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On the Evaluation of Auto-Contouring in Radiotherapy
Published in Jinzhong Yang, Gregory C. Sharp, Mark J. Gooding, Auto-Segmentation for Radiation Oncology, 2021
Voet et al. [37] asked the question as to whether auto-contours need editing by first evaluating B3 for the elective nodal volumes in the head and neck. B3 shows the impact of dose to structures should a plan be generated with unedited contours, on the assumption that the adjusted auto-contours are correct and represent the true anatomy. Therefore, this could be used to assess potential under-dosage to the Planning Treatment Volume (PTV) resulting from not editing contours. Subsequently they compared C2 to C3. C3 represents the DVH for OAR doses that would be performed during clinical planning using edited auto-contours, whereas C2 gives the DVH that would be found if the contours were not edited. However, this comparison assumes that the OAR dose is not critical to the plan generated. Thus, they suggest that auto-contours of OARs only need editing if they are approaching a critical planning dose.
Inherited Defects in Immune Defenses Leading to Pulmonary Disease
Published in Stephen D. Litwin, Genetic Determinants of Pulmonary Disease, 2020
Hereditary C2 deficiency has been described in over 20 families containing individuals who are homozygotes for a "null" gene failing to synthesize C2. This group is remarkable for their increased incidence of connective tissue disorders such as systemic lupus erythematosus, polymyositis, and Henoch-Schonlein purpura [116-118]. C2 is synthesized by macrophages; these cells appear to be otherwise normal in affected persons [119]. C2 deficiency is determined by a gene linked to the HLA histocompatibility gene complex. Family studies analyzing heterozygotes as well as homozygotes for C2 deficiency show that there is a low recombination frequency between the C2 deficiency gene and the histocompatibility B-locus gene with the sequence of genes on the chromosome being histocompatibility A, B, and D loci, factor Β (an alternate complement pathway factor) locus, and C2 locus [42].
Host Defense I: Non-specific Immunity
Published in Constantin A. Bona, Francisco A. Bonilla, Textbook of Immunology, 2019
Constantin A. Bona, Francisco A. Bonilla
Hereditary angioedema results from a deficiency or defect of C1 esterase inhibitor. The absence of C1INH leads to unrestrained proteolysis of C2 and C4 by activated C1s*. The precise mechanism leading to tissue edema is unknown. A vasoactive fragment of C2 may be responsible. The disease is characterized by periodic acute subepithelial swelling, involving predominantly the skin of the extremities, and the gastrointestinal mucosa. Swelling in the oropharynx may be fatal due to asphyxiation. Inheritance is autosomal dominant.
Efficacy and safety of broad spectrum penicillin with or without beta-lactamase inhibitors vs first and second generation cephalosporins as prophylactic antibiotics during cesarean section: a systematic review and meta-analysis
Published in Journal of Obstetrics and Gynaecology, 2023
Qianqian Song, Jingjing Yan, Na Bu, Ying Qian
The most common pathogens isolated from wound infection included Ureaplasma, Staphylococcus and Enterococcus, these can contaminate the myometrium, uterine blood vessels and lymphatic vessels, leading to infections including endometritis during surgery (Jaiyeoba 2012). C1&C2 have been widely used as preventive measures in obstetrics and gynecology surgery. However, they are naturally resistant to Enterococcus but stable to the betalactamase-producing Staphylococci (Bratzler et al.2013, García-Solache and Rice 2019). It is reported that Enterococcus are the most common pathogens in cases of endometritis following cephalosporins prophylaxis (Newton and Wallace 1998). Compared with C1&C2, P2 is effective against Enterococcus and other gram-negative bacteria, but not against Staphylococci. P2+ have a broader antimicrobial spectrum than C1&C2 and are active against gram-positive, gram-negative and anaerobic bacteria, including S.aureus, Enterococci, Streptococci, many Enterobacterales and Bacteroides spp. The aim of the present analysis was to evaluate the efficacy of P2/P2+ which are routinely used clinically vs C1&C2 which are the first choices as prophylactic antibiotics during cesarean delivery.
Complement system network in cell physiology and in human diseases
Published in International Reviews of Immunology, 2021
Roberta Romano, Giuliana Giardino, Emilia Cirillo, Rosaria Prencipe, Claudio Pignata
The classical pathway is initiated by the interaction of immune complexes, made of the Fc portion of IgM or IgG and antigens, with the first zymogen of the cascade, C1q which, in resting conditions, forms an inactive complex with C1r and C1s. Upon interaction with immune complexes, C1q activates C1r, which, in turn, cleaves and activates C1s (Figure 1A). This induces the cleavage of two other components, C2 and C4, with the formation of the complex C4b2a, which hydrolyzes C3 into C3a and C3b that, respectively, recruits inflammatory cells and binds to the C4b2a complex forming C5 convertase [10]. The latter is responsible for the formation of the Membrane Attack Complex that induces lysis of bacterial membranes inserting functional pores in it [1]. Also, viral proteins, apoptotic cells and C-reactive protein can trigger this pathway independently of the presence of antibodies.
A Qualitative Framework of Cumulative Risk and Protection for Understanding Neurodevelopment and Clinical Progress: A Multiple Case Study Approach
Published in Evidence-Based Practice in Child and Adolescent Mental Health, 2021
Bianca C. Bondi, Debra J. Pepler, Mary Motz, Naomi C.Z. Andrews
C1 demonstrated social-emotional concerns that manifested through negative externalizing behaviors. C1 was rated by mother C as having a difficult temperament and mother C noted a challenging mother-child relationship. C1 showed aggressive behaviors both at home and at school, and clinicians were concerned for C1’s risk of mental health problems. C1 had average to high average cognitive abilities. C2 was not reported by mother C or at school to be showing social-emotional or behavioral concerns; however, clinicians were concerned about C2 experiencing unreported internalizing behaviors. C2 endorsed symptoms of deprivation, a lack of safety, as well as loss and separation. C2 was seen as a compliant child who engaged in desirable behaviors to please adults, rated by mother C as having an easy temperament. C2 lacked strong peer relationships and had some speech articulation concerns, for which speech and language supports were received. C2 showed average cognitive and academic achievement. Given these difficulties, clinicians were concerned that C2 would be at high risk for future mental health problems. Both C1 and C2 were in daycare and received psychological assessment at BTC. C2 also accessed speech and language supports. C1 and C2 had access to physician follow-up.