Safety of anti-immunoglobulin E therapy with omalizumab in allergic patients at risk of geohelminth infection

BACKGROUND: Although the role of immunoglobulin E (IgE) in immunity against helminth parasites is unclear, there is concern that therapeutic antibodies that neutralize IgE (anti-IgE) may be unsafe in subjects at risk of helminth infection. OBJECTIVE: We conducted an exploratory study to investigate the safety of omalizumab (anti-IgE) in subjects with allergic asthma and/or perennial allergic rhinitis at high risk of intestinal helminth infection. The primary safety outcome was risk of infections with intestinal helminths during anti-IgE therapy. METHODS: A randomized, double-blind, placebo-controlled trial was conducted in 137 subjects (12–30 years) at high risk of geohelminth infection. All subjects received pre-study anthelmintic treatment, followed by 52 weeks' treatment with omalizumab or placebo. RESULTS: Of the omalizumab subjects 50% (34/68) experienced at least one intestinal geohelminth infection compared with 41% (28/69) of placebo subjects [odds ratio (OR) 1.47, 95% confidence interval (CI) 0.74–2.95, one-sided P = 0.14; OR (adjusted for study visit, baseline infection status, gender and age) 2.2 (0.94–5.15); one-sided P = 0.035], providing some evidence for a potential increased incidence of geohelminth infection in subjects receiving omalizumab. Omalizumab therapy was well tolerated, and did not appear to be associated with increased morbidity attributable to intestinal helminths as assessed by clinical and laboratory adverse events, maximal helminth infection intensities and additional anthelmintic requirements. Time to first infection (OR 1.30, 95% CI 0.79–2.15, one-sided P = 0.15) was similar between treatment groups. Infection severity and response to anthelmintics appeared to be unaffected by omalizumab therapy. CONCLUSIONS: In this exploratory study of allergic subjects at high risk of helminth infections, omalizumab therapy appeared to be safe and well tolerated, but may be associated with a modest increase in the incidence of geohelminth infection

Single Cut Integration

We present an analytic technique for evaluating single cuts for one-loop integrands, where exactly one propagator is taken to be on shell. Our method extends the double-cut integration formalism of one-loop amplitudes to the single-cut case. We argue that single cuts give meaningful information about amplitudes when taken at the integrand level. We discuss applications to the computation of tadpole coefficients.Comment: v2: corrected typo in abstrac

NLO QCD corrections to off-shell top-antitop production with leptonic decays at hadron colliders

We present details of a calculation of the cross section for hadronic top-antitop production in next-to-leading order (NLO) QCD, including the decays of the top and antitop into bottom quarks and leptons. This calculation is based on matrix elements for \nu e e+ \mu- \bar{\nu}_{\mu}b\bar{b} production and includes all non-resonant diagrams, interferences, and off-shell effects of the top quarks. Such contributions are formally suppressed by the top-quark width and turn out to be small in the inclusive cross section. However, they can be strongly enhanced in exclusive observables that play an important role in Higgs and new-physics searches. Also non-resonant and off-shell effects due to the finite W-boson width are investigated in detail, but their impact is much smaller than naively expected. We also introduce a matching approach to improve NLO calculations involving intermediate unstable particles. Using a fixed QCD scale leads to perturbative instabilities in the high-energy tails of distributions, but an appropriate dynamical scale stabilises NLO predictions. Numerical results for the total cross section, several distributions, and asymmetries are presented for Tevatron and the LHC at 7 TeV, 8 TeV, and 14 TeV.Comment: 61 pp. Matches version published in JHEP; one more reference adde

Integrative Genomics Viewer

Author Manuscript 2012 May 07.To the Editor: Rapid improvements in sequencing and array-based platforms are resulting in a flood of diverse genome-wide data, including data from exome and whole-genome sequencing, epigenetic surveys, expression profiling of coding and noncoding RNAs, single nucleotide polymorphism (SNP) and copy number profiling, and functional assays. Analysis of these large, diverse data sets holds the promise of a more comprehensive understanding of the genome and its relation to human disease. Experienced and knowledgeable human review is an essential component of this process, complementing computational approaches. This calls for efficient and intuitive visualization tools able to scale to very large data sets and to flexibly integrate multiple data types, including clinical data. However, the sheer volume and scope of data pose a significant challenge to the development of such tools.National Institute of General Medical Sciences (U.S.) (R01GM074024)National Cancer Institute (U.S.) (R21CA135827)National Human Genome Research Institute (U.S.) (U54HG003067

Effects of testicular microlithiasis on Doppler parameters: report of three cases

BACKGROUND: Testicular microlithiasis is a rare, usually asymptomatic, non-progressive disease of the testes associated with various genetic anomalies, infertility and testicular tumors. According to our literature search, there is no specific data about Doppler findings in this disease. CASE PRESENTATION: Doppler findings of three cases of testicular microlithiasis during last two years in our institution are presented. CONCLUSIONS: Although our hypothesis was to find increased Doppler parameters due to intratesticular arterial compression, our findings suggest that there are no Doppler findings specific to testicular microlithiasis

The teaching of recent and violent conflicts as challenges for history education

This paper has been written with the support of Projects EDU2015-65088P from the DGICYT (Ministry of Education, Spain) and also the Project PICT2012-1594 from the ANPCYT (Argentina) coordinated by the autho

Clinical decision support of therapeutic drug monitoring of phenytoin: measured versus adjusted phenytoin plasma concentrations

<p>Abstract</p> <p>Background</p> <p>Therapeutic drug monitoring of phenytoin by measurement of plasma concentrations is often employed to optimize clinical efficacy while avoiding adverse effects. This is most commonly accomplished by measurement of total phenytoin plasma concentrations. However, total phenytoin levels can be misleading in patients with factors such as low plasma albumin that alter the free (unbound) concentrations of phenytoin. Direct measurement of free phenytoin concentrations in plasma is more costly and time-consuming than determination of total phenytoin concentrations. An alternative to direct measurement of free phenytoin concentrations is use of the Sheiner-Tozer equation to calculate an adjusted phenytoin that corrects for the plasma albumin concentration. Innovative medical informatics tools to identify patients who would benefit from adjusted phenytoin calculations or from laboratory measurement of free phenytoin are needed to improve safety and efficacy of phenytoin pharmacotherapy. The electronic medical record for an academic medical center was searched for the time period from August 1, 1996 to November 30, 2010 for patients who had total phenytoin and free phenytoin determined on the same blood draw, and also a plasma albumin measurement within 7 days of the phenytoin measurements. The measured free phenytoin plasma concentration was used as the gold standard.</p> <p>Results</p> <p>In this study, the standard Sheiner-Tozer formula for calculating an estimated (adjusted) phenytoin level more frequently underestimates than overestimates the measured free phenytoin relative to the respective therapeutic ranges. Adjusted phenytoin concentrations provided superior classification of patients than total phenytoin measurements, particularly at low albumin concentrations. Albumin plasma concentrations up to 7 days prior to total phenytoin measurements can be used for adjusted phenytoin concentrations.</p> <p>Conclusions</p> <p>The results suggest that a measured free phenytoin should be obtained where possible to guide phenytoin dosing. If this is not feasible, then an adjusted phenytoin can supplement a total phenytoin concentration, particularly for patients with low plasma albumin.</p

Long-term benefits of omalizumab in a patient with severe non-allergic asthma

<p>Abstract</p> <p>Introduction</p> <p>Currently, omalizumab is indicated for the treatment of patients with severe allergic uncontrolled asthma despite optimal therapy.</p> <p>Case presentation</p> <p>We studied a 52-year-old man who has been suffering from severe non allergic steroid-resistant asthma with increased levels of total IgE and a lot of comorbidity. After a 3 years long treatment with omalizumab, he presented a significant improvement in disease control in terms of hospitalizations, exacerbation, quality of life and lung function with good safety profile.</p> <p>Conclusion</p> <p>Our case shows, after a long follow-up, how omalizumab can be effective in a severe form of non-atopic asthma. It is therefore hoped that further studies can identify indicators that are able to give to clinicians information about patients who can be responsive to monoclonal anti-IgE antibody even if non allergic.</p

Free-hand sketch synthesis with deformable stroke models

We present a generative model which can automatically summarize the stroke composition of free-hand sketches of a given category. When our model is fit to a collection of sketches with similar poses, it discovers and learns the structure and appearance of a set of coherent parts, with each part represented by a group of strokes. It represents both consistent (topology) as well as diverse aspects (structure and appearance variations) of each sketch category. Key to the success of our model are important insights learned from a comprehensive study performed on human stroke data. By fitting this model to images, we are able to synthesize visually similar and pleasant free-hand sketches