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1.
Shoulder Elbow ; 15(4 Suppl): 33-39, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37974601

RESUMO

Background: Re-tear following rotator cuff repair (RCR) is a concerning complication that can lead to poor patient outcomes and necessitate the need for revision surgery. The purpose of our study was to look at the combined construct of knotted vs. knotless medial row and suture vs. suture tape, focusing primarily on re-tear rates following surgery. Methods: A retrospective observational study of 343 consecutive patients undergoing arthroscopic double row, 4-anchor rotator cuff repair from February 2014 to March 2020 was conducted. Univariate and multivariate statistics were used to assess differences in demographics, comorbidities and tear characteristics between patients who experienced a symptomatic re-tear and those who did not. Results: The overall symptomatic re-tear rate was 7.6%. Patients who had a knotted medial row repair had a significantly lower rate of re-tear (4.7 vs. 11.3%, p = 0.022). Patients that had a knotted medial row and suture tape repair were significantly less likely to experience a re-tear (OR: 0.180, p = 0.001). Discussion: The use of suture tape and a knotted medial row repair decreases the incidence of symptomatic re-tear following rotator cuff repair. The combined construct of suture tape and a knotted medial row in rotator cuff repair decreases the risk for symptomatic re-tear following surgery.

2.
Shoulder Elbow ; 14(5): 544-550, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36199511

RESUMO

Background: The purpose of this study is to evaluate the impact of intravenous tranexamic acid on clinical and hematologic outcomes after total shoulder arthroplasty. Methods: Retrospective review was conducted for 282 consecutive patients undergoing either anatomic shoulder arthroplasty or reverse total shoulder arthroplasty. Univariate analysis and multivariate linear regression were used to compare outcomes for patients receiving intravenous tranexamic acid with those who did not. Results: Of the 282 patients included in this study, 78 patients received intravenous tranexamic acid and 204 did not. Patients who received intravenous tranexamic acid had significantly lower pre- to postoperative change in hemoglobin and hematocrit, and decreased postoperative drain output. In addition, patients receiving intravenous tranexamic acid were significantly less likely to have a postoperative hematocrit <30. There were no significant differences in length of stay, rate of 30 day hematoma, surgical site infection, deep vein thrombosis, or readmission between groups. Conclusion: Intravenous tranexamic acid is associated with a significant reduction in change in hematocrit and hemoglobin and postoperative drain output after both anatomic and reverse total shoulder arthroplasty. Despite improving hematologic outcomes for these patients, tranexamic acid appears to have little impact on clinical outcomes such as length of stay and 30-day complication rates.

3.
Biochem Biophys Res Commun ; 601: 9-15, 2022 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-35219001

RESUMO

Keratinocytes produce lipids that are critical for the skin barrier, however, little is known about the impact of age on fatty acid (FA) biosynthesis in these cells. We have examined the relationship between keratinocyte FA composition, lipid biosynthetic gene expression, gene promoter methylation and age. Expression of elongase (ELOVL6 and 7) and desaturase (FADS1 and 2) genes was lower in adult versus neonatal keratinocytes, and was associated with lower concentrations of n-7, n-9 and n-10 polyunsaturated FA in adult cells. Consistent with these findings, transient FADS2 knockdown in neonatal keratinocytes mimicked the adult keratinocyte FA profile in neonatal cells. Interrogation of methylation levels across the FADS2 locus (53 genomic sites) revealed differential methylation of 15 sites in neonatal versus adult keratinocytes, of which three hypermethylated sites in adult keratinocytes overlapped with a SMARCA4 protein binding site in the FADS2 promoter.


Assuntos
Metilação de DNA , Dessaturase de Ácido Graxo Delta-5 , Ácidos Graxos Dessaturases , Ácidos Graxos Insaturados , Queratinócitos , Adulto , DNA Helicases/metabolismo , Ácidos Graxos Dessaturases/genética , Ácidos Graxos Dessaturases/metabolismo , Ácidos Graxos Insaturados/metabolismo , Humanos , Recém-Nascido , Queratinócitos/metabolismo , Proteínas Nucleares/metabolismo , Regiões Promotoras Genéticas , Fatores de Transcrição/metabolismo
4.
Sci Total Environ ; 738: 140102, 2020 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-32806365

RESUMO

Numerous studies have identified the issue of road surface runoff as a source of contamination into waterways but the impact of vehicular wash-off is less well understood. A ford crossing provides a pathway for vehicle-derived contaminants emanating from both road surface runoff and vehicular wash-off into a river system. Twyford Lane Ford (Ford 1) and Birchgrove Lane Ford (Ford 2), located ca. 600 m apart on a tributary of the River Ouse in Sussex (UK), were the focus of this study. A combination of biomonitoring (assessment of benthic macroinvertebrates) and chemical assessments of water and sediments has been undertaken to determine any detrimental impacts, such as a lack in biodiversity, resulting from the ford crossings. Sediment concentrations of chromium (Cr3+), lead (Pb) and zinc (Zn) were generally elevated at Ford 1, attenuating at sampling points between the fords to then peak at Ford 2. However, sediment particle size was seen to have an influence on elemental concentrations. In general, an increase in elemental concentrations was associated with a higher percentage of fine-grained sediments (≤63 µm). Elevated concentrations of Zn and magnesium (Mg) were identified within water samples taken during a precipitation event following a prolonged dry period. The biomonitoring results found reduced BMWP (Biological Monitoring Working Party) scores at positions close to the ford crossings, and where the stream was in proximity to the roadside. Sensitive Ephemeroptera were largely absent at sampling points closest to the fords, which is likely to be associated with elevated Zn. The results suggest that careful consideration should be applied when selecting crossing points over sensitive waters.

5.
Adv Drug Deliv Rev ; 165-166: 77-95, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32142739

RESUMO

Administration of substances directly into the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord is one approach that can circumvent the blood-brain barrier to enable drug delivery to the central nervous system (CNS). However, molecules that have been administered by intrathecal injection, which includes intraventricular, intracisternal, or lumbar locations, encounter new barriers within the subarachnoid space. These barriers include relatively high rates of turnover as CSF clears and potentially inadequate delivery to tissue or cellular targets. Nanomedicine could offer a solution. In contrast to the fate of freely administered drugs, nanomedicine systems can navigate the subarachnoid space to sustain delivery of therapeutic molecules, genes, and imaging agents within the CNS. Some evidence suggests that certain nanomedicine agents can reach the parenchyma following intrathecal administration. Here, we will address the preclinical and clinical use of intrathecal nanomedicine, including nanoparticles, microparticles, dendrimers, micelles, liposomes, polyplexes, and other colloidalal materials that function to alter the distribution of molecules in tissue. Our review forms a foundational understanding of drug delivery to the CSF that can be built upon to better engineer nanomedicine for intrathecal treatment of disease.


Assuntos
Barreira Hematoencefálica/fisiologia , Sistemas de Liberação de Medicamentos/métodos , Nanopartículas/química , Animais , Transporte Biológico/fisiologia , Ventrículos Cerebrais/metabolismo , Líquido Cefalorraquidiano/fisiologia , Humanos , Injeções Espinhais , Lipossomos/química , Micelas , Espaço Subaracnóideo/metabolismo
6.
AIDS Behav ; 23(9): 2522-2531, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31399793

RESUMO

The PROMISE trial enrolled asymptomatic HIV-infected pregnant and postpartum women not eligible for antiretroviral treatment (ART) per local guidelines and randomly assigned proven antiretroviral strategies to assess relative efficacy for perinatal prevention plus maternal/infant safety and maternal health. The START study subsequently demonstrated clear benefit in initiating ART regardless of CD4 count. Active PROMISE participants were informed of results and women not receiving ART were strongly recommended to immediately initiate treatment to optimize their own health. We recorded their decision and the primary reason given for accepting or rejecting the universal ART offer after receiving the START information. One-third of participants did not initiate ART after the initial session, wanting more time to consider. Six sessions were required to attain 95% uptake. The slow uptake of universal ART highlights the need to prepare individuals and sensitize communities regarding the personal and population benefits of the "Treat All" strategy.


Assuntos
Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Mães/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Complicações Infecciosas na Gravidez/tratamento farmacológico , Adulto , Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade/psicologia , Contagem de Linfócito CD4 , Feminino , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Humanos , Lactente , Saúde Materna , Período Pós-Parto , Gravidez , Adulto Jovem
7.
Oecologia ; 182(4): 995-1005, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27651228

RESUMO

Intraspecific variability is increasingly recognized as an important component of foraging behavior that can have implications for both population and community dynamics. We used an individual-level approach to describe the foraging behavior of an abundant, generalist predator that inhabits a dynamic marine ecosystem, focusing specifically on the different foraging strategies used by individuals in the same demographic group. We collected data on movements and diving behavior of adult female California sea lions (Zalophus californianus) across multiple foraging trips to sea. Sea lions (n = 35) used one of three foraging strategies that primarily differed in their oceanic zone and dive depth: a shallow, epipelagic strategy, a mixed epipelagic/benthic strategy, and a deep-diving strategy. Individuals varied in their degree of fidelity to a given strategy, with 66 % of sea lions using only one strategy on all or most of their foraging trips across the two-month tracking period. All foraging strategies were present in each of the sampling years, but there were inter-annual differences in the population-level importance of each strategy that may reflect changes in prey availability. Deep-diving sea lions traveled shorter distances and spent a greater proportion of time at the rookery than sea lions using the other two strategies, which may have energetic and reproductive implications. These results highlight the importance of an individual-based approach in describing the foraging behavior of female California sea lions and understanding how they respond to the seasonal and annual changes in prey availability that characterize the California Current System.


Assuntos
Comportamento Alimentar , Leões-Marinhos , Animais , Mergulho , Ecossistema , Meio Ambiente
8.
Phys Rev Lett ; 115(15): 152001, 2015 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-26550716

RESUMO

Wide-angle exclusive Compton scattering and single-pion photoproduction from the proton have been investigated via measurement of the polarization transfer from a circularly polarized photon beam to the recoil proton. The wide-angle Compton scattering polarization transfer was analyzed at an incident photon energy of 3.7 GeV at a proton scattering angle of θ_{cm}^{p}=70°. The longitudinal transfer K_{LL}, measured to be 0.645±0.059±0.048, where the first error is statistical and the second is systematic, has the same sign as predicted for the reaction mechanism in which the photon interacts with a single quark carrying the spin of the proton. However, the observed value is ~3 times larger than predicted by the generalized-parton-distribution-based calculations, which indicates a significant unknown contribution to the scattering amplitude.

9.
BMC Obes ; 2: 17, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26217532

RESUMO

BACKGROUND: Obesity rates are disproportionately high among Latinas living in the United States. Few community-based weight management studies have focused on Latina immigrants living in emerging Latino communities. The purpose of this study was to develop and pilot test a theory-based, promotora-delivered, peer support weight loss intervention for Latina immigrants to be administered in a community setting. We employed participatory methods to develop an 8-week program grounded in self-determination theory. Overweight Latina immigrants were recruited to participate in a quasi-experimental pilot study. Data collected pre and post-intervention included height, weight, fasting lipids, glucose, dietary practices, physical activity and depressive symptoms. RESULTS: Twenty-two women completed the intervention. Mean age was 36, mean time in the U.S. was 12 years; the majority was from Mexico. Mean BMI was 33; 68% had a family history of diabetes. The intervention resulted in statistically significant weight loss (mean 2.1 kg, SD 2.6, p < 0.001); mean change in weight remained significant when compared with that of a historical control group (-2.1 kg vs 1.10 kg, p < 0.01) but was attenuated at 6 months. Levels of moderate physical activity increased significantly (p < 0.05) and dietary practices improved (p < 0.01) and remained significant at 6 months. Notably, depressive symptoms also improved (p = <0.001). CONCLUSIONS: This theory-based, promotora-delivered intervention resulted in significant weight loss among a sample of Latina immigrants at 8 weeks. Future studies are needed to test the impact of an extended peer support intervention on long-term weight management. TRIAL REGISTRATION: National Clinical Trials: NCT02344212. Registered 21 January 2015.

10.
ISRN AIDS ; 2014: 852489, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25006529

RESUMO

We describe factors determining retention and survival among HIV-infected children and adolescents engaged in two health care delivery models in Kampala, Uganda: one is a community home-based care (CHBC) and the other is a facility-based family-centred approach (FBFCA). This retrospective cohort study reviewed records from children aged from 0 to 18 years engaged in the two models from 2003 to 2010 focussing on retention/loss to follow-up, mortality, use of antiretroviral therapy (ART), and clinical characteristics. Kaplan Meier survival curves with log rank tests were used to describe and compare retention and survival. Overall, 1,623 children were included, 90.0% (1460/1623) from the CHBC. Children completed an average of 4.2 years of follow-up (maximum 7.7 years). Median age was 53 (IQR: 11-109) months at enrolment. In the CHBC, retention differed significantly between patients on ART and those not (log-rank test, adjusted, P < 0.001). Comparing ART patients in both models, there was no significant difference in long-term survival (log-rank test, P = 0.308, adjusted, P = 0.489), while retention was higher in the CHBC: 94.8% versus 84.7% in the FBFCA (log-rank test, P < 0.001, adjusted P = 0.006). Irrespective of model of care, children receiving ART had better retention in care and survival.

11.
Neurosci Lett ; 559: 34-8, 2014 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-24287379

RESUMO

Cathinone is a ß-keto alkaloid that is the major active constituent of khat, the leaf of the Catha edulis plant that is chewed recreationally in East Africa and the Middle East. Related compounds, such as methcathinone and mephedrone have been increasing in popularity as recreational drugs, resulting in the recent proposal to classify khat as a Class C drug in the UK. There is still limited knowledge of the pharmacological effects of cathinone. This study examined the acute effects of cathinone on core body temperature, locomotor and other behaviors, and neuronal activity in Siberian hamsters. Adult male hamsters, previously implanted with radio telemetry devices, were treated with cathinone (2 or 5mg/kg i.p.), the behavioral profile scored and core body temperature and locomotor activity recorded by radio telemetry. At the end of the study, hamsters received vehicle or cathinone (5mg/kg) and neuronal activation in the brain was determined using immunohistochemical evaluation of c-fos expression. Cathinone dose-dependently induced significant (p<0.0001) increases in both temperature and locomotor activity lasting 60-90min. Cathinone (2mg/kg) increased rearing (p<0.02), and 5mg/kg increased both rearing (p<0.001) and lateral head twitches (p<0.02). Both cathinone doses decreased the time spent at rest (p<0.001). The number of c-fos immunopositive cells were significantly increased in the striatum (p<0.0001) and suprachiasmatic nucleus (p<0.05) following cathinone, indicating increased neuronal activity. There was no effect of cathinone on food intake or body weight. It is concluded that systemic administration of cathinone induces significant behavioral changes and CNS activation in the hamster.


Assuntos
Alcaloides/farmacologia , Temperatura Corporal/fisiologia , Corpo Estriado/metabolismo , Genes fos/fisiologia , Atividade Motora/fisiologia , Proteínas Proto-Oncogênicas c-fos/biossíntese , Regulação para Cima/fisiologia , Animais , Temperatura Corporal/efeitos dos fármacos , Fármacos do Sistema Nervoso Central/farmacologia , Corpo Estriado/efeitos dos fármacos , Cricetinae , Genes fos/efeitos dos fármacos , Masculino , Atividade Motora/efeitos dos fármacos , Phodopus , Proteínas Proto-Oncogênicas c-fos/genética , Regulação para Cima/efeitos dos fármacos
12.
J Neuroendocrinol ; 25(2): 180-9, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22958332

RESUMO

The present study aimed to investigate the actions of fibroblast growth factor 21 (FGF21) on energy balance in a natural model of relative fatness, the Siberian hamster. Hamsters were studied under long days (LD) to promote weight gain, or short days to induce weight loss, and treated with rhFGF21 (3 mg/kg/day) via s.c. minipumps for 14 days. On days 7-9, detailed assessments of ingestive behaviour, metabolic gas exchange and locomotor activity were made. FGF21 caused substantial (P < 0.0001) weight loss in the fat LD state but not in the lean SD state: at the end of the study, FGF21-treated hamsters in LD lost 18% of body weight compared to vehicle controls, which is comparable to the natural body weight loss observed in SD. Epididymal fat pads, a correlate of total carcass fat content, were reduced by 19% in FGF21 treated hamsters in LD, whereas no difference was found in SD. Body weight loss in LD was associated with a reduction in food intake (P < 0.001) and a decreased respiratory exchange ratio (P < 0.001), indicating increased fat oxidation. Treatment with FGF21 maintained the normal nocturnal increase in oxygen consumption and carbon dioxide production into the early light phase in hamsters in LD, indicating increased energy expenditure, although locomotor activity was unaffected. These data suggest a greater efficacy of FGF21 in hamsters in LD compared to those in SD, which is consistent with both the peripheral and possibly central actions of FGF21 with respect to promoting a lean phenotype. The observed differences in FGF21 sensitivity may relate to day length-induced changes in adipose tissue mass.


Assuntos
Adiposidade/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Metabolismo Energético/efeitos dos fármacos , Fatores de Crescimento de Fibroblastos/farmacologia , Sobrepeso/patologia , Adiposidade/genética , Adiposidade/fisiologia , Animais , Peso Corporal/genética , Cricetinae , Ingestão de Alimentos/efeitos dos fármacos , Ingestão de Alimentos/fisiologia , Metabolismo Energético/genética , Fatores de Crescimento de Fibroblastos/fisiologia , Expressão Gênica/efeitos dos fármacos , Homeostase/efeitos dos fármacos , Hipotálamo/efeitos dos fármacos , Hipotálamo/metabolismo , Masculino , Modelos Animais , Sobrepeso/genética , Sobrepeso/metabolismo , Phodopus , Fotoperíodo , Estações do Ano
13.
Phys Rev Lett ; 109(20): 202506, 2012 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-23215479

RESUMO

The neutron capture cross section of (235)U was measured for the neutron incident energy region between 4 eV and 1 MeV at the DANCE facility at the Los Alamos Neutron Science Center with an unprecedented accuracy of 2-3% at 1 keV. The new methodology combined three independent measurements. In the main experiment, a thick actinide sample was used to determine neutron capture and neutron-induced fission rates simultaneously. In the second measurement, a fission tagging detector was used with a thin actinide sample and detailed characteristics of the prompt-fission gamma rays were obtained. In the third measurement, the neutron scattering background was characterized using a sample of (208)Pb. The relative capture cross section was obtained from the experiment with the thick (235)U sample using a ratio method after the subtraction of the fission and neutron scattering backgrounds. Our result indicates errors that are as large as 30% in the 0.5-2.5 keV region, in the current knowledge of neutron capture as embodied in major nuclear data evaluations. Future modifications of these databases using the improved precision data given herein will have significant impacts in neutronics calculations for a variety of nuclear technologies.

14.
Afr Health Sci ; 12(3): 249-58, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23382737

RESUMO

BACKGROUND: Access to pediatric antiretroviral formulations is increasing in resource-limited countries, however adult FDCs are still commonly used by antiretroviral therapy (ART) programs. OBJECTIVE: To describe long-term effectiveness of using adult FDC of d4T+3TC+NVP (Triomune) in children for HIV treatment. METHODS: Clinical, immunologic, and virologic outcomes of HIV-infected ART-naïve children aged six months to 12 years, were evaluated up to 96 weeks post-ART initiation. RESULTS: From March 2004 to June 2006, 104 children were followed with a median age of 5.4 years, median CD4 cell percent and HIV-1 RNA were 11.0% (IQR 6.7-13.9) and 348,846copies/mL (IQR 160,941-681,313) respectively at baseline. Using Kaplan-Meir estimates, 75% of children had undetectable viral loads (<400copies/mL) at 96 weeks of ART. Children with a baseline CD4 cell percent >15% were 3 times more likely to achieve viral load <400copies/mL than those with baseline CD4 cell percent <5% after adjusting for baseline age {aHR = 3.03 (1.10-8.32), p=0.03}; no difference was found among those with CD4 cell percent >5-14.9% and <5%. CONCLUSION: Treatment with generic adult FDC for HIV-infected Ugandan children led to sustained clinical, immunologic and virologic response during 96 weeks of ART. Early initiation of ART is key to achieving virological success.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Medicamentos Genéricos/uso terapêutico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , HIV-1/efeitos dos fármacos , Lamivudina/uso terapêutico , Nevirapina/uso terapêutico , Estavudina/uso terapêutico , Adulto , Fármacos Anti-HIV/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Peso Corporal , Contagem de Linfócito CD4 , Criança , Pré-Escolar , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Seguimentos , Infecções por HIV/imunologia , Humanos , Lactente , Estimativa de Kaplan-Meier , Lamivudina/administração & dosagem , Masculino , Adesão à Medicação , Nevirapina/administração & dosagem , Estavudina/administração & dosagem , Fatores de Tempo , Resultado do Tratamento , Carga Viral/efeitos dos fármacos
15.
Neuropsychologia ; 49(11): 3002-10, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21756926

RESUMO

The present study examined how asymmetrical motor symptomatology helps predict the pattern of perceptual judgements of body-scaled aperture width in lateralised Parkinson's disease (PD). Eleven patients with PD predominantly affecting the left side of their body (LPD), 16 patients with PD predominantly affecting their right side (RPD), and 16 healthy controls made forced-choice judgements about whether or not they would fit without turning their shoulders through a life-sized schematic doorway shown on a large screen. Whereas control and LPD groups made accurate estimations of body-scaled aperture width, RPD patients significantly underestimated aperture width relative to their body, perceiving doorways on average that were 12% narrower than their bodies as wide enough to allow them to pass through without rotation. Across all patients, estimates of body-scaled aperture width correlated with ratio of right-to-left symptom severity. These perceptual errors may indicate a mismatch between the neural representation of external space and that of body size in PD.


Assuntos
Imagem Corporal , Destreza Motora/fisiologia , Doença de Parkinson/psicologia , Desempenho Psicomotor/fisiologia , Idoso , Antiparkinsonianos/efeitos adversos , Atenção/fisiologia , Feminino , Lateralidade Funcional/fisiologia , Humanos , Julgamento , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Doença de Parkinson/tratamento farmacológico , Transtornos da Percepção/etiologia , Transtornos da Percepção/psicologia , Caracteres Sexuais , Percepção Visual/fisiologia
16.
Ann Trop Paediatr ; 31(3): 235-45, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21781419

RESUMO

BACKGROUND: Major obstacles remain in scaling up paediatric HIV treatment, including limited paediatric anti-retroviral drug options for resource-limited settings, challenges with adherence to liquid formulations and treatment fatigue with lifelong therapy. AIM: To determine levels of adherence to HAART in HIV-infected children at 12, 24, 36 and 48 weeks of follow-up and to compare adherence levels before and after switching from syrup to fixed-dose combination (FDC)-tablet anti-retroviral formulations. METHODS: HIV-infected children aged between 6 months and 12 years were initiated on anti-retroviral therapy at Makerere University-Johns Hopkins University Care Clinic, Kampala. Good adherence to HAART was defined as taking ≥95% of prescribed medications. Adherence levels were measured using pharmacy refill data, quarterly unannounced home-visit pill counts and caregiver self-reports. Data were analysed using STATA(®) version 10.0. RESULTS: A total of 129 HIV-infected children were initiated on HAART with 14.7% on syrups and 85.3% on tablet formulations at enrollment. According to caregiver self-reporting, 99.2%, 100%, 100% and 99.2% achieved ≥95% adherence at 12, 24, 36 and 48 weeks, respectively. Using pharmacy refill data, the proportions were 89.9%, 95.4%, 93.8% and 93.0% and for unannounced home visits were 89.8%, 92.4%, 88.9% and 86.2%, respectively. Median adherence to syrup formulations (97%, IQR 93-98) was significantly lower than for tablets (100%, IQR 97-100, p = 0.012, n = 28) using pharmacy refill data. Viral suppression correlated with home visit and pharmacy refill adherence data. CONCLUSION: The majority of children initiating HAART had good adherence when estimated by caregiver self-report and pharmacy refill data but lower adherence when measured by home-visit pill counts. Adherence to tablet formulation of HAART was significantly better than syrup formulation. Medication formulation did not significantly affect viral suppression.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Terapia Antirretroviral de Alta Atividade/métodos , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Instituições de Assistência Ambulatorial , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Uganda , População Urbana
17.
Neuropsychology ; 24(4): 443-56, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20604619

RESUMO

OBJECTIVE: To relate lateralized impairments of visual perception in Parkinson's disease to asymmetries in the severity of motor symptoms. METHOD: Ten patients with worse left-sided motor symptoms (LPD), 15 with worse right-sided (RPD), and 13 healthy age-matched controls (all right-handed) viewed mirror-imaged pairs of emotional chimeric faces, (left side smiling, right neutral, and vice versa), of greyscales (strips whose luminance varied smoothly from black on the left to white on the right, and vice versa) and of gender chimeric faces (left side male, right female, and vice versa). Participants signaled which stimulus appeared happier, brighter, or more feminine, respectively, so showing which side received more attention. RESULTS: For emotional chimeras, controls and LPD showed little bias, whereas RPD showed a strong bias to left hemispace (p = .018, r = .45). Across all patients, this bias was associated with severity of right-sided motor impairment (p = .018, r = .49). The bias was much weaker and insignificant for greyscales (p = .72, r = .14). For gender chimeras, RPD again showed a significantly greater left hemispace bias than did LPD (p = .037, r = .47), although neither patient group differed significantly from controls. Across all patients, this bias correlated with ratio of right-to-left symptom severity (p = .044, r = .48). CONCLUSIONS: The left hemispace bias in RPD is greater for facial than for luminance judgments, and is amplified for emotional judgments. Asymmetrical degeneration of the striatum, particularly involving the left side, appears to underlie this deficit in visual processing.


Assuntos
Viés , Lateralidade Funcional/fisiologia , Transtornos do Humor/etiologia , Doença de Parkinson/complicações , Transtornos da Percepção/etiologia , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Reconhecimento Visual de Modelos/fisiologia , Estimulação Luminosa/métodos
18.
J Neuroendocrinol ; 22(6): 564-75, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20367758

RESUMO

Many vertebrates express profound annual cycles of body fattening, although it is not clear whether these represent differential activity of the central pathways known to mediate homeostatic control of food intake and energy expenditure, or whether the recent discovery of a major role for pars tuberalis-ependymal signalling points towards novel mechanisms. We examined this in the Siberian hamster (Phodopus sungorus) by using gene transfection to up-regulate a major orexigenic peptide, agouti-related peptide (AgRP), and then determined whether this increased anabolic drive could prevent the short-day induced winter catabolic state. Infusions of a recombinant adeno-associated virus encoding an AgRP construct into the hypothalamus of hamsters in the long-day obese phase of their seasonal cycle produced a 20% gain in body weight over 6 weeks compared to hamsters receiving a control reporter construct, reflecting a significant increase in food intake and a significant decrease in energy expenditure. However, all hamsters showed a significant, prolonged decrease in body weight when exposed to short photoperiods, despite the hamsters expressing the AgRP construct maintaining a higher food intake and lower energy expenditure relative to the control hamsters. Visualisation of the green fluorescent protein reporter and analysis of AgRP-immunoreactivity confirmed widespread expression of the construct in the hypothalamus, which was maintained for the 21-week duration of the study. In conclusion, the over-expression of AgRP in the hypothalamus produced a profoundly obese state but did not block the seasonal catabolic response, suggesting a separation of rheostatic mechanisms in seasonality from those maintaining homeostasis of energy metabolism.


Assuntos
Proteína Relacionada com Agouti/genética , Ritmo Circadiano , Redução de Peso , Animais , Sequência de Bases , Cricetinae , Primers do DNA , Dependovirus/genética , Vetores Genéticos , Proteínas de Fluorescência Verde/genética , Microscopia de Fluorescência , Phodopus , Reação em Cadeia da Polimerase
19.
J Dairy Sci ; 92(12): 6134-43, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19923616

RESUMO

The physiological response of the preruminant calf to sustained exposure to moderate cold has not been studied extensively. Effects of cold on growth performance and health of preruminant calves as well as functional measures of energy metabolism, fat-soluble vitamin, and immune responsiveness were evaluated in the present study. Calves, 3 to 10 d of age, were assigned randomly to cold (n = 14) or warm (n = 15) indoor environments. Temperatures in the cold environment averaged 4.7 degrees C during the study. Frequent wetting of the environment and the calves was used to augment effects of the cold environment. Temperatures in the warm environment averaged 15.5 degrees C during the study. There was no attempt to increase the humidity in the warm environment. Preventative medications or vaccinations that might influence disease resistance were not administered. Nonmedicated milk replacer (20% crude protein and 20% fat fed at 0.45 kg/d) and a nonmedicated starter grain fed ad libitum were fed to all calves. Relative humidity was, on average, almost 10% higher in the cold environment. Warm-environment calves were moderately healthier (i.e., lower respiratory scores) and required less antibiotics. Scour scores, days scouring, and electrolyte costs, however, were unaffected by environmental temperature. Growth rates were comparable in warm and cold environments, although cold-environment calves consumed more starter grain and had lower blood glucose and higher blood nonesterified fatty acid concentrations. The nonesterified fatty acid and glucose values for cold-stressed calves, however, did not differ sufficiently from normal values to categorize these calves as being in a state of negative-energy balance. Levels of fat-soluble vitamin, antibody, tumor necrosis factor-alpha, and haptoglobin were unaffected by sustained exposure to moderate cold. These results support the contention that successful adaptation of the dairy calf to cold is dependent upon the availability of adequate nutrition.


Assuntos
Bovinos/fisiologia , Temperatura Baixa , Meio Ambiente , Animais , Glicemia/análise , Bovinos/crescimento & desenvolvimento , Bovinos/imunologia , Bovinos/metabolismo , Ácidos Graxos não Esterificados/sangue , Haptoglobinas/metabolismo , Imunoglobulina G/sangue , Masculino , Fator de Necrose Tumoral alfa/sangue , Vitaminas/sangue
20.
Australas Phys Eng Sci Med ; 32(3): 159-64, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19873940

RESUMO

Non-linear loading of the utilities supply introduced significant electromagnetic field (EMF) interference severe enough to disrupt electrocardiograph (ECG) monitoring and recordings in the new Emergency Department (ED) at the Royal Melbourne Hospital (RMH). This interference was evident even though standard Mu-metal shielding had been installed over the main hospital power feed which runs underneath the department. Investigations revealed that the source of the interference was due to 3rd harmonic currents flowing in the mains cable. This interference was suppressed by introducing third harmonic current into the main power cable in anti-phase to the interfering signal.


Assuntos
Fontes de Energia Elétrica , Eletrocardiografia/instrumentação , Campos Eletromagnéticos , Eletrônica Médica , Serviço Hospitalar de Emergência , Análise de Falha de Equipamento , Humanos
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