Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 48
Filtrar
Mais filtros

Base de dados
País/Região como assunto
Tipo de documento
Intervalo de ano de publicação
1.
Am J Perinatol ; 2023 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-36709758

RESUMO

OBJECTIVE: Despite improvements in our ability for early diagnosis and providing supportive care for infants with gastroschisis, it continues to be associated with long length of stay and morbidity. Intestinal dysfunction secondary to chronic inflammatory insult to exposed bowel is well known; however, little research has been done on the impact of acute inflammation in the perinatal period on intestinal function. This study's aim was to investigate the impact of acute chorioamnionitis on the time to achieve full enteral feeds and length of hospital stay. STUDY DESIGN: Retrospective chart review of 60 mothers and their infants born with gastroschisis at a Level IV NICU from November 2011 to June 2020 was performed. Infants were divided into two groups based on the presence of histologic chorioamnionitis, and outcomes were compared. The primary outcome was delayed full enteral feeds (full enteral feeds after 28 days of life). The secondary outcomes were differences in their time to achieve full enteral feeds and time to hospital discharge, and prolonged length of hospital stay (discharge after 30 days of life). Univariate and multivariate logistic regression analyses were performed to assess the association between the dependent and the predictor variables. RESULT: Of the 60 infants enrolled, 23 (38%) had evidence of histologic chorioamnionitis. The median gestational age was 37 weeks. Fifty-four (90%) infants achieved full enteral feeds, with a median time of 24 days. Median length of hospital stay was 31 days. The presence of histologic chorioamnionitis was not associated with delayed full enteral feeds (odds ratio [OR] = 0.79; 95% confidence interval [CI] = 0.14-4.23; p = 0.80) or prolonged length of hospital stay (OR = 0.45; 95% CI = 0.1-0.23; p = 0.32) in the adjusted analysis. CONCLUSION: Acute placental inflammation during the perinatal period does not impact the infant's time to achieve full feeds or prolong their hospital stay. Larger studies are needed to confirm these findings. KEY POINTS: · Chronic inflammatory injury to exposed bowel in utero is well known in fetuses with gastroschisis.. · Acute inflammatory injury during perinatal period may impact enteral feeding outcomes.. · No impact of acute placental inflammation on time to full enteral feeds..

2.
Curr Opin Pediatr ; 34(2): 184-190, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35051980

RESUMO

PURPOSE OF REVIEW: Parenteral nutrition is an integral part of the care of infants in the neonatal ICU. However, prolonged use of parenteral nutrition can be associated with adverse outcomes, most notably parenteral nutrition-associated liver disease, now known as intestinal failure-associated liver disease (IFALD). This review highlights pertinent developments in the epidemiology of IFALD as it pertains to neonates and showcases recent advances in the pathophysiology, treatment, and outcomes of neonates with IFALD. RECENT FINDINGS: The role of intravenous lipid emulsions in the pathogenesis, prevention, and treatment of IFALD remains a target for investigative studies. Recent data continues to support the use of fish-oil based intravenous lipids, but its use is limited due to concerns for essential fatty acid deficiency. Use of soy-based lipids and mixed lipids is not wrought with such concerns as these are often used at greater doses but their use is limited due to higher proinflammatory fatty acid content, increased phytosterols and decreased antioxidants, risk factors for the development of IFALD. SUMMARY: Hepatic complications may limit the use of parenteral nutrition in the neonatal ICU. However, the pathophysiology of IFALD is continuing to be further elucidated and novel targets are being developed for the treatment of IFALD. As noninvasive disease monitoring strategies continue to be developed, early enteral nutrition ameliorates the risk of IFALD and should be considered when possible.


Assuntos
Enteropatias , Insuficiência Intestinal , Hepatopatias , Animais , Emulsões Gordurosas Intravenosas/efeitos adversos , Ácidos Graxos , Óleos de Peixe , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Enteropatias/complicações , Enteropatias/terapia , Hepatopatias/etiologia , Hepatopatias/terapia , Óleo de Soja/efeitos adversos
3.
Ultraschall Med ; 40(6): 757-763, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29879743

RESUMO

PURPOSE: Optoacoustic imaging with ultrasound (OPUS) can assess in-vivo perfusion/oxygenation through surrogate measures of oxy, deoxy and total hemoglobin content in tissues. The primary aim of our study was to evaluate the ability of OPUS to detect physiological changes in the breast during the menstrual cycle and to determine qualitative/quantitative metrics of normal parenchymal tissue in pre-/post-menopausal women. The secondary aim was to assess the technique's repeatability. MATERIALS AND METHODS: We performed a prospective ethically approved study in volunteers using OPUS (700, 800 and 850 nm wavelengths) in the proliferative/follicular and secretory phase of the menstrual cycle. Regions of interest (ROIs) were drawn on the most superficial region of fibroglandular tissue and same-day intra-observer repeatability was assessed. We used t-tests to interrogate differences in the OPUS measurements due to hormonal changes and interclass correlation coefficients/Bland-Altman plots to evaluate the repeatability of mean ROI signal intensities. RESULTS: 22 pre-menopausal and 8 post-menopausal volunteers were recruited. 21 participants underwent repeatability examinations. OPUS intensity values were significantly higher (p < 0.0001) at all excitation wavelengths in the secretory compared to the proliferative/follicular phase. Post-menopausal volunteers showed similar optoacoustic values to the proliferative/follicular phase of pre-menopausal volunteers. The repeatability of the technique was comparable to other handheld ultrasound modalities. CONCLUSION: OPUS detects changes in perfusion/vascularity related to the menstrual cycle and menopausal status of breast parenchyma.


Assuntos
Neoplasias da Mama , Hormônios , Mama , Neoplasias da Mama/diagnóstico por imagem , Feminino , Hormônios/fisiologia , Humanos , Ciclo Menstrual , Óptica e Fotônica , Estudos Prospectivos
4.
Eur Radiol ; 28(2): 602-609, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28786007

RESUMO

BACKGROUND AND AIM: Multispectral optoacoustic tomography (MSOT) represents a new in vivo imaging technique with high resolution (~250 µm) and tissue penetration (>1 cm) using the photoacoustic effect. While ultrasound contains anatomical information for lesion detection, MSOT provides functional information based on intrinsic tissue chromophores. We aimed to evaluate the feasibility of combined ultrasound/MSOT imaging of breast cancer in patients compared to healthy volunteers. METHODS: Imaging was performed using a handheld MSOT system for clinical use in healthy volunteers (n = 6) and representative patients with histologically confirmed invasive breast carcinoma (n = 5) and ductal carcinoma in situ (DCIS, n = 2). MSOT values for haemoglobin and oxygen saturation were assessed at 0.5, 1.0 and 1.5 cm depth and selected wavelengths between 700 and 850 nm. RESULTS: Reproducible signals were obtained in all wavelengths with consistent MSOT signals in superficial tissue in breasts of healthy individuals. In contrast, we found increased signals for haemoglobin in invasive carcinoma, suggesting a higher perfusion of the tumour and tumour environment. For DCIS, MSOT values showed only little variation compared to healthy tissue. CONCLUSIONS: This preliminary MSOT breast imaging study provided stable, reproducible data on tissue composition and physiological properties, potentially enabling differentiation of solid malignant and healthy tissue. KEY POINTS: • A handheld MSOT probe enables real-time molecular imaging of the breast. • MSOT of healthy controls provides a reproducible reference for pathology identification. • MSOT parameters allows for differentiation of invasive carcinoma and healthy tissue.


Assuntos
Neoplasias da Mama/diagnóstico , Mama/diagnóstico por imagem , Técnicas Fotoacústicas/métodos , Tomografia/métodos , Diagnóstico Diferencial , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Reprodutibilidade dos Testes
5.
bioRxiv ; 2024 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-38370639

RESUMO

The exploration of genotypic variants impacting phenotypes is a cornerstone in genetics research. The emergence of vast collections containing deeply genotyped and phenotyped families has made it possible to pursue the search for variants associated with complex diseases. However, managing these large-scale datasets requires specialized computational tools tailored to organize and analyze the extensive data. GPF (Genotypes and Phenotypes in Families) is an open-source platform ( https://github.com/iossifovlab/gpf ) that manages genotypes and phenotypes derived from collections of families. The GPF interface allows interactive exploration of genetic variants, enrichment analysis for de novo mutations, and phenotype/genotype association tools. In addition, GPF allows researchers to share their data securely with the broader scientific community. GPF is used to disseminate two large-scale family collection datasets (SSC, SPARK) for the study of autism funded by the SFARI foundation. However, GPF is versatile and can manage genotypic data from other small or large family collections. Our GPF-SFARI GPF instance ( https://gpf.sfari.org/ ) provides protected access to comprehensive genotypic and phenotypic data for the SSC and SPARK. In addition, GPF-SFARI provides public access to an extensive collection of de novo mutations identified in individuals with autism and related disorders and to gene-level statistics of the protected datasets characterizing the genes' roles in autism. Here, we highlight the primary features of GPF within the context of GPF-SFARI.

6.
Am J Physiol Heart Circ Physiol ; 304(2): H253-9, 2013 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-23144314

RESUMO

The role of cardiac myosin essential light chain (ELC) in the sarcomere length (SL) dependency of myofilament contractility is unknown. Therefore, mechanical and dynamic contractile properties were measured at SL 1.9 and 2.2 µm in cardiac muscle fibers from two groups of transgenic (Tg) mice: 1) Tg-wild-type (WT) mice that expressed WT human ventricular ELC and 2) Tg-Δ43 mice that expressed a mutant ELC lacking 1-43 amino acids. In agreement with previous studies, Ca(2+)-activated maximal tension decreased significantly in Tg-Δ43 fibers. pCa(50) (-log(10) [Ca(2+)](free) required for half maximal activation) values at SL of 1.9 µm were 5.64 ± 0.02 and 5.70 ± 0.02 in Tg-WT and Tg-Δ43 fibers, respectively. pCa(50) values at SL of 2.2 µm were 5.70 ± 0.01 and 5.71 ± 0.01 in Tg-WT and Tg-Δ43 fibers, respectively. The SL-mediated increase in the pCa(50) value was statistically significant only in Tg-WT fibers (P < 0.01), indicating that the SL dependency of myofilament Ca(2+) sensitivity was blunted in Tg-Δ43 fibers. The SL dependency of cross-bridge (XB) detachment kinetics was also blunted in Tg-Δ43 fibers because the decrease in XB detachment kinetics was significant (P < 0.001) only at SL 1.9 µm. Thus the increased XB dwell time at the short SL augments Ca(2+) sensitivity at short SL and thus blunts SL-mediated increase in myofilament Ca(2+) sensitivity. Our data suggest that the NH(2)-terminal extension of cardiac ELC not only augments the amplitude of force generation, but it also may play a role in mediating the SL dependency of XB detachment kinetics and myofilament Ca(2+) sensitivity.


Assuntos
Cálcio/metabolismo , Acoplamento Excitação-Contração , Deleção de Genes , Contração Miocárdica , Miócitos Cardíacos/metabolismo , Miofibrilas/metabolismo , Cadeias Leves de Miosina/metabolismo , Sequência de Aminoácidos , Animais , Fenômenos Biomecânicos , Feminino , Humanos , Cinética , Camundongos , Camundongos Transgênicos , Força Muscular , Cadeias Leves de Miosina/química , Cadeias Leves de Miosina/genética , Sarcômeros/metabolismo
7.
Arch Biochem Biophys ; 535(1): 3-13, 2013 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-23111184

RESUMO

Actomyosin crossbridges (XBs) are the fundamental source of force generation and pressure development in the myocardium. Faster kinetics are imparted on XBs comprised of the fast, α-myosin heavy chain (MHC) isoform, whereas slower kinetics are imparted on XBs comprised of the slow, ß-MHC isoform. Other factors, such as sarcomere length (SL), influence XB formation, presumably acting through allosteric effects on the kinetics that regulate the XB cycle. We sought to determine whether the slower XB kinetics of ß-MHC were more sensitive to such length-dependent effects than those of α-MHC. We studied the SL effects on mechanical properties of demembranated muscle fibers from normal and propylthiouracil-treated mouse hearts, which expressed predominantly α-MHC or ß-MHC, respectively. Interestingly, XB detachment kinetics were more length-sensitive in ß-MHC fibers, as estimated by tension cost and XB detachment rate constant (c), and as inferred by ktr. The nonlinearity in force responses to various-amplitude step-like changes in muscle length was more pronounced in ß-MHC fibers. This phenomenon is attributed to a greater cooperative/allosteric mechanism in ß-MHC fibers, as estimated by model parameter γ. These data suggest a mechanism whereby greater cooperative/allosteric effects impart an enhanced length-sensitivity of XB cycling kinetics in fibers containing the slower cycling ß-MHC.


Assuntos
Contração Muscular , Miocárdio/metabolismo , Cadeias Pesadas de Miosina/metabolismo , Miosinas Ventriculares/metabolismo , Actomiosina/metabolismo , Trifosfato de Adenosina/metabolismo , Regulação Alostérica , Animais , Fenômenos Biomecânicos , Cálcio/metabolismo , Eletroforese em Gel de Poliacrilamida , Ativação Enzimática , Isoenzimas/metabolismo , Camundongos , Tono Muscular , Miocárdio/enzimologia , Miofibrilas/efeitos dos fármacos , Miofibrilas/metabolismo , Fosforilação , Propiltiouracila/farmacologia , Sarcômeros/metabolismo
8.
Sci Rep ; 13(1): 5370, 2023 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-37005457

RESUMO

Cancer is one of the leading causes of death worldwide. The increasing prevalence and resistance to chemotherapy is responsible for driving the search of novel molecules to combat this disease. In search of novel compounds with pro-apoptotic potential, pyrazolo-pyridine and pyrazolo-naphthyridine derivatives were investigated against cervical cancer (HeLa) and breast cancer (MCF-7) cells. The anti-proliferative activity was determined through the MTT assay. Potent compounds were then analyzed for their cytotoxic and apoptotic activity through a lactate dehydrogenase assay and fluorescence microscopy after propidium iodide and DAPI staining. Flow cytometry was used to determine cell cycle arrest in treated cells and pro-apoptotic effect was verified through measurement of mitochondrial membrane potential and activation of caspases. Compounds 5j and 5k were found to be most active against HeLa and MCF-7 cells, respectively. G0/G1 cell cycle arrest was observed in treated cancer cells. Morphological features of apoptosis were also confirmed, and an increased oxidative stress indicated the involvement of reactive oxygen species in apoptosis. The compound-DNA interaction studies demonstrated an intercalative mode of binding and the comet assay confirmed the DNA damaging effects. Finally, potent compounds demonstrated a decrease in mitochondrial membrane potential and increased levels of activated caspase-9 and -3/7 confirmed the induction of apoptosis in treated HeLa and MCF-7 cells. The present work concludes that the active compounds 5j and 5k may be used as lead candidates for the development of lead drug molecules against cervical and breast cancer.


Assuntos
Antineoplásicos , Neoplasias da Mama , Feminino , Humanos , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/metabolismo , Pontos de Checagem do Ciclo Celular , Apoptose , Caspases/metabolismo , Antineoplásicos/uso terapêutico , Células MCF-7 , Espécies Reativas de Oxigênio/metabolismo , Pirazóis/farmacologia , Pirazóis/uso terapêutico , Piridinas/farmacologia , Piridinas/uso terapêutico , Naftiridinas/farmacologia , Naftiridinas/uso terapêutico , Proliferação de Células , Linhagem Celular Tumoral
9.
J Mol Cell Cardiol ; 53(4): 542-51, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22884844

RESUMO

One limitation in understanding how different familial hypertrophic cardiomyopathy (FHC)-related mutations lead to divergent cardiac phenotypes is that such mutations are often studied in transgenic (TG) mouse hearts which contain a fast cycling myosin heavy chain isoform (α-MHC). However, the human heart contains a slow cycling MHC isoform (ß-MHC). Given the physiological significance of MHC-troponin interplay effects on cardiac contractile function, we hypothesized that cardiac troponin T (cTnT) mutation-mediated effects on contractile function depend on the type of MHC isoform present in the sarcomere. We tested our hypothesis using two variants of cTnT containing mutations at FHC hotspot R92 (R92L or R92Q), expressed against either an α-MHC or ß-MHC background in TG mouse hearts. One finding from our study was that R92L attenuated the length-dependent increase in tension and abolished the length-dependent increase in myofilament Ca(2+) sensitivity only when ß-MHC was present. In addition, α- and ß-MHC isoforms differentially affected how R92 mutations altered crossbridge (XB) recruitment dynamics. For example, the rate of XB recruitment was faster in R92L or R92Q fibers when ß-MHC was present, but was unaffected when α-MHC was present. The R92Q mutation sped XB detachment in the presence of ß-MHC, but not in the presence of α-MHC. R92Q affected the XB strain-dependent influence on XB recruitment dynamics, an effect not observed for R92L. Our findings have major implications for understanding not only the divergent effects of R92 mutations on cardiac phenotype, but also the distinct effects of MHC isoforms in determining the outcome of mutations in cTnT.


Assuntos
Contração Miocárdica , Miocárdio/metabolismo , Cadeias Pesadas de Miosina/metabolismo , Troponina T/genética , Animais , Cardiomiopatia Hipertrófica Familiar/genética , Cardiomiopatia Hipertrófica Familiar/fisiopatologia , Camundongos , Camundongos Transgênicos , Músculos/metabolismo , Miofibrilas/metabolismo , Cadeias Pesadas de Miosina/química , Cadeias Pesadas de Miosina/genética
10.
J Physiol ; 590(23): 6047-63, 2012 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-22966157

RESUMO

Troponin I (TnI) and myosin heavy chain (MHC) are two contractile regulatory proteins that undergo major shifts in isoform expression as cardiac myocytes mature from embryonic to adult stages. To date, many studies have investigated individual effects of embryonic vs. cardiac isoforms of either TnI or MHC on cardiac muscle function and contractile dynamics. Thus, we sought to determine whether concomitant expression of the embryonic isoforms of both TnI and MHC had functional effects that were not previously observed. Adult transgenic (TG) mice that express the embryonic isoform of TnI, slow skeletal TnI (ssTnI), were treated with propylthiouracil (PTU) to revert MHC expression from adult (α-MHC) to embryonic (ß-MHC) isoforms. Cardiac muscle fibres from these mice contained ∼80% ß-MHC and ∼34% ssTnI of total MHC or TnI, respectively, allowing us to test the functional effects of ssTnI in the presence of ß-MHC. Detergent-skinned cardiac muscle fibre bundles were used to study how the interplay between MHC and TnI modulate muscle length-mediated effect on crossbridge (XB) recruitment dynamics, Ca(2+)-activated tension, and ATPase activity. One major finding was that the model-predicted XB recruitment rate (b) was enhanced significantly by ssTnI, and this speeding effect of ssTnI on XB recruitment rate was much greater (3.8-fold) when ß-MHC was present. Another major finding was that the previously documented ssTnI-mediated increase in myofilament Ca(2+) sensitivity (pCa(50)) was blunted when ß-MHC was present. ssTnI expression increased pCa(50) by 0.33 in α-MHC fibres, whereas ssTnI increased pCa(50) by only 0.05 in ß-MHC fibres. Our study provides new evidence for significant interplay between MHC and TnI isoforms that is essential for tuning cardiac contractile function. Thus, MHC-TnI interplay may provide a developmentally dependent mechanism to enhance XB recruitment dynamics at a time when Ca(2+)-handling mechanisms are underdeveloped, and to prevent excessive ssTnI-dependent inotropy (increased Ca(2+) sensitivity) in the embryonic myocardium.


Assuntos
Coração/fisiologia , Cadeias Pesadas de Miosina/fisiologia , Troponina I/fisiologia , Animais , Cálcio/fisiologia , Contração Isométrica , Camundongos , Camundongos Transgênicos , Miofibrilas/fisiologia , Músculos Papilares/fisiologia , Propiltiouracila/farmacologia , Isoformas de Proteínas/fisiologia
11.
J Perinatol ; 41(12): 2766-2773, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34526659

RESUMO

INTRODUCTION: No studies have determined if there is a threshold whereby use of mother's own milk (MOM) during hospitalization predicts exclusive MOM feeding at discharge. METHODS: Among 113 very low birthweight neonates, the ratio of MOM to enteral feeds was measured in the first 14 days, 28 days, and overall hospital stay. The primary outcome was exclusive MOM feeding at discharge. RESULTS: For every 1% increase in MOM consumption in the first 14 and 28 days, the odds of being discharge home on an exclusive MOM diet increased nearly 7-fold (OR 7.01, 95% CI: 2.09-23.50) and 17-fold (OR 17.46, 95% CI 4.67-63.31), respectively. A threshold of >50%, >83%, and >85% MOM consumption compared to overall enteral feeds in the first 14 days, 28 days, and throughout hospitalization, respectively, is recommended. CONCLUSIONS: Promotion of MOM consumption in the first 2-4 weeks is of paramount importance, with negligible impact of increasing MOM consumption after 28 days.


Assuntos
Mães , Alta do Paciente , Aleitamento Materno , Feminino , Humanos , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Unidades de Terapia Intensiva Neonatal , Leite Humano
12.
J Biol Chem ; 284(45): 30889-96, 2009 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-19736309

RESUMO

Nebulin is a giant filamentous F-actin-binding protein ( approximately 800 kDa) that binds along the thin filament of the skeletal muscle sarcomere. Nebulin is one of the least well understood major muscle proteins. Although nebulin is usually viewed as a structural protein, here we investigated whether nebulin plays a role in muscle contraction by using skinned muscle fiber bundles from a nebulin knock-out (NEB KO) mouse model. We measured force-pCa (-log[Ca(2+)]) and force-ATPase relations, as well as the rate of tension re-development (k(tr)) in tibialis cranialis muscle fibers. To rule out any alterations in troponin (Tn) isoform expression and/or status of Tn phosphorylation, we studied fiber bundles that had been reconstituted with bacterially expressed fast skeletal muscle recombinant Tn. We also performed a detailed analysis of myosin heavy chain, myosin light chain, and myosin light chain 2 phosphorylation, which showed no significant differences between wild type and NEB KO. Our mechanical studies revealed that NEB KO fibers had increased tension cost (5.9 versus 4.4 pmol millinewtons(-1) mm(-1) s(-1)) and reductions in k(tr) (4.7 versus 7.3 s(-1)), calcium sensitivity (pCa(50) 5.74 versus 5.90), and cooperativity of activation (n(H) 3.64 versus 4.38). Our findings indicate the following: 1) in skeletal muscle nebulin increases thin filament activation, and 2) through altering cross-bridge cycling kinetics, nebulin increases force and efficiency of contraction. These novel properties of nebulin add a new level of understanding of skeletal muscle function and provide a mechanism for the severe muscle weakness in patients with nebulin-based nemaline myopathy.


Assuntos
Proteínas Musculares/metabolismo , Tono Muscular , Sarcômeros/química , Sarcômeros/fisiologia , Animais , Cálcio/metabolismo , Cinética , Camundongos , Camundongos Knockout , Contração Muscular , Fibras Musculares Esqueléticas/química , Fibras Musculares Esqueléticas/fisiologia , Proteínas Musculares/genética
13.
Nutr Clin Pract ; 35(4): 689-696, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31642112

RESUMO

BACKGROUND: An exclusive human milk-based diet has been shown to decrease necrotizing enterocolitis and improve outcomes for infants ≤1250 g birth weight. Studies have shown that infants who received an exclusive human milk diet with a donor-human milk-derived cream supplement (cream) had improved weight and length velocity when the cream was added to mother's own milk or donor-human milk when energy was <20 kcal/oz using a human milk analyzer. Our objective was to compare growth and cost outcomes of infants ≤1250 g birth weight fed with an exclusive human milk diet, with and without human milk cream, without the use of a human milk analyzer. METHODS: Two cohorts of human milk-fed premature infants were compared from birth to 34 weeks postmenstrual age. Group 1 (2010-2011) received a donor-human milk fortifier, whereas Group 2 (2015-2016) received donor-human milk fortifier plus the commercial cream supplement, if weight gain was <15 g/kg/d. RESULTS: There was no difference in growth between the 2 groups for weight (P = 0.32) or head circumference (P = 0.90). Length velocity was greater for Group 1 (P = 0.03). The mean dose of donor-human milk fortifier was lower in Group 2 (P < 0.001). Group 2 saved an average of $2318 per patient on the cost of human milk products (P < 0.01). CONCLUSIONS: Infants receiving a human milk diet with cream supplementation for growth faltering achieve appropriate growth in a cost-effective feeding strategy.


Assuntos
Suplementos Nutricionais/economia , Alimentos Fortificados/economia , Recém-Nascido Prematuro/crescimento & desenvolvimento , Recém-Nascido de muito Baixo Peso/crescimento & desenvolvimento , Leite Humano , Apoio Nutricional/economia , Análise Custo-Benefício , Enterocolite Necrosante/prevenção & controle , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Doenças do Prematuro/prevenção & controle , Masculino , Apoio Nutricional/métodos , Estudos Retrospectivos , Aumento de Peso
14.
J Pediatr ; 154(4): 527-34, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19028387

RESUMO

OBJECTIVE: To examine for differences in and predictors of health value/utility scores in adolescents with or without inflammatory bowel disease (IBD). STUDY DESIGN: Adolescents with IBD and healthy control subjects were interviewed in an academic health center. We collected sociodemographic data and measured health status, personal, family, and social characteristics, and spiritual well-being. We assessed time tradeoff (TTO) and standard gamble (SG) utility scores for current health. We performed bivariate and multivariable analyses with utility scores used as outcomes. RESULTS: Sixty-seven patients with IBD and 88 healthy control subjects 11 to 19 years of age participated. Among subjects with IBD, mean (SD) TTO scores were 0.92 (0.17), and mean (SD) SG scores were 0.97 (0.07). Among healthy control subjects, mean (SD) TTO scores were 0.99 (0.03) and mean (SD) SG scores were 0.98 (0.03). TTO scores were significantly lower (P= .001), and SG scores trended lower (P= .065) in patients with IBD when compared with healthy control subjects. In multivariable analyses controlling for IBD status, poorer emotional functioning and spiritual well-being were associated with lower TTO (R(2)=0.17) and lower SG (R(2)=0.22) scores. CONCLUSION: Direct utility assessment in adolescents with or without IBD is feasible and may be used to assess outcomes. Adolescents with IBD value their health state highly, although less so than healthy control subjects. Emotional functioning and spiritual well-being appear to influence utility scores most strongly.


Assuntos
Atitude Frente a Saúde , Nível de Saúde , Doenças Inflamatórias Intestinais/terapia , Qualidade de Vida , Adaptação Psicológica , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Feminino , Humanos , Doenças Inflamatórias Intestinais/psicologia , Masculino , Análise Multivariada , Ohio , Espiritualidade
15.
Am J Clin Nutr ; 109(4): 1088-1097, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30982856

RESUMO

BACKGROUND: Mother's own milk (MOM) is protective against gut microbiota alterations associated with necrotizing enterocolitis (NEC) and feeding intolerance among preterm infants. It is unclear whether this benefit is preserved with donor milk (DM) feeding. OBJECTIVE: We aimed to compare microbiota development, growth, and feeding tolerance in very-low-birth-weight (VLBW) infants fed an exclusively human milk diet of primarily MOM or DM. METHODS: One hundred and twenty-five VLBW infants born at Texas Children's Hospital were enrolled and grouped into cohorts based on percentage of MOM and DM in enteral feeds. Feeds were fortified with DM-derived fortifier per unit protocol. Weekly stool samples were collected for 6 wk for microbiota analysis [16S ribosomal RNA (rRNA) sequencing]. A research nurse obtained weekly anthropometrics. Clinical outcomes were compared via Wilcoxon's rank-sum test and Fisher's exact test, as well as multivariate analysis. RESULTS: The DM cohort (n = 43) received on average 14% mothers' milk compared with 91% for the MOM cohort (n = 74). Diversity of gut microbiota across all time points (n = 546) combined was increased in MOM infants (P < 0.001). By 4 and 6 wk of life, microbiota in MOM infants contained increased abundance of Bifidobacterium (P = 0.02) and Bacteroides (P = 0.04), whereas DM-fed infants had increased abundance of Staphylococcus (P = 0.02). MOM-fed infants experienced a 60% reduction in feeding intolerance (P = 0.03 by multivariate analysis) compared with DM-fed infants. MOM-fed infants had greater weight gain than DM-fed infants. CONCLUSIONS: Compared with DM-fed infants, MOM-fed infants have increased gut microbial community diversity at the phylum and genus levels by 4 and 6 wk of life, as well as better feeding tolerance. MOM-fed infants had superior growth. The incidence of NEC and other gastrointestinal morbidity is low among VLBW infants fed an exclusively human milk diet including DM-derived fortifier. This trial was registered at clinicaltrials.gov as NCT02573779.


Assuntos
Microbioma Gastrointestinal , Recém-Nascido de muito Baixo Peso/crescimento & desenvolvimento , Recém-Nascido de muito Baixo Peso/metabolismo , Leite Humano/metabolismo , Adulto , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Biodiversidade , Fezes/microbiologia , Feminino , Humanos , Lactente , Saúde do Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Masculino , Estudos Prospectivos , Adulto Jovem
16.
BMJ ; 380: 362, 2023 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-36804717
17.
BMJ ; 376: o572, 2022 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-35260382
18.
Light Sci Appl ; 6(4): e16247, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30167242

RESUMO

Imaging dynamics at different temporal and spatial scales is essential for understanding the biological complexity of living organisms, disease state and progression. Optoacoustic imaging has been shown to offer exclusive applicability across multiple scales with excellent optical contrast and high resolution in deep-tissue observations. Yet, efficient visualization of multi-scale dynamics remained difficult with state-of-the-art systems due to inefficient trade-offs between image acquisition time and effective field of view. Herein, we introduce the spiral volumetric optoacoustic tomography technique that provides spectrally enriched high-resolution contrast across multiple spatiotemporal scales. In vivo experiments in mice demonstrate a wide range of dynamic imaging capabilities, from three-dimensional high-frame-rate visualization of moving organs and contrast agent kinetics in selected areas to whole-body longitudinal studies with unprecedented image quality. The newly introduced paradigm shift in imaging of multi-scale dynamics adds to the multifarious advantages provided by the optoacoustic technology for structural, functional and molecular imaging.

19.
Photoacoustics ; 7: 20-26, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28652976

RESUMO

Currently, imaging technologies that enable dermsurgeons to visualize non-melanoma skin cancers (NMSC) in vivo preoperatively are lacking, resulting in excessive or incomplete removal. Multispectral optoacoustic tomography (MSOT) is a volumetric imaging tool to differentiate tissue chromophores and exogenous contrast agents, based on differences in their spectral signatures and used for high-resolution imaging of functional and molecular contrast at centimeter scale depth. We performed MSOT imaging with two- and three-dimensional handheld scanners on 21 Asian patients with NMSC. The tumors and their oxygenation parameters could be distinguished from normal skin endogenously. The lesion dimensions and depths were extracted from the spectral melanin component with three-dimensional spatial resolution up to 80 µm. The intraclass correlation coefficient correlating tumor dimension measurements between MSOT and ex vivo histology of excised tumors, showed good correlation. Real-time 3D imaging was found to provide information on lesion morphology and its underlying neovasculature, indicators of the tumor's aggressiveness.

20.
Aviat Space Environ Med ; 77(6): 619-23, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16780240

RESUMO

INTRODUCTION: Prevalence of G-induced loss of consciousness (G-LOC) in the United Kingdom Royal Air Force (RAF) was found to be 19.3% in 1987. With the introduction of the Typhoon, a fourth generation aircraft, the prevalence of G-LOC has been re-assessed to determine the effectiveness of current G tolerance training. METHOD: A survey was sent to 4018 RAF aircrew, irrespective of their current role. Information was requested on G-LOC, role and aircraft type, experience, and attitudes toward G-LOC prevention. RESULTS: Responses were received from 2259 (56.2%) individuals, 882 (39%) of whom were current fast jet aircrew. At least one episode of G-LOC was reported by 20.1% of all respondents. In front line aircraft, prevalence of G-LOC among the 882 fast jet aircrew who responded was 6%. In the whole group, G-LOC was reported most commonly in aircrew under training (70.9%), and was most prevalent in training aircraft (77.4% of G-LOC events). At the time of the G-LOC, 64% of aircrew had less than 100 h total flying time. G-LOC was reported most frequently between +5 to +5.9 Gz, and "push-pull" maneuvers were associated with 31.3% of G-LOC events. Pulling G was not considered a problem by 50.6% of respondents, although over 80% recognized the value of flying currency, use of an anti-G suit, and physical fitness, and 55.6% felt that centrifuge training would be valuable. DISCUSSION: The prevalence of G-LOC in the RAF has changed little since 1987, and there remains considerable scope for aircrew education, particularly with the introduction of the Typhoon.


Assuntos
Hipergravidade/efeitos adversos , Militares/estatística & dados numéricos , Inconsciência/etiologia , Adulto , Medicina Aeroespacial , Distribuição de Qui-Quadrado , Trajes Gravitacionais , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Inquéritos e Questionários , Inconsciência/epidemiologia , Inconsciência/prevenção & controle , Reino Unido/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA