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INTRODUCTION: Skin and subcutaneous infections are dangerous sequelae of soft tissue injuries, especially in austere situations where medical technology is not available. Numerous plant species endemic to North America have been described as having antibacterial properties. Of these, St. John's wort (Hypericum perforatum), chamomile (Matricaria chamomilla), and white oak (Quercus alba) were selected for testing against Staphylococcus aureus. Our objective was to assess the suitability of all 3 plants as potential antiseptic agents using methods easily replicated in a resource-scarce environment. METHODS: Water-soluble natural products were extracted from different concentrations of each plant part using either mechanical agitation at ambient temperature or boiling in unsterilized tap water. Antibacterial activity of each extract against S aureus was assessed using a conventional agar well diffusion bioassay. Zones of inhibition were measured using electronic calipers and were compared to tap water as the negative control. RESULTS: Aqueous extracts of St. John's wort and white oak bark displayed antibacterial effects against S aureus, with St. John's wort being more potent. Chamomile displayed no inhibitory properties at the concentrations examined. CONCLUSIONS: These data suggest that both St. John's wort and white oak are potential candidates for infection prophylaxis and therapy in austere wilderness scenarios, with St. John's wort being the more potent agent. White oak may be more logistically feasible because the larger surface area of a white oak tree allows for harvesting a larger quantity of bark compared to the smaller surface area of the St. John's wort plant.
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Hypericum/química , Matricaria/química , Extratos Vegetais/farmacologia , Quercus/química , Staphylococcus aureus/efeitos dos fármacos , Antibacterianos/química , Antibacterianos/farmacologia , Humanos , América do Norte , Extratos Vegetais/química , Cicatrização/efeitos dos fármacosRESUMO
Data on the effectiveness of strategies for the recruitment of American Indians (AIs) into research is needed. This study describes and compares methods for identifying and recruiting AI tobacco users into a pilot study. Community-based strategies were used to recruit smokers (n = 35), e-cigarette users (n = 28), and dual users (n = 32) of AI descent. Recruitment was considered proactive if study staff contacted the individual at a pow wow, health fair, or vape shop and participation on-site or reactive if the individual contacted the study staff and participation occurred later. Screened, eligible, participated and costs and time spent were compared with Chi square tests. To understand AI descent, the relationship between number of AI grandparents and AI blood quantum was examined. Number of participants screened via the proactive strategy was similar to the reactive strategy (n = 84 vs. n = 82; p-value = 0.8766). A significantly greater proportion of individuals screened via the proactive than the reactive strategy were eligible (77 vs. 50%; p-value = 0.0002) and participated (75 vs. 39%; p-value = < 0.0001). Per participant cost and time estimated for the proactive strategy was $89 and 87 min compared to $79 and 56 min for the reactive strategy. Proportion at least half AI blood quantum was 32, 33, and 70% among those with 2, 3, and 4 AI grandparents, respectively (p = 0.0017). Proactive strategies resulted in two-thirds of the sample, but required more resources than reactive strategies. Overall, we found both strategies were feasible and resulted in the ability to reach sample goals. Lastly, number of AI biological grandparents may be a good, non-invasive indicator of AI blood quantum.
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Sistemas Eletrônicos de Liberação de Nicotina , Indígenas Norte-Americanos/estatística & dados numéricos , Seleção de Pacientes , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Projetos de Pesquisa , Adulto JovemRESUMO
We developed nested PCR protocols and performed a multiyear survey on the prevalence of several protozoan parasites in wild northern bobwhite (Colinus virginianus) and scaled quail (Callipepla squamata) in the Rolling Plains ecoregion of Texas and Oklahoma (i.e. fecal pellets, bird intestines and blood smears collected between 2010 and 2013). Coccidia, cryptosporidia, and microsporidia were detected in 46.2%, 11.7%, and 44.0% of the samples (n = 687), whereas histomona and hematozoa were undetected. Coccidia consisted of one major and two minor Eimeria species. Cryptosporidia were represented by a major unknown Cryptosporidium species and Cryptosporidium baileyi. Detected microsporidia species were highly diverse, in which only 11% were native avian parasites including Encephalitozoon hellem and Encephalitozoon cuniculi, whereas 33% were closely related to species from insects (e.g. Antonospora, Liebermannia, and Sporanauta). This survey suggests that coccidia infections are a significant risk factor in the health of wild quail while cryptosporidia and microsporidia may be much less significant than coccidiosis. In addition, the presence of E. hellem and E. cuniculi (known to cause opportunistic infections in humans) suggests that wild quail could serve as a reservoir for human microsporidian pathogens, and individuals with compromised or weakened immunity should probably take precautions while directly handling wild quail.
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Doenças das Aves/parasitologia , Coccídios/isolamento & purificação , Cryptosporidium/isolamento & purificação , Microsporídios/isolamento & purificação , Microsporidiose/veterinária , Infecções Protozoárias em Animais/parasitologia , Codorniz/parasitologia , Trichomonadida/isolamento & purificação , Tritrichomonas/isolamento & purificação , Animais , Doenças das Aves/epidemiologia , Coccídios/genética , Colinus/parasitologia , Criptosporidiose/epidemiologia , Criptosporidiose/parasitologia , Cryptosporidium/genética , DNA de Protozoário/análise , DNA de Protozoário/genética , Fezes/parasitologia , Feminino , Masculino , Microsporídios/genética , Microsporidiose/epidemiologia , Microsporidiose/parasitologia , Oklahoma/epidemiologia , Reação em Cadeia da Polimerase/métodos , Infecções Protozoárias em Animais/diagnóstico , Infecções Protozoárias em Animais/epidemiologia , Codorniz/sangue , Fatores de Risco , Inquéritos e Questionários , Texas/epidemiologia , Trichomonadida/genética , Tritrichomonas/genéticaRESUMO
Oral cavity cancer (OC) has steadily decreased in the United States (US) since 1973 whereas oropharyngeal cancer (OP) has increased. We analyzed OC and OP cases from the Oklahoma Central Cancer Registry and Surveillance, Epidemiology, and End Results program comparing those diagnosed from 1997-1999 to those diagnosed from 2010-2012. We compared the incidence of OC and OP cases between Oklahoma and the US and by demographic factors. We observed an increase in OP cases, but no change in OC cases in both the US and in Oklahoma, and observed some differences between Oklahoma and the US by race, gender, and age group. A possible explanation for the increasing incidence of OP cancers may be the increasing prevalence of HPV. This study highlighted the differences in temporal trends of OC and OP cancers and the importance of changing risk factors for these cancers.
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Neoplasias Bucais/epidemiologia , Neoplasias Orofaríngeas/epidemiologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Oklahoma/epidemiologia , Sistema de Registros , Programa de SEER , Distribuição por Sexo , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: We aimed to assess patient and surrogate understanding of and satisfaction with communication regarding acute stroke treatments of intravenous thrombolysis (IVT) and endovascular therapy (EVT). METHODS: In this single health-system prospective observational study, patients or their surrogates were interviewed within 72 h of acute stroke therapy. Respondent's satisfaction and self-reported understanding were rated on a Likert scale. Responses to open-ended questions were evaluated for recall of purpose and risks of treatment. RESULTS: Of 56 completed interviews (24 patients and 32 surrogates), 33 patients received IVT alone, 11 IVT and EVT, 12 EVT alone. Forty participants (71%) reported being extremely satisfied with their acute stroke care, 46 (82%) reported no difficulty understanding the purpose of treatment, while 36 (64%) reported no difficulty understanding risks. Two or more risks were verbalized by 8 (24%) participants for IVT, 2 (17%) for EVT, and 7 (64%) for both IVT and EVT. Brain bleeding was the most recalled risk for IVT and "lack of benefit" for EVT. CONCLUSIONS: Majority of the participants were extremely satisfied and reported no difficulty understanding purpose and risks of acute stroke treatment, however only 30% were able to verbalize two or more risks associated with the treatment.
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Isquemia Encefálica , Procedimentos Endovasculares , Acidente Vascular Cerebral , Humanos , Terapia Trombolítica , Isquemia Encefálica/terapia , Trombectomia , Resultado do Tratamento , Satisfação do Paciente , Acidente Vascular Cerebral/tratamento farmacológicoRESUMO
CONTEXT: The COVID-19 pandemic has reduced the capacity to conduct medical research due to recruitment difficulties, supply chain shortages, and funding deficits. The clinical practice of otolaryngology was especially impacted due to a reduction in elective procedures, such as facial plastic surgeries and vocal fold injections. OBJECTIVES: The primary objective was to examine the extent of clinical trial (CTs) disruption secondary to the COVID-19 pandemic in the field of otolaryngology. METHODS: On August 1, 2021, we conducted a systematic search utilizing ClinicalTrials.gov for CTs related to common otolaryngology disorders. We utilized the date range January 1, 2020 through August 1, 2021 to identify all trials potentially affected by the COVID-19 pandemic. Investigators performed screening and data extraction in a duplicate, masked fashion. Trials resulting from the search were extracted for trial status, condition treated, enrollment number, funding, study type, study design, last update posted date, and trial location. Trials that explicitly mentioned COVID-19 as a reason for discontinuation or suspension were coded as such. For trials that did not explicitly mention COVID-19, we coded the reason provided from ClinicalTrials.gov. The Oklahoma State University Center for Health Science Institutional Review Board determined that this project did not qualify as human subject research. RESULTS: A total of 1,777 CTs met the inclusion criteria, and 223 CTs were discontinued between January 1, 2020 and August 1, 2021. Thirty-three (14.8%) of the 223 CTs reported discontinuation explicitly due to the COVID-19 pandemic. The 33 studies had 1,715 participants enrolled in total. Among the primary interventions, 11 (33.3%) were devices, 10 (30.3%) were drugs, 5 (15.2%) were behavioral, 4 (12.1%) were diagnostic tests, 1 (3.0%) was dietary, and 2 (6.1%) were labeled as "other." Regarding the CT location, 20 (60.6%) were conducted in the United States, and 13 (39.4%) were conducted internationally. Of the 33 CTs, 19 (57.6%) were suspended, 9 (27.3%) were terminated, and 5 (15.2%) were withdrawn. The overall most common reason for trial disruption was recruitment difficulties (24.2%). Median enrollment for discontinued trials due to COVID-19 was 37 (interquartile range [IQR], 19-71) and for other reasons was 6 (IQR, 0-27), for which the Mann-Whitney test showed a statistically significant difference between the two (z=-3.913, p<0.001). There were no significant associations between trial location, funding source, randomization, or whether a study involved masked vs unmasked participants. CONCLUSIONS: The COVID-19 pandemic has incited an impact on clinical research in the field of otolaryngology. To preserve trial continuation amid future threats to participant interaction and communication, we recommend further exploration of remote monitoring practices and virtual procedures-those that will maintain the effectiveness and accuracy needed to establish novel therapeutics. We encourage future trials to gauge which remote assessments show the greatest validity, with the long-term goal of establishing innovative study designs resilient to future pandemics.
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COVID-19 , Otolaringologia , COVID-19/epidemiologia , Ensaios Clínicos como Assunto , Estudos Transversais , Humanos , Pandemias , SARS-CoV-2RESUMO
BACKGROUND: In American Indian (AI) tobacco users from the southern plains region of the US, we examined the relationship between nicotine and carcinogen exposure and nicotine metabolism. METHODS: Smokers (nâ¯=â¯27), electronic nicotine delivery system (ENDS) users (nâ¯=â¯21), and dual users (nâ¯=â¯25) of AI descent were recruited from a southern plains state. Urinary biomarkers of nicotine metabolism (nicotine metabolite ratio [NMR]), nicotine dose (total nicotine equivalents [TNE]), and a tobacco-specific lung carcinogen (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and its glucuronides [total NNAL] were measured. RESULTS: The geometric mean of NMR was 3.35 (95% Confidence Interval(CI): 2.42, 4.65), 4.67 (95% CI: 3.39, 6.43), and 3.26 (95% CI: 2.44, 4.37) among smokers, ENDS users, and dual users. Each of the three user groups had relatively low levels of TNE, indicative of light tobacco use. Among smokers, there were inverse relationships between NMR and TNE (râ¯=â¯-0.45) and between NMR and NNAL (râ¯=â¯-0.50). Among dual users, NMR and TNE, and NMR and NNAL were not associated. Among ENDS users, NMR and TNE were not associated. CONCLUSIONS: AI tobacco users with higher NMR did not have higher TNE or NNAL exposure than those with lower NMR. This supports prior work among light tobacco users who do not alter their tobacco consumption to account for nicotine metabolism. IMPACT: The high prevalences of smoking and ENDS among AI in the southern plains may not be related to nicotine metabolism. Environmental and social cues may play a more important role in light tobacco users and this may be particularly true among AI light tobacco users who have strong cultural ties.
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Carcinógenos/metabolismo , Fumar Cigarros/epidemiologia , Indígenas Norte-Americanos , Nicotina/metabolismo , Vaping/epidemiologia , Adulto , Idoso , Biomarcadores/urina , Fumar Cigarros/metabolismo , Fumar Cigarros/urina , Sistemas Eletrônicos de Liberação de Nicotina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nicotina/urina , Produtos do Tabaco , Vaping/metabolismo , Vaping/urinaRESUMO
Objectives: We measured biomarkers of exposure among American Indian (AI) ENDS users, smokers, and dual users. Methods: Urine was analyzed for total nicotine equivalents (TNE) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol(NNAL). Expired-air carbon monoxide (CO) was collected. Two analyses were performed. "CO analysis" included smokers and dual users whose CO was ≥ 6 ppm and ENDS users whose CO was < 6 ppm. "NNAL analysis" included smokers and dual users whose NNAL was ≥ 47.3 pg/mg, and ENDS users whose NNAL was < 47.3 pg/mg. Biomarkers were summarized by geometric means (GM) and compared with nonparametric tests. Results: In both analyses, TNE was no different across the groups, and NNAL and CO were lower in ENDS users. In the NNAL analysis the GM of NNAL was 261.4, 6.1, and 228.0 pg/mg among smokers, ENDS users, and dual users (p < .001). Also in the NNAL analysis, the GM of CO was 14.7, 2.4, and 16.8 ppm among smokers, ENDS users, and dual users (p < .001). Conclusions: ENDS users did not differ in nicotine and had lower exposure to a lung carcinogen and a cardiovascular toxicant than smokers or dual users. Dual users and smokers did not differ in biomarker levels. Results should be used to inform tribal regulations and to educate the AI community on ENDS.
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BACKGROUND: The ability of cyclin-dependent kinases (CDKs) to promote cell proliferation is opposed by cyclin-dependent kinase inhibitors (CKIs), proteins that bind tightly to cyclin-CDK complexes and block the phosphorylation of exogenous substrates. Mice with targeted CKI gene deletions have only subtle proliferative abnormalities, however, and cells prepared from these mice seem remarkably normal when grown in vitro. One explanation may be the operation of compensatory pathways that control CDK activity and cell proliferation when normal pathways are inactivated. We have used mice lacking the CKIs p21(Cip1) and p27(Kip1) to investigate this issue, specifically with respect to CDK regulation by mitogens. RESULTS: We show that p27 is the major inhibitor of Cdk2 activity in mitogen-starved wild-type murine embryonic fibroblasts (MEFs). Nevertheless, inactivation of the cyclin E-Cdk2 complex in response to mitogen starvation occurs normally in MEFs that have a homozygous deletion of the p27 gene. Moreover, CDK regulation by mitogens is also not affected by the absence of both p27 and p21. A titratable Cdk2 inhibitor compensates for the absence of both CKIs, and we identify this inhibitor as p130, a protein related to the retinoblastoma gene product Rb. Thus, cyclin E-Cdk2 kinase activity cannot be inhibited by mitogen starvation of MEFs that lack both p27 and p130. In addition, cell types that naturally express low amounts of p130, such as T lymphocytes, are completely dependent on p27 for regulation of the cyclin E-Cdk2 complex by mitogens. CONCLUSIONS: Inhibition of Cdk2 activity in mitogen-starved fibroblasts is usually performed by the CKI p27, and to a minor extent by p21. Remarkably p130, a protein in the Rb family that is not related to either p21 or p27, will directly substitute for the CKIs and restore normal CDK regulation by mitogens in cells lacking both p27 and p21. This compensatory pathway may be important in settings in which CKIs are not expressed at standard levels, as is the case in many human tumors.
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Quinases relacionadas a CDC2 e CDC28 , Proteínas de Ciclo Celular , Quinases Ciclina-Dependentes/metabolismo , Proteínas Associadas aos Microtúbulos/fisiologia , Proteínas Serina-Treonina Quinases/metabolismo , Proteínas Supressoras de Tumor , Animais , Células Cultivadas , Quinase 2 Dependente de Ciclina , Inibidor de Quinase Dependente de Ciclina p21 , Inibidor de Quinase Dependente de Ciclina p27 , Quinases Ciclina-Dependentes/antagonistas & inibidores , Ciclinas/metabolismo , Embrião de Mamíferos , Inibidores Enzimáticos/metabolismo , Fibroblastos/citologia , Fibroblastos/fisiologia , Deleção de Genes , Humanos , Camundongos , Camundongos Knockout , Proteínas Associadas aos Microtúbulos/deficiência , Proteínas Associadas aos Microtúbulos/genética , Proteínas Serina-Treonina Quinases/antagonistas & inibidores , Proteínas Recombinantes/metabolismo , Baço/imunologia , Linfócitos T/citologia , Linfócitos T/fisiologia , TransfecçãoRESUMO
PURPOSE: We describe and compare lifestyle behaviors, including smoking, physical activity, alcohol consumption, and nutrition, among cancer survivors to individuals with no cancer. METHODS: Data from the 2013 Behavior Risk Factor Surveillance System were used for this cross-sectional study. Weighted analysis was performed, and associations were examined by adjusted prevalence ratios (APRs) and 95 % confidence intervals (CIs). RESULTS: Comparing survivors to individuals with no cancer history, differences were found for a smoking quit attempt (APR 1.08; CI 1.04, 1.12), physical inactivity (APR 1.11; CI 1.07, 1.15), and binge drinking (APR 0.89; CI 0.83, 0.95). An interaction with gender was observed when examining smoking and heavy drinking. Smoking was lower (APR 0.85; CI 0.79, 0.92) among male survivors than males with no cancer history, while higher (APR 1.25; CI 1.18, 1.32) among female survivors compared to females with no cancer history. Heavy drinking (APR 0.85; CI 0.73, 0.98) was lower among male survivors than males with no cancer history, while cancer survivorship was not associated with heavy drinking among females. No differences existed for fruit and vegetable consumption or body mass index. CONCLUSIONS: US cancer survivors are not more likely than the general population to engage in all healthy lifestyle behaviors. Interventions, including improved physician communication, to reduce physical inactivity among all cancer survivors and cigarette smoking among female survivors are needed. IMPLICATIONS FOR CANCER SURVIVORS: Cancer survivors are at increased risk for comorbid conditions, and acceptance of healthy behaviors may reduce dysfunction and improve long-term health. Ultimately, opportunities exist for clinicians to promote lifestyle changes that may improve the length and quality of life of their patients.
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Neoplasias/psicologia , Qualidade de Vida , Sobreviventes/psicologia , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/mortalidade , Estados Unidos , Adulto JovemRESUMO
BACKGROUND: The receptor for advanced glycation end products (RAGE) is a multi-ligand receptor in the immunoglobulin superfamily. RAGE is localized throughout ascending sensory pathways (skin, peripheral nerve, dorsal root ganglion, spinal cord), and in cell types interacting with sensory neurons (endothelial cells, smooth muscle cells, monocytes and macrophages). Neuronal RAGE expression increases in pathological pain states in humans and rodents, and soluble RAGE attenuates thermal hypoalgesia in diabetic mice. The objective of the present study was to investigate whether pharmacological modulation of RAGE could attenuate mechanical allodynia in rodent pain models. METHODS: We developed an anti-RAGE monoclonal antibody (11E6) that binds to the C2 immunoglobulin domain of human RAGE, binds to mouse RAGE, and presumably to the same domain in mouse RAGE. The antinociceptive activity of 11E6 was investigated in mouse models of inflammatory (complete Freund's adjuvant) and neuropathic (chronic constriction injury of the sciatic nerve) pain. Mice were dosed intraperitoneally with 11E6 or IgG (negative control). RESULTS: Increased mechanical thresholds were observed following a single dose of 11E6 in both inflammatory and neuropathic pain models. Similar treatment with IgG did not alter nociceptive sensitivity. Repeated dosing with 11E6 significantly attenuated established mechanical hypersensitivity in a neuropathic pain model in a dose-related fashion. CONCLUSIONS: These data demonstrate that specific modulation of RAGE effectively attenuates nociceptive sensitivity associated with chronic inflammatory and neuropathic pain states.
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Anticorpos Monoclonais/uso terapêutico , Hiperalgesia/tratamento farmacológico , Hiperalgesia/etiologia , Fatores Imunológicos/uso terapêutico , Neuralgia/tratamento farmacológico , Receptor para Produtos Finais de Glicação Avançada/antagonistas & inibidores , Animais , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Experimental/metabolismo , Modelos Animais de Doenças , Feminino , Adjuvante de Freund , Gânglios Espinais/metabolismo , Humanos , Hiperalgesia/fisiopatologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Neuralgia/etiologia , Neurônios Aferentes/metabolismo , Receptor para Produtos Finais de Glicação Avançada/imunologia , Nervo Isquiático/metabolismo , Medula Espinal/metabolismoRESUMO
P130 shares structural and functional homology with pRb and p107. One property common to p107 and p130, but not to pRb, is the ability to stably interact with cyclin A/cdk2 and cyclin E/cdk2 complexes in vitro and in vivo. Using GST-p130 fusion proteins representing various regions of p130, baculovirus-produced cyclin A/cdk2 and cyclin E/cdk2 complexes were found to interact with residues within a part of p130 known as the spacer region. Cyclin E was able to bind the p130 spacer region in the presence or absence of cdk2 whereas cyclin A binding was dependent upon the presence of cdk2. The smallest p130 fusion protein sufficient to interact with cyclin A/cdk2 or cyclin E/cdk2 complexes contained p130 amino acids 652-698 and deletion of p130 amino acids 680-682 abolished binding to both of the cyclin/cdk2 complexes. When overexpressed in C33A cells, a p130 mutant containing a deletion of amino acids 620-697 was unable to form complexes with either cyclin A or cyclin E. This p130 mutant was at least as active as wild type p130 in suppressing the growth of G418 resistant colonies when overexpressed in C33A or SAOS-2 cells.
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Quinases relacionadas a CDC2 e CDC28 , Quinases Ciclina-Dependentes/metabolismo , Ciclinas/metabolismo , Fosfoproteínas/genética , Fosfoproteínas/metabolismo , Proteínas Serina-Treonina Quinases/metabolismo , Proteínas , Homologia de Sequência de Aminoácidos , Quinase 2 Dependente de Ciclina , Humanos , Dados de Sequência Molecular , Proteínas Nucleares/genética , Proteínas Nucleares/metabolismo , Fragmentos de Peptídeos/metabolismo , Mapeamento de Peptídeos , Proteínas Recombinantes/metabolismo , Proteína p107 Retinoblastoma-Like , Proteína p130 Retinoblastoma-Like , Alinhamento de Sequência , Células Tumorais CultivadasRESUMO
BACKGROUND AND PURPOSE: Rapid eye movement (REM) sleep Behavior Disorder (RBD) is a movement disorder associated with loss of REM-related muscle atonia and is characterized by complex, vigorous and frequently violent dream-enacting behavior during REM sleep. RBD is usually idiopathic or secondary to neurological problems such as Parkinson's disease. This study looked at the association of RBD with another sleep disorder, narcolepsy. PATIENTS AND METHODS: Seventy-eight questionnaires were sent to known narcoleptics chosen at random from those with contact details available at the center. The questionnaire addressed current narcolepsy symptoms, medication use and symptoms of RBD. Positive questionnaire results were followed up with a telephone interview. Limited polysomnography (PSG) data was also analyzed. RESULTS: Fifty-five patients responded (response rate 71%). Of these, 20 (36%) had symptoms suggestive of RBD. The typical RBD patient is an older male (mean age of onset 60.9 years, 87% male); however, in this study, females were as likely to have RBD as males, and the mean age was 41 years. Sixty-eight percent of patients who regularly experienced cataplexy and the associated symptoms of narcolepsy (sleep paralysis, hypnogogic hallucinations and automatic behavior) had RBD, compared to 14% of those who never or rarely experienced these symptoms. CONCLUSION: This study implies a stronger relationship between these disorders than a previously published figure of 7-12% This is clinically significant as RBD is a potentially distressing but readily treatable disorder. It follows that narcoleptics, especially those with cataplexy and other associated symptoms, should be questioned about symptoms of RBD and treated accordingly. Similarly, anyone presenting with RBD should be assessed for symptoms of narcolepsy, particularly if female or of a younger age group than would otherwise be expected.
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Narcolepsia/epidemiologia , Transtorno do Comportamento do Sono REM/epidemiologia , Adolescente , Adulto , Idoso , Eletromiografia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Narcolepsia/diagnóstico , Polissonografia , Transtorno do Comportamento do Sono REM/diagnóstico , Inquéritos e QuestionáriosRESUMO
In animals and humans, intravenous administration of the antiviral nucleotide analogue cidofovir results in a dose-limiting nephrotoxicity characterized by damage to the proximal tubular epithelial cells. Probenecid, a competitive inhibitor of organic anion transport in the proximal tubular epithelial cells, was evaluated for its effect on the chronic toxicity and pharmacokinetics of cidofovir. Cynomolgus monkeys (5/sex/group) received cidofovir for 52 consecutive weeks as a once weekly intravenous bolus injection at 0 (saline), 0.1, 0.5, or 2.5 mg/kg/dose alone or at 2.5 mg/kg/dose in combination with probenecid (30 mg/kg/dose via oral gavage 1 h prior to cidofovir administration). Cidofovir-associated histopathological changes were seen only in the kidneys, testes, and epididymides. Nephrotoxicity (mild to moderate cortical tubular epithelial cell karyomegaly, tubular dilation, basement membrane thickening) was present only in monkeys receiving 2.5 mg/kg/dose cidofovir without probenecid. The incidence and severity of testicular (hypo- and aspermatogenesis) and epididymal (severe oligo- and aspermia) changes were increased in monkeys administered cidofovir at 2.5 mg/kg/dose, either alone or in combination with oral probenecid. Renal drug clearance was decreased between Weeks 1 and 52 in the 2.5 mg/kg/dose groups and resulted in an increased systemic exposure to cidofovir (as measured by AUC) that was significantly greater in monkeys administered cidofovir alone (312% increase in males, 98% in females) than in those coadministered probenecid (32% increase in males, 3% in females). These results demonstrate that oral probenecid coadministration protects against the morphological evidence of nephrotoxicity and the accompanying decrease in renal clearance in monkeys receiving chronic intravenous cidofovir treatment.
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Antivirais/toxicidade , Citosina/análogos & derivados , Organofosfonatos , Compostos Organofosforados/toxicidade , Probenecid/farmacologia , Administração Oral , Animais , Cidofovir , Citosina/farmacocinética , Citosina/toxicidade , Feminino , Injeções Intravenosas , Rim/efeitos dos fármacos , Rim/patologia , Macaca fascicularis , Masculino , Tamanho do Órgão/efeitos dos fármacos , Compostos Organofosforados/farmacocinéticaRESUMO
Thirty adult guinea pigs were bilaterally vasectomized and subsequently sacrificed at one, three, and six months after operation. Cell counts were performed on five seminiferous tubules from each animal to identify and quantitate changes in spermatogenesis. Forty-three per cent of the animals had alterations in spermatogenesis that were characterized by generalized hypospermatogenesis and presence of multinucleated spermatids. There was a high incidence (93 per cent) of sperm-agglutinating antibodies in the vasectomized group. Sperm antibodies were not detected in the normal and sham-operated animals. Mean testicular weights and seminiferous tubule diameters were significantly reduced in the hypospermatogenic animals. The intersitial tissue of the vasectomized and sham-operated animals was morphologically indistinguishable from that of unoperated animals.
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Testículo/patologia , Vasectomia , Animais , Contagem de Células , Cobaias , Masculino , Espermatogênese , Fatores de TempoRESUMO
The objective of this investigation was to determine if sperm antibody formation after vasectomy in guinea pigs can be inhibited by passive administration of antiserum to spermatozoa. Sperm antibody was obtained by bleeding vasectomized guinea pigs which had sperm-agglutinating antibody titers of 1 : 16 or higher. Gamma globulin was obtained by ammonium sulfate precipitation. Vasectomized guinea pigs were injected with immune gamma globulin and normal gamma globulin for a period of two weeks after vasectomy. In the group receiving normal gamma globulin the serum titer of sperm-agglutinating antibody reached 1 : 32 and remained at that level for duration of the study. In guinea pigs receiving immune gamma globulin detectable serum titers of sperm-agglutinating antibody did not develop. The investigation suggests that sperm antibody formation can be prevented by treating vasectomized animals with passive sperm antibody to spermatozoa.
Assuntos
Autoanticorpos/imunologia , Espermatozoides/imunologia , Animais , Imunofluorescência , Cobaias , Imunização Passiva , Imunoglobulina G/imunologia , Terapia de Imunossupressão , Masculino , Vasectomia/efeitos adversosRESUMO
Worksite smoking cessation intervention programs have become increasingly popular, although program evaluations are often unavailable. In 1984, the Texas Operations of Dow Chemical USA offered a Smoking Cessation Incentive Program (SCIP) to its employees. SCIP was a highly publicized, upbeat program that had the active support of management and union. Altogether, 7,516 employees (95.4% of all employees) were surveyed about their smoking habits; 28.3% identified themselves as smokers. A total of 1,113 employees voluntarily enrolled in SCIP from March 1, 1984, through March 1, 1985. Smoking cessation methods included a buddy program, nicotine-containing chewing gum, American Lung Association self-help material and group clinics, and incentive prizes. SCIP registrants, compared to employees identified as smokers in a pre-program survey who did not participate in SCIP, were significantly (P less than .01) more often females, whites, administrators, professionals, heavier smokers, and smokers who had tried to quit at least two times prior to SCIP. There were 326 (29.3%) SCIP participants who quit smoking for at least one month during SCIP. A total of 265 (23.8%) succeeded at quitting for at least six months and remained ex-smokers at the end of the program. Logistic regression analysis showed administrators had significantly higher six-month or more rates of quitting than did professionals, craftsmen, operators or clerical workers.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Indústria Química , Promoção da Saúde/organização & administração , Prevenção do Hábito de Fumar , Estudos Transversais , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Fumar/psicologia , Apoio Social , TexasRESUMO
Surgical specimens of human vas deferens, mounted isometrically in vitro, were tested for their reactivity to norepinephrine, the major neurohumoral control mechanism in this tissue, under a variety of conditions. There was no significant difference in reactivity (measured as amplitude and frequency of contraction) between vasa obtained under either spinal or local anesthesia. Similarly, the age of the donor (range, 20 to 79 years) had no effect on either measure of reactivity. Prostaglandins A1 (10(-7) gm/ml) and E2 (10(-9) gm/ml), Escherichia coli (10(5) organisms/ml), and E. coli endotoxin (10(-7) gm/ml) did not affect norepinephrine responses, suggesting that the role of these compounds in problems of fertility is not related to an alternation in sperm transport through the vas. Nitrofurantoin (10(-5) gm/ml) also had no effect on reactivity to norepinephrine, providing further evidence that low sperm counts in patients taking this drug are more appropriately attributed to a direct effect on spermatogenesis than to an effect on sperm transport.