Studies into the mechanism of measles-associated immune suppression during a measles outbreak in the Netherlands.

Measles causes a transient immune suppression, leading to increased susceptibility to opportunistic infections. In experimentally infected non-human primates (NHPs) measles virus (MV) infects and depletes pre-existing memory lymphocytes, causing immune amnesia. A measles outbreak in the Dutch Orthodox Protestant community provided a unique opportunity to study the pathogenesis of measles immune suppression in unvaccinated children. In peripheral blood mononuclear cells (PBMC) of prodromal measles patients, we detected MV-infected memory CD

Improvement of radiocephalic fistula maturation: rationale and design of the Liposomal Prednisolone to Improve Hemodialysis Fistula Maturation (LIPMAT) study - a randomized controlled trial

Non-maturation is a frequent complication of radiocephalic arteriovenous fistulas (RCAVF). In an animal model, liposomal prednisolone improved maturation of experimental fistulas. The Liposomal Prednisolone to Improve Hemodialysis Fistula Maturation (LIPMAT) study investigates if liposomal prednisolone improves RCAVF maturation. The LIPMAT study is an investigator-initiated, multicenter, double-blinded, placebo-controlled randomized controlled trial with 1:1 randomization to liposomal prednisolone or placebo. Eighty patients receiving an RCAVF will be included. The primary outcome is the cephalic vein diameter six weeks after surgery, measured by ultrasound. The LIPMAT study started in May 2016. Enrollment is expected to be completed by the end of 2017. The LIPMAT study is the first to evaluate the efficacy of liposomal prednisolone to enhance RCAVF maturatio

Improvement of radiocephalic fistula maturation: rationale and design of the Liposomal Prednisolone to Improve Hemodialysis Fistula Maturation (LIPMAT) study – a randomized controlled trial

Non-maturation is a frequent complication of radiocephalic arteriovenous fistulas (RCAVF). In an animal model, liposomal prednisolone improved maturation of experimental fistulas. The Liposomal Prednisolone to Improve Hemodialysis Fistula Maturation (LIPMAT) study investigates if liposomal prednisolone improves RCAVF maturation. The LIPMAT study is an investigator-initiated, multicenter, double-blinded, placebo-controlled randomized controlled trial with 1:1 randomization to liposomal prednisolone or placebo. Eighty patients receiving an RCAVF will be included. The primary outcome is the cephalic vein diameter six weeks after surgery, measured by ultrasound. The LIPMAT study started in May 2016. Enrollment is expected to be completed by the end of 2017. The LIPMAT study is the first to evaluate the efficacy of liposomal prednisolone to enhance RCAVF maturatio

Clinical nephrology-epidemiology-clinical trials: Determinants of outcome in ANCA-associated glomerulonephritis: A prospective clinico-histopathological analysis of 96 patients

Background. The predictive value of clinical and renal histological features for renal outcome in patients with anti-neutrophil cytoplasmic autoantibody (ANCA)-associated glomerulonephritis was investigated in a prospective analysis of 96 patients with ANCA-associated vasculitis, and moderate renal involvement (creatinine <500 \uce\ubcmol/L). Methods. The extent of 39 histological features in 96 biopsies (performed at entry in a clinical trial) was scored by two independent observers, according to a standardized protocol. Age, gender, diagnosis, glomerular filtration rate at entry (GFR0), ANCA-specificity, proteinuria, and treatment of these 96 patients were also taken into account. Treatment was standardized and started after the biopsy was performed. Endpoints included renal function at 18 months (GFR18), GFR18 corrected for GFR0 (CORGFR18), and the occurrence of relapse or death. Results. Parameters that most strongly correlated with GFR18 were GFR0 (r = 0.67), interstitial fibrosis (r = -0.45), glomerulosclerosis (r = -0.37), and tubular atrophy (r = -0.36). Parameters that most strongly correlated with CORGFR18 were segmental (r = 0.45) and cellular (r = 0.30) crescents, and fibrinoid necrosis (r = 0.46). None of the clinical and histological features predicted the occurrence of relapse or death. By applying a stepwise linear multiple regression analysis, we designed a formula for the estimation of renal function at 18 months: GFR18 (mL/min) = 17 + 0.71 \uc3\u97 GFR0 (mL/min) + 0.34 \uc3\u97 fibrinoid necrosis (%) + 0.33 \uc3\u97 segmental crescents (%), (r2 = 0.60; standard deviation = 19 mL/min). Our results were independent of diagnosis, ANCA-specificity, and treatment limb. Conclusions. These data suggest that in ANCA-associated glomerulonephritis, GFR0 and predominantly chronic renal lesions are potent predictors of GFR18. Active lesions are associated with renal function recovery and may be reversible. The formula for the estimation of GFR18 shows that a combination of GFR0 and renal histology is a better predictor for GFR18 than GFR0 only

Vergleichende dreidimensionale Vokaltraktbildgebung mittels MRT beim Singen und Sprechen

Hintergrund: Die Magnetresonanztomographie (MRT) ist zur Darstellung des Vokaltraktes beim Singen und Sprechen etabliert, wobei viele Studien auf schnelle zweidimensionale Aufnahmen konzentriert sind. Zusätzlich ist jedoch auch eine dreidimensionale Bildgebung möglich. Durch diese können detailgetreue Modelle geschaffen werden, aus denen ein direkter Rückschluss auf die Vokaltraktresonanzen möglich ist.Material und Methoden: In der vorliegenden Studie wurden Vokaltraktmodelle mittels 3D MRT bei einem professionellen Tenor erstellt. Dafür phonierte der Sänger im MRT die Vokale /a/, /i/ und /u/ in seiner Sprechstimmlage (C3) in Sing- und Sprechstimmfunktion sowie in seiner hohen Singstimmfunktion oberhalb des Passaggios (A4). Aus dem gewonnenen Bildmaterial wurde jeweils der Vokaltrakt segmentiert, ein dreidimensionales Zahnmodell des Probanden anhand von anatomischen Landmarken eingefügt und mittels 3D Drucker ausgedruckt. Die gedruckten Modelle wurden nun durch Einfügen von Breitbandrauschen im Glottisbereich und Ableiten von Transferfunktionen vor der Mundöffnung akustisch analysiert und die Formantfrequenzen bestimmt.Ergebnisse: Vorläufige Ergebnisse zeigen deutliche Vokaltraktmodifikationen zwischen Sing- und Sprechstimme auf gleicher Tonhöhe, sowie für die hohe Singstimme in allen Vokalkonditionen. Insgesamt war der Vokaltrakt in der Singstimmfunktion länger als beim Sprechen und es zeigte sich der supralaryngeale Raum beim Singen vokalunabhängig erweitert. In der akustischen Analyse konnte eine Erhöhung der Formantfrequenzen mit Clusterbildung der Formanten 3-5 in der Singstimmfunktion ermittelt werden.Diskussion: Die Verlängerung des Vokaltraktes und Erweiterung des supralaryngealen Bereichs sind möglicherweise Mechanismen, welche für die Klangformung in der Singstimmfunktion von Bedeutung sind