Search

Although most hepatitis C virus (HCV)-infected individuals develop chronic infection, about 25% of them are able to clear the virus spontaneously without any therapeutic intervention. The aim of the present study was to identify genes associated with spontaneous HCV clearance in a population of Iranian patients. We genotyped 110 single-nucleotide polymorphisms (SNPs) in 59 selected—candidate—genes in a cohort of 107 HCV-infected participants who spontaneously cleared the infection and 176 participants whose infection persisted. Three out of the 110 SNPs were found to be associated with HCV outcome (P-values<0.03). rs11506105 in EGFR(epidermal growth factor receptor gene), and rs11881222 and rs12979860 in IL28B(interferon-λ3 gene). Multivariate logistic regression of the three markers showed that the A/A genotypes in both rs11506105 (EFGR) and rs11881222 (IL28B), and the C/C genotype in rs12979860 (IL28B) are associated with HCV clearance (recessive model: odds ratio (OR)=2.06, 95% confidence interval (95% CI)=1.09–3.88, P=0.025; OR=2.09, 95% CI=1.23–3.60, P=0.007; and OR=1.95, 95% CI=1.15–3.35, P=0.014 for rs11506105, rs12979860 and rs11881222, respectively). In conclusion, EGFRand IL28BSNPs are strong independent predictive markers of spontaneous viral clearance.

Climatic changes and interannual variability in the Mediterranean overturning circulation are crucially linked to dense water formation in the Levantine Sea, namely the Levantine Intermediate Water whose formation zone, comprising multiple and intermittent sources, extends over fluctuating pathways. To probe into the variability of this water formation and spreading, a unique dataset was collected during the winter of 2019 in the western Levantine Sea, via oceanographic cruises, profiling floats and a glider, at a spatio‐temporal distribution suited to resolve mesoscale circulation features and intermittent convection events. This study highlights the competition between two source regions, the Cretan Sea and the Rhodes Cyclonic Gyre, to supply the Mediterranean overturning circulation in Levantine Intermediate Water. The Cretan source was estimated as the most abundant, supported by increasingly saltier water masses coming from the Levantine Sea under the pumping effect of a water deficit caused by strong western outflow toward the Ionian Sea. The Mediterranean overturning circulation is a conveyor belt transporting salt from its easternmost areas toward the North Atlantic Ocean. To explore how the formation of dense and salty waters called the Levantine Intermediate Water fits into this circulation, the western Levantine Sea was investigated during the winter of 2019 via cruise surveys and an array of autonomous sensors. This study highlights the competition between two source regions, the southern Aegean Sea and the northwestern Levantine Sea, to supply the Mediterranean overturning circulation in Levantine Intermediate Water. In the period under study, the first region was estimated as the most abundant source. This source was supported by increasingly saltier water masses coming from the Levantine Sea, under the pumping effect of a water draught in the Aegean Sea. These observations help to nuance the complex picture of Levantine circulation patterns which are subject to large variability. Descriptive oceanography of the Levantine Intermediate Water formation zone using an in‐situmultiplatform approachCompetition between two source regions to supply the Mediterranean overturning circulation in Levantine Intermediate WaterThe Cretan Sea is the most abundant source, supported by increasingly saltier waters coming from the Levantine Sea Descriptive oceanography of the Levantine Intermediate Water formation zone using an in‐situmultiplatform approach Competition between two source regions to supply the Mediterranean overturning circulation in Levantine Intermediate Water The Cretan Sea is the most abundant source, supported by increasingly saltier waters coming from the Levantine Sea

Prolonged‐release tacrolimus was developed to provide a more convenient once‐daily dosing that could improve patient adherence. We conducted a multicenter, prospective, observational, 12‐month study to describe the efficacy, safety and patient preference of conversion from tacrolimus twice‐daily to once‐daily formulation in stable kidney transplant recipients in routine clinical practice. Conversion was made on a 1 mg: 1 mg basis (1 mg: 1.1 mg in patients with trough levels <6 ng/mL). The study included 1832 patients (mean age (±SD): 50.0 ± 13.4 years; 62.7% male). After conversion, a modest reduction in tacrolimus trough levels, necessitating an increase in daily dose, was observed (mean changes at 12 months of –9.1% and +1.24%, respectively; p < 0.0001). Mean glomerular filtration rate did not change significantly (56.5 ± 19.7 mL/min at conversion vs. 55.7 ± 20.6 mL/min at 12 months). Proteinuria, blood pressure, lipid, hepatic and glucose parameters remained stable. Eight patients (0.4%) had acute rejection and 34 patients (1.85%) discontinued treatment. Almost all patients (99.4%) preferred the once‐daily formulation, because of less frequent dosing (66%) and improved adherence (34%). In conclusion, at similar doses to twice‐daily tacrolimus, once‐daily formulation provided stable renal function, a low acute rejection rate, and good tolerability in stable kidney transplant recipients in the routine clinical practice setting.

The purpose of this study was to assess several acoustic features of the voices of 26 parkinsonian patients under two conditions, with and without bilateral chronic stimulation of the subthalamic nucleus (STN) to estimate the effectiveness of this procedure on parkinsonian speech. When compared to unstimulated patients, stimulated patients showed longer duration of sustained vowels, shorter duration of sentences, nonsense words, and pauses, more variable fundamental frequency (f0) in sentences, and more stable f0 during sustained vowels. Relative intensity was unchanged in both conditions. Further acoustic analyses are warranted to clarify the role of STN stimulation on parkinsonian speech.

With a few exceptions, most published studies do not show an influence of antibodies to the hepatitis C virus (HCV) on the success of a kidney transplant.

ObjectivesTo assess the oral system of parkinsonian patients treated with chronic stimulation of the bilateral subthalamic nucleus (STN) to evaluate precisely the effectiveness of this procedure on the articulatory organs. MethodsLoad sensitive cantilevers were used to sample ramp and hold force contractions generated by the upper lip, lower lip, and tongue. The subject was given the instruction to produce forces as rapidly and as accurately as possible in response to the target signal (ranging from 0.25 to 2 N), which appeared on a screen. Maximal force of each effector organ was also measured. Fourteen healthy control subjects and 10 patients participated in this study. After an overnight fast the patients were evaluated in the morning under two conditions: during bilateral stimulation and 1 hour after stopping STN stimulation. ResultsDuring STN stimulation, dynamic and static control of the articulatory organs were improved: the maximal strength of the articulatory organs, their accuracy to reach the target, and the precision of the hold phase increased. In addition, the reaction time and the rise time of the ramp phase decreased. Patients' speech as assessed by the item 18 of the unified Parkinson's disease rating scale (UPDRS) was greatly improved by electrical stimulation of the STN ConclusionsImprovement of oral control of the stimulated patients suggests that STN stimulation modulates neuronal structures involved in speech. However, more patients have to be evaluated for a fuller understanding of the effect of this surgical procedure on speech.

An acute ethanol load (50mmol/kg, i.p.) induces an increase in the total non-heme iron and in the low-molecular-weight non-heme iron complexes (LMW-Fe) content both in liver and cerebellum. This increase in LMW-Fe is associated with a decrease in some essential trace elements (selenium, zinc, copper) playing a role in the anti-oxidant system. These changes could contribute to the enhancement in lipid peroxidation which occurs at the hepatic and cerebellar level following the ethanol administration.The administration of allopurinol prior to the ethanol load prevents the changes in non-heme iron and trace elements. This prevention may contribute to the protective effects of allopurinol on the ethanol-induced oxidative stress.

Subcutaneous recombinant human erythropoietin seems to be more effective than intravenous administration. Local pain, however, may diminish patient compliance with the subcutaneous route. Recently continuous intravenous intradialysis administration of rHuEpo has been reported to be more efficacious in stimulating erythropoiesis than the usual postdialysis intravenous bolus.

A prospective study of the frequency, timing, etiology and risk factors of infections in renal transplant recipients during the first year after transplantation was conducted in 50 consecutive patients. Neither prophylaxis with trimethoprim-sulfamethoxazole nor antiviral prophylaxis was administered. Two hundred twenty-eight episodes of infection were registered (4.5 per patient), 19 of which were severe. Forty-seven percent of all infectious episodes occurred during the first two months after transplantation. The more frequent infections were bacterial (64 %), viral (22 %) and fungal (11 %).Escherichia coli was the most common agent isolated (n=36), followed by cytomegalovirus (n=32). Urinary tract infections were most common (n=144), especially asymptomatic bacteriuria (n=106). Surgical reintervention and the use of antilymphocytic globulins were associated with a higher frequency of severe infections (p<0.05), and invasive candidiasis was associated with allograft loss (p<0.03). Annual survival rates of patients and allografts were 100 % and 94 %, respectively. The frequency of mild infections was higher than that observed in other studies using bacterial or viral prophylaxis. Nevertheless, the number of severe infections and the survival rates of patients and allografts were similar to those reported in previous studies.

Each VLSI circuit includes some blocks used to convert data, to give the microprocessor commands, and some programmable logic array blocks. These blocks are called random logic blocks. To propagate the test data through these random logic blocks, combinatorial or synchronous sequential, explicit knowledge is required of the input/output combinations that can functionally be generated. The usual representations of the random logic are unsuitable for this because they have not been designed for this purpose. A new model has been developed to obtain this knowledge. It makes clearer all the possible input/output combinations, and it allows direct simulations and inferences through all kinds of random logic blocks.

We compared the survival of 842 patients on centre haemodialysis to 272 patients on continuous ambulatory peritoneal dialysis (CAPD). All patients selected had begun treatment between 1 January 1984 and 30 June 1988 and were from six centres which participate in a regional renal patients registry. Patients on CAPD were older and had a greater proportion of diabetes and other associated diseases. Age, diabetes, and cardiovascular diseases were associated with a shorter survival on treatment in all the patients studied. Without adjustment for risk factors, patient 3-year survival was higher in centre haemodialysis than in CAPD, 80% versus 64% respectively. However, no significant differences could be shown in the survival rates of the two treatment modalities after accounting for the heterogeneity of the patients in the two groups, either by stratification or by multivariate analysis (Cox). Age was the main predictive factor for CAPD patient survival, while the influence of diabetes and cardiovascular diseases was less clear. Technique survival was much better in centre haemodialysis (94% versus 56% in CAPD, 3-year survival). Older age and diabetes mellitus were associated with a greater risk of switching from centre haemodialysis to CAPD and a trend to retain those patients on CAPD.