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Search Results: 1 - 10 of 226921 matches for " Nicola R. Boulter "
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Immunological Interactions between 2 Common Pathogens, Th1-Inducing Protozoan Toxoplasma gondii and the Th2-Inducing Helminth Fasciola hepatica
Catherine M. D. Miller, Nicholas C. Smith, Rowan J. Ikin, Nicola R. Boulter, John P. Dalton, Sheila Donnelly
PLOS ONE , 2009, DOI: 10.1371/journal.pone.0005692
Abstract: Background The nature of the immune response to infection is dependent on the type of infecting organism. Intracellular organisms such as Toxoplasma gondii stimulate a Th1-driven response associated with production of IL-12, IFN-γ, nitric oxide and IgG2a antibodies and classical activation of macrophages. In contrast, extracellular helminths such as Fasciola hepatica induce Th2 responses characterised by the production of IL-4, IL-5, IL-10 and IgG1 antibodies and alternative activation of macrophages. As co-infections with these types of parasites commonly exist in the field it is relevant to examine how the various facets of the immune responses induced by each may influence or counter-regulate that of the other. Principal Findings Regardless, of whether F. hepatica infection preceded or succeeded T. gondii infection, there was little impact on the production of the Th1 cytokines IL-12, IFN-γ or on the development of classically-activated macrophages induced by T. gondii. By contrast, the production of helminth-specific Th2 cytokines, such as IL-4 and IL-5, was suppressed by infection with T. gondii. Additionally, the recruitment and alternative activation of macrophages by F. hepatica was blocked or reversed by subsequent infection with T. gondii. The clinical symptoms of toxoplasmosis and the survival rate of infected mice were not significantly altered by the helminth. Conclusions Despite previous studies showing that F. hepatica suppressed the classical activation of macrophages and the Th1-driven responses of mice to bystander microbial infection, as well as reduced their ability to reject these, here we found that the potent immune responses to T. gondii were capable of suppressing the responses to helminth infection. Clearly, the outcome of particular infections in polyparasitoses depends on the means and potency by which each pathogen controls the immune response.
The Role of the P2X7 Receptor in Infectious Diseases
Catherine M. Miller,Nicola R. Boulter,Stephen J. Fuller,Alana M. Zakrzewski,Michael P. Lees,Bernadette M. Saunders,James S. Wiley,Nicholas C. Smith
PLOS Pathogens , 2011, DOI: 10.1371/journal.ppat.1002212
Abstract: ATP is an extracellular signal for the immune system, particularly during an inflammatory response. It is sensed by the P2X7 receptor, the expression of which is upregulated by pro-inflammatory cytokines. Activation of the P2X7 receptor opens a cation-specific channel that alters the ionic environment of the cell, activating several pathways, including (i) the inflammasome, leading to production of IL-1β and IL-18; (ii) the stress-activated protein kinase pathway, resulting in apoptosis; (iii) the mitogen-activated protein kinase pathway, leading to generation of reactive oxygen and nitrogen intermediates; and (iv) phospholipase D, stimulating phagosome-lysosome fusion. The P2X7 receptor can initiate host mechanisms to remove pathogens, most particularly those that parasitise macrophages. At the same time, the P2X7 receptor may be subverted by pathogens to modulate host responses. Moreover, recent genetic studies have demonstrated significant associations between susceptibility or resistance to parasites and bacteria, and loss-of-function or gain-of-function polymorphisms in the P2X7 receptor, underscoring its importance in infectious disease.
Avoid adding insult to injury – correct management of sick female endurance athletes
T Hew-Butler, J Boulter, R Bhorat, TD Noakes
South African Medical Journal , 2012,
Abstract: Objectives. To evaluate the efficacy of Ringer’s lactate, isotonic saline and hypertonic saline on the clinical and biochemical recovery of athletes with exercise-associated hyponatraemic encephalopathy caused by fluid overload. Methods. We retrospectively reviewed serial blood sodium concentrations (Na+) and qualitative signs of recovery and time to recovery in two healthy menstruant females hospitalised with dilutional exercise-associated hyponatraemic encephalopathy after withdrawal from the 2011 Comrades Marathon (89 km) and Argus Cycle Tour (109 km). Results. Improvements in blood Na+ did not occur with intravenous administration of Ringer’s lactate solution, but did occur with administration of isotonic and hypertonic saline. Qualitative improvements in mental status were not quantitatively related to the biochemical value of blood Na+ or subsequent return to normonatraemia. Conclusions. Hyponatraemia should be suspected in all female athletes presenting to the medical area of endurance races with vomiting, altered mental status and a history of high fluid intake. If a diagnosis of exercise-associated hyponatraemia with cerebral encephalopathy is confirmed, the treatment of choice is administration of an intravenous bolus of hypertonic saline. Administration of Ringer’s lactate should be discouraged, as this does not correct Na+ and appears to delay recovery.
Less invasive Achilles tendon reconstruction
Michael R Carmont, Nicola Maffulli
BMC Musculoskeletal Disorders , 2007, DOI: 10.1186/1471-2474-8-100
Abstract: We describe our current method of peroneus brevis reconstruction for the Achilles tendon using two para-midline incisions.This technique allows reconstruction of the Achilles tendon using peroneus brevis preserving skin integrity over the site most prone to wound breakdown, and can be especially used to reconstruct the Achilles tendon in the presence of previous surgery.Acute Achilles tendons ruptures may be managed either operatively or non-operatively. However, generally 6 weeks following a rupture a direct repair opposing the tendon ends becomes increasingly difficult. Over time, scar tissue forms, the muscles atrophy with disuse, and the tendon ends weaken. Chronic and neglected Achilles tendon ruptures are debilitating: their optimal management is surgical [1]. Operative procedures for reconstruction of the Achilles tendon include flap tissue turn down using one [2-4] and two flaps [5], local tendon transfer [6-9], and autologous hamstring tendon harvesting [10]. All of these techniques use a single longitudinal incision for exposure. Following these procedures, complications, especially wound breakdown and infection (9%), are not infrequent, are probably related to the paucity of the soft tissue vascularity, and may require plastic surgical procedures to cover significant soft tissue defects [11-14].We previously described our open technique to allow full exposure for late reconstruction of chronic Achilles tendon tears using peroneus brevis [9]. We describe our current method, using less invasive surgery than an open reconstruction. Our technique uses two para-midline incisions preserving skin integrity over the site most prone to wound breakdown.The patient is positioned prone with a calf tourniquet. Skin preparation is performed in the usual fashion, and sterile drapes are applied. Pre-operative anatomical markings include the palpable tendon defect, both malleoli, and the base of the fifth metatarsal.Three skin incisions are made (Figure 1), and accurate h
Medial patellofemoral ligament reconstruction: a new technique
Michael R Carmont, Nicola Maffulli
BMC Musculoskeletal Disorders , 2007, DOI: 10.1186/1471-2474-8-22
Abstract: We describe our transverse patella double tunnel technique to reconstruct the medial patellofemoral ligament using a free autologous gracilis or semitendinous graft.Patellofemoral dislocations are common, and tend to occur with as a result of quadriceps contraction across a flexed, valgus knee with the weight bearing tibia externally rotated compared to the femur [1]. The dislocation usually reduces spontaneously or with muscle relaxing drugs.Once the normal relationship of the patellofemoral joint is restored, patients may begin their rehabilitation. Non operative management is the recommended option following primary patellar dislocation [2,3]. Conservative management focuses on concentric exercises to strengthen the quadriceps, and especially the vastus medialis, to prevent further instability. If the dislocation recurs after a trial of rehabilitation, operative intervention is considered, with the aim of restoring the soft tissue anatomy to normal. Ninety four percent of patients suffer a tear to the medial patellofemoral ligament (MPFL) following a patellar dislocation [4]. These lesions have been classified according to there anatomic location by Nomura [5]. In cadavers, MPFL reconstruction showed a significant reduction in lateral displacement and ligament load compared with medial transfer of the tibial tuberosity [6].We describe our transverse patella double tunnel technique to reconstruct the medial patellofemoral ligament.The patient is placed supine, with an above knee tourniquet, following the administration of prophylactic antibiotics (Figure 1). Skin preparation and sterile draping is performed in a standard fashion.The tendons of semitendinosus and gracilis are harvested in the usual fashion [7,8]. The tendon is debrided of muscle tissue, prepared with a Vicryl locking suture (Ethicon, Edinburgh) on both ends, sized using anterior cruciate ligament (ACL) tunnel sizers, and stored within a moist swab.The patella is approached through a 4 cm midline in
Management of insertional Achilles tendinopathy through a Cincinnati incision
Michael R Carmont, Nicola Maffulli
BMC Musculoskeletal Disorders , 2007, DOI: 10.1186/1471-2474-8-82
Abstract: We describe our current method of exposure of the Achilles tendon insertion and debridement of the peritendinous and tendon tissue with osteotomy of the calcaneum through a transverse skin incision at the level of the Achilles insertion.This method has been used since 2002 on over 40 patients for exposure of the Achilles tendon insertion and the distal Achilles tendon.The Cincinnati incision allows adequate exposure, has minimal risk of symptomatic iatrogenic nerve injury, and has minimal problems related to the scar.Achilles tendon disorders have been divided into insertional and non-insertional [1]. The distal portion of the Achilles is affected in 24% of patients with Achilles tendinopathy [2], but the actual incidence of insertional Achilles tendinopathy is unknown. Histology of recalcitrant calcific insertional tendinopathy has shown fibrocartilagenous or calcifying metaplasia, with no evidence of inflammation at the tendon insertion [3]. Conservative treatments for Achilles tendinopathy include rest, ice, non-steroidal anti-inflammatory drugs, careful footwear selection and activity avoidance, leading to the resolution of symptoms in most patients. Eccentric exercises of the gastro-soleus complex, although beneficial for midportion tendinopathy, are not as effective for insertional tendinopathy, helping in only 32% of patients [4]. Extra-corporeal sock wave therapy is effective [5], but this modality may not be readily available. Surgery is the mainstay of management for the 10% of patients not responding to 3–6 months of conservative management [6].Traditionally, surgery of the Achilles tendon is performed through longitudinal extensile incisions. Achilles tendon surgery is prone to the complications of wound healing, wound breakdown and iatrogenic nerve injury [7].We describe our current method, used since 2002 on over 40 patients, of exposure of the Achilles tendon insertion and the distal Achilles tendon. Using this approach, a wide exposure of the inserti
Achilles tendon rupture following surgical management for tendinopathy: a case report
Michael R Carmont, Nicola Maffulli
BMC Musculoskeletal Disorders , 2007, DOI: 10.1186/1471-2474-8-19
Abstract: We present a case of Achilles tendon rupture, sustained whilst isometrically loading the Achilles tendon during an eccentric loading exercise programme. Conclusion: Bilateral surgical exploration and debridement had previously been performed after conservative management of bilateral Achilles tendinopathy had been unsuccessful.Achilles tendinopathy is understood to be a failed healing response process involving separation of collagen bundles, increase of hydrophilic extracellular matrix, haphazard neovascularisation, and absence of inflammatory cells [1,2]. Patients present with pain and thickening of the tendon [3]. Tendinopathy may lead to reduced tensile strength and a predisposition to rupture [4]. Management aims to alleviate symptoms and reduce the theoretical risk of rupture. Conservative methods include eccentric loading exercises and the avoidance of aetiological factors [5]. Operative management is utilised following the failure of non-operative methods [6,7].We report the case of a patient who experienced an Achilles tendon rupture following surgical exploration of Achilles tendinopathy.A 44 year old retired Police Officer had a 4 year history of bilateral Achilles tendinopathy. The ailment had been managed conservatively with eccentric loading exercises and the avoidance of aetiological factors [5], but his symptoms failed to settle. The patient underwent surgical exploration to both tendons using a medial approach. The paratendon was excised, and fish mouth fasciotomies of the crural fascia were performed proximally [8]. Small similarly sized nodules were present in both tendons. Longitudinal tenotomies were performed through the nodules within the tendons, and the tendinopathic areas were excised. The fat from Kager's triangle was also detached from the anterior aspect of the tendon [8]. Post-operatively, the patient was immobilised in a below knee synthetic cast, fully weight bearing as able. The casts were removed two weeks after surgery, and routine
Inflationary Perturbations in Palatini Generalised Gravity
Nicola Tamanini,Carlo R. Contaldi
Physics , 2010, DOI: 10.1103/PhysRevD.83.044018
Abstract: We examine the generation of primordial perturbations during an inflationary epoch in generalised theories of gravity when the equations of motion are derived using the Palatini variational principle. Both f(R) and Scalar-Tensor theories are considered and we compare our results with those obtained under the conventional metric formalism. Non-linear generalisations of the action lead to different theories under the two variational choices and we obtain distinct results for scalar and tensor spectral indices and their ratio. We find the following general result; inflation driven solely by f(R) modifications alone do not result in suitable curvature perturbations whilst Scalar-Tensor theories generate nearly scalar invariant curvature perturbations but no tensor modes.
History as Contemporary History in the Thinking of Benedetto Croce  [PDF]
Nicola Conati
Open Journal of Philosophy (OJPP) , 2015, DOI: 10.4236/ojpp.2015.51007
Abstract: In this brief consideration of mine, trying to remain as faithful as possible to the texts taken into exam, I will first try to introduce the concept of history as contemporary history in the thinking of Benedetto Croce, whereas the second part of the reasoning will point toward proving and meditating on how such concept crosses the whole philosophical system of the Italian intellectual. What does contemporary history mean according to Benedetto Croce? Why is the spirit of the historian fundamental in the description of this concept? What kind of connection exists between story and contemporary history? What does pathology of history mean? How does the concept of contemporary history relate to that of awareness, of finished and thinking? These are but a few of the questions to which I tried to find an answer with this essay.
The Psychological Trauma in Children and Adolescents: Scientific and Sociological Profiles  [PDF]
Nicola Malizia
Sociology Mind (SM) , 2017, DOI: 10.4236/sm.2017.71002
Abstract: Despite the research on trauma, which until recent times has been directed towards the category of adults, today scholars need to turn their attention to children and adolescents who may undergo traumatic experiences at different stages of their growth. There is a prevailing hypothesis that the narrow and partial cognitive processes of memory, attention and dysfunctional problem solving skills constitute the main problem of exposure to trauma, which also compromises the family equilibrium, taking into account that traumatic events are arbitrary and unpredictable. It is possible that dissociation phenomena and derealization emerge in response to a traumatic event. The specificity and complexity of the treatment of disorders resulting from traumatic development have prompted specialists of different orientations to formulate guidelines and treatment protocols to guide clinical work.
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