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1.
Occup Med (Lond) ; 74(1): 93-98, 2024 02 19.
Artículo en Inglés | MEDLINE | ID: mdl-38085666

RESUMEN

BACKGROUND: Prior to any infectious disease emergence as a public health concern, early occupational preparedness is crucial for protecting employees from novel pathogens- coronavirus disease 2019 (COVID-19) is no different. AIMS: This study ascertains how occupational safety and health (OSH)/Human Resource (HR) professionals in the Republic of Ireland had managed to prepare their workplaces prior to the advent of COVID-19. METHODS: As part of a larger COVID-19 workplace study, online focus groups were conducted with OSH/HR professionals. Collected data were transcribed verbatim and entered into NVivo for thematic analysis incorporating intercoder reliability testing. RESULTS: Fifteen focus groups were conducted with OSH/HR professionals (n = 60) from various occupational settings. Three levels of organizational preparedness were identified: 'early awareness and preparation'; 'unaware and not ready' and 'aware, but not ready'. Most organizations were aware of the COVID-19 severity, but not fully prepared for the pandemic, especially stand-alone enterprises that may not have sufficient resources to cope with an unanticipated crisis. The experiences shared by OSH professionals illustrate their agility in applying risk management and control skills to unanticipated public/occupational health crises that arise. CONCLUSIONS: General pandemic preparedness such as the availability of work-from-home policies, emergency scenario planning and prior experience in workplace outbreaks of infectious diseases were helpful for workplace-associated COVID-19 prevention. This is the first study conducted with OSH/HR professionals in Ireland regarding COVID-19 preparedness in workplaces, which provides valuable insights into research literature, as well as empirical experience for the preparation of future public health emergencies.


Asunto(s)
COVID-19 , Salud Laboral , Humanos , Preparación para una Pandemia , Reproducibilidad de los Resultados , COVID-19/epidemiología , COVID-19/prevención & control , Personal de Salud
3.
BJOG ; 128(10): 1674-1681, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33587784

RESUMEN

OBJECTIVE: Antenatal anaemia is associated with increased peripartum transfusion requirement in South Africa. We studied whether HIV was associated with the response to treatment of iron-deficiency anaemia. DESIGN: Prospective cohort study. SETTING: Hospital-based antenatal anaemia clinic in South Africa. SAMPLE: Equal-sized cohorts of pregnant women testing positive for HIV (HIV+) and testing negative for HIV (HIV-) with iron-deficiency anaemia. METHODS: Haemoglobin trajectories of women with confirmed iron-deficiency anaemia (ferritin < 50 ng/ml) were estimated from the initiation of iron supplementation using mixed-effects modelling, adjusted for baseline HIV status, ferritin level, maternal and gestational ages and time-varying iron supplementation. MAIN OUTCOME MEASURES: Haemoglobin trajectories. RESULTS: Of 469 women enrolled, 51% were HIV+, 90% of whom were on antiretroviral therapy (with a mean CD4+ lymphocyte count of 403 cells/mm3 ). Anaemia diagnoses did not differ by HIV status. A total of 400 women with iron-deficiency anaemia were followed during treatment with oral or intravenous (6%) iron therapy. In multivariable analysis, haemoglobin recovery was 0.10 g/dl per week slower on average in women who were HIV+ versus women who were HIV- (P = 0.001), 0.01 g/dl per week slower in women with higher baseline ferritin (P < 0.001) and 0.06 g/dl per week faster in women who were compliant with oral iron therapy (P = 0.002). CONCLUSIONS: Compared with women who were HIV-, women who were HIV+ with iron-deficiency anaemia had slower but successful haemoglobin recovery with iron therapy. Earlier effective management of iron deficiency could reduce the incidence of peripartum blood transfusion. TWEETABLE ABSTRACT: Among pregnant women with iron-deficiency anaemia in South Africa, HIV slows haemoglobin recovery in response to oral iron therapy.


Asunto(s)
Anemia Ferropénica/tratamiento farmacológico , Infecciones por VIH , Hierro/administración & dosificación , Complicaciones Hematológicas del Embarazo/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo , Atención Prenatal , Administración Intravenosa , Administración Oral , Adolescente , Adulto , Anemia Ferropénica/sangre , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Hierro/sangre , Persona de Mediana Edad , Embarazo , Complicaciones Hematológicas del Embarazo/sangre , Estudios Prospectivos , Resultado del Tratamiento , Adulto Joven
4.
Am J Public Health ; 108(7): 896-901, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29874497

RESUMEN

Although community capacity has been prominent in the public health literature for nearly 20 years, the field has only operationalized a few dimensions. An intriguing dimension of capacity is a community's ability to critically reflect. On the basis of previous research as well as theoretical and practical insights from management and organizational learning literature, we offer a process framework for critical reflexivity practice in community. The framework draws on ideas regarding cognition and agency, praxis, as well as the transformative learning model to conceptualize how reflexivity happens as an emergent community process. The implication is that reflexivity is a community-level process of making meaning of experiences that drive a common narrative. Inclusivity and establishing consensus are paramount, and can be difficult in light of power dynamics and consideration of dissenting voices and different experiences; enlightened self-interest and creating conducive spaces for dialogue are key in this process. Strengthening communities' ability to gain and employ collective wisdom from their experience will also build their overall capacity for population health improvement.


Asunto(s)
Aprendizaje , Evaluación de Programas y Proyectos de Salud , Salud Pública , Participación de la Comunidad , Humanos , Liderazgo , Características de la Residencia
5.
Vox Sang ; 112(8): 713-722, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28960367

RESUMEN

BACKGROUND AND OBJECTIVES: Interventions to prevent and detect bacterial contamination of platelet concentrates (PCs) have reduced, but not eliminated the sepsis risk. Standardized bacterial strains are needed to validate detection and pathogen reduction technologies in PCs. Following the establishment of the First International Reference Repository of Platelet Transfusion-Relevant Bacterial Reference Strains (the 'repository'), the World Health Organization (WHO) Expert Committee on Biological Standardisation (ECBS) endorsed further repository expansion. MATERIALS AND METHODS: Sixteen bacterial strains, including the four repository strains, were distributed from the Paul-Ehrlich-Institut (PEI) to 14 laboratories in 10 countries for enumeration, identification and growth measurement on days 2, 4 and 7 after low spiking levels [10-25 colony-forming units (CFU)/PC bag]. Spore-forming (Bacillus cereusPEI-B-P-07-S, Bacillus thuringiensisPEI-B-P-57-S), Gram-negative (Enterobacter cloacaePEI-B-P-43, Morganella morganiiPEI-B-P-74, PEI-B-P-91, Proteus mirabilisPEI-B-P-55, Pseudomonas fluorescensPEI-B-P-77, Salmonella choleraesuisPEI-B-P-78, Serratia marcescensPEI-B-P-56) and Gram-positive (Staphylococcus aureusPEI-B-P-63, Streptococcus dysgalactiaePEI-B-P-71, Streptococcus bovisPEI-B-P-61) strains were evaluated. RESULTS: Bacterial viability was conserved after transport to the participating laboratories with one exception (M. morganiiPEI-B-P-74). All other strains showed moderate-to-excellent growth. Bacillus cereus, B. thuringiensis, E. coli, K. pneumoniae, P. fluorescens, S. marcescens, S. aureus and S. dysgalactiae grew to >106 CFU/ml by day 2. Enterobacter cloacae, P. mirabilis, S. epidermidis, S. bovis and S. pyogenes achieved >106 CFU/ml at day 4. Growth of S. choleraesuis was lower and highly variable. CONCLUSION: The WHO ECBS approved all bacterial strains (except M. morganiiPEI-B-P-74 and S. choleraesuisPEI-B-P-78) for repository enlargement. The strains were stable, suitable for spiking with low CFU numbers, and proliferation was independent of the PC donor.


Asunto(s)
Plaquetas/microbiología , Seguridad de la Sangre/normas , Transfusión de Plaquetas , Bancos de Muestras Biológicas , Escherichia coli/crecimiento & desarrollo , Humanos , Klebsiella pneumoniae/crecimiento & desarrollo , Estándares de Referencia , Staphylococcus aureus/crecimiento & desarrollo , Staphylococcus epidermidis/crecimiento & desarrollo , Organización Mundial de la Salud
7.
Phys Med Biol ; 62(8): 3025-3050, 2017 04 21.
Artículo en Inglés | MEDLINE | ID: mdl-28323633

RESUMEN

We present a novel two-dimensional (2D) MAET scanner, with a rotating object of interest and two fixed pairs of electrodes. Such an acquisition scheme, with our novel reconstruction techniques, recovers the boundaries of the regions of constant conductivity uniformly well, regardless of their orientation. We also present a general image reconstruction algorithm for the 2D MAET in a circular chamber with point-like electrodes immersed into the saline surrounding the object. An alternative linearized reconstruction procedure is developed, suitable for recovering the material interfaces (boundaries) when a non-ideal piezoelectric transducer is used for acoustic excitation. The work of the scanner and the linearized reconstruction algorithm is demonstrated using several phantoms made of high-contrast materials and a biological sample.


Asunto(s)
Procesamiento de Imagen Asistido por Computador/métodos , Tomografía/instrumentación , Algoritmos , Electricidad , Campos Magnéticos , Fantasmas de Imagen , Rotación , Tomografía/métodos , Ondas Ultrasónicas
8.
Pharmacogenomics J ; 15(3): 272-7, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25266681

RESUMEN

Several reports have shown that statin treatment benefits patients with asthma; however, inconsistent effects have been observed. The mir-152 family (148a, 148b and 152) has been implicated in asthma. These microRNAs suppress HLA-G expression, and rs1063320, a common SNP in the HLA-G 3'UTR that is associated with asthma risk, modulates miRNA binding. We report that statins upregulate mir-148b and 152, and affect HLA-G expression in an rs1063320-dependent fashion. In addition, we found that individuals who carried the G minor allele of rs1063320 had reduced asthma-related exacerbations (emergency department visits, hospitalizations or oral steroid use) compared with non-carriers (P=0.03) in statin users ascertained in the Personalized Medicine Research Project at the Marshfield Clinic (n=421). These findings support the hypothesis that rs1063320 modifies the effect of statin benefit in asthma, and thus may contribute to variation in statin efficacy for the management of this disease.


Asunto(s)
Asma/tratamiento farmacológico , Asma/genética , Antígenos HLA-G/genética , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Polimorfismo de Nucleótido Simple/genética , Regiones no Traducidas 3'/genética , Alelos , Línea Celular Tumoral , Femenino , Células Hep G2 , Humanos , Masculino , MicroARNs/genética , Persona de Mediana Edad , Riesgo
9.
J Evol Biol ; 25(7): 1399-414, 2012 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-22686488

RESUMEN

Species delimitation within recently evolved groups can be challenging because species may be difficult to distinguish morphologically. Following the General Lineage Concept, we apply a multiple evidence approach to assess species limits within the carpet chameleon Furcifer lateralis, which is endemic to Madagascar and exported in large numbers for the pet trade. Cryptic speciation within F. lateralis was considered likely because this species (1) has a vast distribution, (2) occupies exceptionally diverse habitats and (3) exhibits subtle regional differences in morphology. Phylogenetic trees reconstructed using nuclear and mitochondrial genes recovered three well-supported clades corresponding with geography. Morphological results based on canonical variates analysis show that these clades exhibit subtle differences in head casque morphology. Ecological niche modelling results found that these phylogenetic groups also occupy unique environmental space and exhibit patterns of regional endemism typical of other endemic reptiles. Combined, our findings provide diverse yet consistent evidence for the existence of three species. Consequently, we elevate the subspecies F. lateralis major to species rank and name a new species distributed in northern and western Madagascar. Initial ecological divergence, associated with speciation of F. lateralis in humid eastern habitat, fits the Ecographic Constraint model for species diversification in Madagascar. By contrast, the second speciation event provides some support for the Riverine Barrier model, with the Mangoky River possibly causing initial isolation between species. These findings thus support two contrasting models of speciation within closely related species and demonstrate the utility of applying a combined-evidence approach for detecting cryptic speciation.


Asunto(s)
Lagartos/clasificación , Animales , Especiación Genética , Madagascar , Filogeografía
10.
Acta Crystallogr Sect E Struct Rep Online ; 68(Pt 11): m1410, 2012 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-23284376

RESUMEN

The Zn(II) ion in the title compound, [Zn(C(24)H(28)N(2)O(6))](n), is located on a twofold rotation axis and is at the midpoint of a crown-4 moiety of 3,3'-[(1,7-dioxa-4,10-diaza-cyclo-dodecane-4,10-di-yl)bis-(methyl-ene)]dibenzoate anion. It is octahedrally coordinated by two N atoms and two O atoms of the crown moiety from one ligand and two carboxyl-ate O atoms from two bridging intra-chain ligands. Metallomacrocyclic rings are identified in the structure. The metallomacrocycle contains two Zn(II) ions and 14 atoms from the bridging ligands. Repetition of these units gives rise to an infinite zigzag chain along [101]. C-H⋯O hydrogen bonds occur.

11.
Eur J Surg Oncol ; 37(11): 928-36, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-21855267

RESUMEN

INTRODUCTION: Current methods of identifying axillary node metastases in breast cancer patients are highly accurate, but are associated with several adverse events. This review evaluates the diagnostic accuracy of magnetic resonance imaging (MRI) techniques for identification of axillary metastases in early stage newly diagnosed breast cancer patients. METHODS: Comprehensive searches were conducted in April 2009. Study quality was assessed. Sensitivity and specificity were meta-analysed using a bivariate random effects approach, utilising pathological diagnosis via node biopsy as the comparative gold standard. RESULTS: Based on the highest sensitivity and specificity reported in each of the nine studies evaluating MRI (n = 307 patients), mean sensitivity was 90% (95% CI: 78-96%; range 65-100%) and mean specificity 90% (95% CI: 75-96%; range 54-100%). Across five studies evaluating ultrasmall super-paramagnetic iron oxide (USPIO)-enhanced MRI (n = 93), mean sensitivity was 98% (95% CI: 61-100%) and mean specificity 96% (95% CI: 72-100%). Across three studies of gadolinium-enhanced MRI (n = 187), mean sensitivity was 88% (95% CI: 78-94%) and mean specificity 73% (95% CI: 63-81%). In the single study of in-vivo proton MR spectroscopy (n = 27), sensitivity was 65% (95% CI: 38-86%) and specificity 100% (95% CI: 69-100%). CONCLUSIONS: USPIO-enhanced MRI showed a trend towards higher sensitivity and specificity and may make a useful addition to the current diagnostic pathway. Additional larger studies with standardised methods and standardised criteria for classifying a node as positive are needed. Current estimates of sensitivity and specificity do not support replacement of SLNB with any current MRI technology in this patient group.


Asunto(s)
Neoplasias de la Mama/secundario , Ganglios Linfáticos/patología , Metástasis Linfática/diagnóstico , Imagen por Resonancia Magnética/métodos , Axila , Neoplasias de la Mama/diagnóstico , Femenino , Humanos , Reproducibilidad de los Resultados
12.
Health Technol Assess ; 15(4): iii-iv, 1-134, 2011 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21276372

RESUMEN

BACKGROUND: Breast cancer is the most common type of cancer in women. Evaluation of axillary lymph node metastases is important for breast cancer staging and treatment planning. OBJECTIVES: To evaluate the diagnostic accuracy, cost-effectiveness and effect on patient outcomes of positron emission tomography (PET), with or without computed tomography (CT), and magnetic resonance imaging (MRI) in the evaluation of axillary lymph node metastases in patients with newly diagnosed early-stage breast cancer. DATA SOURCES: A systematic review of literature and an economic evaluation were carried out. Key databases (including MEDLINE, EMBASE and nine others) plus research registers and conference proceedings were searched for relevant studies up to April 2009. A decision-analytical model was developed to determine cost-effectiveness in the UK. REVIEW METHODS: One reviewer assessed titles and abstracts of studies identified by the search strategy, obtained the full text of relevant papers and screened them against inclusion criteria. Data from included studies were extracted by one reviewer using a standardised data extraction form and checked by a second reviewer. Discrepancies were resolved by discussion. Quality of included studies was assessed using the quality assessment of diagnostic accuracy studies (QUADAS) checklist, applied by one reviewer and checked by a second. RESULTS: Forty-five citations relating to 35 studies were included in the clinical effectiveness review: 26 studies of PET and nine studies of MRI. Two studies were included in the cost-effectiveness review: one of PET and one of MRI. Of the seven studies evaluating PET/CT (n = 862), the mean sensitivity was 56% [95% confidence interval (CI) 44% to 67%] and mean specificity 96% (95% CI 90% to 99%). Of the 19 studies evaluating PET only (n = 1729), the mean sensitivity was 66% (95% CI 50% to 79%) and mean specificity 93% (95% CI 89% to 96%). PET performed less well for small metastases; the mean sensitivity was 11% (95% CI 5% to 22%) for micrometastases (≤ 2 mm; five studies; n = 63), and 57% (95% CI 47% to 66%) for macrometastases (> 2 mm; four studies; n = 111). The smallest metastatic nodes detected by PET measured 3 mm, while PET failed to detect some nodes measuring > 15 mm. Studies in which all patients were clinically node negative showed a trend towards lower sensitivity of PET compared with studies with a mixed population. Across five studies evaluating ultrasmall super-paramagnetic iron oxide (USPIO)-enhanced MRI (n = 93), the mean sensitivity was 98% (95% CI 61% to 100%) and mean specificity 96% (95% CI 72% to 100%). Across three studies of gadolinium-enhanced MRI (n = 187), the mean sensitivity was 88% (95% CI 78% to 94%) and mean specificity 73% (95% CI 63% to 81%). In the single study of in vivo proton magnetic resonance spectroscopy (n = 27), the sensitivity was 65% (95% CI 38% to 86%) and specificity 100% (95% CI 69% to 100%). USPIO-enhanced MRI showed a trend towards higher sensitivity and specificity than gadolinium-enhanced MRI. Results of the decision modelling suggest that the MRI replacement strategy is the most cost-effective strategy and dominates the baseline 4-node sampling (4-NS) and sentinel lymph node biopsy (SLNB) strategies in most sensitivity analyses undertaken. The PET replacement strategy is not as robust as the MRI replacement strategy, as its cost-effectiveness is significantly affected by the utility decrement for lymphoedema and the probability of relapse for false-negative (FN) patients. LIMITATIONS: No included studies directly compared PET and MRI. CONCLUSIONS: Studies demonstrated that PET and MRI have lower sensitivity and specificity than SLNB and 4-NS but are associated with fewer adverse events. Included studies indicated a significantly higher mean sensitivity for MRI than for PET, with USPIO-enhanced MRI providing the highest sensitivity. However, sensitivity and specificity of PET and MRI varied widely between studies, and MRI studies were relatively small and varied in their methods; therefore, results should be interpreted with caution. Decision modelling based on these results suggests that the most cost-effective strategy may be MRI rather than SLNB or 4-NS. This strategy reduces costs and increases quality-adjusted life-years (QALYs) because there are fewer adverse events for the majority of patients. However, this strategy leads to more FN cases at higher risk of cancer recurrence and more false- positive (FP) cases who would undergo unnecessary axillary lymph node dissection. Adding MRI prior to SLNB or 4-NS has little effect on QALYs, though this analysis is limited by lack of available data. Future research should include large, well-conducted studies of MRI, particularly using USPIO; data on the long-term impacts of lymphoedema on cost and patient utility; studies of the comparative effectiveness and cost-effectiveness of SLNB and 4-NS; and more robust UK cost data for 4-NS and SLNB as well as the cost of MRI and PET techniques. FUNDING: This study was funded by the Health Technology Assessment programme of the National Institute of Health Research.


Asunto(s)
Axila , Neoplasias de la Mama/patología , Diagnóstico Precoz , Ganglios Linfáticos/patología , Metástasis Linfática/diagnóstico , Imagen por Resonancia Magnética/economía , Tomografía de Emisión de Positrones/economía , Costos y Análisis de Costo , Femenino , Humanos , Ganglios Linfáticos/diagnóstico por imagen , Reino Unido
13.
Eur J Surg Oncol ; 37(3): 187-98, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21269795

RESUMEN

PURPOSE: Sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND) are used to assess axillary nodal status in breast cancer, but are invasive procedures associated with morbidity, including lymphoedema. This systematic review evaluates the diagnostic accuracy of positron emission tomography (PET), with or without computed tomography (CT), for assessment of axillary nodes in early breast cancer. METHODS: Eleven databases including MEDLINE, EMBASE and the Cochrane Library, plus research registers and conference proceedings, were searched in April 2009. Study quality was assessed using the QUality Assessment of Diagnostic Accuracy Studies (QUADAS) checklist. Sensitivity and specificity were meta-analysed using a bivariate random effects approach. RESULTS: Across 26 studies evaluating PET or PET/CT (n = 2591 patients), mean sensitivity was 63% (95% CI: 52-74%; range 20-100%) and mean specificity 94% (95% CI: 91-96%; range 75-100%). Across 7 studies of PET/CT (n = 862), mean sensitivity was 56% (95% CI: 44-67%) and mean specificity 96% (90-99%). Across 19 studies of PET-only (n = 1729), mean sensitivity was 66% (50-79%) and mean specificity 93% (89-96%). Mean sensitivity was 11% (5-22%) for micrometastases (≤2 mm; five studies; n = 63), and 57% (47-66%) for macrometastases (>2 mm; four studies; n = 111). CONCLUSIONS: PET had lower sensitivity and specificity than SLNB. Therefore, replacing SLNB with PET would avoid the adverse effects of SLNB, but lead to more false negative patients at risk of recurrence and more false positive patients undergoing unnecessary ALND. The present evidence does not support the routine use of PET or PET-CT for the assessment of the clinically negative axilla.


Asunto(s)
Axila/diagnóstico por imagen , Neoplasias de la Mama/patología , Metástasis Linfática/diagnóstico por imagen , Tomografía de Emisión de Positrones/métodos , Axila/patología , Femenino , Humanos , Metástasis Linfática/patología , Estadificación de Neoplasias , Sensibilidad y Especificidad , Biopsia del Ganglio Linfático Centinela , Tomografía Computarizada por Rayos X
14.
J Psychopharmacol ; 24(11): 1717-24, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-19493957

RESUMEN

Dehydroepiandrosterone (DHEA) and its metabolites, DHEA-sulphate (DHEA-S) and androsterone, have neurosteroid activity. In this study, we examined whether DHEA, DHEA-S and androsterone, can influence serotonin (5-HT) neuronal firing activity via modulation of γ-aminobutryic acid (GABA(A)) receptors. The firing of presumed 5-HT neurones in a slice preparation containing rat dorsal raphe nucleus was inhibited by the GABA(A) receptor agonists 4,5,6,7-tetrahydroisoxazolo[5,4-c]pyridinyl-3-ol (THIP) (25 µM) and GABA (100 µM). DHEA (100 and 300 µM) and DHEA-S (1, 10 and 100 µM) caused a rapid and reversible attenuation of the response to THIP. DHEA (100 µM) and DHEA-S (100 µM) also attenuated the effect of GABA. Androsterone (10 and 30 µM) markedly enhanced the inhibitory response to THIP (25 µM). The effect was apparent during androsterone administration but persisted and even increased in magnitude after drug wash-out. The data indicate that GABA(A) receptor-mediated regulation of 5-HT neuronal firing is sensitive to negative modulation by DHEA and its metabolite DHEA-S is sensitive to positive modulation by the metabolite androsterone. The effects of these neurosteroids on GABA(A) receptor-mediated regulation of 5-HT firing may underlie some of the reported behavioural and psychological effects of endogenous and exogenous DHEA.


Asunto(s)
Deshidroepiandrosterona/metabolismo , Deshidroepiandrosterona/farmacología , Neurotransmisores/metabolismo , Neurotransmisores/farmacología , Receptores de GABA-A/fisiología , Serotonina/metabolismo , Animales , Deshidroepiandrosterona/administración & dosificación , Deshidroepiandrosterona/análogos & derivados , Sulfato de Deshidroepiandrosterona/metabolismo , Sulfato de Deshidroepiandrosterona/farmacología , Agonistas de Receptores de GABA-A/metabolismo , Agonistas de Receptores de GABA-A/farmacología , Isoxazoles/metabolismo , Isoxazoles/farmacología , Masculino , Inhibición Neural/efectos de los fármacos , Inhibición Neural/fisiología , Neuronas/efectos de los fármacos , Neuronas/metabolismo , Neuronas/fisiología , Neurotransmisores/administración & dosificación , Núcleos del Rafe/efectos de los fármacos , Núcleos del Rafe/metabolismo , Núcleos del Rafe/fisiología , Ratas , Receptores de GABA-A/metabolismo , Serotonina/farmacología , Ácido gamma-Aminobutírico/metabolismo , Ácido gamma-Aminobutírico/farmacología
15.
Euro Surveill ; 14(33)2009 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-19712642

RESUMEN

During the containment phase in the United Kingdom (April to June 2009), a cluster of influenza A(H1N1)v cases was identified prompting further investigation and public health action by the Health Protection Agency. The first confirmed case, a pupil at a school in England, was imported. During the following two weeks, 16 further cases were confirmed with epidemiological links to the first imported case. In this cluster, we found that significant transmission occurred in two classes with attack rates of 17.4% and 7.4%. In each of the two classes a case had attended school whilst symptomatic. Other settings included a choir and a party. Minimum and maximum attack rates were 3.6% and 4.2% for the choir and 14.3% and 25% for the party. We did not find any evidence of transmission on two school bus trips despite exposure over 50 minutes to a symptomatic case and over two periods of 30 minutes to a case during the prodromal phase (i.e. within 12 hours of symptom onset). Nor was there onward transmission in another school despite exposure over several hours to two cases, both of whom attended school during the prodromal phase.


Asunto(s)
Brotes de Enfermedades/estadística & datos numéricos , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/epidemiología , Gripe Humana/transmisión , Instituciones Académicas , Medio Social , Estudiantes/estadística & datos numéricos , Análisis por Conglomerados , Inglaterra/epidemiología , Humanos , Incidencia , Vigilancia de la Población , Medición de Riesgo/métodos , Factores de Riesgo
16.
Stress ; 12(4): 362-9, 2009 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-19051121

RESUMEN

Stressful stimuli cause region-specific increases in c-fos expression within the rat brain. Early maternal separation (EMS) is a model of early life adversity that results in long lasting changes to stress and anxiety responses. This study examined the regional distribution of c-fos mRNA after exposure to the elevated plus-maze (EPM) and how EMS altered this pattern. On each of post-natal days 5-21 pups were separated from the dam for 6 h -- control rats remained undisturbed. At 70 days old, male offspring were either exposed to the EPM or left undisturbed in the home cage. After exposure to the EPM, c-fos mRNA expression was significantly increased in specific brain areas, including cingulate cortex, medial amygdala and hippocampus. EMS rats displayed greater anxiety behaviour on the EPM vs. controls. Although EMS caused no overall effect on basal c-fos mRNA, a significant interaction between treatment group and exposure to the EPM occurred in the dentate gyrus and piriform cortex, with lower EPM-induced mRNA levels in EMS rats. The region-specific increase in c-fos mRNA reflects activation of neural circuits associated with EPM-induced anxiety. The effect of EMS on this activation in the two regions suggests these areas may contribute to the differential response to the anxiogenic stress of the EPM.


Asunto(s)
Ansiedad/metabolismo , Privación Materna , Aprendizaje por Laberinto/fisiología , Proteínas Proto-Oncogénicas c-fos/biosíntesis , Amígdala del Cerebelo/metabolismo , Animales , Giro Dentado/metabolismo , Femenino , Hipocampo/metabolismo , Masculino , ARN Mensajero/metabolismo , Ratas
17.
Eur J Cancer Care (Engl) ; 17(6): 578-84, 2008 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-18707618

RESUMEN

This paper's aims were to investigate the time and costs of healthcare professionals involved with follow-up clinics for breast cancer patients; and to quantify the numbers of local recurrences detected. An audit of breast cancer patients diagnosed with disease recurrence was conducted, and data were collected from the cancer audit system and from an analysis of relevant case notes. Costs of the time spent in follow-up clinics by clinical staff were also collected. The study found that sixty-nine breast cancer patients were diagnosed with local recurrence between 1 January 1999 and 31 December 2004. Only 15% (10) of recurrences were detected at routine follow up, 48% were first noticed by patients themselves, and 37% were detected at routine mammography. Six separate follow-up clinics were scheduled each week. This involved a total clinic time of approximately 20 h, and a total weekly cost of around pound 4857, with an annual cost of pound 252,564. Our recommendation is that alternative methods of follow up need to be implemented so that healthcare professionals have more time for newly diagnosed patients, those on active treatment and those with relapsed disease.


Asunto(s)
Neoplasias de la Mama/economía , Continuidad de la Atención al Paciente/economía , Personal de Salud/economía , Auditoría Médica/estadística & datos numéricos , Recurrencia Local de Neoplasia/economía , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/diagnóstico , Inglaterra , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Recurrencia Local de Neoplasia/diagnóstico , Estadificación de Neoplasias
18.
Biotechnol Bioeng ; 96(3): 559-69, 2007 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-16902948

RESUMEN

Biocatalysis continues to emerge as a powerful technique for the efficient synthesis of optically pure pharmaceuticals that are difficult to access via conventional chemistry. The power of biocatalysis can be enhanced if two or more reactions can be achieved by a single whole cell biocatalyst containing a pathway designed de-novo to facilitate a required synthetic sequence. The enzymes transketolase (TK) and transaminase (TAm) respectively catalyze asymmetric carbon--carbon bond formation and amine group addition to suitable substrate molecules. The ability of a transaminase to accept the product of the transketolase reaction can allow the two catalysts to be employed in series to create chiral amino-alcohols from achiral substrates. As proof of principle, the beta-alanine: pyruvate aminotransferase (beta-A:P TAm) from Pseudomonas aeruginosa has been cloned, to create plasmid pQR428, for overexpression in E.coli strain BL21gold(DE3). Production of the beta-A:P TAm alongside the native transketolase (overexpressed from plasmid pQR411), in a single E.coli host, has created a novel biocatalyst capable of the synthesis of chiral amino alcohols via a synthetic two-step pathway. The feasibility of using the biocatalyst has been demonstrated by the formation of a single diastereoisomer of 2-amino-1,3,4-butanetriol (ABT) product, in up to 21% mol/mol yield, by the beta-A:P TAm, via transamination of L-erythrulose synthesized by TK, from achiral substrates glycolaldehyde (GA) and beta-hydroxypyruvate (beta-HPA). ABT synthesis was achieved in a one-pot process, using either whole cells of the dual plasmid strain or cell lysate, while the dual alcohol-amine functionality of ABT makes it an excellent synthon for many pharmaceutical syntheses.


Asunto(s)
Amino Alcoholes/síntesis química , Proteínas Bacterianas/química , Escherichia coli/enzimología , Pseudomonas aeruginosa/enzimología , Transcetolasa/química , beta-Alanina-Piruvato Transaminasa/química , Proteínas Bacterianas/genética , Catálisis , Sistema Libre de Células/enzimología , Escherichia coli/genética , Pseudomonas aeruginosa/genética , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Estereoisomerismo , Transcetolasa/genética , beta-Alanina-Piruvato Transaminasa/genética
19.
J Environ Qual ; 34(5): 1573-80, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-16091610

RESUMEN

Diazinon [O,O-diethyl O-2-isopropyl-6-methyl(pyrimidine-4-yl) phosphorothioate] and imidacloprid [1-(1-[6-chloro-3-pyridinyl]methyl)-N-nitro-2-imidazolidinimine] are applied to lawns for insect control simultaneously with nitrogenous fertilizers such as urea, but their potential effect on urease activity and nitrogen availability in turfgrass management has not been evaluated. Urease activity in enzyme assays, washed cell assays, and soil slurries was examined as a function of insecticide concentration. Intact cores from field sites were used to assess the effect of insecticide application on urease activity in creeping bentgrass (Agrostis palustris Huds.) and bluegrass (Poa pratensis L.) sod. Bacterial urease from Bacillus pasteurii and plant urease from jack bean [Canavalia ensiformis (L.) DC.] were unaffected by the insecticides. Both insecticides inhibited the growth of Proteus vulgaris, a urease-producing bacterium, but only diazinon significantly reduced urease activity in washed cells; neither insecticide inhibited urease activity in sonicated cells. Neither diazinon nor imidacloprid inhibited urease activity in Woolper soil (fine, mixed, mesic Typic Argiudoll) slurries, but diazinon slightly inhibited urease activity in Maury soil (fine, mixed, semiactive, mesic Typic Paleudalf) slurries. Imidacloprid had no effect on urease activity in creeping bentgrass or bluegrass sod at up to 10 times the commercial application rate. Diazinon briefly, but significantly, reduced urease activity in bluegrass sod. Co-application of imidacloprid and urea appears to be benign with respect to urease activity in soil and sod. Diazinon, in contrast, appears to have a significant, short-term, inhibitory effect on the microbial urease-producing community, but that effect depends on soil type.


Asunto(s)
Agrostis/efectos de los fármacos , Bacterias/efectos de los fármacos , Canavalia/efectos de los fármacos , Insecticidas/toxicidad , Poa/efectos de los fármacos , Suelo , Ureasa/metabolismo , Agrostis/crecimiento & desarrollo , Bacterias/enzimología , Canavalia/enzimología , Diazinón/toxicidad , Imidazoles/toxicidad , Neonicotinoides , Nitrocompuestos , Poa/crecimiento & desarrollo
20.
Neuropeptides ; 39(4): 403-7, 2005 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-15975651

RESUMEN

The lateral dorsal nucleus of the bed nuclei of the stria terminalis (BST-LD) expresses dense oxytocin binding while lower binding is detected in the medial anterior BST (BST-MA) and adjacent ventrolateral septum (VLS). However, in vitro examination of neuronal responses to oxytocin showed that the BST-LD exhibited small, transient responses which desensitized upon repeated challenge. In contrast, the BST-MA and VLS exhibited significantly larger responses with no significant desensitization. This inverse relationship between oxytocin binding density and electrophysiological responsiveness is also seen in the central and medial amygdaloid nuclei, which have respective associations with the lateral and medial divisions of the BST. Thus, excitatory responses to oxytocin vary markedly between BST sub-divisions and may reflect associations within the extended amygdala.


Asunto(s)
Oxitocina/farmacología , Núcleos Septales/efectos de los fármacos , Núcleos Septales/fisiología , Potenciales de Acción/efectos de los fármacos , Amígdala del Cerebelo/citología , Animales , Electrofisiología , Vías Nerviosas , Neuronas/efectos de los fármacos , Neuronas/fisiología , Técnicas de Cultivo de Órganos , Ratas , Ratas Wistar , Núcleos Septales/citología
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