The prevention of anaphylactoid reactions to iodinated radiological contrast media: a systematic review

BACKGROUND: Anaphylactoid reactions to iodinated contrast media are relatively common and potentially life threatening. Opinion is divided as to the utility of medications for preventing these reactions. We performed a systematic review to assess regimes for the prevention of anaphylactoid reactions to iodinated contrast media. METHODS: Searches for studies were conducted in the Medline, EMBASE, CINAHL and CENTRAL databases. Bibliographies of included studies and review articles were examined and experts were contacted. Randomised clinical trials that examined agents given prior to iodinated contrast material for the prevention of anaphylactoid reactions were included in the review. The validity of the included studies was examined using a component approach. RESULTS: Six studies met the inclusion criteria, but only one of these fulfilled all of the validity criteria. There were four studies that examined the use of H1 antihistamines, each was used to prevent anaphylactoid reactions to ionic contrast. The random effects pooled relative risk demonstrated a significant reduction in the overall rate of anaphylactoid reactions (RR = 0.4, 95% CI 0.18-0.9, p = 0.027). There were insufficient studies to produce a pooled statistic for the use of corticosteroids, however regimes of steroids (methylprednisolone 32 mg) given at least six hours and again two hours prior to the administration of contrast suggested a reduction in the incidence of anaphylactoid reactions. CONCLUSION: In conclusion, there are few high quality randomised clinical trials that have addressed the question of the optimal methods to prevent allergic type reactions to iodinated radiological contrast media. Allowing for these limitations, the results suggest that H1 antihistamines given immediately prior to the administration of ionic contrast may be useful in preventing reactions to ionic contrast and are suggestive of a protective effect of corticosteroids when given in two doses at least six hours prior and again two hours prior to the administration of contrast, both ionic and non-ionic. These agents should be considered for use in patients who are at high risk of an anaphylactoid reaction to contrast media and for who prophylactic therapy is considered necessary. Further research is needed before definitive recommendations can be made

Building Babies - Chapter 16

In contrast to birds, male mammals rarely help to raise the offspring. Of all mammals, only among rodents, carnivores, and primates, males are sometimes intensively engaged in providing infant care (Kleiman and Malcolm 1981). Male caretaking of infants has long been recognized in nonhuman primates (Itani 1959). Given that infant care behavior can have a positive effect on the infant’s development, growth, well-being, or survival, why are male mammals not more frequently involved in “building babies”? We begin the chapter defining a few relevant terms and introducing the theory and hypotheses that have historically addressed the evolution of paternal care. We then review empirical findings on male care among primate taxa, before focusing, in the final section, on our own work on paternal care in South American owl monkeys (Aotus spp.). We conclude the chapter with some suggestions for future studies.Deutsche Forschungsgemeinschaft (HU 1746/2-1) Wenner-Gren Foundation, the L.S.B. Leakey Foundation, the National Geographic Society, the National Science Foundation (BCS-0621020), the University of Pennsylvania Research Foundation, the Zoological Society of San Dieg

Is Medical Research Informing Professional Practice More Highly Cited? Evidence from AHFS DI Essentials in Drugs.com

This is an accepted manuscript of an article published by Springer in Scientometrics on 21/02/2017, available online: https://doi.org/10.1007/s11192-017-2292-3 The accepted version of the publication may differ from the final published version.Citation-based indicators are often used to help evaluate the impact of published medical studies, even though the research has the ultimate goal of improving human wellbeing. One direct way of influencing health outcomes is by guiding physicians and other medical professionals about which drugs to prescribe. A high profile source of this guidance is the AHFS DI Essentials product of the American Society of Health-System Pharmacists, which gives systematic information for drug prescribers. AHFS DI Essentials documents, which are also indexed by Drugs.com, include references to academic studies and the referenced work is therefore helping patients by guiding drug prescribing. This article extracts AHFS DI Essentials documents from Drugs.com and assesses whether articles referenced in these information sheets have their value recognised by higher Scopus citation counts. A comparison of mean log-transformed citation counts between articles that are and are not referenced in AHFS DI Essentials shows that AHFS DI Essentials references are more highly cited than average for the publishing journal. This suggests that medical research influencing drug prescribing is more cited than average

FLT3 mutations in canine acute lymphocytic leukemia

<p>Abstract</p> <p>Background</p> <p>FMS-like tyrosine kinase 3 (FLT3) is a commonly mutated protein in a variety of human acute leukemias. Mutations leading to constitutively active FLT3, including internal tandem duplications of the juxtamembrane domain (ITD), result in continuous cellular proliferation, resistance to apoptotic cell death, and a poorer prognosis. A better understanding of the molecular consequences of FLT3 activation would allow improved therapeutic strategies in these patients. Canine lymphoproliferative diseases, including lymphoma and acute leukemias, share evolutionarily conserved chromosomal aberrations and exhibit conserved mutations within key oncogenes when compared to their human counterparts. A small percentage of canine acute lymphocytic leukemias (ALL) also exhibit <it>FLT3 </it>ITD mutations.</p> <p>Methods</p> <p>We molecularly characterized <it>FLT3 </it>mutations in two dogs and one cell line, by DNA sequencing, gene expression analysis via quantitative real-time PCR, and sensitivity to the FLT3 inhibitor lestaurtinib via <it>in vitro </it>proliferation assays. FLT 3 and downstream mediators of FLT3 activation were assessed by Western blotting.</p> <p>Results</p> <p>The canine B-cell leukemia cell line, GL-1, and neoplastic cells from 2/7 dogs diagnosed cytologically with ALL were found to have <it>FLT3 </it>ITD mutations and <it>FLT3 </it>mRNA up-regulation. Lestaurtinib, a small molecule FLT3 inhibitor, significantly inhibited the growth of GL-1 cells, while not affecting the growth of two other canine lymphoid cell lines without the <it>FLT3 </it>mutation. Finally, western blots were used to confirm the conserved downstream mediators of <it>FLT3 </it>activating mutations.</p> <p>Conclusions</p> <p>These results show that ALL and FLT3 biology is conserved between canine and human patients, supporting the notion that canine ALL, in conjunction with the GL-1 cell line, will be useful in the development of a relevant large animal model to aid in the study of human FLT3 mutant leukemias.</p

Assessment of the Public Administration Tools for the improvement of the Eco-efficiency of Small and Medium Sized Enterprises

Small and Medium Sized Enterprises (SME) face barriers to the implementation and development of eco-efficiency that could be overcome taking advantage of the adequate stimuli and incentives. A previous research and a thorough literature analysis show Public Administration (PA) is a key stakeholder. PA could use better its tools to stimulate SME to improve their ecoefficiency. Among these tools it can be named well known command and control tools like legislation or taxes, but also price policies, green procurement, ecological education, eco-innovation support and others. This paper reviews these tools and how they contribute to overcome barriers to ecoefficiency by offering external and internal incentives for SME. The analysis is focused on the case of Venezuelan public administration and SME but it can be generalized to other case studies. In addition, a panel of experts validates the results and assesses the public administration tools by means of the policy Delphi method. The assessment is based on criteria like: market influence, capability of the public administration for controlling results, tool costs, impact on public administration image, timespan to get results, etc. The assessment, therefore, allows ranking and understanding the tools according to their effectiveness and efficiency to support SME to improve their ecoefficiency. Due to the specific characteristics of the case study: SME of Venezuela, the method shows the best mix of public administration tools includes mainly command and control tools. Also the mix includes certain new-approach tools like advertising about responsible consumption and eco-efficient products, or education/training in environmental responsibility. The method also allows understanding better how the tools will help accomplishing the objectives for ecoefficiency of the public administration. Therefore, this research provides a method for raising information to be used when planning the actions to improve eco-efficiency of the SME.Fernández-Viñé, MB.; Gómez-Navarro, T.; Capuz-Rizo, SF. (2013). Assessment of the Public Administration Tools for the improvement of the Eco-efficiency of Small and Medium Sized Enterprises. Journal of Cleaner Production. 47:265-273. doi:10.1016/j.jclepro.2012.08.026S2652734

Examining the policy needs for implementing nature-based solutions in cities: Findings from city-wide transdisciplinary experiences in Glasgow, UK, Genk, Belgium and Poznań, Poland

To advance the science and practice of implementing nature-based solutions in cities, it is important to examine the obstacles and provide means to overcome them. This paper presents a conceptual framework of policy needs for analysing the science of nature-based solutions’ implementation and connect it to the practice of their implementation that advances the literature by connecting well-researched gaps to a more innovative action-oriented policy development approach that we argue is required for embedding scaled-up nature-based solutions. We conceptualise and ground the policy needs framework of skills, knowledge and partnerships theoretically in current literature of NBS policy and planning and empirically in three European case study cities: Genk in Belgium, Glasgow in UK and Poznan in Poland. The cross-case study analysis points to the knowledge needs of systems’ thinking and solutions-oriented thinking as paramount for implementing nature-based solutions. Our analysis further points to the skills’ needs of negotiation and collaboration for administrative silo bridging and for forging multi-sectoral partnerships essential for planning, and co-managing NBS. We conclude with three ways forward to addressing the policy needs for implementation: first, cities can invest in tailored and targeted capacity building programs, second, institutional spaces need to be established that allow for collaborative learning through and for partnerships and third, cities need to chart governance innovations that promote evidence-based policy for nature-based solutions’ design and implementation

The Past and Future of Tuberculosis Research

Renewed efforts in tuberculosis (TB) research have led to important new insights into the biology and epidemiology of this devastating disease. Yet, in the face of the modern epidemics of HIV/AIDS, diabetes, and multidrug resistance—all of which contribute to susceptibility to TB—global control of the disease will remain a formidable challenge for years to come. New high-throughput genomics technologies are already contributing to studies of TB's epidemiology, comparative genomics, evolution, and host–pathogen interaction. We argue here, however, that new multidisciplinary approaches—especially the integration of epidemiology with systems biology in what we call “systems epidemiology”—will be required to eliminate TB