Medicine and Health Sciences Commons^™

Development And Characterization Of A Severe Acute Respiratory Syndrome-Associated Coronavirus-Neutralizing Human Monoclonal Antibody That Provides Effective Immunoprophylaxis In Mice, Thomas Greenough, Gregory Babcock, Anjeanette Roberts, Hector Hernandez, William Thomas, Jennifer Coccia, Robert Graziano, Mohan Srinivasan, Israel Lowy, Robert Finberg, Kanta Subbarao, Leatrice Vogel, Mohan Somasundaran, Katherine Luzuriaga, John Sullivan, Donna Ambrosino

William D Thomas Jr

BACKGROUND: Severe acute respiratory syndrome (SARS) remains a significant public health concern after the epidemic in 2003. Human monoclonal antibodies (MAbs) that neutralize SARS-associated coronavirus (SARS-CoV) could provide protection for exposed individuals. METHODS: Transgenic mice with human immunoglobulin genes were immunized with the recombinant major surface (S) glycoprotein ectodomain of SARS-CoV. Epitopes of 2 neutralizing MAbs derived from these mice were mapped and evaluated in a murine model of SARS-CoV infection. RESULTS: Both MAbs bound to S glycoprotein expressed on transfected cells but differed in their ability to block binding of S glycoprotein to Vero E6 cells. Immunoprecipitation analysis revealed …

Treatment With Monoclonal Antibodies Against Clostridium Difficile Toxins, Israel Lowy, Deborah Molrine, Brett Leav, Barbara Blair, Roger Baxter, Dale Gerding, Geoffrey Nichol, William Thomas, Mark Leney, Susan Sloan, Catherine Hay, Donna Ambrosino

William D Thomas Jr

BACKGROUND: New therapies are needed to manage the increasing incidence, severity, and high rate of recurrence of Clostridium difficile infection.

METHODS: We performed a randomized, double-blind, placebo-controlled study of two neutralizing, fully human monoclonal antibodies against C. difficile toxins A (CDA1) and B (CDB1). The antibodies were administered together as a single infusion, each at a dose of 10 mg per kilogram of body weight, in patients with symptomatic C. difficile infection who were receiving either metronidazole or vancomycin. The primary outcome was laboratory-documented recurrence of infection during the 84 days after the administration of monoclonal antibodies or placebo.

RESULTS: …

Therapy With A Severe Acute Respiratory Syndrome-Associated Coronavirus-Neutralizing Human Monoclonal Antibody Reduces Disease Severity And Viral Burden In Golden Syrian Hamsters, Anjeanette Roberts, William Thomas, Jeannette Guarner, Elaine Lamirande, Gregory Babcock, Thomas Greenough, Leatrice Vogel, Norman Hayes, John Sullivan, Sherif Zaki, Kanta Subbarao, Donna Ambrosino

William D Thomas Jr

BACKGROUND: Immunotherapy with monoclonal antibodies (MAbs) offers safe interventions for the prevention of infection in patients after organ transplantation and for the treatment of cancers and autoimmune diseases. MAb 201 is a severe acute respiratory syndrome-associated coronavirus (SARS-CoV)-specific MAb that prevents establishment of viral replication in vitro and prevents viral replication in vivo when administered prophylactically. The efficacy of MAb 201 in the treatment of SARS was evaluated in golden Syrian hamsters, an animal model that supports SARS-CoV replication to high levels and displays severe pathological changes associated with infection, including pneumonitis and pulmonary consolidation. METHODS: Golden Syrian hamsters that …

Clinical Decision Support (Cds) & Meaningful Use Frequently Asked Questions, Paul Kleeberg, Donald Levick, Jerome Osheroff, Jacob Reider, Jonathan Teich

Donald Levick MD

No abstract provided.

Preventing Paediatric Obesity; Recommendations From A Community-Based Qualitative Investigation, Patricia Tucker, Jennifer Irwin, L. Sangster Bouck, Meizi He, G. Pollett

Trish Tucker

Childhood obesity is on the rise, and interventions targeted at pre-school-aged children are essential for the primary prevention of this disease. Physical activity programming and decreasing screen viewing may be advantageous ways to reduce the early onset of obesity. Parents' perceptions regarding effective tools and programmes to target obesity are needed to develop an efficacious programme. Ten semi-structured focus groups were conducted for this qualitative study. Two experienced moderators facilitated all focus groups which were conducted in local day cares, workplaces and play groups, frequented by parents. All focus groups were audio-recorded and transcribed verbatim. Strategies to ensure trustworthiness of …

Preschoolers' Physical Activity Behaviours: Parents' Perspectives, Jennifer Irwin, Meizi He, L. Sangster Bouck, Patricia Tucker, Graham Pollett

Trish Tucker

OBJECTIVES: To understand parents' perspectives of their preschoolers' physical activity behaviours. METHODS: A maximum variation sample of 71 parents explored their preschoolers' physical activity behaviours through 10 semi-structured focus group discussions. RESULTS: Parents perceived Canada's Physical Activity Guidelines for Children as inadequate; that their preschoolers get and need more than 30-90 minutes of activity daily; and that physical activity habits must be established during the preschool years. Nine barriers against and facilitators toward adequate physical activity were proposed: child's age, weather, daycare, siblings, finances, time, society and safety, parents' impact, and child's activity preferences. DISCUSSION: The need for education and …

Response To ‘Reply To Van Zandvoort, Tucker, Irwin And Burke: Physical Activity At Daycare: Issues, Challenges And Perspectives’ By Albon, Melissa Van Zandvoort, Patricia Tucker, Jennifer Irwin, Shauna Burke

Trish Tucker

No abstract provided.

Screen-Viewing Behaviors Among Preschoolers Parents' Perceptions, Meizi He, Jennifer Irwin, L. Sangster Bouck, Patricia Tucker, Graham Pollett

Trish Tucker

BACKGROUND: Childhood obesity has emerged as a public health concern in Canada. It has been suggested that excessive screen viewing (i.e., television, computer, video) is a major factor contributing to the increased risk of obesity in children. Exploring young children's experiences with this modifiable behavior may be beneficial to the creation of a multifaceted program aimed at the primary prevention of obesity. OBJECTIVES: To seek parents' perceptions and insights pertaining to their preschoolers' screen-viewing behaviors. METHODS: This qualitative study targeted a heterogeneous sample of parents with children aged 2.5 to 5 years. Two experienced moderators using a semistructured interview guide …

Physical Activity Behaviors During The Preschool Years, Patricia Tucker, Jennifer Irwin

Trish Tucker

This is the first Canadian study to measure physical activity participation and opportunities for outdoor playtime among preschoolers. Preschoolers in the London, Ontario study spent significantly more time engaging in high-intensity indoor activity versus outdoor activity. Daycare providers reported the children in their care had access to approximately 2 hours of daily outdoor playtime. Nearly half the study‟s parents reported their preschoolers did not engage in physical activity at the level needed for health gains. Insufficient activity among such a large segment of preschoolers has potentially serious physical and psychological health implications. Daycare settings afford ample opportunity for physical activity …

Post-Resuscitation Complications In Term Neonates, Marie Frazier, Joseph Werthammer

Joseph Werthammer

Objective: It has been recommended that all newborn babies who have received substantial resuscitation be cared for in an environment where post-resuscitation care can be provided. To test this recommendation, we examined whether infants who received delivery room resuscitation and seemingly recovered by 5 min age are at increased risk of short-term morbidity. Study design: We undertook a retrospective analysis of the outcomes of babies who received delivery room resuscitation, and who had seemingly recovered by 5 min age, over a 1 year time period at a single academic institution. The 33 babies were compared with outcomes of 33 controls …

Post-Resuscitation Complications In Term Neonates, Marie Frazier, Joseph Werthammer

Marie D. Frazier

Objective: It has been recommended that all newborn babies who have received substantial resuscitation be cared for in an environment where post-resuscitation care can be provided. To test this recommendation, we examined whether infants who received delivery room resuscitation and seemingly recovered by 5 min age are at increased risk of short-term morbidity. Study design: We undertook a retrospective analysis of the outcomes of babies who received delivery room resuscitation, and who had seemingly recovered by 5 min age, over a 1 year time period at a single academic institution. The 33 babies were compared with outcomes of 33 controls …

Effects Of A Multicomponent Wellness Intervention On Dyslipidemia Among Overweight Adolescents, Olga Hardy, Jean Wiecha, Albert Kim, Carlos Salas, Rayna Briceno, Kwesi Moody, Joan Becker, Greer Glazer, Carol Ciccarelli, Ling Shi, Laura Hayman

Laura L. Hayman

Behavioral changes are the first line of treatment for dyslipidemia in adolescents, but outcome data on the effectiveness of this approach are inconsistent. This study aims to assess the effect of a 13-week multicomponent wellness intervention program, which included weekly nutrition classes and structured cardiovascular, flexibility, and strength training on dyslipidemia in nine overweight/obese [body mass index (BMI) > or = 85th percentile] and nine lean (BMIpercentile) adolescents. Clinical measurements and lipid profile assessment were performed before and after the intervention. At the completion of the study, the overweight/obese adolescents demonstrated a 15% increase in high-density lipoprotein cholesterol (HDL-C) levels (mean, …

Increased Toll-Like Receptor (Tlr) Mrna Expression In Monocytes Is A Feature Of Metabolic Syndrome In Adolescents, Olga Hardy, Albert Kim, Carol Ciccarelli, Laura Hayman, Jean Wiecha

Laura L. Hayman

BACKGROUND: Metabolic syndrome (MetSyn) is diagnosed frequently in some but not all overweight adolescents. Chronic inflammation, as seen in obesity, is strongly associated with MetSyn. OBJECTIVES: The aim of this pilot study was to assess the correlation between activation of the innate immune system and MetSyn, independent of body mass index (BMI), in a young population. METHODS: We quantitatively measured both systemic pro-inflammatory cytokines and gene expression of Toll-like receptors (TLRs) and downstream cytokines in circulating monocytes obtained from nine adolescents with metabolic syndrome (Overwt-MetSyn) and eight BMI-matched controls (Overwt-Healthy). RESULTS: The Overwt-MetSyn group demonstrated a significant elevation in expression …

Familial Clustering Of Habitual Constipation: A Prospective Study In Children From West Virginia, Yoram Elitsur, Jenna Dolan

Jenna B. Dolan M.D.

Objective: To investigate familial clustering of habitual constipation in pediatric patients who attended our medical facilities.

Patients and Methods: Children with the diagnosis of functional, habitual constipation or patients without constipation and their respective family members were prospectively recruited to our study. Constipation was established in all participants using a standard questionnaire (Rome criteria).

Results: A total of 112 children and their families participated in the study, of which 37 were probands families (test) and 75 children and their respective family members constituted the control group. A total of 310 family members completed the questionnaire. No significant differences were found …