scholarly journals Comprehensive Serological Profile and Specificity of Maternal and Neonatal Cord Blood SARS CoV-2 Antibodies

2021 ◽  
Author(s):  
Rupsa C. Boelig ◽  
Sidhartha Chaudhury ◽  
Zubair H. Aghai ◽  
Emily Oliver ◽  
Francesca Manusco ◽  
...  
Keyword(s):  
Cord Blood ◽  
Influenza A ◽  
High Efficiency ◽  
Placental Transfer ◽  
Maternal Blood ◽  
Primary Objective ◽  
Full Length ◽  
University Hospital ◽  
History Of ◽  
Highly Correlated

AbstractObjectiveTo describe the profile and specificity of maternal and neonatal cord-blood antibody profile in response SARS-CoV-2 virus exposureMethodsThis is a Prospective cohort study of delivering patients at Thomas Jefferson University Hospital from April 2020-February 2021. Primary objective was to describe unique maternal and fetal antibody epitope titers and specificity in those patients with COVID-19 history. Serologic profile assessed with a multiplex platform. Antigens used were: HA-trimer Influenza A (Hong Kong H3), spike trimers for SARS-CoV-2, SARS-CoV-1, MERS-CoV, and betacoronaviruses HKU-1 and OC43, as well as the spike N-terminal domain (NTD), spike receptor binding domain (RBD), and nucleocapsid protein (N; full length) for SARS-CoV-2.Results112 maternal samples and 101 maternal and cord blood pairs were analyzed. Thirty-seven had a known history of COVID-19 (positive PCR test) in the pregnancy and of those, 17 (47%) were diagnosed with COVID-19 within 30 days of delivery. Fifteen of remaining seventy-six (20%) without a known diagnosis had positive maternal serology. For those with history of COVID-19 we identified robust IgG response in maternal blood to CoV2 nucleocapsid (N), spike (S) full-length and S (RBD) antigens with more modest responses to the S (NTD) antigen. By contrast, the maternal blood IgM response appeared more specific to S (full-length), than N, S (RBD) or S (NTD) epitopes. There were significantly higher maternal and cord blood IgG response not just to CoV2 spike (p < 10−18), but also CoV1 spike (p < 10−9) and MERS spike (p < 10−8). By contrast, maternal IgM responses were more specific to CoV2 (p < 10−19), but to a lesser degree for CoV1 (p < 10−5), and no significant differences for MERS. Maternal and cord-blood IgG were highly correlated for both S and N (R2 = 0.96 and 0.94).ConclusionsPlacental transfer is efficient, with robust N and S responses. Both nucleocapsid and spike antibody responses should be studied for a better understanding of COVID-19 immunity. IgG antibodies are cross reactive with related CoV-1 and MERS spike epitopes while IgM, which cannot cross placenta to provide neonatal passive immunity, is more SARS CoV-2 specific. Neonatal cord blood may have significantly different fine-specificity than maternal blood, despite the high efficiency of IgG transfer.

scholarly journals Differences in the placental pharmacokinetics of vedolizumab and ustekinumab during pregnancy in women with inflammatory bowel disease: a prospective multicentre study

2021 ◽  
Vol 14 ◽  
pp. 175628482110327
Author(s):  
Katarina Mitrova ◽  
Barbora Pipek ◽  
Martin Bortlik ◽  
Ludek Bouchner ◽  
Jan Brezina ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Cord Blood ◽  
Bowel Disease ◽  
Tumour Necrosis ◽  
Placental Transfer ◽  
Maternal Blood ◽  
Drug Levels ◽  
Lower Drug ◽  
Inflammatory Bowel ◽  
Necrosis Factor

Background: Vedolizumab demonstrated different placental pharmacokinetics than other immunoglobulin G1 antibodies, leading to lower drug levels in cord blood in contrast to maternal blood at the time of delivery. The placental transfer of ustekinumab seems to have a pattern similar to anti-tumour necrosis factor agents. Current evidence on the placental pharmacokinetics of vedolizumab and ustekinumab is limited. We aimed to assess the placental transfer of ustekinumab and vedolizumab in pregnant patients with inflammatory bowel disease. Methods: Consecutive women from a prospective observational study who were exposed to ustekinumab or vedolizumab within 2 months prior to conception or during pregnancy were included. Ustekinumab and vedolizumab levels were measured in maternal and cord blood at the time of delivery. Results: Drug levels were available in 31 infant-mother pairs (15 exposed to ustekinumab and 16 to vedolizumab). The median maternal and newborn ustekinumab levels were 5.3 mg/l and 10.3 mg/l, respectively (the median infant-to-maternal ratio was 1.7), while the median maternal and cord vedolizumab levels were 7.3 mg/l and 4.5 mg/l (the median infant-to-maternal ratio was 0.66). The ustekinumab levels in cord blood positively correlated with the maternal levels at delivery (ρ = 0.751, p = 0.001). However, no correlation with the timing of the last drug administration was found. In contrast, the vedolizumab levels in cord blood demonstrated significant positive correlation with the maternal levels (ρ = 0.831, p < 0.001) along with the gestational week of the last infusion (ρ = 0.736, p = 0.001). Conclusion: Vedolizumab demonstrated different placental pharmacokinetics, leading to lower drug levels in cord blood compared to maternal blood at delivery; in contrast, the placental transfer of ustekinumab seems to have a pattern similar to anti-tumour necrosis factor (TNF) agents.

Epidemiological study of granulomatous prostatitis in a tertiary hospital: Associated risk factors and relationship with prostate cancer

2020 ◽  
pp. 039156032097985
Author(s):  
Iris Coello Torà ◽  
Marta de la Cruz Ruiz ◽  
Paula Carrillo García ◽  
Enrique Carmelo Pieras Ayala
Keyword(s):  
Urinary Tract ◽  
Tertiary Care ◽  
Tumor Resection ◽  
Previous History ◽  
Primary Objective ◽  
University Hospital ◽  
Care Hospital ◽  
History Of ◽  
Tract Infections ◽  
Granulomatous Prostatitis

Objective: The primary objective was to estimate the incidence of granulomatous prostatitis (GP) in Son Espases University Hospital, a tertiary care hospital, in Palma de Mallorca (Spain). As secondary objectives, presence of concomitant PCa in the biopsy was analyzed, as well as the history of previous BCG instillations, biopsy origin, urinary symptoms, and cardiovascular risk (CV) factors. Methods: A descriptive retrospective study of GP and the aforedescribed variables were carried out from 2010 to 2017. Results: A total of 3651 histopathological prostate specimens were analyzed, 39 of which were diagnosed with GP (incidence of 1.06%). Lower urinary tract symptoms (LUTS) were present in a 48.7% and previous history of bladder tumor resection (TURBT) was present in 35.9% of the cases. Also, urinary tract infections were equally present. All cases with prior TURBT had intravesical instillations with BCG, although 5 (12.8%) and 4 (10.3%) cases had abnormal rectal examination and elevated PSA levels after instillations, respectively. Finally, in 14 cases (35.9%) there was also a diagnosis of concomitant PCa. The most common CV risk factor in these patients was smoking (79.5%) followed by hypertension (64.8%). Conclusions: The estimated incidence of GP in our center (1.06%)g is close to that described by other authors. About 14 cases were diagnosed with PCa (35.9%), a higher value than previously described in the literature, and most of these were found incidentally, especially in cystoprostatectomies. This high percentage of concomitant GP and PCa could be due to a rise in Transrectal Prostate biopsies (TRPB), as in recent years there has been a tendency to increase the use of PSA in routine clinical practice.

scholarly journals Analysing cord blood levels of TNF inhibitors to validate the EULAR points to consider for TNF inhibitor use during pregnancy

2021 ◽  
pp. annrheumdis-2021-221036
Author(s):  
Nafise Ghalandari ◽  
Erik Kemper ◽  
Ineke (Hubertina) Crijns ◽  
Gertjan Wolbink ◽  
Theo Rispens ◽  
...  
Keyword(s):  
Cord Blood ◽  
Concentration Ratio ◽  
Placental Transfer ◽  
Certolizumab Pegol ◽  
Maternal Blood ◽  
Blood Levels ◽  
Tnf Inhibitor ◽  
Blood Samples ◽  
Time Points ◽  
Median Concentration

BackgroundTo minimise placental transfer of tumour necrosis factor inhibitors (TNFi), the European League Against Rheumatism (EULAR) created points to consider (PtC) for the use of TNFi during pregnancy. We are the first to validate the EULAR-PtC by analysing TNFi concentrations in cord blood.MethodsPatients were derived from the Preconceptional Counselling in Active Rheumatoid Arthritis Study. TNFi was stopped at the time points recommended by the EULAR. Maternal blood and cord blood were collected and analysed for the concentration of TNFi.Results111 patients were eligible for the analysis. Median stop time points were gestational age (GA) 37.0 weeks for certolizumab pegol, GA 25.0 weeks for etanercept, GA 19.0 weeks for adalimumab and GA 18.4 weeks for infliximab. Certolizumab pegol (n=68) was detectable in 5.9% of cord blood samples, with a median concentration of 0.3 µg/mL (IQR: 0.2–1.3) and a median cord/maternal concentration ratio of 0.010. Etanercept (n=30) was not detected in any cord blood samples. Adalimumab (n=25) was detectable in 48.0% of cord blood samples, with a median concentration of 0.5 µg/mL (IQR: 0.2–0.7) and a median concentration ratio of 0.062 (IQR: 0.018–0.15). Infliximab (n=14) was detectable in 57.1% of cord blood samples, with a median concentration of 0.4 µg/mL (IQR: 0.1–1.2) and a median concentration ratio of 0.012 (IQR: 0.006–0.081).ConclusionCompliance with the EULAR-PtC results in absence or low levels of TNFi in cord blood.

ZAANGAŻOWANIA KOŚCIOŁA KATOLICKIEGO NA RZECZ MIGRANTÓW – PRZESŁANKI DOKTRYNALNO-PRAWNE

2017 ◽  
Vol 13 (`1) ◽  
pp. 49-68
Author(s):  
Piotr Wojnicz
Keyword(s):  
Pastoral Care ◽  
Social Integration ◽  
Catholic Church ◽  
Local Community ◽  
Primary Objective ◽  
Human Migration ◽  
Religious Orders ◽  
Important Thing ◽  
History Of ◽  
The Catholic Church

The Catholic Church is naturally associated with migrants and its history and doctrine areinextricably linked with the migration of people. Many of the documents of the Catholic Church referto the history of human migration. The responsibility of the Catholic Church for migrants has deephistorical and theological roots. The Catholic Church sees both the positive and the negative sidesof this phenomenon The pastoral care of migrants is a response to the needs of these people. It doesnot replace the territorial structures. They both work closely together and complement each other.The primary objective of the pastoral care of migrants is to enable migrants to integrate with thelocal community. An important element of these structures are religious orders of men and women.The most important thing for migrants is the Christian attitude of the local community tothem. Church repeatedly stressed the importance of hospitality to migrants. Both human andChristian attitude towards migrants expresses itself in a good reception, which is the main factorin overcoming the inevitable difficulties, preventing opposites and solving various problems. Thisattitude helps to alleviate the problems associated with the process of social integration.

Methodological Approaches to Evaluate Fetal Drug Exposure

2019 ◽  
Vol 25 (5) ◽  
pp. 496-504 ◽  
Author(s):  
Naïm Bouazza ◽  
Frantz Foissac ◽  
Déborah Hirt ◽  
Saïk Urien ◽  
Sihem Benaboud ◽  
...  
Keyword(s):  
Cord Blood ◽  
Drug Exposure ◽  
Placental Transfer ◽  
Ex Vivo ◽  
Pharmacokinetic Analysis ◽  
Population Pharmacokinetic ◽  
Pbpk Models ◽  
Drug Concentrations ◽  
Fetal Drug Exposure

Background: Drug prescriptions are usual during pregnancy, however, women and their fetuses still remain an orphan population with regard to drugs efficacy and safety. Most xenobiotics diffuse through the placenta and some of them can alter fetus development resulting in structural abnormalities, growth or functional deficiencies. Methods: To summarize the different methodologies developed towards the prediction of fetal drug exposure. Results: Neonatal cord blood concentration is the most specific measurement of the transplacental drug transfer at the end of pregnancy. Using the cord blood and mother drug concentrations altogether, drug exchanges between the mother and fetus can be modeled and quantified via a population pharmacokinetic analysis. Thereafter, it is possible to estimate the fetus exposure and the fetus-to-mother exposure ratio. However, the prediction of placental transfer before any administration to pregnant women is desirable. Animal studies remain difficult to interpret due to structural and functional inter-species placenta differences. The ex-vivo perfusion of the human placental cotyledon is the method of reference to study the human placental transfer of drugs because it is thought to mimic the functional placental tissue. However, extrapolation of data to in vivo situation remains difficult. Some research groups have extensively worked on physiologically based models (PBPK) to predict fetal drug exposure and showed very encouraging results. Conclusion: PBPK models appeared to be a very promising tool in order to predict fetal drug exposure in-silico. However, these models mainly picture the end of pregnancy and knowledge regarding both, development of the placental permeability and transporters is strongly needed.

The Earl, the Kings, and the Chronicler

2019 ◽  
Author(s):  
Robert B. Patterson
Keyword(s):  
Civil War ◽  
Twelfth Century ◽  
Full Length ◽  
English History ◽  
Cultural Revival ◽  
South Wales ◽  
Anglo Norman ◽  
Merchant Class ◽  
History Of ◽  
William The Conqueror

This book is the first full length biography of Robert (c.1088 × 90–1147), grandson of William the Conqueror and eldest son of King Henry I of England (1100–35). He could not succeed his father because he was a bastard. Instead, as the earl of Gloucester, Robert helped change the course of English history by keeping alive the prospects for an Angevin succession through his leadership of its supporters in the civil war known as the Anarchy against his father’s successor, King Stephen (1135–54). The earl is one of the great figures of Anglo-Norman History (1066–1154). He was one of only three landed super-magnates of his day, a model post-Conquest great baron, Marcher lord, borough developer, and patron of the rising merchant class. His trans-Channel barony stretched from western Lower Normandy across England to South Wales. He was both product as well as agent of the contemporary cultural revival known as the Renaissance of the Twelfth Century, bilingual, well educated, and a significant literary patron. In this last role, he is especially notable for commissioning the greatest English historian since Bede, William of Malmesbury, to produce a history of their times which justified the Empress Matilda’s claim to the English throne and Earl Robert’s support of it.

scholarly journals Gas-filled urachal abscess with a pinging sound in a heifer calf

2019 ◽  
Vol 64 (No. 8) ◽  
pp. 362-366 ◽  
Author(s):  
R Sato ◽  
K Yamada ◽  
Y Shinozuka ◽  
H Ochiai ◽  
K Onda
Keyword(s):  
Fistulous Tract ◽  
Failure To Thrive ◽  
Abdominal Distension ◽  
Intravenous Urography ◽  
University Hospital ◽  
Growth Depression ◽  
Poor Growth ◽  
History Of ◽  
Heifer Calf ◽  
Urachal Abscess

A 6-month-old crossbred of a Holstein and Japanese Black heifer calf weighing 95 kg presented with a history of intermittent abdominal distension and failure to thrive. The physical examination identified a pinging sound over the dorsal left flank. The abdominal radiography showed a huge gas-filled mass. The intravenous urography revealed no communication between the mass and the urinary bladder. Although the visual examination and palpation of the umbilicus did not reveal visible abnormalities, an umbilical disease was suspected because the animal exhibited poor growth, depression, and a hunched back posture. When the eschar adhering to the centre of the umbilicus was removed, the presence of a fistulous tract was revealed. The umbilical ultrasound examination revealed an intra-abdominal abscess and the fistulography demonstrated that the abscess communicated with the umbilicus. The abscess, compressing into the rumen, was observed by computed tomography. From these images, it was diagnosed as an umbilical cord remnant abscess and a definitive diagnosis of a urachal abscess was obtained by open abdominal surgery and the subsequent removal of the mass. The calf was discharged from the university hospital on day 14 after the operation. This case shows that a urachal abscess should be considered when a pinging sound is present, even if the animal exhibits no swelling or pain of the umbilicus.

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