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991.
Ioana Agache Jessica Beltran Cezmi Akdis Mubeccel Akdis Carlos Canelo-Aybar Giorgio Walter Canonica Thomas Casale Tomas Chivato Jonathan Corren Stefano Del Giacco Thomas Eiwegger Davide Firinu James E. Gern Eckard Hamelmann Nicola Hanania Mika Mäkelä Irene Hernández-Martín Parameswaran Nair Liam O'Mahony Nikolaos G. Papadopoulos Alberto Papi Hae-Sim Park Luis Pérez de Llano Margarita Posso Claudio Rocha Santiago Quirce Joaquin Sastre Mohamed Shamji Yang Song Corinna Steiner Jurgen Schwarze Pablo Alonso-Coello Oscar Palomares Marek Jutel 《Allergy》2020,75(5):1023-1042
Five biologicals have been approved for severe eosinophilic asthma, a well-recognized phenotype. Systematic reviews (SR) evaluated the efficacy and safety of benralizumab, dupilumab, mepolizumab, omalizumab and reslizumab (alphabetical order) compared to standard of care for severe eosinophilic asthma. PubMed, Embase and Cochrane Library were searched to identify RCTs and health economic evaluations, published in English. Critical and important asthma-related outcomes were evaluated for each of the biologicals. The risk of bias and the certainty of the evidence were assessed using GRADE. 19 RCTs (three RCTs for benralizumab, three RCTs for dupilumab, three RCTs for mepolizumab, five RCTs for omalizumab and five RCTs for reslizumab), including subjects 12 to 75 years old (except for omalizumab including also subjects 6-11 years old), ranging from 12 to 56 weeks were evaluated. All biologicals reduce exacerbation rates with high certainty of evidence: benralizumab incidence rate ratio (IRR) 0.53 (95% CI 0.39 to 0.72), dupilumab (IRR) 0.43 (95% CI 0.32 to 0.59), mepolizumab IRR 0.49 (95% CI 0.38 to 0.66), omalizumab (IRR) 0.56 (95% CI 0.40 to 0.77) and reslizumab (IRR) 0.46 (95% CI 0.37 to 0.58). Benralizumab, dupilumab and mepolizumab reduce the daily dose of oral corticosteroids (OCS) with high certainty of evidence. All evaluated biologicals probably improve asthma control, QoL and FEV1, without reaching the minimal important difference (moderate certainty). Benralizumab, mepolizumab and reslizumab slightly increase drug-related adverse events (AE) and drug-related serious AE (low to very low certainty of evidence). The incremental cost-effectiveness ratio per quality-adjusted life year value is above the willingness to pay threshold for all biologicals (moderate certainty). Potential savings are driven by decrease in hospitalizations, emergency and primary care visits. There is high certainty that all approved biologicals reduce the rate of severe asthma exacerbations and for benralizumab, dupilumab and mepolizumab for reducing OCS. There is moderate certainty for improving asthma control, QoL, FEV1. More data on long-term safety are needed together with more efficacy data in the paediatric population. 相似文献
992.
Sharon V. dos Reis Walter O. Beys-da-Silva Lucas Tirloni Lucélia Santi Adriana Seixas Carlos Termignoni Márcia V. da Silva Alexandre J. Macedo 《Journal of basic microbiology》2020,60(9):809-815
The aim of this study was to select and identify thermophilic bacteria from Caatinga biome (Brazil) able to produce thermoactive keratinases and characterize the keratinase produced by the selected isolate. After enrichment in keratin culture media, an Anoxybacillus caldiproteolyticus PC2 was isolated. This thermotolerant isolate presents a remarkable feature producing a thermostable keratinase at 60°C. The partially purified keratinase, identified as a thermolysin-like peptidase, was active at a pH range of 5.0–10.0 with maximal activity at a temperature range of 50–80°C. The optimal activity was observed at pH 7.0 and 50–60°C. These characteristics are potentially useful for biotechnological purposes such as processing and bioconversion of keratin. 相似文献
993.
Chiara Masetti Elena Generali Francesca Colapietro Antonio Voza Maurizio Cecconi Antonio Messina Paolo Omodei Claudio Angelini Michele Ciccarelli Salvatore Badalamenti G. Walter Canonica Ana Lleo Alessio Aghemo the for the Humanitas Covid- Task Force 《European journal of clinical investigation》2020,50(9):e13314
994.
Thiago Thomaz Mafort MD PhD Agnaldo José Lopes MD PhD Cláudia Henrique da Costa MD PhD Mariana Soares da Cal MS Mariana Carneiro Lopes MD Bruno Rangel Antunes da Silva MD PhD Luana Fortes Faria MD Anamelia Costa Faria MD MSc Walter Costa MD Raquel Esteves Brandão Salles MD Marcos César Santos de Castro MD MSc Rogério Rufino MD PhD 《Journal of clinical ultrasound : JCU》2020,48(9):515-521
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Walter Knirsch Sonia Bertholdt Gaby Stoffel Brian Stiasny Roland Weber Hitendu Dave Rene Prêtre Michael von Rhein Oliver Kretschmar 《Pediatric cardiology》2014,35(5):851-856
Infants with hypoplastic left heart syndrome (HLHS) are at risk for interstage morbidity and mortality, especially between the first and second surgical stages after the Norwood and hybrid procedures. This study compared the morbidity and mortality of patients treated by either the Norwood or the hybrid procedure for HLHS between the first and second stages who were undergoing interstage monitoring. Between October 2008 and December 2011, 26 infants (14 boys) with HLHS (n = 16) and other univentricular heart malformations with aortic arch anomaly (n = 10) were scheduled for interstage monitoring after Norwood I (n = 12) and hybrid (n = 14) procedures. Three infants (11.5 %) died after first-stage palliation (one hybrid patient and two Norwood patients), and three infants (11.5 %) died after second-stage palliation (two hybrid patients and one Norwood patient) (p = 0.83), all after early second-stage surgery (<90 days). The Norwood I and hybrid procedures did not differ in terms of overall mortality (23 %) (three hybrid and three Norwood patients; p = 1.00). Seven infants (26.9 %) could not be discharged from the hospital due to hemodynamic instability and were referred for early second-stage surgery (<90 days). After the first stage, the invasive reevaluation rate before discharge was high (53.8 %), with cardiac catheterizations for 8 of 14 patients after the hybrid procedure and for 6 of 12 patients after the Norwood procedure (p = 0.69). A total of 11 reinterventions were performed (eight by catheter and three by surgery). Of the eight catheter reinterventions, five were performed for hybrid patients (p = 0.22). For 14 infants, 89 days (range 10–177 days) of interstage monitoring were scheduled. One infant (3.9 %) died during the interstage monitoring. The findings showed a breach of the physiologic criteria for interstage monitoring in seven infants (50 %) after 10 days (range 4–68 days) (five hybrid and two Norwood patients), leading to rehospitalization and catheterization for six patients (four hybrid and two Norwood patients), requiring interventions for two patients (patent arterial duct stent dilation, and atrial septal defect stenting, all for hybrid patients). Overall, three of the seven patients with red flag events of interstage monitoring were candidates for early second-stage surgery. In conclusion, morbidity among infants treated for HLHS remains high, either before or after hospital discharge, emphasizing the need of interstage monitoring programs. Despite retrograde aortic flow in infants with HLHS after the hybrid procedure, the mortality rate was comparable between the two groups. Mortality occurs after early second-stage surgery (<90 days). 相似文献
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