Early Reaction Research Articles

A comparative study on early treatment outcome and adverse drug reaction profile of two protease inhibitor-based antiretroviral regimens in human immunodeficiency virus patients at a tertiary care teaching hospital, Rajasthan

Introduction: Second-line antiretroviral therapy (ART) regimens are used when patients develop treatment failure from first-line drug regimens. The present study is aimed to compare treatment outcome in terms of clinical, virological, and immunological effectiveness over 1 year of follow-up in human immunodeficiency virus (HIV) patients, switched to various second-line ART regimens and to assess adverse drug reactions (ADRs). Materials and Methods: A longitudinal observational study was conducted at ART center, SMS Hospital, Jaipur, after approval from Institutional Research Review Board. One hundred HIV positive patients, resistant to first line ART, switched to either of the 2 s line ART regimens were followed for 1 year for early treatment outcomes and any ADRs. Results: Out of 97 patients enrolled 65 patients received Tenofovir and 32 patients received Zidovudine (ZDV) along with lamivudine and Atazanavir/ritonavir. There was significant increment in CD4 count from the baseline value (202.51–438.52 cells/mm3) after 12 months of therapy. On comparison, CD4 cell rise was not significantly different between the two groups. However, Plasma viral load suppression was achieved insignificantly more number of patients in ZDV group than in tenofovir group: 31 (96.9%) versus 57 (87.7%), respectively. Opportunistic infections (OI) were seen in 21.5% and 28.1% patients respectively at the time of switching of second-line ART. Out of 59 ADRs reported, nausea, vomiting, diarrhea, hyperbilirubinemia, dyslipidemia, and anemia were most common. Conclusion: Nonadherence, drug resistance, and treatment failure are the major challenges in controlling HIV disease. Our study shows that both the second-line regimens were comparable in improvement in CD4 count and viral load suppression with 1 year success rate of 90.7%.

Early Reactions of Parents to Their Trans and Gender Non-Conforming Children

Pre-adolescent transgender and gender non-conforming (TGNC) youth who are supported by their parents have improved psychosocial outcomes. Despite the important role parents play in TGNC youth’s development, there is little research on their experiences. This study explored the early parenting experiences of 34 parents of pre-adolescent TGNC youth. Parents were recruited from online communities and listservs, and interviewed via phone about their early parenting experiences. Data were analyzed via thematic analysis. Findings indicate that parents became aware of their child’s TGNC identity either through observing their child’s gender behaviors, or by their child verbalizing their identity. Parents, on average, became aware of their child’s gender identity exploration when they were just over 3 and a half years old. Parents felt a mix of emotions, with many reporting a lack of concern or positive emotions regarding their child’s rejection of traditional gender roles. Parents without prior knowledge of transgender people or existing connections to lesbian, gay, bisexual, transgender, or queer (LGBTQ+) people sought out information from the Internet. The findings are both consistent with and diverge from prior research with parents, suggesting both new areas for research, and additional ways in which TGNC youth and their parents can be best supported.

Individual Radiosensitivity as a Risk Factor for the Radiation-Induced Acute Radiodermatitis.

Background: Up to 95% of irradiated patients suffer from ionizing radiation (IR) induced early skin reaction, acute radiation dermatitis (ARD). Some experts think that additional skin hydration can reduce acute skin reactions. Individual radiosensitivity (IRS) determined from lymphocytes may help to predict acute radiation toxicity. The purpose of this study is to evaluate the clinical manifestation of ARD in different skincare groups during whole breast radiotherapy depending on IRS and other risk factors. Methods: A total of 108 early-stage breast cancer patients were randomized into best supportive care (BSC) and additional skincare (ASC) groups. IRS was evaluated using a G2 assay modified with caffeine-induced G2 checkpoint arrest. All patients received a 50 Gy dose to the breast planning target volume (PTV). Clinical assessment of ARD symptoms according to the CTCAE grading scale was performed once a week. Results: IRS was successfully determined for 91 out of 108 patients. A total of 10 patients (11%) had normal IRS, 47 patients (52%) were categorized as radiosensitive, and 34 (37%) as highly radiosensitive. There was no significant difference in the manifestation of ARD between patient groups by skincare or IRS. According to logistic regression, patients with bigger breasts were prone to more severe ARD (p = 0.002). Conclusions: The additional skincare did not improve skin condition during RT. A total of 89% of patients had increased radiosensitivity. IRS determined before RT did not show the predictive value for the manifestation of ARD. Logistic regression revealed that breast volume was the most significant risk factor for the manifestation of ARD.

Is There Any Evidence of Monocytes Involvement in Alzheimer's Disease? A Pilot Study on Human Postmortem Brain.

Background:The role of neuroinflammation has become more evident in the pathogenesis of neurodegenerative diseases. Increased expression of microglial markers is widely reported in Alzheimer’s disease (AD), but much less is known about the role of monocytes in AD pathogenesis. In AD animal models, bone marrow-derived monocytes appear to infiltrate the parenchyma and contribute to the phagocytosis of amyloid-β depositions, but this infiltration has not been established in systematic studies of the human brain postmortem.Objective:In addition to assessing the distribution of different subtypes of microglia by immunostaining for CD68, HLA-DR, CD163, and CD206, we focused on the involvement of C-chemokine receptor type2 (CCR2) positive monocytes during the AD course.Methods:We used formalin-fixed and paraffin-embedded tissue from four vulnerable brain regions (hippocampus, occipital lobe, brainstem, and cerebellum) from neuropathologically characterized AD cases at different Braak stages and age-matched controls.Results:Only singular migrated CCR2-positive cells were found in all brain regions and stages. The brainstem showed the highest number of positive cells overall, followed by the hippocampus. This mechanism of recruitment seems to work less efficiently in the human brain at an advanced age, and the ingress of monocytes obviously takes place in much reduced numbers or not at all.Conclusion:In contrast to studies on animal models, we observed only a quite low level of myeloid monocytes associated with AD pathology. Furthermore, we provide evidence associating early microglial reactions carried out in particular by pro-inflammatory cells with early effects on tangle- and plaque-positive vulnerable brain regions.

Bioavailability evaluation of calcium, magnesium and zinc in Brazilian cheese through a combined model of in vitro digestion and Caco-2 cells

Cheese has important nutritional properties as a result of their protein, lipid and essential minerals content. This study analyzed the bioavailability of Ca, Mg and Zn in Brazilian cheeses, using the in vitro INFOGEST digestion method coupled with assays in Caco-2 cells. Furosine content (marker of the early Maillard reaction) was also evaluated. Two self-produced fresh cheeses, cow and goat Minas frescal; and two commercial matured goat cheeses, Blue and Pyramid, were analyzed. Mineral bioaccessibility after in vitro digestion was in the range of 44.4–74.7 %, 54.8–66.1 % and 18.2–38.7 % for Ca, Mg and Zn, respectively. Bioaccessibilty was significantly affected by the mineral and fat content level. The digested fresh cheeses (Minas frescal) showed the highest values of soluble Ca and Mg; and the Pyramid goat cheese presented the greatest Ca and Zn transport efficacy across Caco-2 cell monolayers. Furosine could be a useful indicator to evaluate cheese ripeness and its indirect effect on the mineral availability.

Influence of supplementary materials on the early age hydration reactions and microstructural progress of magnesium phosphate cement matrices

The microstructures of magnesium phosphate cement (MPC) compounds are porous due to rapid speed of hydration reaction and great level heat release at very early ages. Consequently, MPCs lose mass in water region for spongy structure, which limits the application in the water structures. For improving the solidity of microstructures, decrease of high hydration heat discharge and little extension of final setting time (FST) of the magnesium phosphate cement (MPC) composites at early hydration ages, different supplementary cementitious materials (SCMs) such as fly ash (FA), silica fume (SF), bauxite (BX), Phosphogypsum (PG), aluminum silicate (AS) and silica nanoparticles (SNP) were introduced to MPC compositions. It was revealed that pH was not too acidic for adding foreign materials at very early stages (i.e. 4 mins–10 min), where dissolving speed of magnesia (MgO) particles were declined. Thus, FST was delayed and decreased heat release of fresh specimens except for combination with SNP. The research also identified the different intermediate crystals such as mullite, enstatite, berlinite, lizardite, CSH and ettringite in the microstructures of MPC blended with SCMs, which was confirmed by XRD, SEM and FTIR experiments. Furthermore, the structural integrity of samples was significantly improved as compared to control for the existence of secondary rocks, where the specimens having FA, BX and AS presented the mechanical strength properties 30% higher at 28d than the reference matrix. However, the explored results might be a potential solution to design and improve the water resistance properties of MPC compounds for applying in the water structures.

Coronavirus and emergency management in Nigeria

Relevance .This study examines the efforts of the Nigerian government towards managing the coronavirus infection. COVID-19 is an infectious disease that originated from Wuhang, China at the end of 2019. In the early stages, the virus infected about 300 people and caused the deaths of six people. Despite early detections and reactions by the Chinese government, the disease spread to the different countries of the world. By June 2021 more than 170 million (170,000,000) people have been infected with the disease with more than three million and sixty thousand (3,600,000) deaths. According to Johns Hopkins University in Nigeria, in June 2021, 167 thousand cases of diseases and more than 2 thousand deaths were registered. Materials and Methods . The study analyses data from open sources such as academic journals, books, newspapers and online sources. Results and Discussion. Findings of the study reveal that while the actions of the Nigerian government have been preventive, they have not curtailed the spread of the virus. Conclusion . The researchers recommend that the Nigerian government intensifies its efforts towards to limit the spread of the virus by effectively implementing lockdowns and bans on public gatherings, improve testing capacities to identify and isolate carriers of the virus.

The 4GFOR model – Coupling 4G early diagenesis and benthic foraminiferal ecology

The 4GFOR model presented in this paper combines the OMEXDIA model of Soetaert et al. (1996) with four theoretical species of benthic foraminifera. The geochemical part of the model simulates the succession of early diagenetic redox reactions in the superficial sediment layers. The four theoretical foraminiferal species, each representing a group of biological species with comparable microhabitats, differ by their limitations with respect to oxygen and nitrate concentration and their ability to feed on different organic matter types. The foraminiferal model is a transformation model in which different proportions of four types of organic matter with different reactivity are attributed to each of the theoretical species. The model has been manually tuned and tested on a large data set from two stations, at 1000 and 550 m depth, in the Bay of Biscay. The model adequately simulates the vertical distribution of shallow, intermediate and deep infaunal species. The 4GFOR model can be used to test several hypotheses concerning foraminiferal ecology. The model has already allowed us to conclude that it is high unlikely that shallow infaunal taxa feed exclusively on the most labile part of the organic matter flux, since it was unable to reproduce the field observations while using this hypothesis. Another important conclusion based on our preliminary model results is that the absence of deep infaunal taxa close to the sediment surface may be explained by their decreasing competitiveness in well oxygenated environments. In the future, the inversion of the 4GFOR model may yield a powerful paleoceanographic tool, enabling us to reconstruct major limiting environmental factors (oxygen and nitrate concentrations; quantity and quality of the organic flux to the ocean floor) from benthic foraminiferal assemblage data.

Biomimetic Ceramic Composite: Characterization, Cell Response, and In Vivo Biocompatibility.

The present study aimed to synthesize biphasic calcium phosphate ceramics (CaPs) composed of β-tricalcium phosphate (β-TCP) and hydroxyapatite (HAp) from the propagated Scleractinian coral and dicalcium phosphate anhydrous using a solid-state reaction followed by heat treatment at a temperature of 1100 °C for 1 h to 7 days. The as-prepared coral and coral-derived biphasic CaPs samples were characterized through scanning electron microscopy, X-ray diffractometry, Fourier transform infrared spectroscopy, and Raman spectroscopy. The cell response of the biphasic CaPs was evaluated by in vitro cytotoxicity assessment using mouse fibroblast (L929) cells. The bilateral femoral defect rabbit model was used to assess the early local reaction of the coral-derived biphasic CaPs bone graft on tissue. The results confirmed that the co-existence of β-TCP and HAp was formed at 1100 °C for 1 h. The ratio of HA/β-TCP increased as the heat-treatment time increased. The coral-derived biphasic CaPs comprising 61% HAp and 39% β-TCP (defined as HT-3) were not cytotoxic. Furthermore, no significant differences in local tissue reaction were observed between the HT-3 sample and autogenous bone. Therefore, the synthesized coral-derived biphasic CaPs is a candidate for bone grafting due to its good biocompatibility.

The Effects of Wearing Helmets on Reaction of Motorcycle Riders

In Taiwan, motorcycles are the most commonly used means of transportation and also have the highest accident rate. Because motorcycles are less stable and provide less protection than cars, motorcycle riders are vulnerable in traffic accidents. Furthermore, head trauma is often fatal, causing a great loss to society. Although helmets provide protection to the head, they also affect the visual field of motorcycle riders. However, the literature mostly focuses on the protective effect of helmets after a collision and rarely considers the influence of helmets prior to collisions. In the study design, participants wore three different types of helmet and watched a pre-recorded video of an actual street with pre-placed warning triangles at a speed of 60 km/h. Participants were asked to press a button when they saw a warning triangle. The time between participants seeing the warning triangle and arriving at the warning triangle was calculated. This time is referred to as the “early reaction time.” The number of missed presses and false presses was also recorded. The results of the study show that: (1) Of the three types of helmet, wearing half helmets produced the longest early reaction times, followed by 3/4 helmets, with full face helmets with the shortest early reaction times. (2) Early reaction times when wearing a half helmet were the same as early reaction times when not wearing a helmet. (3) The results for the total number of missed and false presses when wearing the three types of helmet were the same as for the results of the early reaction time analysis. (4) Sex and age had no effect on early reaction times. The experimental results can be used as a reference for helmet design and academic research.

What are you calling intuitive? Subject heterogeneity as a driver of response times in an impunity game

Studies on the intuitive or deliberate nature of human actions often use time constraints for identification, assuming that constrained individuals fall back to intuitive behavior. This identification strategy disregards individual heterogeneity and self-priming, i.e. the behavioral rule that subjects can form during the instructions phase, and then apply irrespective of the time constraint. We use respondent data from an impunity game as an example of how subject heterogeneity can drive results. 24 respondents face 240 more or less unfair allocation proposals out of a small or large pie and can accept or reject the offer. Upon rejection respondents burn their own money, but not the proposer’s. Respondents decisions are communicated to the proposer. On average, emotional rejections take longer than deliberate acceptances. Including individual heterogeneity, though, we find that subjects who mostly accept (reject) take more time to reject (accept). Faster decisions are the ones conforming with the modal early reaction. We attribute this finding to heterogeneity in self-priming. Since self-priming is orthogonal to time constraints, it has the capacity to invalidate their use in the identification of dual decision modes.

Early and Later Perceptions and Reactions to the COVID-19 Pandemic in Germany: On Predictors of Behavioral Responses and Guideline Adherence During the Restrictions.

In March 2020, the German government enacted measures on movement restrictions and social distancing due to the COVID-19 pandemic. As this situation was previously unknown, it raised numerous questions about people’s perceptions of and behavioral responses to these new policies. In this context, we were specifically interested in people’s trust in official information, predictors for self-prepping behavior and health behavior to protect oneself and others, and determinants for adherence to social distancing guidelines. To explore these questions, we conducted three studies in which a total of 1,368 participants were surveyed (Study 1 N=377, March 2020; Study 2 N=461, April 2020; Study 3 N=530, April 2021) across Germany between March 2020 and April 2021. Results showed striking differences in the level of trust in official statistics (depending on the source). Furthermore, all three studies showed congruent findings regarding the influence of different factors on the respective behavioral responses. Trust in official statistics predicted behavioral responses in all three studies. However, it did not influence adherence to social distancing guidelines in 2020, but in 2021. Furthermore, adherence to social distancing guidelines was associated with higher acceptance rates of the measures and being older. Being female and less right-wing orientated were positively associated with guidelines adherence only in the studies from 2020. This year, political orientation moderated the association between acceptance of the measures and guideline adherence. This investigation is one of the first to examine perceptions and reactions during the COVID-19 pandemic in Germany across 1year and provides insights into important dimensions that need to be considered when communicating with the public.

Monitoring the pozzolanic effect of fly ash in blended OPC mortars by electrical impedance spectroscopy

Fly ash (FA) is a pozzolanic material widely used to replace ordinary Portland cement (OPC) in mortars and concretes. The main purpose of this replacement is to improve the durability of these materials in a sustainable way from an environmental and economical perspective.Main technical advantages, such as the improvement in durability and the enhancement of mechanical properties with long-time hydration, are derived from the pozzolanic activity. Several studies aimed to evaluate the pozzolanic reaction extent have been reported by using thermogravimetric analysis (TGA), mechanical compressive strength and mercury intrusion porosimetry (MIP). Besides, other complementary non-destructive techniques that reflect the effect of FA on microstructure are of great scientific and technical interest.In this work, an alternative non-destructive method, the electrical impedance spectroscopy (EIS) followed by the equivalent circuit (EC) analysis has been applied to identify two electrical relaxations, which are strongly associated to microstructural properties.The high frequency relaxation was assigned to the electrical conductivity of the calcium silicate hydrate (C-S-H) gel. Additionally, this C-S-H gel conductivity was separated into dc-conductivity and frequency-dependent conductivity, that provided information regarding the periods of early pozzolanic reaction (around 12 days) and high pozzolanic activity (around 28 days).This research provides conclusive evidence of the validity of the applied EIS-EC method on account of the significative relationships found between electrical parameters and physicochemical properties determined by TGA, compressive strength and MIP.Specifically, non-evaporable water, compressive strength and gel-pore-volume of diameter less than 10 nm exhibited significative exponential correlations with dc-electrical resistivity of the high frequency relaxation. These correlations validated the appropriate allocation of the high frequency relaxation to C-S-H gel.

Pre-existing immunity and vaccine history determine hemagglutinin-specific CD4 T cell and IgG response following seasonal influenza vaccination

Effectiveness of seasonal influenza vaccination varies between individuals and might be affected by vaccination history among other factors. Here we show, by monitoring frequencies of CD4 T cells specific to the conserved hemagglutinin epitope HA118-132 and titres of IgG against the corresponding recombinant hemagglutinin protein, that antigen-specific CD4 T cell and antibody responses are closely linked to pre-existing immunity and vaccine history. Upon immunization, a strong early reaction is observed in all vaccine naïve participants and also in vaccine experienced individuals who have not received the respective seasonal vaccine in the previous year. This response is characterized by HA118-132 specific CD4 T cells with a follicular helper T cell phenotype and by ascending titers of hemagglutinin-specific antibodies from baseline to day 28 following vaccination. This trend was observed in only a proportion of those participants who received the seasonal vaccine the year preceding the study. Regardless of history, levels of pre-existing antibodies and CD127 expression on CD4 T cells at baseline were the strongest predictors of robust early response. Thus, both pre-existing immunity and vaccine history contribute to the response to seasonal influenza vaccines.

Synthesis and Mechanism of Spherical Ag-doped Polypyrrole Assisted by Complexing Agents

Highly dispersed Ag-doped Polypyrrole (PPy) spherical composites can be efficiently synthesized via oxidative polymerization of pyrrole with FeCl3 in an aqueous Ag+-containing solution in the presence of trisodium citrate, followed by concentrated ammonia treatment. However, the formation mechanisms involved in how to control the shape and how to get the metallic Ag0 need further investigation. In order to elucidate the formation mechanisms, the intermediates in different reaction stage were collected and investigated. Combining the experimental phenomenon and the structure characterization of the samples, it was found that citrate ions make a role of complexing Ag+ to produce [Ag3(C6H5O7)n+1]3n− complexes in the early reaction stage, then mainly play a role of steric stabilizer of AgCl micelles and are responsible for the shape tailoring of PPy composite as well as the reduction of Ag+ in the process of ammonia treatment. Evidently, negative-charged AgCl micelles become the main nucleation sites of pyrrole polymerization through the electrostatic attraction between the negative and positive ions. Concentrated ammonia is adopted to eliminate AgCl cores from the precursor of Ag-doped PPy composites obtained by chemical redox reaction and provides an accelerated reaction condition for reduction of Ag+ by reductants (citrate ion or pyrrole monomer). Ag-containing micelles induction method is a facial chemical method to obtain uniform Ag-doped composites and can be broadened to design other Ag-containing functional materials.

Vaccination Coverage of Children with Epidermolysis Bullosa Against Vaccine Preventable Diseases According to National Preventive Vaccination Programmes: Cross-Sectional Study

Background. Patients with epidermolysis bullosa (EB) have higher risk of developing infectious diseases. Its prevention requires timely vaccination. For now, there are no studies showing vaccination coverage for this category of children. Objective. Our aim was to study vaccination coverage of children with EB according to national preventive vaccination programmes. Methods. This retrospective cross-sectional study examined medical records of patients with EB from Russian Federation and neighbouring countries. Vaccination coverage (completeness and timeliness) and age of immunization initiation were analyzed. Moreover, we have studied the spectrum of early post-vaccine reactions and the course of the post-vaccine period in children with EB vaccinated for the first time. Results. The study included medical records of 134 patients with EB aged from 8 months to 17 years 8 months. Vaccination was performed according to national immunization programs in 37 (28%) children, only 21 cases were carried out in a timely manner. Medical exemptions were the major reason for the refusal of vaccination in most cases (82%). 48 patients with EB were vaccinated against 12 vaccine preventable diseases in the hospital. The post-vaccine period was asymptomatic in 36 (76%) patients, 10 (20%) patients had tenderness and hyperemia at the injection site, 2 (4%) patients had subfebrile fever. Conclusion. Most children with EB are still unvaccinated or vaccinated untimely. Immunization of such children against vaccine preventable disease according to the individual plan can be pretty useful.

ПРИМЕНЕНИЕ ДЕЗОКСИРИБОНУКЛЕАТА НАТРИЯ ДЛЯ ПРОФИЛАКТИКИ ЛУЧЕВОГО ЦИСТИТА У ПАЦИЕНТОВ С РАКОМ ТЕЛА ИЛИ ШЕЙКИ МАТКИ

Results: To develop a method for reducing the frequency and severity of early radiation reactions in patients with cancer of the uterus or cervix.
 Material and methods: We analyzed the results of treatment of 60 patients with cancer of the uterus and cervix, patients received a postoperative course of external beam radiotherapy combined with the intramuscular administration of the Derinat® radioprotector (sodium deoxyribonucleate); in the second arm, they received a postoperative course of external beam radiotherapy and standard therapy in case of radiation cystitis. The assessment of radiation reactions severity was performed with the EORTC QLQ-C30 criteria, WBC count, IPSS scale, urine analysis and cystoscopic examination evaluated with the developed by us scale.
 Results: Evaluation of the quality of life in patients with cervical or uterine cancer at the final stage of treatment using the IPSS scale showed that in the arm of patients with sodium deoxyribonucleate, there was a 30.4 % (p> 0.05) decrease in the symptoms of urinary disorders. The use of the radioprotector sodium deoxyribonucleate also statistically significantly reduced the incidence of radiation cystitis by 73 %. According to cystoscopy, the total bladder injury score at the end of treatment was 147 % lower. The number of leukocytes in the urine analysis at the end of treatment was 116.3 % lower (p≤0.01) in those who received sodium deoxyribonucleate
 Conclusion: The data obtained indicate the radioprotective efficacy of sodium deoxyribonucleate and make it possible to recommend its intramuscular administration to patients with cancer of the uterus and cervix against the background of external beam radiation therapy to reduce the frequency and severity of acute radiation cystitis in patients with cancer of the uterus or cervical cancer receiving external beam radiation therapy.

AUditive Direct in Utero Observation (AUDIO): A Randomized Controlled Trial for a Prenatal Demonstration of Fetal Hearing.

Introduction: The objective of this randomized controlled study was to demonstrate whether acoustic stimulation in utero is associated with fetal reactivity which is documentable by cardiotocography. Materials and methods: A monocentric randomized controlled trial was performed at a single university tertiary hospital between September 2016 and July 2017. This study was registered as a randomized clinical trial on clinicaltrail.gov (registration number NCT04622059). Unselected pregnancies at term of gestation were consecutively recruited for the purpose of this study. After 10 min of normal cardiotocography without accelerations (non-stress-test with a basal frequency between 110 and 150 beats/min, normal variability between 6 and 15 b/min, no accelerations, and no fetal movements), fetuses were randomized at a 1:1 ratio to either of the two groups. Fetuses in group A (n = 105) received acoustic stimulation after 10 min from the beginning of the CTG, whereas fetuses in group B received no stimulation (n = 105). The outcome variables investigated were the lapse of time between the beginning of the CTG and the occurrence of the first acceleration, and the lapse of time between the beginning of the CTG and the first fetal movement noticed. Results: The lapse of time between the beginning of the CTG and the occurrence of the first acceleration was significantly shorter in the group with acoustic stimulation compared to the other group (14.87 ± 5.01 vs. 21.90 ± 6.94 min, p-value < 0.001 log-rank test). Similarly, the lapse of time between the beginning of the CTG and the occurrence of the first fetal movement was significantly shorter in group A compared to group B (17.77 ± 7.62 vs. 23.28 ± 7.61 min, p-value < 0.001, log-rank test). Fetal cardiac acceleration and the occurrence of a fetal movement during the first 20 min of the CTG were more frequently recorded in group A compared to group B (respectively, 15% vs. 5% and 20% vs. 8%). Conclusion: This RCT showed an early fetal reaction following auditive stimulus, documentable by cardiotocography. Further research is needed to investigate a possible role of acoustic stimulation in utero for the prenatal diagnosis of congenital hypoacusis.

Characteristics of patients with spontaneous resolution of sesame allergy

BackgroundThe prevalence of sesame allergy is increasing; strict avoidance is the mainstay of therapy. Lately, sesame oral immunotherapy was presented as an alternative treatment, with a high rate of success. Therefore, data on the natural history and the clinical characteristics of patients with persistent sesame allergy are important for the management of patients with sesame allergy. ObjectiveTo describe the natural history of patients with sesame allergy and the clinical characteristics of patients with spontaneous resolution of sesame allergy compared with patients with persistent sesame allergy. MethodsIn our retrospective study, electronic health records of patients with sesame allergy diagnosis were reviewed for demographic and clinical data. Statistical analysis of clinical characteristics of patients with spontaneous resolution compared with persistent sesame allergy was performed. ResultsA total of 190 patients with sesame allergy were followed for 3.86 ±4.43 years. Of these patients, 61 (32.1%) had spontaneous resolution of sesame allergy. Patients with mild, early (before the age of 10 months) first sesame allergic reaction, with smaller than 7-mm skin prick test and without concomitant tree nut allergy had better resolution rate (56.1%). ConclusionSesame allergy spontaneously resolved in approximately one-third of our patients and in more than half of the patients with mild first reaction (grade 1) at a young age (<10 months), with small skin prick test (<7 mm) and no concomitant tree nut allergy. Larger prospective studies with longer follow-up period are needed to better characterize the sesame allergic patients with persistent allergy who may need oral immunotherapy.

Poe in Cyberspace: The First Amendment, Antitrust Law, and an Internet Rhubarb

Poe in Cyberspace: The First Amendment, Antitrust Law, and an Internet Rhubarb