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1.
Pathogens ; 13(3)2024 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-38535577

RESUMEN

Coagulase-negative staphylococci (CoNS) are reportedly responsible for 50-60% of bloodstream infections in very preterm (<1500 g) infants in neonatal intensive care units (NICUs). Staphylococcus capitis is an increasingly prevalent pathogen in the neonatal setting, frequently causing central-line-associated bloodstream infections (CLABSIs) that can be difficult to eradicate. Central venous catheter (CVC) removal versus in situ treatment with CoNS CLABSIs is a controversial treatment strategy with no clear consensus. We reviewed all S. capitis CLABSIs in our NICU between 2019 and 2022, focusing on the role of catheter removal in eradication. Among the 25 patients, 17 CVCs were removed after diagnosis, leading to a 76.5% eradication rate in this group. Three infants had a persistently positive blood culture after CVC substitution. A new catheter was then inserted after a 48 h washout period, resulting in resolution of the infection. Only two of the eight patients (25%) who retained their catheter after diagnosis achieved infection eradication with antibiotic therapy alone. When feasible, catheter removal seems to be the most effective strategy for eradicating S. capitis CLABSIs, sometimes even requiring a 48 h washout period before reinsertion. Further studies on this topic are needed to better standardize the management of this type of infection.

2.
Ital J Pediatr ; 49(1): 91, 2023 Jul 21.
Artículo en Inglés | MEDLINE | ID: mdl-37480047

RESUMEN

BACKGROUND: We describe the first school-located influenza vaccination campaign with quadrivalent live-attenuated influenza vaccine (LAIV) among pre-school children in Italy, coupled with an innovative school-centred influenza-like illnesses (ILIs) surveillance using a self-sampling non-invasive saliva collection method. METHODS: The pilot study was proposed during the 2021/2022 influenza season to fifteen pre-schools in the Milan municipality. LAIV was offered directly in school to all healthy children without contraindications. ILI differential diagnosis was conducted by real-time RT-PCR for influenza A/B and SARS-CoV-2. RESULTS: Five pre-schools were involved in the pilot project and overall, 135 families (31.2%) participated in the study, adhering to both surveillance and vaccination; 59% of families had an immigrant background. No pupil experienced adverse reactions after vaccination. Nineteen saliva samples were collected from sixteen children (11.8%). Six samples (31.6%) tested positive for SARS-CoV-2; none was positive for influenza A/B. CONCLUSIONS: The participation in the immunisation campaign was good, considering possible absences due to COVID-19 pandemic, and the intranasal administration was well tolerated and helped to overcome parental hesitancy. Saliva sampling represented a useful tool to reduce children's stress and increase parents' compliance. The high participation of families with an immigrant background suggests that school-based interventions can represent an effective strategy to overcome socioeconomic and cultural barriers.


Asunto(s)
COVID-19 , Gripe Humana , Virosis , Preescolar , Humanos , Niño , Proyectos Piloto , Gripe Humana/diagnóstico , Gripe Humana/prevención & control , Pandemias/prevención & control , COVID-19/epidemiología , COVID-19/prevención & control , SARS-CoV-2 , Vacunación , Italia/epidemiología
3.
Aten Primaria ; 55(7): 102642, 2023 07.
Artículo en Español | MEDLINE | ID: mdl-37167849

RESUMEN

OBJECTIVE: To evaluate the perceptions and preferences of users and health professionals on teleconsultation in primary care. DESIGN: Cross-sectional study with a telephone survey of users and a face-to-face survey of professionals carried out at 2021. SETTING: Urban primary health care. PARTICIPANTS: Random sample of users with teleconsultations in the last year, stratified by sex and age, and doctors and nurses from participating centres. MEASUREMENTS: Likert variables assessing teleconsultation according to consultation motives, preferences and related aspects. Descriptive analysis and comparison of proportions and means. RESULTS: Three hundred patients and 48 professionals answered the questionnaire. Both groups value positively the teleconsultation for the management of the electronic prescription (EP) (83% and 83%, respectively), sick leave (SL) (80% and 64%) and issues related to COVID-19 (71% and 58%). The positive assessment of teleconsultation decreases for the treatment of acute pathologies (47% and 25%) and chronic diseases (49% and 33%). Globally, people <70 years value teleconsultation more highly (P<.001), without differences between sexes. Users and professionals prefer face-to-face consultation for chronic diseases (82% and 83%) and acute pathologies (82% and 94%), and teleconsultation for EP (68.7% and 88.6%). 52% of users prefer face-to-face visits for SL compared to 29% of professionals (P<.05). CONCLUSIONS: Teleconsultation implementation has been well valued by both patients and professionals. The face-to-face visit is preferred for chronic and acute pathologies, especially in the elderly. It will be necessary to define in which cases teleconsultation is the best tool according to the characteristics of each population.


Asunto(s)
COVID-19 , Consulta Remota , Humanos , Anciano , Estudios Transversales , Atención Primaria de Salud , Enfermedad Crónica
4.
Glob Chang Biol ; 29(7): 1854-1869, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36583374

RESUMEN

Woody plant species store nonstructural carbohydrates (NSCs) for many functions. While known to buffer against fluctuations in photosynthetic supply, such as at night, NSC stores are also thought to buffer against environmental extremes, such as drought or freezing temperatures by serving as either back-up energy reserves or osmolytes. However, a clear picture of how NSCs are shaped by climate is still lacking. Here, we update and leverage a unique global database of seasonal NSC storage measurements to examine whether maximum total NSC stores and the amount of soluble sugars are associated with clinal patterns in low temperatures or aridity, indicating they may confer a benefit under freezing or drought conditions. We examine patterns using the average climate at each study site and the unique climatic conditions at the time and place in which the sample was taken. Altogether, our results support the idea that NSC stores act as critical osmolytes. Soluble Sugars increase with both colder and drier conditions in aboveground tissues, indicating they can plastically increase a plants' tolerance of cold or arid conditions. However, maximum total NSCs increased, rather than decreased, with average site temperature and had no relationship to average site aridity. This result suggests that the total amount of NSC a plant stores may be more strongly determined by its capacity to assimilate carbon than by environmental stress. Thus, NSCs are unlikely to serve as reservoir of energy. This study is the most comprehensive synthesis to date of global NSC variation in relation to climate and supports the idea that NSC stores likely serve as buffers against environmental stress. By clarifying their role in cold and drought tolerance, we improve our ability to predict plant response to environment.


Asunto(s)
Carbohidratos , Fotosíntesis , Azúcares , Madera , Plantas , Metabolismo de los Hidratos de Carbono , Árboles/química
5.
Evol Appl ; 15(11): 1945-1962, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36426125

RESUMEN

Phenotypic plasticity is a main mechanism for organisms to cope with changing environments and broaden their ecological range. Plasticity is genetically based and can evolve under natural selection, such that populations within a species show distinct phenotypic responses to the environment if evolved under different conditions. Understanding how intraspecific variation in phenotypic plasticity arises is critical to assess potential adaptation to ongoing climate change. Theory predicts that plasticity is favored in more favorable but variable environments. Yet, many theoretical predictions about benefits, costs, and selection on plasticity remain untested. To test these predictions, we took advantage of three genetic trials in the northern Rocky Mountains, USA, which assessed 23 closely located Pinus ponderosa populations over 27 years. Mean environmental conditions and their spatial patterns of variation at the seed source populations were characterized based on six basic climate parameters. Despite the small area of origin, there was significant genetic variation in phenotypic plasticity for tree growth among populations. We found a significant negative correlation between phenotypic plasticity and the patch size of environmental heterogeneity at the seed source populations, but not with total environmental spatial variance. These results show that populations exposed to high microhabitat heterogeneity have evolved higher phenotypic plasticity and that the trigger was the grain rather than the total magnitude of spatial heterogeneity. Contrary to theoretical predictions, we also found a positive relationship between population plasticity and summer drought at the seed source, indicating that drought can act as a trigger of plasticity. Finally, we found a negative correlation between the quantitative genetic variance within populations and their phenotypic plasticity, suggesting compensatory adaptive mechanisms for the lack of genetic diversity. These results improve our understanding of the microevolutionary drivers of phenotypic plasticity, a critical process for resilience of long-lived species under climate change, and support decision-making in tree genetic improvement programs and seed transfer strategies.

6.
Artículo en Inglés | MEDLINE | ID: mdl-36141796

RESUMEN

In the last years, there has been a big effort to identify risk factors for reading difficulties and to develop new methodologies to help struggling readers. It has been shown that early intervention is more successful than late intervention, and that intensive training programs can benefit children with reading difficulties. The aim of our study is to investigate the effectiveness of an intensive computerized phonological training program designed to improve reading performance in a sample of children with reading difficulties at the early stages of their reading learning process. Thirty-two children with reading difficulties were randomly assigned to one of the two intervention groups: RDIR (children with reading difficulties following a computerized intensive remediation strategy) (n = 20) (7.01 ± 0.69 years), focused on training phonemic awareness, decoding and reading fluency through the computational training; and RDOR (children with reading difficulties following an ordinary remediation strategy) (n = 12) (6.92 ± 0.82 years), which consisted of a reinforcement of reading with a traditional training approach at school. Normal readers (NR) were assigned to the control group (n = 24) (7.32 ± 0.66 years). Our results indicate that both the RDIR and RDOR groups showed an increased reading performance after the intervention. However, children in the RDIR group showed a stronger benefit than the children in the RDOR group, whose improvement was weaker. The control group did not show significant changes in reading performance during the same period. In conclusion, results suggest that intensive early intervention based on phonics training is an effective strategy to remediate reading difficulties, and that it can be used at school as the first approach to tackle such difficulties.


Asunto(s)
Dislexia , Lectura , Niño , Cognición , Dislexia/terapia , Intervención Educativa Precoz , Humanos , Aprendizaje
7.
Artículo en Inglés | MEDLINE | ID: mdl-35805445

RESUMEN

Background: In the Lombardy Region, Italy, HPV vaccination is recommended and offered free of charge to 12-years-old males since 2017. The expected vaccination thresholds are still far to be reached. Methods: A cross-sectional survey to investigate parents' attitudes towards the HPV vaccine and knowledge about HPV was administered to parents of boys aged 6 to 18 years attending a large pediatric hospital for outpatient specialistic evaluations. Two parallel multiple logistic regression analyses were conducted to estimate the odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) for attitude towards HPV vaccination and perceived need for more information about HPV vaccination. Results: A positive attitude towards HPV vaccination was found in 74% of interviewed parents. Knowledge of HPV, having a generally positive attitude toward vaccination, and mothers filling in the survey were positively associated with a positive attitude to the HPV vaccine. Parents' perceived need for more information about HPV vaccination was positively associated with the child's age, general positive attitude toward vaccination, Christian religion, and positive attitude toward HPV vaccination; knowing that HPV vaccination is free of charge significantly reduced the risk of asking for more information on HPV vaccination. Conclusions: The majority of parents of male children and adolescents in our study have a positive attitude toward HPV vaccination. Attitude toward HPV vaccination and perceived need for more information on HPV vaccination were directly related to a positive attitude toward vaccines in general. In addition, knowledge of HPV and related pathologies favors a positive attitude toward HPV vaccination. Future health programs should target an even wider diffusion of evidence-based information on vaccines in general and on the HPV vaccine in young males, to support a positive attitude toward vaccines in the general population.


Asunto(s)
Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Adolescente , Niño , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Infecciones por Papillomavirus/prevención & control , Aceptación de la Atención de Salud , Encuestas y Cuestionarios , Vacunación
8.
Children (Basel) ; 9(5)2022 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-35626832

RESUMEN

Congenital cytomegalovirus infection (cCMV) is the most common congenital viral infection, with a consistent rate of morbidity, mortality, and long-term sequelae, especially in the case of late diagnosis. Nevertheless, a universal screening for CMV is not currently recommended, and global awareness about this infection, as well as accurate and shared indications on follow-up and treatment, are still lacking. We reviewed data about 59 suspect cCMV cases who referred to our center from 2014 to 2021. We report 41 cases of confirmed cCMV diagnosed at birth, with clinical or radiological abnormalities in 36.6% of them. Other five patients received a late diagnosis and all presented neurological impairment. Twelve patients received therapy with Valganciclovir within the first month of life, with favorable outcome in nine cases. Therapy after the first month of life was attempted in four patients, with improvement in one case. The overall awareness about cCMV infection was 32.6%. Considering our population, maternal serological screening followed by targeted testing of neonates could be an effective strategy. Some aspects of cCMV infection management should be further investigated, such as indication of treatment after the first month of life or in asymptomatic patients. Awareness about the infection should be improved to implement preventive strategies.

9.
New Phytol ; 235(6): 2211-2222, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35524463

RESUMEN

Trade-offs among carbon sinks constrain how trees physiologically, ecologically, and evolutionarily respond to their environments. These trade-offs typically fall along a productive growth to conservative, bet-hedging continuum. How nonstructural carbohydrates (NSCs) stored in living tree cells (known as carbon stores) fit in this trade-off framework is not well understood. We examined relationships between growth and storage using both within species genetic variation from a common garden, and across species phenotypic variation from a global database. We demonstrate that storage is actively accumulated, as part of a conservative, bet-hedging life history strategy. Storage accumulates at the expense of growth both within and across species. Within the species Populus trichocarpa, genetic trade-offs show that for each additional unit of wood area growth (in cm2 yr-1 ) that genotypes invest in, they lose 1.2 to 1.7 units (mg g-1 NSC) of storage. Across species, for each additional unit of area growth (in cm2 yr-1 ), trees, on average, reduce their storage by 9.5% in stems and 10.4% in roots. Our findings impact our understanding of basic plant biology, fit storage into a widely used growth-survival trade-off spectrum describing life history strategy, and challenges the assumptions of passive storage made in ecosystem models today.


Asunto(s)
Ecosistema , Rasgos de la Historia de Vida , Carbohidratos , Carbono , Plantas , Árboles/fisiología
10.
Proc Natl Acad Sci U S A ; 118(33)2021 08 17.
Artículo en Inglés | MEDLINE | ID: mdl-34389667

RESUMEN

Climate change is expected to pose a global threat to forest health by intensifying extreme events like drought and insect attacks. Carbon allocation is a fundamental process that determines the adaptive responses of long-lived late-maturing organisms like trees to such stresses. However, our mechanistic understanding of how trees coordinate and set allocation priorities among different sinks (e.g., growth and storage) under severe source limitation remains limited. Using flux measurements, isotopic tracing, targeted metabolomics, and transcriptomics, we investigated how limitation of source supply influences sink activity, particularly growth and carbon storage, and their relative regulation in Norway spruce (Picea abies) clones. During photosynthetic deprivation, absolute rates of respiration, growth, and allocation to storage all decline. When trees approach neutral carbon balance, i.e., daytime net carbon gain equals nighttime carbon loss, genes encoding major enzymes of metabolic pathways remain relatively unaffected. However, under negative carbon balance, photosynthesis and growth are down-regulated while sucrose and starch biosynthesis pathways are up-regulated, indicating that trees prioritize carbon allocation to storage over growth. Moreover, trees under negative carbon balance actively increase the turnover rate of starch, lipids, and amino acids, most likely to support respiration and mitigate stress. Our study provides molecular evidence that trees faced with severe photosynthetic limitation strategically regulate storage allocation and consumption at the expense of growth. Understanding such allocation strategies is crucial for predicting how trees may respond to extreme events involving steep declines in photosynthesis, like severe drought, or defoliation by heat waves, late frost, or insect attack.


Asunto(s)
Carbono/metabolismo , Picea/crecimiento & desarrollo , Picea/metabolismo , Estrés Fisiológico , Fotosíntesis/fisiología , Fenómenos Fisiológicos de las Plantas , Transpiración de Plantas
11.
Plant Cell Environ ; 44(10): 3322-3335, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34251033

RESUMEN

Predicted increases in forest drought mortality highlight the need for predictors of incipient drought-induced mortality (DIM) risk that enable proactive large-scale management. Such predictors should be consistent across plants with varying morphology and physiology. Because of their integrative nature, indicators of water status are promising candidates for real-time monitoring of DIM, particularly if they standardize morphological differences among plants. We assessed the extent to which differences in morphology and physiology between Pinus ponderosa populations influence time to mortality and the predictive power of key indicators of DIM risk. Time to incipient mortality differed between populations but occurred at the same relative water content (RWC) and water potential (WP). RWC and WP were accurate predictors of drought mortality risk. These results highlight that variables related to water status capture critical thresholds during DIM and the associated dehydration processes. Both WP and RWC are promising candidates for large-scale assessments of DIM risk. RWC is of special interest because it allows comparisons across different morphologies and can be remotely sensed. Our results offer promise for real-time landscape-level monitoring of DIM and its global impacts in the near term.


Asunto(s)
Sequías , Pinus ponderosa/fisiología , Plantones/crecimiento & desarrollo , Agua/metabolismo , Pinus ponderosa/crecimiento & desarrollo , Plantones/fisiología
12.
Ecol Appl ; 31(3): e2274, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33617144

RESUMEN

Warming-induced mountain pine beetle (Dendroctonus ponderosae; MPB) outbreaks have caused extensive mortality of whitebark pine (Pinus albicaulis; WBP) throughout the species' range. In the highest mountains where WBP occur, they cross alpine treeline ecotones (ATEs) where growth forms transition from trees to shrub-like krummholz, some of which survived recent MPB outbreaks. This observation motivated the hypothesis that ATEs are refugia for WBP because krummholz growth forms escape MPB attack and have the potential to produce viable seed. To test this hypothesis, we surveyed WBP mortality along transects from the ATE edge (locally highest krummholz WBP) downslope into the forest and, to distinguish if survival mechanisms are unique to ATEs, across other forest ecotones (OFEs) from the edge of WBP occurrence into the forest. We replicated this design at 10 randomly selected sites in the U.S. Northern Rocky Mountains. We also surveyed reproduction in a subset of ATE sites. Mortality was nearly absent in upper ATEs (mean ± SE percent dead across all sites of 0.03% ± 0.03% 0-100 m from the edge and 14.1% ± 1.7% 100-500 m from the edge) but was above 20% along OFEs (21.4 ± 5.2% 0-100 m and 32.4 ± 2.7% 100-500 m from the edge). We observed lower reproduction in upper ATEs (16 ± 9.9 cones/ha and 12.9 ± 5.3 viable seeds/cone 0-100 m from the edge) compared to forests below (317.1 ± 64.4 cones/ha and 32.5 ± 2.5 viable seeds/cone 100-500 m from the edge). Uniquely high WBP survival supports the hypothesis that ATEs serve as refugia because krummholz growth forms escape MPB attack. However, low reproduction suggests ATE refugia function over longer time periods. Beyond our WBP system, we propose that plant populations in marginal environments are candidate refugia if distinct phenotypes result in reduced disturbance impacts.


Asunto(s)
Escarabajos , Pinus , Animales , Brotes de Enfermedades , Corteza de la Planta , Refugio de Fauna
13.
New Phytol ; 229(6): 3172-3183, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33280134

RESUMEN

Under prolonged drought and reduced photosynthesis, plants consume stored nonstructural carbohydrates (NSCs). Stored NSC depletion may impair the regulation of plant water balance, but the underlying mechanisms are poorly understood, and whether such mechanisms are independent of plant water deficit is not known. If so, carbon costs of fungal symbionts could indirectly influence plant drought tolerance through stored NSC depletion. We connected well-watered Pinus ponderosa seedling pairs via ectomycorrhizal (EM) networks where one seedling was shaded (D) and the other kept illuminated (LD) and compared responses to seedling pairs in full light (L). We measured plant NSCs, osmotic and water potential, and transfer of 13 CO2 through EM to explore mechanisms linking stored NSCs to plant water balance regulation and identify potential tradeoffs between plant water retention and EM fungi under carbon-limiting conditions. NSCs decreased from L to LD to D seedlings. Even without drought, NSC depletion impaired osmoregulation and turgor maintenance, both of which are critical for drought tolerance. Importantly, EM networks propagated NSC depletion and its negative effects on water retention from carbon stressed to nonstressed hosts. We demonstrate that NSC storage depletion influences turgor maintenance independently of plant water deficit and reveal carbon allocation tradeoffs between supporting fungal symbionts and retaining water.


Asunto(s)
Micorrizas , Agua , Carbohidratos , Sequías , Plantones , Árboles
14.
Brain Imaging Behav ; 15(4): 2109-2120, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33048291

RESUMEN

The link between literacy difficulties and brain alterations has been described in depth. Resting-state fMRI (rs-fMRI) has been successfully applied to the study of intrinsic functional connectivity (iFc) both in dyslexia and typically developing children. Most related studies have focused on the stages from late childhood into adulthood using a seed to voxel approach. Our study analyzes iFc in an early childhood sample using the multivariate pattern analysis. This facilitates a hypothesis-free analysis and the possible identification of abnormal functional connectivity patterns at a whole brain level. Thirty-four children with literacy difficulties (LD) (7.1 ± 0.69 yr.) and 30 typically developing children (TD) (7.43 ± 0.52 yr.) were selected. Functional brain connectivity was measured using an rs-fMRI acquisition. The LD group showed a higher iFc between the right middle frontal gyrus (rMFG) and the default mode network (DMN) regions, and a lower iFc between the rMFG and both the bilateral insular cortex and the supramarginal gyrus. These results are interpreted as a DMN on/off routine malfunction in the LD group, which suggests an alteration of the task control network regulating DMN activity. In the LD group, the posterior cingulate cortex also showed a lower iFc with both the middle temporal poles and the fusiform gyrus. This could be interpreted as a failure in the integration of information between brain regions that facilitate reading. Our results show that children with literacy difficulties have an altered functional connectivity in their reading and attentional networks at the beginning of the literacy acquisition. Future studies should evaluate whether or not these alterations could indicate a risk of developing dyslexia.


Asunto(s)
Dislexia , Alfabetización , Adulto , Encéfalo/diagnóstico por imagen , Mapeo Encefálico , Niño , Preescolar , Dislexia/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética
15.
Ecol Appl ; 30(8): e02188, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32492227

RESUMEN

As the climate warms, drought will increasingly occur under elevated temperatures, placing forest ecosystems at growing risk of extensive dieback and mortality. In some cases, increases in tree density following early 20th-century fire suppression may exacerbate this risk. Treatments designed to restore historical stand structure and enhance resistance to high-severity fire might also alleviate drought stress by reducing competition, but the duration of these effects and the underlying mechanisms remain poorly understood. To elucidate these mechanisms, we evaluate tree growth, mortality, and tree-ring stable-carbon isotope responses to stand-density reduction treatments with and without prescribed fire in a ponderosa pine forest of western Montana. Moderate and heavier cutting experiments (basal area reductions of 35% and 56%, respectively) were initiated in 1992, followed by prescribed burning in a subset of the thinned units. All treatments led to a growth release that persisted to the time of resampling. The treatments had little effect on climate-growth relationships, but they markedly altered seasonal carbon isotope signals and their relationship to climate. In burned and unburned treatments, carbon isotope discrimination (Δ13 C) increased in the earlywood (EW) and decreased in the latewood (LW) relative to the control. The sensitivity of LW Δ13 C to late-summer climate also increased in all treatments, but not in the control. Such increased sensitivity indicates that the reduction in competition enabled trees to continue to fix carbon for new stem growth, even when the climate became sufficiently stressful to stop new assimilation in slower-growing trees in untreated units. These findings would have been masked had we not separated EW and LW. The importance of faster growth and enhanced carbon assimilation under late-summer climatic stress became evident in the second decade post-treatment, when mountain pine beetle activity increased locally, and tree mortality rates in the controls of both experiments increased to more than twice those in their respective treatments. These findings highlight that, when thinning is used to restore historical forest structure or increase resistance to high-severity fire, there will likely be additional benefits of enhanced growth and physiological activity under climatic stress, and the effects may persist for more than two decades.


Asunto(s)
Ecosistema , Pinus ponderosa , Animales , Bosques , Montana , Árboles
16.
Pediatr Infect Dis J ; 39(7): e149-e151, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32433225

RESUMEN

Severe acute respiratory syndrome coronavirus 2 infection in children mainly shows a milder course. In complicated cases, it is unknown whether inflammation is predictive of disease severity, as in adults. Moreover, cardiac involvement is anecdotally described. We report the case of a 2-month-old infant with severe acute respiratory syndrome coronavirus 2 infection presenting with fever, tachycardia and elevated interleukin-6, who was diagnosed with myocarditis and treated with immunoglobulins.


Asunto(s)
Infecciones por Coronavirus/patología , Inflamación/virología , Miocarditis/virología , Neumonía Viral/patología , Betacoronavirus/aislamiento & purificación , COVID-19 , Infecciones por Coronavirus/metabolismo , Infecciones por Coronavirus/virología , Femenino , Fiebre/virología , Humanos , Inmunoglobulinas/uso terapéutico , Lactante , Inflamación/diagnóstico , Inflamación/metabolismo , Interleucina-6/metabolismo , Miocarditis/diagnóstico , Pandemias , Neumonía Viral/metabolismo , Neumonía Viral/virología , SARS-CoV-2 , Taquicardia/virología
17.
Case Rep Endocrinol ; 2020: 6688927, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33457025

RESUMEN

OBJECTIVE: Congenital adrenal hyperplasia (CAH) is the most common cause of adrenal insufficiency in pediatrics. Chronic glucocorticoid replacement is the mainstay of treatment in the classic forms of CAH, and mineralocorticoid replacement therapy is mandatory in the salt-wasting form. Fasting is a mild stressor, which can expose to dehydration, hypotension, hypoglycemia, and acute adrenal crisis in patients with adrenal insufficiency. CASE: We report the case of an adolescent affected by the classic form with salt-losing CAH, who observed Ramadan for 30 days, without individualized therapeutic management plan. After Ramadan, a dramatic increase of ACTH level (1081 pg/ml, n.v. 6-57), reduced cortisolemia, tendency to hypotension, and weight loss were recorded. She experienced insomnia, intense thirst, asthenia, and headache. The symptoms disappeared restarting the previous therapy schedule and increasing the total hydrocortisone daily dose with progressive restoring of hormonal control. CONCLUSION: Our case confirms that patients with CAH are vulnerable, especially during fasting in Ramadan, with a higher risk of acute adrenal crisis. CAH patients should reform and individualize their treatment plan and be submitted to careful monitoring.

18.
J Exp Bot ; 71(3): 1139-1150, 2020 01 23.
Artículo en Inglés | MEDLINE | ID: mdl-31641748

RESUMEN

Desiccation-tolerant (DT) organisms can lose nearly all their water without dying. Desiccation tolerance allows organisms to survive in a nearly completely dehydrated, dormant state. At the cellular level, sugars and proteins stabilize cellular components and protect them from oxidative damage. However, there are few studies of the dynamics and drivers of whole-plant recovery in vascular DT plants. In vascular DT plants, whole-plant desiccation recovery (resurrection) depends not only on cellular rehydration, but also on the recovery of organs with unequal access to water. In this study, in situ natural and artificial irrigation experiments revealed the dynamics of desiccation recovery in two DT fern species. Organ-specific irrigation experiments revealed that the entire plant resurrected when water was supplied to roots, but leaf hydration alone (foliar water uptake) was insufficient to rehydrate the stele and roots. In both species, pressure applied to petioles of excised desiccated fronds resurrected distal leaf tissue, while capillarity alone was insufficient to resurrect distal pinnules. Upon rehydration, sucrose levels in the rhizome and stele dropped dramatically as starch levels rose, consistent with the role of accumulated sucrose as a desiccation protectant. These findings provide insight into traits that facilitate desiccation recovery in dryland ferns associated with chaparral vegetation of southern California.


Asunto(s)
Raíces de Plantas/fisiología , Pteridaceae/fisiología , Agua/fisiología , Desecación , Lluvia , Sacarosa/metabolismo
19.
Sci Signal ; 12(586)2019 06 18.
Artículo en Inglés | MEDLINE | ID: mdl-31213567

RESUMEN

Autosomal dominant mutations in GRIN2B are associated with severe encephalopathy, but little is known about the pathophysiological outcomes and any potential therapeutic interventions. Genetic studies have described the association between de novo mutations of genes encoding the subunits of the N-methyl-d-aspartate receptor (NMDAR) and severe neurological conditions. Here, we evaluated a missense mutation in GRIN2B, causing a proline-to-threonine switch (P553T) in the GluN2B subunit of NMDAR, which was found in a 5-year-old patient with Rett-like syndrome with severe encephalopathy. Structural molecular modeling predicted a reduced pore size of the mutant GluN2B-containing NMDARs. Electrophysiological recordings in a HEK-293T cell line expressing the mutated subunit confirmed this prediction and showed an associated reduced glutamate affinity. Moreover, GluN2B(P553T)-expressing primary murine hippocampal neurons showed decreased spine density, concomitant with reduced NMDA-evoked currents and impaired NMDAR-dependent insertion of the AMPA receptor subunit GluA1 at stimulated synapses. Furthermore, the naturally occurring coagonist d-serine restored function to GluN2B(P553T)-containing NMDARs. l-Serine dietary supplementation of the patient was hence initiated, resulting in the increased abundance of d-serine in the plasma and brain. The patient has shown notable improvements in motor and cognitive performance and communication after 11 and 17 months of l-serine dietary supplementation. Our data suggest that l-serine supplementation might ameliorate GRIN2B-related severe encephalopathy and other neurological conditions caused by glutamatergic signaling deficiency.


Asunto(s)
Encefalopatías , Suplementos Dietéticos , Mutación con Pérdida de Función , Receptores de N-Metil-D-Aspartato , Síndrome de Rett , Serina , Animales , Encefalopatías/tratamiento farmacológico , Encefalopatías/genética , Encefalopatías/metabolismo , Encefalopatías/patología , Niño , Cognición/efectos de los fármacos , Humanos , Masculino , Ratones , Modelos Moleculares , Actividad Motora/efectos de los fármacos , Actividad Motora/genética , N-Metilaspartato/farmacología , Receptores de N-Metil-D-Aspartato/química , Receptores de N-Metil-D-Aspartato/genética , Receptores de N-Metil-D-Aspartato/metabolismo , Síndrome de Rett/tratamiento farmacológico , Síndrome de Rett/genética , Síndrome de Rett/metabolismo , Síndrome de Rett/patología , Serina/administración & dosificación , Serina/farmacocinética
20.
Proc Natl Acad Sci U S A ; 116(30): 15282-15287, 2019 07 23.
Artículo en Inglés | MEDLINE | ID: mdl-31209057

RESUMEN

Consistent with a ubiquitous life history trade-off, trees exhibit a negative relationship between growth and longevity both among and within species. However, the mechanistic basis of this life history trade-off is not well understood. In addition to resource allocation conflicts among multiple traits, functional conflicts arising from individual morphological traits may also contribute to life history trade-offs. We hypothesized that conflicting functional effects of xylem structural traits contribute to the growth-longevity trade-off in trees. We tested this hypothesis by examining the extent to which xylem morphological traits (i.e., wood density, tracheid diameters, and pit structure) relate to growth rates and longevity in two natural populations of the conifer species Pinus ponderosa Hydraulic constraints arise as trees grow larger and xylem anatomical traits adjust to compensate. We disentangled the effects of size through ontogeny in individual trees and growth rates among trees on xylem traits by sampling each tree at multiple trunk diameters. We found that the oldest trees had slower lifetime growth rates compared with younger trees in the studied populations, indicating a growth-longevity trade-off. We further provide evidence that a single xylem trait, pit structure, with conflicting effects on xylem function (hydraulic safety and efficiency) relates to the growth-longevity trade-off in a conifer species. This study highlights that, in addition to trade-offs among multiple traits, functional constraints based on individual morphological traits like that of pit structure provide mechanistic insight into how and when life history trade-offs arise.


Asunto(s)
Pinus ponderosa/crecimiento & desarrollo , Carácter Cuantitativo Heredable , Xilema/crecimiento & desarrollo , Factores de Edad , Fenómenos Biomecánicos , Rasgos de la Historia de Vida , Pinus ponderosa/anatomía & histología , Xilema/anatomía & histología
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