RESUMO
Arbuscular mycorrhizal (AM) fungi are widespread root symbionts that often improve the fitness of their plant hosts. We tested whether local adaptation in mycorrhizal symbioses would shape the community structure of these root symbionts in a way that maximizes their symbiotic functioning. We grew a native prairie grass (Andropogon gerardii) with all possible combinations of soils and AM fungal inocula from three different prairies that varied in soil characteristics and disturbance history (two native prairie remnants and one recently restored). We identified the AM fungi colonizing A. gerardii roots using PCR amplification and cloning of the small subunit rRNA gene. We observed 13 operational taxonomic units (OTUs) belonging to six genera in three families. Taxonomic richness was higher in the restored than the native prairies with one member of the Gigaspora dominating the roots of plants grown with inocula from native prairies. Inoculum source and the soil environment influenced the composition of AM fungi that colonized plant roots. Correspondingly, host plants and AM fungi responded significantly to the soil-inoculum combinations such that home fungi often had the highest fitness and provided the greatest benefit to A. gerardii. Similar patterns were observed within the soil-inoculum combinations originating from two native prairies, where five sequence types of a single Gigaspora OTU were virtually the only root colonizers. Our results indicate that indigenous assemblages of AM fungi were adapted to the local soil environment and that this process occurred both at a community scale and at the scale of fungal sequence types within a dominant OTU.
Assuntos
Adaptação Fisiológica/genética , Glomeromycota/isolamento & purificação , Raízes de Plantas/microbiologia , Poaceae/microbiologia , Microbiologia do Solo , Clonagem Molecular , Variação Genética , Glomeromycota/classificação , Glomeromycota/genética , Dados de Sequência Molecular , Micorrizas/classificação , Micorrizas/genética , Micorrizas/isolamento & purificação , Filogenia , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , SimbioseRESUMO
Human polymorphonuclear leukocytes exhibit an enhanced rate of oxygen consumption during phagocytosis of relatively avirulent strains of Salmonella typhi or Staphylococcus aureus. However, phagocytosis of a virulent strain of Salmonella typhi is not associated with augmented oxygen consumption. The ability of a bacterial strain to alter the postphagocytic rate of oxygen consumption of polymorphonuclear leukocytes may be related to its in vivo virulence.
Assuntos
Leucócitos/metabolismo , Consumo de Oxigênio , Fagocitose , Salmonella typhi/patogenicidade , Cianetos/farmacologia , Hexosefosfatos/metabolismo , Humanos , Leucócitos/citologia , Polarografia , Infecções por Salmonella/sangue , Staphylococcus , VirulênciaRESUMO
Boneless ham muscles (Semimembranosus+Adductor) were injected (20% w/w) with a curing brine containing no plum ingredient (control), fresh plum juice concentrate (FP), dried plum juice concentrate (DP), or spray dried plum powder (PP) at 2.5% or 5%. Hams were cooked, vacuum-packaged, stored at<4°C and evaluated at 2-week intervals over 10 week. Evaluations were performed on sliced product to determine cook loss, vacuum-package purge, Allo-Kramer shear force, 2-thiobarbituric acid-reactive substances (TBARS), proximate analysis, objective color, sensory panel color and sensory attributes. FP, DP and 2.5% PP increased (P<0.05) cook loss by 2% to 7% depending on treatment and level, but the highest cook loss (17.7%) was observed in hams with 5% PP. Shear force values increased as the level of plum ingredient increased (P<0.05) from 2.5% to 5%, and the highest shear values were observed in hams containing 5% FP. There were no differences (P>0.05) in lipid oxidation among treatments as determined by TBARS and sensory evaluation. FP and PP ham color was similar to the control, but DP had a more intense atypical color of cured ham. Minimal changes in physical, chemical and sensory properties were observed during storage of all treatments.
RESUMO
The recovery of ecosystem C and N dynamics after disturbance can be a slow process. Chronosequence approaches offer unique opportunities to use space-for-time substitution to quantify the recovery of ecosystem C and N stocks and estimate the potential of restoration practices for C sequestration. We studied the distribution of C and N stocks in two chronosequences that included long-term cultivated lands, 3- to 26-year-old prairie restorations, and remnant prairie on two related soil series. Results from the two chronosequences did not vary significantly and were combined. Based on modeling predictions, the recovery rates of different ecosystem components varied greatly. Overall, C stocks recovered faster than N stocks, but both C and N stocks recovered more rapidly for aboveground vegetation than for any other ecosystem component. Aboveground C and N reached 95% of remnant levels in only 13 years and 21 years, respectively, after planting to native vegetation. Belowground plant C and N recovered several decades later, while microbial biomass C, soil organic C (SOC), and total soil N recovered on a century timescale. In the cultivated fields, SOC concentrations were depleted within the surface 25 cm, coinciding with the depth of plowing, but cultivation apparently led to redistribution of soil C, increasing SOC stocks deeper in the soil profile. The restoration of prairie vegetation was effective at rebuilding soil organic matter (SOM) in the surface soil. Accrual rates were maintained at 43 g C x m(-2) x yr(-1) and 3 g N x m(-2) x yr(-1) in the surface 0.16 Mg/m2 soil mass during the first 26 years of restoration and were predicted to reach 50% of their storage potential (3500 g C/m2) in the first 100 years. We conclude that restoration of tallgrass prairie vegetation can restore SOM lost through cultivation and has the potential to sequester relatively large amounts of SOC over a sustained period of time. Whether restored prairies can retain the C apparently transferred to the subsoil by cultivation practices remains to be seen.
Assuntos
Carbono/metabolismo , Ecossistema , Nitrogênio/metabolismo , Poaceae/metabolismo , Solo/análise , Carbono/análise , Conservação dos Recursos Naturais , Produtos Agrícolas/metabolismo , Illinois , Nitrogênio/análise , Fatores de TempoRESUMO
BACKGROUND: Over the past few decades, advanced imaging modalities with excellent diagnostic capabilities have emerged. The aim of the present position statement was to systematically review existing literature to define Canadian recommendations for their clinical use. METHODS: A systematic literature review to 2005 was conducted for positron emission tomography (PET), multidetector computed tomographic angiography and magnetic resonance imaging (MRI) in ischemic heart disease. Papers that met the criteria were reviewed for accuracy, prognosis data and study quality. Recommendations were presented to primary and secondary panels of experts, and consensus was achieved. RESULTS: Indications for PET include detection of coronary artery disease (CAD) with perfusion imaging, and defining viability using fluorodeoxyglucose to determine left ventricular function recovery and/or prognosis after revascularization (class I). Detection of CAD in patients, vessel segments and grafts using computed tomographic angiography was considered class IIa at the time of the literature review. Dobutamine MRI is class I for CAD detection and, along with late gadolinium enhancement MRI, class I for viability detection to predict left ventricular function recovery. Imaging must be performed at institutions and interpreted by physicians with adequate experience and training. CONCLUSIONS: Cardiac imaging using advanced modalities (PET, multidetector computed tomographic angiography and MRI) is useful for CAD detection, viability definition and, in some cases, prognosis. These modalities complement the more widespread single photon emission computed tomography and echocardiography. Given the rapid evolution of technology, initial guidelines for clinical use will require regular updates. Evaluation of their integration in clinical practice should be ongoing; optimal use will require proper training. A joint effort among specialties is recommended to achieve these goals.
Assuntos
Angiografia Coronária , Imageamento por Ressonância Magnética , Isquemia Miocárdica/diagnóstico , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , HumanosRESUMO
The gradual loss of striatal dopamine and dopaminergic neurons residing in the substantia nigra (SN) causes parkinsonism characterized by slow, halting movements, rigidity, and resting tremor when neuronal loss exceeds a threshold of approximately 80%. It is estimated that there is extensive compensation for several years prior to symptom onset, during which vulnerable neurons asynchronously die. Recent evidence would argue that much of the compensatory response of the nigrostriatal system is multimodal including both pre-synaptic and striatal mechanisms. Although parkinsonism may have multiple causes, the classic syndrome, Parkinson's disease (PD), is frequently modeled in small animals by repeated administration of the selective neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Because the MPTP model of PD recapitulates many of the known behavioral and pathological features of human PD, we asked whether the striatal cells of mice treated with MPTP in a semi-chronic paradigm enact a transcriptional program that would help elucidate the response to dopamine denervation. Our findings reveal a time-dependent dysregulation in the striatum of a set of genes whose products may impact both the viability and ability to communicate of dopamine neurons in the SN.
Assuntos
1-Metil-4-Fenil-1,2,3,6-Tetra-Hidropiridina/farmacologia , Corpo Estriado/efeitos dos fármacos , Expressão Gênica/efeitos dos fármacos , Intoxicação por MPTP/metabolismo , Análise de Variância , Animais , Corpo Estriado/metabolismo , Modelos Animais de Doenças , Intoxicação por MPTP/genética , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Modelos Biológicos , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Análise de Componente Principal/métodos , Reprodutibilidade dos TestesRESUMO
Somatic gene therapy is a potentially useful strategy for the delivery of growth factors or cytokines to enhance wound healing. Experimental excisional and incisional wounds in impaired-healing diabetic mice (db/db) were treated with aFGF and with a plasmid coding for aFGF. A eukaryotic expression plasmid composed of the Hst signal peptide sequence in-frame with the human aFGF sequence was used. Transfection of tissues was accomplished either by direct plasmid uptake or by uptake facilitated with cationic liposomes. The results show that the closure of excisional wounds was significantly accelerated (p < 0.05) by topical application of human recombinant aFGF or by transfection with the aFGF plasmid but not by vehicle or control plasmid not containing the aFGF sequence. In incisional wounds, aFGF or transfection with the plasmid significantly increased the wound-breaking strength compared to their corresponding controls (p < 0.05). Quantitative histology of the plasmid-treated incisional wound sections revealed improved wound quality. The transcription of mRNA from human aFGF cDNA in the incisional wound tissue extracts was confirmed by RT-PCR, and the expressed aFGF was detected by immune dot blot and immunohistochemistry assays. The transfection was a transient process with a peak at 9 d in db/+ (littermates of the diabetic mice) incisional wounds, at 36 d in db/db incisional wounds, and at 27 d in db/db excisional wounds. Cells transfected with human aFGF occupied up to 6.4% of the transectional area in the wound sites. Thus, aFGF gene delivery resulted in both gene expression and a functional improvement in healing.
Assuntos
DNA Complementar/metabolismo , Fator 1 de Crescimento de Fibroblastos/genética , Cicatrização/genética , Animais , Diabetes Mellitus Experimental/genética , Feminino , Fator 1 de Crescimento de Fibroblastos/farmacologia , Humanos , Camundongos , Camundongos Endogâmicos C57BL , Reação em Cadeia da Polimerase , Biossíntese de Proteínas , Proteínas Recombinantes/genética , Proteínas Recombinantes/farmacologia , Fatores de Tempo , Transcrição Gênica , Transfecção , Cicatrização/efeitos dos fármacosRESUMO
One hundred and twenty-lead body surface potential maps (BSPMs) were recorded at rest, at immediate cessation of exercise and after 1 (early) and 5 minutes (late) of recovery in 14 patients with isolated, critical, left anterior descending (LAD) coronary artery stenosis. Exercise endpoints, at an average peak rate of 98 +/- 13, were usual pain worsening in 13 LAD patients, and diagnostic ST depression in lead V5 in 1 patient. Twelve patients also had positive thallium scans. BSPMs were also recorded in 8 normal subjects who exercised to peak heart rates similar to those of the LAD subjects. Spatially, there were similar exercise changes in QRS and ST-segment integral patterns over the precordium and inferior torso in both groups. These were transient in the control group but persisted to late recovery in the LAD group, particularly for ST integral. Quantitatively, multivariate analysis revealed significant temporal differences between the 2 groups. However, the only independent BSPM variable was the sum of ST integral decrease, averaging --2,323 +/- 1,809 microV.s for normal patients between rest and immediate cessation of exercise, compared with -3,828 +/- 2,329 microV.s for the LAD patients (p less than 0.05). Late recovery minus rest difference averaged -1,264 +/- 1,080 microV.s for normal subjects and -2,575 +/- 1,844 microV.s for LAD patients (p less than 0.01). To control for the physiologic changes of exercise, the ST integral temporal differential maps of the normal subjects were subtracted from those of the LAD patients and the sum of negative intergroup differences was assumed to reflect only ischemia. Correlation of ST integral ischemia values at immediate cessation of exercise and late recovery was high (r = 0.88); however, intertechnique correlations of the BSPM variables with quantitative angiographic scores and thallium perfusion scan scores revealed generally low r values (range 0 to 0.52). These data demonstrate that ischemic repolarization changes are detectable and quantifiable by BSPM at low levels of cardiac stress in patients with 1-vessel disease when the usual electrocardiographic criteria of myocardial ischemia are frequently absent. The data further suggest that ST integral changes reflective of myocardial ischemia persist well after the exercise recovery period and that they are complementary to, rather than substitutionary for, other indirect measures of myocardial ischemia.
Assuntos
Doença das Coronárias/fisiopatologia , Eletrocardiografia , Teste de Esforço , Adulto , Idoso , Angiografia Coronária , Doença das Coronárias/diagnóstico por imagem , Eletrocardiografia/métodos , Feminino , Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Cintilografia , Radioisótopos de TálioRESUMO
⢠The carbon sink strength of arbuscular mycorrhizal fungi (AMF) was investigated by comparing the growth dynamics of mycorrhizal and nonmycorrhizal Andropogon gerardii plants over a wide range of equivalent tissue phosphorus : nitrogen (P : N) ratios. ⢠Host growth, apparent photosynthesis (Anet ), net C gain (Cn ) and P and N uptake were evaluated in sequential harvests of mycorrhizal and nonmycorrhizal A. gerardii plants. Response curves were used to assess the effect of assimilate supply on the mycorrhizal symbiosis in relation to the association of C with N and P. ⢠Mycorrhizal plants had higher Cn than nonmycorrhizal plants at equivalent shoot P : N ratios even though colonization did not affect plant dry mass. The higher Cn in mycorrhizal plants was related to both an increase in specific leaf area and enhanced photosynthesis. The additional carbon gain associated with the mycorrhizal condition was not allocated to root biomass. The Cn in the mycorrhizal plants was positively related to the proportion of active colonization in the roots. ⢠The calculated difference between Cn values in mycorrhizal and nonmycorrhizal plants, Cdiff , appeared to correspond to the sink strength of the AMF and was not an indirect result of enhanced nutrition in mycorrhizal plants.
RESUMO
Bioremediation of metal-contaminated wastestreams has been successfully demonstrated. Normally, whole cells or microbial exopolymers are used to concentrate and/or precipitate metals in the wastestream to aid in metal removal. Analogous remediation of metal-contaminated soils is more complex because microbial cells or large exopolymers do not move freely through the soil. The use of microbially produced surfactants (biosurfactants) is an alternative with potential for remediation of metal-contaminated soils. The distinct advantage of biosurfactants over whole cells or exopolymers is their small size, generally biosurfactant molecular weights are less than 1500. A second advantage is that biosurfactants have a wide variety of chemical structures that may show different metal selectivities and thus, metal removal efficiencies. A review of the literature shows that complexation capacities of several bacterial exopolymers was similar to the complexation capacity of a rhamnolipid biosurfactant produced by Pseudomonas aeruginosa ATCC 9027.
Assuntos
Metais/isolamento & purificação , Poluentes do Solo/isolamento & purificação , Tensoativos/química , Peso Molecular , PorosidadeRESUMO
Body surface ST integral maps were recorded in 36 coronary artery disease (CAD) patients at: rest; peak, angina-limited exercise; and, 1 and 5 min of recovery. They were compared to maps of 15 CAD patients who exercised to fatigue, without angina, and eight normal subjects. Peak exercise heart rates were similar (NS) in all groups. With exercise angina, patients with two and three vessel CAD had significantly (p less than 0.05) greater decrease in the body surface sum of ST integral values than patients with single vessel CAD. CAD patients with exercise fatigue, in the absence of angina, had decreased ST integrals similar (NS) to patients with single vessel CAD who manifested angina and the normal control subjects. There was, however, considerable overlap among individuals; some patients with single vessel CAD had as much exercise ST integral decrease as patients with three vessel CAD. All CAD patients had persistent ST integral decreases at 5 min of recovery and there was a direct correlation of the recovery and peak exercise ST changes. Exercise ST changes correlated, as well, with quantitative CAD angiographic scores, but not with thallium perfusion scores. These data suggest exercise ST integral body surface mapping allows quantitation of myocardium at ischemic risk in patients with CAD, irrespective of the presence or absence of ischemic symptoms during exercise. A major potential application of this technique is selection of CAD therapy guided by quantitative assessment of ischemic myocardial risk.
Assuntos
Doença das Coronárias/diagnóstico , Eletrocardiografia/métodos , Adulto , Angiografia Coronária , Teste de Esforço , Feminino , Coração/diagnóstico por imagem , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Cintilografia , Fatores de Risco , Radioisótopos de TálioRESUMO
The advent of rapid diagnostic testing for respiratory syncytial virus facilitated decisions for isolation of infectious hospitalized patients. However, diagnosing other viruses by clinical examination such as influenza may be difficult. If patients with influenza are not diagnosed on hospital admission, nosocomial infections may occur. The purpose of our study was to identify patients with nosocomial influenza infections during one winter season in a large children's hospital, document the morbidity, identify potential index cases as roommate exposures who were not identified as having influenza at the time of admission and determine ways in which these cases could have been prevented. From December, 1989, to March, 1990, 74 patients were found to have positive influenza cultures; 11 (15%) were determined to be nosocomial in origin. Hospitalization was extended for 6 patients. Additional costs for these 11 patients resulting from influenza infection totaled +83,000. Six index cases were identified as potential exposures to 7 (67%) of those who acquired nosocomial infections. In none of these potential index cases had influenza been considered as an admission diagnosis. Rapid tests for influenza are necessary to identify patients with influenza at admission and to identify hospitalized patients with nosocomial infection to decrease the number of diagnostic tests and institute appropriate isolation procedures.
Assuntos
Infecção Hospitalar/diagnóstico , Hospitalização , Influenza Humana/diagnóstico , Orthomyxoviridae/isolamento & purificação , Criança , Pré-Escolar , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Feminino , Humanos , Lactente , Recém-Nascido , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Masculino , Programas de Rastreamento , MorbidadeRESUMO
The increased ability to leukocytes to reduce nitroblue tetrazolium (NBT) has been used to detect the presence of systemic bacterial infection. This test has been utilized to evaluate infections and leukocyte dysfunction in children, but has not been extensively applied to traumatized patients or infected volunteers. Moreover, the technic as originally described presented methodologic difficulties. In this study of 889 such patients, a modified NBT test provided excellent differentiation of 63 systemic bacterial infections (NBT score greater than or equal to 10%) from non-infectious fevers, local enteric diseases, and certain viral and plasmodial infections (NBT score less than or equal to 9%). Splenectomy was associated with a transient false-positive score and clinical typhoid fever with a false-negative response
Assuntos
Infecções Bacterianas/diagnóstico , Leucócitos/efeitos dos fármacos , Nitroazul de Tetrazólio , Sais de Tetrazólio , Doença Aguda , Infecções Bacterianas/etiologia , Reações Falso-Positivas , Febre/diagnóstico , Humanos , Malária/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Sepse/diagnóstico , Esplenectomia , Viroses/diagnóstico , Ferimentos e Lesões/complicaçõesRESUMO
Pseudomonas aeruginosa produces rhamnolipids which are tenso-active compounds with potential industrial and environmental applications. There are two main types of rhamnolipids produced in liquid cultures, rhamnosyl-beta-hydroxydecanoyl-beta-hydroxydecanoate (mono-rhamnolipid) and rhamnosyl-rhamnosyl-beta-hydroxydecanoyl-beta-hydroxyd ecanoate (di-rhamnolipid). In this work we report the selective isolation of a rhamnolipid deficient mutant (IBT8), which does not accumulate mono-rhamnolipid while still producing di-rhamnolipid. IBT8 was selected after random mutagenesis with Tn501; yet, its mono-rhamnolipid deficiency was found associated neither with its Tn501 insertion nor with a possible alteration in the rhlABRI genes for rhamnosyl-transferase 1 synthesis. Different possibilities to explain IBT8 phenotype are discussed.
Assuntos
Decanoatos/metabolismo , Glicolipídeos/biossíntese , Pseudomonas aeruginosa/metabolismo , Ramnose/análogos & derivados , Proteínas de Bactérias/genética , Genes Bacterianos , Hexosiltransferases/genética , Mutagênese Insercional , Mutação , Pseudomonas aeruginosa/genética , Ramnose/metabolismoRESUMO
Giant coronary artery aneurysms are rare in adults and are usually found in association with Kawasaki's disease arising in childhood. We report a case of a thrombosed giant right coronary artery aneurysm presenting as an intracardiac mass detected after inferior wall myocardial infarction. Histologic analysis indicated that fibromuscular dysplasia was the underlying cause of the aneurysm.
Assuntos
Aneurisma Coronário/diagnóstico , Trombose Coronária/diagnóstico , Idoso , Aneurisma Coronário/etiologia , Aneurisma Coronário/patologia , Aneurisma Coronário/cirurgia , Trombose Coronária/complicações , Vasos Coronários/patologia , Ecocardiografia Transesofagiana , Displasia Fibromuscular/complicações , Humanos , Masculino , Infarto do Miocárdio/complicaçõesRESUMO
OBJECTIVE: To confirm the advantages of goserelin prior to endometrial ablation for the treatment of dysfunctional uterine bleeding. DESIGN: Multicenter, prospective, randomized, double-blind study. PATIENT(S): Cycling premenopausal women with dysfunctional uterine bleeding. TREATMENT: Patients were randomized to goserelin or placebo (sham depot) once monthly for 2 months prior to endometrial ablation. Treatment was timed to allow surgery 6 weeks later on day 7 of the menstrual cycle. MAIN OUTCOME MEASURE(S): Amenorrhea rates, endometrial histology and thickness, pain and blood loss scores, and surgical parameters. RESULT(S): At 24 weeks after surgery, significantly more goserelin than placebo patients experienced amenorrhea (40% versus 26%). Blood loss was reduced from baseline, but not different between the groups. At surgery, mean endometrial thickness was 1.6 mm and 3.4 mm for the goserelin and placebo groups, respectively, with significantly more atrophic glands and stroma in the goserelin group. Surgery was significantly shorter (by 22%) and easier in the goserelin than in the placebo group, with a significantly lower median fluid absorption in the goserelin groups. In both groups, pain scores were reduced patient satisfaction was high (> 92%), and re-intervention rate was low (2.8%). CONCLUSION(S): Goserelin in combination with endometrial ablation was superior to endometrial ablation alone for the treatment of dysfunctional uterine bleeding.
Assuntos
Antineoplásicos Hormonais/uso terapêutico , Endométrio/cirurgia , Gosserrelina/uso terapêutico , Hemorragia Uterina/terapia , Adulto , Método Duplo-Cego , Endométrio/diagnóstico por imagem , Endométrio/efeitos dos fármacos , Feminino , Seguimentos , Humanos , Histeroscopia , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia , Hemorragia Uterina/tratamento farmacológico , Hemorragia Uterina/patologia , Hemorragia Uterina/cirurgiaRESUMO
STUDY OBJECTIVE: The aim was to compare the costs and effects of management of intractable urinary incontinence by urinary catheterisation or incontinence pads. DESIGN: This was a prospective, randomised study comparing catheterisation with pads, supplemented by additional data collected from patients with chronic indwelling catheters. Main outcome measures were costs of equipment, nursing time, patient preference, nursing preference, and clinical and bacteriological assessment of urinary infection. SUBJECTS: 78 intractably incontinent elderly female patients were randomly allocated to management by urinary catheter or pads and toileting. Supplementary data on equipment costs and nursing time were collected from 27 patients, of whom 22 were already catheterised at the time of the randomisation and five were catheterised by the nursing staff after the last date for entry into the randomisation. MAIN RESULTS: Of the 38 patients randomised to catheterisation, 14 refused consent so only 24 were catheterised on day 1 of the study. There was a rapid removal of catheters, especially in the first six weeks of the study and only four of the randomised catheter patients completed the full 26 weeks of the study. However, eight of the pads patients were catheterised between the 7th and 22nd week because of deteriorating general condition and all retained their catheters for the remainder of the study period. Of 35 patients who had experienced catheters and pads, 12 expressed a clear preference for catheters, 12 for pads, and 11 were undecided. Nurses were in favour of the use of pads, mainly because of concerns about urinary infection with catheters. Comparing costs for patients managed with catheters (532 patient weeks) or pads (903 patient weeks), catheter patients required less nursing time (15.4 v 29.0 h per patient per week) but equipment costs were higher (19.20-24.65 pounds v 8.79-11.35 pounds per patient per week), mainly because of the cost of catheter care (12.75 pounds per patient per week). Asymptomatic bacteriuria was prevalent in both groups but 73% of catheterised patients received treatment for clinical signs of infection compared with 40% of pads patients. Only 30% of patients who were treated had any generalised symptoms of infection. CONCLUSIONS: Use of catheters reduces nursing time but may increase weekly equipment costs depending on the cost of laundry. Despite the high dropout rate among patients randomised to catheters a minority of patients (12/35) expressed a clear preference for catheters and we believe that more patients with intractable incontinence should be given a trial of catheterisation to assess acceptability. Bacteriuria was prevalent in pads or catheter patients but no major episodes of invasive infection were noted in either group.
Assuntos
Custos de Cuidados de Saúde/estatística & dados numéricos , Tampões Absorventes para a Incontinência Urinária/economia , Serviço Hospitalar de Enfermagem/economia , Cateterismo Urinário/economia , Incontinência Urinária/economia , Idoso , Atitude do Pessoal de Saúde , Bacteriúria/etiologia , Análise Custo-Benefício , Feminino , Humanos , Satisfação do Paciente , Estudos Prospectivos , Distribuição Aleatória , Reino Unido , Incontinência Urinária/microbiologia , Incontinência Urinária/terapia , Infecções Urinárias/etiologiaRESUMO
External hyphae of vesicular-arbuscular mycorrhizal (VAM) fungi were quantified over a growing season in a reconstructed tallgrass prairie and an ungrazed cool-season pasture. In both sites, hyphal lengths increased throughout the growing season. Peak external hyphal lengths were 111 m cm-3 of soil in the prairie and 81 m cm-3 of soil in the pasture. These hyphal lengths calculate to external hyphal dry weights of 457 µg cm-3 and 339 µg cm-3 of soil for prairie and pasture communities, respectively. The relationships among external hyphal length, root characteristics, soil P and soil moisture were also determined. Measures of gross root morphology [e.g., specific root length (SRL) and root mass] have a strong association with external hyphal length. Over the course of the study, both grassland communities experienced a major drought event in late spring. During this period a reduction in SRL occurred in both the pasture and prairie without a measured reduction in external hyphal length. Recovery for both the pasture and prairie occurred not by increasing SRL, but rather by increasing external hyphal length. This study suggests that growth is coordinated between VAM hyphae and root morphology, which in turn, are constrained by plant community composition and soil nutrient and moisture conditions.
RESUMO
STUDY DESIGN: This study compared the effectiveness of two transpedicular screw placement techniques: blind screw placement versus screw placement after direct determination of the superior, medial, and inferior borders of the pedicle through the opening of a "window" by the partial laminectomy and tapping technique. OBJECTIVES: To determine if the incidence and severity of pedicle violations resulting from transpedicular screw placement could be reduced by direct determination of the superior, medial, and inferior borders of the pedicle through the opening of a "window" by partial laminectomy. SUMMARY OF BACKGROUND DATA: Several studies regarding transpedicular screw fixation for unstable cervical spine injuries have been reported, but none has addressed the effectiveness in lowering the incidence of pedicle violation by opening a "window" by partial laminectomy for direct determination of the superior, medial, and inferior borders of the pedicle and using the tapping technique before and in planning for screw placement. METHODS: Eight adult cadaveric cervical spines (40 vertebrae from C3 to C7) were used for this study. Two groups were formed according to screw placement techniques. The first group was composed of 38 blinded transpedicular screw placements. The second group was composed of 40 screw placements using the partial laminectomy and tapping technique. After transpedicular screw placement, all specimens were evaluated radiographically and visually for violation of the pedicle. RESULTS: A decrease in the incidence and severity of pedicle violation was seen in the second group with opening of the lamina and tapping technique compared with the blind screw placement group. However, the percentage of screws found to violate the pedicle with the opening of the lamina and tapping technique still was relatively high. CONCLUSIONS: Transpedicular screw placement in the cervical spine is difficult, and a high percentage of violations of the pedicle wall occur. This technique should not be used routinely.