Number of person-tests of HLA-B*15∶02 screening compared to mammography and Pap smear.

1<p>Overall SJS/TEN mortality rate ranged from 5% to 30%.</p>2<p>Based on the recommended biennial screening for 20 years from aged 50 years and detection of one case per 715 persons screened over this period. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0096990#pone.0096990-Warner1" target="_blank">[25]</a> Number excluded 20% non-compliance rate that was assumed in the original report.</p>3<p>Based on the recommended quinquennial screening for 35 years from aged 24 years and detection of one case per 1000 persons screened over this period. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0096990#pone.0096990-Raffle1" target="_blank">[26]</a>.</p

Real-World Efficiency of Pharmacogenetic Screening for Carbamazepine-Induced Severe Cutaneous Adverse Reactions

<div><p>Objectives</p><p>We evaluated the cost and efficiency of routine HLA-B*15∶02 screening to prevent carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis (CBZ-SJS/TEN) in Hong Kong.</p><p>Methods</p><p>Data were extracted from patients who commenced CBZ as the first-ever AED treatment or tested for HLA-B*15∶02 allele in three years before policy implementation (pre-policy: 16 September 2005 to 15 September 2008) and three years after (post-policy: 16 September 2008 to 15 September 2011). Using published unit costs, we estimated the cost of screening by comparing the costs to prevent and treat CBZ-SJS/TEN. We compared the number of person-tests needed and the cost to prevent resultant death with cancer screening programs.</p><p>Results</p><p>The number of screening tests needed to prevent one case of CBZ-SJS/TEN was 442, and to prevent one resultant death was 1,474 to 8,840. The screening cost was $332 per person, of which 42$146,749 to prevent a case of CBZ-SJS/TEN, and $489,386–$2,934,986 to prevent a resultant death. The corresponding numbers of tests and costs for mammography and Pap smear to prevent death due to breast and cervical cancers were 7,150 and 7,000, and $614,900 and$273,000, respectively. Comparing to the SJS/TEN treatment cost, HLA-B*15∶02 screening would become cost saving if a point-of-care test of less than $37 was available.</p><p>Conclusions</p><p>HLA-B*15∶02 screening is as efficient as mammography and Pap smear in preventing death. Development of point-of-care testing will vastly improve efficiency.</p></div

Cost of HLA-B*15∶02 screening compared with mammography and Pap smear.

1<p>Upper-limit cost of HLA-B*15∶02 screening to prevent one death was estimated from overall SJS/TEN mortality rate at 5%, and 30% mortality rate was used for lower-limit.</p>2<p>Costs were converted from UK sterling to US dollars using the May 2004 exchange rate of £0.56 to $1.</p>†<p>Excluded costs of diagnostic screening, biopsy and all subsequent procedures if any abnormality was found.</p>#<p>Cost for an additional consultation was included based on the observed 98.6% non-same-day test turnaround rate.</p><p>SJS, Stevens-Johnson Syndrome; TEN, toxic epidermal necrolysis.</p

Electroencephalogram Showing Repetitive Focal Spikes or Sharps Less Than Three per Second

<p>Electroencephalogram Showing Repetitive Focal Spikes or Sharps Less Than Three per Second</p

Electroencephalogram after Combination Anti-Epileptic Therapy with the Focal Spikes Abolished

<p>Ten days after successful treatment, occasional interictal discharges within a normal background were observed.</p

The [NiFe]-Hydrogenase of <i>Pyrococcus furiosus</i> Exhibits a New Type of Oxygen Tolerance

We report the first direct electrochemical characterization of the impact of oxygen on the hydrogen oxidation activity of an oxygen-tolerant, group 3, soluble [NiFe]-hydrogenase: hydrogenase I from <i>Pyrococcus furiosus</i> (<i>Pf</i>SHI), which grows optimally near 100 °C. Chronoamperometric experiments were used to probe the sensitivity of <i>Pf</i>SHI hydrogen oxidation activity to both brief and prolonged exposure to oxygen. For experiments between 15 and 80 °C, following short (<200 s) exposure to 14 μM O₂ under oxidizing conditions, <i>Pf</i>SHI always maintains some fraction of its initial hydrogen oxidation activity; i.e., it is oxygen-tolerant. Reactivation experiments show that two inactive states are formed by interaction with oxygen and both can be quickly (<150 s) reactivated. Analogous experiments, in which the interval of oxygen exposure is extended to 900 s, reveal that the response is highly temperature-dependent. At 25 °C, under sustained 1% O₂/ 99% H₂ exposure, the H₂oxidation activity drops nearly to zero. However, at 80 °C, up to 32% of the enzyme’s oxidation activity is retained. Reactivation of <i>Pf</i>SHI following sustained exposure to oxygen occurs on a much longer time scale (tens of minutes), suggesting that a third inactive species predominates under these conditions. These results stand in contrast to the properties of oxygen-tolerant, group 1 [NiFe]-hydrogenases, which form a single state upon reaction with oxygen, and we propose that this new type of hydrogenase should be referred to as oxygen-resilient. Furthermore, <i>Pf</i>SHI, like other group 3 [NiFe]-hydrogenases, does not possess the proximal [4Fe3S] cluster associated with the oxygen tolerance of some group 1 enzymes. Thus, a new mechanism is necessary to explain the observed oxygen tolerance in soluble, group 3 [NiFe]-hydrogenases, and we present a model integrating both electrochemical and spectroscopic results to define the relationships of these inactive states

Additional file 1: of Association between different acute stroke therapies and development of post stroke seizures

Table S1. Univariate logistic regression with baseline risk factors (age, NIHSS and mRS02 at 90 days) and treatment for seizure outcome. Table S2. Logistic regression model with treatment groups plus age for seizure outcome. Table S3. Logistic regression model with treatment groups plus NIHSS for seizure outcome. Table S4. Logistic regression model with treatment groups plus mRS02 for seizure outcome. Table S5. Logistic regression model with treatment groups unadjusted. Table S6. Logistic regression model with treatment groups adjusted for age, NIHSS and mRS02. Table S7. Median (IQR) of the baseline NIHSS and number (percentage) of mRS (0–2) in the sensitivity analysis NIHSS ≥ 6. Table S8. Median (IQR) of the baseline NIHSS and number (percentage) of mRS (0–2) in the sensitivity analysis NIHSS > 8. (DOCX 63 kb