Successful Non-Invasive treatment of stricturing fibrosing colonopathy in an adult patient

<p>Abstract</p> <p>Objective</p> <p>Fibrosing colonopathy (FC) is a rare entity associated with cystic fibrosis (CF). Until now, patients with stricturing FC have usually been treated surgically. In this instance, we aimed at avoiding surgery by applying a new conservative approach.</p> <p>Methods</p> <p>Case report on an adult with CF who developed persistent abdominal pain due to a non-passable stricture in the right transverse colon. Histology confirmed fibrosing colonopathy.</p> <p>Results</p> <p>Initially we treated the patient with prednisolone pulse therapy and additive antibiotic therapy. For maintenance therapy we administered budesonide. The patient underwent clinical, laboratory and endoscopic follow-up over a three-year period. The stricture healed and was easy to pass. A relapse in the cecum at the ileocecal valve again improved under steroid and antibiotic therapy.</p> <p>Conclusions</p> <p>We present a novel therapeutic approach for advanced stricturing FC in an adult patient which successfully avoided surgery (right hemicolectomy) over a three year follow up.</p

Effective range expansion in various scenarios of EFT(\notpi)

Using rigorous solutions, we compare the ERE parameters obtained in three different scenarios of EFT(\notpi) in nonperturbative regime. A scenario with unconventional power counting (like KSW) is shown to be disfavored by the PSA data, while the one with elaborate prescription of renormalization but keeping conventional power counting intact seems more promising.Comment: 6 pages, 3 tables, no figure, revtex4-1, minor revisions, to appear in EP

Chiral effective theory predictions for deuteron form factor ratios at low Q^2

We use chiral effective theory to predict the deuteron form factor ratio G_C/G_Q as well as ratios of deuteron to nucleon form factors. These ratios are calculated to next-to-next-to-leading order. At this order the chiral expansion for the NN isoscalar charge operator (including consistently calculated 1/M corrections) is a parameter-free prediction of the effective theory. Use of this operator in conjunction with NLO and NNLO chiral effective theory wave functions produces results that are consistent with extant experimental data for Q^2 < 0.35 GeV^2. These wave functions predict a deuteron quadrupole moment G_Q(Q^2=0)=0.278-0.282 fm^2-with the variation arising from short-distance contributions to this quantity. The variation is of the same size as the discrepancy between the theoretical result and the experimental value. This motivates the renormalization of G_Q via a two-nucleon operator that couples to quadrupole photons. After that renormalization we obtain a robust prediction for the shape of G_C/G_Q at Q^2 < 0.3 GeV^2. This allows us to make precise, model-independent predictions for the values of this ratio that will be measured at the lower end of the kinematic range explored at BLAST. We also present results for the ratio G_C/G_M.Comment: 31 pages, 7 figure

Limited antigenic diversity of Plasmodium falciparum apical membrane antigen 1 supports the development of effective multi-allele vaccines

BackgroundPolymorphism in antigens is a common mechanism for immune evasion used by many important pathogens, and presents major challenges in vaccine development. In malaria, many key immune targets and vaccine candidates show substantial polymorphism. However, knowledge on antigenic diversity of key antigens, the impact of polymorphism on potential vaccine escape, and how sequence polymorphism relates to antigenic differences is very limited, yet crucial for vaccine development. Plasmodium falciparum apical membrane antigen 1 (AMA1) is an important target of naturally-acquired antibodies in malaria immunity and a leading vaccine candidate. However, AMA1 has extensive allelic diversity with more than 60 polymorphic amino acid residues and more than 200 haplotypes in a single population. Therefore, AMA1 serves as an excellent model to assess antigenic diversity in malaria vaccine antigens and the feasibility of multi-allele vaccine approaches. While most previous research has focused on sequence diversity and antibody responses in laboratory animals, little has been done on the cross-reactivity of human antibodies.MethodsWe aimed to determine the extent of antigenic diversity of AMA1, defined by reactivity with human antibodies, and to aid the identification of specific alleles for potential inclusion in a multi-allele vaccine. We developed an approach using a multiple-antigen-competition enzyme-linked immunosorbent assay (ELISA) to examine cross-reactivity of naturally-acquired antibodies in Papua New Guinea and Kenya, and related this to differences in AMA1 sequence.ResultsWe found that adults had greater cross-reactivity of antibodies than children, although the patterns of cross-reactivity to alleles were the same. Patterns of antibody cross-reactivity were very similar between populations (Papua New Guinea and Kenya), and over time. Further, our results show that antigenic diversity of AMA1 alleles is surprisingly restricted, despite extensive sequence polymorphism. Our findings suggest that a combination of three different alleles, if selected appropriately, may be sufficient to cover the majority of antigenic diversity in polymorphic AMA1 antigens. Antigenic properties were not strongly related to existing haplotype groupings based on sequence analysis.ConclusionsAntigenic diversity of AMA1 is limited and a vaccine including a small number of alleles might be sufficient for coverage against naturally-circulating strains, supporting a multi-allele approach for developing polymorphic antigens as malaria vaccines

Modified Chrispin-Norman chest radiography score for cystic fibrosis: observer agreement and correlation with lung function

Contains fulltext : 96114.pdf ( ) (Closed access)OBJECTIVE: To test observer agreement and two strategies for possible improvement (consensus meeting and reference images) for the modified Chrispin-Norman score for children with cystic fibrosis (CF). METHODS: Before and after a consensus meeting and after developing reference images three observers scored sets of 25 chest radiographs from children with CF. Observer agreement was tested for line, ring, mottled and large soft shadows, for overinflation and for the composite modified Chrispin-Norman score. Correlation with lung function was assessed. RESULTS: Before the consensus meeting agreement between observers 1 and 2 was moderate-good, but with observer 3 agreement was poor-fair. Scores correlated significantly with spirometry for observers 1 and 2 (-0.72<R<-0.42, P < 0.05), but not for observer 3. Agreement with observer 3 improved after the consensus meeting. Reference images improved agreement for overinflation and mottled and large shadows and correlation with lung function, but agreement for the modified Chrispin-Norman score did not improve further. CONCLUSION: Consensus meetings and reference images improve among-observer agreement for the modified Chrispin-Norman score, but good agreement was not achieved among all observers for the modified Chrispin-Norman score and for bronchial line and ring shadows

Trigonometry of 'complex Hermitian' type homogeneous symmetric spaces

This paper contains a thorough study of the trigonometry of the homogeneous symmetric spaces in the Cayley-Klein-Dickson family of spaces of 'complex Hermitian' type and rank-one. The complex Hermitian elliptic CP^N and hyperbolic CH^N spaces, their analogues with indefinite Hermitian metric and some non-compact symmetric spaces associated to SL(N+1,R) are the generic members in this family. The method encapsulates trigonometry for this whole family of spaces into a single "basic trigonometric group equation", and has 'universality' and '(self)-duality' as its distinctive traits. All previously known results on the trigonometry of CP^N and CH^N follow as particular cases of our general equations. The physical Quantum Space of States of any quantum system belongs, as the complex Hermitian space member, to this parametrised family; hence its trigonometry appears as a rather particular case of the equations we obtain.Comment: 46 pages, LaTe