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1.
Cell ; 187(13): 3373-3389.e16, 2024 Jun 20.
Artículo en Inglés | MEDLINE | ID: mdl-38906102

RESUMEN

The gut microbiota influences the clinical responses of cancer patients to immunecheckpoint inhibitors (ICIs). However, there is no consensus definition of detrimental dysbiosis. Based on metagenomics (MG) sequencing of 245 non-small cell lung cancer (NSCLC) patient feces, we constructed species-level co-abundance networks that were clustered into species-interacting groups (SIGs) correlating with overall survival. Thirty-seven and forty-five MG species (MGSs) were associated with resistance (SIG1) and response (SIG2) to ICIs, respectively. When combined with the quantification of Akkermansia species, this procedure allowed a person-based calculation of a topological score (TOPOSCORE) that was validated in an additional 254 NSCLC patients and in 216 genitourinary cancer patients. Finally, this TOPOSCORE was translated into a 21-bacterial probe set-based qPCR scoring that was validated in a prospective cohort of NSCLC patients as well as in colorectal and melanoma patients. This approach could represent a dynamic diagnosis tool for intestinal dysbiosis to guide personalized microbiota-centered interventions.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Microbioma Gastrointestinal , Inmunoterapia , Neoplasias Pulmonares , Neoplasias , Femenino , Humanos , Masculino , Akkermansia , Carcinoma de Pulmón de Células no Pequeñas/microbiología , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/inmunología , Disbiosis/microbiología , Heces/microbiología , Microbioma Gastrointestinal/efectos de los fármacos , Inhibidores de Puntos de Control Inmunológico/uso terapéutico , Inhibidores de Puntos de Control Inmunológico/farmacología , Inmunoterapia/métodos , Neoplasias Pulmonares/microbiología , Neoplasias Pulmonares/tratamiento farmacológico , Metagenómica/métodos , Neoplasias/microbiología , Resultado del Tratamiento
2.
J Cell Sci ; 137(12)2024 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-38832513

RESUMEN

Division plane positioning is crucial for proper growth and development in many organisms. In plants, the division plane is established before mitosis, by accumulation of a cytoskeletal structure called the preprophase band (PPB). The PPB is thought to be essential for recruitment of division site-localized proteins, which remain at the division site after the PPB disassembles. Here, we show that the division site-localized protein TANGLED1 (TAN1) is recruited independently of the PPB to the cell cortex by the plant cytokinetic machinery, the phragmoplast, from experiments using both the PPB-defective mutant discordia1 (dcd1) and chemical treatments that disrupt the phragmoplast in maize. TAN1 recruitment to de novo sites on the cortex is partially dependent on intact actin filaments and the myosin XI motor protein OPAQUE1 (O1). These data imply a yet unknown role for TAN1 and possibly other division site-localized proteins during the last stages of cell division when the phragmoplast touches the cell cortex to complete cytokinesis.


Asunto(s)
Citocinesis , Proteínas de Plantas , Zea mays , Zea mays/metabolismo , Zea mays/genética , Proteínas de Plantas/metabolismo , Proteínas de Plantas/genética , Citoesqueleto de Actina/metabolismo
3.
J Immunol ; 212(6): 1022-1028, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38294253

RESUMEN

Plasma cells secrete an abundance of Abs and are a crucial component of our immune system. The intestinal lamina propria harbors the largest population of plasma cells, most of which produce IgA. These Abs can bind to beneficial gut bacteria to reinforce intestinal homeostasis and provide protection against enteric pathogens. Plasma cells downregulate many cell-surface proteins commonly used to identify B cells. In mice, expression of the surface marker CD138 has been widely used to identify plasma cells in lymph nodes, bone marrow, and spleen. Intestinal plasma cells require liberation via extensive tissue processing involving treatment with collagenase. We report that detection of CD138 surface expression is reduced following collagenase treatment. Using a mouse in which yellow fluorescent protein expression is controlled by the plasma cell requisite transcription factor Blimp-1, we show that surface detection of transmembrane activator and CAML interactor captures a significant proportion of Ab-secreting plasma cells in the intestinal lamina propria and gut-draining mesenteric lymph nodes. Additionally, we describe a flow cytometry panel based on the detection of surface markers to identify murine B cell subsets in the intestinal lamina propria and, as a proof of concept, combine it with a cutting-edge fate-tracking system to characterize the fate of germinal center B cells activated in early life. By identifying plasma cells and other key intestinal B subsets in a manner compatible with several downstream applications, including sorting and culturing and in vitro manipulations, this efficient and powerful approach can enhance studies of mucosal immunity.


Asunto(s)
Inmunoglobulina A , Células Plasmáticas , Animales , Ratones , Linfocitos B , Colagenasas/metabolismo , Membrana Mucosa , Mucosa Intestinal
4.
Proc Natl Acad Sci U S A ; 119(11): e2112820119, 2022 03 15.
Artículo en Inglés | MEDLINE | ID: mdl-35254909

RESUMEN

SignificanceKarrikins are chemicals in smoke that stimulate regrowth of many plants after fire. However, karrikin responses are not limited to species from fire-prone environments and can affect growth after germination. Putatively, this is because karrikins mimic an unknown signal in plants, KAI2 ligand (KL). Karrikins likely require modification in plants to become bioactive. We identify a gene, KUF1, that appears to negatively regulate biosynthesis of KL and metabolism of a specific karrikin. KUF1 expression increases in response to karrikin or KL signaling, thus forming a negative feedback loop that limits further activation of the signaling pathway. This discovery will advance understanding of how karrikins are perceived and how smoke-activated germination evolved. It will also aid identification of the elusive KL.


Asunto(s)
Proteínas de Arabidopsis/genética , Arabidopsis/efectos de los fármacos , Arabidopsis/genética , Furanos/farmacología , Regulación de la Expresión Génica de las Plantas/efectos de los fármacos , Genes de Plantas , Hidrolasas/genética , Piranos/farmacología , Arabidopsis/metabolismo , Plantones/genética , Plantones/metabolismo , Transducción de Señal
5.
Int J Aging Hum Dev ; : 914150231208688, 2024 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-38291615

RESUMEN

Using a sample of middle-aged and older adults, this research explores associations between generativity and two key risk factors for suicide: thwarted belonging (T.B.) and perceived burdensomeness (P.B.). These variables are typically studied as predictors of suicide; the current study is unique in examining their psychosocial correlates. Erikson described, generativity as a psychosocial construct that characterizes adult well-being in mid-life, conceptualized as the sense one has successfully guided and contributed to the younger generation through mentoring. Using the Midlife in the United States Survey (MIDUS), the current analyses indicate that generativity is associated with lower levels of P.B. and T.B., even after accounting for measures of hopelessness, depressive symptoms, financial stability, perceived neighborhood quality, chronic health conditions, and respondent's demographic characteristics including gender and age. Results are discussed in terms of applications for suicide-risk prevention, and with regard to the promotion of positive psychosocial development across the lifespan.

6.
J Zoo Wildl Med ; 54(4): 721-727, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38251995

RESUMEN

A pharmacokinetic study of ceftiofur crystalline free acid sterile oil suspension (CCFA) was performed in six apparently healthy juvenile American alligators (Alligator mississippiensis). A single intramuscular dose of 30 mg/kg was administered in the triceps muscle. Blood samples were collected prior to treatment and at 4, 12, 24, 48, 72, 120, 144, 192, 288, and 366 h post administration. Plasma samples were analyzed for ceftiofur equivalent concentrations using liquid chromatography-mass spectrometry. Pharmacokinetic parameters were determined by noncompartmental analysis. Mean peak plasma concentration was 23.2 µg/ml (range, 16.0-27.9), median time to maximum concentration was 72 h (range, 72-120), mean area under the curve from 0 to 366 h postdose was 4.24 h · mg/ml (range, 3.54-4.97), and mean terminal half-life was 143 h (range, 90.8-220). Plasma concentrations were maintained above the minimum inhibitory concentration for this study of 2.0 µg/ml, which was established from similar CCFA pharmacokinetic studies in other reptilian species, through the end of the data collection of 366 h. Because of prolonged plasma concentrations, a dosing interval could not be established in this study. Future studies should include extended collection time points and multidose studies to determine dosing regimens.


Asunto(s)
Caimanes y Cocodrilos , Animales , Cefalosporinas , Recolección de Datos , Estado de Salud
7.
Plant Physiol ; 190(2): 1440-1456, 2022 09 28.
Artículo en Inglés | MEDLINE | ID: mdl-35809069

RESUMEN

Karrikins (KARs) are chemicals in smoke that can enhance germination of many plants. Lettuce (Lactuca sativa) cv. Grand Rapids germinates in response to nanomolar karrikinolide (KAR1). Lettuce is much less responsive to KAR2 or a mixture of synthetic strigolactone analogs, rac-GR24. We investigated the molecular basis of selective and sensitive KAR1 perception in lettuce. The lettuce genome contains two copies of KARRIKIN INSENSITIVE2 (KAI2), which in Arabidopsis (Arabidopsis thaliana) encodes a receptor that is required for KAR responses. LsKAI2b is more highly expressed than LsKAI2a in dry achenes and during early stages of imbibition. Through cross-species complementation assays in Arabidopsis, we found that an LsKAI2b transgene confers robust responses to KAR1, but LsKAI2a does not. Therefore, LsKAI2b likely mediates KAR1 responses in lettuce. We compared homology models of KAI2 proteins from lettuce and a fire-follower, whispering bells (Emmenanthe penduliflora). This identified pocket residues 96, 124, 139, and 161 as candidates that influence the ligand specificity of KAI2. Further support for the importance of these residues was found through a broader comparison of pocket residues among 281 KAI2 proteins from 184 asterid species. Almost all KAI2 proteins had either Tyr or Phe identity at position 124. Genes encoding Y124-type KAI2 are more broadly distributed in asterids than in F124-type KAI2. Substitutions at residues 96, 124, 139, and 161 in Arabidopsis KAI2 produced a broad array of responses to KAR1, KAR2, and rac-GR24. This suggests that the diverse ligand preferences observed among KAI2 proteins in plants could have evolved through relatively few mutations.


Asunto(s)
Proteínas de Arabidopsis , Arabidopsis , Arabidopsis/genética , Arabidopsis/metabolismo , Proteínas de Arabidopsis/genética , Proteínas de Arabidopsis/metabolismo , Furanos/metabolismo , Furanos/farmacología , Germinación/genética , Hidrolasas/genética , Lactuca/genética , Lactuca/metabolismo , Ligandos , Piranos , Humo
8.
BMC Infect Dis ; 22(1): 472, 2022 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-35578171

RESUMEN

BACKGROUND: Interactions between humans and animals are the key elements of zoonotic spillover leading to zoonotic disease emergence. Research to understand the high-risk behaviors associated with disease transmission at the human-animal interface is limited, and few consider regional and local contexts. OBJECTIVE: This study employed an integrated behavioral-biological surveillance approach for the early detection of novel and known zoonotic viruses in potentially high-risk populations, in an effort to identify risk factors for spillover and to determine potential foci for risk-mitigation measures. METHOD: Participants were enrolled at two community-based sites (n = 472) in eastern and western Thailand and two hospital (clinical) sites (n = 206) in northeastern and central Thailand. A behavioral questionnaire was administered to understand participants' demographics, living conditions, health history, and animal-contact behaviors and attitudes. Biological specimens were tested for coronaviruses, filoviruses, flaviviruses, influenza viruses, and paramyxoviruses using pan (consensus) RNA Virus assays. RESULTS: Overall 61/678 (9%) of participants tested positive for the viral families screened which included influenza viruses (75%), paramyxoviruses (15%), human coronaviruses (3%), flaviviruses (3%), and enteroviruses (3%). The most salient predictors of reporting unusual symptoms (i.e., any illness or sickness that is not known or recognized in the community or diagnosed by medical providers) in the past year were having other household members who had unusual symptoms and being scratched or bitten by animals in the same year. Many participants reported raising and handling poultry (10.3% and 24.2%), swine (2%, 14.6%), and cattle (4.9%, 7.8%) and several participants also reported eating raw or undercooked meat of these animals (2.2%, 5.5%, 10.3% respectively). Twenty four participants (3.5%) reported handling bats or having bats in the house roof. Gender, age, and livelihood activities were shown to be significantly associated with participants' interactions with animals. Participants' knowledge of risks influenced their health-seeking behavior. CONCLUSION: The results suggest that there is a high level of interaction between humans, livestock, and wild animals in communities at sites we investigated in Thailand. This study highlights important differences among demographic and occupational risk factors as they relate to animal contact and zoonotic disease risk, which can be used by policymakers and local public health programs to build more effective surveillance strategies and behavior-focused interventions.


Asunto(s)
Enfermedades Transmisibles Emergentes , Animales , Animales Salvajes , Bovinos , Enfermedades Transmisibles Emergentes/epidemiología , Humanos , Aves de Corral , Porcinos , Tailandia/epidemiología , Zoonosis/epidemiología
9.
BMC Psychiatry ; 22(1): 647, 2022 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-36241971

RESUMEN

BACKGROUND: Hoarding symptoms are associated with functional impairment, though investigation of disability among individuals with hoarding disorder has largely focused on clutter-related impairment to home management activities and difficulties using space because of clutter. This analysis assesses disability among individuals with hoarding symptoms in multiple domains of everyday functioning, including cognition, mobility, self-care, interpersonal and community-level interactions, and home management. The magnitude of the association between hoarding and disability was compared to that of medical and psychiatric disorders with documented high disability burden, including major depressive disorder (MDD), diabetes, and chronic pain. METHODS: Data were cross-sectionally collected from 16,312 adult participants enrolled in an internet-based research registry, the Brain Health Registry. Pearson's chi-square tests and multivariable logistic regression models were used to quantify the relationship between hoarding and functional ability relative to MDD, diabetes, and chronic pain. RESULTS: More than one in ten participants endorsed clinical (5.7%) or subclinical (5.7%) hoarding symptoms (CHS and SCHS, respectively). After adjusting for participant demographic characteristics and psychiatric and medical comorbidity, CHS and SCHS were associated with increased odds of impairment in all domains of functioning. Moderate to extreme impairment was endorsed more frequently by those with CHS or SCHS compared to those with self-reported MDD, diabetes, and/or chronic pain in nearly all domains (e.g., difficulty with day-to-day work or school: CHS: 18.7% vs. MDD: 11.8%, p < 0.0001) except mobility and self-care. While those with current depressive symptoms endorsed higher rates of impairment than those with hoarding symptoms, disability was most prevalent among those endorsing both hoarding and comorbid depressive symptoms. CONCLUSIONS: Hoarding symptoms are associated with profound disability in all domains of functioning. The burden of hoarding is comparable to that of other medical and psychiatric illnesses with known high rates of functional impairment. Future studies should examine the directionality and underlying causality of the observed associations, and possibly identify target interventions to minimize impairment associated with hoarding symptomatology.


Asunto(s)
Dolor Crónico , Trastorno Depresivo Mayor , Diabetes Mellitus , Acaparamiento , Trastornos Mentales , Adulto , Humanos
10.
Coral Reefs ; 40(4): 1137-1153, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34720372

RESUMEN

A paramount challenge in coral reef ecology is to estimate the abundance and composition of the communities residing in such complex ecosystems. Traditional 2D projected surface cover estimates neglect the 3D structure of reefs and reef organisms, overlook communities residing in cryptic reef habitats (e.g., overhangs, cavities), and thus may fail to represent biomass estimates needed to assess trophic ecology and reef function. Here, we surveyed the 3D surface cover, biovolume, and biomass (i.e., ash-free dry weight) of all major benthic taxa on 12 coral reef stations on the island of Curaçao (Southern Caribbean) using structure-from-motion photogrammetry, coral point counts, in situ measurements, and elemental analysis. We then compared our 3D benthic community estimates to corresponding estimates of traditional 2D projected surface cover to explore the differences in benthic community composition using different metrics. Overall, 2D cover was dominated (52 ± 2%, mean ± SE) by non-calcifying phototrophs (macroalgae, turf algae, benthic cyanobacterial mats), but their contribution to total reef biomass was minor (3.2 ± 0.6%). In contrast, coral cover (32 ± 2%) more closely resembled coral biomass (27 ± 6%). The relative contribution of erect organisms, such as gorgonians and massive sponges, to 2D cover was twofold and 11-fold lower, respectively, than their contribution to reef biomass. Cryptic surface area (3.3 ± 0.2 m2 m-2 planar reef) comprised half of the total reef substrate, rendering two thirds of coralline algae and almost all encrusting sponges (99.8%) undetected in traditional assessments. Yet, encrusting sponges dominated reef biomass (35 ± 18%). Based on our quantification of exposed and cryptic reef communities using different metrics, we suggest adjustments to current monitoring approaches and highlight ramifications for evaluating the ecological contributions of different taxa to overall reef function. To this end, our metric conversions can complement other benthic assessments to generate non-invasive estimates of the biovolume, biomass, and elemental composition (i.e., standing stocks of organic carbon and nitrogen) of Caribbean coral reef communities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00338-021-02118-6.

11.
Hum Genet ; 138(5): 467-481, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31032534

RESUMEN

Interindividual variation in drug response occurs in canine patients just as it does in human patients. Although canine pharmacogenetics still lags behind human pharmacogenetics, significant life-saving discoveries in the field have been made over the last 20 years, but much remains to be done. This article summarizes the available published data about the presence and impact of genetic polymorphisms on canine drug transporters, drug-metabolizing enzymes, drug receptors/targets, and plasma protein binding while comparing them to their human counterparts when applicable. In addition, precision medicine in cancer treatment as an application of canine pharmacogenetics and pertinent considerations for canine pharmacogenetics testing is reviewed. The field is poised to transition from single pharmacogene-based studies, pharmacogenetics, to pharmacogenomic-based studies to enhance our understanding of interindividual variation of drug response in dogs. Advances made in the field of canine pharmacogenetics will not only improve the health and well-being of dogs and dog breeds, but may provide insight into individual drug efficacy and toxicity in human patients as well.


Asunto(s)
Sistema Enzimático del Citocromo P-450/genética , Monitoreo de Drogas/veterinaria , Proteínas de Transporte de Membrana/genética , Polimorfismo Genético/genética , Medicina de Precisión/métodos , Animales , Perros , Humanos , Farmacogenética/métodos
12.
Drug Metab Dispos ; 47(11): 1314-1324, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31427433

RESUMEN

Dogs are commonly used in human and veterinary pharmaceutical development. Physiologically based pharmacokinetic modeling using recombinant cytochrome P450 (CYP) enzymes requires accurate estimates of CYP abundance, particularly in liver. However, such estimates are currently available for only seven CYPs, which were determined in a limited number of livers from one dog breed (beagle). In this study, we used a label-free shotgun proteomics method to quantitate 11 CYPs (including four CYPs not previously measured), cytochrome P450 oxidoreductase, and cytochrome b5 in liver microsomes from 59 dogs representing four different breeds and mixed-breed dogs. Validation included showing correlation with CYP marker activities, immunoquantified protein, as well as CYP1A2 and CYP2C41 null allele genotypes. Abundance values largely agreed with those previously published. Average CYP abundance was highest (>120 pmol/mg protein) for CYP2D15 and CYP3A12; intermediate (40-89 pmol/mg) for CYP1A2, CYP2B11, CYP2E1, and CYP2C21; and lowest (<12 pmol/mg) for CYP2A13, CYP2A25, CYP2C41, CYP3A26, and CYP1A1. The CYP2C41 gene was detected in 12 of 58 (21%) livers. CYP2C41 protein abundance averaged 8.2 pmol/mg in those livers, and was highest (19 pmol/mg) in the only liver with two CYP2C41 gene copies. CYP1A2 protein was not detected in the only liver homozygous for the CYP1A2 stop codon mutation. Large breed-associated differences were observed for CYP2B11 (P < 0.0001; ANOVA) but not for other CYPs. Research hounds and Beagles had the highest CYP2B11 abundance; mixed-breed dogs and Chihuahua were intermediate; whereas greyhounds had the lowest abundance. These results provide the most comprehensive estimates to date of CYP abundance and variability in canine liver. SIGNIFICANCE STATEMENT: This work provides the most comprehensive quantitative analysis to date of the drug-metabolizing cytochrome P450 proteome in dogs that will serve as a valuable reference for physiologically based scaling and modeling used in drug development and research. This study also revealed high interindividual variation and dog breed-associated differences in drug-metabolizing cytochrome P450 expression that may be important for predicting drug disposition variability among a genetically diverse canine population.


Asunto(s)
Sistema Enzimático del Citocromo P-450/análisis , Perros/metabolismo , Microsomas Hepáticos/enzimología , Animales , Cruzamiento , Sistema Enzimático del Citocromo P-450/genética , Femenino , Genotipo , Masculino , Modelos Biológicos , Especificidad de la Especie
13.
BMC Pregnancy Childbirth ; 18(1): 303, 2018 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-30021539

RESUMEN

BACKGROUND: Gestational diabetes mellitus (GDM) is a global public health concern with potential implications for the health of a mother and her offspring. However, data on the prevalence and risk factors of GDM in Latin America are scarce. The study was designed to estimate the prevalence of GDM and identify maternal risk factors among Peruvian women. METHODS: A cross-sectional study was conducted among 1300 pregnant women attending a prenatal clinic in Lima, Peru. GDM was diagnosed using an Oral Glucose Tolerance Test (OGTT) performed between 24 and 28 gestational weeks using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Depression status was assessed using the Patient Health Questionnaire-9. Multivariate logistic regression models were used to identify risk factors of GDM. RESULTS: Approximately 16% of pregnant women were diagnosed with GDM. The prevalence of obesity and depression were 24.4 and 10.6%, respectively. After adjusting for confounders, mid-pregnancy obesity was associated with a 1.64-fold increased odds of GDM (OR: 1.64; 95% CI: 1.03-2.61). Participants with a family history of diabetes had a 1.5-fold increased odds of developing GDM (OR: 1.51, 95% CI: 1.10-2.07) as compared to women without this family history. Depression was associated with a 1.54-fold increased odds of GDM (OR: 1.54; 95% CI:1.09-2.17). CONCLUSIONS: GDM is highly prevalent and was associated with maternal obesity, family history of diabetes and antepartum depression among Peruvian women. Intervention programs aimed at early diagnoses and management of GDM need to take maternal obesity, family history of diabetes and antepartum depression into account.


Asunto(s)
Diabetes Gestacional , Intervención Médica Temprana/organización & administración , Obesidad/epidemiología , Adulto , Estudios Transversales , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/epidemiología , Diagnóstico Precoz , Femenino , Prueba de Tolerancia a la Glucosa/métodos , Prueba de Tolerancia a la Glucosa/estadística & datos numéricos , Humanos , Anamnesis/estadística & datos numéricos , Evaluación de Necesidades , Perú/epidemiología , Embarazo , Prevalencia , Medición de Riesgo , Factores de Riesgo
14.
Palliat Support Care ; 16(5): 520-527, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-29072148

RESUMEN

OBJECTIVE: Family caregivers play an important role in end-of-life (EoL) decision making when the patient is unable to make his/her own decisions. While communication about EoL care between patients and family is perhaps a first step toward advance care planning (ACP)/EoL decisions, not every culture puts great value on open communication about this topic. The aims of the present study were to explore EoL communication and the aspects of communication among caregivers of Latino patients in the rural United States (U.S.)-Mexico border region. METHOD: This study analyzed data from a hospice needs assessment collected from 189 family caregivers of Latino patients at a home health agency in a rural U.S.-Mexico border region. Bivariate tests and logistic regression were used to address our aims. RESULTS: About half of the family caregivers (n = 96, 50.8%) reported to have ever engaged in EoL discussion with patients. Significant predictors of EoL discussion included life-sustaining treatment preference (odds ratio [OR] = 0.44, p < 0.05); knowledge of an advance directive (AD) (OR = 5.50, p < 0.01); and distrust of physicians (OR = 0.29, p < 0.01). Caregivers who preferred extending the life of their loved one even if he/she had to rely on life supports were less likely to engage in EoL communication. Also, caregivers who worried that physicians might want to stop treatments (i.e., "pull the plug") too soon were less likely to do so. Conversely, caregivers who had knowledge about ADs were more likely to engage in EoL communication. SIGNIFICANCE OF RESULTS: EoL communication is a complex process influenced by individual, social, and cultural values and the beliefs of both the patient and his/her family. Inclusion of family caregivers in the ACP process and facilitating culturally tailored EoL communication between patients and family caregivers is important.


Asunto(s)
Cuidadores/psicología , Toma de Decisiones , Hispánicos o Latinos/psicología , Relaciones Enfermero-Paciente , Cuidado Terminal/psicología , Planificación Anticipada de Atención , Anciano , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Cuidado Terminal/métodos , Estados Unidos
15.
Palliat Support Care ; 15(3): 279-287, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-27609418

RESUMEN

OBJECTIVE: Hospice is an important method of promoting quality end-of-life (EoL) care, yet its utilization is relatively low in underserved populations. The unique characteristics of a border community-such as a lack of healthcare resources and cultural integration-impact EoL decision making. The aim of our study was to assess the willingness to use hospice care services and its predictors among family caregivers of Latino patients in the United States (U.S.)-Mexico border region of Southern California. METHOD: This study analyzes secondary data from a home health agency in the U.S.-Mexico border region. Quantitative data were collected via a face-to-face interview with 189 caregivers of patients enrolled in the agency. Bivariate tests and logistic regression were employed to address our study objectives. RESULTS: The majority (83%) of family caregivers were willing to use hospice services for their loved ones. The factors impacting willingness to use hospice services included the primary language of the caregiver (OR = 6.30, CI 95% = 1.68, 23.58); trust in doctors to make the right decisions (OR = 3.77, CI 95% = 1.05, 13.57); and the belief that using hospice care means giving up on life (OR = 0.52, CI 95% = 0.30; 0.88). Caregivers who trusted doctors to make the best decisions for their loved ones and English-speaking caregivers were more willing to utilize hospice services, while caregivers who held a strong belief that hospice care means giving up on life were less likely to consider using hospice care for their loved ones. SIGNIFICANCE OF RESULTS: The willingness of family caregivers to use hospice services for their loved ones is influenced by cultural perspectives about hospice care. As the importance of family involvement in EoL care planning has been highlighted, family caregivers' beliefs about hospice care services need to be addressed within their particular cultural context.


Asunto(s)
Cuidadores/psicología , Toma de Decisiones , Cuidados Paliativos al Final de la Vida/estadística & datos numéricos , Aceptación de la Atención de Salud/psicología , Adulto , Anciano , California , Femenino , Hispánicos o Latinos/psicología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Aceptación de la Atención de Salud/etnología
16.
Ann Clin Psychiatry ; 28(2): 85-94, 2016 05.
Artículo en Inglés | MEDLINE | ID: mdl-27285389

RESUMEN

BACKGROUND: Medical students and physicians in training and in practice are at risk for excessive alcohol use and abuse, potentially impacting the affected individuals as well as their family members, trainees, and patients. However, several roadblocks to care, including stigma, often keep them from seeking treatment. METHODS: We analyzed data from anonymous questionnaires completed by medical students, house staff, and faculty from 2009 to 2014 as part of a depression awareness and suicide prevention program at a state-supported medical school in the United States. The authors explored associations between self-reported "drinking too much" and depression, suicidal ideation, substance use, intense affective states, and mental health treatment. RESULTS: Approximately one-fifth of the respondents reported "drinking too much." "Drinking too much" was associated with more severe depression and impairment, past suicide attempts and current suicidal ideation, intense affective states, and other substance use. Those who were "drinking too much" were more likely than others to accept referrals for mental health treatment through the anonymous interactive screening program, suggesting that this program may be effective in skirting the stigma barrier for accessing mental health care for this at-risk population. CONCLUSIONS: The self-reported prevalence of "drinking too much" among medical students, house staff, and faculty is high and associated with negative mental health outcomes. Targeted, anonymous screenings may identify at-risk individuals and provide mental health care referrals to those in need.


Asunto(s)
Centros Médicos Académicos/organización & administración , Alcoholismo/epidemiología , Derivación y Consulta , Adulto , Alcoholismo/psicología , California/epidemiología , Depresión/epidemiología , Depresión/psicología , Docentes Médicos/psicología , Femenino , Humanos , Internado y Residencia , Masculino , Medición de Riesgo , Estigma Social , Estudiantes de Medicina/psicología , Ideación Suicida , Encuestas y Cuestionarios
17.
Clin Auton Res ; 26(1): 49-58, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26695397

RESUMEN

PURPOSE: Abnormal blood pressure (BP) response to orthostatic maneuvers may predict adverse health outcomes. Orthostatic hypotension (OH) is defined as a fall in BP of ≥20/10 mmHg, and orthostatic hypertension (OHTN) is defined as an increase in systolic BP (SBP) of ≥20 mmHg, with standing. Herein, we document the prevalence of OH and OHTN in American veterans. METHODS: The influence of demographic characteristics, life habits, co-incident medical conditions, and prescription medication use on these prevalence rates and associations between abnormal orthostatic BP responses and severity of self-reported symptoms of fatigue, dizziness, trouble concentrating, and head and neck discomfort were determined. RESULTS: 286 veterans participated; 14 % were classified with OH, 22 % with OHTN, and 64 % with normal BP responses to standing (reference group). An increased prevalence of the diagnosis of diabetes mellitus (27 %) and hypertension (63 %) was noted, which did not differ by orthostatic BP classification. Veterans with OH were older than the reference group and were prescribed more antihypertensive medications than the reference and OHTN groups. While the prevalence of OH increased with age, the prevalence of OHTN was comparable in young (20-30 years) and old (70+ years) veterans (17 vs. 19 %, respectively). The severity of fatigue and dizziness was increased in veterans with OH and OHTN compared to the reference group. CONCLUSION: These data suggest a relatively high prevalence of OH and OHTN, which is associated with increased self-reported severity of fatigue and dizziness in American veterans, findings which may adversely impact long-term health outcomes.


Asunto(s)
Hipertensión/epidemiología , Hipotensión Ortostática/epidemiología , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Estados Unidos , Veteranos/estadística & datos numéricos
18.
J Cell Sci ; 126(Pt 18): 4262-73, 2013 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-23868973

RESUMEN

Although hippocampal neurons are well-distinguished by the morphological characteristics of their dendrites and their structural plasticity, the mechanisms involved in regulating their neurite initiation, dendrite growth, network formation and remodeling are still largely unknown, in part because the key molecules involved remain elusive. Identifying new dendrite-active cues could uncover unknown molecular mechanisms that would add significant understanding to the field and possibly lead to the development of novel neuroprotective therapy because these neurons are impaired in many neuropsychiatric disorders. In our previous studies, we deleted the gene encoding CRMP3 in mice and identified the protein as a new endogenous signaling molecule that shapes diverse features of the hippocampal pyramidal dendrites without affecting axon morphology. We also found that CRMP3 protects dendrites against dystrophy induced by prion peptide PrP(106-126). Here, we report that CRMP3 has a profound influence on neurite initiation and dendrite growth of hippocampal neurons in vitro. Our deletional mapping revealed that the C-terminus of CRMP3 probably harbors its dendritogenic capacity and supports an active transport mechanism. By contrast, overexpression of the C-terminal truncated CRMP3 phenocopied the effect of CRMP3 gene deletion with inhibition of neurite initiation or decrease in dendrite complexity, depending on the stage of cell development. In addition, this mutant inhibited the activity of CRMP3, in a similar manner to siRNA. Voltage-gated calcium channel inhibitors prevented CRMP3-induced dendritic growth and somatic Ca(2+) influx in CRMP3-overexpressing neurons was augmented largely via L-type channels. These results support a link between CRMP3-mediated Ca(2+) influx and CRMP3-mediated dendritic growth in hippocampal neurons.


Asunto(s)
Canales de Calcio/metabolismo , Dendritas/metabolismo , Hipocampo/metabolismo , Proteínas del Tejido Nervioso/metabolismo , Neuritas/metabolismo , Animales , Canales de Calcio/fisiología , Dendritas/fisiología , Hipocampo/fisiología , Ratones , Morfogénesis , Proteínas del Tejido Nervioso/genética , Transducción de Señal , Transfección
19.
Eur J Pediatr ; 174(7): 943-8, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25633581

RESUMEN

UNLABELLED: Exposure to tobacco smoke has been not evaluated in children with bronchopulmonary dysplasia (BPD). We evaluate the association of in utero smoking (IUS) and environmental tobacco smoke (ETS) with the respiratory events of BPD and non-BPD children. Two hundred sixty-two children born before 35 weeks of gestational age (GA) and regularly followed up in our regional network for preterms were enrolled. They were paired according to their BPD status, their gestational age and birth weight (131 children with BPD and 131 without BPD, 28 mean weeks GA; mean weight 1000 g). Respiratory data were obtained prospectively during their first 2 years of life. A complementary questionnaire was completed by the parents about their child's respiratory health at the age of 2, their home environment, and tobacco status. IUS concerned 12.6 %; ETS, 48.8 % (67 % in BPD children treated with oxygen at home). No further influence on respiratory outcome could be found by exposure to intrauterine smoke or extrauterine tobacco smoke in this patient sample. CONCLUSION: IUS and ETS exposures are as high in preterm children as in a general pediatric population. The highest exposure occurs among BPD infants treated with oxygen at home. WHAT IS KNOWN: • Environmental tobacco smoke (ETS) and in utero smoking (IUS) are responsible for many morphological, functional, and clinical changes in children. • Children with bronchopulmonary dysplasia (BPD) have more respiratory events in their first years of life than preterm children without BPB, maybe triggered by ETS and IUS. What is New: • The exposition to ETS and IUS is high in preterm children with and without BDP, as high as in a general. • Pedaitric population, particularly in children with BPD and treated with oxygen at home. • No further influence on respiratory outcome could be found by exposure to ETS or IUS in our studied population.


Asunto(s)
Displasia Broncopulmonar/epidemiología , Efectos Tardíos de la Exposición Prenatal , Fumar/epidemiología , Contaminación por Humo de Tabaco/estadística & datos numéricos , Asma/diagnóstico , Asma/epidemiología , Displasia Broncopulmonar/terapia , Estudios de Casos y Controles , Preescolar , Femenino , Francia/epidemiología , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Masculino , Terapia por Inhalación de Oxígeno , Embarazo , Estudios Prospectivos , Fumar/efectos adversos
20.
J Pharm Pharm Sci ; 18(4): 368-95, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26626242

RESUMEN

PURPOSE: Delineate the stereospecific pharmacokinetics and pharmacodynamics of the chiral flavonoids pinocembrin and pinostrobin. OBJECTIVE: Characterize for the first time the stereoselective pharmacokinetics of two flavonoids, pinocembrin and pinostrobin and their bioactivity in several in vitro assays with relevant roles in heart disease, colon cancer, and diabetes etiology and pathophysiology. METHODS: Chiral flavonoids were intravenously and orally administered to male Sprague-Dawley rats. Concentrations in serum and urine were characterized via stereospecific HPLC or LC/MS. Pure enantiomeric forms of each flavonoid were tested, where possible, to identify the stereospecific contribution to bioactivity in comparison to their racemates. RESULTS: Short half-lives (0.2-6 h) in serum were observed, while a better estimation of half-life (3-26 h) and other pharmacokinetic parameters were observed using urinary data. The flavonoids are predominantly excreted via non-renal routes (fe values of 0.3-4.6 %), and undergo rapid and extensive phase II metabolism. Chiral differences in the chemical structure of these compounds result in significant pharmacodynamic differences. CONCLUSION: The importance of understanding the stereospecific pharmacokinetics and pharmacodynamics of two chiral flavonoids were delineated.This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on ABSTRACT on the issue's contents page.


Asunto(s)
Cromatografía Líquida de Alta Presión/métodos , Cromatografía Liquida/métodos , Flavanonas/administración & dosificación , Administración Intravenosa , Administración Oral , Animales , Flavanonas/química , Flavanonas/farmacocinética , Semivida , Masculino , Espectrometría de Masas/métodos , Ratas , Ratas Sprague-Dawley , Estereoisomerismo
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