1,085 research outputs found
The comparative clinical course of pregnant and non-pregnant women hospitalised with influenza A(H1N1)pdm09 infection
Introduction: The Influenza Clinical Information Network (FLU-CIN) was established to gather detailed clinical and epidemiological information about patients with laboratory confirmed A(H1N1)pdm09 infection in UK hospitals. This report focuses on the clinical course and outcomes of infection in pregnancy.Methods: A standardised data extraction form was used to obtain detailed clinical information from hospital case notes and electronic records, for patients with PCR-confirmed A(H1N1)pdm09 infection admitted to 13 sentinel hospitals in five clinical 'hubs' and a further 62 non-sentinel hospitals, between 11th May 2009 and 31st January 2010.Outcomes were compared for pregnant and non-pregnant women aged 15-44 years, using univariate and multivariable techniques.Results: Of the 395 women aged 15-44 years, 82 (21%) were pregnant; 73 (89%) in the second or third trimester. Pregnant women were significantly less likely to exhibit severe respiratory distress at initial assessment (OR?=?0.49 (95% CI: 0.30-0.82)), require supplemental oxygen on admission (OR?=?0.40 (95% CI: 0.20-0.80)), or have underlying co-morbidities (p-trend <0.001). However, they were equally likely to be admitted to high dependency (Level 2) or intensive care (Level 3) and/or to die, after adjustment for potential confounders (adj. OR?=?0.93 (95% CI: 0.46-1.92). Of 11 pregnant women needing Level 2/3 care, 10 required mechanical ventilation and three died.Conclusions: Since the expected prevalence of pregnancy in the source population was 6%, our data suggest that pregnancy greatly increased the likelihood of hospital admission with A(H1N1)pdm09. Pregnant women were less likely than non-pregnant women to have respiratory distress on admission, but severe outcomes were equally likely in both groups
The Use of Transdermal Estrogen in Castrate-resistant, Steroid-refractory Prostate Cancer
BACKGROUND: Androgen-deprivation therapy is the mainstay of treatment for metastatic prostate cancer. Corticosteroids and estrogens are also useful agents in castration-resistant prostate cancer (CRPC). However, oral estrogens are associated with thromboembolic events, which limits their use, and transdermal estrogens may offer a safer alternative. This study was carried out to determine the safety and effectiveness of transdermal estrogens in CRPC. PATIENTS AND METHODS: Forty-one patients with CRPC and steroid-resistant prostate cancer were eligible for this dose-escalation study of transdermal estradiol. A starting dose of 50 mcg/24 hours was applied and increased if prostate-specific antigen (PSA) rose > 5 ng/mL in steps to 300 mcg/24 hours. The primary endpoint was PSA response, and secondary outcomes included incidence of thromboembolic events and progression-free survival. Patients who progressed were offered diethylstilbestrol. RESULTS: Five (13%) of 40 patients had > 50% PSA reduction for at least 1 month at any transdermal estradiol dose. No venous-thromboembolic events were observed, and responses plateaued at 200 mcg/24 hours. A correlation between PSA response and rising sex hormone binding globulin was seen. Fifty percent of patients subsequently responded to low-dose diethylstilbestrol. CONCLUSION: Transdermal estradiol appears to be a low toxicity treatment option to control CRPC after failure of steroid therapy. Modulation of sex hormone binding globulin by transdermal estradiol may be one mechanism of action of estrogens on CRPC. Oral estrogens remain effective after the use of transdermal estradiol
Regulatory T cells expressing granzyme B play a critical role in controlling lung inflammation during acute viral infection
The inflammatory response to lung infections must be tightly regulated, enabling pathogen elimination while maintaining crucial gas exchange. Using recently described “depletion of regulatory T cell” (DEREG) mice, we found that selective depletion of regulatory T cells (Tregs) during acute respiratory syncytial virus (RSV) infection enhanced viral clearance but increased weight loss, local cytokine and chemokine release, and T-cell activation and cellular influx into the lungs. Conversely, inflammation was decreased when Treg numbers and activity were boosted using interleukin-2 immune complexes. Unexpectedly, lung (but not draining lymph node) Tregs from RSV-infected mice expressed granzyme B (GzmB), and bone marrow chimeric mice with selective loss of GzmB in the Treg compartment displayed markedly enhanced cellular infiltration into the lung after infection. A crucial role for GzmB-expressing Tregs has not hitherto been described in the lung or during acute infections, but may explain the inability of children with perforin/GzmB defects to regulate immune responses to infection. The effects of RSV infection in mice with defective immune regulation closely parallel the observed effects of RSV in children with bronchiolitis, suggesting that the pathogenesis of bronchiolitis may involve an inability to regulate virus-induced inflammation
The politics of the teaching of reading
Historically, political debates have broken out over how to teach reading in primary schools and infant classrooms. These debates and “reading wars” have often resulted from public concerns and media reportage of a fall in reading standards. They also reflect the importance placed on learning to read by parents, teachers, employers, and politicians. Public and media-driven controversies over the teaching of reading have resulted in intense public and professional debates over which specific methods and materials to use with beginning readers and with children who have reading difficulties. Recently, such debates have led to a renewed emphasis on reading proficiency and “standardized” approaches to teaching reading and engaging with literacy. The universal acceptance of the importance of learning to read has also led to vested interests in specific methods, reading programmes, and early literacy assessments amongst professional, business, commercial, and parental lobbying groups. This article traces these debates and the resulting growing support for a quantitative reductionist approach to early-reading programmes
Measurement of two-halo neutron transfer reaction p(Li,Li)t at 3 MeV
The p(\nuc{11}{Li},\nuc{9}{Li})t reaction has been studied for the first time
at an incident energy of 3 MeV delivered by the new ISAC-2 facility at
TRIUMF. An active target detector MAYA, build at GANIL, was used for the
measurement. The differential cross sectionshave been determined for
transitions to the \nuc{9}{Li} ground andthe first excited states in a wide
range of scattering angles. Multistep transfer calculations using different
\nuc{11}{Li} model wave functions, shows that wave functions with strong
correlations between the halo neutrons are the most successful in reproducing
the observation.Comment: 6 pages, 3 figures, submitted to Physical Review Letter
Measurement of the Muon Decay Parameter delta
The muon decay parameter delta has been measured by the TWIST collaboration.
We find delta = 0.74964 +- 0.00066(stat.) +- 0.00112(syst.), consistent with
the Standard Model value of 3/4. This result implies that the product Pmuxi of
the muon polarization in pion decay, Pmu, and the muon decay parameter xi falls
within the 90% confidence interval 0.9960 < Pmuxi < xi < 1.0040. It also has
implications for left-right-symmetric and other extensions of the Standard
Model.Comment: Extended to 5 pages. Referee's comments answere
A search for two body muon decay signals
Lepton family number violation is tested by searching for
decays among the 5.8 positive muon decay events analyzed by the
TWIST collaboration. Limits are set on the production of both massless and
massive bosons. The large angular acceptance of this experiment allows
limits to be placed on anisotropic decays, which can arise
from interactions violating both lepton flavor and parity conservation.
Branching ratio limits of order are obtained for bosons with masses
of 13 - 80 MeV/c and with different decay asymmetries. For bosons with
masses less than 13 MeV/c the asymmetry dependence is much stronger and
the 90% limit on the branching ratio varies up to . This is
the first study that explicitly evaluates the limits for anisotropic two body
muon decays.Comment: 7 pages, 5 figures, 2 tables, accepted by PR
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