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Aging affects the number and function of gamma-delta (γδ) T cells in a tissue-specific manner, modifying the risk for inflammatory disease. These aging-related γδT-cell variations in gingival tissues that could increase the risk for inflammation and periodontal disease remain unknown. Here we sought to identify quantitative and qualitative variations in gingival γδT cells associated with aging that could have an impact in oral immunoinflammatory responses. For this, gingival tissues from young (4 mo) and aged (24 mo) male and female mice were collected and analyzed by flow cytometry. Cell suspensions were stimulated and stained with eFluor450 (cell viability), anti-CD45 (hematopoietic cells), anti-CD3 (lymphocytes), anti-TCRγδ (γδT cells), anti-IL-15rα (cell proliferation), and anti-Notch-3 (senescence marker). Detection of intracellular cytokines IL-17A and interferon γ (IFNγ) was performed. Gingival expression of specific γ- and δ-chains and cytokines was evaluated by quantitative reverse transcription polymerase chain reaction. A significantly higher number of IL-17A-producing γδT cells and IL-17A expression levels were observed in gingival tissues from aged females but not males. Similarly, the number of gingival Notch-3+ γδT cells increased with aging only in females. IL-15rα was not detected in gingival γδT cells. Chains γ1, 2, 4, 5, 6, and 7 as well as δ1, 2, 4, and 6 were detected. Detection levels of all γ chains except γ1 as well as δ1 and δ2 changed with aging in males, females, or both. Interestingly, number of IL-17A-producing conventional T cells similarly increased with aging only in females. Both sexes showed increased IFNγ+ conventional T-cell numbers with aging; however, it reached significance only in females. In conclusion, the number of gingival IL-17A-producing γδT cells and IL-17A expression increase naturally with aging specifically in females. This sexual dimorphism in gingival γδT and conventional Th17 cell numbers and phenotypes suggests distinct aging-related mechanisms of periodontitis in males and females.
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Interleucina-17 , Receptores de Antígenos de Linfocitos T gamma-delta , Masculino , Femenino , Animales , Ratones , Interleucina-17/metabolismo , Receptores de Antígenos de Linfocitos T gamma-delta/metabolismo , Citometría de Flujo , Citocinas , Interferón gamma , Envejecimiento , Células Th17RESUMEN
Previous studies indicated that Tai Chi might be an effective way to improve or prevent cognitive impairments in older populations. However, existing research does not provide clear recommendations about the optimal dose of Tai Chi practice, which is the most effective in improving cognitive function in older adults. The purpose of this systematic review and meta-analysis was to investigate the dose-response relationship between Tai Chi and cognition in community-dwelling older adults. A total of 16 studies with 1121 subjects were included in this study. Meta-regression analyses of Tai Chi duration (Tai Chi session duration, Tai Chi practice duration per week, study duration, and Tai Chi practice duration for the entire study) on the study effect size (ES) were performed to examine the dose-response association of Tai Chi and cognition. The results showed that there was a positive effect of Tai Chi on cognitive function, but there were no statistically significant dose duration effects on cognition. The findings suggest that Tai Chi has beneficial effects on cognitive function, but a longer duration was not associated with larger effects. In order to establish evidence-based clinical interventions using Tai Chi, future research should clearly demonstrate intervention protocol, particularly the style and intensity of Tai Chi.
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Disfunción Cognitiva , Taichi Chuan , Anciano , Cognición , Disfunción Cognitiva/prevención & control , Humanos , Vida Independiente , Factores de TiempoRESUMEN
The NASA Perseverance rover Mast Camera Zoom (Mastcam-Z) system is a pair of zoomable, focusable, multi-spectral, and color charge-coupled device (CCD) cameras mounted on top of a 1.7 m Remote Sensing Mast, along with associated electronics and two calibration targets. The cameras contain identical optical assemblies that can range in focal length from 26 mm ( 25.5 ∘ × 19.1 ∘ FOV ) to 110 mm ( 6.2 ∘ × 4.2 ∘ FOV ) and will acquire data at pixel scales of 148-540 µm at a range of 2 m and 7.4-27 cm at 1 km. The cameras are mounted on the rover's mast with a stereo baseline of 24.3 ± 0.1 cm and a toe-in angle of 1.17 ± 0.03 ∘ (per camera). Each camera uses a Kodak KAI-2020 CCD with 1600 × 1200 active pixels and an 8 position filter wheel that contains an IR-cutoff filter for color imaging through the detectors' Bayer-pattern filters, a neutral density (ND) solar filter for imaging the sun, and 6 narrow-band geology filters (16 total filters). An associated Digital Electronics Assembly provides command data interfaces to the rover, 11-to-8 bit companding, and JPEG compression capabilities. Herein, we describe pre-flight calibration of the Mastcam-Z instrument and characterize its radiometric and geometric behavior. Between April 26 t h and May 9 t h , 2019, â¼45,000 images were acquired during stand-alone calibration at Malin Space Science Systems (MSSS) in San Diego, CA. Additional data were acquired during Assembly Test and Launch Operations (ATLO) at the Jet Propulsion Laboratory and Kennedy Space Center. Results of the radiometric calibration validate a 5% absolute radiometric accuracy when using camera state parameters investigated during testing. When observing using camera state parameters not interrogated during calibration (e.g., non-canonical zoom positions), we conservatively estimate the absolute uncertainty to be < 10 % . Image quality, measured via the amplitude of the Modulation Transfer Function (MTF) at Nyquist sampling (0.35 line pairs per pixel), shows MTF Nyquist = 0.26 - 0.50 across all zoom, focus, and filter positions, exceeding the > 0.2 design requirement. We discuss lessons learned from calibration and suggest tactical strategies that will optimize the quality of science data acquired during operation at Mars. While most results matched expectations, some surprises were discovered, such as a strong wavelength and temperature dependence on the radiometric coefficients and a scene-dependent dynamic component to the zero-exposure bias frames. Calibration results and derived accuracies were validated using a Geoboard target consisting of well-characterized geologic samples. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11214-021-00795-x.
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While pyrochlore iridate thin films are theoretically predicted to possess a variety of emergent topological properties, experimental verification of these predictions can be obstructed by the challenge in thin film growth. Here we report on the pulsed laser deposition and characterization of thin films of a representative pyrochlore compound Bi2Ir2O7. The films were epitaxially grown on yttria-stabilized zirconia substrates and have lattice constants that are a few percent larger than that of the bulk single crystals. The film composition shows a strong dependence on the oxygen partial pressure. Density-functional-theory calculations indicate the existence of BiIr antisite defects, qualitatively consistent with the high Bi: Ir ratio found in the films. Both Ir and Bi have oxidation states that are lower than their nominal values, suggesting the existence of oxygen deficiency. The iridate thin films show a variety of intriguing transport characteristics, including multiple charge carriers, logarithmic dependence of resistance on temperature, antilocalization corrections to conductance due to spin-orbit interactions, and linear positive magnetoresistance.
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Two-dimensional transition metal dichalcogenides (e.g. MoS2) have recently emerged as a promising material system for electronic and optoelectronic applications. A major challenge for these materials, however, is to realize bipolar electrical transport properties (i.e. both p-type and n-type conduction), which is critical for enhancing device performance and functionalities. Here, we demonstrate the transition metal zinc as a p-type dopant in the otherwise n-type MoS2, through systematic characterizations of large area Zn-doped MoS2 thin films grown by a one-step chemical vapor deposition (CVD) approach. Raman characterization and X-ray photoelectron spectroscopy studies identified millimeter-scale, monolayer films with 1-2% Zn as dopants. Zinc doping suppresses n-type conductivity in MoS2 and shifts its Fermi level downwards. The stability and p-type nature of Zn dopants were further confirmed by density-functional-theory calculations of formation energies and electronic band structures. The electrical transport properties of Zn-MoS2 films can be influenced by stoichiometry, and p-type gate transfer characteristics were realized by thermal treatment under a sulfur atmosphere. Our work highlights transition-metal doping followed by sulfur vacancy elimination in CVD grown films as a promising route for achieving large area p-type transition metal dichalcogenide films that are essential for practical applications in electronics and optoelectronics.
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OBJECTIVE: To measure performance, fidelity and preference of two emergency umbilical vessel catheter (eUVC) simulation models. STUDY DESIGN: A randomized crossover trial of senior pediatric residents randomized to place an eUVC first using a real cord (RC) or simulated cord (SC), and then place an eUVC using the other model. The eUVC placement times were recorded and analyzed. Subjects rated physical and functional fidelity and preference for each model. RESULTS: The eUVC placement time (mean±s.d. s) was slower in RC vs SC (153 s ±71 vs 88 s ±35, P<0.001), however, there was no difference in eUVC placement time in the group that worked with SC first (115 s ±36 vs 97 s ±35, P=0.161). Physical and functional fidelity of RC were rated higher than SC (P<0.001), and RC were preferred. CONCLUSION: RC has higher physical and functional fidelity, and are preferred for training by pediatric residents, despite longer placement times.
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CONTEXT: Clinical decision support systems (CDSSs) can help clinicians assess cardiovascular disease (CVD) risk and manage CVD risk factors by providing tailored assessments and treatment recommendations based on individual patient data. The goal of this systematic review was to examine the effectiveness of CDSSs in improving screening for CVD risk factors, practices for CVD-related preventive care services such as clinical tests and prescribed treatments, and management of CVD risk factors. EVIDENCE ACQUISITION: An existing systematic review (search period, January 1975-January 2011) of CDSSs for any condition was initially identified. Studies of CDSSs that focused on CVD prevention in that review were combined with studies identified through an updated search (January 2011-October 2012). Data analysis was conducted in 2013. EVIDENCE SYNTHESIS: A total of 45 studies qualified for inclusion in the review. Improvements were seen for recommended screening and other preventive care services completed by clinicians, recommended clinical tests completed by clinicians, and recommended treatments prescribed by clinicians (median increases of 3.8, 4.0, and 2.0 percentage points, respectively). Results were inconsistent for changes in CVD risk factors such as systolic and diastolic blood pressure, total and low-density lipoprotein cholesterol, and hemoglobin A1C levels. CONCLUSIONS: CDSSs are effective in improving clinician practices related to screening and other preventive care services, clinical tests, and treatments. However, more evidence is needed from implementation of CDSSs within the broad context of comprehensive service delivery aimed at reducing CVD risk and CVD-related morbidity and mortality.
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Enfermedades Cardiovasculares/prevención & control , Sistemas de Apoyo a Decisiones Clínicas/normas , Hemoglobina Glucada/análisis , Lipoproteínas LDL/sangre , Humanos , Factores de RiesgoRESUMEN
The presence of regulatory T cells (Treg) in solid tumors is known to play a role in patient survival in ovarian cancer and other malignancies. We assessed inherited genetic variations via 749 tag single-nucleotide polymorphisms (SNP) in 25 Treg-associated genes (CD28, CTLA4, FOXP3, IDO1, IL10, IL10RA, IL15, 1L17RA, IL23A, IL23R, IL2RA, IL6, IL6R, IL8, LGALS1, LGALS9, MAP3K8, STAT5A, STAT5B, TGFB1, TGFB2, TGFB3, TGFBR1, TGRBR2, and TGFBR3) in relation to ovarian cancer survival. We analyzed genotype and overall survival in 10,084 women with invasive epithelial ovarian cancer, including 5,248 high-grade serous, 1,452 endometrioid, 795 clear cell, and 661 mucinous carcinoma cases of European descent across 28 studies from the Ovarian Cancer Association Consortium (OCAC). The strongest associations were found for endometrioid carcinoma and IL2RA SNPs rs11256497 [HR, 1.42; 95% confidence interval (CI), 1.22-1.64; P = 5.7 × 10(-6)], rs791587 (HR, 1.36; 95% CI, 1.17-1.57; P = 6.2 × 10(-5)), rs2476491 (HR, = 1.40; 95% CI, 1.19-1.64; P = 5.6 × 10(-5)), and rs10795763 (HR, 1.35; 95% CI, 1.17-1.57; P = 7.9 × 10(-5)), and for clear cell carcinoma and CTLA4 SNP rs231775 (HR, 0.67; 95% CI, 0.54-0.82; P = 9.3 × 10(-5)) after adjustment for age, study site, population stratification, stage, grade, and oral contraceptive use. The rs231775 allele associated with improved survival in our study also results in an amino acid change in CTLA4 and previously has been reported to be associated with autoimmune conditions. Thus, we found evidence that SNPs in genes related to Tregs seem to play a role in ovarian cancer survival, particularly in patients with clear cell and endometrioid epithelial ovarian cancer.
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Perfilación de la Expresión Génica , Predisposición Genética a la Enfermedad , Variación Genética , Neoplasias Ováricas/genética , Neoplasias Ováricas/mortalidad , Linfocitos T Reguladores/metabolismo , Femenino , Expresión Génica , Mutación de Línea Germinal , Humanos , Subunidad alfa del Receptor de Interleucina-2/genética , Clasificación del Tumor , Invasividad Neoplásica , Neoplasias Ováricas/patología , Evaluación del Resultado de la Atención al Paciente , Polimorfismo de Nucleótido Simple , PronósticoRESUMEN
CONTEXT: Recent years have seen rising interest in initiatives that focus on public health improvement. This includes support for accreditation of public health departments-administered by the Public Health Accreditation Board (PHAB)-and increasing expectations that health departments should use evidence-based programs, services, and policies (interventions) such as those described in The Guide to Community Preventive Services (The Community Guide). OBJECTIVE: This project was initiated to explore the potential connections between Community Guide interventions and PHAB domains, standards, and measures. DESIGN: The project team focused on developing a Crosswalk tool to assist health departments in identifying evidence-based interventions from The Community Guide whose implementation could help document conformity with PHAB domains, standards, and measures. All Community Preventive Services Task Force-recommended interventions were reviewed to determine whether they reflect the intent and requirements of the PHAB standards and measures. MAIN OUTCOME MEASURES: Three types of connections were defined through which Community Guide interventions could be relevant to the required documentation for a PHAB measure. All instances of these connections were identified and included in the Crosswalk. RESULTS: The Crosswalk tool consists of 2 tables. The first table cross-references individual PHAB domains, standards, and measures with interventions from The Community Guide that could help provide documentation for accreditation. The second table can help accreditation preparation staff to engage with program staff. It is searchable by Community Guide topic, identifying the PHAB measures that relate to each Community Guide intervention within that topic. The type, location, and extent of connections between Community Guide interventions and PHAB domains, standards, and measures are presented and discussed. CONCLUSIONS: Tools such as the Crosswalk can be instrumental in advancing the use of evidence-based interventions in public health practice.
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Servicios Preventivos de Salud/organización & administración , Administración en Salud Pública/normas , Práctica de Salud Pública/normas , Mejoramiento de la Calidad/organización & administración , Acreditación , Concienciación , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/organización & administración , Humanos , Servicios Preventivos de Salud/normas , Mejoramiento de la Calidad/normasRESUMEN
3,4-Methylenedioxymethamphetamine (MDMA) is known to enhance tactile sensory perception, an effect that contributes to its popularity as a recreational drug. The neurophysiological basis for the effects of MDMA on somatosensation are unknown. However, MDMA interactions with the serotonin transporter (SERT) and subsequent enhancement of serotonin neurotransmission are well known. The rat trigeminal somatosensory system receives serotonergic afferents from the dorsal raphe nucleus. Because these fibers express SERT, they should be vulnerable to MDMA-induced effects. We found that administration of a challenge injection of MDMA (3 mg/kg i.p.) after repeated MDMA treatment (3 mg/kg per day for 4 days) elicits both serotonin and norepinephrine efflux in the ventral posterior medial (VPM) thalamus of Long-Evans hooded rats, the main relay along the lemniscal portion of the rodent trigeminal somatosensory pathway. We evaluated the potential for repeated MDMA administration to modulate whisker-evoked discharge of individual neurons in this region. After surgically implanting stainless steel eight-wire multichannel electrode bundles, we recorded spike train activity of single cells while activating the whisker pathway using a piezoelectric mechanical stimulator. We found that repeated MDMA administration increased the spontaneous firing rate but reduced both the magnitude and duration of whisker-evoked discharge in individual VPM thalamic neurons. The time course of drug action on neuronal firing patterns was generally consistent with fluctuations in neurotransmitter efflux as shown from our microdialysis studies. On the basis of these results, we propose that single use and repeated administration of MDMA may "distort," rather than enhance, tactile experiences in humans, in part, by disrupting normal spike firing patterns through somatosensory thalamic relay circuits.
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N-Metil-3,4-metilenodioxianfetamina/farmacología , Neurotransmisores/metabolismo , Estimulación Física , Núcleos Talámicos Posteriores/metabolismo , Serotoninérgicos/farmacología , Animales , Cromatografía Líquida de Alta Presión , Fenómenos Electrofisiológicos , Potenciales Evocados Somatosensoriales/fisiología , Potenciales Postsinápticos Excitadores/efectos de los fármacos , Potenciales Postsinápticos Excitadores/fisiología , Espacio Extracelular/efectos de los fármacos , Espacio Extracelular/metabolismo , Masculino , Microdiálisis , N-Metil-3,4-metilenodioxianfetamina/administración & dosificación , N-Metil-3,4-metilenodioxianfetamina/farmacocinética , Norepinefrina/análisis , Norepinefrina/metabolismo , Técnicas de Placa-Clamp , Núcleos Talámicos Posteriores/efectos de los fármacos , Ratas , Ratas Long-Evans , Serotonina/análisis , Serotonina/metabolismo , Serotoninérgicos/administración & dosificación , Serotoninérgicos/farmacocinética , Vibrisas/fisiologíaRESUMEN
BACKGROUND: Cryptococcus gattii causes disease among immunocompetent individuals in the tropics and subtropics. We document the appearance of C. gattii infections on Vancouver Island (VI), a temperate region, and discuss reasons for this emergence. METHODS: Data on Cryptococcus hospitalizations for the calendar years 1995 through 2004 were reviewed. Viable historic isolates stored at the provincial public health laboratory between 1987 and 2000 were serotyped. Human cases were mapped by place of residence. RESULTS: Cryptococcosis among HIV negative individuals diagnosed on VI increased sharply after 1999. C. gattii was not detected in stored isolates prior to 1999. C. gattii cases lived in a specific biogeoclimatic zone on VI. Higher rates of illness were associated with exposure to the central region of VI. CONCLUSIONS: The emergence of C. gattii in a temperate region is unprecedented. Clinicians should consider C. gattii in the differential diagnosis of individuals who travelled to certain areas in British Columbia.
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Enfermedades Transmisibles Emergentes/epidemiología , Criptococosis/epidemiología , Colombia Británica/epidemiología , Enfermedades Transmisibles Emergentes/microbiología , Criptococosis/microbiología , Cryptococcus , Hospitalización , Humanos , SerotipificaciónRESUMEN
MDMA (3,4-methylenedioxymethamphetamine, Ecstasy) is reported to enhance tactile sensory perception, an effect that is believed to contribute to its popularity as a recreational drug. To date, no literature exists that addresses the neurophysiological mechanisms underlying the effects of MDMA on somatosensation. However, MDMA interactions with the serotonin transporter protein (SERT) are well known. The rat trigeminal somatosensory system has been studied extensively and receives serotonergic afferents from the dorsal raphe nucleus. Given that these fibers express SERT, they should be vulnerable to MDMA-induced effects. We found that short-term low-dose MDMA administration (3 mg/kg i.p.) led to a significant increase in 5-hydroxytryptamine (5-HT) efflux in the ventral posterior medial (VPM) thalamus, the main relay along the lemniscal portion of the rodent trigeminal somatosensory pathway. We further evaluated the potential for MDMA to modulate whisker-evoked discharge (WED) of individual neurons in this region. After surgically implanting stainless steel 8-wire multichannel electrode bundles, we recorded spike train activity from single cells of halothane-anesthetized rats while mechanically activating the whisker pathway. We found that short-term low-dose MDMA (3 mg/kg i.p.) increased the spontaneous firing rate but reduced the magnitude and duration of WED in individual VPM thalamic neurons. It is noteworthy that the time course of drug action on neuronal firing patterns was generally consistent with increased 5-HT efflux as shown from our microdialysis studies. Based on these results, we propose the working hypothesis that MDMA may "distort" rather than enhance tactile experiences in humans, in part, by disrupting normal spike firing patterns through somatosensory thalamic relay circuits.
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N-Metil-3,4-metilenodioxianfetamina/farmacología , Neurotransmisores/metabolismo , Transducción de Señal/efectos de los fármacos , Tálamo/efectos de los fármacos , Animales , Relación Dosis-Respuesta a Droga , Masculino , Malondialdehído/sangre , Actividad Motora/efectos de los fármacos , N-Metil-3,4-metilenodioxianfetamina/sangre , Norepinefrina/metabolismo , Ratas , Ratas Long-Evans , Tiempo de Reacción/efectos de los fármacos , Serotonina/metabolismo , Tálamo/fisiologíaRESUMEN
Open precipitation and throughfall was collected at a Norway spruce stand in Finland using funnel-type collectors and at a black spruce stand in Canada using trough-type collectors. The presence or absence of a rim on the funnel, funnel diameter (9, 14 and 20 cm) and length of sampling period (1, 2 and 4 weeks) on monthly values were evaluated at the Norway spruce stand, and the number of collectors required for defined levels of accuracy and precision of throughfall loads to be reached and the influence of the spatial arrangement of collectors on solute concentrations was studied at both stands. The presence of a rim had no significant effect on open precipitation and throughfall amounts, but did on throughfall DOC, Ca(2+), Mg(2+), K(+), Na(+) and Cl(-) ion loads. Deposition loads increased with decreasing funnel diameter; for open precipitation, this was due to increased catch efficiency while for throughfall the increase was attributed to canopy interaction and leaching of litter trapped in the collectors. Calculated monthly H(+) loads decreased and those for all other constituents increased with collection period length. Using 15 collectors at the Norway spruce stand would allow throughfall loads to be determined to within 20% of the true mean weekly value with a confidence level of 95% for most solute, but not for NH(4) (+)-N, NO(3) (-)-N, Mg(2+) and SO(4) (2-)-S. Using 15 trough collectors, the same confidence level at the more heterogeneous black spruce stand would only be achieved for H(+), Cl(-), DOC and SO(4) (2-)-S loads. In both stands, using either random or systematic placements of throughfall collectors gave similar results.
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Monitoreo del Ambiente/métodos , Árboles , Ecosistema , Conductividad Eléctrica , Monitoreo del Ambiente/instrumentación , Concentración de Iones de Hidrógeno , Picea/química , Lluvia , Reproducibilidad de los Resultados , Agua/análisis , Agua/químicaRESUMEN
OBJECTIVE: To identify the determinants of medication non-adherence in women with fibromyalgia (FM). METHODS: Participants included 10 rheumatologists and 127 women recruited from tertiary care hospitals and the community. Demographic, clinical and psychosocial characteristics and patient-physician discordance were assessed at the baseline visit. Non-adherence was assessed 2 weeks later. Multivariable generalized estimating equations were used to identify determinants of non-adherence to medication. RESULTS: The average age of the women was 50.4 (s.d. 10.5) yr and the mean disability score was 60.3 (16.0) yr. Sixty (47.2%) women were non-adherent to medication; 20 (33.3%) of these were intentionally non-adherent, 24 (40.0%) were unintentionally non-adherent, and the remaining subjects were both. Overall non-adherence was predicted by higher patient-physician discordance. Unintentional non-adherence was predicted by community subjects, not being under a rheumatologist's care, less disease activity, less use of instrumental coping, and higher patient-physician discordance. Intentional non-adherence was predicted by shorter duration under a rheumatologist's care and higher patient-physician discordance. CONCLUSION: The therapeutic relationship, in addition to clinical and psychosocial characteristics, influenced non-adherence to medication.
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Fibromialgia/tratamiento farmacológico , Negativa del Paciente al Tratamiento/psicología , Adaptación Psicológica , Adulto , Femenino , Fibromialgia/psicología , Humanos , Masculino , Persona de Mediana Edad , Selección de Paciente , Estudios Prospectivos , Escalas de Valoración Psiquiátrica , Psicometría , Factores SocioeconómicosRESUMEN
SETTING: A randomised, controlled clinical trial of the effectiveness of a family-based programme of directly observed treatment (DOT) for tuberculosis. METHODS: TB patients seen in Victoria, Australia, were randomly allocated to DOT observed by a family member (FDOT), or to standard supervised but non-observed therapy (ST). The outcome measure was compliance, measured by blinded testing of isoniazid levels in urine. An intention-to-treat analysis was used. RESULTS: Of 173 patients, 87 were allocated to FDOT and 86 to ST. Only 58% in the FDOT group were able to receive FDOT, the major reason being living alone and not having a family member to observe treatment. The rate of non-compliance was 24% (41/173), with no significant difference between FDOT (22/87) and ST (19/86). No clinical or socio-demographic variable predicted compliance. CONCLUSIONS: We were unable to demonstrate a benefit of FDOT in an urban, industrialised country setting. FDOT may be more appropriate in developing countries, where extended family support is often available and the burden of TB is much higher. Poor compliance and the difficulty in predicting non-compliance shown in this study highlights the need for DOT for all TB patients.
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Antituberculosos/uso terapéutico , Salud de la Familia , Isoniazida/uso terapéutico , Cooperación del Paciente , Tuberculosis Pulmonar/tratamiento farmacológico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antituberculosos/orina , Femenino , Humanos , Isoniazida/orina , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Población UrbanaRESUMEN
Salmonella is a common cause of bacterial foodborne illness in the United States. The epidemiology and costs of nontyphoidal salmonellosis in California from 1990 through 1999 are described using surveillance, hospitalization, and death data. Trends in Salmonella rates and factors associated with prolonged hospitalization were evaluated using Poisson and linear regression models, respectively. There were 56,660 reported cases, 11,102 hospitalizations, and 74 deaths attributed to Samonella. Reported case and hospital discharge rates have decreased since 1996. Among reported cases, infants had the highest rate (121 cases per 10(5) person-years), followed by children 1-4 years of age (40 cases per 10(5) person-years). The highest hospitalization rates were among the elderly and young children. Most deaths occurred among persons aged 65 or more years (59%). Among hospitalizations, gastroenteritis (61%) and septicemia (23%) were the most common Salmonella diagnoses. Salmonella pneumonia patients were the oldest (median age, 55 years) and Salmonella meningitis patients the youngest (median age, 0.3 years). These two diagnoses were the costliest, approaching 30,000 dollars (median) per hospitalization. Having an acquired immunodeficiency syndrome diagnosis or multiple Salmonella diagnoses was independently associated with prolonged hospitalization. The estimated 10-year hospitalization costs for Salmonella were $200 million. Salmonellosis is a costly disease that disproportionately affects the young and elderly.
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Causas de Muerte , Costos de Hospital/estadística & datos numéricos , Hospitalización/economía , Infecciones por Salmonella/economía , Infecciones por Salmonella/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , California/epidemiología , Niño , Preescolar , Comorbilidad , Femenino , Costos de Hospital/tendencias , Hospitalización/tendencias , Humanos , Lactante , Tiempo de Internación/economía , Modelos Lineales , Masculino , Persona de Mediana Edad , Morbilidad , Alta del Paciente/economía , Alta del Paciente/tendencias , Vigilancia de la Población , Factores de Riesgo , Infecciones por Salmonella/etiología , Distribución por SexoRESUMEN
Mycobacterium ulcerans infection is the third most important mycobacterial infection world-wide affecting immunocompetent individuals and causes chronic progressive skin ulcers. It has been described in many different regions world-wide. The diagnosis of M. ulcerans infection is often delayed because the diagnosis is difficult to make when new cases appear outside known endemic areas. However, molecular methods are now available to diagnose and distinguish M. ulcerans from other mycobacteria, allowing rapid diagnosis. Presented here is the case of a previously well girl from Townsville, Queensland, with extensive M. ulcerans infection involving the elbow joint, triceps tendon and underlying bone. Rapid diagnosis by polymerase chain reaction confirmed M. ulcerans infection. This is the first known case of M. ulcerans infection from Townsville in over 25 years, highlighting the changing epidemiology of this disease.
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Infecciones por Mycobacterium no Tuberculosas/diagnóstico , Infecciones por Mycobacterium no Tuberculosas/terapia , Mycobacterium ulcerans/aislamiento & purificación , Reacción en Cadena de la Polimerasa/métodos , Úlcera Cutánea/microbiología , Antibacterianos , Niño , Terapia Combinada , Quimioterapia Combinada/administración & dosificación , Codo , Femenino , Estudios de Seguimiento , Humanos , Mycobacterium ulcerans/efectos de los fármacos , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Trasplante de Piel/métodos , Úlcera Cutánea/terapia , Resultado del Tratamiento , Cicatrización de Heridas/fisiologíaRESUMEN
Mean annual (1994-1996) budgets for Cd, Cu, Ni, Pb and Zn at two background, forested catchments, VK and HJ, in Finland are presented. Budgets for plots (VK3, HJ1 and HJ4) included throughfall (TF), litterfall (LF) and soil leaching fluxes, and for catchments terrestrial retention and leaching and lake sedimentation fluxes. Total deposition (TD) loads were relatively low (Cd < 0.1, Cu < 2, Ni < 1, Pb < 3 and Zn < 5 mg m-2 year-1) and that even in these areas almost half of the TD was in the form of dry deposition. Retention of TD within catchments was > or = 77% for all metals, except for Ni at VK (54%). For Cu and Pb, the retention was 94-97%. Most of the retention (74-97%) took place in the terrestrial part of the catchment, lake sedimentation accounting for the remainder. Plot-scale soil leaching fluxes at 40 cm of Cd, Cu (VK3) and Ni (VK3) were greater (> or = 100%) than TD inputs. Most of the catchment retention must therefore have taken place either deeper in the soil or in the lowland peatland areas. The humus layer was particularly effective in retaining Cu and Cd (65-81% and 51-78% of total inputs to the forest floor (TF + LF)). The retention of Pb by the humus layer was less than expected (26-54% of TF + LF). Litterfall was a particularly important internal flux for Zn.
Asunto(s)
Metales Pesados/química , Contaminantes del Suelo/análisis , Árboles , Contaminantes Atmosféricos/análisis , Monitoreo del Ambiente , Finlandia , Sedimentos Geológicos/química , Sustancias Húmicas , Hojas de la Planta/química , SueloRESUMEN
We describe an immunocompetent adolescent who presented with exceptionally severe Bordetella holmesii infection, including previously undescribed manifestations. Sequelae included a severe restrictive lung defect due to pulmonary fibrosis.