pulmonary safety profile from 4 phase 2 studies of carfilzomib (CFZ), a next generation proteasome inhibitor recently approved for the treatment of relapsed and refractory MM. Methods: Included in this analysis were 526 pts with relapsed and/or refractory MM treated with CFZ in the following trials: 003-A0, 003-A1, 004, and 005. In all studies, CFZ was dosed on Days 1, 2, 8, 9, 15, and 16 of a 28-day cycle (C). Doses could be escalated from 20 mg/m2 in C1 to 27 mg/m2 in C2 for all studies except 005 (15 mg/m2 in C1, 20 mg/m2 in C2, and 27 mg/m2in C3). Pts with NYHA class III-IV heart failure and recent MI/unstable angina were excluded. A comprehensive strategy based on Standardized MedDRA Query preferred terms was used wherein clinically related event terms were grouped to determine the most comprehensive occurrences of adverse events (AEs). The cardiac grouping included cardiac arrhythmias, cardiac failure, cardiomyopathy, and ischemic heart disease (IHD). Medical history was analyzed for relevant comorbid conditions, and baseline cardiac risk factor was defined as pts on ≥1 prior cardiac medication. Multiple dyspnea AE terms were grouped as were pulmonary infections from the Infections and Infestations System Organ Classes. Pulmonary AE analyses included dyspnea time-to-event and duration-of-event analyses. Results: In all, 73.6% pts had a medical history of a cardiac event and 70.0% demonstrated baseline cardiac risk factors. The most common cardiac AEs were arrhythmias, the majority of which were low-grade, benign, supra-ventricular events such as tachycardia and palpitations. Congestive heart failure (CHF) events were predominantly Grade (G) 3. There were 4 (0.8%) G5 cardiac SAEs, all cardiac arrest. An additional 4 pts had a cardiac component to their death for a total of 8 (1.5%) deaths on study or within 30 days of treatment with a cardiac component. Of note, 7 of the 8 deaths occurred in pts with baseline cardiac risk factors. Overall, 6 pts (1.1%) had a CFZ dose reduction and 23 (4.4%) discontinued treatment due to a cardiac AE. Cardiac events leading to discontinuation included CHF (1.7%), arrhythmia (1.1%), and IHD (1.0%). In general, the rate of cardiac events decreased over time with increased of number of cycles (C1 52/526 pts, 9.9%; C9–11 3/154 pts, 1.9%). The most commonly reported pulmonary AE was dyspnea (42.2%). Of note, the majority of the dyspnea events were G1 or G2 with 1 G5 dyspnea occurring in the clinical setting of CHF. Dyspnea was reported by a higher percentage of pts in earlier cycles vs later cycles (11.8% in C1; 3.2% in C6), suggesting it is likely not associated with cumulative toxicity. The median duration of a dyspnea event was 8 days and the majority of episodes were transient, with 64% lasting <2 weeks. Notably, no interstitial lung disease (ILD) or pulmonary fibrosis AEs were reported. At least 1 pulmonary infection AE was reported for 18.8% of pts; pneumonia was the most common AE (67 pts, 12.7%) as well as the most common SAE (52 pts, 9.9%). Pulmonary infections resulted in the death of 2 pts. Conclusion: Cardiac event deaths and deaths with a cardiac etiology are not unexpected in this heavily pretreated, late-stage population. Rates reported here are comparable to those noted in the literature for this population. While dyspnea was frequently observed, events were mainly G1 or G2 and transient, and there were no AEs of ILD or pulmonary fibrosis. Pulmonary infection rates were comparable to those previously reported in the literature. Importantly, CFZ discontinuations and dose reductions due to these AEs were uncommon. Cardiac and pulmonary AEs are being further characterized in ongoing randomized clinical trials. Disclosures: Lonial: Millennium: Consultancy; Celgene: Consultancy; Novartis: Consultancy; Bristol Myers Squibb: Consultancy; Onyx Pharmaceuticals: Consultancy; Merck: Consultancy. Off Label Use: Carfilzomib for the treatment of Multiple Myeloma. Niesvizky:Celgene: Consultancy, Research Funding, Speakers Bureau; Millennium: Consultancy, Research Funding, Speakers Bureau; Onyx Pharmaceuticals: Consultancy, Research Funding. McCulloch:Onyx Pharmaceuticals: Employment. Rajangam:Onyx Pharmaceuticals: Employment. Vij:Celgene: Consultancy, Research Funding, Speakers Bureau; Millennium: Speakers Bureau; Onyx Pharmaceuticals: Consultancy, Research Funding.

Objective: To examine racial differences in outcomes with coronary computed to­mographic angiography (CCTA) vs standard emergency department (ED) evaluation for chest pain.Design: Retrospective analysis of the pro­spective, randomized, multicenter Rule Out Myocardial Ischemia/Infarction by Comput­er Assisted Tomography (ROMICAT-II) trial.Setting: ED at nine hospitals in the United States.Participants: 940 patients who were Cau­casian or African American (AA) presenting to the ED with chest pain.Interventions: CCTA or standard ED evalu­ationMain Outcome Measures: Length of stay, hospital admission, direct ED discharge, downstream testing and repeat ED visit or hospitalization for recurrent chest pain at 28 days. Safety end points: missed acute coronary syndrome (ACS) and cumulative radiation exposure during the index visit and follow-up period.Results: 659 (66%) patients self-identified as Caucasian and 281 (28%) self-identified as AA. AA were younger and more often female compared with Caucasians, had a higher prevalence of hypertension (64% vs 49%, P<.001) and diabetes (23% vs 14%, P<.001) and a lower prevalence of hyperlipidemia (28% vs 51%, P<.001). ACS was more frequent among Caucasians (10% vs 2%, P<.001). Randomization to CCTA resulted in a reduction in median LOS for Caucasians (7.4 vs 24.7 hours, P<.001) and AA (8.9 vs. 26.3, P<.001; P-interac­tion=.88). Both AA and Caucasian patients experienced greater radiation exposure and more downstream testing with CCTA compared with standard evaluation.Conclusions: Early CCTA reduced median LOS for both AA and Caucasian patients presenting to the ED with chest pain by ap­proximately 17 hours compared with stan­dard evaluation.Ethn Dis. 2018;28(4):517- 524; doi:10.18865/ed.28.4.517.

AbstractDargaite, ideally BaCa12(SiO4)4(SO4)2O3, is an additional member of the arctite group belonging to minerals with a modular intercalated antiperovskite structure derived from hatrurite. The holotype specimen was found at a small outcrop of larnite pseudoconglomerates in the Judean Mts, West Bank, Palestinian Autonomy. Larnite, fluorellestadite–fluorapatite, brownmillerite, fluormayenite–fluorkyuygenite and ye'elimite are the main minerals of the holotype specimen; ternesite, shulamitite and periclase are noted rarely. Dargaite, nabimusaite and gazeevite occur in linear zones with higher porosity within larnite rocks. Pores are filled with ettringite and Ca-hydrosilicates, less commonly with gibbsite, brucite, baryte, katoite and calciolangbeinite. Dargaite is colourless, transparent with a white streak and has a vitreous lustre. It exhibits pronounced parting and imperfect cleavage along (001). Mohs’ hardness is ~4.5–5.5. The empirical formula is (Ba0.72K0.24Na0.04)Σ1(Ca11.95Mg0.04Na0.01)Σ12([SiO4]0.91 [PO4]0.05[AlO4]0.03[Ti4+O4]0.01)Σ4([SO4]0.84[PO4]0.14[CO3]0.02)Σ2(O2.54F0.46)Σ3. Dargaite is trigonal R$\overline 3 $m, the unit-cell parameters are: a = 7.1874(4) Å, c = 41.292(3) Å, V = 1847.32(19) Å3 and Z = 3. The crystal structure of dargaite was refined from X-ray single-crystal data to R1 = 3.79%. The calculated density is 3.235 g cm–3. The following main Raman bands are distinguished on the holotype dargaite (cm–1): 122, 263, 323, 464, 523, 563, 641 and 644, 829 and 869, 947, 991 and 1116. The formation conditions of dargaite are linked to the local occurrence of pyrometamorphic by-products (gases, fluids and melts) transforming earlier mineral associations at ~900°C.

2002 Background: Our phase IIa study evaluated the safety, toxicity, and clinical activity of the cyclic RGD pentapeptide cilengitide (EMD121974), an inhibitor of integrins avβ3 and avβ5, as a single agent at doses of 500 and 2000 mg in pts with recurrent GBM. Methods: In this multicenter, open-label, randomized, uncontrolled study, pts with GBM and measurable disease that had relapsed after previous temozolomide and radiotherapy were randomized to receive cilengitide at either 500 mg or 2000 mg i.v., 2x/week, until progression. Neurologic exams were performed after every cycle (4 weeks) and MRIs were performed every other cycle. Central, blinded pathology and radiology reviews were performed. The primary endpoint was Progression Free Survival (PFS) at 6 months (6-mth PFS). Secondary endpoints included response, survival, time to disease progression, safety, tolerability and pharmacokinetics (PK). Results: 81 pts accrued (median Karnofsky Performance Status 80%; median age 57 yrs) at 15 sites including 41 at the 500 mg and 40 at the 2000 mg dose levels. Demographic and pretreatment variables were comparable between dose level cohorts. The median number of infusions was 16 [range, 4–179]. PK studies revealed significantly greater exposures among the 2000 mg cohort. Treatment related NCI CTC grade 3 adverse events (AEs) included elevated transaminases (at 500 mg), arthralgia/ myalgia (at 500 mg), and weight increase/ edema (at 2000 mg) in 1 patient, respectively. No grade 4 therapy related AEs were reported. One CTC grade 2 cerebral hemorrhage was reported in a pt at progression. The 6- mth PFS was 16.1% (n=13/81 pts). 10 pts (12.3 %, n=4 with 500 mg, n=6 with 2000 mg) received 12 or more cycles. Six pts (7.4%) remain progression-free and on treatment. Median Overall Survival (mOS) was 6.5 mths [95% CI: 5.2–9.3 mths] in the 500 mg arm and 9.9 mths [95% CI, 6.3–15.7 mths] in the 2000 mg arm. Although not statistically significant, there was a trend towards better tumor control in pts receiving 2000 mg 2x/week. Conclusions: Cilengitide was well tolerated and demonstrated single agent activity in recurrent GBM, with long term disease stabilization in a subset of pts. [Table: see text]

Objective.Identify factors affecting the rate of hand hygiene opportunities in an acute care hospital.Design.Prospective observational study.Setting.Medical and surgical in-patient units, medical-surgical intensive care unit (MSICU), neonatal intensive care unit (NICU), and emergency department (ED) of an academic acute care hospital from May to August, 2012.Participants.Healthcare workers.Methods.One-hour patient-based observations measured patient interactions and hand hygiene opportunities as defined by the “Four Moments for Hand Hygiene.” Rates of patient interactions and hand hygiene opportunities per patient-hour were calculated, examining variation by room type, healthcare worker type, and time of day.Results.During 257 hours of observation, 948 healthcare worker-patient interactions and 1,605 hand hygiene opportunities were identified. Moments 1, 2, 3, and 4 comprised 42%, 10%, 9%, and 39% of hand hygiene opportunities. Nurses contributed 77% of opportunities, physicians contributed 8%, other healthcare workers contributed 11%, and housekeeping contributed 4%. The mean rate of hand hygiene opportunities per patient-hour was 4.2 for surgical units, 4.5 for medical units, 5.2 for ED, 10.4 for NICU, and 13.2 for MSICU (P < .001). In non-ICU settings, rates of hand hygiene opportunities decreased over the course of the day. Patients with transmission-based precautions had approximately half as many interactions (rate ratio [RR], 0.55 [95% confidence interval (CI), 0.37-0.80]) and hand hygiene opportunities per hour (RR, 0.47 [95% CI, 0.29-0.77]) as did patients without precautions.Conclusions.Measuring hand hygiene opportunities across clinical settings lays the groundwork for product use-based hand hygiene measurement. Additional work is needed to assess factors affecting rates in other hospitals and health care settings.