RESUMEN
Over 125 million years of ant-plant interactions have culminated in one of the most intriguing evolutionary outcomes in life history. The myrmecophyte Duroia hirsuta (Rubiaceae) is known for its mutualistic association with the ant Myrmelachista schumanni and several other species, mainly Azteca, in the north-western Amazon. While both ants provide indirect defences to plants, only M. schumanni nests in plant domatia and has the unique behaviour of clearing the surroundings of its host tree from heterospecific plants, potentially increasing resource availability to its host. Using a 12-year survey, we asked how the continuous presence of either only M. schumanni or only Azteca spp. benefits the growth and defence traits of host trees. We found that the continuous presence of M. schumanni improved relative growth rates and leaf shearing resistance of Duroia better than trees with Azteca. However, leaf herbivory, dry matter content, trichome density, and secondary metabolite production were the same in all trees. Survival depended directly on ant association (> 94% of trees died when ants were absent). This study extends our understanding of the long-term effects of strict ant-plant mutualism on host plant traits in the field and reinforces the use of D. hirsuta-M. schumanni as a model system suitable for eco-co-evolutionary research on plant-animal interactions.
Asunto(s)
Hormigas , Mirmecófitas , Hojas de la Planta , Rubiaceae , Simbiosis , Animales , Hormigas/fisiología , Herbivoria , Mirmecófitas/crecimiento & desarrollo , Mirmecófitas/fisiología , Hojas de la Planta/crecimiento & desarrollo , Rubiaceae/crecimiento & desarrollo , Rubiaceae/fisiología , Árboles/crecimiento & desarrolloRESUMEN
INTRODUCTION: Efficient delivery of therapeutics across the blood-brain barrier (BBB) for the treatment of central nervous system (CNS) tumors is a major challenge to the development of safe and efficacious therapies. Locoregional drug delivery platforms offer an improved therapeutic index by achieving high drug concentrations in the target tissue with negligible systemic exposure. Intrathecal (intraventricular) [IT] and convection-enhanced delivery [CED] are two clinically relevant methods being employed for various CNS malignancies. Both of these standalone platforms suffer from passive post-administration distribution forces, sometimes limiting the desired distribution for tumor therapy. Focused ultrasound and microbubble-mediated blood-brain barrier opening (FUS-BBBO) is a recent modality used for enhanced drug delivery. It is postulated that coupling of FUS with these alternative delivery routes may provide benefits. Multimodality FUS may provide the desired ability to increase the depth of parenchymal delivery following IT administration and provide a means for contour directionality with CED. Further, the transient enhanced permeability achieved with FUS-BBBO is well established, but drug residence and transit times, important to clinical dose scheduling, have not yet been defined. The present investigation comprises two discrete studies: 1. Conduct a comprehensive quantitative evaluation to elucidate the effect of FUS-BBBO as it relates to varying routes of administration (IT and IV) in its capacity to facilitate drug penetration within the striatal-thalamic region. 2. Investigate the impact of combining FUS-BBBO with CED on drug distribution, with a specific focus on the temporal dynamics of drug retention within the target region. METHODS: Firstly, we quantitatively assessed how FUS-BBBO coupled with IT and IV altered fluorescent dye (Dextran 2000 kDa and 70 kDa) distribution and concentration in a predetermined striatal-thalamic region in naïve mice. Secondly, we analyzed the pharmacokinetic effects of using FUS mediated BBB disruption coupled with CED by measuring the volume of distribution and time-dependent concentration of the dye. RESULTS: Our results indicate that IV administration coupled with FUS-BBBO successfully enhances delivery of dye into the pre-defined sonication targets. Conversely, measurable dye in the sonication target was consistently less after IT administration. FUS enhances the distribution volume of dye after CED. Furthermore, a shorter time of residence was observed when CED was coupled with FUS-BBBO application when compared to CED alone. CONCLUSION: 1. Based on our findings, IV delivery coupled with FUS-BBBO is a more efficient means for delivery to deep targets (i.e. striatal-thalamic region) within a predefined spatial conformation compared to IT administration. 2. FUS-BBBO increases the volume of distribution (Vd) of dye after CED administration, but results in a shorter time of residence. Whether this finding is reproducible with other classes of agents (e.g., cytotoxic agents, antibodies, viral particles, cellular therapies) needs to be studied.
Asunto(s)
Neoplasias Encefálicas , Encéfalo , Ratones , Animales , Barrera Hematoencefálica , Sistemas de Liberación de Medicamentos/métodos , Neoplasias Encefálicas/tratamiento farmacológico , Sonicación/métodos , MicroburbujasRESUMEN
Low-grade gliomas are a broad category of tumors that can manifest at different stages of life. As a group, their prognosis has historically been considered to be favorable, and surgery is a mainstay of treatment. Advances in the molecular characterization of individual lesions has led to newer classification systems, a better understanding of the biological behavior of different neoplasms, and the identification of previously unrecognized entities. New prospective genetic and molecular data will help delineate better treatment paradigms and will continue to change the taxonomy of central nervous system tumors in the coming years. Advances in the field of radiomics will help predict the molecular profile of a particular tumor through noninvasive testing. Similarly, more precise methods of intraoperative tumor tissue analysis will aid surgical planning. Improved surgical outcomes propelled by novel surgical techniques and intraoperative adjuncts and emerging forms of medical treatment in the field of immunotherapy have enriched the management of these lesions. We review the contemporary management and innovations in the treatment of low-grade gliomas.
Asunto(s)
Neoplasias Encefálicas , Neoplasias del Sistema Nervioso Central , Glioma , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/cirugía , Glioma/diagnóstico por imagen , Glioma/cirugía , Humanos , Pronóstico , Estudios ProspectivosRESUMEN
Otitis externa is an inflammatory disease of the external ear canal; a therapeutic alternative is the controlled-flux electrolyzed acidic solution (SAEFC) with bactericidal and bacteriostatic properties. The purpose of this study was to evaluate the clinical and cytological efficacies of SAEFC in otitis externa. A total of 30 dogs were examined. The clinical and cytological evaluations were on days 1, 7 and 14; the following was considered: Pain, erythema, exudate, inflammation, ulcers, putrid odor and pigmentation. Cytological evaluations were carried out to examine the presence of polymorphonuclear leukocytes (PMN), intra-cellular bacteria (cocci; IC), extra-cellular bacteria (EC) and yeasts on days 1, 7 and 14. A cotton swab saturated with SAEFC was applied for each dog's ear. The values of PMN diminished having a significant difference between days. The presence of IC (cocci) had a difference in evaluations from day 1 to day 7 and from day 7 to day 14 demonstrating an important drop. The evaluation of pain showed a sustained decrease until reaching 95.00% of remission, erythema diminished 68.33%, the exudate dropped to 90.00%, inflammation was no longer present by day 14 in 78.00% of the cases and 21.67% showed a slight inflammation, the putrid odor dropped to 95.00% and 5.00% presented a mild odor and by day 14 ear pigmentation was no longer present in 51.67% of the cases and the 48.33% had slight pigmentation. The use of SAEFC is an effective alternative treatment in dogs with otitis externa.
RESUMEN
OBJECTIVE: Screening for cervical spine injury after blunt trauma is common, but there remains varied practice patterns and clinical uncertainty regarding adequate radiographic evaluation. An oft-cited downside of MRI is the added risk compared to CT in the pediatric population; however, these specific risks have not yet been reported. This study examines the risks of cervical spine MRI in pediatric trauma patients in the context of what value MRI adds. METHODS: This was a retrospective observational study of all pediatric blunt trauma patients who were evaluated with a cervical spine MRI over a 4-year period at a level 1 pediatric trauma center. Clinical and radiographic data were abstracted, as well as anesthesia requirements and MRI-related major adverse events. CT and MRI results were compared for their ability to detect clinically unstable injuries - those requiring halo or surgery. RESULTS: There was one major adverse event related to MRI among the 269 patients who underwent cervical spine MRI - a rate of 0.37%. While 55% of children had an airway and anesthesia for MRI, only 57% of these airways were newly placed for the MRI. None of the 85 patients newly intubated for MRI developed aspiration pneumonitis or ventilator-associated pneumonia, and no patients had a significant neurologic event while at MRI. Another area of the body was imaged concurrently with the cervical spine MRI in 64% of patients and 83% of MRIs were performed within 48 h. CT and MRI were both 100% sensitive for injuries requiring halo or operative intervention. Eighty-three patients had an MRI performed after a negative CT, 11% (9/83) of these patients had a clinically stable injury detected on subsequent MRI, and none of these patients presented for delayed cervical spine complications. CONCLUSIONS: Overall, the safety profile of MRI in this setting is excellent and less than one-third of patients need new airway and anesthesia solely for MRI. In this clinical scenario, MRIs can happen relatively quickly and many patients require another body part to be imaged concurrently anyway. MRI and CT were both 100% sensitive for clinically unstable injuries. In the appropriate patients, MRI remains a safe and radiation-free alternative to CT.
Asunto(s)
Traumatismos del Cuello , Traumatismos Vertebrales , Heridas no Penetrantes , Humanos , Niño , Toma de Decisiones Clínicas , Tomografía Computarizada por Rayos X/métodos , Incertidumbre , Traumatismos Vertebrales/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Traumatismos del Cuello/complicaciones , Vértebras Cervicales/diagnóstico por imagen , Vértebras Cervicales/lesiones , Heridas no Penetrantes/diagnóstico por imagen , Heridas no Penetrantes/complicaciones , Estudios RetrospectivosRESUMEN
Acromegaly results from excessive secretion of insulinlike growth factor-1 and growth hormone, which most commonly occurs because of pituitary somatotrophinoma. Diagnostic features of acromegaly include elevated insulinlike growth factor-1 and growth hormone; lesion on brain MRI; and clinically dysmorphic features, such as soft tissue swelling, jaw prognathism, and acral overgrowth. Transsphenoidal resection is the primary therapy for individuals with acromegaly, even in the cases where gross total resection is not possible because of parasellar extension and cavernous sinus involvement. For recurrent or persistent disease after resection, systemic medications and stereotactic radiosurgery are used.
Asunto(s)
Acromegalia , Adenoma , Adenoma Hipofisario Secretor de Hormona del Crecimiento , Hormona de Crecimiento Humana , Neoplasias Hipofisarias , Radiocirugia , Acromegalia/diagnóstico , Acromegalia/etiología , Acromegalia/cirugía , Adenoma/cirugía , Adenoma Hipofisario Secretor de Hormona del Crecimiento/complicaciones , Adenoma Hipofisario Secretor de Hormona del Crecimiento/patología , Adenoma Hipofisario Secretor de Hormona del Crecimiento/cirugía , Humanos , Neoplasias Hipofisarias/complicaciones , Neoplasias Hipofisarias/cirugía , Radiocirugia/efectos adversos , Radiocirugia/métodos , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Rheumatoid arthritis (RA)-associated interstitial lung disease (RA-ILD) is the most common pulmonary complication of RA, increasing morbidity and mortality. Anti-citrullinated protein antibodies have been associated with the development and progression of both RA and fibrotic lung disease; however, the role of protein citrullination in RA-ILD remains unclear. Here, we demonstrate that the expression of peptidylarginine deiminase 2 (PAD2), an enzyme that catalyzes protein citrullination, is increased in lung homogenates from subjects with RA-ILD and their lung fibroblasts. Chemical inhibition or genetic knockdown of PAD2 in RA-ILD fibroblasts attenuated their activation, marked by decreased myofibroblast differentiation, gel contraction, and extracellular matrix gene expression. Treatment of RA-ILD fibroblasts with the proteoglycan syndecan-2 (SDC2) yielded similar antifibrotic effects through regulation of PAD2 expression, phosphoinositide 3-kinase/Akt signaling, and Sp1 activation in a CD148-dependent manner. Furthermore, SDC2-transgenic mice exposed to bleomycin-induced lung injury in an inflammatory arthritis model expressed lower levels of PAD2 and were protected from the development of pulmonary fibrosis. Together, our results support a SDC2-sensitive profibrotic role for PAD2 in RA-ILD fibroblasts and identify PAD2 as a promising therapeutic target of RA-ILD.
Asunto(s)
Artritis Reumatoide/genética , Lesión Pulmonar/genética , Arginina Deiminasa Proteína-Tipo 2/genética , Fibrosis Pulmonar/genética , Sindecano-2/genética , Animales , Anticuerpos Antiproteína Citrulinada/genética , Artritis Reumatoide/complicaciones , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/patología , Bleomicina/toxicidad , Citrulinación/genética , Fibroblastos/metabolismo , Regulación de la Expresión Génica/genética , Humanos , Pulmón/metabolismo , Pulmón/patología , Lesión Pulmonar/inducido químicamente , Lesión Pulmonar/complicaciones , Lesión Pulmonar/patología , Ratones , Ratones Transgénicos , Fosfatidilinositol 3-Quinasas/genética , Proteínas Proto-Oncogénicas c-akt/genética , Fibrosis Pulmonar/complicaciones , Fibrosis Pulmonar/tratamiento farmacológico , Fibrosis Pulmonar/patología , Proteínas Tirosina Fosfatasas Clase 3 Similares a Receptores , Factor de Transcripción Sp1/genéticaRESUMEN
OBJECTIVE: Transforaminal endoscopic colloid cyst resection is well described. However, some anatomical colloid cyst variants may warrant a modified approach. Rarely, colloid cysts separate the forniceal columns and grow superiorly within the leaflets of the septum pellucidum. Thus, the authors' goal was to characterize the imaging features, clinical presentation, surgical strategy, and outcomes of patients with this superiorly recessed colloid cyst variant. METHODS: A retrospective evaluation of patients who underwent endoscopic resection of colloid cysts from 1999 to 2020 was performed. The patients were dichotomized depending on whether the cyst was located predominately below the forniceal columns or was superiorly recessed (forniceal column separation with variable intraseptal extension). This comparative cohort study focused on clinical presentation, imaging features, operative technique, and patient outcome. RESULTS: In total, 182 patients were identified. Seventeen patients had colloid cysts that were defined as superiorly recessed and underwent transseptal interforniceal removal, and 165 patients underwent a standard transforaminal approach. Patients had similar demographic characteristics. However, transseptal cysts were on average larger (17.8 mm vs 11.4 mm, p < 0.0001), and these patients had a greater frontal-occipital horn ratio (0.45 vs 0.41, p = 0.012). They were also more likely to have undergone a previous resection (p = 0.02). The two cohorts had similar surgical outcomes, with no differences in extent of resection, recurrence, or complications. CONCLUSIONS: Superiorly recessed intraseptal colloid cysts are larger and tend to splay the bodies of the fornix, thus requiring a parasagittal transseptal interforniceal endoscopic approach. This achieves complete removal with comparatively negligible morbidity or rare recurrence (5.9%).
RESUMEN
OBJECTIVES: Intracranial arachnoid cysts are commonly characterized as congenital. Evidence to support a congenital origin is scant and documented evolution during infancy also calls into question the genesis of these lesions. To improve our understanding of the natural history and the clinical significance of arachnoid cysts on prenatal ultrasound, we conducted a study to describe the fate of these cysts after initial diagnosis. METHODS: We conducted a retrospective descriptive review of all prenatal ultrasounds with reported intracranial arachnoid cysts at a tertiary care center from 2010 to 2016 and cohort study comparing patients with additional ultrasound abnormalities to those with an isolated finding of arachnoid cyst. Data collected included gestational age at cyst diagnosis, cyst evolution on follow-up imaging, cyst size and cyst location, postnatal imaging and neurosurgical consultation and intervention. Statistical analysis including Chi-square and Fisher's exact tests and univariate logistic regressions were performed using Stata v. 13 (StataCorp 2013. Stata Statistical Software: Release 13. College Station, TX: StataCorp LP). Confidence intervals were reported at 95% and a p-value < .05 was considered significant. RESULTS: A total of 33,621 anatomical ultrasound scans were performed from 2010 to 2016. Seventy patients (0.2%) had prenatal findings of arachnoid cyst, of which the mean gestational age was 21.46 weeks. Ventriculomegaly was observed in one patient (1.4%) at the time of diagnosis and other abnormalities were found in twelve patients (17%). Complete sonographic follow-up prior to delivery was obtained in 53 (75.7%) patients with 5(9.4%) progression, 5(9.4%) regression, and 43(81.1%) no longer visualized. Forty-three cysts (81.1%) were no longer visualized on follow-up imaging, all of which were interhemispheric in location. All of the cysts that progressed in size on prenatal ultrasounds were > 2 cm in size on initial diagnosis. Cyst fenestration was performed in two patients (2.9%) that had arachnoid cysts measuring at least 3 cm in each dimension on prenatal imaging, one at eight months and one at six months of age. Patients with and without additional sonographic abnormalities had similar rates of AMA (23.1% vs 26.3%, p = .56), nulliparity (61.5% vs 70.2%, p = .38), obesity (0.0% vs 12.3%, p = .221), major medical comorbidities (38.5% vs 33.3%, p = .48) and pregnancy achieved via Assisted Reproductive Technology (38.5% vs 24.6%, p = .25), respectively. Patients with additional sonographic abnormalities were significantly more likely to have prenatal Magnetic Resonance Imaging (OR: 8.28, CI: 1.84-40.4, p = .07), prenatal neurosurgery consultation (OR: 8.25, CI: 1.23-69.05, p = .04) and invasive diagnostic genetic testing (OR: 11.25, CI: 2.33-64.35, p = .003). CONCLUSIONS: Arachnoid cysts are infrequently found on prenatal screening. Size greater than 2 cm on second trimester ultrasound and location outside of the interhemispheric fissure may indicate the need for further evaluation and eventual fenestration. Prenatally diagnosed arachnoid cysts are not typically associated with other anatomic or genetic abnormalities, although the presence of additional abnormalities usually leads to more intensive prenatal and postnatal investigations.
Asunto(s)
Quistes Aracnoideos , Hidrocefalia , Quistes Aracnoideos/complicaciones , Quistes Aracnoideos/diagnóstico por imagen , Quistes Aracnoideos/cirugía , Niño , Estudios de Cohortes , Femenino , Humanos , Hidrocefalia/diagnóstico por imagen , Hidrocefalia/etiología , Hidrocefalia/cirugía , Lactante , Imagen por Resonancia Magnética/métodos , Embarazo , Pronóstico , Estudios RetrospectivosRESUMEN
INTRODUCTION: Tethered cord syndrome (TCS) is an amalgamation of neurological, urological, orthopedic, and dermatologic signs and symptoms with radiographic evidence of a thickened filum and low-lying conus. Surgical sectioning of the filum and disconnection of any tethering entities such as dermal sinus tracts or lipomas has been shown to improve outcomes. The manifestation of TCS symptoms in the absence of a low-lying conus has been referred to as occult tethered cord syndrome (OTCS) and is much less well reviewed in the literature. To date, there has only been one randomized controlled trial examining the effect of intervention in OTCS; therefore, contemporary data is often elicited from limited cohorts. OBJECTIVE: To perform a comprehensive literature review of management in OTCS and evaluate treatment response rates to sectioning of the filum terminale. RESULTS: Seventeen papers met inclusion criteria for our review. Sample sizes ranged from 8 to 60 children, and results were mixed, often dependent on study design, definition of typical OTCS symptoms, and follow-up intervals. Symptomatic improvement was observed in > 50% of patients for all but one study; however, the recurrence rates were highly variable. CONCLUSION: The data regarding the efficacy of surgical treatment in OTCS is mixed and merits more rigorous scientific examination with strict and clear parameters regarding symptomatic operationalization and follow-up time points to monitor for TCS recurrence.
Asunto(s)
Cauda Equina , Lipoma , Defectos del Tubo Neural , Cauda Equina/diagnóstico por imagen , Cauda Equina/cirugía , Niño , Humanos , Recurrencia Local de Neoplasia , Defectos del Tubo Neural/diagnóstico por imagen , Defectos del Tubo Neural/cirugíaRESUMEN
PURPOSE: A new class of heart-rate sensing, closed-loop vagal nerve stimulator (VNS) devices for refractory epilepsy may improve seizure control by using pre-ictal autonomic changes as an indicator for stimulation. We compared our experience with closed- versus open-loop stimulator implantation at a single institution. METHODS: We conducted a retrospective chart review of consecutive VNS implantations performed from 2004 to 2018. Bivariate and multivariable analyses were performed to compare changes in seizure frequency and clinical outcomes (Engel score) with closed- versus open-loop devices. Covariates included age, duration of seizure history, prior epilepsy surgery, depression, Lennox Gastaut Syndrome (LGS), tonic seizures, multiple seizure types, genetic etiology, and VNS settings. We examined early (9-month) and late (24-month) outcomes. RESULTS: Seventy subjects received open-loop devices, and thirty-one received closed-loop devices. At a median of 8.5 months, there was a greater reduction of seizure frequency after use of closed-loop devices (median 75% [IQR 10-89%]) versus open-loop (50% [0-78%], p < 0.05), confirmed in multivariable analysis (odds ratio 2.72 [95% CI 1.02 - 7.4]). Similarly, Engel outcomes were better after closed-loop compared to open-loop confirmed in the multivariable analysis at the early timepoint (OR 0.26 [95% CI 0.09 - 0.69]). These differences did not persist at a median of 24.5 months. CONCLUSIONS: This retrospective single-center study suggests the use of closed-loop VNS devices is associated with greater seizure reduction and more favorable clinical outcomes than open-loop devices at 9-months though not at 24-months. Expansion of this study to other centers is warranted to increase the generalizability of our study.
Asunto(s)
Epilepsia Refractaria , Epilepsia , Estimulación del Nervio Vago , Epilepsia Refractaria/terapia , Epilepsia/terapia , Humanos , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
BACKGROUND AND AIM: Rabbits often experience skin diseases. The beneficial effects of plant extracts and essential oils are well known in other species, but the properties of these natural ingredients have not been evaluated in rabbits in vivo. The objective of the current study was to evaluate the effect of a topical, commercial solution made of essential oils, plant-extracted polyunsaturated fatty acids, and Vitamin E on rabbits suffering from skin problems. MATERIALS AND METHODS: Thirty New Zealand rabbits (no sex distinction) were included in this study, with an average weight of 2-3 kg. The rabbits were divided into two groups: The first group was treated with a topical solution made from natural ingredients, and the second was a control group. The rabbits' hair and skin conditions were evaluated on days 1, 14, 28, and 35 after treatment. Data were analyzed using a Kruskal-Wallis range test. RESULTS: Significant differences were determined in terms of glossy hair variability on days 28 and 35 (p≤0.0001). On days 14-35, hair loss was determined to have reduced (p=0.001), and flaking and odor improved in the treatment group, showing increased scores and significant differences (p=0.0001). By contrast, the control group showed stable overall skin and hair score and an increase in the dryness score. CONCLUSION: The topical application of essential oils and polyunsaturated fatty acids with Vitamin E was able to improve hair shine and skin hydration and reduce flaking, bad odor, and hair loss, improving the general, and cutaneous aspect of rabbits.
RESUMEN
Studies of altitudinal and latitudinal gradients have identified links between the evolution of insect flight morphology, landscape structure and microclimate. Although lowland tropical rainforests offer steeper shifts in conditions between the canopy and the understorey, this vertical gradient has received far less attention. Butterflies, because of their great phenotypic plasticity, are excellent models to study selection pressures that mould flight morphology. We examined data collected over 5 years on 64 Nymphalidae butterflies in the Ecuadorian Chocó rainforest. We used phylogenetic methods to control for similarity resulting from common ancestry, and explore the relationships between species stratification and flight morphology. We hypothesized that species should show morphological adaptations related to differing micro-environments, associated with canopy and understorey. We found that butterfly species living in each stratum presented significantly different allometric slopes. Furthermore, a preference for the canopy was significantly associated with low wing area to thoracic volume ratios and high wing aspect ratios, but not with the relative distance to the wing centroid, consistent with extended use of fast flapping flight for canopy butterflies and slow gliding for the understorey. Our results suggest that microclimate differences in vertical gradients are a key factor in generating morphological diversity in flying insects.
Asunto(s)
Mariposas Diurnas/fisiología , Vuelo Animal , Bosque Lluvioso , Adaptación Fisiológica , Animales , Evolución Biológica , Alas de AnimalesRESUMEN
The efficacy of afoxolaner was evaluated in two captive Burmese python snakes, which were naturally infested with Ophionyssus natricis mites. The administration of a single oral dose of afoxolaner eliminated live O. natricis mites from both snakes by Day 3. Environmental samples collected from the snakes' terrariums were negative for dead mites by Day 30.
L'efficacité de l'afoxolaner a été évaluée chez deux serpents python birmans captifs, naturellement infestés par des acariens Ophionyssus natricis. L'administration d'une dose orale unique d'afoxolaner a éliminé les acariens O. natricis vivants des deux serpents à jour 3. Les échantillons environnementaux prélevés dans les terrariums des serpents étaient négatifs pour les acariens morts à jour 30.
Se evaluó la eficacia de afoxolaner en dos serpientes pitón birmanas cautivas, que estaban naturalmente infestadas con ácaros Ophionyssus natricis. La administración de una sola dosis oral de afoxolaner eliminó los ácaros O. natricis vivos de ambas serpientes en el día 3. Las muestras ambientales recolectadas de los terrarios de las serpientes dieron negativo para ácaros muertos en el día 30.
A eficácia do afoxolaner foi avaliada em duas cobras python birmanesas de cativeiro, que foram naturalmente infestadas com ácaros Ophionyssus natricis. A administração de uma única dose oral de afoxolaner eliminou ácaros O. natricis vivos de ambas as cobras no dia 3. As amostras ambientais coletadas dos terrários das cobras foram negativas para ácaros mortos no dia 30.
Asunto(s)
Boidae , Isoxazoles , Infestaciones por Ácaros , Ácaros , Naftalenos , Animales , Boidae/parasitología , Isoxazoles/uso terapéutico , Infestaciones por Ácaros/tratamiento farmacológico , Infestaciones por Ácaros/veterinaria , Naftalenos/uso terapéuticoRESUMEN
OBJECTIVE: Early surgical intervention for pediatric refractory epilepsy is increasingly advocated as surgery has become safer and data have demonstrated improved outcomes with early seizure control. There is concern that the risks associated with staged invasive electroencephalography (EEG) in very young children outweigh the potential benefits. Here, the authors present a cohort of children with refractory epilepsy who were referred for invasive monitoring, and they evaluate the role and safety of staged invasive EEG in those 3 years old and younger. METHODS: The authors conducted a retrospective review of children 3 years and younger with epilepsy, who had been managed surgically at two institutions between 2001 and 2015. A cohort of pediatric patients older than 3 years of age was used for comparison. Demographics, seizure etiology, surgical management, surgical complications, and adverse events were recorded. Statistical analysis was completed using Stata version 13. A p < 0.05 was considered statistically significant. Fisher's exact test was used to compare proportions. RESULTS: Ninety-four patients (45 patients aged ≤ 3 [47.9%]) and 208 procedures were included for analysis. Eighty-six procedures (41.3%) were performed in children younger than 3 years versus 122 in the older cohort (58.7%). Forty-two patients underwent grid placement (14 patients aged ≤ 3 [33.3%]); 3 of them developed complications associated with the implant (3/42 [7.14%]), none of whom were among the younger cohort. Across all procedures, 11 complications occurred in the younger cohort versus 5 in the older patients (11/86 [12.8%] vs 5/122 [4.1%], p = 0.032). Two adverse events occurred in the younger group versus 1 in the older group (2/86 [2.32%] vs 1/122 [0.82%], p = 0.571). Following grid placement, 13/14 younger patients underwent guided resections compared to 20/28 older patients (92.9% vs 71.4%, p = 0.23). CONCLUSIONS: While overall complication rates were higher in the younger cohort, subdural grid placement was not associated with an increased risk of surgical complications in that population. Invasive electrocorticography informs management in very young children with refractory, localization-related epilepsy and should therefore be used when clinically indicated.
Asunto(s)
Epilepsia Refractaria/cirugía , Electrocorticografía/métodos , Electroencefalografía/métodos , Procedimientos Neuroquirúrgicos/métodos , Adolescente , Factores de Edad , Niño , Preescolar , Estudios de Cohortes , Electrocorticografía/efectos adversos , Electrodos Implantados , Electroencefalografía/efectos adversos , Femenino , Humanos , Lactante , Masculino , Monitoreo Fisiológico , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Convulsiones/cirugíaRESUMEN
BACKGROUND: The pathophysiological connection between Chiari malformation and syringomyelia is accepted. Debate remains, however, how can we best define changes in syringomyelia following surgery. OBJECTIVE: To introduce a grading system focusing on syrinx reduction based on routinely and reproducible radiological information, and provide a suggestion of the application of this scale for prediction of patient's prognoses. METHODS: Data from 48 patients with Chiari malformation and syringomyelia were compiled. We calculated syrinx cross-sectional area by approximating an ellipse in the largest axial plane. We compared the percentage of reduction or enlargement following surgery. The percentage change was grouped into four grades: Grade 0 = Increasing size, grade I ≤ 50% reduction, grade II = 50% to 90% reduction, grade III ≥ 90% reduction. RESULTS: A total of 89.6% of patients had syrinx improvement after surgery. A total of 5 patients were grade 0, 14 were grade I, 20 patients were grade II, and 9 patients met criteria for grade III. The mean postoperative syrinx area was 24.1 mm2 (0-169 mm2) with a mean syrinx reduction of 62.7%. CONCLUSION: Radiological improvement of syringomyelia can be mathematically defined and standardized to assist in communication in outcome-based trials. Radiological resolution is expected most patients.
Asunto(s)
Malformación de Arnold-Chiari/complicaciones , Malformación de Arnold-Chiari/cirugía , Siringomielia/diagnóstico por imagen , Siringomielia/etiología , Resultado del Tratamiento , Adolescente , Adulto , Niño , Descompresión Quirúrgica , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios RetrospectivosRESUMEN
Sarcoptic mange is a pruritic, contagious, ectoparasitic skin disease that affects mammals, including the domestic dog. The objective of this study was to evaluate and compare the efficacy of afoxolaner plus milbemycin oxime (NexGard Spectra) and afoxolaner alone (NexGard) as treatments for sarcoptic mange in naturally infested dogs. A total of 142 dogs naturally infested with Sarcoptes scabiei was evaluated. The dogs were diagnosed by microscopic examinations of skin scrapings. The dogs were divided into 2 groups: 96 dogs were treated with a combined dosage of 2.50 to 5.36 mg/kg body weight (BW) of afoxolaner and 0.50 to 1.07 mg/kg BW of milbemycin oxime and 46 dogs were treated with 2.50 mg/kg BW of afoxolaner alone. The presence or absence of pruritus and lesions were evaluated using an analogous scale on days 7, 14, 21, 28, and 56 after receiving the treatment. Data obtained were analyzed by Student's t-test (P ≤ 0.05). The single oral treatment of afoxolaner plus milbemycin oxime resulted in a significant reduction in pruritus of 87.4% at 28 d after treatment (P ≤ 0.05). Resolution of the lesions after treatment was variable, with a significant decrease (P ≤ 0.05) observed within the first 14 d, although this parameter continued to improve until the end of the study on day 28, when a decrease of 96% was observed. By the end of the study, a single dose of either the afoxolaner alone or the afoxolaner combined with milbemycin oxime was effective in significantly reducing the signs associated with sarcoptic mange during a 56-day evaluation period.
La gale sarcoptique est une maladie cutanée pruritique et contagieuse causée par un ectoparasite qui affecte les mammifères, incluant le chien domestique. L'objectif de la présente étude était d'évaluer et de comparer l'efficacité d'afoxolaner plus oxime de milbemycine (NexGard Spectra) et l'afoxolaner seul (NexGard) comme traitement pour la gale sarcoptique chez des chiens naturellement infestés. Un total de 142 chiens naturellement infestés avec Sarcoptes scabei furent évalués. Les chiens étaient diagnostiqués par examen microscopique de grattages cutanés. Les chiens furent divisés en deux groupes : 96 chiens furent traités avec un dosage combiné de 2,50 à 5,36 mg/kg de poids corporel (BW) d'afoxolaner et de 0,50 à 1,07 mg/kg BW d'oxime de milbemycine et 46 chiens furent traités avec 2,50 mg/kg BW d'afoxolaner seul. La présence ou l'absence de prurit et de lésions furent évaluées en utilisant une échelle analogue aux jours 7, 14 21, 28 et 56 après avoir reçu le traitement. Les données obtenues furent analysées à l'aide d'un test de t de Student (P ≤ 0,05). Le traitement unique avec de l'afloxolaner plus oxime de milbemycine a résulté en une réduction significative du prurit de 87,4 % au jour 28 après le traitement (P ≤ 0,05). Une résolution des lésions après le traitement était variable, avec une diminution significative (P ≤ 0,05) étant observée au cours des 14 premiers jours, bien que ce paramètre continua de s'améliorer jusqu'à la fin de l'étude au jour 28, alors qu'une diminution de 96 % fut observée. À la fin de cette étude, une dose unique de soit de l'afoxolaner seul ou une combinaison afoxolaner-oxime de milbemycie était efficace à réduire de manière significative les signes associés avec la galle sarcoptique durant une période d'évaluation de 56 jours.(Traduit par Docteur Serge Messier).
Asunto(s)
Antihelmínticos/uso terapéutico , Enfermedades de los Perros/parasitología , Isoxazoles/uso terapéutico , Macrólidos/uso terapéutico , Naftalenos/uso terapéutico , Escabiosis/tratamiento farmacológico , Animales , Antihelmínticos/administración & dosificación , Enfermedades de los Perros/tratamiento farmacológico , Perros , Quimioterapia Combinada , Isoxazoles/administración & dosificación , Macrólidos/administración & dosificación , Naftalenos/administración & dosificaciónRESUMEN
BACKGROUND: Endonasal endoscopic transsphenoidal surgery (EETS) for pituitary adenoma has become a mainstay of treatment over the last two decades and it is generally accepted that once this learning curve is achieved, a plateau is reached with little incremental improvement. OBJECTIVE: The objective of this study was to assess the slope of the learning curve over a long period of time for a variety of outcomes measures. METHODS: We examined outcomes and complications in a consecutive series of 600 EETS for pituitary adenoma grouped into quartiles based on date of surgery. RESULTS: GTR significantly increased across quartiles from 55 to 79% in the last quartile (p < 0.005). The rate of intraoperative CSF leak significantly decreased from 60% in the first quartile to 33% in the last quartile and the rate of lumbar drain placement from 28% in the first quartile to 6% in the last quartile (p < 0.005). Hormonal remission for secreting adenomas increased from 68% in the first quartile to 90% in the last quartile (p < 0.05). The rate of post-operative CSF leak trended lower (3% in first quartile to 0.7% in last two quartiles). The greatest improvement in outcome occurred between the first and second quartiles (19.9%), but persistent improvement occurred between the second and third (6.7%) and third and fourth quartiles (8.0%). CONCLUSION: Although the slope of the learning curve is steeper earlier in a surgeon's experience, the slope does not plateau and continues to increase even over more than a decade.