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1
Blom, Marianne, Aase Meyer, Peter Gerner-Smidt, Knud Gaarslev, and Frank Espersen. "Evaluation of Statens Serum Institut Enteric Medium for Detection of Enteric Pathogens." Journal of Clinical Microbiology 37, no. 7 (1999): 2312–16. http://dx.doi.org/10.1128/jcm.37.7.2312-2316.1999.
Повний текст джерелаАнотація:
The efficacy of the Statens Serum Institut (SSI) enteric medium for isolation and direct identification of enteric pathogens was evaluated. Six different biochemical reactions can be read by using the SSI enteric medium, allowing direct identification of a range of enteric pathogens. All 248 gram-negative bacterial species that were tested grew on the SSI enteric medium. Only 10 of 248 bacteria (4%) showed discrepant results in the biochemical reactions, and none of these were enteric pathogens. Forty-three of 47 enteric pathogens (92%) produced identical rates of semiquantitative growth on the SSI enteric medium and 5% blood agar, whereas three Vibrio spp. and oneAeromonas spp. showed reduced growth. Gram-positive bacteria did not grow on the SSI enteric medium. Most enteric pathogens had a detection limit of 50 bacteria per ml of feces, but higher numbers of Vibrio spp. and some Shigella spp. were required for detection. The growth rates of 125 enteric pathogens and 12 Yersinia spp. on the SSI enteric medium, xylose lysine deoxycholate (XLD), Hektoen enteric (HE),Salmonella-Shigella (SS), and cefsulodin-irgasan-novobiocin (CIN) agar were compared. Detection rates after application of 200 CFU were 99% for SSI enteric medium, 92% for XLD, 88% for HE, and 82% for SS agar. The 12 Yersinia spp. grew excellently on both the SSI enteric medium and CIN agar. We conclude that the performance of the SSI enteric medium compares favorably to those of other media tested. Its ability to detect Yersinia spp. may limit the number of media needed in the typical laboratory. The direct identification of enteric pathogens on the medium may also provide a more rapid diagnosis.
2
Shigoli, Peter, Gunturu Revathi, Elusah Juliet, and Kimang'a Nyerere. "Performance of Statens Serum Institut Enteric Medium for Detection of Enteric Pathogens in Stool in Routine Laboratory Diagnostics." Universal Journal of Clinical Medicine 3, no. 2 (June 2015): 11–14. http://dx.doi.org/10.13189/ujcm.2015.030201.
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3
Bratcher, P. E., and M. H. Nahm. "Cross-Reactivity of Current Serogroup 6 Factor Sera from Statens Serum Institut with the Recently Described Pneumococcal Serotype 6D." Journal of Clinical Microbiology 48, no. 8 (June 23, 2010): 3044–45. http://dx.doi.org/10.1128/jcm.00839-10.
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4
LIND, I., and L. BERTHELSEN. "Epidemiology of meningococcal disease in Denmark 1974–1999: contribution of the laboratory surveillance system." Epidemiology and Infection 133, no. 2 (December 22, 2004): 205–15. http://dx.doi.org/10.1017/s0950268804003413.
Повний текст джерелаАнотація:
The Danish meningococcal disease laboratory surveillance system was established in 1974, based on close collaboration between local Departments of Clinical Microbiology and the Reference Laboratory at Statens Serum Institut. The completeness of the clinical notification system integrated with the laboratory surveillance system has been estimated to be more than 95%. Overall 4257 (79%) of 5356 cases of meningococcal disease notified during 1974–1999 were confirmed by culture of Neisseria meningitidis. The proportion of culture-confirmed cases ranged from 70% in 1989 to 89% in 1980. Only 26 patients (0·6%) with culture-confirmed meningococcal disease were not notified. Serological phenotype and susceptibility to penicillin and sulphonamide were determined for all isolates. Multilocus enzyme electrophoresis and/or DNA-based analyses were used for the assessment of clusters and outbreaks. Meningococcal antibody tests and counter-immunoelectrophoresis were used for the ascertainment of suspected cases. These combined systems allowed timely and reliable management of outbreaks and identification of clusters.
5
Risum, Malene, Mai-Britt Vestergaard, Ulla Møller Weinreich, Marie Helleberg, Nadja Hawwa Vissing, and René Jørgensen. "Therapeutic Drug Monitoring of Isavuconazole: Serum Concentration Variability and Success Rates for Reaching Target in Comparison with Voriconazole." Antibiotics 10, no. 5 (April 23, 2021): 487. http://dx.doi.org/10.3390/antibiotics10050487.
Повний текст джерелаАнотація:
Isavuconazole (ISZ) is used in the treatment of aspergillosis and mucormycosis. The purpose of this study was to evaluate the therapeutic drug monitoring (TDM) of ISZ samples from a clinical setting performed at Statens Serum Institut. Materials/methods: Isavuconazole serum concentrations were determined by fluorescent detection on a UHPLC. Serum-ISZ (s-ISZ) results were included and compared to those of serum-voriconazole (s-VRZ) in a 33 month period from March 2017. Clinical data were obtained for patients receiving ISZ. The therapeutic range was initially 2–10 mg/L, but was adjusted to 2–5 mg/L during the study period except for selected patients with Mucorales infections who received off-label doses of ISZ. Results: A total of 273 s-ISZ and 1242 s-VRZ measurements from 35 and 283 patients, respectively, were included. Seventeen patients had received both ISZ and VRZ with TDM within the study period. The median s-ISZ was 4.3 mg/L (0.5–15.4 mg/L) with 83% of measurements within the therapeutic index. The median s-VRZ was 2.6 mg/L (0.2–21.9 mg/L) with 67% of measurements within the therapeutic index. The median intra-/interindividual coefficient of variation (CV) was 43.4%/54.8% for ISZ compared to 53.2%/83.3% for VRZ. For patients receiving ISZ, the adverse events were mostly gastroenteric and few drug–drug interactions were observed. Furthermore, immediate change from ISZ to VRZ treatment seemed to lead to prolonged metabolism of ISZ with detection up to 35 days after discontinuation. Conclusions: The majority of patients achieved s-ISZ levels well within the therapeutic range with less intra/interindividual CV than patients receiving VRZ.
6
Roglić, Srđan, Drusia Dickson, Branko Miše, Klaudija Višković, Vera Katalinić-Janković, George Rutherford, and Josip Begovac. "Successful Treatment of Disseminated Bacillus Calmette-Guérin Disease in an HIV-Infected Child with a Linezolid-Containing Regimen." Case Reports in Infectious Diseases 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/1528981.
Повний текст джерелаАнотація:
Upon HIV infection diagnosis, an 8-month-old boy was transferred for evaluation of worsening respiratory distress requiring mechanical ventilation.Pneumocystis jiroveciipneumonia (PCP) was diagnosed; the boy also had a nonhealing ulcer at the site of vaccination with Statens Serum Institut (Danish strain) Bacillus Calmette-Guérin (BCG) vaccine and associated axillary lymphadenopathy. PCP treatment resulted in weaning from mechanical ventilation. Antimycobacterial treatment was immediately attempted but was discontinued because of hepatotoxicity. Over several months, he developed splenic lesions and then disseminated skin and cystic bone lesions.M. boviswas repeatedly cultured from both skin and bone lesions despite various multidrug antimycobacterial regimens which included linezolid. Eventually, treatment with a regimen of rifabutin, isoniazid, ethambutol, and linezolid led to definitive cure. Clinicians should consider a linezolid-containing regimen for treatment of severe disseminated BCG infection, especially if other drug regimens have failed. Although drug toxicity is a particular concern for young children, this patient received linezolid for 13 months without serious toxicity. This case also highlights the need for universal screening among pregnant women to prevent vertical transmission of HIV. Finally, routine immunization with BCG vaccine at birth should be questioned in countries with low and declining burden of tuberculosis.
7
Henson, Dawn, Jaap van Dissel, Simone Joosten, Andrew Graves, Søren Hoff, Darius Soonawala, Corine Prines, et al. "Vaccination with a Hybrid 1 (H1) fusion protein combined with a liposomal adjuvant (CAF01) induced antigen specific T-cells 3 years post vaccination in a human clinical trial. (VAC7P.971)." Journal of Immunology 192, no. 1_Supplement (May 1, 2014): 141.16. http://dx.doi.org/10.4049/jimmunol.192.supp.141.16.
Повний текст джерелаАнотація:
Abstract Approximately one third of the world’s population is infected with Mycobacterium tuberculosis. Developing novel vaccines to protect against pulmonary tuberculosis is a public health priority. In this study, a Hybrid 1 (H1) subunit vaccine containing a recombinant fusion protein of Ag85B and ESAT-6 was paired with a two-component CAF01 liposomal adjuvant system developed and manufactured by Statens Serum Institut. A phase I clinical study was performed to evaluate H1:CAF01 in healthy non-BCG vaccinated adult male and female subjects between the ages of 18 and 55 years old. The subjects were randomized into four groups including H1 alone or H1 with 125/25µg, 313/125µg or 625/125µg CAF01 and were vaccinated on study days 0 and 56. PBMCs harvested approximately 150 weeks post vaccination were used to assess antigen specific responses by a 13-color intracellular cytokine staining assay. Vaccination with H1:CAF01 resulted in statistically significant Ag85B-specific CD4 polyfunctional CD154+ T cells compared to H1 alone. ESAT-6 stimulation resulted in detection of CD4 polyfunctional CD154+ T cells responses that were not elevated to a statistically significant extent compared to H1 alone. This is the first demonstration of the persistence of an antigen-specific cellular immune response up to 3 years after vaccination in a clinical trial using H1:CAF01 vaccination.
8
Honda-Okubo, Yoshikazu, Jeremy Baldwin, and Nikolai Petrovsky. "Advax-CpG Adjuvant Provides Antigen Dose-Sparing and Enhanced Immunogenicity for Inactivated Poliomyelitis Virus Vaccines." Pathogens 10, no. 5 (April 21, 2021): 500. http://dx.doi.org/10.3390/pathogens10050500.
Повний текст джерелаАнотація:
Global immunization campaigns have resulted in a major decline in the global incidence of polio cases, with wild-type poliovirus remaining endemic in only two countries. Live oral polio vaccine (OPV) played a role in the reduction in polio case numbers; however, the risk of OPV developing into circulating vaccine-derived poliovirus makes it unsuitable for eradication programs. Trivalent inactivated polio virus (TIPV) vaccines which contain formalin-inactivated antigens produced from virulent types 1, 2 and 3 reference polio strains grown in Vero monkey kidney cells have been advocated as a replacement for OPV; however, TIPVs have weak immunogenicity and multiple boosts are required before peak neutralizing titers are reached. This study examined whether the incorporation of the novel polysaccharide adjuvant, Advax-CpG, could boost the immunogenicity of two TIPV vaccines, (i) a commercially available polio vaccine (IPOL®, Sanofi Pasteur) and (ii) a new TIPV formulation developed by Statens Serum Institut (SSI). Mice were immunized intramuscularly based on recommended vaccine dosage schedules and serum antibody titers were followed for 12 months post-immunization. Advax-CpG significantly enhanced the long-term immunogenicity of both TIPV vaccines and had at least a 10-fold antigen dose-sparing effect. An exception was the poor ability of the SSI TIPV to induce serotype type 1 neutralizing antibodies. Immunization with monovalent IPVs suggested that the low type 1 response to TIPV may be due to antigen competition when the type 1 antigen was co-formulated with the type 2 and 3 antigens. This study provides valuable insights into the complexity of the formulation of multivalent polio vaccines and supports the further development of adjuvanted antigen-sparing TIPV vaccines in the fight to eradicate polio.
9
Becker, Ulrich, Carsten Ehrhardt, Marc Schneider, Leon Muys, Dorothea Gross, Klaus Eschmann, Ulrich F. Schaefer, and Claus-Michael Lehr. "A Comparative Evaluation of Corneal Epithelial Cell Cultures for Assessing Ocular Permeability." Alternatives to Laboratory Animals 36, no. 1 (February 2008): 33–44. http://dx.doi.org/10.1177/026119290803600106.
Повний текст джерелаАнотація:
The purpose of this study was to evaluate the potential value of different epithelial cell culture systems as in vitro models for studying corneal permeability. Transformed human corneal epithelial (HCE-T) cells and Statens Serum Institut rabbit corneal (SIRC) cells were cultured on permeable filters. SkinEthic human corneal epithelium (S-HCE) and Clonetics human corneal epithelium (C-HCE) were received as ready-to-use systems. Excised rabbit corneas (ERCs) and human corneas (EHCs) were mounted in Ussing chambers, and used as references. Barrier properties were assessed by measuring transepithelial electrical resistance, and by determining the apparent permeability of markers with different physico–chemical properties, namely, fluorescein, sodium salt; propranolol hydrochloride; moxaverine hydrochloride; timolol hydrogenmaleate; and rhodamine 123. SIRC cells and the S-HCE failed to develop epithelial barrier properties, and hence were unable to distinguish between the permeation markers. Barrier function and the power to differentiate compound permeabilities were evident with HCE-T cells, and were even more pronounced in the case of C-HCE, corresponding very well with data from ERCs and EHCs. A net secretion of rhodamine 123 was not observed with any of the models, suggesting that P-glycoprotein or similar efflux systems have no significant effects on corneal permeability. Currently available corneal epithelial cell culture systems show differences in epithelial barrier function. Systems lacking functional cell–cell contacts are of limited value for assessing corneal permeability, and should be critically evaluated for other purposes.
10
CARRILLO, CATHERINE D., ADAM G. KOZIOL, AMIT MATHEWS, NORIKO GOJI, DOMINIC LAMBERT, GEORGE HUSZCZYNSKI, MARTINE GAUTHIER, KINGSLEY AMOAKO, and BURTON W. BLAIS. "Comparative Evaluation of Genomic and Laboratory Approaches for Determination of Shiga Toxin Subtypes in Escherichia coli." Journal of Food Protection 79, no. 12 (December 1, 2016): 2078–85. http://dx.doi.org/10.4315/0362-028x.jfp-16-228.
Повний текст джерелаАнотація:
ABSTRACT The determination of Shiga toxin (ST) subtypes can be an important element in the risk characterization of foodborne ST-producing Escherichia coli (STEC) isolates for making risk management decisions. ST subtyping methods include PCR techniques based on electrophoretic or pyrosequencing analysis of amplicons and in silico techniques based on whole genome sequence analysis using algorithms that can be readily incorporated into bioinformatics analysis pipelines for characterization of isolates by their genetic composition. The choice of technique will depend on the performance characteristics of the method and an individual laboratory's access to specialized equipment or personnel. We developed two whole genome sequence–based ST subtyping tools: (i) an in silico PCR algorithm requiring genome assembly to replicate a reference PCR-based method developed by the Statens Serum Institut (SSI) and (ii) an assembly-independent routine in which raw sequencing results are mapped to a database of known ST subtype sequence variants (V-Typer). These tools were evaluated alongside the SSI reference PCR method and a recently described PCR-based pyrosequencing technique. The V-Typer method results corresponded closely with the reference method in the analysis of 67 STEC cultures obtained from a World Health Organization National Reference Laboratory. In contrast, the in silico PCR method failed to detect ST subtypes in several cases, a result which we attribute to assembly-induced errors typically encountered with repetitive gene sequences. The V-Typer can be readily integrated into bioinformatics protocols used in the identification and characterization of foodborne STEC isolates.
11
Jiang, Fan, Tiehui Sun, Peng Cheng, Jie Wang, and Wenping Gong. "A Summary on Tuberculosis Vaccine Development—Where to Go?" Journal of Personalized Medicine 13, no. 3 (February 24, 2023): 408. http://dx.doi.org/10.3390/jpm13030408.
Повний текст джерелаАнотація:
Background: Tuberculosis (TB) is an old infectious disease caused by Mycobacterium tuberculosis infection. Vaccination is the most effective way to prevent and control TB. However, there is relatively little literature that systematically analyzes the progress of new TB vaccine research from a bibliometric perspective. This study was conducted to examine the development of TB vaccines over the past 20 years and to identify research priorities and directions for the future. Methods: The Science Citation Index Expanded (SCI-E) of the Web of Science Core Collection (WOSCC) database was selected to search the literature related to TB vaccines. The countries, institutions, authors, journals, references, and keywords of each publication were analyzed and visualized using the VOSviewer, CiteSpace, and Bibliometrix software. Furthermore, GraphPad Prism and Microsoft Excel 365 were also used for statistical analysis. Results: As of 20 October 2022, 7960 publications related to TB vaccines were identified with 288,478 citations. The United States of America (USA) accounted for the largest share (2658, 33.40%), followed by the United Kingdom (UK, 1301, 16.34%), and China (685, 8.6%). Regarding affiliations, the University of London had the most publications (427) and shared the highest H-index (76) with the Statens Serum Institut of Denmark. In terms of the number of articles for the journals and authors, the journal Vaccine ranked first with 629 articles. Professor Peter Anderssen has published the highest number of papers (160). The burst keywords and thematic maps analysis showed that future trends in TB vaccine development would focus on exploring the interaction mechanisms between M. tuberculosis and the host. Conclusion: The number of publications on TB vaccines has grown over the past two decades. Developed countries play a significant role in TB vaccine research, and developing countries are fast catching up. We believe that future research will be aimed at understanding the fine molecular mechanisms of host–pathogen interaction, leading to the development of better TB vaccines.
12
Swarthout, Todd D., Andrea Gori, Naor Bar-Zeev, Arox W. Kamng’ona, Thandie S. Mwalukomo, Farouck Bonomali, Roseline Nyirenda, et al. "Evaluation of Pneumococcal Serotyping of Nasopharyngeal-Carriage Isolates by Latex Agglutination, Whole-Genome Sequencing (PneumoCaT), and DNA Microarray in a High-Pneumococcal-Carriage-Prevalence Population in Malawi." Journal of Clinical Microbiology 59, no. 1 (October 21, 2020): e02103-20. http://dx.doi.org/10.1128/jcm.02103-20.
Повний текст джерелаАнотація:
ABSTRACTAccurate assessment of the serotype distribution associated with pneumococcal colonization and disease is essential for evaluating and formulating pneumococcal vaccines and for informing vaccine policy. For this reason, we evaluated the concordance between pneumococcal serotyping results by latex agglutination, whole-genome sequencing (WGS) with PneumoCaT, and DNA microarray for samples from community carriage surveillance in Blantyre, Malawi. Nasopharyngeal swabs were collected according to WHO recommendations between 2015 and 2017 by using stratified random sampling among study populations. Participants included healthy children 3 to 6 years old (vaccinated with the 13-valent pneumococcal conjugate vaccine [PCV13] as part of the Expanded Program on Immunization [EPI]), healthy children 5 to 10 years old (age-ineligible for PCV13), and HIV-infected adults (18 to 40 years old) on antiretroviral therapy (ART). For phenotypic serotyping, we used a 13-valent latex kit (Statens Serum Institut [SSI], Denmark). For genomic serotyping, we applied the PneumoCaT pipeline to whole-genome sequence libraries. For molecular serotyping by microarray, we used the BUGS Bioscience Senti-SP microarray. A total of 1,347 samples were analyzed. Concordance was 90.7% (95% confidence interval [CI], 89.0 to 92.2%) between latex agglutination and PneumoCaT, 95.2% (95% CI, 93.9 to 96.3%) between latex agglutination and the microarray, and 96.6% (95% CI, 95.5 to 97.5%) between the microarray and PneumoCaT. By detecting additional vaccine serotype (VT) pneumococci carried at low relative abundances (median, 8%), the microarray increased VT detection by 31.5% over that by latex serotyping. To conclude, all three serotyping methods were highly concordant in identifying dominant serotypes. Latex serotyping is accurate in identifying vaccine serotypes and requires the least expertise and resources for field implementation and analysis. However, WGS, which adds population structure, and microarray, which adds multiple-serotype carriage, should be considered at regional reference laboratories for investigating the importance of vaccine serotypes at low relative abundances in transmission and disease.
13
Carter, Emma, Ben Morton, Dima ElSafadi, Kondwani Jambo, Tinashe Kenny-Nyazika, Angela Hyder-Wright, Gift Chiwala, et al. "A feasibility study of controlled human infection with intradermal Bacillus Calmette–Guérin (BCG) injection: Pilot BCG controlled human infection model." Wellcome Open Research 8 (October 2, 2023): 424. http://dx.doi.org/10.12688/wellcomeopenres.19811.1.
Повний текст джерелаАнотація:
Tuberculosis (TB) caused 1.5 million deaths in 2020, making it the leading infectious killer after COVID-19. Bacille Calmette-Guerin (BCG) is the only licensed vaccine against TB but has sub-optimal efficacy against pulmonary TB and reduced effectiveness in regions close to the equator with high burden. Efforts to find novel vaccines are hampered due to the need for large-scale, prolonged, and costly clinical trials. Controlled human infection models (CHIMs) for TB may be used to accelerate vaccine development by ensuring only the most promising vaccine candidates are selected for phase 3 trials, but it is not currently possible to give participants Mycobacterium tuberculosis as a challenge agent. This study aims to replicate and refine an established BCG CHIM at the Liverpool School of Tropical Medicine. Participants will receive an intradermal injection with licensed BCG vaccine (Statens Serum Institut strain). In phase A, participants will undergo punch biopsy two weeks after administration, paired with minimally invasive methods of skin sampling (skin swab, microbiopsy, skin scrape). BCG detection by classical culture and molecular methods will be compared between these techniques and gold standard punch biopsy. Techniques meeting our pre-defined sensitivity and specificity criteria will be applied in Phase B to longitudinally assess intradermal BCG growth two, seven and fourteen days after administration. We will also measure compartmental immune responses in skin, blood and respiratory mucosa in Phase B. This feasibility study will transfer and refine an existing and safe model of BCG controlled human infection. Longitudinal BCG quantification has the potential to increase model sensitivity to detect vaccine and therapeutic responses. If successful, we aim to transfer the model to Malawi in future studies, a setting with endemic TB disease, to accelerate development of vaccines and therapeutics relevant for underserved populations who stand to benefit the most. Registration: ISRCTN: ISRCTN94098600 and ClinicalTrials.gov: NCT0582059
14
Carter, Emma, Ben Morton, Dima ElSafadi, Kondwani Jambo, Tinashe Kenny-Nyazika, Angela Hyder-Wright, Gift Chiwala, et al. "A feasibility study of controlled human infection with intradermal Bacillus Calmette–Guérin (BCG) injection: Pilot BCG controlled human infection model." Wellcome Open Research 8 (June 5, 2024): 424. http://dx.doi.org/10.12688/wellcomeopenres.19811.2.
Повний текст джерелаАнотація:
Tuberculosis (TB) caused 1.5 million deaths in 2020, making it the leading infectious killer after COVID-19. Bacille Calmette-Guerin (BCG) is the only licensed vaccine against TB but has sub-optimal efficacy against pulmonary TB and reduced effectiveness in regions close to the equator with high burden. Efforts to find novel vaccines are hampered due to the need for large-scale, prolonged, and costly clinical trials. Controlled human infection models (CHIMs) for TB may be used to accelerate vaccine development by ensuring only the most promising vaccine candidates are selected for phase 3 trials, but it is not currently possible to give participants Mycobacterium tuberculosis as a challenge agent. This study aims to replicate and refine an established BCG CHIM at the Liverpool School of Tropical Medicine. Participants will receive an intradermal injection with licensed BCG vaccine (Statens Serum Institut strain). In phase A, participants will undergo punch biopsy two weeks after administration, paired with minimally invasive methods of skin sampling (skin swab, microbiopsy, skin scrape). BCG detection by classical culture and molecular methods will be compared between these techniques and gold standard punch biopsy. Techniques meeting our pre-defined sensitivity and specificity criteria will be applied in Phase B to longitudinally assess intradermal BCG growth two, seven and fourteen days after administration. We will also measure compartmental immune responses in skin, blood and respiratory mucosa in Phase B. This feasibility study will transfer and refine an existing and safe model of BCG controlled human infection. Longitudinal BCG quantification has the potential to increase model sensitivity to detect vaccine and therapeutic responses. If successful, we aim to transfer the model to Malawi in future studies, a setting with endemic TB disease, to accelerate development of vaccines and therapeutics relevant for underserved populations who stand to benefit the most. Registration: ISRCTN: ISRCTN94098600 and ClinicalTrials.gov: NCT05820594
15
Rangel-Frausto, M. Sigfrido, Samuel Ponce-de-León-Rosales, Claudia Martinez-Abaroa, and Kaare Hasløv. "Tuberculosis and Tuberculin Quality: Best Intentions, Misleading Results." Infection Control & Hospital Epidemiology 22, no. 08 (August 2001): 481–84. http://dx.doi.org/10.1086/501937.
Повний текст джерелаАнотація:
Abstract Objective: To compare the performance of three purified protein derivative (PPD) formulations: Tubersol (Connaught); RT23, Statens Serum Institut (SSI); and RT23, Mexico, tested in Mexican populations at low and high risk for tuberculosis (TB). Design: A double-blinded clinical trial. Setting: A university hospital in Mexico City. Participants: The low-risk population was first or second-year medical students with no patient contact; the high-risk population was healthcare workers at a university hospital. Methods: Each of the study subjects received the three different PPD preparations. Risk factors for TB, including age, gender, occupation, bacille Calmette-Guerin (BCG) status, and TB exposure, were recorded. A 0.1-mL aliquot of each preparation was injected in the left and right forearms of volunteers using the Mantoux technique. Blind readings were done 48 to 72 hours later. Sensitivity and specificity were calculated at 10 mm of induration using Tubersol as the reference standard. The SSI tested the potency of the different PPD preparations in previously sensitized guinea pigs. Results: The low-risk population had a prevalence of positive PPD of 26%. In the low-risk population, RT23 prepared in Mexico, compared to the 5 TU of Tubersol, had a sensitivity of 51%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 86%. The RT23 prepared at the SSI had a sensitivity of 69%, a specificity of 99%, a positive predictive value of 95%, and a negative predictive value of 90%. In the high-risk population, the prevalence of positive PPD was 57%. The RT23 prepared in Mexico had a sensitivity of 33%, a specificity of 100%, and a positive predictive value of 53%; the RT23 prepared at the SSI had a sensitivity of 91%, a specificity of 98%, a positive predictive value of 98%, and a negative predictive value of 89%. RT23 used in Mexico had a potency of only 23% of that of the control. There was no statistical association among those with a positive PPD, irrespective of previous BCG vaccination (relative risk, 0.97; 95% confidence interval, 0.76-1.3; P=.78). Conclusions: Healthcare workers had twice the prevalence of positive PPD compared to medical students. RT23 prepared in Mexico had a low sensitivity in both populations compared to 5 TU of Tubersol and RT23 prepared at the SSI. Previous BCG vaccination did not correlate with a positive PPD. Low potency of the RT23 preparation in Mexico was confirmed in guinea pigs. Best intentions in a TB program are not enough if they are not followed by high-quality control.
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Aarestrup, F. M., and N. F. Friis. "Antimicrobial susceptibility testing of Mycoplasma hyosynoviae isolated from pigs during 1968 to 1971 and during 1995 and 19961This study is a part of the Danish Integrated Antimicrobial Resistance Monitoring and Research Programme (DANMAP) conducted in collaboration between Statens Serum Institut, the National Food Agency of Denmark and the Danish Veterinary Laboratory and funded jointly by the Danish Ministry of Health and the Danish Ministry of Agriculture and Fisheries.1." Veterinary Microbiology 61, no. 1-2 (March 1998): 33–39. http://dx.doi.org/10.1016/s0378-1135(98)00169-2.
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Cordtz, R., S. Kristensen, R. Westermann, K. Duch, F. Pearce, J. Lindhardsen, C. Torp-Pedersen, M. P. Andersen, and L. Dreyer. "OP0173 INCIDENCE OF COVID-19 INFECTION AND HOSPITALISATION ACCORDING TO VACCINATION STATUS AND DMARD TREATMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS: A NATIONWIDE MATCHED COHORT STUDY FROM DENMARK." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 114–15. http://dx.doi.org/10.1136/annrheumdis-2022-eular.349.
Повний текст джерелаАнотація:
BackgroundPatients with rheumatoid arthritis (RA) may have impaired immunogenicity to COVID-19 vaccines.ObjectivesTo investigate the incidence of COVID-19 infection and hospitalisation in unvaccinated and vaccinated patients with RA compared with matched individuals; and secondarily in patients with RA according to DMARD treatment.MethodsDanish nationwide matched cohort study from January to October 2021. Patients with RA were identified in DANBIO and matched 1:20 with individuals from the general population on age, sex, and vaccination status (month and exact type of vaccination). Primary and secondary outcomes were COVID-19 hospitalisation (Danish National Patient Register) and positive SARS-CoV2 PCR test (Danish COVID-19 Surveillance Register), respectively. Stratified by vaccination status, incidence rates (IRs) per 1000 person years (PY) and comorbidity-adjusted hazard ratios (aHRs) in cause-specific Cox models were calculated with 95% confidence intervals. Using the Aalen-Johansen estimator, the cumulative incidence of COVID-19 hospitalisations was visualised according to RA and vaccine exposure status.ResultsRegardless of vaccination status, patients with RA had increased incidence of COVID-19 hospitalisation compared to matched individuals (Table 1). However, the absolute risk was 0.20% for unvaccinated patients at 60 days and 0.08% for comparators, whereas it remained below 0.05% at 180 days of follow-up in both groups when fully vaccinated (Figure 1). Increased SARS-CoV2 infection rates were seen only among unvaccinated patients with RA (Table 1). Unadjusted analyses showed increased incidence of COVID-19 hospitalisation among rituximab-treated compared with conventional DMARD treated: unvaccinated HR 4.71 (1.98 to 11.18) and vaccinated HR 11.69 (2.07 to 66.06). However, the proportions of patients with previous cancer and treated with prednisolone were higher among the rituximab treated.Table 1.UnvaccinatedPartially vaccinatedFully vaccinatedRAControlsRAControlsRAControlsN28 447568 94027 154542 61026 217523 826Women, %71.371.371.271.271.071.0Age in years, median [IQR]67.7 [34.2 to 88.3]67.8 [34.2 to 88.4]68.4 [36.4 to 88.6]68.4 (36.5 to 88.6)68.9 [40.9 to 88.7]68.9 (41.0 to 88.7)Methotrexate /55.5 /0.5 /55.4 /1.2 /55.7 /1.3 /Sulfasalazine /14.2 /0.1 /13.7 /0.3 /13.5 /0.3 /Hydroxychloroquine /10.4 /0.1 /10.3 /0.0 /10.3 /0.0 /Other csDMARD,11.0 /0.2 /10.7 /0.3 /10.6 /0.3 /Prednisolone,all in %12.52.012.20.512.20.5TNFi /16.9 /0.1 /17.2 /2.9 /17.1 /3.1 /abatacept /1.5 /0.0 /1.5 /0.5 /1.5 /0.5 /tocilizumab /3.0 /0.0 /3.0 /0.0 /2.9 /0.0 /rituximab, all in %2.20.12.10.12.10.1COVID-19 hospitalisationN65727119511131Median [IQR] days of follow-up102 [62 to 137]115 [88 to 146]28 [22 to 35]30 (21 to 39)150 [111 to 189]150 (111 to 189)Rate per 1000 PY10.4 (8.0 to 13.4)4.7 (4.3 to 5.1)5.5 (3.0 to 10.0)2.2 (1.8 to 2.7)0.9 (0.5 to 1.6)0.5 (0.4 to 0.6)Adjusted HRa1.88 (1.44 to 2.46)1 (Ref.)2.47 (1.25 to 4.89)1 (Ref.)1.94 (1.03 to 3.66)1 (Ref.)SARS-CoV2 infectionRate per 1000 PY37.8 (33.6 to 42.6)33.9 (33.1 to 34.8)27 (20.7 to 35.1)28.5 (27 to 30.2)11.3 (9.2 to 13.9)10.4 (9.9 to 10.9)Adjusted HRa1.22 (1.09 to 1.57)1 (Ref.)0.87 (0.95 to 1.74)1 (Ref.)1.09 (0.92 to 1.14)1 (Ref.)IQR, Interquartile range. a Adjusted for cancer history, cardiovascular disease, diabetes mellitus, chronic kidney disease, and chronic lung disease.Figure 1.Cumulative incidence of COVID-19 hospitalisation (%) as a function of follow-up time (days) for (A) unvaccinated, (B) partially vaccinated and (C) fully vaccinated patients and comparators.ConclusionThe incidence of COVID-19 hospitalisation was increased for both unvaccinated and vaccinated patients with RA compared with controls. Importantly, the parallel decreasing risk for patients with RA suggests a comparable relative benefit of vaccination. Less favourable outcomes among rituximab-treated warrant that this drug should be considered with extra care.AcknowledgementsThe authors wish to acknowledge The Danish Departments of Clinical Microbiology and Statens Serum Institut for carrying out laboratory analysis, registration, and release of the national SARS-CoV-2 surveillance data use in the present study. Further, the authors wish to thank all the Danish departments of rheumatology for reporting to the DANBIO register.Disclosure of InterestsRené Cordtz: None declared, Salome Kristensen: None declared, Rasmus Westermann: None declared, Kirsten Duch: None declared, Fiona Pearce Grant/research support from: Pearce reports a grant from Vifor Pharma outside the submitted work., Jesper Lindhardsen: None declared, Christian Torp-Pedersen Grant/research support from: Torp-Pedersen reports grants from Bayer and Novo Nordisk outside the submitted work., Mikkel Porsborg Andersen: None declared, Lene Dreyer Speakers bureau: Dreyer has received speakers bureau from Eli Lilly and Galderma., Grant/research support from: Dreyer has received research grant/support from BMS.
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Usman Aslam, Muhammad Ubaidullah Khan, Sadia Chiragh, Abdul Karim, and Mushtaq Ahmed. "Effect of Atorvastatin Alone and in Combination with Aspirin on Uric Acid Handling of Normal Rats." Proceedings 35, no. 2 (April 21, 2021): 78–82. http://dx.doi.org/10.47489/pszmc784-35-2-78-82.
Повний текст джерелаАнотація:
Introduction: Low doses of aspirin and statins are usually given in conjunction to patients with coronary artery disease. Aspirin at low doses is known to cause hyperuricemia in these patients which can further worsen their condition, while statins can theoretically counteract this effect. However, this interaction needs to be tested.
Aims & Objectives: To estimate the effect of atorvastatin and low dose of aspirin alone and in combination on serum uric acid level and urinary uric acid excretion in normal rats.
Place and duration of study: Post Graduate Medical Institute, Lahore from July, 2018 to August, 2018.
Material & Methods: Twenty-four healthy Sprague Dawley rats were distributed equally into four groups (Normal control, Aspirin, Atorvastatin and Combination groups). They were given distilled water, aspirin (6.75mg/kg), atorvastatin (5mg/kg) or combination of the same doses of aspirin and atorvastatin for 4 weeks. One ml blood and twenty-four-hour urine sample was collected on week 0 and 4 for estimation of uric acid and creatinine concentrations. Fractional excretion of uric acid was calculated.
Results: At the end of four weeks the Aspirin group had higher serum uric acid level and lower fractional excretion of uric acid as compared to the Normal control group. Atorvastatin group had lower serum uric acid and higher urinary uric acid level as compared to Aspirin group while combination had higher serum uric acid level versus Normal control. fractional excretion of uric acid decreased from 0-4 weeks in Aspirin and Combination groups only.
Conclusion: The role of atorvastatin in lowering serum uric acid levels in group receiving atorvastatin alone and in combination group emerged non-significant.
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Memon, A. R., M. Akram, U. Bhatti, A. S. Khan, K. Rani, and H. Riaz. "Vitamin B3 (Niacin) in Diet Act as Protective Negotiator for Development of Myocardial Infarction." Pakistan Journal of Medical and Health Sciences 15, no. 5 (May 30, 2021): 1127–29. http://dx.doi.org/10.53350/pjmhs211551127.
Повний текст джерелаАнотація:
Background: Vitamin B3 (Niacin) is known to decrease LDL‐cholesterol, and triglycerides, and increase HDL‐cholesterol levels. The evidence of benefits with niacin monotherapy or add‐on to statin‐based therapy is controversial. Aim: To determine the effects of vitamin B3 with statins on lipid profile of patients of angina pectoris with dyslpidemia. Study Design: Randomized control trial study. Place and Duration of Study: Department of Biochemistry, Shaikha Fatima Institute of Nursing & Health Sciences (SFINHS), Lahore with collaboration of Cardiology OPD of Shaikh Zayed Hospital Lahore from 1st November 2019 to 31st January 2020. Methodology: Seventy four diagnosed cases of angina pectoris with dyslipidemia were recruited with age range from 30 to 50 years. They were divided into two groups; Group I contained 36 patients as controlled group which was given treatment of angina with Tab. Rovista (statin) 10mg at dinner for treatment of dyslipidemia and Group II contained 38 patients as case study group which was given treatment of angina with Tab. Rovista (statin) 10 mg at dinner and tablet Vitamin B3 500 mg with single OD dose at day time for treatment of dyslipidemia for 8 weeks. Results: The mean serum cholesterol levels at zero level (before the start of treatment) of group I was 244 mg/dl and group II was 246 mg/dl, LDL of group I was 169 mg/dl while group II was 170 mg/dl and HDL of group I was 20 mg/dl while group II was 19 mg/dl . After the treatment group I which taken only statins for treatment of dyslipidemia the mean serum cholesterol levels was 210 mg/dl, LDL was 144 mg/dl and HDL was 26 mg/dl while the mean values of group II (taken statin as well as vitamin B3) serum cholesterol level was 192 mg/dl, LDL was 122 mg/dl and HDL was 44 mg/dl. The results shown there were significant effects of statin therapy along with vitamin B3 on serum LDL and serum HDL levels. Conclusion: There were significant effects of statin therapy along with vitamin B3 on serum LDL and Serum HDL levels. Key Words: Vitamin B3, Serum Cholesterol, Serum LDL &HDL
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Akhter, SP, S. Khan, T. Mehdi, Md Nasiruddin, and FH Mollah. "Renal Function Before and After Coronary Artery Bypass Grafting (CABG): Off Pump vs. On Pump." Bangladesh Journal of Medical Biochemistry 3, no. 2 (February 15, 2013): 36–41. http://dx.doi.org/10.3329/bjmb.v3i2.13809.
Повний текст джерелаАнотація:
Coronary Artery Bypass Grafting (CABG) is associated with a significant morbidity and mortality and several factors have been identified as predictive of complications. These include renal dysfunction and in particular renal replacement therapy. More than 600,000 coronary artery graft procedures are performed annually in the United States. Of those patients with coronary arterial disease 10% patients undergo CABG surgery. To explore the association of renal function between off-pump and on-pump-CABG. To evaluate the degree of impairment of renal function in on-pump, 80 patients (off-pump group = 50, on-pump group = 30) who underwent CABG were recruited from cardiac surgery dept. of National Heart Foundation and Research Institute Mirpur Dhaka and National Institute of Cardiovascular Disease (NICVD). Subjects were selected according to exclusion and inclusion criteria. Purpose and procedure of the study were explained in detail and informed written consent was taken from the study subjects. All the information of the study subject including history, clinical finding were recorded in a preformed data sheet. Serum urea and creatinine were significantly higher in on-pump group patients 12 hours after CABG. Serum urea was significantly higher and serum creatinine was slightly in onpump group in comparison to off-pump group. The mean urea and creatinine were found significantly higher in on-pump group in comparison to off-pump group and CCr was slightly higher lower in on-pump but not significantly decreased. DOI: http://dx.doi.org/10.3329/bjmb.v3i2.13809 Bangladesh J Med Biochem 2010; 3(2): 36-41
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Goodrich, Erin L., and Julie L. Webb. "Complete Blood Count and Biochemistry Reference Intervals for Healthy Adult Donkeys in the United States." Animals 14, no. 14 (July 9, 2024): 2018. http://dx.doi.org/10.3390/ani14142018.
Повний текст джерелаАнотація:
Previous hematologic and serum biochemistry reference interval (RI) values have been established for donkeys in various geographic regions, life-stages, or for specific donkey breeds. The last extensive investigation establishing RIs for adult donkeys in the United States (U.S.) was published over three decades ago. We aimed to establish updated robust RIs using a reference population of apparently healthy adult donkeys from across the U.S. Standard sized (n = 102), miniature (n = 17), and mammoth (n = 1) donkeys from four different states were enrolled, with 20% of the study population including donkeys captured directly from the wild in Death Valley National Park, CA. RIs were established in accordance with the American Society for Veterinary Clinical Pathology and Clinical Laboratory Standards Institute guidelines. The findings will assist practitioners with the interpretation of their complete blood count and biochemistry panel results in U.S. donkeys. This study also highlights a comparison of results for some important analytes in U.S. donkeys compared to U.S. horses and previously established donkey RIs.
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Chellamuthu, Lalithambigai, Sinthu S. Sarathamani, and Abhijit V. Boratne. "A perspective on the widening gap between Covishield vaccine doses in India." Indian Journal of Community Health 33, no. 3 (September 30, 2021): 541–42. http://dx.doi.org/10.47203/ijch.2021.v33i03.026.
Повний текст джерелаАнотація:
The Oxford University-AstraZeneca’s vector-based vaccine called Covishield (ChAdOx1 nCoV- 19 Vaccine) is being manufactured and distributed by Serum Institute of India (SII). National roll out of this vaccine was in a phased manner starting from 16th January 2021. At present, many states are facing shortage of vaccines. Government of India kept changing its policy on dosing gap of Covishield vaccine based on researches. The latest recommendation citing “real-life evidence” from the UK is to extend the two doses of Covishield to 12-16 weeks. This reasonable approach will not only a breathing space for the government but also aids in free up doses for a larger number of people to get their first dose of the vaccine.
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Zhu, Yong, Neha Jain, Vipra Vanage, Norton Holschuh, and Jessica Smith. "Association Between Ready-to-Eat Cereal Consumption and Serum Level of 25-hydroxyvitamin D in US Children and Adults, NHANES 2013–2014." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 1514. http://dx.doi.org/10.1093/cdn/nzaa061_142.
Повний текст джерелаАнотація:
Abstract Objectives Previous studies have shown that consumption of ready-to-eat (RTE) cereal is associated with higher dietary intake of vitamin D; however, little is known about the association between RTE cereal consumption and vitamin D status measured by the serum biomarker, 25-hydroxyvitamin D. The study was conducted to examine association between consumption of RTE cereal and serum level of 25-hydroxyvitamin D, the clinical biomarker for vitamin D status in children and adults in the United States. Methods Children aged 1–18 years old (N = 2553) and adults aged 19 years or older (N = 4901) from the National Health and Nutrition Examination Survey 2013–2014 were included in the study. Day 1 dietary data were used to classify participants by RTE cereal consumption status. Vitamin D deficiency and inadequacy were assessed by serum levels of 25-hydroxyvitaminD using cut-off values recommended by the National Academy of Medicine. Adjusted odds ratio (aOR) and 95% confidence intervals (CI) were calculated using survey logistic regression for associations between RTEC consumption and vitamin D status in children and adults. Results Both children and adults who reported RTE cereal consumption had a significantly higher level of serum 25-hydroxyitamin D than children and adults who did not consume RTE cereal (P < 0.05). Adjusting for age, gender, race/ethnicity, family income to poverty ratio, season of data collection, and use of vitamin D containing supplements, children who consumed RTE cereal were less likely to have vitamin D inadequacy than non-eaters (aOR = 0.48, 95% CI = [0.34, 0.68]). In adults, RTEC eaters were less likely to have vitamin D deficiency than non-eaters (aOR = 0.52, 95% CI = [0.28, 0.97]). Conclusions Consumption of RTE cereal is associated with better vitamin D status in both children and adults in the United States. Funding Sources The study was funded by the Bell Institute of Health and Nutrition, General Mills, Inc.
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Kashyapa, Hrishikesh, Rupali Bajrang Jadhav, and Anuradha Deshkar. "Comparison of the efficacy and safety of rosuvastatin versus atorvastatin in reduction of low density lipoprotein cholesterol in patients of type 2 diabetes mellitus with dyslipidemia." International Journal of Research in Medical Sciences 6, no. 8 (July 25, 2018): 2671. http://dx.doi.org/10.18203/2320-6012.ijrms20183249.
Повний текст джерелаАнотація:
Background: Approximately 80% of deaths in diabetic patients are attributable to cardiovascular disease (CVD), which in turn is highly correlated with diabetic dyslipidemia. Statins are drug of choice for raised LDL-C in treating dyslipidemia. The present study compares the efficacy and safety of rosuvastatin against commonly used atorvastatin in patients of type 2 diabetes mellitus with dyslipidemia, so as to guide the present treatment strategies in the management of the same in Indian population.Methods: The study was a single blinded study conducted in a district level tertiary care hospital attached to a medical teaching institute. Patients fulfilling the inclusion criteria were randomized in two groups. Group I received atorvastatin (10mg) and group II received rosuvastatin (5mg) at bedtime orally daily. Serum TC, serum LDL-C, serum HDL-C and serum TG were assessed on week 0, week 6 and week 12.Results: At the end of 12 weeks, the percentage reduction of LDL-C levels in atorvastatin group was 33.58% whereas in rosuvastatin group, it was 43.12%. The percentage reduction in total cholesterol (TC) in atorvastatin group was 24.85% while in rosuvastatin group, it was 30.8%. Rise in HDL-C levels in atorvastatin group was 7.1% whereas in rosuvastatin group, it was 11.16%. All these differences were statistically significant. There was no significant difference in reduction of TG levels between the two groups.Conclusions: Rosuvastatin 5mg causes greater reduction in LDL-C and TC, comparable reduction of TG and greater rise in HDL-C when compared with atorvastatin 10mg therapy.
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Hall, Breese. "A Single Shot at Salmonella typhi: A New Typhoid Vaccine With Pediatric Advantages." Pediatrics 96, no. 2 (August 1, 1995): 348–50. http://dx.doi.org/10.1542/peds.96.2.348.
Повний текст джерелаАнотація:
A new typhoid vaccine has just been licensed, which is the third typhoid vaccine available in the United States.1,2 Since publication of the 1994 Red Book occurred before licensure, this new vaccine is not included. The recommendations concerning the two previously licensed typhoid vaccines in the 1994 Red Book remain unchanged.3 The new vaccine, Typhoid Vi, is manufactured by Pasteur Mérieux (Marnes-La-Coquette, France). This parenteral vaccine is composed of the purified Vi (virulence) antigen, which is the capsular polysaccharide (ViCPS) of Salmonella typhi. The two previously licensed typhoid vaccines are an oral live-attenuated vaccine, the Ty21a vaccine, manufactured by the Swiss Serum and Vaccine Institute, and the parenteral heat-phenol-inactivated vaccine (Berne, Switzerland), manufactured by Wyeth-Ayerst, which has been available for many years.
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Mohammed, Yousif Abdelhameed, Ameer M. Dafalla, Dafalla O. Abuidris, Adam D. Abakar, A. Mergani, Amira S. Khalafalla, Abuagla M. Dafalla, Mutaz I. Hassan, and Mohammed Abdelwahed. "Association of Body Mass Index with Serum Vitamin D and PSA Levels among Sudanese Prostate Cancer Patients." Journal of Drug Delivery and Therapeutics 11, no. 6 (November 15, 2021): 1–5. http://dx.doi.org/10.22270/jddt.v11i6.5029.
Повний текст джерелаАнотація:
Background: Prostate cancer is the second most common cancer in men worldwide and the second leading cause of cancer deaths in men in the United States. Obesity has been consistently associated with lower 25-hydroxyvitamin D (25(OH)D) concentrations.
Objectives: This cross-sectional study aimed to evaluate the serum vitamin D and PSA levels in Sudanese Obese and Non-Obese prostate cancer (PCa) attending the National Cancer Institute.
Patients and Methods: Eighty six prostate cancer patients were included in this study, they were identified by clinical examination, histopathology and prostate-specific antigen (PSA). The mean age of them was 71.78 ± 8.04 years. Serum Vitamin D and PSA were measured by Electrochemiluminescence (ECL) immunoassay reactions using (Cobase411, serial No: 0868-16, manufactured by Hitachi high technologies corporation, Tokyo-Japan) the Elecsys reagents kit (Roche – Germany)
Results: The means of serum vitamin D levels of among obese was 35.5 ± 15.4 ng/dL and 38.4 ± 16.2 ng/dL among non-obese group with non-significant differences(P=0.505). No significant association was observed between PSA levels and obese and non-obese (P=0.351). Vitamin D levels non-significantly negative correlated with BMI (r = -0.031, P = 0.778) and PSA (r = -0.062, P = 0.569), but there was insignificantly Positive correlated between PSA and vitamin D level (r = 0.151, P = 0.164).
Conclusion: insignificant differences between vitamin D and serum PSA with BMI, Oral supplementation is recommended for individuals with low level of vitamin D.
Keywords: Prostate cancer, Body mass index, Vitamin D, PSA, Sudanese.
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Malacova, Eva, Peihua (Rachel) Cheang, Eleanor Dunlop, Jill L. Sherriff, Robyn M. Lucas, Robin M. Daly, Caryl A. Nowson, and Lucinda J. Black. "Prevalence and predictors of vitamin D deficiency in a nationally representative sample of adults participating in the 2011–2013 Australian Health Survey." British Journal of Nutrition 121, no. 8 (January 24, 2019): 894–904. http://dx.doi.org/10.1017/s0007114519000151.
Повний текст джерелаАнотація:
AbstractVitamin D deficiency is recognised as a public health problem globally, and a high prevalence of deficiency has previously been reported in Australia. This study details the prevalence of vitamin D deficiency in a nationally representative sample of Australian adults aged ≥25 years, using an internationally standardised method to measure serum 25-hydroxyvitamin D (25(OH)D) concentrations and identifies demographic and lifestyle factors associated with vitamin D deficiency. We used data from the 2011–2013 Australian Health Survey (n 5034 with complete information on potential predictors and serum 25(OH)D concentrations). Serum 25(OH)D concentrations were measured by a liquid chromatography-tandem MS that is certified to the reference measurement procedures developed by the National Institute of Standards and Technology, Ghent University and the US Centers for Disease Control and Prevention. Vitamin D deficiency and insufficiency were defined as serum 25(OH)D concentrations <50 nmol/l and 50 to <75 nmol/l, respectively. Overall, 20 % of participants (19 % men; 21 % women) were classified as vitamin D deficient, with a further 43 % classified as insufficient (45 % men; 42 % women). Independent predictors of vitamin D deficiency included being born in a country other than Australia or the main English-speaking countries, residing in southern (higher latitude) states of Australia, being assessed during winter or spring, being obese, smoking (women only), having low physical activity levels and not taking vitamin D or Ca supplements. Given our increasingly indoor lifestyles, there is a need to develop and promote strategies to maintain adequate vitamin D status through safe sun exposure and dietary approaches.
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Mohammed, Muaath Ahmed, Ibrahim Abdelrhim Ali, Abdarahiem Alborai Abeadalla, and Omer Abdelaziz Musa. "Reference intervals for serum creatinine and urea in the adult western Sudanese population." South Sudan Medical Journal 17, no. 1 (February 19, 2024): 6–10. http://dx.doi.org/10.4314/ssmj.v17i1.2.
Повний текст джерелаАнотація:
Introduction: Serum creatinine and urea levels are affected by numerous factors such as ethnicity, environment, age, sex, and anthropometric measurements. The Clinical and Laboratory Standards Institute (CLSI) recommends that each laboratory should establish its own reference intervals for biochemistry and haematology. There are no local reference intervals for serum creatinine and blood urea in Sudan; instead, intervals derived from worldwide research are used. The purpose of this study was to determine the blood urea and serum creatinine reference intervals for healthy adults in the Western Sudanese population.
Method: Randomly selected adult Sudanese residents of Al Fashir City who were from the Western Sudan states of Kordofan and Darfur were the subjects of a cross-sectional study conducted in September and October 2018. We recruited 153 participants. After giving their consent, they were evaluated using a questionnaire that collected medical history and demographic information. We used standard techniques to measure blood pressure, body mass index, urea, and creatinine. Kolmogorov-Smirnov tests were used to assess the distributions of the creatinine and urea values, and reference intervals calculated. T-tests were used to investigate differences of mean creatinine and urea levels by sex and age. IBM SPSS Statistics version 25 was used to analyse the data and p ≤ 0.05 was considered significant.
Results: Overall, the reference intervals (Mean±1.96*SD) for serum creatinine and urea levels were 0.45-0.92 mg/dL and 7.6-27.9 mg/dL respectively, compared to international reference intervals adopted from the American Board of Internal Medicine (ABIM) serum creatinine (males 0.7-1.3, females 0.5-1.1 mg/dL) and blood urea (17.12-42.8 mg/dL for both sexes) and The Western Sudanese population’s mean serum creatinine and urea levels were, respectively, 0.69 mg/dL and 17.8 mg/dL. Male sex was associated with higher levels of both creatinine and urea (p<0.001).
Conclusion: This study documented lower reference intervals for creatinine and urea in the Western Sudanese population.
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Goguet, Emilie, Carol Weiss, Cara Olsen, John Powers, Si’Ana Coggins, David Tribble, Julian Davies, et al. "Correlates of immunity in SARS-CoV-2 post-vaccine infections in the Prospective Assessment of SARS-CoV-2 Seroconversion (PASS) Study." Journal of Immunology 210, no. 1_Supplement (May 1, 2023): 159.02. http://dx.doi.org/10.4049/jimmunol.210.supp.159.02.
Повний текст джерелаАнотація:
Abstract Background: We sought to determine pre-infection correlates of immunity against SARS-CoV-2 post-vaccine infections. Methods: Serum and saliva samples from 176 BNT162b2-vaccinated adults in the Prospective Assessment of SARS-CoV-2 Seroconversion study were collected between October and December 2021 and assessed for serum and saliva levels of WT SARS-CoV-2 Spike (S)-specific IgG and IgA antibodies using a microsphere-based multiplex immunoassay. Serum samples were also assessed for neutralization activity against D614G, Delta (617.2), and Omicron BA.1 and BA.1.1 variants using a lentiviral pseudovirus neutralization assay. After the fall visit, participants reported all positive PCR and/or antigen tests for SARS-CoV-2. Duration, severity, and type of symptoms, as well as risk exposures and adherence to precautionary measures, were assessed by questionnaires during the spring 2022 visit. Results: Thirty-two participants (18.2%) had infections between December 7, 2021 and April 1, 2022. Pre-infection anti-S IgG antibody levels and neutralizing titers against BA.1 and BA.1.1 were higher in individuals that did not develop infection (p values 0.0098, 0.0313, and 0.021, respectively). No individuals with an anti-S level greater than 15,000 binding antibody units (BAU/ml) developed a post-vaccine infection. Conclusion: High serum anti-S IgG antibody levels, high neutralization titers against Omicron subvariants, and low home risk scores correlated with protection against post-vaccine infections during the initial Omicron wave. BAU levels greater than 15,000 in the fall of 2021 were associated with complete protection during the initial Omicron wave. This work was supported in whole, or in part, with federal funds from the Defense Health Program (HU00012020067, HU00012020094) and the Immunization Healthcare Branch (HU00012120104) of the Defense Health Agency, United States Department of Defense, and the National Institute of Allergy and Infectious Disease (HU00011920111), under Inter-Agency Agreement Y1-AI-5072.
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Agudelo Zapata, Yessica, Jonathan Alexander Cortés-Vásquez, Andrés Felipe Linares Vaca, Carlos Alejandro Mancera Rodríguez, Shahar Alexandra Perea-Ariza, Karen Yuliana Ramírez Iriarte, Camilo Andrés Castro Saldarriaga, Edith Ángel Muller, Arturo José Parada Baños, and Jorge Eduardo Caminos Pinzón. "papel de la vitamina D en la gestación y la preeclampsia: de la biología molecular a la clínica." Revista Colombiana de Endocrinología, Diabetes & Metabolismo 3, no. 2 (March 20, 2017): 22–36. http://dx.doi.org/10.53853/encr.3.2.30.
Повний текст джерелаАнотація:
Los niveles séricos de vitamina D bajos se han asociado con un riesgo elevado de preeclampsia, una de las principales causas de mortalidad materna en Colombia y el mundo. La asociación parte del papel de la vitamina D en la inflamación y de su relación con el eje renina-angiotensina-aldosterona. El Instituto de Salud de los Estados Unidos sugiere que la vitamina D debe suplementarse de forma rutinaria durante el control prenatal; sin embargo, la Organización Mundial de la Salud, respaldada en medicina basada en la evidencia, sugiere la no suplementación de rutina de esta vitamina. En Colombia, no se conoce la prevalencia de la deficiencia o insuficiencia de vitamina D y los puntos de corte de normalidad aún son objeto de discusión. El objetivo del presente artículo es el de presentar una revisión desde la bases de la biología molecular a la clínica, dilucidando el papel de la vitamina D en la gestación y en su relación con la preeclampsia, así como el de invitar al desarrollo de programas de investigación en temas relacionados con la vitamina D en el país. Abstract The low serum levels of vitamin D have been associated with the risk of preeclampsia, a leading cause of maternal mortality in Colombia. The biological plausibility of the association is the vitamin D role in inflammation and its relationship with the renin-angiotensin-aldosterone axis. The Institute of Medicine of the United States suggests that vitamin D should be supplemented routinely during antenatal care, however, the World Health Organization, supported by evidence-based medicine, suggests not supplement it. In Colombia, the prevalence of deficiency or insufficiency of vitamin D is not known and even normal break- points are discussed. The aim of this article is to review from the molecular biology to the clinic, elucidating the role of vitamin D during pregnancy and in the genesis of preeclampsia, and to encourage research in this field in the country.
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Nham, Eliel, A.-Yeung Jang, Hyun Jung Ji, Ki Bum Ahn, Joon-Yong Bae, Man-Seong Park, Jin Gu Yoon, et al. "Development and Validation of an Enzyme-Linked Immunosorbent Assay-Based Protocol for Evaluation of Respiratory Syncytial Virus Vaccines." Viruses 16, no. 6 (June 12, 2024): 952. http://dx.doi.org/10.3390/v16060952.
Повний текст джерелаАнотація:
Recently, respiratory syncytial virus (RSV) vaccines based on the prefusion F (pre-F) antigen were approved in the United States. We aimed to develop an enzyme-linked immunosorbent assay (ELISA)-based protocol for the practical and large-scale evaluation of RSV vaccines. Two modified pre-F proteins (DS-Cav1 and SC-TM) were produced by genetic recombination and replication using an adenoviral vector. The protocol was established by optimizing the concentrations of the coating antigen (pre-F proteins), secondary antibodies, and blocking buffer. To validate the protocol, we examined its accuracy, precision, and specificity using serum samples from 150 participants across various age groups and the standard serum provided by the National Institute of Health. In the linear correlation analysis, coating concentrations of 5 and 2.5 μg/mL of DS-Cav1 and SC-TM showed high coefficients of determination (r > 0.90), respectively. Concentrations of secondary antibodies (alkaline phosphatase-conjugated anti-human immunoglobulin G, diluted 1:2000) and blocking reagents (5% skim milk/PBS-T) were optimized to minimize non-specific reactions. High accuracy was observed for DS-Cav1 (r = 0.90) and SC-TM (r = 0.86). Further, both antigens showed high precision (coefficient of variation < 15%). Inhibition ELISA revealed cross-reactivity of antibodies against DS-Cav1 and SC-TM, but not with the attachment (G) protein.
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HA, Krishnamurthy, Bharathi S, and Roja GT. "The predictive significance of ratio between white blood cells count and serum albumin in assessing the functional outcome of acute ischemic stroke." Journal of Medical and Scientific Research 11, no. 2 (April 1, 2023): 119–24. http://dx.doi.org/10.17727/jmsr.2023/11-23.
Повний текст джерелаАнотація:
Introduction: The acute ischemic infarction is associated with significant damage to brain parenchyma, where the high degree of acute inflammation is found. This work aimed to study the predictive value of ratio between blood WBCs and serum albumin levels in assessing the functional outcome in subjects with acute ischemic stroke. Materials and methods: A prospective observational study was conducted on 223 subjects from February 2022 to August 2022 at K.R. Hospital, Mysore. The data collected from patients of acute ischemic stroke, with the onset of stroke within 24 hours. Severity of stroke was assessed by using National Institute of Health Stroke Scale (NIHSS) at the time of admission. Data was collected using a pretested proforma meeting the objectives of the study. Results: The study has 124(55.6%) male and 99(44.4%) of female patients. Most of the patients (65%) were in the age group of more than 66 years. Most of the patients i.e., 66 (29.6%) had moderate to severe stroke at presentation as assessed by NIHSS stroke scale. At the end of third month of follow up, the acute ischemic stroke patients with MRS of >3 had WBCs count/serum albumin ratio of 4361.1 (p value - 0.001). Conclusion: The significant acute inflammation is found in acute ischemic stroke and it may be one of the causes of poor outcome and disability in so many ischemic stroke patients. This study once again endorses the use of high intensive statins and adequate dose of antiplatelet agents as early as possible in acute ischemic stroke patients. Keywords: acute ischemic stroke; WBCs; Modified Rankin Scale; NIHSS; serum albumin
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NEOGI, TUHINA, ROBERT TERKELTAUB, R. CURTIS ELLISON, STEVEN HUNT, and YUQING ZHANG. "Serum Urate Is Not Associated with Coronary Artery Calcification: The NHLBI Family Heart Study." Journal of Rheumatology 38, no. 1 (October 1, 2010): 111–17. http://dx.doi.org/10.3899/jrheum.100639.
Повний текст джерелаАнотація:
Objective.Urate may have effects on vascular remodeling and atherosclerosis. We had shown an association between serum uric acid (SUA) and carotid atherosclerotic plaques. Inflammation and vascular remodeling in atherosclerosis promote coronary artery calcification (CAC), a preclinical marker for atherosclerosis. Here, we examined whether SUA is associated with CAC, using the same study sample and methods as for our previous carotid atherosclerosis study.Methods.The National Heart, Lung, and Blood Institute Family Heart Study is a multicenter study designed to assess risk factors for heart disease. Participants were recruited from population-based cohorts in the US states of Massachusetts, North Carolina, Minnesota, Utah, and Alabama. CAC was assessed with helical computed tomography (CT). We conducted sex-specific and family-cluster analyses, as well as additional analyses among persons without risk factors related to both cardiovascular disease and hyperuricemia, adjusting for potential confounders as we had in the previous study of carotid atherosclerosis.Results.For the CAC study, 2412 subjects had both SUA and helical CT results available (55% women, age 58 ± 13 yrs, body mass index 27.6 ± 5.3). We found no association of SUA with CAC in men or women [OR in men: 1.0, 1.11, 0.86, 0.90; women: 1.0, 0.83, 1.00, 0.87 for increasing categories of SUA: < 5 (referent group), 5 to < 6, 6 to < 6.8, ≥ 6.8 mg/dl, respectively], nor in subgroup analyses.Conclusion.Replicating the methods used to demonstrate an association of SUA with carotid atherosclerosis did not reveal any association between SUA and CAC, suggesting that SUA likely does not contribute to atherosclerosis through effects on arterial calcification. The possibility that urate has divergent pathophysiologic effects on atherosclerosis and artery calcification merits further study.
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Martić, Nikola, Dragan Zečević, Milena Đurđević, Dragana Milijašević, Nataša Tomić, Mladena Lalić-Popović, Nemanja Todorović, Danilo Medin, Branimir Mićanović, and Boris Milijašević. "Comparative analysis of the use of lipid modifying agents in the Republic of Serbia and Nordic countries in the period 2015-2017." Hospital Pharmacology - International Multidisciplinary Journal 7, no. 3 (2020): 966–75. http://dx.doi.org/10.5937/hpimj2003966m.
Повний текст джерелаАнотація:
Introduction: Cardiovascular diseases are the leading cause of death both in Serbia and in the rest of the world. It has been shown that as many as 80% of them are preventable. Control of serum lipid levels is one of the most important tasks of cardiovascular diseases prevention. Aim: The aim of the study was to analyze the use of serum lipid-modifying drugs in Serbia, Norway and Finland in the period 2015-2017. Methods: Data on drugs use during 2015, 2016 and 2017 were taken from the official websites of national drug regulatory authorities: the Serbian Medicines and Medical Devices Agency, the Norwegian Institute of Public Health and the Finnish Medicines Agency. Use was expressed as DDD/1000 inhabitants/day according to the Anatomical Therapeutic Chemical classification. Results: The share of drugs used for treatment of cardiovascular diseases in total drugs use was the largest in all three countries during the observed period. The use of lipidmodifying agents was 3-4 times lower in Serbia than in Norway or Finland. Of all lipidmodifying drugs, statins are most commonly prescribed in all three countries. Atorvastatin and rosuvastatin are the most widely used in Serbia, and simvastatin and atorvastatin in Norway and Finland. Conclusions: Use of lipid-modifying drugs in Serbia is lower than in Norway and Finland, but it is constantly increasing. This use in Serbia still represents the smallest share of all drugs for the treatment of cardiovascular diseases.
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Ravi Kant, Shashi Kala Kumari, Rakesh Sinha, Ranjeet Kumar, and Arun Kumar. "Association of inflammatory markers, serum ferritin and high sensitive C reactive protein, with HbA1c and dyslipidemia in male patients of type 2 diabetes mellitus." Asian Journal of Medical Sciences 15, no. 4 (April 1, 2024): 78–83. http://dx.doi.org/10.3126/ajms.v15i4.61885.
Повний текст джерелаАнотація:
Background: Diabetes mellitus (DM) is a common metabolic disorder affecting insulin secretion, insulin sensitivity, or both, resulting in hyperglycemia. As it progresses, almost all systems including cardiovascular, nervous, renal, etc. are involved eventually manifesting as several health-related complications. As all the systems of the human body work in harmony with each other, development of insulin resistance, dyslipidemia, and setting in of chronic inflammatory states evidenced by the rise in inflammatory markers are interrelated. Aims and Objectives: The aim of this study was to establish the correlation of the inflammatory markers, serum ferritin and high sensitivity C-reactive protein (hs-CRP), with glycated hemoglobin (HbA1c) and dyslipidemia in patients of type 2 DM. Materials and Methods: The present cross-sectional study was carried out in the Department of Biochemistry, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand. A total of 80 male patients of type 2 DM aged between 40 and 60 years with blood HbA1c level of more than 6.5% were included in the study. Results: The inflammatory markers hs-CRP and ferritin were found to be positively correlated with HbA1c, triglycerides, total cholesterol, and low-density lipoprotein-cholesterol but negatively correlated with high-density lipoprotein-cholesterol. Conclusion: Estimation of serum ferritin and hs-CRP can detect the ongoing inflammatory and free radical-mediated damages in diabetic patients at an early period before the development of diabetic-related complications such as atherosclerosis and myocardial infarction.
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Cetin Sanlialp, Sara, Gokay Nar, and Rukiye Nar. "Relationship between circulating serum omentin-1 levels and nascent metabolic syndrome in patients with hypertension." Journal of Investigative Medicine 70, no. 3 (December 2, 2021): 780–85. http://dx.doi.org/10.1136/jim-2021-002071.
Повний текст джерелаАнотація:
The prevalence of metabolic syndrome (MetS) is more common in patients with hypertension and is associated with an increased risk of target organ damage and/or cardiovascular disease (CVD). Omentin-1 is a beneficial adipokine considered to play a role in MetS and MetS-related states such as obesity, diabetes, and coronary artery disease. The aim of this study was to determine the relationship between circulating omentin-1 levels and MetS uncomplicated by diabetes or CVD (nascent MetS) in patients with hypertension. In this study, 110 patients (54 men, 49%; average age: 49.72±11.32 years) treated for hypertension but without overt diabetes and/or CVD were enrolled. 66 patients were stratified into MetS (+) (group 1) and 44 patients into MetS (−) (group 2) according to the American Heart Association/National Heart, Lung, and Blood Institute criteria. The triglyceride glucose (TyG) index was used to assess insulin resistance. Circulating omentin-1 levels in venous blood samples were measured by an ELISA kit. Circulating omentin-1 levels in patients with MetS were significantly lower than in patients without MetS (46.35 ng/mL (42.70–57.70 ng/mL) vs 130.95 ng/mL (62.83–236.48 ng/mL), p<0.001). Omentin-1 was inversely correlated with TyG index (r=−0.204, p=0.033). In a multivariate logistic regression analysis, omentin-1, TyG index, and body mass index were independent predictors of MetS. A receiver operating characteristic curve analysis determined that the best cut-off value for omentin-1 in predicting MetS was 62.20 ng/mL and the area under the curve was 0.880 (95% CI 0.817 to 0.942, p<0.001). The findings of this study suggest that circulating omentin-1 levels are inversely related to the presence of MetS and may be a reliable marker to predict the development of MetS in patients with hypertension.
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Kraus, Frank Bernhard, Marija Kocijancic, Alexander Kluttig та Beatrice Ludwig-Kraus. "Test validation, method comparison and reference range for the measurement of β-hydroxybutyrate in peripheral blood samples". Biochemia medica 30, № 1 (15 лютого 2020): 118–27. http://dx.doi.org/10.11613/bm.2020.010707.
Повний текст джерелаАнотація:
Introduction: The measurement of β-hydroxybutyrate (βOHB) concentrations is a corner stone of the diagnosis of diabetic ketoacidosis and other ketonic states. The aim of this study was to perform a validation of a peripheral blood βOHB assay (Randox) on a Roche cobas c502 analyser and to establish a βOHB reference range for the validated assay. Materials and methods: Precision, linearity and limit of detection and blank (LoD, LoB) were determined according to Clinical and Laboratory Standards Institute (CLSI) EP05-A3, EP 06-A and EP17-A2 guidelines, using commercial control material and residual patient sample pools. As method comparison, for 190 semi-quantitative measurements of urine ketones we determined the corresponding βOHB blood concentration. The reference range was based on the CLSI C28-A3 guideline, using 304 randomly selected serum samples from population based German National Cohort (GNC) study. Results: Coefficients of variation for the validated assay ranged from 1.5% for high concentrations (3.1 mmol/L) to 6.5% for low concentrations (0.1 mmol/L). Detection capacity was LoB = 0.011 mmol/L and LoD = 0.037 mmol/L. Linearity of the assay ranged from 0.10 to 3.95 mmol/L. The agreement between the semi-quantitative urine ketone test and the βOHB blood test was moderate (Kappa = 0.66). The obtained 95% serum reference range was estimated as 0.02 to 0.28 mmol/l βOHB. Conclusions: The Ranbut βOHB assay showed good precision and analytical performance. Our results confirm that βOHB measurement in peripheral blood is indeed a preferable alternative to the semi-quantitative measurement of urine ketones.
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PEIXOTO, RODOLFO DE MORAES, GRACE BARBOSA DOS SANTOS, EVANDRO SANTOS AMANSO, MARIA DA CONCEIÇÃO AQUINO DE SÁ, RENATA DE MORAES PEIXOTO ARAÚJO, and MATEUS MATIUZZI DA COSTA. "ANTI-Lentivirus, Brucella abortus AND B. ovis ANTIBODIES IN SMALL RUMINANTS RAISED IN PERNAMBUCO AND BAHIA." Revista Caatinga 29, no. 2 (June 2016): 507–11. http://dx.doi.org/10.1590/1983-21252016v29n229rc.
Повний текст джерелаАнотація:
ABSTRACT: Goat and sheep production in the semi-arid northeast of Brazil has shown great economic potential. However, health problems can compromise the productivity of these animals. Given the scarcity of studies about the occurrence of these diseases, the aim of the present study was to analyze the serological diagnosis of anti-Brucella and anti-lentivirus antibodies among small ruminants in municipalities located in the Brazilian states of Bahia and Pernambuco. The samples were collected from local slaughterhouses and dairy farms. In total, 997 serum samples from animals in slaughterhouses and dairy herds were collected. In order to diagnose the caprine arthritis encephalitis virus (CAEV), the samples underwent agarose gel immunodiffusion (AGID) testing. The buffered acidified antigen test (goats) and agarose gel immunodiffusion test (sheep) were used to detect anti-Brucella abortus and B. ovis antibodies following the methodology recommended by the Institute of Technology of Paraná (TECPAR). With anti-CAEV antibodies, seropositivity rates of 4.1% and 2.2% were recorded for animals from the slaughterhouses and dairy farms, respectively. None of the animals (goats or sheep) were positive for anti-B. abortus antibodies. With B. ovis, a seropositivity rate of 6.5% (n = 13) was recorded among the 199 sheep serum samples. Results of the present study confirmed the presence of the CAE virus in the meat and dairy herds studied, although the prevalence was low. Natural infection by B. abortus did not occur in the goat and sheep herds assessed. Seropositivity for B. ovis was confirmed, although prevalence was low. Direct tests are required to diagnose ovine brucellosis.
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Wong, Eileen, Else Agger, Peter Andersen, and JoAnne Flynn. "Immunogenicity of TB vaccine H56 in non-human primates (VAC4P.1113)." Journal of Immunology 194, no. 1_Supplement (May 1, 2015): 72.18. http://dx.doi.org/10.4049/jimmunol.194.supp.72.18.
Повний текст джерелаАнотація:
Abstract Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains a major global health problem. Several TB vaccine candidates are currently in various stages of development and clinical testing, including the protein subunit vaccine H56, from Statens Serum Institute (Copenhagen, Denmark). The cationic liposome adjuvant CAF09 was recently developed to enhance the CD4 and CD8 T cell response when administered with H56 vaccine. We vaccinated non-human primates (NHP) with H56 vaccine and CAF09 adjuvant by intranasal and subcutaneous routes and compared differences in immunogenicity. We measured the immune response to the vaccine in blood samples at multiple time points by IFN-γ ELISPOT and intracellular cytokine staining (IFN-γ, IL-2, TNF, IL-17, IL-6, IL-10) and in bronchoalveolar lavage fluid (BAL) by intracellular cytokine staining. NHPs were challenged with Mtb, and recall responses assessed. Frequencies of activated T cells producing cytokines transiently increased following vaccinations, but were generally low. CD4 responses were highest to the Ag85B vaccine component, while CD8 responses were highest to the Rv2660c vaccine component. There were no significant differences in cytokine production between the two vaccination routes in blood or BAL. This may lead to further H56/CAF09 vaccine trials in NHPs with Mtb challenge and future clinical trials, while strengthening understanding of the immune response necessary for protection from TB.
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Jean de Dieu, Baziki, Bodjo S. Charles, Nick Nwankpa, Ethel Chitsungo, Cisse Rahamatou Moustapha Boukary, Naomi Maina, Takele A. Tefera, Rume Veronica Nwankpa, Nduta Mwangi, and Yao Mathurin Koffi. "Development and Evaluation of Epitope-Blocking ELISA for Detection of Antibodies against Contagious Caprine Pleuropneumonia in Goat Sera." Veterinary Sciences 6, no. 4 (October 18, 2019): 82. http://dx.doi.org/10.3390/vetsci6040082.
Повний текст джерелаАнотація:
Enzyme linked immunosorbent assays (ELISAs) have been developed for the detection of antibodies against contagious caprine pleuropneumonia (CCPP), the causative agent of which is Mycoplasma capricolum subsp. Capripneumoniae (Mccp). The currently available commercial CCPP competitive ELISA (CCPP cELISA) kit produced and supplied by IDEXX Company (Westbrook, Maine, United States) is relatively expensive for most African laboratories. To address this issue and provide a variety of choices, a sensitive and specific blocking-ELISA (b-ELISA) test to detect antibodies against CCPP was developed. We describe the newly developed CCPP blocking-ELISA based on the blocking of an epitope of a monoclonal antibody (Mccp-25) by a positive serum sample against the Mccp protein coated on a plate. The Percentage Inhibition (PI) cut-off value for the CCPP b-ELISA was set at 50 using 466 CCPP negative and 84 CCPP positive small ruminant sera. Of the negative sera, 307 were obtained from the Botswana National Veterinary Laboratory (BNVL) and 159 from the Friedrich-Loeffler-Institute (FLI) Germany. The 84 positive sera samples came from experimentally vaccinated goats at the AU-PANVAC facility in Debre-Zeit, Ethiopia. The relative diagnostic sensitivity and specificity of the CCPP b-ELISA was 93% and 88%, respectively. This test result indicated good correlation with that of the commercial CCPP cELISA by IDEXX Company (Westbrook, Maine, United States) with a Cohen’s κ agreement of κ agreement of 0.85. The newly developed CCPP b-ELISA will be useful in the detection of antibodies for the diagnosis CCPP and for sero-surveillance during vaccination campaigns.
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Arashi, Hiroyuki, Junichi Yamaguchi, Erisa Kawada-Watanabe, Hisao Otsuki, Haruki Sekiguchi, Hiroshi Ogawa, and Nobuhisa Hagiwara. "The Effects of Lipid-Lowering Therapy on Serum Eicosapentaenoic Acid to Arachidonic Acid Ratio: An HIJ-PROPER Sub-Analysis." Journal of Cardiovascular Pharmacology and Therapeutics 25, no. 6 (June 22, 2020): 548–55. http://dx.doi.org/10.1177/1074248420931621.
Повний текст джерелаАнотація:
Background: Controversy remains regarding the influence of lipid-lowering therapy on the eicosapentaenoic acid/arachidonic acid ratio. Objective: This study aimed to clarify the effects of lipid-lowering therapy on the eicosapentaenoic acid/arachidonic acid ratio in patients with acute coronary syndrome (ACS). Methods: This was a post hoc sub-analysis of the Heart Institute of Japan-PRoper level of lipid-lowering with pitavastatin and ezetimibe in ACS study. We compared the eicosapentaenoic acid/arachidonic acid ratio changes from baseline to the 3-month follow-up after contemporary lipid-lowering therapy with pitavastatin + ezetimibe therapy and pitavastatin mono-therapy. Results: Among patients with ACS and dyslipidemia, the eicosapentaenoic acid/arachidonic acid increased significantly in the pitavastatin mono-therapy group (0.40 ± 0.26 to 0.46 ± 0.34, P < .0001) but did not increase in the pitavastatin + ezetimibe group (0.37 ± 0.22 to 0.38 ± 0.27, P = .18). When the analysis was limited to patients who received 2 mg/day of pitavastatin during the follow-up period, these trends in changes of the eicosapentaenoic acid/arachidonic acid ratio remained unchanged. Multivariate analysis showed that ezetimibe use ( P = .005; β = 0.09), ST-elevation myocardial infarction ( P = .04; β = −0.01), and baseline low-density lipoprotein cholesterol (LDL-C) level ( P = .0003; β = 0.12) were independent predictors of the percentage change in the eicosapentaenoic acid/arachidonic acid ratio. These trends were similar even when the analysis was limited to patients who did not take statins at enrollment. Conclusion: Standard lipid-lowering therapy with pitavastatin mono-therapy improved the eicosapentaenoic acid/arachidonic acid ratio for patients with ACS. Intensive lipid-lowering therapy with pitavastatin + ezetimibe did not improve the eicosapentaenoic acid/arachidonic acid ratio, although LDL-C decreased significantly. Inhibition of the improvement in the eicosapentaenoic acid/arachidonic acid ratio by adding ezetimibe may affect cardiovascular disease prognosis.
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Maqsood, Mariam, Saleha Sadeeqa, Maqsood Ahmad, and Hafsa Afzal. "Efficacy and safety of atorvastatin and rosuvastatin in ischemic heart disease patients: A prospective study." Tropical Journal of Pharmaceutical Research 18, no. 7 (May 31, 2021): 1533–38. http://dx.doi.org/10.4314/tjpr.v18i7.25.
Повний текст джерелаАнотація:
Purpose: To compare the safety and efficacy of two commonly used statins namely; atorvastatin and rosuvastatin, and determine the efficiency of CoQ10 in the reversal of statin-induced myopathy.
Methods: An investigational study design was adopted using randomized trials involving patients suffering from ischemic heart disease and receiving either atorvastatin or rosuvastatin. The study was conducted at Punjab Institute of Cardiology, Lahore, Pakistan during the period, November 2016 - February 2017. A total number of 95 male and female patients, between the ages of 40 and 80 years, were selected. Their blood samples were analyzed for lipid profile, total cholesterol, serum high-density lipoprotein-cholesterol (HDL-C), serum triglycerides, low-density lipoproteins-cholesterol (LDL-C) and total cholesterol/HDL-C ratio.
Results: Gender and dose showed significant correlation with creatine phosphokinase (CPK) levels, (p = 0.001) and (p > 0.001), respectively. The patients using rosuvastatin 20 mg had a higher risk of developing myopathy than those treated with atorvastatin 40 mg (p = 0.023), while atorvastatin 20 mg patients were more prone to induce myopathy than 10 mg (p = 0.001) recipients. Atorvastatin 20 mg produced higher CPK levels than rosuvastatin 10 mg (p = 0.002). A substantial increase in CPK levels was found with rosuvastatin 20 mg and atorvastatin 20 mg usage (p > 0.001). It was observed that rosuvastatin 20 mg significantly increased the risk of myopathy compared to atorvastatin 10 mg (p > 0.001). However, rosuvastatin 20 mg/day considerably reduced the blood cholesterol as compared to atorvastatin 10mg/day (p = 0.001). CPK levels reduced significantly following treatment with CoQ10 (p = 0.022).
Conclusion: Rosuvastatin users are more prone to the risk of myopathy, myalgic symptoms and rise in CPK levels than atorvastatin users, and these effects are dose related. CoQ10 is effective in lowering CPK levels and reversing myalgia.
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Demchuk, A. M., D. Tanne, M. D. Hill, S. E. Kasner, S. Hanson, M. Grond, and S. R. Levine. "Predictors of good outcome after intravenous tPA for acute ischemic stroke." Neurology 57, no. 3 (August 14, 2001): 474–80. http://dx.doi.org/10.1212/wnl.57.3.474.
Повний текст джерелаАнотація:
Background: Thrombolytic therapy for acute ischemic stroke with IV alteplase is increasingly well established in North America but not elsewhere. Baseline factors that altered the response to alteplase were not identified by the National Institute of Neurological Disorders and Stroke tPA Stroke Study Group.Methods: The authors gathered information from centers in the United States, Canada, and Germany on 1,205 patients with acute ischemic stroke treated with IV alteplase. The purpose was to identify independent factors that were predictive of good outcome using multivariable logistic regression modelling. The modified Rankin Scale score was dichotomized into good outcome (mRS 0 to 1) and poor outcome (mRS >1) as the primary outcome measure.Results: In relative order of decreasing magnitude, milder baseline stroke severity, no history of diabetes mellitus, normal CT scan, normal pretreatment blood glucose level, and normal pretreatment blood pressure were independent predictors of good outcome among patients treated with IV alteplase for acute ischemic stroke. Confounding was observed among history of diabetes mellitus, CT scan appearance, baseline serum glucose level, and blood pressure, suggesting important relationships among these variables.Conclusions: Several factors were independently predictive of good outcome among patients with acute ischemic stroke treated with alteplase. These results require further confirmation before clinical implementation.
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Young, Melissa, Hanqi Luo, Janet Peerson, Yaw Addo, Parminder Suchdev, and Yi-An Ko. "Adjusting Iron Biomarkers for Inflammation in Pregnant Women: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project." Current Developments in Nutrition 6, Supplement_1 (June 2022): 964. http://dx.doi.org/10.1093/cdn/nzac067.084.
Повний текст джерелаАнотація:
Abstract Objectives Accurate assessment of iron deficiency during pregnancy is essential for program planning and interventions. We aimed to examine the relationship between serum ferritin (SF) and soluble transferrin receptor (sTfR) and inflammation and examine the impact of inflammation on the prevalence of iron deficiency in a large multi-country analysis. Methods Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project provided 17 pregnancy datasets (n = 14,077) from 15 countries including at least one iron (serum ferritin, SF; soluble transferrin receptor, sTfR) and inflammation biomarker (C-reactive protein, CRP or α-1-acid glycoprotein, AGP). Spearman rank correlations between CRP or AGP and iron biomarkers (SF, sTfR) were examined. We report unadjusted and adjusted prevalence of iron deficiency, using the BRINDA regression correction approach to adjust for inflammation on behalf of the BRINDA Pregnancy Workgroup. Results Ferritin concentrations were positively correlated with CRP in 6 out of 14 surveys (ρ from 0.65 in Mexico, P < 0.0001 to 0.06 in Vietnam, P < 0.05) and AGP in 8 out of 9 surveys (correlation coefficients (ρ) ranging from 0.41, in Guatemala to 0.19 in Pakistan, P < 0.0001). Among the 8 datasets with both CRP and AGP, adjustment for both AGP and CRP increased the estimated prevalence of iron deficiency (ferritin < 15 μg/L) by a median of 18.8 percentage points (pp) compared to 15.6 pp for AGP alone and 10.5 pp for CRP alone. sTfR concentrations were positively correlated with AGP in 4 out of 12 surveys (ρ ranging from 0.36 in Vietnam to 0.09 in Pakistan, P < 0. 01) and positively associated with CRP in 4 out of 10 surveys (ρ ranging from 0.20 in Vietnam to 0.07 in US and Ghana, P < 0.05). Conclusions Failing to adjust for inflammation during pregnancy appears to underestimate iron deficiency using serum ferritin during pregnancy. Given the weak and inconsistent association between sTfR and inflammation, adjustment of sTfR biomarkers during pregnancy does not appear warranted at this time. Funding Sources Bill & Melinda Gates Foundation, Centers for Disease Control and Prevention, Eunice Kennedy Shriver National Institute of Child Health and Human Development, HarvestPlus, and the United States Agency for International Development.
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Abeynayake, Janaki. "Laboratory Based Preliminary Study on Anti-SARS-CoV-2 Antibody Response among State Sector Healthcare Workers in a Single District in Sri Lanka." Virology & Immunology Journal 6, no. 3 (October 11, 2022): 1–6. http://dx.doi.org/10.23880/vij-16000300.
Повний текст джерелаАнотація:
Background: Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is responsible for the current COVID-19 pandemic. Healthcare workers are one of the risk groups due to their strategic role in patient management. Presence of antiSARS-CoV-2antibodies in serum following seroconversion could be determined through antibody ELISA assay. Objectives: This study was to analyze the laboratory identified viral markers of Anti SARS-CoV-2 antibody in blood samples of health care workers to demonstrate the seroconversion to SARS-CoV-2 virus following exposures, natural infection or vaccination and to describe the sociodemographic, and clinical parameters among them. Study design: This laboratory based retrospective study was conducted at the National Virus Reference Laboratory (NVRL), at the Medical Research Institute (MRI). The study retrospectively analyzed 235 blood samples received to the NVRL, for testing of anti-SARS-CoV-2 antibody among health care workers in a one month period. All samples requested for anti-SARSCoV-2 antibody were tested with SARS-CoV-2 spike protein specific IgG antibody, and with SARS-CoV-2 Total Ab ELISA. The socio-demographic data were gathered through the request forms were also analyzed. Results: Total 235blood samples were tested for anti-SARS-CoV-2 antibody and 234(99.6%) were confirmed to have spike protein specific IgG antibody while 2% were confirmed to have Nucleo-capsid protein targeting antibodies of the positives, 100% were vaccinated with two doses of vaccine and 1% had positive PCR. Conclusion: The current study encounters a significantly high prevalence of vaccine induces SARS-CoV-2 antibody carriers among the healthcare workers in the study community.
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Lindsey, Changhong Y., J. Edward Brown, Nahid R. Torabazar, and Leonard A. Smith. "EL4 Cell-Based Colorimetric Toxin Neutralization Activity Assays for Determination of Neutralizing Anti-Ricin Antibodies." Journal of AOAC INTERNATIONAL 96, no. 1 (January 1, 2013): 147–54. http://dx.doi.org/10.5740/jaoacint.12-285.
Повний текст джерелаАнотація:
Abstract A recombinant ricin toxin A-chain 1-33/44-198 vaccine (RVEc™), developed at the United States Army Medical Research Institute of Infectious Diseases as a vaccine candidate, is under investigation in a phase 1 clinical study. To effectively evaluate the immunogenicity of this ricin vaccine and to eliminate the use of radioactive material, an EL4 cell-based colorimetric toxin neutralization activity (TNA) assay using a CellTiter 96® AQueous One Solution Cell Proliferation Assay Reagent has been developed, optimized, and applied in the vaccine efficacy studies. The TNA assay measures the protective neutralizing anti-ricin antibodies in animal sera by determining the cell viability after ricin exposure in the assay system and comparing it to a purified mouse polyclonal anti-ricin IgG standard curve. The standard curve of the anti-ricin TNA assay closely fits a four-parameter logistic regression model. The unknown test sample concentration was expressed as μg/mL, but not the 50% effective concentration (EC50), which was determined by most TNA assays. The neutralizing endpoint titers, not the 50% effective dilution (ED50), of human specimens were measured with the TNA assay in support of the clinical study of the RVEc vaccine. The optimal amount of ricin toxin, EL4 cells, and concentration of standards used in the assay system was established to minimize false-negative and false-positive results of serum specimens from the nonclinical and clinical studies of RVEc. The testing conditions were adjusted to optimize assay performance. The colorimetric TNA assay replaced a radioactive TNA assay previously used in the ricin vaccine studies.
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Davis, Jennie, Charles Arnold, Anne Williams, Parminder Suchdev, Melissa Young, Tamerlan Rajabov, and Reina Engle-Stone. "Inflammation Mediates the Relationship Between BMI and Serum Ferritin Among Women With Normal to High BMI in Azerbaijan but Not Malawi: BRINDA Project." Current Developments in Nutrition 5, Supplement_2 (June 2021): 1023. http://dx.doi.org/10.1093/cdn/nzab053_016.
Повний текст джерелаАнотація:
Abstract Objectives Considering the known metabolic relationships between adiposity, inflammation, and iron status, we examined whether inflammation mediates the relationship between BMI and serum ferritin (SF) concentration among women of reproductive age (15–49 years) with normal to high BMI in a low-income country (Malawi) and an upper-middle income country (Azerbaijan). Methods Cross-sectional survey data were analyzed from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project. Women with underweight (BMI <18.5 kg/m2), pregnancy, or a positive malaria test were excluded (total for analysis: Malawi, n = 594; Azerbaijan, n = 2528). Descriptive statistics were calculated to determine the proportion of women with overweight/obesity (OwOb, BMI ≥ 25 kg/m2), any inflammation (C-reactive protein [CRP] >5 μg/L or α-1-acid glycoprotein [AGP] >1 g/L), and iron deficiency (inflammation-adjusted SF < 15 μg/L). The relationship between BMI and unadjusted SF concentration and potential mediation by CRP and AGP was assessed separately in each country via structural equation modeling procedures, accounting for the complex survey designs. Results In Malawi, the proportion of women with OwOb was 16%, inflammation 12%, and inflammation-adjusted iron deficiency 14% (12% unadjusted). In Azerbaijan, the proportions were: 57%, 35%, and 45% (31% unadjusted), respectively. In Malawi, BMI was not associated with SF concentration (P = 0.65). In Azerbaijan, a 1-unit increase in BMI was associated with a 3.3% (95% CI: 2.5, 4.3) increase in SF concentration. Approximately 61% of this relationship was mediated by CRP and AGP, of which 46% was via CRP and 15% via AGP. Conclusions Iron status is commonly adjusted for inflammation in populations with high expected burden of undernutrition and infectious disease. Considering that obesity is a source of inflammation, these data suggest that measurement and adjustment for inflammation may improve assessment of iron status in populations in which OwOb is common. Funding Sources Bill & Melinda Gates Foundation, Centers for Disease Control and Prevention, Eunice Kennedy Shriver National Institute of Child Health and Human Development, HarvestPlus, and the United States Agency for International Development.
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Chacon-Cruz, Enrique, Rosa Maria Rivas-Landeros, Maria Luisa Volker-Soberanes, Erika Zoe Lopatynsky-Reyes, Chandra Becka, and Jorge Arturo Alvelais-Palacios. "12 years active surveillance for pediatric pleural empyema in a Mexican hospital: effectiveness of pneumococcal 13-valent conjugate vaccine, and early emergence of methicillin-resistant Staphylococcus aureus." Therapeutic Advances in Infectious Disease 6 (January 2019): 204993611983931. http://dx.doi.org/10.1177/2049936119839312.
Повний текст джерелаАнотація:
Background: Previous publications have proved the effectiveness of the 13-valent pneumococcal conjugate vaccine (PCV13) on pneumococcal pleural empyema (PnPE) in children, with little emergence of other pathogens. We searched the literature to establish whether PCV13 reduces PnPE, and to identify other pathogens causing pleural empyemas (PEs). Material and methods: From October 2005 to January 2018 (12.3 years) we performed active surveillance for all cases of PE at the General Hospital of Tijuana, Mexico. Isolates from pleural fluid (PF) were identified by conventional culture, and since 2014, polymerase chain reaction (PCR) was added for all culture-negative PFs. Streptococcus pneumoniae serotypes were detected by either Quellung reaction (Statens Serum Institute®) or PCR. Clinical, imagenological, laboratorial and microbiological evaluation was performed on each patient. Statistical analysis was purely descriptive. Results: A total of 64 PEs were identified (5.28/year). Median age was 51 months (1–191), hospitalization days 18 (4–35). Decortication was performed in 42%, and two children died (3.2%). Bacterial identification was obtained from 51 (80%). S. pneumoniae was the leading cause (29 = 56.8%), followed by Staphylococcus aureus (14 = 27.4%), Streptococcus pyogenes (3–5 = 9%) and others (5 = 9.8%). PCV13 was initiated in May 2012, and its impact on serotype-specific PnPE was 81% (much fewer than serotype 3) and for all PnPE 56.1%; however, for all PE −2.1% due to an increase of PE caused by S. aureus for all but one methicillin-resistant S. aureus (MRSA). Conclusions: Following 12.3 years of active surveillance, PCV13 has shown impact on both serotype-specific and all PnPEs; however, an increase of PEs by MRSA has emerged. Continuous surveillance is crucial to establish whether this epidemiological finding is transitory or not.
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Ferreira, Claudiomiro Machado. "As bibliotecas públicas municipais e a administração pública direta: o apoio legal para o suporte financeiro das bibliotecas: qual é e como conseguir?Municipal public libraries and the direct public administration:legal support for..." RDBCI: Revista Digital de Biblioteconomia e Ciência da Informação 10, no. 1 (July 10, 2012): 180. http://dx.doi.org/10.20396/rdbci.v10i1.1904.
Повний текст джерелаАнотація:
Este trabalho tem o objetivo de apresentar e demonstrar jurídica e administrativamente como as bibliotecas públicas municipais devem se estruturar e agir para cobrar do município a aplicação do artigo 16 da Lei Federal nº10.753, de 30 de outubro de 2003, que Institui a Política Nacional do Livro e que prevê que “os Municípios consignarão (...) verbas (...) para sua manutenção e aquisição de livros”. Sua elaboração deve-se ao fato de a Lei e o Artigo serem muito conhecidos, mas de inexistir um estudo e uma explicação clara e objetiva de como as bibliotecas devem agir para exigir um direito legal, deixar de viver de doações e começar a atuar com recursos financeiros próprios.Abstract This work aims to present and demonstrate, in a legal and administrative form, how the municipal public libraries should be structured and to act to collect from the municipality the application of title 16 of Federal Law nº.10753, October 30, 2003, that established the National Book Policy which states that "Municipalities consign (...) funds (...) for their maintenance and purchase of books." Their preparation is due to the fact that the Law and the titles are well known, but the non-existence of a study and a clear and objective explanation of how libraries should act to require a legal right, no longer live on donations and start acting with its own resources.
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Nesen, A. O., P. S. Semenovykh, K. O. Savicheva, and V. Y. Galchinska. "The effects of complex therapy with the additional dapagliflozin intake on the copeptin level in the blood serum of patients with diabetic nephropathy." Ukrainian Therapeutical Journal, no. 2 (June 27, 2023): 47–52. http://dx.doi.org/10.30978/utj2023-2-47.
Повний текст джерелаАнотація:
Objective — to determine the effects of drug therapy with inclusion of sodium‑glucose cotransporter 2 (SGLT2) inhibitor dapagliflozin on the blood levels of copeptin as a biomarker of renal and vascular lesions in patients with diabetic nephropathy (DN) at various disease stages.
Materials and methods. Examinations involved 83 in‑hospital patients with DN, treated in the clinic of L. T. Mala National Institute of Therapy. Patients were divided into 2 groups depending on the therapy. 42 patients received a standard course of treatment, including antidiabetic drugs, renin‑angiotensin‑aldosterone system blockers and statins. In addition to standard therapy, the remaining 41 patients were administered SGLT2 inhibitor dapagliflozin in a dose of 10 mg per day. Patients were re‑examined after 6 months treatment. Determination of the copeptin level in blood serum was carried out by the enzyme immunoassay method using the set of reagents Human CPP Elisa Kit manufactured by FineTest, China.
Results. The results of investigation of the effects of complex nephroprotective therapy on the lipid profile indicators in patients with type 2 diabetes mellitus (DM2) demonstrated significant decrease in the levels of total cholesterol by 11.78% (р <0.05), triglycerides by 19.75% (р <0.05) and non‑significant increase of high‑density lipoproteins by 5.10%. In patients with DM2 and with glomerular filtration rate (GFR) >90 mL/(min · 1.73 m2) (I stage chronic kidney disease (CKD)) the level of copeptin after treatment decreased by 19.3% (p <0.05); in patients with (DM2) and GFR of 60—89 mL/(min · 1.73 m2) (CKD II stage) — by 18.9% (p <0.05), and with GFR of 45—59 mL/(min · 1.73 m2) (CKD III stage) — by 24.8% (p <0.05). The significant decrease of copeptin levels was revealed in diabetic patients with both preserved and reduced GFR. In DM2 patients with normal GFR, the copeptin level after standard treatment decreased by 17.6% (p <0.05), and in case of dapagliflozin administration by 20.6% (p <0.05). In patients with reduced GFR, blood serum copeptin levels decreased by 18.9% (p <0.05) after standard therapy, and by 22.1% (p <0.05) under the influence of dapagliflozin.
Conclusions. Complex therapy with the use of SGLT2 inhibitor dapagliflozin contributed to more significant reduction of copeptin levels in patients with DN compared to the standard treatment, regardless of the kidneys’ functional state. The decrease of copeptin levels against the background of the improved main clinical and laboratory parameters indicates not only an improvement in the kidneys’ functional state, but also reduction of cardiovascular risk in this group of patients.