scholarly journals A Novel Earwax Method to Measure Acute and Chronic Glucose Levels

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1069
Author(s):  
Andrés Herane-Vives ◽  
Susana Espinoza ◽  
Rodrigo Sandoval ◽  
Lorena Ortega ◽  
Luis Alameda ◽  
...  
Keyword(s):  
Postprandial Glucose ◽  
The Novel ◽  
Sampling Device ◽  
Clinical Method ◽  
Postprandial Glycemia ◽  
Novel Device ◽  
Glucose Levels ◽  
Standard Serum

Diabetes is the fourth cause of death globally. To date, there is not a practical, as well as an accurate sample for reflecting chronic glucose levels. We measured earwax glucose in 37 controls. Participants provided standard serum, glycated hemoglobin (HbA1c) and earwax samples at two time-points, one month apart. The specimens measured baseline fasting glucose, a follow-up postprandial glucose level and a between sample chronic glucose, calculated using the average level on the two occasions. The baseline earwax sample was obtained using a clinical method and the follow-up using a novel self-sampling earwax device. The earwax analytic time was significantly faster using the novel device, in comparison to the clinical use of the syringe. Earwax accurately reflected glucose at both assessments with stronger correlations than HbA1c. Follow-up postprandial concentrations were more significant than their respective fasting baseline concentrations, reflecting differences in fasting and postprandial glycemia and more efficient standardization at follow up. Earwax demonstrated to be more predictable than HbA1c in reflecting systemic fasting, postprandial and long-term glucose levels, and to be less influenced by confounders. Earwax glucose measurements were approximately 60% more predictable than HbA1c in reflecting glycemia over a month. The self-sampling device provided a sample that might accurately reflect chronic glycemia.

scholarly journals A Novel Earwax Method to Measure Acute and Chronic Glucose Levels

2020 ◽  
Author(s):  
Andres Herane-Vives ◽  
Susana Espinoza ◽  
Rodrigo Sandoval ◽  
Lorena Ortega ◽  
Luis Alameda ◽  
...  
Keyword(s):  
Glycated Haemoglobin ◽  
Postprandial Glucose ◽  
The Novel ◽  
Serum Samples ◽  
Sampling Device ◽  
Clinical Method ◽  
Novel Device ◽  
Glucose Levels ◽  
Standard Serum

Increased chronic glucose is associated with pandemic diseases. To date, there is not a practical, as well as accurate sample for reflecting that level. We measured earwax glucose in 37 controls. They provided standard serum samples, Glycated Haemoglobin (HbA1c) and earwax samples on two time-points, one month a part. The specimens measured baseline fasting glucose, a follow-up postprandial glucose level and a between sample chronic glucose, calculated using the average level on the two occasions. The baseline earwax sample was obtained using a clinical method and the follow-up using a novel self-sampling earwax device. The earwax analytic time was significantly faster using the novel device in comparison to the clinical use of the syringe. Earwax accurately reflected glucose at both assessments with stronger correlations than HbA1c. Follow-up postprandial concentrations were more significant than their respective fasting baseline concentrations, reflecting differences in fasting and postprandial glycaemia and more efficient standardisation at follow up. Earwax demonstrated to be more predictable than HbA1c in reflecting systemic fasting, postprandial and long-term glucose levels and immune by confounders. Earwax glucose was approximately 60% more predictable than HbA1c in reflecting glycaemia over a month. The self-sampling device provided a sample that might accurately reflect chronic glycaemia.

scholarly journals A Novel Earwax Self-Sampling Device: A Feasibility Study

2021 ◽  
Vol 11 (11) ◽  
pp. 4882
Author(s):  
Andrés Herane-Vives ◽  
Rodrigo Sandoval ◽  
Lorena Ortega ◽  
Susana Espinoza ◽  
Anthony Cleare ◽  
...  
Keyword(s):  
Extraction Method ◽  
Clinical Applications ◽  
New Method ◽  
The Novel ◽  
Sampling Device ◽  
Clinical Method ◽  
Novel Device ◽  
Coefficients Of Variation ◽  
The Right

(1) Background: Earwax might provide the long-term concentration of substances that are altered in chronic diseases. Standardised earwax extraction has to be exclusively performed by clinicians. We investigated the safety, reliability, and tolerance of a novel self-sampling earwax device in comparison with a clinical method; (2) Methods: We compared the reliability between both methods in a longitudinal study. We first cleaned both ears at baseline in 37 controls. Secondly, we obtained a sample a month after by extracting earwax from the right ear with a novel self-sampling device, and from the left ear by using the clinical method. Reliability of both methods was measured by coefficients of variation; (3) Results: The weight of the baseline samples was not significantly different between ear sides. The reliability of the two methods was not significantly different. The self-extraction method removed eight times more earwax than the clinical method. The new method proved to be well tolerated; (4) Conclusions: The novel device was as reliable as the clinical method in sampling earwax. In view of its practicality, safety, tolerability and efficiency, the new method may have clinical applications at a reduced cost.

Measuring Earwax Cortisol Concentration Using a Non-Stressful Method (Preprint)

2020 ◽  
Author(s):  
Andrés Herane-Vives
Keyword(s):  
Cortisol Level ◽  
Local Stress ◽  
Extraction Methods ◽  
Cortisol Concentration ◽  
The Novel ◽  
Sampling Device ◽  
Related Factors ◽  
Novel Device ◽  
Cortisol Levels ◽  
The Right

BACKGROUND “Short-term” samples are not the most appropriate for reflecting Chronic Cortisol Concentration (CCC). Although hair is used for reflecting the systemic cortisol level over “long-term”, its use appears clinically problematic. Local stress and non-stress related factors may release a circumscribed cortisol secretion that is accumulated in hair. Non-stressful earwax extraction methods may provide a more accurate specimen to measure CCC. OBJECTIVE Correlate cortisol levels using hair, serum and earwax samples METHODS Earwax from both ears of 37 controls were extracted using a clinical procedure commonly associated with local pain. One month later, earwax from the left ear side was extracted using the same procedure, and earwax from the right ear side was comfortably extracted, using an earwax self-sampling device. Participants also provided one centimetre of hair that represented the retrospective month of cortisol output, and one serum sample that reflected the effect of systemic stressors on cortisol levels. Earwax (ECC), Hair (HCC) and Serum (SCC) Cortisol Concentration were correlated and compared. Confounders´ effect on cortisol levels were studied. RESULTS Serum showed the largest and hair the lowest cortisol concentration (p<0.01). Left-ECC was larger than Right-ECC (p=0.03). Right-ECC was the only sample unaffected by confounders (all p>0.05). Right-ECC and HCC showed the only significant association (r=0.39; p=0.03). CONCLUSIONS The self-sampling device did not represent a local stressor for the ceruminous glands. It provided the cortisol level with the least likely to be affected by confounding factors over the previous month. ECC using the novel device may constitute another accurate, but more suitable and affordable specimen for measuring CCC.

scholarly journals Waning antibody responses in COVID-19: what can we learn from the analysis of other coronaviruses?

Infection ◽  
2021 ◽  
Author(s):  
Ali Hamady ◽  
JinJu Lee ◽  
Zuzanna A. Loboda
Keyword(s):  
Cross Reactivity ◽  
Antibody Responses ◽  
The Novel ◽  
Incidence And Mortality ◽  
Antibody Titres ◽  
Human Coronaviruses ◽  
Public Health Strategies ◽  
Antibody Dynamics

Abstract Objectives The coronavirus disease 2019 (COVID-19), caused by the novel betacoronavirus severe acute respiratory syndrome 2 (SARS-CoV-2), was declared a pandemic in March 2020. Due to the continuing surge in incidence and mortality globally, determining whether protective, long-term immunity develops after initial infection or vaccination has become critical. Methods/Results In this narrative review, we evaluate the latest understanding of antibody-mediated immunity to SARS-CoV-2 and to other coronaviruses (SARS-CoV, Middle East respiratory syndrome coronavirus and the four endemic human coronaviruses) in order to predict the consequences of antibody waning on long-term immunity against SARS-CoV-2. We summarise their antibody dynamics, including the potential effects of cross-reactivity and antibody waning on vaccination and other public health strategies. At present, based on our comparison with other coronaviruses we estimate that natural antibody-mediated protection for SARS-CoV-2 is likely to last for 1–2 years and therefore, if vaccine-induced antibodies follow a similar course, booster doses may be required. However, other factors such as memory B- and T-cells and new viral strains will also affect the duration of both natural and vaccine-mediated immunity. Conclusion Overall, antibody titres required for protection are yet to be established and inaccuracies of serological methods may be affecting this. We expect that with standardisation of serological testing and studies with longer follow-up, the implications of antibody waning will become clearer.

scholarly journals Outpatient management of heart valve disease following the COVID-19 pandemic: implications for present and future care

Heart ◽  
2020 ◽  
Vol 106 (20) ◽  
pp. 1549-1554 ◽  
Author(s):  
Benoy Nalin Shah ◽  
Dominik Schlosshan ◽  
Hannah Zelie Ruth McConkey ◽  
Mamta Heena Buch ◽  
Andrew John Marshall ◽  
...  
Keyword(s):  
Heart Valve ◽  
Waiting Times ◽  
Severe Disease ◽  
Valve Disease ◽  
Heart Valve Disease ◽  
The Novel ◽  
Future Care ◽  
Novel Coronavirus

The established processes for ensuring safe outpatient surveillance of patients with known heart valve disease (HVD), echocardiography for patients referred with new murmurs and timely delivery of surgical or transcatheter treatment for patients with severe disease have all been significantly impacted by the novel coronavirus pandemic. This has created a large backlog of work and upstaging of disease with consequent increases in risk and cost of treatment and potential for worse long-term outcomes. As countries emerge from lockdown but with COVID-19 endemic in society, precautions remain that restrict ‘normal’ practice. In this article, we propose a methodology for restructuring services for patients with HVD and provide recommendations pertaining to frequency of follow-up and use of echocardiography at present. It will be almost impossible to practice exactly as we did prior to the pandemic; thus, it is essential to prioritise patients with the greatest clinical need, such as those with symptomatic severe HVD. Local procedural waiting times will need to be considered, in addition to usual clinical characteristics in determining whether patients requiring intervention would be better suited having surgical or transcatheter treatment. We present guidance on the identification of stable patients with HVD that could have follow-up deferred safely and suggest certain patients that could be discharged from follow-up if waiting lists are triaged with appropriate clinical input. Finally, we propose that novel models of working enforced by the pandemic—such as increased use of virtual clinics—should be further developed and evaluated.

In Vivo Performance of a Novel, Anatomically Shaped, Total Meniscal Prosthesis Made of Polycarbonate Urethane: A 12-Month Evaluation in Goats

2017 ◽  
Vol 45 (12) ◽  
pp. 2824-2834 ◽  
Author(s):  
Anne C.T. Vrancken ◽  
Gerjon Hannink ◽  
Wojciech Madej ◽  
Nico Verdonschot ◽  
Tony G. van Tienen ◽  
...  
Keyword(s):  
Treatment Options ◽  
Wear Particles ◽  
The Novel ◽  
Stifle Joint ◽  
Physiological Loading ◽  
Polycarbonate Urethane ◽  
Sham Surgery

Background: Injury or loss of the meniscus generally leads to degenerative osteoarthritic changes in the knee joint. However, the treatment options for symptomatic patients with total meniscectomy are limited. Therefore, we developed a novel, anatomically shaped, total meniscal implant made of polycarbonate urethane. Purpose: To evaluate the in vivo performance of this novel total meniscal implant. The assessment particularly focused on the implant’s response to long-term physiological loading in a goat model and its chondroprotective capacity in comparison to clinically relevant controls. Study Design: Controlled laboratory study. Methods: Surgery was performed to the stifle joint of 26 female Saanen goats, subdivided into 4 groups: implant, allograft, total meniscectomy, and sham surgery. The sham group’s contralateral joints served as nonoperated controls. After 12 months of follow-up, investigators evaluated implant wear, deformation, and the histopathological condition of the synovium and cartilage. Results: Wear of the implant’s articulating surfaces was minimal, which was confirmed by the absence of wear particles in the synovial fluid. Implant deformation was limited. However, one implant failed by complete tearing of the posterior horn extension. No differences in cartilage histopathological condition were observed for the implant, allograft, and meniscectomy groups. However, locally, the cartilage scores for these groups were significantly worse than those of the nonoperated controls. Conclusion: Whereas this study demonstrated that the novel implant is resistant to wear and that deformation after 12 months of physiological loading is acceptable, reinforcement of the implant horns is necessary to prevent horn failure. Although the implant could not protect the cartilage from developing degenerative changes, the progression of damage was similar in the allograft group. Clinical Relevance: This novel polycarbonate urethane implant may have the potential to become an alternative treatment for symptomatic patients with total meniscectomy.

Theileria parva live vaccination: parasite transmission, persistence and heterologous challenge in the field

Parasitology ◽  
2007 ◽  
Vol 134 (9) ◽  
pp. 1205-1213 ◽  
Author(s):  
C. A. L. OURA ◽  
R. BISHOP ◽  
B. B. ASIIMWE ◽  
P. SPOONER ◽  
G. W. LUBEGA ◽  
...  
Keyword(s):  
East Coast ◽  
Treatment Protocol ◽  
Carrier State ◽  
The Novel ◽  
Theileria Parva ◽  
Follow Up Study ◽  
Heterologous Challenge ◽  
Overt Disease

SUMMARYThe ‘Muguga cocktail’ live vaccine, delivered by an infection and treatment protocol, has been widely deployed in Eastern, Central and Southern Africa to protect cattle against East Coast fever, caused by Theileria parva. The vaccine contains 3 component stocks (Muguga, Serengeti-transformed and Kiambu 5). In a previous study, parasites from vaccinated and unvaccinated animals were genotyped with a panel of micro- and minisatellite markers (Oura et al.2004a) and it was shown that only the Kiambu 5 stock establishes a long-term carrier state but there was no evidence for the transmission of this stock. Also parasite genotypes different from the 3 component vaccine stocks were identified in vaccinated animals. We now report a follow-up study on the same farm, some 4 years after the initial vaccination, aimed at establishing the source of the novel parasite genotypes identified in vaccinated cattle, determining the longevity of the carrier state established by the Kiambu 5 vaccine stock and re-examining whether vaccine transmission can occur over a longer time-scale. To do this, samples were taken from vaccinated and unvaccinated cattle and the parasites were genotyped with a series of micro- and minisatellite markers. The data indicate that the vaccine stabilates contain at least 6 parasite genotypes, the Kiambu 5 stock can be detected in many but not all vaccinated cattle for up to 4 years and can be transmitted to unvaccinated cattle which share grazing and that some of the vaccinated animals become infected with local genotypes without causing overt disease.

scholarly journals Technical feasibility and safety of transluminal antegrade dilation for hepaticojejunostomy stricture using a novel fine-gauge electrocautery dilator (with video)

2020 ◽  
Vol 08 (06) ◽  
pp. E733-E737 ◽  
Author(s):  
Takeshi Ogura ◽  
Nobu Nishioka ◽  
Masanori Yamada ◽  
Tadahiro Yamada ◽  
Saori Ueno ◽  
...  
Keyword(s):  
Bile Duct ◽  
Intrahepatic Bile Duct ◽  
The Novel ◽  
Technical Success ◽  
Long Term Follow Up ◽  
Secondary Endpoints ◽  
Patient Refusal ◽  
A Prospective Study

Abstract Background and study aims A novel fine-gauge electrocautery dilator (ED) has recently become available in Japan. The current study evaluated the safety and feasibility of transluminal antegrade dilation for hepaticojejunal stricture (HJS) using this novel ED. Patients and methods Patients who with complicated HJS were retrospectively enrolled. The primary and secondary endpoints of this study were rates of technical success defined as functional antegrade HJS dilation using the novel ED and types of adverse events, respectively. A total of 22 patients were enrolled. Among them, six were treated using an enteroscopic approach due to the absence of bile duct dilation or patient refusal to undergo EUS-HGS. Therefore, 16 patients underwent EUS-HGS. Results The procedure was successful in 15 of 16 patients (93.8 %). The contrast medium flowed from the intrahepatic bile duct to the intestine of 14 of 15 patients (93.3 %). The resolution rate of HJS was 13 of 14 (92.9 %) at 6 months. Conclusion Our technique might offer a new option with which to treat HJS, although a prospective study with long-term follow-up is needed.

scholarly journals Difficulties in Translating Appetite Sensations Effect of Turmeric-Based Beverage When Given Prior to Isoenergetic Medium- or High-Fat Meals in Healthy Subjects

Nutrients ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 736 ◽  
Author(s):  
Yoghatama Zanzer ◽  
Ângela Batista ◽  
Anestis Dougkas ◽  
Juscelino Tovar ◽  
Yvonne Granfeldt ◽  
...  
Keyword(s):  
Gut Hormones ◽  
Postprandial Glucose ◽  
Wheat Bread ◽  
High Fat ◽  
Postprandial Glycemia ◽  
White Wheat ◽  
Glucose Levels ◽  
Prospective Consumption ◽  
Desire To Eat

The established effect of turmeric and its curcuminoids on appetite sensations was previously shown to be mediated by gut hormones release. In in vitro and preclinical studies, curcumin was shown to induce GLP-1 secretion and improve postprandial glycemia. In humans, consumption of 220 mL turmeric-based beverage (TUR, containing 185 mg gallic acid equivalents (GAE)) prior to white wheat bread (WWB, 50 g available carbohydrate) reduced early postprandial glucose levels and induced peptide tyrosine–tyrosine (PYY) release, as well as lowered ‘desire to eat’ and ‘prospective consumption’ in a postprandial setting, compared to control. In the present study, 12 healthy participants (5 men, 7 women) were admitted. An identical beverage was given and consumed prior to isoenergetic (423 kcal) medium-fat (MF) or high-fat (HF) meals. Appetite sensations including perceived ‘hunger’, ‘desire to eat’, ‘satiety’, ‘fullness’, ‘prospective consumption’, and ‘thirst’ were measured using visual analogue scales. MF induced 18% (p = 0.039) higher ‘satiety’ compared to HF. TUR consumption prior to either MF or HF did not modulate the perceived appetite sensations. Whether macronutrient-induced appetite sensations override the actual turmeric effects warrants further investigation.

scholarly journals Novel Technique of Transepithelial Corneal Cross-Linking Using Iontophoresis in Progressive Keratoconus

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Marco Lombardo ◽  
Sebastiano Serrao ◽  
Paolo Raffa ◽  
Marianna Rosati ◽  
Giuseppe Lombardo
Keyword(s):  
Controlled Trial ◽  
Cross Linking ◽  
The Novel ◽  
Novel Technique ◽  
Randomized Controlled ◽  
Average Improvement ◽  
Corrected Distance Visual Acuity ◽  
Spherical Equivalent Refraction

In this work, the authors presented the techniques and the preliminary results at 6 months of a randomized controlled trial (NCT02117999) comparing a novel transepithelial corneal cross-linking protocol using iontophoresis with the Dresden protocol for the treatment of progressive keratoconus. At 6 months, there was a significant average improvement with an average flattening of the maximum simulated keratometry reading of0.72±1.20 D (P=0.01); in addition, corrected distance visual acuity improved significantly (P=0.08) and spherical equivalent refraction was significantly less myopic (P=0.02) 6 months after transepithelial corneal cross-linking with iontophoresis. The novel protocol using iontophoresis showed comparable results with standard corneal cross-linking to halt progression of keratoconus during 6-month follow-up. Investigation of the long-term RCT outcomes are ongoing to verify the efficacy of this transepithelial corneal cross-linking protocol and to determine if it may be comparable with standard corneal cross-linking in the management of progressive keratoconus.

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