Comparing supplementary oxygen benefits from a portable oxygen concentrator and a liquid oxygen portable device during a walk test in COPD patients on long-term oxygen therapy

SummaryBackgroundDifferences in oxygen delivery between portable oxygen concentrators (POC) and liquid oxygen (LO) portable units, pose a question if POCs are equally effective as LOs in reducing exercise-induced hypoxaemia.DesignRandomized, single-blind clinical trial.PatientsThirteen COPD patients (means: age 66±11 year, FEV1 35.2±13.7% predicted) and respiratory failure (means: PaO2 52±5mmHg, PaCO2 51.3±7.5mmHg).MethodsAll patients underwent a series of 6-min walk tests (6MWT) carried out in random order among one of the three devices: POC, LO cylinder and cylinder with compressed air (CA). Oxygen supplementation was 3lpm for LO and an equivalent to 3lpm in a pulse flow system for POC.ResultsThe mean SpO2 was equally improved at rest: 92.9±2.8% with POC and 91.7±2.0% with LO compared to CA—87.8±2.7% (POC and LO vs. CA p<0.05). POC and LO significantly improved oxygenation during 6MWT (mean SpO2 was 84.3±5% and 83.8±4.2%, respectively) compared to breathing CA—77.6±7.4%, p<0.05. Mean 6MWT distance increased with LO (350±83m) and POC (342±96m) when compared to CA (317±84m), however, these differences were not statistically significant. Dyspnoea score assessed at the end of the exercise (Borg scale) was significantly lower when breathing oxygen (4.2±1.2 with POC and 4.1±1.7 with LO vs. 5.4±1.9 with CA, p<0.05).ConclusionsEffectiveness of oxygen supplementation from a POC did not differ from the LO source during 6MWT in COPD patients with respiratory failure. Oxygen at 3lpm flow was not sufficient to prevent hypoxaemia during strenuous exercise

The crosstalk between EGF, IGF, and Insulin cell signaling pathways - computational and experimental analysis

<p>Abstract</p> <p>Background</p> <p>Cellular response to external stimuli requires propagation of corresponding signals through molecular signaling pathways. However, signaling pathways are not isolated information highways, but rather interact in a number of ways forming sophisticated signaling networks. Since defects in signaling pathways are associated with many serious diseases, understanding of the crosstalk between them is fundamental for designing molecularly targeted therapy. Unfortunately, we still lack technology that would allow high throughput detailed measurement of activity of individual signaling molecules and their interactions. This necessitates developing methods to prioritize selection of the molecules such that measuring their activity would be most informative for understanding the crosstalk. Furthermore, absence of the reaction coefficients necessary for detailed modeling of signal propagation raises the question whether simple parameter-free models could provide useful information about such pathways.</p> <p>Results</p> <p>We study the combined signaling network of three major pro-survival signaling pathways: <b>E</b>pidermal <b>G</b>rowth <b>F</b>actor <b>R</b>eceptor (EGFR), <b>I</b>nsulin-like <b>G</b>rowth <b>F</b>actor-1 <b>R</b>eceptor (IGF-1R), and <b>I</b>nsulin <b>R</b>eceptor (IR). Our study involves static analysis and dynamic modeling of this network, as well as an experimental verification of the model by measuring the response of selected signaling molecules to differential stimulation of EGF, IGF and insulin receptors. We introduced two novel measures of the importance of a node in the context of such crosstalk. Based on these measures several molecules, namely Erk1/2, Akt1, Jnk, p70S6K, were selected for monitoring in the network simulation and for experimental studies. Our simulation method relies on the Boolean network model combined with stochastic propagation of the signal. Most (although not all) trends suggested by the simulations have been confirmed by experiments.</p> <p>Conclusion</p> <p>The simple model implemented in this paper provides a valuable first step in modeling signaling networks. However, to obtain a fully predictive model, a more detailed knowledge regarding parameters of individual interactions might be necessary.</p

Biosimilars: a position paper of the European Society for Medical Oncology, with particular reference to oncology prescribers.

Biosimilars present a necessary and timely opportunity for physicians, patients and healthcare systems. If suitably developed clinically, manufactured to the correct standards and used appropriately, they can positively impact on the financial sustainability of healthcare systems. A critical consideration regarding the introduction of biosimilars into the clinic centres on the required information concerning all the respective procedures. This position paper aims to describe the issues revolving around biosimilars that are relevant to the field of oncology, especially the prescribers. More specifically, we discuss aspects related to definition, forms of biosimilars, labelling, extrapolation, interchangeability, switching, automatic substitution, clinical standards on safety and efficacy, responsibilities among prescribers and pharmacists, potential impact on financial burden in healthcare and the current scenario and future prospects of biosimilars in Europe and the rest of the world

Os Momentos de transição nas rotinas de creche e de jardim de infância

Relatório do Projeto de Investigação Mestrado em Educação Pré-Escolar Versão Definitiva JaneiroO presente Relatório do Projeto de Investigação representa um estudo transversal alicerçado nas vivências ocorridas nos contextos de estágio, por outras palavras, no estágio em Creche e o no estágio em Jardim de Infância, no âmbito do Mestrado em Educação Pré-Escolar. No estudo participaram as duas Educadoras Cooperantes e os respetivos grupos de crianças. A temática em estudo consiste nos Momentos de Transição, isto é, os momentos em que as crianças transitam de uma atividade para a seguinte, e a metodologia que se considera mais apropriada ao estudo empírico posiciona-se na abordagem da investigação-ação. O método de recolha de informação baseia-se na observação participante, nas notas de campo e na análise documental, sendo complementada com inquéritos por questionário apresentados às Educadoras Cooperantes. Em jeito de complementaridade, articulam-se as experiências vivenciadas nos contextos. Este Projeto de Investigação tem como intencionalidade, refletir acerca da relação existente entre as conceções das Educadoras Cooperantes e as suas práticas pedagógicas, bem como, implementar melhorias, nas salas dos contextos de estágio, no que diz respeito à gestão dos momentos de transição. A partir desta investigação, é possível compreender que os momentos de transição são, de facto, valorizados nas conceções das Educadoras Cooperantes como momentos que requerem atenção e planeamento, porém efetivamente nem sempre a intervenção é congruente com o que defendem.This Report of the Investigation Project represents a cross-sectional study based on experiences that occured in the two internships - on nursery and on kindergarten. The two Cooperating Educators and their respective groups of children had participated in the study. The theme under study consist in the Moments of Transition, that is, the moments when the children move from one activity to the next one, and the methodology which is considered more appropriated to the empirical study is positioned in the action-research approach. The collecting information method is based on participant observation, field notes and document analysis, being complemented with questionnaire surveys presented to the Cooperating Educators. In a way of complementarity, the experiences lived in the contexts are articulated. This Investigation Project intends to reflect about the relationship between the Cooperating Educators concepts and their practices, it also intends to implement improvements in the rooms of the internship contexts, when it comes to the management of transition moments. From this investigation, it is possible to understand that transition moments are, in fact, valued in the Cooperative Educators conceptions as moments that require attention and planning, however, the intervention is not always consistent with what they defend

In Vivo Fluorescence Lifetime Imaging Monitors Binding of Specific Probes to Cancer Biomarkers

One of the most important factors in choosing a treatment strategy for cancer is characterization of biomarkers in cancer cells. Particularly, recent advances in Monoclonal Antibodies (MAB) as primary-specific drugs targeting tumor receptors show that their efficacy depends strongly on characterization of tumor biomarkers. Assessment of their status in individual patients would facilitate selection of an optimal treatment strategy, and the continuous monitoring of those biomarkers and their binding process to the therapy would provide a means for early evaluation of the efficacy of therapeutic intervention. In this study we have demonstrated for the first time in live animals that the fluorescence lifetime can be used to detect the binding of targeted optical probes to the extracellular receptors on tumor cells in vivo. The rationale was that fluorescence lifetime of a specific probe is sensitive to local environment and/or affinity to other molecules. We attached Near-InfraRed (NIR) fluorescent probes to Human Epidermal Growth Factor 2 (HER2/neu)-specific Affibody molecules and used our time-resolved optical system to compare the fluorescence lifetime of the optical probes that were bound and unbound to tumor cells in live mice. Our results show that the fluorescence lifetime changes in our model system delineate HER2 receptor bound from the unbound probe in vivo. Thus, this method is useful as a specific marker of the receptor binding process, which can open a new paradigm in the “image and treat” concept, especially for early evaluation of the efficacy of the therapy

Bone mineral density and bone turnover in male master track and field athletes aged 40-64

We evaluated areal bone mineral density (aBMD), bone mineral content (BMC), and markers of bone turnover in male competitive masters athletes representing different training profile in the past and at present, aged 40–64 (14 endurance runners, and 12 speed-power athletes), and non-sport controls (n¼13). Dual-energy X-ray absorptiometry measurements of total body and regional aBMD, BMC and soft tissue composition were acquired. Serum concentrations of osteocalcin (OC), C-terminal crosslinking telopeptide of type I collagen (CTX), tumour necrosis factor-a (TNF-a), total testosterone (TT), free testosterone (FT) and insulin like growth factor-1 (IGF-1) were measured. Adjusted total and regional aBMD and BMC (covariates: body mass, body height and age) were significantly greater in all measured regions in speed-power athletes than in endurance athletes and control subjects, but adjusted aBMD and BMC values were not significantly different between endurance athletes and controls. No differences in bone formation (OC), bone resorption (CTX), and serum concentrations of TNF-a, TT, FT and IGF-1 were noted. This suggests that weight-bearing exercise in young age and the training continuation in later life may be an important contributor to the aBMD and BMC in the middle age and in the elderly. It seems also that training-related bone differences in men are not caused by present alterations in bone turn-over or somatotropic effects. However, conclusions must be drawn with caution due to a large variability of biochemical markers