1,390 research outputs found
Urinary ATP as an indicator of infection and inflammation of the urinary tract in patients with lower urinary tract symptoms
BACKGROUND:
Adenosine-5'-triphosphate (ATP) is a neurotransmitter and inflammatory cytokine implicated in the pathophysiology of lower urinary tract disease. ATP additionally reflects microbial biomass thus has potential as a surrogate marker of urinary tract infection (UTI). The optimum clinical sampling method for ATP urinalysis has not been established. We tested the potential of urinary ATP in the assessment of lower urinary tract symptoms, infection and inflammation, and validated sampling methods for clinical practice.
METHODS:
A prospective, blinded, cross-sectional observational study of adult patients presenting with lower urinary tract symptoms (LUTS) and asymptomatic controls, was conducted between October 2009 and October 2012. Urinary ATP was assayed by a luciferin-luciferase method, pyuria counted by microscopy of fresh unspun urine and symptoms assessed using validated questionnaires. The sample collection, storage and processing methods were also validated.
RESULTS:
75 controls and 340 patients with LUTS were grouped as without pyuria (n = 100), pyuria 1-9 wbc ?l(-1) (n = 120) and pyuria ?10 wbc ?l(-1) (n = 120). Urinary ATP was higher in association with female gender, voiding symptoms, pyuria greater than 10 wbc ?l(-1) and negative MSU culture. ROC curve analysis showed no evidence of diagnostic test potential. The urinary ATP signal decayed with storage at 23°C but was prevented by immediate freezing at ??-20°C, without boric acid preservative and without the need to centrifuge urine prior to freezing.
CONCLUSIONS:
Urinary ATP may have a role as a research tool but is unconvincing as a surrogate, clinical diagnostic marker
Participatory Epidemiology: Use of Mobile Phones for Community-Based Health Reporting
Clark Freifeld and colleagues discuss mobile applications, including their own smartphone application, that show promise for health monitoring and information sharing
Helium in the adult critical care setting
Helium is a low-density inert gas whose physical properties are very different from those of nitrogen and oxygen. Such properties could be clinically useful in the adult critical care setting, especially in patients with upper to more distal airway obstruction requiring moderate to intermediate levels of FiO2. However, despite decades of utilization and reporting, it is still difficult to give any firm clinical recommendation in this setting. Numerous case reports are available in the context of upper airway obstruction of different origins, but there is a lack of controlled studies for this indication. One study reported a helium-induced beneficial effect on surrogates of work of breathing after extubation in non-COPD patients, possibly in relation to laryngeal consequences of tracheal intubation. Physiological benefits of helium-oxygen breathing have been demonstrated in the context of acute severe asthma, but there is a lack of large controlled studies demonstrating an effect on pertinent clinical endpoints, except for a study reported only as an abstract, which mentioned a reduction in the intubation rate in helium-treated patients. Finally, there are a number of physiological studies in the context of COLD-COPD patients demonstrating a beneficial effect, mainly by a reduction in the resistive inspiratory work of breathing but also by a reduction in hyperinflation. Reduction of hypercapnia was mainly observed in spontaneously breathing and noninvasively ventilated helium-treated patients but not in intubated patients during controlled ventilation, suggesting that the decrease in PaCO2 was mainly in relation to a diminution in CO2 production, related to the diminution in work of breathing and not an improved alveolar ventilation. Moreover, there is little evidence that helium-oxygen could improve parameters of heterogeneity in such patients. Two RCTs were unable to demonstrate a reduction in the intubation rate in such setting, but they were likely underpowered. An adequately powered international multicentric study is ongoing and will help to determinate the exact place of the helium-oxygen mixture in the future. The place of the mixture during the weaning period will deserve further evaluation
First-line latanoprost therapy in ocular hypertension or open-angle glaucoma patients: a 3-month efficacy analysis stratified by initial intraocular pressure
<p>Abstract</p> <p>Background</p> <p>Prospective, multicenter, randomized, double-masked trials have shown latanoprost instilled once daily to be at least as effective as and generally superior to timolol administered twice daily and to be as effective as other frequently prescribed prostaglandin analogues. This study prospectively assessed the efficacy of latanoprost monotherapy in a large cohort of treatment-naive patients with a broad range of baseline intraocular pressure (IOP) levels treated in actual clinical practice settings.</p> <p>Methods</p> <p>This prospective, open-label, multicenter, uncontrolled, phase IV study included treatment-naive ocular hypertension or open-angle glaucoma subjects initiating latanoprost once daily (evening). IOP levels were measured at baseline and after 1 and 3 months. The primary efficacy outcome was mean change in IOP from baseline to month 3. Analyses were stratified by baseline IOP: ≥ 20 and <24 mmHg <it>vs </it>≥ 24 mmHg.</p> <p>Results</p> <p>Efficacy analyses (intent to treat) included 572 subjects: 20 to <24 mmHg group, N = 252; ≥ 24 mmHg group, N = 320. Mean baseline IOP levels were 22.2 ± 0.9 mmHg and 26.7 ± 2.8 mmHg, respectively. At month 3, significant IOP reductions were seen in both groups (p < 0.0001, within-group differences); reductions were smaller in the 20 to <24 mmHg group (-6.3 ± 2.4 <it>vs </it>-9.2 ± 3.7 mmHg, respectively; -28.0 ± 10.6% <it>vs </it>-34.1 ± 11.9%, respectively). An IOP reduction of ≥ 30% from baseline to month 3 was noted in 48.4% and 65.6% of subjects, respectively (p < 0.0001). At month 3, targets IOPs of ≤ 18 mmHg were achieved by ≥ 70% of subjects in both groups. Latanoprost was well tolerated with an adverse event profile similar to that reported in the literature.</p> <p>Conclusions</p> <p>This "real world" study found once-daily latanoprost to be effective and safe in treatment-naive ocular hypertension or open-angle glaucoma patients. Patients with baseline IOP levels of 20 to <24 mmHg as well as ≥ 24 mmHg benefitted from initial latanoprost therapy.</p> <p>Trial Registration</p> <p>Trial Registration Number: NCT00647101</p
Measurement of Exclusive B Decays to Final States Containing a Charmed Baryon
Using data collected by the CLEO detector in the Upsilon(4S) region, we
report new measurements of the exclusive decays of B mesons into final states
of the type Lambda_c^+ p-bar n(pi), where n=0,1,2,3. We find signals in modes
with one, two and three pions and an upper limit for the two body decay
Lambda_c^+ pbar. We also make the first measurements of exclusive decays of B
mesons to Sigma_c p-bar n(pi), where n=0,1,2. We find signals in modes with one
and two pions and an upper limit for the two body decay Sigma_c p-bar.
Measurements of these modes shed light on the mechanisms involved in B decays
to baryons.Comment: 11 pages postscript, also available through
http://w4.lns.cornell.edu/public/CLNS, submitted to PR
Measurement of the Relative Branching Fraction of to Charged and Neutral B-Meson Pairs
We analyze 9.7 x 10^6 B\bar{B}$ pairs recorded with the CLEO detector to
determine the production ratio of charged to neutral B-meson pairs produced at
the Y(4S) resonance. We measure the rates for B^0 -> J/psi K^{(*)0} and B^+ ->
J/psi K^{(*)+} decays and use the world-average B-meson lifetime ratio to
extract the relative widths f+-/f00 = Gamma(Y(4S) -> B+B-)/Gamma(Y(4S) ->
B0\bar{B0}) = = 1.04 +/- 0.07(stat) +/- 0.04(syst). With the assumption that
f+- + f00 = 1, we obtain f00 = 0.49 +/- 0.02(stat) +/- 0.01(syst) and f+- =
0.51 +/- 0.02(stat) +/- 0.01(syst). This production ratio and its uncertainty
apply to all exclusive B-meson branching fractions measured at the Y(4S)
resonance.Comment: 11 pages postscript, also available through
http://w4.lns.cornell.edu/public/CLN
Observation of the Charmed Baryon at CLEO
The CLEO experiment at the CESR collider has used 13.7 fb of data to
search for the production of the (css-ground state) in
collisions at {\rm GeV}. The modes used to
study the are ,
, , , and
. We observe a signal of 40.49.0(stat) events
at a mass of 2694.62.6(stat)1.9(syst) {\rm MeV/}, for all modes
combined.Comment: 10 pages postscript, also available through
http://w4.lns.cornell.edu/public/CLN
First Observation of the Decays and B^{0}\to D^{*-}p\bar{n}$
We report the first observation of exclusive decays of the type B to D^* N
anti-N X, where N is a nucleon. Using a sample of 9.7 times 10^{6} B-Bbar pairs
collected with the CLEO detector operating at the Cornell Electron Storage
Ring, we measure the branching fractions B(B^0 \to D^{*-} proton antiproton
\pi^+) = ({6.5}^{+1.3}_{-1.2} +- 1.0) \times 10^{-4} and B(B^0 \to D^{*-}
proton antineutron) = ({14.5}^{+3.4}_{-3.0} +- 2.7) times 10^{-4}. Antineutrons
are identified by their annihilation in the CsI electromagnetic calorimeter.Comment: 9 pages postscript, also available through
http://w4.lns.cornell.edu/public/CLN
Measurements of B --> D_s^{(*)+} D^{*(*)} Branching Fractions
This article describes improved measurements by CLEO of the and branching fractions, and first evidence
for the decay , where
represents the sum of the , , and
L=1 charm meson states. Also reported is the first
measurement of the polarization in the decay . A partial reconstruction technique, employing only the fully
reconstructed and slow pion from the decay, enhances sensitivity. The observed branching fractions are
, , and , where the first error is statistical,
the second systematic, and the third is due to the uncertainty in the branching fraction. The measured longitudinal
polarization, , is consistent with
the factorization prediction of 54%.Comment: 26 pages (LaTeX), 15 figures. To be submitted to PR
Study of the Decays B0 --> D(*)+D(*)-
The decays B0 --> D*+D*-, B0 --> D*+D- and B0 --> D+D- are studied in 9.7
million Y(4S) --> BBbar decays accumulated with the CLEO detector. We determine
Br(B0 --> D*+D*-) = (9.9+4.2-3.3+-1.2)e-4 and limit Br(B0 --> D*+D-) < 6.3e-4
and Br(B0 --> D+D-) < 9.4e-4 at 90% confidence level (CL). We also perform the
first angular analysis of the B0 --> D*+D*- decay and determine that the
CP-even fraction of the final state is greater than 0.11 at 90% CL. Future
measurements of the time dependence of these decays may be useful for the
investigation of CP violation in neutral B meson decays.Comment: 21 pages, 5 figures, submitted to Phys. Rev.
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