Peroxidase-labelling of Chicken Antibodies

Chicken antibodies have several advantages over mammalian antibodies due to the phylogenetical differences between birds and mammals, resulting in an increased sensitivity and a decreased background in many immunological assays. So far, there has been a very limited use of avian antibodies. This is probably partly due to tradition but also because there are very few optimized methods for the labelling of chicken antibodies. We report upon the suitable conditions for peroxidase-labelling of chicken antibodies with a modified periodate method.     

No increased risk of hypoglycaemic episodes during 48 h of subcutaneous glucagon-like-peptide-1 administration in fasting healthy subjects

Objective  It is uncertain whether the ability to avoid hypoglycaemia during fasting is preserved, and the risk of reactive hypoglycaemia after an oral glucose stimulus following a prolonged fasting period is increased at augmented glucagon-like peptide-1 (GLP-1) levels.
Design  A randomized, double-blind placebo-controlled cross-over study in eight healthy men to assess the safety, in terms of hypoglycaemia, of a continuously infused pharmacological dose of native GLP-1 during long-term fasting. After an overnight fast the fasting period continued for 48 h and was followed by a 3-h oral glucose tolerance test (OGTT). GLP-1(7-36 amide) or placebo was continuously infused subcutaneously and titrated to a dose of 4·8 pmol/kg per min.
Results  Two subjects in the GLP-1 group and one subject in the placebo group were withdrawn due to protocol specified plasma glucose (PG) ≤ 2·8 m m and neuroglycopaenic symptoms.
The infusion of GLP-1 resulted in pharmacological levels of intact GLP-1. During the fasting period PG, insulin and C-peptide levels declined and glucagon, GH and free fatty acid (FFA) levels increased with no differences between GLP-1 and placebo. During OGTT circulating levels of insulin and C-peptide were higher with GLP-1 infusion. However, PG was similar during GLP-1 vs. placebo infusions. GLP-1 infusion increased norepinephrine and cortisol levels during OGTT.
Conclusion  The counter-regulatory response during 48 h of subcutaneous GLP-1 infusion was preserved despite long-term fasting with no apparent increased risk of hypoglycaemic episodes. No reactive hypoglycaemia was observed when the fast was followed by an OGTT. Thus use of long-acting GLP-1 analogues may not increase the risk of hypoglycaemia.     

Six year results of the Rebalance mobile bearing total ankle replacement

BackgroundWe report the outcomes of a prospective consecutive series of 267 total ankle replacements (TARs) using a new mobile bearing Rebalance® prosthesis.MethodsBetween April 2011 and December 2018, 267 consecutive Rebalance® prostheses were implanted in 255 patients at 3 different centers. Estimated survival curves with 95% confidence intervals were produced with the Kaplan–Meier method. 110 ankles were followed for at least 5 years and clinical and radiological outcomes were assessed in 92 of these ankles.ResultsTwenty-one ankles were revised at a mean of 34 (7–60) months. The estimated survival was 90% (95% CI 86–95) at 5 years and 88.3% (95% CI 83.–94 at 6 years. The ankles followed for at least 5 years demonstrated a median Likert score of 1 (1–4). Radiolucent zones were detected in 14% and osteolytic cysts in 3%.ConclusionThe survival rate of the Rebalance prosthesis conforms with other reports of similar designs. The satisfaction rate was high. Radiological zones and osteolytic cysts were found at a lower rate than usually reported for mobile bearing TARs. These results favour further use of this implant.     

Instant availability of patient records,but diminished availability of patient information: A multi-method study of GP's use of electronic patient records

Background  

In spite of succesful adoption of electronic patient records (EPR) by Norwegian GPs, what constitutes the actual benefits and effects of the use of EPRs in the perspective of the GPs and patients has not been fully characterized. We wanted to study primary care physicians' use of electronic patient record (EPR) systems in terms of use of different EPR functions and the time spent on using the records, as well as the potential effects of EPR systems on the clinician-patient relationship.