Time Under the Curve: Assessing the Impact of Regional Lead Treatment Center Home Visit on the Length of Exposure in Lead Poisoned Children

A high proportion of Connecticut residents are at risk of health effects due to lead exposure, especially children under the age of six. The Yale Regional Lead Treatment Center (YRLTC) assists families of children with blood lead levels (BLL) exceeding the Centers for Disease Control and Prevention (CDC) maximum BLL of 5 µg/dL. YRLTC incorporates home visits of lead-exposed children living in Southern Connecticut to mitigate lead poisoning by emphasizing public health initiatives and social work, rather than using a clinic-only approach. This project aimed to evaluate the merits of this new interdisciplinary approach and its tangible effects on health outcomes. Key informant interviews provided perspectives on the value and themes of home visits. Questions focused on physiological measures of lead poisoning and cognitive development, patient interactions during home visits as well as legal, and logistical challenges to lead abatement. The team also shadowed home visits in order to understand the intervention.https://elischolar.library.yale.edu/ysph_pbchrr/1029/thumbnail.jp

Tetrasubstituted copper phthalocyanines : correlation between liquid crystalline properties, films alignment and sensing propertie

Copper phthalocyanines (CuPc) containing alkylthio (-S(CH2)nCH3, n=7 and 15), alkyloxy- (-O(CH2)nCH3, n=7 and 15) and polyoxo (-O(CH2CH2O)3CH3 and -S(CH2CH2O)3CH3) substituents were synthesized and investigated to reveal the effects of substituents type (alkylthio, alkyloxy and polyoxo) and the type of the connecting heteroatom (oxygen or sulphur) on the mesogenic properties, films alignment and sensing behaviour. The liquid crystalline properties of these phthalocyanines were investigated by differential scanning calorimetry, polarizing optical microscopy and X-ray diffraction techniques. The structure and morphology of spun thin films of copper phthalocyanine derivatives were studied by the UV-Vis and Raman spectroscopies as well atomic force microscopy. The sensing properties of CuPc films were studied by the measurement of conductivity change upon interaction with ammonia in the range 10-50 ppm. All investigated films of CuPc derivatives display thermotropic columnar mesomorphism. It was shown that the films with polyoxo- (-O(CH2CH2O)3CH3 and -S(CH2CH2O)3CH3) substituents as well as with alkylthio -S(CH2)nCH3 (n=7) substituents, which are liquid crystalline at room temperature, form ordered films with a random planar alignment of columns. Their films exhibit the better sensor performance with the maximal sensor response for the films of CuPc containing (-S(CH2CH2O)3CH3) substituents

Synthesizing and evaluating the photodynamic efficacy of asymmetric heteroleptic A(7)B type novel lanthanide bis-phthalocyanine complexes

Tuncel, Ozge/0000-0002-0873-133X; Ozcelik, Serdar/0000-0003-2029-0108; ONAL, EMEL/0000-0001-7210-9126In this study heteroleptic A(7)B type novel Lu(iii) and Eu(iii) lanthanide phthalocyanines (LnPc(Pox)[Pc '(AB(3)SH)]) with high extinction coefficients have been synthesized as candidate photosensitizers with reaction yields higher than 33%. The singlet oxygen quantum yields of LuPc(Pox)[Pc '(AB(3)SH)] and EuPc(Pox)[Pc '(AB(3)SH)], respectively, were measured 17% and 1.4% by the direct method in THF. The singlet oxygen quantum yield of LuPc(Pox)[Pc '(AB(3)SH)] in THF is the highest among lutetium(iii) bis-phthalocyanine complexes to date. The photodynamic efficacy of the heteroleptic lanthanide phthalocyanines was evaluated by measuring cell viabilities of A549 and BEAS-2B lung cells, selected to representing in vitro models for testing cancer and normal cells against potential drugs. The cell viabilities demonstrated concentration dependent behavior and were varied by the type of phthalocyanines complexes. Irradiation of the cells for 30 minutes with LED array at 660 nm producing flux of 0.036 J cm(-2) s(-1) increased cell death for LuPcPox-OAc, LuPc(Pox)[Pc '(AB(3)SH)] and ZnPc. The IC50 concentrations of LuPc(Pox)[Pc '(AB(3)SH)] and ZnPc were determined to be below 10 nM for both cell lines, agreeing very well with the singlet oxygen quantum yield measurements. These findings suggest that LuPc(Pox)[Pc '(AB(3)SH)] and particularly LuPcPox-OAc are promising drug candidates enabling lowered dose and shorter irradiation time for photodynamic therapy.Scienti.c and Technological Research Council of Turkey (TUB.ITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [116Z337]We are thankful to the Scienti.c and Technological Research Council of Turkey (TUB.ITAK) for financial support (project number: 116Z337)

Comparison of clinical and PET-derived prognostic factors in patients with non-Hodgkin lymphoma: a special emphasis on bone marrow involvement

tuncel, murat/0000-0003-2352-3587WOS: 000536763500008PubMed: 32209829Objective in patients with non-Hodgkin lymphoma (NHL), we investigated F-18 FDG PET/computed tomography (CT) parameters, clinical findings, laboratory parameters, and bone marrow involvement (BMI) status for predictive methods in progression-free survival (PFS) and overall survival (OS), and whether F-18 FDG PET/CT could take the place of bone marrow biopsy (BMB). Methods the performance of F-18 FDG PET/CT (BMPET) was evaluated. the prognostic value of maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), stage, international prognostic index (IPI) score, IPI risk, lactate dehydrogenase (LDH), B2 microglobulin, Ki67 proliferation index, and the presence of BMI was evaluated for OS and PFS. Kaplan-Meier curves were drawn for each designated cutoff value, and 5-year PFS and 7-year OS were evaluated using log-rank analysis. Results the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of BMPET and BMB to identify BMI were 69, 100, 86.1, 80, 100%, and 81.6, 100, 92.5, 89, 100%, respectively. the sensitivity, specificity, PPV, NPV, and accuracy of BMPET in patients with Ki67- proliferation index >25% were all 100%. BMPET, IPI risk, MTV, and LDH were found to be independent prognostic predictors for PFS, whereas BMPET, SUVmax, and MTV for OS. Five-year PFS analysis estimated as follows: BMPET (+) = 22%, BMPET (-) = 80%, LDH 437 (U/L) = 51%, MTV 56 (cm(3)) = 49%, low IPI risk = 87%, intermediate IPI risk = 69%, high IPI risk = 25%. Seven-year OS analysis was found as: SUVmax 17.6 = 48%, MTV 56 (cm(3)) = 45.8%, BMPET (-) = 72.5%, BMPET (+) = 42%. Conclusion in the Ki-67 proliferation index > 25% group, F-18 FDG PET/CT was able to differentiate BMI independently from NHL subgroups. We recommend using this method with large patient groups. MTV and BMPET were independent prognostic indicators for OS and PFS and may help to determine high-risk patients

Nosocomial Infections in a Neurological Intensive Care Unit

WOS: 000270682900006Background: Nosocomial infections in intensive care units are common and associated with high morbidity, mortality. This study was planned to evaluate the occurance and causes of site specific nosocomial infections in a neurological intensive care unit (NICU) and their relevance to underlying diseases. Methods: Patients treated for more than 24 hours in Ege University Medical School Hospital NICU were evaluated by prospective daily surveillance for overall and site specific infections during the 12 months of the year 2005. Nosocomial infections incidence and their relation with underlying disease were investigated. Results: Three hundred and fifty six patients were included. A hundred and ten nosocomial infections were seen. The rate of infection per 100 patients was 30.8. Site-specific infections were; urinary tract infection (49.1%), pneumonia (30.9%), catheter related blood stream infections (18.1%) and primary bacteremia (1.8%). In univariate analysis, no differences were found between the patients with stroke and other NICU disorders in terms of risk factors for NICU-AI such as; age, gender, type of nosocomial infections, length of stay, and mortality. But the length of stay was significantly prolonged and mortality was significantly higher in patients with NICU-AI when compared with patients without NICU-AIs. Conclusion: The incidence of nosocomial infections in our NICU was found to be as high as in other critical care units and causes higher mortality. This was supposed to be associated with prolonged hospital stay and insufficient compliance to infection control measures instead of the underlying disease of the patients

Is Vitamin D Insufficiency Associated with Mortality of Critically Ill Patients?

Objective. To evaluate the vitamin D status of our critically ill patients and its relevance to mortality. Patients and Methods. We performed a prospective observational study in the medical intensive care unit of a university hospital between October 2009 and March 2011. Vitamin D levels were measured and insufficiency was defined as <20 ng/mL. Results. Two hundred and one patients were included in the study. The median age was 66 (56–77) and the majority of patients were male (56%). The median serum level of vitamin D was 14,9 ng/mL and 139 (69%) patients were vitamin D insufficient on admission. While we grouped the ICU patients as vitamin D insufficient and sufficient, vitamin D insufficient patients had more severe acute diseases and worse laboratory values on admission. These patients had more morbidities and were exposed to more invasive therapies during stay. The mortality rate was significantly higher in the vitamin D insufficient group compared to the vitamin D sufficient group (43% versus 26%, P=0,027). However, logistic regression analysis demonstrated that vitamin D insufficiency was not an independent risk factor for mortality. Conclusion. Vitamin D insufficiency is common in our critically ill patients (69%), but it is not an independent risk factor for mortality

Is Vitamin D Insufficiency Associated with Mortality of Critically Ill Patients?

Objective. To evaluate the vitamin D status of our critically ill patients and its relevance to mortality. Patients and Methods. We performed a prospective observational study in the medical intensive care unit of a university hospital between October 2009 and March 2011. Vitamin D levels were measured and insufficiency was defined as <20 ng/mL. Results. Two hundred and one patients were included in the study. The median age was 66 (56-77) and the majority of patients were male (56%). The median serum level of vitamin D was 14,9 ng/mL and 139 (69%) patients were vitamin D insufficient on admission. While we grouped the ICU patients as vitamin D insufficient and sufficient, vitamin D insufficient patients had more severe acute diseases and worse laboratory values on admission. These patients had more morbidities and were exposed to more invasive therapies during stay. The mortality rate was significantly higher in the vitamin D insufficient group compared to the vitamin D sufficient group (43% versus 26%, P = 0, 027). However, logistic regression analysis demonstrated that vitamin D insufficiency was not an independent risk factor for mortality. Conclusion. Vitamin D insufficiency is common in our critically ill patients (69%), but it is not an independent risk factor for mortality