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OBJECTIVES: Multidisciplinary clinics like Aerodigestive programs focus on issues associated with airway, pulmonary, and gastrointestinal issues. Rarely, significant neurological issues like posterior fossa abnormality are identified as the primary etiology. We describe 3 such patients and compare their clinical presentation to the other patients seen in Aerodigestive clinic. METHODS: A retrospective chart review was conducted to review the 3 posterior fossa patients and the remainder of children that were referred to the Aerodigestive Clinic at Children's Hospital Los Angeles from June 2016 to August 2018. Clinical characteristics including triple endoscopies and sleep studies were recorded. RESULTS: Of the 110 patients included for review, 3 patients (3%) had an underlying posterior fossa abnormality; all of whom had symptoms of sleep disordered breathing along with dysphagia compared with 30% incidence of this symptom profile in the remaining Aerodigestive population. CONCLUSION: Presence of sleep disordered breathing and dysphagia, with underlying vomiting history, warrants considering evaluation for posterior fossa abnormalities in addition to traditional workup for aerodigestive disorders. Due to the rarity of this presentation and small sample size, future studies with multicenter collaboration may help better describe identifiers to delineate this population with similar aerodigestive symptoms and clarify diagnostic algorithms.
Assuntos
Transtornos de Deglutição , Síndromes da Apneia do Sono , Criança , Humanos , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/epidemiologia , Transtornos de Deglutição/etiologia , Estudos RetrospectivosRESUMO
LAY ABSTRACT: Children diagnosed with autism are likely to be more overweight than children who do not have autism. There are many group programs that help children to be more physically active and improve their eating habits to achieve healthy weight, but most of these programs do not allow children with autism to participate. We studied a program that was specially adapted so children with autism could participate together with peers who do not have autism. The program lasted 8 weeks and was offered in the evening at a large healthcare center in a big city. The children participated with a parent or another adult who takes care of them. We analyzed data that were part of a previous project where we studied how physical activity trackers called Fitbit help overweight children to change their eating and exercise habits so they can achieve healthier weight. Out of 158 families in the study, 15 families had a child or children with autism. We measured changes in the weight of children with and without autism and compared how many of the children completed the program. Children who had autism had similar results in achieving healthy weight and finishing the program compared to their peers without autism. Our study found that when a group weight management program is slightly changed to meet the needs of children with autism, they can successfully participate and benefit similarly to their peers who do not have autism. REGISTRATION: This trial was registered with ClinicalTrials.gov (NCT03215641).
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Transtorno do Espectro Autista , Obesidade Infantil , Programas de Redução de Peso , Adulto , Transtorno do Espectro Autista/terapia , Criança , Humanos , Sobrepeso/terapia , Obesidade Infantil/terapia , Instituições AcadêmicasRESUMO
Cardiovascular disease (CVD) including atherosclerosis is the leading cause of death worldwide. As CVDs and atherosclerosis develop, plaques begin to form in the blood vessels and become calcified. Calcification within the vasculature and atherosclerotic plaques have been correlated with rupture and consequently, acute myocardial infarction. However, current imaging methods to identify vascular calcification have limitations in determining plaque composition and structure. Nanoparticles can overcome these limitations due to their versatility and ability to incorporate a wide range of targeting and contrast agents. In this review, we summarize the current understanding of calcification in atherosclerosis, their role in instigating plaque instability, and clinical methodologies to detect and analyze vascular calcification. In addition, we highlight the potential of calcium-targeting ligands and nanoparticles to create novel calcium-detecting tools.
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Monocyte chemoattractant protein-1 (MCP-1) stimulates the migration of monocytes to inflammatory sites, leading to the progression of many diseases. Recently, we described a monocyte-targeting peptide amphiphile micelle (MCP-1 PAM) incorporated with the chemokine receptor CCR2 binding motif of MCP-1, which has a high affinity for monocytes in atherosclerotic plaques. We further report here the biomimetic components of MCP-1 PAMs and the influence of the nanoparticle upon binding to monocytes. We report that MCP-1 PAMs have enhanced secondary structure compared to the MCP-1 peptide. As a result, MCP-1 PAMs displayed improved binding and chemoattractant properties to monocytes, which upregulated the inflammatory signaling pathways responsible for monocyte migration. Interestingly, when MCP-1 PAMs were incubated in the presence of prostate cancer cells in vitro, the particle displayed anticancer efficacy by reducing CCR2 expression. Given that monocytes play an important role in tumor cell migration and invasion, our results demonstrate that PAMs can improve the native biofunctional properties of the peptide and may be used as an effective inhibitor to prevent chemokine-receptor interactions that promote disease progression.
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Liposomes form spontaneously by the assimilation of phospholipids, the primary component of cell membranes. Due to their unique ability to form selectively permeable bilayers in situ, they are widely used as nanocarriers for drug and small-molecule delivery. However, there is a lack of straightforward methodologies to encapsulate living microorganisms. Here we demonstrate the successful encapsulation of whole cells in phospholipid vesicles by using the inverse-emulsion technique of generating unilamellar vesicles. This method of liposome preparation allows for a facile encapsulation of large biomaterials that previously was not easily attainable. Using Escherichia coli as a model organism, we found that liposomes can protect the bacterium against external protease degradation and from harsh biological environments. Liposomes prepared by the inverse-emulsion method were also capable of encapsulating yeast and were found to be naturally susceptible to hydrolysis by enzymes such as phospholipases, thus highlighting their potential role as cell delivery carriers.