Antibody therapeutics targeting ion channels: are we there yet?

The combination of technological advances, genomic sequences and market success is catalyzing rapid development of antibody-based therapeutics. Cell surface receptors and ion channel proteins are well known drug targets, but the latter has seen less success. The availability of crystal structures, better understanding of gating biophysics and validation of physiological roles now form an excellent foundation to pursue antibody-based therapeutics targeting ion channels to treat a variety of diseases.     

Coccidioidomycosis Infection of a Total Knee Arthroplasty in a Nonendemic Region

Fungal prosthetic joint infections are rare and difficult to treat. There is an ongoing discussion about the type and duration of antifungal treatment and the necessity of prosthesis removal. We report the first European case of an infected total knee arthroplasty with Coccidioides immitis. Treatment consisted of lifelong treatment with oral fluconazole at a dose of 400 mg/d, without total knee arthroplasty removal. After 6 months, the initial complaints of pain and swelling were completely resolved. This case report clearly states that a travel history and culturing for fungi are helpful in patients with persisting complaints after joint arthroplasty.     

颈臂丛联合神经阻滞麻醉应用于锁骨骨折手术中的临床体会

目的探讨颈臂丛联合神经阻滞麻醉应用锁骨骨折手术中的临床效果。方法选取锁骨骨折手术患者115例,随机分为观察组和对照组。观察组采用颈臂丛联合阻滞麻醉,对照组采用颈浅丛神经阻滞麻醉。观察2组麻醉效果的优良率、心率、平均动脉压、氧饱和度以及不良反应。结果 2组患者心率与平均动脉压比较差异具有统计学意义P<0.01,氧饱和度比较差异无统计学意义P>0.05。观察组麻醉优良率明显高于对照组,x2=7.9367,P<0.05。2组患者麻醉后不良反应发生率比较,x2=0.2413,P>0.05。结论颈臂丛联合阻滞是一种较好的麻醉方法,、效果理想、并发症少,适合锁骨骨折手术推广使用。     

Automatic classification of gait in children with early-onset ataxia or developmental coordination disorder and controls using inertial sensors

Early-Onset Ataxia (EOA) and Developmental Coordination Disorder (DCD) are two conditions that affect coordination in children. Phenotypic identification of impaired coordination plays an important role in their diagnosis. Gait is one of the tests included in rating scales that can be used to assess motor coordination.A practical problem is that the resemblance between EOA and DCD symptoms can hamper their diagnosis. In this study we employed inertial sensors and a supervised classifier to obtain an automatic classification of the condition of participants. Data from shank and waist mounted inertial measurement units were used to extract features during gait in children diagnosed with EOA or DCD and age-matched controls. We defined a set of features from the recorded signals and we obtained the optimal features for classification using a backward sequential approach. We correctly classified 80.0%, 85.7%, and 70.0% of the control, DCD and EOA children, respectively. Overall, the automatic classifier correctly classified 78.4% of the participants, which is slightly better than the phenotypic assessment of gait by two pediatric neurologists (73.0%). These results demonstrate that automatic classification employing signals from inertial sensors obtained during gait maybe used as a support tool in the differential diagnosis of EOA and DCD. Furthermore, future extension of the classifier’s test domains may help to further improve the diagnostic accuracy of pediatric coordination impairment. In this sense, this study may provide a first step towards incorporating a clinically objective and viable biomarker for identification of EOA and DCD.     

Homelessness predicts attrition but not alcohol abstinence in outpatients experiencing co-occurring alcohol dependence and serious mental illness

Background: Adults experiencing homelessness and serious mental illnesses (SMI) are at an increased risk of poor mental health and treatment outcomes compared with stably housed adults with SMI. The additional issue of alcohol misuse further complicates the difficulties of those living with homelessness and SMI. In this secondary data analysis, the authors investigated the impact of homelessness on attrition and alcohol use in a contingency management (CM) intervention that rewarded alcohol abstinence in outpatients with SMI. Methods: The associations between housing status and attrition and alcohol abstinence during treatment, as assessed by ethyl glucuronide (EtG) urine tests, were evaluated in 79 adults diagnosed with alcohol dependence and SMI. Results: Thirty-nine percent (n = 31) of participants reported being homeless at baseline. Individuals who were homeless were more likely to drop out of CM (n = 10, 62.5%) than those who were housed (n = 4, 16.7%), χ²(1) = 8.86, P < .05. Homelessness was not associated with attrition in the noncontingent control group. Accounting for treatment group and prerandomization EtG levels, neither the effect of housing status nor the interaction of housing status and group were associated with EtG-assessed alcohol abstinence during treatment. Conclusions: Individuals experiencing homelessness and co-occurring alcohol dependence and SMI receiving CM had higher rates of attrition, relative to those who were housed. Homelessness was not associated with differences in biologically assessed alcohol abstinence.     

黛力新治疗冠心病伴情绪障碍的心理护理观察

目的观察黛力新药物治疗背景下心理护理干预对冠心病伴情绪障碍患者的临床疗效。方法采用历史性回顾方法,选取我院自2015年9月~2016年9月收治的60例冠心病伴情绪障碍患者,按照护理方法的不同,随机分为两组。对照组患者30例,行常规药物治疗。观察组患者30例,在对照组的基础上,增加心理护理干预措施,观察两组患者的临床治疗效果及护理满意度。结果观察组患者临床治疗总有效率为93.33%(28/30),明显高于对照组的70.00%(21/30),两组比较,差异有统计学意义(P0.05)。观察组护理总满意度为96.67%(29/30),明显高于对照组的73.33%(22/30),两组比较,差异有统计学意义(P0.05)。结论黛力新药物治疗背景下心理护理干预对冠心病伴情绪障碍临床疗效确切,且具有较高的安全性,值得在临床护理中实施应用。