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81.
Cytokine dysregulation in the post-Q-fever fatigue syndrome 总被引:1,自引:4,他引:1
Penttila IA; Harris RJ; Storm P; Haynes D; Worswick DA; Marmion BP 《QJM : monthly journal of the Association of Physicians》1998,91(8):549-560
The post-Q-fever fatigue syndrome (QFS) (inappropriate fatigue, myalgia and
arthralgia, night sweats, changes in mood and sleep patterns) follows about
20% of laboratory-proven, acute primary Q-fever cases. Cytokine
dysregulation resulting from chronic immune stimulation and modulation by
persistence of Coxiella burnetii cells or their antigens is hypothesized.
We studied cytokine release patterns of peripheral blood mononuclear cells
(PBMC) stimulated with various ligands in short- term culture, from 18
patients with active QFS, and 27 controls: six with resolving QFS, five who
had had acute primary Q-fever without subsequent QFS, eight healthy Q-fever
vaccinees and eight healthy subjects without Q-fever antibody. Conditioned
media (CM) from PBMC stimulated in short-term culture with Q-fever
antigens, PHA or measles antigen (as an unrelated antigen) were assayed for
IL-2, IL-4, IL-5, IL- 6, IL-10 and IFN gamma by AgEIA, and for IL-1 and TNF
alpha/beta by bioassay. Aberrant cytokine release patterns were observed
with PBMC from QFS patients when stimulated with Q-fever antigens: an
accentuated release of IL-6 which was significantly [p = 0.01,
non-parametric one- way analysis of variance (ANOVA)] in excess of medians
for all four control groups. With IL-2, the number of responders in the
active QFS group was decreased relative to control groups (Fisher's exact
test, p = 0.01) whereas the number of IFN gamma responders was increased
(Fisher's exact test, p = 0.0008). Significant correlations were observed
between concentrations of IL-6 in CM, total symptom scores, and scores for
other key symptoms.
相似文献
82.
Post-infection fatigue syndrome following Q fever 总被引:3,自引:2,他引:3
Ayres JG; Flint N; Smith EG; Tunnicliffe WS; Fletcher TJ; Hammond K; Ward D; Marmion BP 《QJM : monthly journal of the Association of Physicians》1998,91(2):105-123
In 1989, 147 individuals in the West Midlands, UK, were infected with Q
fever. Five years later, following anecdotal reports of fatigue, we used a
questionnaire-based case-control study to determine the prevalence of
chronic fatigue syndrome symptoms in this group. Replies from 71 patients
were compared with those from 142 age- and sex-matched controls. Increased
sweating (52.9% vs. 31.6%, p = 0.006), breathlessness (50.7% vs. 30.6%, p =
0.006), blurred vision (34.3% vs. 17.8%, p = 0.016) and undue tiredness
(68.7% vs. 51.5%, p = 0.03) were found in controls compared to cases. These
findings were similar to those in Australian abbatoir workers
occupationally exposed to Q fever. CDC criteria for chronic fatigue
syndrome were fulfilled by 42.3% of cases and 26% of controls. Using visual
analogue scores, symptoms were more severe in cases than in controls. Our
findings support the existence of a chronic fatigue state following acute Q
fever, in a group of patients exposed just once to the organism, and in
circumstances free of such confounding factors as lawsuits over
compensation.
相似文献
83.
Hepatitis A virus infections associated with clotting factor concentrate in the United States 总被引:2,自引:0,他引:2
BACKGROUND: Two cases of hepatitis A among persons exposed to the same lot of solvent/detergent-treated antihemophilic factor VIII concentrate were reported to a surveillance system. An investigation was conducted to find additional cases and determine the source of infection. STUDY DESIGN AND METHODS: A seroprevalence study was conducted among persons with exposure to the suspect lot for serologic evidence of recent infection with hepatitis A virus (HAV). RESULTS: Six cases of recent HAV infection were discovered: four of the patients had been infused with material from the suspect lot of factor VIII, and two had received infusions of factor IX concentrate made from plasma pools common to the suspect factor VIII lot. HAV was identified in one of the plasma pools, in the factor VIII product, and in serum or stool from two factor VIII recipients and one factor IX recipient. The genetics sequence of the virus in the plasma pool, the factor VIII lot, and the factor VIII recipients were identical, while that of the virus in the factor IX recipient differed by a single base. CONCLUSION: These data document the transmission of HAV by a factor VIII concentrate and implicate factor IX products manufactured from a common source-plasma pool. 相似文献
84.
Anushka BP Fernando Gonzalo P Urcelay Adam C Mar Tony A Dickinson Trevor W Robbins 《Neuropsychopharmacology》2014,39(6):1420-1430
Safety signals (SSs) have been shown to reinforce instrumental avoidance behavior due to their ability to signal the absence of an aversive event; however, little is known of their neural mediation. This study investigated whether infusions of d-amphetamine in the nucleus accumbens (Nac), previously shown to potentiate responding for appetitive conditioned reinforcers (CRfs), also regulate avoidance responding for a SS. Rats were trained on a free-operant task in which lever-press responses avoided shock and were reinforced with an auditory SS. Rats were then cannulated in the Nac core (NacC) or shell (NacS) and infused with d-amphetamine and, in separate NacS groups, other drugs, before extinction sessions with the SS present or absent following responding. Selective effects of d-amphetamine were found in the NacS, but not in the NacC, when the SS was present in the session. A significant increase in response rate during the presentation of the SS reflected a disruption of its fear-inhibiting properties. In parallel, a decrease in avoidance response rate reflected the reduced influence of the SS as a CRf. Inactivation of the NacS reduced avoidance responding only when the SS was present in the session, whereas the D1–D2 DA receptor antagonist α-flupenthixol reduced responding both before and during the SS regardless of the presence of the SS. Atomoxetine (ATO), a selective noradrenaline reuptake inhibitor, had no effect on responding. These results indicate a role for the NacS in the mediation of the conditioned reinforcing properties of a SS. These effects appear to be modulated by dopaminergic mechanisms but seem distinct from those previously reported with food-related CRfs. 相似文献
85.
C Brenneis K Kistner M Puopolo S Jo DP Roberson M Sisignano D Segal EJ Cobos BJ Wainger S Labocha N Ferreirós C Hehn J Tran G Geisslinger PW Reeh BP Bean C J Woolf 《British journal of pharmacology》2014,171(2):438-451
Background and Purpose: Selective nociceptor fibre block is achieved by introducing the cell membrane impermeant sodium channel blocker lidocaine N-ethyl bromide (QX-314) through transient receptor potential V1 (TRPV1) channels into nociceptors. We screened local anaesthetics for their capacity to activate TRP channels, and characterized the nerve block obtained by combination with QX-314.Experimental Approach: We investigated TRP channel activation in dorsal root ganglion (DRG) neurons by calcium imaging and patch-clamp recordings, and cellular QX-314 uptake by MS. To characterize nerve block, compound action potential (CAP) recordings from isolated nerves and behavioural responses were analysed.Key Results: Of the 12 compounds tested, bupivacaine was the most potent activator of ruthenium red-sensitive calcium entry in DRG neurons and activated heterologously expressed TRPA1 channels. QX-314 permeated through TRPA1 channels and accumulated intracellularly after activation of these channels. Upon sciatic injections, QX-314 markedly prolonged bupivacaine''s nociceptive block and also extended (to a lesser degree) its motor block. Bupivacaine''s blockade of C-, but not A-fibre, CAPs in sciatic nerves was extended by co-application of QX-314. Surprisingly, however, this action was the same in wild-type, TRPA1-knockout and TRPV1/TRPA1-double knockout mice, suggesting a TRP-channel independent entry pathway. Consistent with this, high doses of bupivacaine promoted a non-selective, cellular uptake of QX-314.Conclusions and Implications: Bupivacaine, combined with QX-314, produced a long-lasting sensory nerve block. This did not require QX-314 permeation through TRPA1, although bupivacaine activated these channels. Regardless of entry pathway, the greatly extended duration of block produced by QX-314 and bupivacaine may be clinically useful. 相似文献
86.
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88.
Reske AW Rau A Reske AP Koziol M Gottwald B Alef M Ionita JC Spieth PM Hepp P Seiwerts M Beda A Born S Scheuermann G Amato MB Wrigge H 《Critical care (London, England)》2011,15(6):R279-10
Introduction
Computed tomography (CT) is considered the gold standard for quantification of global or regional lung aeration and lung mass. Quantitative CT, however, involves the exposure to ionizing radiation and requires manual image processing. We recently evaluated an extrapolation method which calculates quantitative CT parameters characterizing the entire lung from only 10 reference CT-slices thereby reducing radiation exposure and analysis time. We hypothesized that this extrapolation method could be further validated using CT-data from pigs and sheep, which have a different thoracic anatomy.Methods
We quantified volume and mass of the total lung and differently aerated lung compartments in 168 ovine and 55 porcine whole-lung CTs covering lung conditions from normal to gross deaeration. Extrapolated volume and mass parameters were compared to the respective values obtained by whole-lung analysis. We also tested the accuracy of extrapolation for all possible numbers of CT slices between 15 and 5. Bias and limits of agreement (LOA) were analyzed by the Bland-Altman method.Results
For extrapolation from 10 reference slices, bias (LOA) for the total lung volume and mass of sheep were 18.4 (-57.2 to 94.0) ml and 4.2 (-21.8 to 30.2) grams, respectively. The corresponding bias (LOA) values for pigs were 5.1 (-55.2 to 65.3) ml and 1.6 (-32.9 to 36.2) grams, respectively. All bias values for differently aerated lung compartments were below 1% of the total lung volume or mass and the LOA never exceeded ± 2.5%. Bias values diverged from zero and the LOA became considerably wider when less than 10 reference slices were used.Conclusions
The extrapolation method appears robust against variations in thoracic anatomy, which further supports its accuracy and potential usefulness for clinical and experimental application of quantitative CT. 相似文献89.
Reske AW Reske AP Heine T Spieth PM Rau A Seiwerts M Busse H Gottschaldt U Schreiter D Born S Gama de Abreu M Josten C Wrigge H Amato MB 《Critical care (London, England)》2011,15(1):R71-10
Introduction
Quantitative computed tomography (qCT)-based assessment of total lung weight (Mlung) has the potential to differentiate atelectasis from consolidation and could thus provide valuable information for managing trauma patients fulfilling commonly used criteria for acute lung injury (ALI). We hypothesized that qCT would identify atelectasis as a frequent mimic of early posttraumatic ALI.Methods
In this prospective observational study, Mlung was calculated by qCT in 78 mechanically ventilated trauma patients fulfilling the ALI criteria at admission. A reference interval for Mlung was derived from 74 trauma patients with morphologically and functionally normal lungs (reference). Results are given as medians with interquartile ranges.Results
The ratio of arterial partial pressure of oxygen to the fraction of inspired oxygen was 560 (506 to 616) mmHg in reference patients and 169 (95 to 240) mmHg in ALI patients. The median reference Mlung value was 885 (771 to 973) g, and the reference interval for Mlung was 584 to 1164 g, which matched that of previous reports. Despite the significantly greater median Mlung value (1088 (862 to 1,342) g) in the ALI group, 46 (59%) ALI patients had Mlung values within the reference interval and thus most likely had atelectasis. In only 17 patients (22%), Mlung was increased to the range previously reported for ALI patients and compatible with lung consolidation. Statistically significant differences between atelectasis and consolidation patients were found for age, Lung Injury Score, Glasgow Coma Scale score, total lung volume, mass of the nonaerated lung compartment, ventilator-free days and intensive care unit-free days.Conclusions
Atelectasis is a frequent cause of early posttraumatic lung dysfunction. Differentiation between atelectasis and consolidation from other causes of lung damage by using qCT may help to identify patients who could benefit from management strategies such as damage control surgery and lung-protective mechanical ventilation that focus on the prevention of pulmonary complications. 相似文献90.
Indoor workload of a zonal service hospital for one month was studied. Service personnel and their dependents form the bulk of workload. Though the absolute number of ex-servicemen and their dependents is small, the resources spent on them are quite high. The average stay in hospital is 15 days. Rapid turnover of the patients reveals appropriate utilization of resources. Optimization of resources is possible by reducing the number of admissions for administrative purposes.KEY WORDS: Exservicemen, Hospital Admission, Medical facility, Resource Utilisation, Servicemen 相似文献