scholarly journals Biphasic pattern in the effect of severe measles infection; the difference between additive and multiplicative scale

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nhat Thanh Hoang Le ◽  
Nhan Thi Ho ◽  
Bryan Grenfell ◽  
Stephen Baker ◽  
Ronald B. Geskus
Keyword(s):  
Infectious Diseases ◽  
Hospital Admission ◽  
Measles Virus ◽  
Hospital Admissions ◽  
Admission Rate ◽  
Second Phase ◽  
Before And After ◽  
The Difference ◽  
Two Phases ◽  
Additive Scale

Abstract Background Infection with measles virus (MeV) causes immunosuppression and increased susceptibility to other infectious diseases. Only few studies reported a duration of immunosuppression, with varying results. We investigated the effect of immunosuppression on the incidence of hospital admissions for infectious diseases in Vietnamese children. Methods We used retrospective data (2005 to 2015; N = 4419) from the two pediatric hospitals in Ho Chi Minh City, Vietnam. We compared the age-specific incidence of hospital admission for infectious diseases before and after hospitalization for measles. We fitted a Poisson regression model that included gender, current age, and time since measles to obtain a multiplicative effect measure. Estimates were transformed to the additive scale. Results We observed two phases in the incidence of hospital admission after measles. The first phase started with a fourfold increased rate of admissions during the first month after measles, dropping to a level quite comparable to children of the same age before measles. In the second phase, lasting until at least 6 years after measles, the admission rate decreased further, with values up to 20 times lower than in children of the same age before measles. However, on the additive scale the effect size in the second phase was much smaller than in the first phase. Conclusion The first phase highlights the public health benefits of measles vaccination by preventing measles and immune amnesia. The beneficial second phase is interesting, but its strength strongly depends on the scale. It suggests a complicated interaction between MeV infection and the host immunity.

scholarly journals Involvement of NO in Antinociception of NSAIDS in Murine Formalin Hind Paw Assay

Drug Research ◽  
2020 ◽  
Vol 70 (04) ◽  
pp. 145-150 ◽  
Author(s):  
Viviana Noriega ◽  
Hugo F. Miranda ◽  
Juan Carlos Prieto ◽  
Ramón Sotomayor-Zárate ◽  
Fernando Sierralta
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Dose Response ◽  
Rank Order ◽  
Linear Regression Analysis ◽  
Second Phase ◽  
Response Curves ◽  
Before And After ◽  
Two Phases ◽  
Phase Phase

AbstractThere are different animal models to evaluate pain among them the formalin hind paw assay which is widely used since some of its events appear to be similar to the clinical pain of humans. The assay in which a dilute solution of formalin is injected into the dorsal hindpaw of a murine produces two ‘phases’ of pain behavior separated by a inactive period. The early phase (Phase I) is probably due to direct activation of nociceptors and the second phase (Phase II) is due to ongoing inflammatory input and central sensitization. Mice were used to determine the potency antinociceptive of piroxicam (1,3,10,and 30 mg/kg), parecoxib (0.3, 1,3,10 and 30 mg/kg), dexketoprofen (3,10,30 and 100 mg/kg) and ketoprofen (3,10,30 and 100 mg/kg). Dose-response for each NSAIDs were created before and after 5 mg/kg of L-NAME i.p. or 5 mg/kg i.p. of 7-nitroindazole. A least-squares linear regression analysis of the log dose–response curves allowed the calculation of the dose that produced 50% of antinociception (ED50) for each drug. The ED50 demonstrated the following rank order of potency, in the phase I: piroxicam > dexketoprofen > ketoprofen > parecoxib and in the phase II: piroxicam > ketoprofen > parecoxib > dexketoprofen. Pretreatment of the mice with L-NAME or 7-nitroindazol induced a significant increase of the analgesic power of the NSAIDs, with a significant reduction of the ED50. It is suggested that NO may be involved in both phases of the trial, which means that nitric oxide regulates the bioactivity of NSAIDs.

In-Situ X-ray Diffraction Study of Lithium Intercalation in Nanostructured Anatase Titanium dioxide

1998 ◽  
Vol 536 ◽  
Author(s):  
R. Van de Krol ◽  
E. A. Meulenkamp ◽  
A. Goossens ◽  
J. Schoonman
Keyword(s):  
Phase Transformation ◽  
Maximum Amount ◽  
Lithium Intercalation ◽  
X Ray Diffraction ◽  
X Ray ◽  
Before And After ◽  
The Difference ◽  
Two Phases ◽  
Reversible Phase

AbstractElectrochemical lithium intercalation in nanostructured anatase TiO2 is investigated with in-situ X-ray diffraction. A complete and reversible phase transformation from tetragonal anatase TiO2 to orthorhombic anatase Li0.5TiO2 is observed. The difference of the XRD spectra before and after insertion can be fitted with the lattice parameters of the two phases as fit parameters. The maximum amount of lithium that can be dissolved in anatase TiO2 before the phase transformation occurs is found to be very small.

Domiciliary Nebuliser Therapy — A Valuable Option in Chronic Asthma and Chronic Obstructive Pulmonary Disease?

1998 ◽  
Vol 43 (2) ◽  
pp. 48-51 ◽  
Author(s):  
D.J. Godden ◽  
A. Robertson ◽  
N. Currie ◽  
J.S. Legge ◽  
J.A.R. Friend ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Admission ◽  
Pulmonary Disease ◽  
Hospital Admissions ◽  
Severe Disease ◽  
Structured Interview ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Technical Performance ◽  
Before And After

Domiciliary nebulisers are in widespread use for patients who have severe chronic airways disease, both asthma and chronic obstructive pulmonary disease (COPD). We report a study of the use of domiciliary nebulisers designed to assess practical problems and the value of such therapy in preventing hospital admissions. A total of 405 patients underwent a structured interview at home and their case records were reviewed. Technical performance of the nebuliser compressors was assessed The mean (SD) age of those interviewed was 64.5 (12) years. 185 patients had a physician diagnosis of asthma, and 208 had COPD. 87% patients used their nebuliser at least once daily. Side effects, reported by 54%, were related to frequency of use and commoner in younger patients. 29 subjects (7%) died within 2 years of receiving their nebuliser. Among the survivors, the 2 year periods before and after supply of the nebuliser were compared The percentage of patients requiring hospital admission for exacerbations of lung disease fell from 56% to 46% (p<0.01) but the number and duration of admissions was unchanged Those whose admission duration increased had more severely impaired spirometry when the nebuliser was supplied and had lower activity scores and higher breathlessness scores at the time of interview indicating more severe disease. Approximately half of the compressors were malfunctioning and patients' understanding of the principles of nebuliser treatment was poor. The provision of domiciliary nebuliser can influence hospital admission inpatients with obstructive airways disease. There is also a need for improved patient education and for technical support which may require the development of a nurse-run nebuliser service.

scholarly journals Change in Admission Rates Among Patients Presenting to Emergency Departments with VTE and Low Risk of Complications: A Retrospective Cohort Study from 11 Community Hospitals

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4694-4694
Author(s):  
William Rhoades ◽  
Rasha Khatib ◽  
Kara Nitti ◽  
Marc McDowell ◽  
Rick Szymialis ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Health Research ◽  
Clinical Guidelines ◽  
Research Funding ◽  
Hospital Admissions ◽  
Low Risk ◽  
Hospital Treatment ◽  
Community Hospitals ◽  
Study Results ◽  
Before And After

Background: Venous thromboembolism (VTE) is often diagnosed in the emergency department (ED), but adherence to clinical guidelines in the management of VTE in the ED may be low. The 2016 update of the American College of Chest Physicians (CHEST) guidelines has recommended home management or early discharge instead of in-hospital treatment for patients with low risk VTE. Gaps in clinical practice and clinical guideline recommendations need to be identified to improve VTE management in the ED. Objectives: To investigate changes in management of patients with low-risk VTE who received a diagnosis in the ED before and after the February 2016 update of CHEST guidelines on antithrombotic therapy for VTE. Methods: This retrospective analysis examined patient electronic medical records from January 1, 2013 to December 31, 2018 from a large healthcare system in Illinois. Data were collected on patients presenting in 11 EDs in community hospitals who were given a primary diagnosis or discharge diagnosis of VTE based on International Classification of Diseases, Ninth Revision or Tenth Revision. VTE was categorized as low-risk if diagnosis was either lower-extremity DVT or PE and a pulmonary embolism score index (PESI) lower than 85. A multivariable logistic regression model was constructed to measure the adjusted odds of hospital admissions among patients with low-risk VTE before and after the update of the CHEST guidelines. The model was adjusted for patient demographics and clinical characteristics, type of anticoagulant administered, preexisting comorbidities, and hospital characteristics. Results: Among 2,193,965 ED visits over the 6-year period, 15,543 visits representing 14,530 patients who received diagnoses of DVT (55%) or PE (45%) were included in the analysis. The mean age was 65.0 ± 17.4 years, with 46% being male and 63% Caucasian. A total of 83% of patients with DVT were considered low risk based on DVT location and 49% of patients with PE were low risk based on PESI. The rates of hospital admission for management of low-risk VTE declined from 81% in 2013 to 73% in 2018. In the adjusted model, patients visiting EDs between 2016 and 2018 (post-update of guidelines) were equally likely to be admitted compared with patients visiting EDs between 2013 and 2015 (pre-update of guidelines; odds ratio [OR]=0.91; 95% confidence interval [CI]: 0.81, 1.02). Patients who received a diagnosis of PE compared with DVT (OR=4.90; 95% CI: 4.26, 5.64) and patients who received vitamin K antagonists compared with direct oral anticoagulants (OR=1.74; 95% CI: 1.54, 1.96) had higher odds of hospital admission. However, the presence of a pharmacist was associated with lower odds of hospital admission (OR=0.68; 95% CI: 0.55, 0.85). Conclusions: Our study results indicate that most patients receiving a diagnosis of low-risk VTE in EDs were admitted for in-hospital management despite clinical guidelines recommending otherwise. The 2016 update of CHEST guidelines recommending outpatient management had minimal effects on decreasing the rate of admissions of patients with low-risk VTE. More effort in real-world practices is needed to adopt guideline recommendations and integrate clinical evidence on new and existing treatment advances. Disclosures Rhoades: Bristol-Meyers Squibb: Research Funding. Khatib:National Institutes of Health: Research Funding; Bristol-Meyers Squibb: Research Funding; Takeda: Research Funding. Nitti:Takeda: Research Funding; Bristol-Meyers Squibb: Research Funding. McDowell:Bristol-Meyers Squibb: Research Funding. Szymialis:Bristol-Meyers Squibb: Employment. Blair:Takeda: Research Funding; Bristol-Meyers Squibb: Research Funding; National Institutes of Health: Research Funding.

scholarly journals TWO PHASES IN THE DEVELOPMENT OF HEDWIG CONRAD-MARTIUS’ ONTOLOGICAL INVESTIGATION ON HUMAN BEING AND LIVING THINGS

2021 ◽  
Vol 10 (2) ◽  
pp. 398-424
Author(s):  
SIMONA BERTOLINI ◽  
Keyword(s):  
Structure Change ◽  
Second Phase ◽  
Human Being ◽  
Human Knowledge ◽  
Living Things ◽  
Ontological Categories ◽  
Biological Ontology ◽  
The Difference ◽  
Two Phases ◽  
Theoretical Results

Interest in the ontological constitution of living beings (with particular reference to the human being) characterizes the whole development of Hedwig Conrad-Martius’ philosophy. Several works written by the philosopher over the years deal with both the phenomenological description and the ontological foundation of the difference between plants, animals, and humans. Specifically, the ontological structure of the human being is investigated as a layered structure which presupposes those of plants and animals while overcoming them in a more complex and spiritual unity, on which human freedom and human knowledge depend. Although this topic maintains a crucial role in Conrad-Martius’ thought, the way the philosopher addresses it and the theoretical results of her phenomenological-ontological inquiry about it do not remain unchanged. Indeed, the ontological structure at the basis of phenomenal differences as well as the metaphysical foundations of this structure change over the decades. This paper aims at distinguishing between two phases, characterized by different ontological categories, through which Conrad-Martius’ anthropology and biological ontology develop. In the first phase, at the beginning of the twenties (precisely in her work Metaphysical Dialogues), the essential differences between plants, animals, and humans are explained with reference to a vital origin preceding the constitution of reality; to describe it Conrad-Martius employs terms such as “abyss” and “under-earthly realm.” In the second phase, exemplified by some writings published in the forties and the fifties, the reference to such a dimension disappears and the eidetic variety within the living world, including human specificity, is exclusively traced back to the finalistic substantiation of essences in the natural beings.

Frequency of Emergency Department Visits for Sickle Cell Disease Vaso-Occlusive Crisis and Its Contribution to Hospital Admission Rates

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5569-5569
Author(s):  
Patrick Loeffler ◽  
Taylor Mueller ◽  
Abdullah Kutlar ◽  
Robert Gibson ◽  
LaShon Sturgis ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sickle Cell Disease ◽  
Hospital Admission ◽  
Admission Rate ◽  
Cell Disease ◽  
Admission Rates ◽  
Time Period ◽  
Number Of Visits ◽  
The Difference ◽  
First Time

Abstract Background: Patients with sickle cell disease (SCD) vaso-occlusive crisis (VOC) frequently seek care in the emergency department (ED). To improve and increase consistency of care patients with uncomplicated VOC, are treated in the Emergency Department Observation Unit (EDOU) where they are treated with an individualized protocol-based pathway. EDOUs have been shown to be effective in meeting treatment guidelines and reducing hospital admission. Objective: This study examines the admission rates of individuals with SCD stratified by frequency of presentation at the EDOU. Methods: A retrospective review of an ED database was completed to explore the relationship between EDOU utilization and admission rate for patients with uncomplicated VOC. All patient records meeting pathway inclusion criteria for uncomplicated VOC during the time period September 2013 through May 2015 were included in the study. Visits were first associated with individual patients. Then, based on the number of visits per time period, patients were categorized as high users, moderate users, or low users. Categorization was done using the number of visits during the first, 12-month period (9/11/13 - 9/10/14), or the second, nine-month period (9/10/14 - 5/31/15). Adaptations to the categorization scheme for the nine-month time period were as follows. Low users were patients that had no more than one visit in either the first or second time period; moderate users were patients with two or three visits in the first time period or two visits in the second; high users were patients with four or more visits in the first time period, or three or more visits in the second time period. Admission rates were calculated as percentages of visits to the EDOU. Rates of admission for high, middle, and low users were compared using an unpaired, one-tailed Student's t-test. This study was approved by expedited review by the institution's Institutional Review Board (IRB). Results: A total of 727 visits for 154 patients were included in the analysis. High users (n=44) had a total of 539 visits and an average patient admission rate of 22% (n=118). Moderate users (n=49) had a total of 108 visits and an admission rate of 31% (n=33). Low users (N=61) had a total of 80 visits and an admission rate of 36% (n=29). The difference between the number of high user admissions and low user admissions was significant (p<0.01) as was the difference between the number of moderate-user visits and the number of high-user visits (p=0.04). The difference between the number of moderate and low user admissions was not significant (p=0.14). Conclusion: This study found that the difference in the number of admissions between high and low users and between high and moderate users was significant. The findings provide support for the value of the EDOU in reducing unnecessary hospital admissions. These findings also raise important questions regarding the phenotypic expression of pain in SCD and the availability of care. Although the criteria for categorization of patients in this study was limited and the time periods unequal the results suggest different patterns of personal response to pain and treatment seeking. It is unknown how these groups may be different in regards to access to care, treatment preferences, self-care practices, or severity of disease. It can be hypothesized from these results that there may be two different patterns of care seeking with some patients only using the EDOU when crisis is severe (low users) and other patients (high users) using the EDOU as part of their regular pain treatment strategy. To address these questions it is necessary to further examine the differences between these groups to look for explanations that can address increased utilization of the EDOU among some patients. Disclosures No relevant conflicts of interest to declare.

scholarly journals Polarity and reorganization of the endoplasmic reticulum during fertilization and ooplasmic segregation in the ascidian egg.

1993 ◽  
Vol 120 (6) ◽  
pp. 1337-1346 ◽  
Author(s):  
J E Speksnijder ◽  
M Terasaki ◽  
W J Hage ◽  
L F Jaffe ◽  
C Sardet
Keyword(s):  
Thick Layer ◽  
Second Phase ◽  
Calcium Waves ◽  
Cell Region ◽  
Vegetal Cortex ◽  
Before And After ◽  
Ooplasmic Segregation ◽  
Two Phases ◽  
Sperm Aster

During the first cell cycle of the ascidian egg, two phases of ooplasmic segregation create distinct cytoplasmic domains that are crucial for later development. We recently defined a domain enriched in ER in the vegetal region of Phallusia mammillata eggs. To explore the possible physiological and developmental function of this ER domain, we here investigate its organization and fate by labeling the ER network in vivo with DiIC16(3), and observing its distribution before and after fertilization in the living egg. In unfertilized eggs, the ER-rich vegetal cortex is overlaid by the ER-poor but mitochondria-rich subcortical myoplasm. Fertilization results in striking rearrangements of the ER network. First, ER accumulates at the vegetal-contraction pole as a thick layer between the plasma membrane and the myoplasm. This accompanies the relocation of the myoplasm toward that region during the first phase of ooplasmic segregation. In other parts of the cytoplasm, ER becomes progressively redistributed into ER-rich and ER-poor microdomains. As the sperm aster grows, ER accumulates in its centrosomal area and along its astral rays. During the second phase of ooplasmic segregation, which takes place once meiosis is completed, the concentrated ER domain at the vegetal-contraction pole moves with the sperm aster and the bulk of the myoplasm toward the future posterior side of the embryo. These results show that after fertilization, ER first accumulates in the vegetal area from which repetitive calcium waves are known to originate (Speksnijder, J. E. 1992. Dev. Biol. 153:259-271). This ER domain subsequently colocalizes with the myoplasm to the presumptive primary muscle cell region.

Previous Comorbidity and Lack of Patient Free Choice of Technique Predict Early Mortality in Peritoneal Dialysis

2009 ◽  
Vol 29 (2) ◽  
pp. 150-157 ◽  
Author(s):  
José Portolés ◽  
Gloria del Peso ◽  
M. José Fernández-Reyes ◽  
M. Auxiliadora Bajo ◽  
Paula López-Sánchez
Keyword(s):  
Peritoneal Dialysis ◽  
Prognostic Factors ◽  
Hospital Admission ◽  
Hospital Admissions ◽  
Risk Estimation ◽  
Admission Rate ◽  
Individual Characteristics ◽  
Hospital Admission Rate ◽  
Predialysis Patient ◽  
Choice Of Technique

Objective To study the prognostic factors for mortality and hospital admission for patients on peritoneal dialysis (PD). Method Biannual data on individual characteristics, clinical and analytical progress, treatment, and events were studied for a cohort of incident patients undergoing PD (2003-2006) in a reference area of 8.8 million people. Results 489 patients (age 53.58 years, 61.6% male) with 3-year follow-up were included. They presented at inclusion with Charlson Comorbidity Index (CCI) of 5.25; previous cardiovascular (CV) event, 23.7%; diabetes mellitus (DM), 19.1%; and hypertension (HT), 89.9%. Annual hospitalization rate per patient-year at risk was 0.6. The variables that predicted admission were CCI [odds ratio (OR) 1.14 per point], DM (OR 1.66), and previous CV event (OR 1.90). Anemia maintained significance when corrected for CCI: hemoglobin, 0.79 per 1 g/dL Hb; CCI, 1.15 per point. Annual mortality rate was 5.4%. Those that died were older (67.47 vs 52.78 years) and had a higher CCI (8.35 vs 5.0), a lower initial Hb (11.5 vs 12.2 g/dL), a higher hospital admission rate, a higher annual rate of peritonitis, more previous CV events (50.0% vs 22.1%), and higher prevalence of DM (38.5% vs 17.9%). Survival analysis identified the following prognostic factors: CCI [hazard ratio (HR) 1.51 per point], CV event (HR 2.85), DM (HR 2.52), age (HR 1.06 per year), and mandatory referral to PD (HR 6.54). The effect of CV events and DM persisted after correction for age, and that of choice of technique after correcting for CCI and/or age. Conclusions The CCI is useful for risk estimation in PD patients. Previous CV event, DM, and age are the most relevant risk factors. Control of anemia has prognostic value for hospital admissions. Mandatory referral to PD is associated with higher mortality. The prognosis in PD depends on predialysis patient management.

Accuracy assessment of surgical planning and three-dimensional-printed patient-specific guides for orthopaedic osteotomies

2017 ◽  
Vol 231 (6) ◽  
pp. 499-508 ◽  
Author(s):  
Gwen Sys ◽  
Hannelore Eykens ◽  
Gerlinde Lenaerts ◽  
Felix Shumelinsky ◽  
Cedric Robbrecht ◽  
...  
Keyword(s):  
Accuracy Assessment ◽  
Average Distance ◽  
Three Dimensional ◽  
Patient Specific ◽  
Second Phase ◽  
Experimental Setup ◽  
Operative Planning ◽  
The Difference ◽  
Two Phases ◽  
Improved Accuracy

This study analyses the accuracy of three-dimensional pre-operative planning and patient-specific guides for orthopaedic osteotomies. To this end, patient-specific guides were compared to the classical freehand method in an experimental setup with saw bones in two phases. In the first phase, the effect of guide design and oscillating versus reciprocating saws was analysed. The difference between target and performed cuts was quantified by the average distance deviation and average angular deviations in the sagittal and coronal planes for the different osteotomies. The results indicated that for one model osteotomy, the use of guides resulted in a more accurate cut when compared to the freehand technique. Reciprocating saws and slot guides improved accuracy in all planes, while oscillating saws and open guides lead to larger deviations from the planned cut. In the second phase, the accuracy of transfer of the planning to the surgical field with slot guides and a reciprocating saw was assessed and compared to the classical planning and freehand cutting method. The pre-operative plan was transferred with high accuracy. Three-dimensional-printed patient-specific guides improve the accuracy of osteotomies and bony resections in an experimental setup compared to conventional freehand methods. The improved accuracy is related to (1) a detailed and qualitative pre-operative plan and (2) an accurate transfer of the planning to the operation room with patient-specific guides by an accurate guidance of the surgical tools to perform the desired cuts.

Future projections of child oral-related hospital admission rates in Western Australia

2016 ◽  
Vol 22 (6) ◽  
pp. 491 ◽  
Author(s):  
Alla Alsharif ◽  
Estie Kruger ◽  
Marc Tennant
Keyword(s):  
Dental Caries ◽  
Hospital Admission ◽  
Hospital Admissions ◽  
Admission Rate ◽  
Projection Data ◽  
Impacted Teeth ◽  
Admission Rates ◽  
The Future ◽  
Hospital Morbidity ◽  
Western Australian

This study aimed to project the hospital admission rates of Western Australian children for oral conditions, with a particular focus on dental caries, embedded and impacted teeth, and pulp and periapical conditions through to the year 2026. Two methods were used to generate projection data through to the year 2026, using the Western Australian Hospital Morbidity Dataset for the period 1999–2000 to 2008–2009. The projected admission rate increase in those children aged 14 years and younger from 2000 to 2026 was 43%. The admission rates are expected to more than double over time (7317 cases in 2026 compared to only 3008 cases in 2000) for those children living in metropolitan areas. Dental caries, embedded and impacted teeth, and pulp and periapical conditions will remain the top (mostly) preventable causes of admission throughout this time. Anticipating the future burden of oral-related hospital admissions in children, in terms of expected numbers of cases, is vital for optimising the resource allocation for early diagnosis, prevention and treatment. A concerted effort will be required by policymakers and oral healthcare communities to effect substantial change for the future.

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