44 research outputs found

    Use of anticoagulants and antiplatelet agents in stable outpatients with coronary artery disease and atrial fibrillation. International CLARIFY registry

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    Autoantibodies against type I IFNs in patients with life-threatening COVID-19

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    Interindividual clinical variability in the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is vast. We report that at least 101 of 987 patients with life-threatening coronavirus disease 2019 (COVID-19) pneumonia had neutralizing immunoglobulin G (IgG) autoantibodies (auto-Abs) against interferon-w (IFN-w) (13 patients), against the 13 types of IFN-a (36), or against both (52) at the onset of critical disease; a few also had auto-Abs against the other three type I IFNs. The auto-Abs neutralize the ability of the corresponding type I IFNs to block SARS-CoV-2 infection in vitro. These auto-Abs were not found in 663 individuals with asymptomatic or mild SARS-CoV-2 infection and were present in only 4 of 1227 healthy individuals. Patients with auto-Abs were aged 25 to 87 years and 95 of the 101 were men. A B cell autoimmune phenocopy of inborn errors of type I IFN immunity accounts for life-threatening COVID-19 pneumonia in at least 2.6% of women and 12.5% of men

    Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

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    Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

    Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

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    Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

    CO2 gasification of dairy and swine manure: A life cycle assessment approach

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    SSCI-VIDE+CARE+DLGInternational audienceCO2 gasification of three different chars obtained from the pyrolysis of two dairy manure samples and a swine manure sample was evaluated. Dairy samples were firstly pretreated by anaerobic digestion process and swine sample by bio-drying process. Subsequently, manure samples were pyrolyzed between 30 degrees C and 980 degrees C obtaining a solid fuel (biochar), which was later gasified using different vol.% CO2 (15-90%) which was the gasifying agent. Gasification was conducted at 900 degrees C. Thermal behavior and gasification characteristics were studied by means of the thermogravimetric-mass spectrometric analysis. In this sense, the reactivity of the samples was influenced by the catalytic activity of the mineral matter contained in the remaining biomass ashes. On the other hand, the viability of the manure gasification process vs the traditional use of manure as fertilizer was studied by means of the life cycle assessment (LCA) methodology. Two different scenarios were analyzed: gasification of manure sample before anaerobic digestion (Pre) and gasification of manure after anaerobic digestion (Dig R). According to the results obtained, the gasification of char Pre was the most viable scenario from the economic and environmental viewpoints whereas the gasification of char Dig R was the best energetic option. (C) 2016 Elsevier Ltd. All rights reserved

    Life cycle assessment of swine and dairy manure: Pyrolysis and combustion processes

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    SSCI-VIDE+CARE+DLGInternational audienceThe valorization of three different manure samples via pyrolysis and combustion processes was evaluated. Dairy manure (sample Pre) was biologically pretreated by anaerobic digestion (sample Dig R) whereas swine manure (sample SW) was pretreated by a biodrying process. Thermal behavior of manure samples were studied by means of thermogravimetric analysis coupled with mass spectrometry (TGA-MS). These processes could be divided into four general stages: dehydration, devolatilization, char transformation (oxidation for combustion) and inorganic matter decomposition. The main differences observed among the samples were attributed to their different composition and pretreatment. The economic feasibility, energetic and environmental impacts of pyrolysis and combustion technologies for dairy samples were carried out by means of life cycle assessment (LCA) methodology. Four different scenarios were analyzed. The economic feasibility of the pyrolysis process was demonstrated, being sample Dig R the best environmental option. However, the combustion of sample Pre was the best energetic option. (c) 2015 Elsevier Ltd. All rights reserved

    Energetic, economic and environmental assessment of the pyrolysis and combustion of microalgae and their oils

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    SSCI-VIDE+CARE+DLGInternational audienceThe physico-chemical characteristics of two microalgae species (Scenedesmus sp and Nannochloropsis gaditana) and their extracted oils have been investigated. Microalgae oils had high calorific value, low ash content, high volatile content and low moisture. A comparison of the pyrolysis and combustion performance of microalgae and oils samples was carried out by performing simultaneous TGA (thermogravimetric analysis) and DSC (differential scanning calorimeter) coupled with mass spectrometry (MS). The thermochemical behavior of microalgae samples was a function of their biochemical composition (proteins, carbohydrates and lipids) and inorganic content (ash content). Thermal treatment of microalgae oils released lesser NOx and SOx emissions than those of the parent microalgae. Finally, the economic viability and environmental sustainability of pyrolysis and combustion technologies of microalgae and their oils was evaluated by means of life cycle assessment methodology. Four different scenarios were analyzed and compared in order to provide useful information from the industrial point of view. CO and CO2 were the main gases produced during the pyrolysis and combustion processes. Materials and energy requirements of the processes involved were calculated by process simulation. Microalgae oils were the best option in terms of energetic performance. Selling price of microalgae biomass and plant capacity are critical variables to be considered for establishing the financial feasibility of the thermochemical process. (C) 2015 Elsevier Ltd. All rights reserved

    Eficacia de las maniobras de reposicionamiento canalicular en el vértigo posicional paroxístico benigno: revisión de 176 casos tratados en un centro hospitalario de tercer nivel.

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    [spa] Introducción y objetivos El vértigo posicional paroxístico benigno es la entidad más frecuente dentro de los vértigos de origen periférico. El objetivo del siguiente trabajo es revisar los resultados obtenidos con las diferentes maniobras de reposicionamiento canalicular específicas para cada tipo de canal semicircular afectado, evaluando posibles factores de riesgo relacionados con un peor pronóstico. Métodos Se han revisado retrospectivamente 176 pacientes diagnosticados de vértigo posicional paroxístico benigno en nuestro centro, de los cuales 150 tenían vértigo del canal semicircular posterior, 20 del horizontal, 3 del superior y 3 multicanal. Se ha usado la maniobra de Epley para el tratamiento del canal posterior y del superior y la maniobra de Lempert para el tratamiento del horizontal. En los casos refractarios se ha realizado siempre un estudio de imagen cerebral con resonancia. Resultados La maniobra de Epley ha mostrado una eficacia al primer intento del 74,6% para el canal posterior y del 100% para el superior. La eficacia de la maniobra de Lempert para el canal horizontal ha sido del 72,72% en los casos de canalolitiasis y del 58,33% en los de cupulolitiasis. Más complicado ha sido el tratamiento de los pacientes con más de un canal afectado y con antecedente quirúrgico en el mes previo. Conclusiones Las maniobras de reposicionamiento canalicular permiten alcanzar una tasa de éxito muy alta, obteniendo mejores resultados en el tratamiento del canal posterior. Hacen falta más estudios para confirmar la sospecha de que la cirugía previa pueda ser un factor de peor pronóstico
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