Effects of low dose morphine on perceived sleep quality in patients with refractory breathlessness : a hypothesis generating study

© 2015 Asian Pacific Society of Respirology. Background and objective The management of chronic refractory breathlessness is one of the indications for regular low-dose (≤30 mg/24 h) oral sustained release morphine. Morphine may disrupt sleep in some conditions and improve sleep quality in others. This study aimed to determine any signal of regular, low-dose morphine on perceived sleep disruption due to breathlessness and perceived sleep quality. Methods This is a secondary analysis of data from 38 participants with refractory breathlessness (30 male; 33 with COPD) aged 76 ± 0.9 years who completed a double-blind, randomized, placebo-controlled, cross-over study in which they received 20 mg oral sustained release morphine daily and placebo for 4 days each. Participant ratings of sleep disruption due to breathlessness and perceived sleep quality were obtained daily throughout the 8-day trial. Results Perceived sleep disruption due to breathlessness over the 4-day period ranged between 13% and 32% of participants for placebo and 13% and 26% for morphine, decreasing by each day of the study during the morphine arm. Most participants reported 'very good' or 'quite good' sleep throughout the trial and were less likely to perceive poor sleep quality during the morphine arm (odds ratio = 0.55, 95% confidence interval: 0.34-0.88, P = 0.01). Participants who reported decreased breathlessness during the 4 days on morphine were also likely to report improved sleep quality with morphine (P = 0.039). Conclusion Four days of low-dose morphine improved perceived sleep quality in elderly participants with refractory breathlessness. Regular low-dose morphine targeted to reduce refractory breathlessness may yield associated benefits by reducing sleep disruption and improving sleep quality

Sensitive and specific serodiagnosis of Leishmania infantum infection in dogs by using peptides selected from hypothetical proteins identified by an immunoproteomic approach

In Brazil, the percentage of infected dogs living in areas where canine visceral leishmaniasis (CVL) is endemic ranges from 10 to 62%; however, the prevalence of infection in dogs is probably higher than figures reported from serological studies. In addition, problems with the occurrence of false-positive or false-negative results in the serodiagnosis of CVL have been reported. The present work analyzed the potential of synthetic peptides mapped from hypothetical proteins for improvement of the serodiagnosis of Leishmania infantum infection in dogs. From 26 identified leishmanial proteins, eight were selected, considering that no homologies between these proteins and others from trypanosomatide sequence databases were encountered. The sequences of these proteins were mapped to identify linear B-cell epitopes, and 17 peptides were synthesized and tested in enzyme-linked immunosorbent assays (ELISAs) for the serodiagnosis of L. infantum infection in dogs. Of these, three exhibited sensitivity and specificity values higher than 75% and 90%, respectively, to differentiate L. infantum-infected animals from Trypanosoma cruziinfected animals and healthy animals. Soluble Leishmania antigen (SLA) showed poor sensitivity (4%) and specificity (36%) to differentiate L. infantum-infected dogs from healthy and T. cruzi-infected dogs. Lastly, the three selected peptides were combined in different mixtures and higher sensitivity and specificity values were obtained, even when sera from T. cruzi-infected dogs were used. The study’s findings suggest that these three peptides can constitute a potential tool for more sensitive and specific serodiagnosis of L. infantum infection in dogsThis work was supported by grants from the Pró-Reitoria de Pesquisa from UFMG (Edital 07/2012), Instituto Nacional de Ciência e Tecnologia em Nano-biofarmacêutica (INCT-NANOBIOFAR, Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG) (CBB-APQ-02364-08, CBB-APQ-00356-10, CBB-APQ-00496-11, and CBB-APQ-00819-12), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (APQ-472090/2011-9), and the Instituto Nacional de Ciência e Tecnologia em Vacinas (INCT-V). E.A.F.C. and A.P.F. are CNPq grant recipients. M.A.C.-F. is a FAPEMIG/CAPES grant recipient. This study was supported in Spain, in part, by grants from the Ministerio de Ciencia e Innovación (FIS/PI1100095)

The Effect of Norepinephrine and Caffeic Acid on Cytokines and Nitric Oxide Production by Granulocytes is Age-Dependent

There is a large increase in the number of elderly people in modern societies. This demographic phenomenon has been paralleled by an epidemic of chronic diseases and inflammatory process usually associated with advanced age. In this work we seek to fill a gap that still exists in the process of immunoregulation “old guy’ looking to narrow the knowledge regarding their correlation with the immune system and the nervous system. The Nitric Oxide (NO) and Interleukins productions were studied in healthy subjects in age ranging from 20 to 80 years divided in three age groups: (20-39), (40-59) and (60-80) years. NO production was quantified in a Griess reaction. The results were expressed through the nitrite concentration calculated by linear regression using a standard curve obtained from a solution of sodium nitrite and 1mM RPMI. Interleukins 8, 10 and 4 (IL-8, IL-10 and IL-4) productions were measured by sandwich ELISA. Ours results demonstrated that Norepinephrine (NoAD) can no longer modulate the inflammatory cytokine profile and that there is a significant decay of the contribution of Caffeic Acid (CA) as an antioxidant and / or anti-inflammatory age-related. Thus, our results showed a lack of NoAD and CA modulation in human granulocyte in ageing dependent process

Cost-effectiveness and value of information analysis of NephroCheck and NGAL tests compared to standard care for the diagnosis of acute kidney injury

Acknowledgements We are grateful to Thomas Walker and Rebecca Albrow at NICE for their thoughtful comments on earlier versions of the economic model and to the NICE Diagnostic Committee for their critical review of our identifed evidence. We are also grateful for the advice and clinical guidance received from the NICE Specialist Advisory Group for DG19 and to Peter S Hall and Alison F Smith (on behalf of the team) for providing early versions of their economic model that was instrumental in the development and structuring of the model used in this study. A big thank goes also to Lara Kemp for her secretarial support and patience throughout the study. The results presented in this paper have not been published previously in any academic journals, nor have they been submitted elsewhere. This work has informed the development of NICE guidance for diagnostic testing for AKI (https://www.nice.org.uk/guidance/dg39) and a full report to the funder describing the totality of this work will be published in the NIHR, HTA mono‑ graph series in due course. Funding The fndings presented in this manuscript are part of a broader research project funded by the National Institute for Health Research (NIHR) and com‑missioned through the NICE Diagnostic Assessment Programme (project no 12/88/97). The views expressed are those of the authors and not necessarily those of NICE, the NHS, the NIHR or the Department of Health. The Health Economics Research Unit and the Health Services Research Unit, University of Aberdeen, are funded by the Chief Scientist Ofce of the Scottish Government Health and Social Care Directorates.Peer reviewedPublisher PD

Measurement of the forward Z boson production cross-section in pp collisions at s=13\sqrt{s} = 13 TeV

A measurement of the production cross-section of Z bosons in pp collisions at $\sqrt{s} = 13$ TeV is presented using dimuon and dielectron final states in LHCb data. The cross-section is measured for leptons with pseudorapidities in the range $2.0 \eta 4.5$, transverse momenta $p_\text{T} 20$ GeV and dilepton invariant mass in the range $60 m(\ell\ell) 120$ GeV. The integrated cross-section from averaging the two final states is \begin{equation*}\sigma_{\text{Z}}^{\ell\ell} = 194.3 \pm 0.9 \pm 3.3 \pm 7.6\text{ pb,}\end{equation*} where the first uncertainty is statistical, the second is due to systematic effects, and the third is due to the luminosity determination. In addition, differential cross-sections are measured as functions of the Z boson rapidity, transverse momentum and the angular variable $\phi^*_\eta$

Prescription opioid use disorder and heroin use among 12-34 year-olds in the United States from 2002 to 2014

Trend analyses of prescription opioids in the U.S. indicate use, especially use of prescription opioids stronger than morphine, has more than doubled among adults since the early 1990's (Frenk, Porter, & Paulozzi, 2015). Prescription opioids, like Oxycontin®, are effective pharmacological treatments for acute and chronic pain (Fitzcharles and Shir, 2009 ; Gallagher and Rosenthal, 2008). When used as indicated, these medications can be an important component of pain management. However, their high abuse potential presents concerns regarding their nonmedical use, which can be defined as ‘use of a prescription opioid that was not prescribed, or taken for the experience or feeling it caused’ (SAMHSA, 2014). In the United States, nonmedical use of prescription opioids (NMPO) is increasingly recognized as a serious public health problem among adults (Blanco et al., 2007; Han et al., 2015 ; Huang et al., 2006). Nonmedical prescription drug use, specifically nonmedical use of prescription opioids, is also a growing problem in other countries such as Canada (Fischer et al., 2014 ; Fischer et al., 2013) and Australia (Degenhardt et al., 2006 ; Rintoul et al., 2011)

Measurement of the Tau Lepton Polarisation at LEP2

A first measurement of the average polarisation P_tau of tau leptons produced in e+e- annihilation at energies significantly above the Z resonance is presented. The polarisation is determined from the kinematic spectra of tau hadronic decays. The measured value P_tau = -0.164 +/- 0.125 is consistent with the Standard Model prediction for the mean LEP energy of 197 GeV.A first measurement of the average polarisation Pτ of tau leptons produced in e + e − annihilation at energies significantly above the Z resonance is presented. The polarisation is determined from the kinematic spectra of tau hadronic decays. The measured value Pτ=−0.164±0.125 is consistent with the Standard Model prediction for the mean LEP energy of 197 GeV.A first measurement of the average polarisation P_tau of tau leptons produced in e+e- annihilation at energies significantly above the Z resonance is presented. The polarisation is determined from the kinematic spectra of tau hadronic decays. The measured value P_tau = -0.164 +/- 0.125 is consistent with the Standard Model prediction for the mean LEP energy of 197 GeV

Les droits disciplinaires des fonctions publiques : « unification », « harmonisation » ou « distanciation ». A propos de la loi du 26 avril 2016 relative à la déontologie et aux droits et obligations des fonctionnaires

The production of tt‾ , W+bb‾ and W+cc‾ is studied in the forward region of proton–proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98±0.02 fb−1 . The W bosons are reconstructed in the decays W→ℓν , where ℓ denotes muon or electron, while the b and c quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions.The production of $t\overline{t}$, $W+b\overline{b}$ and $W+c\overline{c}$ is studied in the forward region of proton-proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98 $\pm$ 0.02 \mbox{fb}^{-1}. The $W$ bosons are reconstructed in the decays $W\rightarrow\ell\nu$, where $\ell$ denotes muon or electron, while the $b$ and $c$ quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions