741 research outputs found
Comparison of two sampling protocols and four home-range estimators using radio-tracking data from urban badgers Meles meles
Radio-telemetry is often the method of choice for studies of species whose behaviour is difficult to observe directly. However, considerable debate has ensued about the best way of deriving home-range estimates. In recent years, kernel estimators have become the most widely used method, together with the oldest and simplest method, the minimum convex polygon (MCP). More recently, it has been suggested that the local convex hull (LCH) might be more appropriate than kernel methods in cases where an animal’s home range includes a priori inaccessible areas. Yet another method, the Brownian bridge (BB), explicitly uses autocorrelated data to determine movement paths and, ultimately, home ranges or migration routes of animals. Whereas several studies have used simulation techniques to compare these different methods, few have used data from real animals. We used radio-telemetric data from urban badgers Meles meles to compare two sampling protocols (10-minute vs at least 30-minute inter-fix intervals) and four home-range estimators (MCP, fixed kernels (FK), LCH and BB). We used a multi-response permutation procedure and randomisation tests to compare overall patterns of fixes and degree of overlap of home ranges estimated using data from different sampling protocols, and a general linear model to compare the influence of sampling protocols and home-range estimator on the size of habitat patches. The shape of the estimated home ranges was influenced by sampling protocol in some cases. By contrast, the sizes and proportions of different habitats within home ranges were influenced by estimator type but not by sampling protocol. LCH performed consistently better than FK, and is especially appropriate for patchy study areas containing frequent no-go zones. However, we recommend using LCH in combination with other methods to estimate total range size, because LCH tended to produce smaller estimates than any other method. Results relating to BB are preliminary but suggest that this method is unsuitable for species in which range size is small compared to average travel speed.Marie-Curie Intra-European Fellowship (BSSUB - 24007); Defra WSC contract WM0304; Wildlife Biology granted the permit to upload the article to this repositor
Measurement of teicoplanin by liquid chromatography-tandem mass spectrometry:development of a novel method
Teicoplanin is an antibiotic used for the treatment of endocarditis, osteomyelitis, septic arthritis and methicillin-resistant Staphylococcus aureus. Teicoplanin is emerging as a suitable alternative antibiotic to vancomycin, where their trough serum levels are monitored by immunoassay routinely. This is the first report detailing the development of a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for measuring teicoplanin in patients' serum
Development of a liquid chromatography tandem mass spectrometry method for the simultaneous measurement of voriconazole, posaconazole and itraconazole
Background Azole-based antifungals are the first-line therapy for some of the most common mycoses and are now also being used prophylactically to protect immunocompromised patients. However, due to variability in both their metabolism and bioavailability, therapeutic drug monitoring is essential to avoid toxicity but still gain maximum efficacy. Methods Following protein precipitation of serum with acetonitrile, 20  µL of extract was injected onto a 2.1 × 50 mm Waters Atlantis dC18 3  µm column. Detection was via a Waters Quattro Premier XE tandem mass spectrometer operating in ESI-positive mode. Multiple reaction monitoring (MRM) detected two product ions for each compound and one for each isotopically labelled internal standard. Ion suppression, linearity, stability, matrix effects, recovery, imprecision, lower limits of measuring interval and detection were all assessed. Results Optimal chromatographic separation was achieved using gradient elution over 8 minutes. Voriconazole, posaconazole and itraconazole eluted at 1.71, 2.73 and 3.41 min, respectively. The lower limits of measuring interval for all three compounds was 0.1 mg/L. The assay was linear to 10 mg/L for voriconazole (R2 = 0.995) and 5 mg/L for posaconazole (R2 = 0.990) and itraconazole (R2 = 0.991). The assay was both highly accurate and precise with % bias of voriconazole, posaconazole and itraconazole, respectively, when compared with previous NEQAS samples. The intra-assay precision (CV%) was 1.6%, 2.5% and 1.9% for voriconazole, posaconazole and itraconazole, respectively, across the linear range. Conclusion A simple and robust method has been validated for azole antifungal therapeutic drug monitoring. This new assay will result in a greatly improved sample turnaround time and will therefore vastly increase the clinical utility of azole antifungal drug monitoring. </jats:sec
Rolofylline, an adenosine A1−receptor antagonist, in acute heart failure
Background:
Worsening renal function, which is associated with adverse outcomes, often develops
in patients with acute heart failure. Experimental and clinical studies suggest that
counterregulatory responses mediated by adenosine may be involved. We tested the
hypothesis that the use of rolofylline, an adenosine A1−receptor antagonist, would
improve dyspnea, reduce the risk of worsening renal function, and lead to a more
favorable clinical course in patients with acute heart failure.
Methods:
We conducted a multicenter, double-blind, placebo-controlled trial involving patients
hospitalized for acute heart failure with impaired renal function. Within 24 hours
after presentation, 2033 patients were randomly assigned, in a 2:1 ratio, to receive
daily intravenous rolofylline (30 mg) or placebo for up to 3 days. The primary end
point was treatment success, treatment failure, or no change in the patient’s clinical
condition; this end point was defined according to survival, heart-failure status,
and changes in renal function. Secondary end points were the post-treatment development
of persistent renal impairment and the 60-day rate of death or readmission
for cardiovascular or renal causes.
Results:
Rolofylline, as compared with placebo, did not provide a benefit with respect to the
primary end point (odds ratio, 0.92; 95% confidence interval, 0.78 to 1.09; P=0.35).
Persistent renal impairment developed in 15.0% of patients in the rolofylline group
and in 13.7% of patients in the placebo group (P=0.44). By 60 days, death or readmission
for cardiovascular or renal causes had occurred in similar proportions of patients
assigned to rolofylline and placebo (30.7% and 31.9%, respectively; P=0.86).
Adverse-event rates were similar overall; however, only patients in the rolofylline
group had seizures, a known potential adverse effect of A1-receptor antagonists.
Conclusions:
Rolofylline did not have a favorable effect with respect to the primary clinical composite
end point, nor did it improve renal function or 60-day outcomes. It does not
show promise in the treatment of acute heart failure with renal dysfunction. (Funded
by NovaCardia, a subsidiary of Merck; ClinicalTrials.gov numbers, NCT00328692
and NCT00354458.
Randomised controlled trial of a Calcium Channel or Angiotensin Converting Enzyme Inhibitor/Angiotensin Receptor Blocker Regime to Reduce Blood Pressure Variability following Ischaemic Stroke (CAARBS): a protocol for a feasibility study
Introduction Raised blood pressure (BP) is common after stroke and is associated with a poor prognosis, yet trials of BP lowering in the immediate poststroke period have not demonstrated a benefit. One possible explanation for this may be that BP variability (BPV) rather than absolute levels predicts outcome, as BPV is increased after stroke and is associated with poor outcomes. Furthermore, there is evidence of distinct antihypertensive class effects on BPV despite similar BP-lowering effects. However, whether BPV in the immediate poststroke period is a therapeutic target has not been prospectively investigated. The objectives of this trial are to assess the feasibility and safety of recruiting patients following an acute ischaemic stroke or transient ischaemic attack (TIA) to an interventional randomised controlled trial comparing the effects of two different antihypertensive drug classes on BPV. Secondary exploratory objectives are to assess if different therapeutic strategies have diverse effects on levels of BPV and if this has an impact on outcomes. Methods 150 adult patients with first-ever ischaemic stroke or TIA who require antihypertensive therapy for secondary prevention will be recruited within 7 days of the event from stroke services across three sites. After baseline assessments they will be randomly assigned to treatment with a calcium channel blocker or ACE inhibitor/angiotensin receptor blocker-based regimen and followed up for a period of three months. Ethics and dissemination Ethical and regulatory approvals have been granted. Dissemination is planned via publication in peer-reviewed medical journals and presentation at relevant conferences. Trial registration number ISRCTN10853487
Macular Pigment and its Contribution to Visual Performance and Experience [El pigmento macular y su contribución al rendimiento y experiencia visuals]
There is now a consensus, based on histological, biochemical and spectral absorption data, that the yellow colour observed at the macula lutea is a consequence of the selective accumulation of dietary xanthophylls in the central retina of the living eye. Scientific research continues to explore the function(s) of MP in the human retina, with two main hypotheses premised on its putative capacity to (1) protect the retina from (photo)-oxidative damage by means of its optical filtration and/or antioxidant properties, the so-called protective hypothesis and (2) influence the quality of visual performance by means of selective short wavelength light absorption prior to photoreceptor light capture, thereby attenuating the effects of chromatic aberration and light scatter, the so-called acuity and visibility hypotheses. The current epidemic of age-related macular degeneration has directed researchers to investigate the protective hypothesis of MP, while there has been a conspicuous lack of work designed to investigate the role of MP in visual performance. The aim of this review is to present and critically appraise the current literature germane to the contribution of MP, if any, to visual performance and experience
Systolic blood pressure reduction during the first 24 h in acute heart failure admission: friend or foe?
Aims:
Changes in systolic blood pressure (SBP) during an admission for acute heart failure (AHF), especially those leading to hypotension, have been suggested to increase the risk for adverse outcomes.
Methods and results:
We analysed associations of SBP decrease during the first 24 h from randomization with serum creatinine changes at the last time-point available (72 h), using linear regression, and with 30- and 180-day outcomes, using Cox regression, in 1257 patients in the VERITAS study. After multivariable adjustment for baseline SBP, greater SBP decrease at 24 h from randomization was associated with greater creatinine increase at 72 h and greater risk for 30-day all-cause death, worsening heart failure (HF) or HF readmission. The hazard ratio (HR) for each 1 mmHg decrease in SBP at 24 h for 30-day death, worsening HF or HF rehospitalization was 1.01 [95% confidence interval (CI) 1.00–1.02; P = 0.021]. Similarly, the HR for each 1 mmHg decrease in SBP at 24 h for 180-day all-cause mortality was 1.01 (95% CI 1.00–1.03; P = 0.038). The associations between SBP decrease and outcomes did not differ by tezosentan treatment group, although tezosentan treatment was associated with a greater SBP decrease at 24 h.
Conclusions:
In the current post hoc analysis, SBP decrease during the first 24 h was associated with increased renal impairment and adverse outcomes at 30 and 180 days. Caution, with special attention to blood pressure monitoring, should be exercised when vasodilating agents are given to AHF patients
Predictors and associations with outcomes of length of hospital stay in patients with acute heart failure: results from VERITAS
Background:
The length of hospital stay (LOS) is important in patients admitted for acute heart failure (AHF) because it prolongs an unpleasant experience for the patients and adds substantially to health care costs.
Methods and Results:
We examined the association between LOS and baseline characteristics, 10-day post-discharge HF readmission, and 90-day post-discharge mortality in 1347 patients with AHF enrolled in the VERITAS program. Longer LOS was associated with greater HF severity and disease burden at baseline; however, most of the variability of LOS could not be explained by these factors. LOS was associated with a higher HF risk of both HF readmission (odds ratio for 1-day increase: 1.08; 95% confidence interval [CI] 1.01–1.16; P = .019) and 90-day mortality (hazard ratio for 1-day increase: 1.05; 95% CI 1.02–1.07; P < .001), although these associations are partially explained by concurrent end-organ damage and worsening heart failure during the first days of admission.
Conclusions:
In patients who have been admitted for AHF, longer length of hospital stay is associated with a higher rate of short-term mortality.
Clinical Trial Registration:
VERITAS-1 and -2: Clinicaltrials.gov identifiers NCT00525707 and NCT00524433
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