Publications by authors named "Elizabeth Jung"

6 Publications

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Guideline No. 416: Labour, Delivery, and Postpartum Care for People with Physical Disabilities.

J Obstet Gynaecol Can 2021 Feb 22. Epub 2021 Feb 22.

Calgary, AB.

Objective: To describe evidence-based practice for managing the labour, delivery, and postpartum care of people with physical disabilities in Canada.

Target Population: This guideline addresses the needs of people with physical disabilities, with a focus on conditions that affect strength and mobility, as well as those that affect neurological or musculoskeletal function or structure. Although aspects of this guideline may apply to people with solely intellectual, developmental, or sensory disabilities (e.g., hearing and vision loss), the needs of this population are beyond the scope of this guideline.

Outcomes: Safe and compassionate care for people with physical disabilities who are giving birth.

Benefits, Harms, And Costs: Implementation of this guideline will improve health care provider awareness of specific complications people with physical disabilities may experience during labour, delivery, and the postpartum period and therefore increase the likelihood of a safe birth.

Evidence: A literature review was conducted using MEDLINE (474), Embase (36), and the Cochrane Central Register of Controlled Trials (CENTRAL; 28) databases. The results have been filtered for English language, publication date of 2013 to present, observational studies, systematic reviews, meta-analyses, and guidelines and references in these publications were also reviewed.

Validation Methods: The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations).

Intended Audience: Maternal-fetal medicine specialists, obstetricians, family physicians, nurses, midwives, neurologists, physiatrists, and those who care for people with physical disabilities.

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February 2021

Directive clinique n 416 : Soins pendant l'accouchement et la période post-partum chez les personnes ayant un handicap physique.

J Obstet Gynaecol Can 2021 Feb 20. Epub 2021 Feb 20.

Calgary, Alb.

Objectif: Décrire les pratiques fondées sur des données probantes en matière de prise en charge des soins pendant l'accouchement et la période post-partum chez les personnes ayant un handicap physique au Canada.

Population Cible: La présente directive clinique aborde les besoins des personnes ayant un handicap physique en mettant l'accent sur les problèmes de santé qui affectent la force et la mobilité, ainsi que sur ceux qui touchent les fonctions ou structures neurologiques ou musculosquelettiques. Bien que certains aspects de cette directive puissent s'appliquer aux personnes ayant une déficience intellectuelle, un trouble neurodéveloppemental ou un handicap sensoriel (p. ex., perte auditive ou visuelle) seulement, les besoins de cette population sortent du cadre de la présente directive. RéSULTATS: Prestation de soins sûrs et empathiques aux personnes parturientes ayant un handicap physique. BéNéFICES, RISQUES ET COûTS: La mise en œuvre de la présente directive permettra aux fournisseurs de soins de santé de mieux connaître les complications particulières que peuvent présenter les personnes ayant un handicap physique pendant l'accouchement et la période post-partum, ce qui augmentera la probabilité d'un accouchement sécuritaire. DONNéES PROBANTES: Une revue de la littérature a été effectuée à l'aide des bases de données MEDLINE (474), Embase(36) et le Cochrane Central Register of Controlled Trials (CENTRAL; 28). Les résultats ont été filtrés pour obtenir des études observationnelles, des revues systématiques, des méta-analyses et des directives publiées en anglais depuis 2013. Les références de ces articles ont également été passées en revue. MéTHODES DE VALIDATION: Les auteurs ont évalué la qualité des données probantes et la solidité des recommandations en utilisant la méthodologie GRADE (Grading of Recommendations Assessment, Development and Evaluation). Voir l'annexe A en ligne (tableau A1 pour les définitions et tableau A2 pour l'interprétation des recommandations fortes et faibles). PUBLIC VISé: Spécialistes en médecine fœto-maternelle, obstétriciens, médecins de famille, infirmières, sages-femmes, neurologues, physiatres et autres professionnels qui donnent des soins aux personnes ayant un handicap physique.
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February 2021

Safety, tolerability, pharmacokinetics, and immunogenicity of motavizumab, a humanized, enhanced-potency monoclonal antibody for the prevention of respiratory syncytial virus infection in at-risk children.

Pediatr Infect Dis J 2009 Apr;28(4):267-72

Hospital Clínico Pontificia Universidad Católica de Chile, Santiago, Chile.

Background: : Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infection in young children. Motavizumab is an investigational humanized monoclonal antibody for RSV prophylaxis.

Methods: : A dose-escalation study was conducted followed by assessment of safety, tolerability, serum concentrations, and immunogenicity during a second consecutive RSV season. In season 1, premature infants aged < or =6 months or children < or =24 months with chronic lung disease of prematurity received monthly motavizumab (3 or 15 mg/kg). In season 2, children who received > or =3 motavizumab doses in season 1 were randomized to receive monthly motavizumab or palivizumab 15 mg/kg.

Results: : Of 217 children enrolled in season 1, 211 (97.2%) received motavizumab 15 mg/kg and 205 (94.5%) patients completed the study through 90 days after the final dose. In season 2, 136 children were randomized to receive motavizumab (n = 66) or palivizumab (n = 70). The most commonly reported related adverse event was transient injection site erythema. In season 1, mean trough motavizumab concentrations were 7.9 and 50.2 microg/mL after the 3- and 15-mg/kg doses, respectively. Trough concentrations increased with repeated motavizumab dosing; a similar pattern was seen in season 2. Antimotavizumab reactivity occurred infrequently (3.3%) in season 1. In season 2, no treatment group-specific antidrug antibody was detected through 90 to 120 days after dosing with either product.

Conclusions: : The pharmacokinetic profile of motavizumab was similar to that of other IgG1 antibodies. Increased adverse reactions or immunogenicity were not observed during and after a second season of treatment with motavizumab. Safety findings from these studies supported the continued development of motavizumab.
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April 2009

The endoplasmic reticulum exit of glutamate transporter is regulated by the inducible mammalian Yip6b/GTRAP3-18 protein.

J Biol Chem 2008 Mar 31;283(10):6175-83. Epub 2007 Dec 31.

Department of Neuroscience, Johns Hopkins University, 625 N. Wolfe Street, Baltimore, MD 21287, USA.

GTRAP3-18 interacts with and reduces the activity of the neuronal specific Na(+)/K(+) glutamate transporter, EAAC1 both in vitro and in vivo. GTRAP3-18 and the related isoform, JM4, are distant relatives of the Rab GTPase-interacting factor PRA1, and share a topology of four transmembrane domains and cytosolic termini. GTRAP3-18 and JM4 are resident endoplasmic reticulum (ER) proteins. The physiological role of GTRAP3-18 is poorly understood. We demonstrate for the first time that GTRAP3-18 is a regulator of ER protein trafficking. Expression of GTRAP3-18 delays the ER exit of EAAC1, as well as other members of the excitatory amino acid transporter family. GTRAP3-18 uses hydrophobic domain interactions in the ER membrane to self-associate and cytoplasmic interactions at the C terminus to regulate trafficking. The features of GTRAP3-18 activity are consistent with recent phylogenic sequence analyses suggesting GTRAP3-18 and JM4 be reclassified as mammalian isoforms of the yeast protein family Yip, Yip6b, and Yip6a, respectively.
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March 2008

Clinical trial of safety and efficacy of INH-A21 for the prevention of nosocomial staphylococcal bloodstream infection in premature infants.

J Pediatr 2007 Sep 24;151(3):260-5, 265.e1. Epub 2007 Jul 24.

DeVos Children's Hospital, Grand Rapids, Michigan, USA.

Objective: To determine if INH-A21, an intravenous immune globulin (IGIV) derived from donors with high titers of antibody to surface adhesins of Staphylococcus epidermidis and S. aureus prevents late-onset sepsis (LOS) in very low birth weight (VLBW) infants.

Study Design: In this double-blind, placebo-controlled study, infants with birth weights 500 to 1250 g were randomized to receive up to four doses of INH-A21 (Veronate) or placebo. The primary objective was to determine the safety and efficacy of INH-A21 versus placebo for prevention of S. aureus LOS in VLBW infants.

Results: A total of 1983 infants from 95 neonatal intensive care units were randomized, and received at least one dose of study drug. S. aureus LOS developed in 50 of 989 (5%) and 60 of 994 (6%) infants who received placebo or INH-A21, respectively (P = .34). No differences were found in the frequencies of LOS caused by coagulase-negative staphylococci (CoNS), Candida spp, or overall mortality. No adverse events were statistically significantly associated with INH-A21 infusions compared with placebo.

Conclusion: INH-A21 failed to reduce the incidence of staphylococcal LOS or candidemia in premature infants.
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September 2007

Multicenter study to assess safety and efficacy of INH-A21, a donor-selected human staphylococcal immunoglobulin, for prevention of nosocomial infections in very low birth weight infants.

Pediatr Infect Dis J 2005 Oct;24(10):858-66

Wesley Medical Center, Wichita, KS, USA.

Background: Prophylactic administration of intravenous immunoglobulin has been inconsistent in reducing the risk of sepsis in very low birth weight (VLBW) infants presumably because of varying titers of organism specific IgG antibodies. INH-A21 is an intravenous immunoglobulin from donors with high titers of antistaphylococcal antibodies. This dose-ranging study explored safety and preliminary activity of INH-A21 for prevention of staphylococcal sepsis in VLBW infants.

Methods: This was a multicenter, double blind, group-sequential study. Infants with birth weights 500-1250 g were randomized to receive up to 4 doses of placebo, 250 mg/kg, 500 mg/kg or 750 mg/kg INH-A21. Safety and frequencies of sepsis were compared across treatment groups.

Results: All treatment groups had similar mean gestational age, birth weight, Apgar score and maternal use of antibiotics. Randomizations to 250 mg/kg (N = 94) and 500 mg/kg (N = 96) doses were terminated after interim analyses demonstrated a low probability of finding a difference when compared with placebo. Infants randomized to the INH-A21 750 mg/kg group (N = 157) had fewer episodes of Staphylococcus aureus sepsis [relative risk (RR), 0.37; 95% confidence interval (CI), 0.12-1.12; P = 0.14], candidemia (RR 0.34; 95% CI 0.09-1.22; P = 0.09) and mortality (RR 0.64; 95% CI 0.25-1.61; P = 0.27) when compared with the placebo-treated cohort (N = 158). No dose-related trends were observed for adverse events or morbidities associated with prematurity.

Conclusions: INH-A21 750 mg/kg demonstrated potential to reduce sepsis caused by S. aureus, candidemia and mortality in VLBW infants. Although statistical significance was not reached, based on the magnitude of the estimated differences, the efficacy and safety of INH-A21 750 mg/kg should be evaluated in an adequately powered, well-controlled study.
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October 2005