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1.
Exp Eye Res ; 240: 109789, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38242423

RESUMEN

Age-related macular degeneration (AMD), a leading cause of vision loss, primarily arises from the degeneration of retinal pigment epithelium (RPE) and photoreceptors. Current therapeutic options for dry AMD are limited. Encouragingly, cultured RPE cells on parylene-based biomimetic Bruch's membrane demonstrate characteristics akin to the native RPE layer. In this study, we cultivated human embryonic stem cell-derived polarized RPE (hESC-PRPE) cells on parylene membranes at both small- and large-scale settings, collecting conditioned supernatant, denoted as PRPE-SF. We conducted a comprehensive analysis of the morphology of the cultured hESC-RPE cells and the secreted growth factors in PRPE-SF. To evaluate the in vivo efficacy of these products, the product was administered via intravitreal injections of PRPE-SF in immunodeficient Royal College of Surgeons (iRCS) rats, a model for retinal degeneration. Our study not only demonstrated the scalability of PRPE-SF production while maintaining RPE cell phenotype but also showed consistent protein concentrations between small- and large-scale batches. We consistently identified 10 key factors in PRPE-SF, including BMP-7, IGFBP-2, IGFBP-3, IGFBP-4, IGFBP-6, MANF, PEDF, PDGF-AA, TGFß1, and VEGF. Following intravitreal administration of PRPE-SF, we observed a significant increase in the thickness of the outer nuclear layer (ONL) and photoreceptor preservation in iRCS rats. Furthermore, correlation analysis revealed that IGFBP-3, IGFBP-4, MANF, PEDF, and TGFß1 displayed positive associations with in vivo bioactivity, while GDF-15 exhibited a negative correlation. Overall, this study highlights the feasibility of scaling up PRPE-SF production on parylene membranes without compromising its essential constituents. The outcomes of PRPE-SF administration in an animal model of retinal degeneration present substantial potential for photoreceptor preservation. Moreover, the identification of candidate surrogate potency markers, showing strong positive associations with in vivo bioactivity, lays a solid foundation for the development of a promising therapeutic intervention for retinal degenerative diseases.


Asunto(s)
Polímeros , Degeneración Retiniana , Epitelio Pigmentado de la Retina , Xilenos , Humanos , Animales , Ratas , Epitelio Pigmentado de la Retina/metabolismo , Proteína 3 de Unión a Factor de Crecimiento Similar a la Insulina/metabolismo , Proteína 4 de Unión a Factor de Crecimiento Similar a la Insulina , Degeneración Retiniana/metabolismo
2.
J Biomed Sci ; 31(1): 47, 2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38724973

RESUMEN

The field of regenerative medicine has witnessed remarkable advancements with the emergence of induced pluripotent stem cells (iPSCs) derived from a variety of sources. Among these, urine-derived induced pluripotent stem cells (u-iPSCs) have garnered substantial attention due to their non-invasive and patient-friendly acquisition method. This review manuscript delves into the potential and application of u-iPSCs in advancing precision medicine, particularly in the realms of drug testing, disease modeling, and cell therapy. U-iPSCs are generated through the reprogramming of somatic cells found in urine samples, offering a unique and renewable source of patient-specific pluripotent cells. Their utility in drug testing has revolutionized the pharmaceutical industry by providing personalized platforms for drug screening, toxicity assessment, and efficacy evaluation. The availability of u-iPSCs with diverse genetic backgrounds facilitates the development of tailored therapeutic approaches, minimizing adverse effects and optimizing treatment outcomes. Furthermore, u-iPSCs have demonstrated remarkable efficacy in disease modeling, allowing researchers to recapitulate patient-specific pathologies in vitro. This not only enhances our understanding of disease mechanisms but also serves as a valuable tool for drug discovery and development. In addition, u-iPSC-based disease models offer a platform for studying rare and genetically complex diseases, often underserved by traditional research methods. The versatility of u-iPSCs extends to cell therapy applications, where they hold immense promise for regenerative medicine. Their potential to differentiate into various cell types, including neurons, cardiomyocytes, and hepatocytes, enables the development of patient-specific cell replacement therapies. This personalized approach can revolutionize the treatment of degenerative diseases, organ failure, and tissue damage by minimizing immune rejection and optimizing therapeutic outcomes. However, several challenges and considerations, such as standardization of reprogramming protocols, genomic stability, and scalability, must be addressed to fully exploit u-iPSCs' potential in precision medicine. In conclusion, this review underscores the transformative impact of u-iPSCs on advancing precision medicine and highlights the future prospects and challenges in harnessing this innovative technology for improved healthcare outcomes.


Asunto(s)
Tratamiento Basado en Trasplante de Células y Tejidos , Células Madre Pluripotentes Inducidas , Medicina de Precisión , Humanos , Medicina de Precisión/métodos , Células Madre Pluripotentes Inducidas/citología , Tratamiento Basado en Trasplante de Células y Tejidos/métodos , Evaluación Preclínica de Medicamentos/métodos , Orina/citología , Medicina Regenerativa/métodos
3.
Int J Mol Sci ; 25(7)2024 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-38612560

RESUMEN

Retinal degenerative diseases, including age-related macular degeneration and retinitis pigmentosa, significantly contribute to adult blindness. The Royal College of Surgeons (RCS) rat is a well-established disease model for studying these dystrophies; however, molecular investigations remain limited. We conducted a comprehensive analysis of retinal degeneration in RCS rats, including an immunodeficient RCS (iRCS) sub-strain, using ocular coherence tomography, electroretinography, histology, and molecular dissection using transcriptomics and immunofluorescence. No significant differences in retinal degeneration progression were observed between the iRCS and immunocompetent RCS rats, suggesting a minimal role of adaptive immune responses in disease. Transcriptomic alterations were primarily in inflammatory signaling pathways, characterized by the strong upregulation of Tnfa, an inflammatory signaling molecule, and Nox1, a contributor to reactive oxygen species (ROS) generation. Additionally, a notable decrease in Alox15 expression was observed, pointing to a possible reduction in anti-inflammatory and pro-resolving lipid mediators. These findings were corroborated by immunostaining, which demonstrated increased photoreceptor lipid peroxidation (4HNE) and photoreceptor citrullination (CitH3) during retinal degeneration. Our work enhances the understanding of molecular changes associated with retinal degeneration in RCS rats and offers potential therapeutic targets within inflammatory and oxidative stress pathways for confirmatory research and development.


Asunto(s)
Degeneración Macular , Degeneración Retiniana , Retinitis Pigmentosa , Cirujanos , Humanos , Adulto , Animales , Ratas , Retina
4.
Clin Exp Allergy ; 51(3): 419-429, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33278848

RESUMEN

BACKGROUND: The natural history of childhood rhinitis is not well described. OBJECTIVE: This study aimed to identify different rhinitis trajectories in early childhood and their predictors and allergic associations. METHODS: Rhinitis symptoms were ascertained prospectively from birth until 6 years using standardized questionnaires in 772 participants. Rhinitis was defined as one or more episodes of sneezing, runny and/or blocked nose >2 weeks duration. Latent trajectories were identified using group-based modelling, and their predictive risk factors and allergic associations were examined. RESULTS: Three rhinitis trajectory groups were identified: 7.6% (n = 59) were termed early transient rhinitis, 8.6% (n = 66) late transient rhinitis, and 6.6% (n = 51) persistent rhinitis. The remaining 77.2% (n = 596) were classified as non-rhinitis/reference group. Early transient rhinitis subjects were more likely of Indian ethnicity, had siblings, reported childcare attendance, early wheezing and eczema in the first 3 years of life. Late transient rhinitis was associated with antenatal exposure to smoking, higher maternal education levels, and wheezing at age 36-72 months. Persistent rhinitis was associated with male gender, paternal and maternal history of atopy, eczema, and house dust mite sensitization. CONCLUSIONS & CLINICAL RELEVANCE: Risk factors for early transient rhinitis involve a combination of genetic and early environmental exposures, whereas late transient rhinitis may relate to maternal factors and early respiratory infections independent of atopy. In contrast, persistent rhinitis is strongly associated with atopic risk and likely represents the typical trajectory associated with allergic disorders. Allergic rhinitis symptoms may commence as early as the first year of life and may inform development of early interventive strategies.


Asunto(s)
Rinitis/fisiopatología , Edad de Inicio , Animales , Estudios de Casos y Controles , Niño , Guarderías Infantiles , Preescolar , Estudios de Cohortes , Progresión de la Enfermedad , Escolaridad , Etnicidad , Femenino , Humanos , Lactante , Mascotas , Embarazo , Efectos Tardíos de la Exposición Prenatal/epidemiología , Ruidos Respiratorios , Rinitis/clasificación , Rinitis/epidemiología , Rinitis/etnología , Factores de Riesgo , Factores Sexuales , Singapur , Fumar/epidemiología , Contaminación por Humo de Tabaco/estadística & datos numéricos
5.
COPD ; 18(6): 657-663, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34468237

RESUMEN

Impaired mucociliary clearance may increase COPD exacerbation risk. We aimed to compare bronchial ciliary function and epithelial ultrastructure of COPD patients to healthy controls and explore its relationship to exacerbator phenotypes (frequent [FE] and infrequent [IFE] exacerbator). In this cross-sectional study, 16 COPD patients and 12 controls underwent bronchial brushings. Ciliary beat frequency (CBF) and dyskinesia index (DI; % of dyskinetic cilia) were assessed using digital high-speed video microscopy, and epithelial ultrastructure using transmission electron microscopy (TEM). Bronchial epithelium in COPD showed lower CBF and higher DI, compared to controls (median [IQR] CBF: 6.8 (6.1-7.2) Hz vs 8.5 (7.7-8.9) Hz, p<0.001 and DI: 73.8 (60.7-89.8) % vs 14.5 (11.2-16.9) %, p<0.001, respectively). This was true for FE and IFE phenotypes of COPD, which were similar in terms of bronchial CBF or DI. Subgroup analyses demonstrated lower CBF and higher DI in FE and IFE COPD phenotypes compared to controls, irrespective of smoking status. TEM showed more loss of cilia, extrusion of cells, cytoplasmic blebs and dead cells in COPD patients versus controls. Profound dysfunction of bronchial cilia is a feature of COPD irrespective of exacerbation phenotype and smoking status, which is likely to contribute to poor mucus clearance in COPD.Supplemental data for this article is available online at https://doi.org/10.1080/15412555.2021.1963695 .


Asunto(s)
Cilios , Enfermedad Pulmonar Obstructiva Crónica , Bronquios , Cilios/ultraestructura , Estudios Transversales , Humanos , Mucosa Respiratoria
6.
J Allergy Clin Immunol ; 142(1): 86-95, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29452199

RESUMEN

BACKGROUND: Dynamic establishment of the nasal microbiota in early life influences local mucosal immune responses and susceptibility to childhood respiratory disorders. OBJECTIVE: The aim of this case-control study was to monitor, evaluate, and compare development of the nasal microbiota of infants with rhinitis and wheeze in the first 18 months of life with those of healthy control subjects. METHODS: Anterior nasal swabs of 122 subjects belonging to the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) birth cohort were collected longitudinally over 7 time points in the first 18 months of life. Nasal microbiota signatures were analyzed by using 16S rRNA multiplexed pair-end sequencing from 3 clinical groups: (1) patients with rhinitis alone (n = 28), (2) patients with rhinitis with concomitant wheeze (n = 34), and (3) healthy control subjects (n = 60). RESULTS: Maturation of the nasal microbiome followed distinctive patterns in infants from both rhinitis groups compared with control subjects. Bacterial diversity increased over the period of 18 months of life in control infants, whereas infants with rhinitis showed a decreasing trend (P < .05). An increase in abundance of the Oxalobacteraceae family (Proteobacteria phylum) and Aerococcaceae family (Firmicutes phylum) was associated with rhinitis and concomitant wheeze (adjusted P < .01), whereas the Corynebacteriaceae family (Actinobacteria phylum) and early colonization with the Staphylococcaceae family (Firmicutes phylum; 3 weeks until 9 months) were associated with control subjects (adjusted P < .05). The only difference between the rhinitis and control groups was a reduced abundance of the Corynebacteriaceae family (adjusted P < .05). Determinants of nasal microbiota succession included sex, mode of delivery, presence of siblings, and infant care attendance. CONCLUSION: Our results support the hypothesis that the nasal microbiome is involved in development of early-onset rhinitis and wheeze in infants.


Asunto(s)
Microbiota , Mucosa Nasal/microbiología , Ruidos Respiratorios , Rinitis/microbiología , Estudios de Casos y Controles , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Mucosa Nasal/inmunología , Ruidos Respiratorios/inmunología , Rinitis/inmunología , Singapur
7.
Graefes Arch Clin Exp Ophthalmol ; 256(11): 2113-2125, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30215097

RESUMEN

PURPOSE: To create new immunodeficient Royal College of Surgeons (RCS) rats by introducing the defective MerTK gene into athymic nude rats. METHODS: Female homozygous RCS (RCS-p+/RCS-p+) and male nude rats (Hsd:RH-Foxn1mu, mutation in the foxn1 gene; no T cells) were crossed to produce heterozygous F1 progeny. Double homozygous F2 progeny obtained by crossing the F1 heterozygotes was identified phenotypically (hair loss) and genotypically (RCS-p+ gene determined by PCR). Retinal degenerative status was confirmed by optical coherence tomography (OCT) imaging, electroretinography (ERG), optokinetic (OKN) testing, superior colliculus (SC) electrophysiology, and by histology. The effect of xenografts was assessed by transplantation of human embryonic stem cell-derived retinal pigment epithelium (hESC-RPE) and human-induced pluripotent stem cell-derived RPE (iPS-RPE) into the eye. Morphological analysis was conducted based on hematoxylin and eosin (H&E) and immunostaining. Age-matched pigmented athymic nude rats were used as control. RESULTS: Approximately 6% of the F2 pups (11/172) were homozygous for RCS-p+ gene and Foxn1mu gene. Homozygous males crossed with heterozygous females resulted in 50% homozygous progeny for experimentation. OCT imaging demonstrated significant loss of retinal thickness in homozygous rats. H&E staining showed photoreceptor thickness reduced to 1-3 layers at 12 weeks of age. Progressive loss of visual function was evidenced by OKN testing, ERG, and SC electrophysiology. Transplantation experiments demonstrated survival of human-derived cells and absence of apparent immune rejection. CONCLUSIONS: This new rat animal model developed by crossing RCS rats and athymic nude rats is suitable for conducting retinal transplantation experiments involving xenografts.


Asunto(s)
Modelos Animales de Enfermedad , Células Madre Embrionarias Humanas/trasplante , Síndromes de Inmunodeficiencia/terapia , Células Madre Pluripotentes Inducidas/trasplante , Distrofias Retinianas/terapia , Epitelio Pigmentado de la Retina/trasplante , Animales , Supervivencia Celular , Electrorretinografía , Femenino , Técnicas de Genotipaje , Supervivencia de Injerto/fisiología , Células Madre Embrionarias Humanas/fisiología , Humanos , Síndromes de Inmunodeficiencia/diagnóstico , Síndromes de Inmunodeficiencia/fisiopatología , Células Madre Pluripotentes Inducidas/fisiología , Masculino , Fenotipo , Ratas , Ratas Desnudas , Retina/fisiopatología , Distrofias Retinianas/diagnóstico , Distrofias Retinianas/fisiopatología , Epitelio Pigmentado de la Retina/fisiología , Tomografía de Coherencia Óptica , Tirosina Quinasa c-Mer/genética
8.
Hum Mol Genet ; 23(13): 3362-74, 2014 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-24518672

RESUMEN

Primary ciliary dyskinesia (PCD) is an inherited chronic respiratory obstructive disease with randomized body laterality and infertility, resulting from cilia and sperm dysmotility. PCD is characterized by clinical variability and extensive genetic heterogeneity, associated with different cilia ultrastructural defects and mutations identified in >20 genes. Next generation sequencing (NGS) technologies therefore present a promising approach for genetic diagnosis which is not yet in routine use. We developed a targeted panel-based NGS pipeline to identify mutations by sequencing of selected candidate genes in 70 genetically undefined PCD patients. This detected loss-of-function RSPH1 mutations in four individuals with isolated central pair (CP) agenesis and normal body laterality, from two unrelated families. Ultrastructural analysis in RSPH1-mutated cilia revealed transposition of peripheral outer microtubules into the 'empty' CP space, accompanied by a distinctive intermittent loss of the central pair microtubules. We find that mutations in RSPH1, RSPH4A and RSPH9, which all encode homologs of components of the 'head' structure of ciliary radial spoke complexes identified in Chlamydomonas, cause clinical phenotypes that appear to be indistinguishable except at the gene level. By high-resolution immunofluorescence we identified a loss of RSPH4A and RSPH9 along with RSPH1 from RSPH1-mutated cilia, suggesting RSPH1 mutations may result in loss of the entire spoke head structure. CP loss is seen in up to 28% of PCD cases, in whom laterality determination specified by CP-less embryonic node cilia remains undisturbed. We propose this defect could arise from instability or agenesis of the ciliary central microtubules due to loss of their normal radial spoke head tethering.


Asunto(s)
Proteínas de Unión al ADN/genética , Síndrome de Kartagener/genética , Axonema/metabolismo , Axonema/fisiología , Proteínas del Citoesqueleto/genética , Femenino , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Síndrome de Kartagener/fisiopatología , Microscopía Electrónica , Microscopía Fluorescente , Mutación , Proteínas/genética
9.
Graefes Arch Clin Exp Ophthalmol ; 254(8): 1553-1565, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27335025

RESUMEN

PURPOSE: A subretinal implant termed CPCB-RPE1 is currently being developed to surgically replace dystrophic RPE in patients with dry age-related macular degeneration (AMD) and severe vision loss. CPCB-RPE1 is composed of a terminally differentiated, polarized human embryonic stem cell-derived RPE (hESC-RPE) monolayer pre-grown on a biocompatible, mesh-supported submicron parylene C membrane. The objective of the present delivery study was to assess the feasibility and 1-month safety of CPCB-RPE1 implantation in Yucatán minipigs, whose eyes are similar to human eyes in size and gross retinal anatomy. METHODS: This was a prospective, partially blinded, randomized study in 14 normal-sighted female Yucatán minipigs (aged 2 months, weighing 24-35 kg). Surgeons were blinded to the randomization codes and postoperative and post-mortem assessments were performed in a blinded manner. Eleven minipigs received CPCB-RPE1 while three control minipigs underwent sham surgery that generated subretinal blebs. All animals except two sham controls received combined local (Ozurdex™ dexamethasone intravitreal implant) and systemic (tacrolimus) immunosuppression or local immunosuppression alone. Correct placement of the CPCB-RPE1 implant was assessed by in vivo optical coherence tomography and post-mortem histology. hESC-RPE cells were identified using immunohistochemistry staining for TRA-1-85 (a human marker) and RPE65 (an RPE marker). As the study results of primary interest were nonnumerical no statistical analysis or tests were conducted. RESULTS: CPCB-RPE1 implants were reliably placed, without implant breakage, in the subretinal space of the minipig eye using surgical techniques similar to those that would be used in humans. Histologically, hESC-RPE cells were found to survive as an intact monolayer for 1 month based on immunohistochemistry staining for TRA-1-85 and RPE65. CONCLUSIONS: Although inconclusive regarding the necessity or benefit of systemic or local immunosuppression, our study demonstrates the feasibility and safety of CPCB-RPE1 subretinal implantation in a comparable animal model and provides an encouraging starting point for human studies.


Asunto(s)
Células Madre Embrionarias Humanas/trasplante , Degeneración Macular/cirugía , Epitelio Pigmentado de la Retina/trasplante , Trasplante de Células Madre/métodos , Animales , Células Cultivadas , Modelos Animales de Enfermedad , Estudios de Factibilidad , Femenino , Humanos , Degeneración Macular/diagnóstico , Estudios Prospectivos , Epitelio Pigmentado de la Retina/citología , Porcinos , Porcinos Enanos , Tomografía de Coherencia Óptica , Resultado del Tratamiento
10.
Environ Monit Assess ; 188(1): 53, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26694710

RESUMEN

Dissipation behaviour of the chloronicotinyl insecticide, imidacloprid (Tatamida 17.8 % SL), in fresh and cured cardamom capsules was studied following application at doses 20 and 40 g a.i. ha(-1) in a cardamom plantation of Indian Cardamom Hills (ICH), Idukki, Kerala, India. A single-laboratory ultra performance liquid chromatography mass spectrometry (UPLC-MS/MS) method was developed and validated for the estimation of imidacloprid and its six metabolites (5-hydroxy, olefin, guanidine, urea, 6-chloronicotinic acid and nitrosimine) in fresh and cured cardamom. At the lower dose, the initial deposits of total imidacloprid residues were 1.91 and 7.23 µg g(-1), respectively, in fresh and cured cardamom. At the higher dose, the initial residues were 3.94 and 14.72 µg g(-1), respectively, in fresh and cured capsules. The residues dissipated below the quantitation level of 0.01 µg g(-1) after 21 and 28 days at lower dose and after 28 days for both at higher dose. The half-lives of imidacloprid in fresh and cured cardamom were 4.02 and 3.63 days, respectively, at lower dose and 3.61 days for both at higher dose. The waiting periods of imidacloprid on fresh and cured cardamom at lower and higher doses were 21.40, 27.10, 23.85 and 30.70 days, respectively. The mean processing factor of imidacloprid was 3.96 at 20 g a.i. ha(-1). Amongst metabolites of imidacloprid, urea had maximum residues in fresh and cured cardamom followed by 5-hydroxy and guanidine. Other metabolites such as 6-chloronicotinic acid, olefin and nitrosimine were not detected either in fresh or cured cardamom.


Asunto(s)
Elettaria/química , Imidazoles/química , Insecticidas/química , Nitrocompuestos/química , Elettaria/metabolismo , Monitoreo del Ambiente , Semivida , Imidazoles/análisis , Imidazoles/metabolismo , India , Insecticidas/análisis , Insecticidas/metabolismo , Cinética , Neonicotinoides , Ácidos Nicotínicos , Nitrocompuestos/análisis , Nitrocompuestos/metabolismo , Espectrometría de Masas en Tándem
11.
J Vasc Surg ; 62(5): 1119-24.e9, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26254452

RESUMEN

OBJECTIVE: A recent investigation has documented an increased risk of aneurysm-related complications after endovascular aneurysm repair (EVAR) of familial abdominal aortic aneurysms (fAAAs). We hypothesized that fAAA patients are not at increased risk for complications following open AAA repair or EVAR when compared with sporadic abdominal aortic aneurysm (spAAA) patients. To this end, we performed a single institution retrospective review. METHODS: Epidemiologic data were collected through the electronic medical record. Family history data were obtained from a questionnaire administered at the initial vascular surgery consultation. Major adverse events were defined as myocardial infarction, respiratory failure, renal failure, bowel ischemia, limb ischemia, multisystem organ failure, intracranial hemorrhage, paraplegia, hemorrhage, or death. Endoleaks were classified in accordance with the standardized reporting practices of the Society for Vascular Surgery. AAA-related complications were defined as the need for a secondary intervention due to endoleak, limb ischemia, or postimplantation rupture. RESULTS: A total of 392 patients with complete clinical data underwent elective AAA repair from 2004 to 2014. Of these 392 patients, 89 (23%) were classified as fAAA patients and 303 (77%) were classified as spAAA patients. With the exception of increased rates of chronic obstructive pulmonary disease (P = .0009) and pack-years smoked (P = .03) in spAAA patients, demographics did not differ. Sixty-two percent (n = 55) of fAAA patients and 68% (n = 205) of spAAA patients underwent EVAR (P = .30). fAAA patients did not incur any significant difference in major adverse events following open AAA repair (fAAA, 9% vs spAAA, 11%; P = .75). Additionally, fAAA patients did not incur any significant difference in major adverse events following EVAR (fAAA, 4% vs spAAA, 5%; P = .70). Patients with fAAA did have a significantly increased rate of endoleak (fAAA, 24% vs spAAA, 12%; P = .03) and secondary intervention following EVAR (fAAA, 21% vs spAAA, 12%; P = .04). CONCLUSIONS: The current study shows that patients with fAAA do not have increased perioperative morbidity following open or endovascular AAA repair. However, patients with fAAA do have an increased risk of endoleak and secondary intervention following EVAR. These findings suggest that EVAR and open AAA repair are both safe and effective for fAAA patients. The increased rate of endoleak and secondary intervention in patients with fAAA suggests that this subpopulation may benefit from closer post-EVAR surveillance or open surgical repair in good risk patients.


Asunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Implantación de Prótesis Vascular/efectos adversos , Endofuga/cirugía , Procedimientos Endovasculares/efectos adversos , Anciano , Anciano de 80 o más Años , Aneurisma de la Aorta Abdominal/diagnóstico , Aneurisma de la Aorta Abdominal/genética , Aneurisma de la Aorta Abdominal/mortalidad , Prótesis Vascular , Implantación de Prótesis Vascular/instrumentación , Implantación de Prótesis Vascular/mortalidad , Procedimientos Quirúrgicos Electivos , Registros Electrónicos de Salud , Endofuga/diagnóstico , Endofuga/etiología , Endofuga/mortalidad , Procedimientos Endovasculares/instrumentación , Procedimientos Endovasculares/mortalidad , Femenino , Predisposición Genética a la Enfermedad , Herencia , Humanos , Isquemia/etiología , Isquemia/cirugía , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Linaje , Pennsylvania , Falla de Prótesis , Reoperación , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Stents , Factores de Tiempo , Resultado del Tratamiento
12.
Pediatr Allergy Immunol ; 26(1): 25-33, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25557088

RESUMEN

BACKGROUND: Rhinitis is common in early childhood, but allergic rhinitis is considered a later manifestation of the atopic march. This study aimed to evaluate rhinitis (allergic and non-allergic) in the first 18 months of life, its link with other atopic manifestations and the role of respiratory viruses. METHODS: Subjects (n = 1237) of the Singapore GUSTO birth cohort were followed up quarterly until 18 months of age with questionnaires to screen for rhinitis symptoms lasting at least 2 wk and with monthly calls to positive subjects to detect prolonged/recurrent rhinitis symptoms (total duration ≥ 4 wk). Anterior nasal swabbing for molecular-based virus detection was conducted during these visits and near (within a month) rhinitis episodes. Skin prick testing to common environmental and food allergens was conducted at the 18 month visit. RESULTS: Prolonged/recurrent rhinitis was significantly associated with history of parental atopy (mother: aOR = 2.17; father: aOR = 1.82) and atopic comorbidities of eczema (aOR = 2.53) and wheeze (aOR = 4.63) (p < 0.05), though not with allergen sensitization. Although the frequency of nasal respiratory virus detection during scheduled quarterly visits did not differ between prolonged/recurrent rhinitis and matched controls (p > 0.05), virus detection was higher in swabs obtained within a month following rhinitis episodes in prolonged/recurrent rhinitis subjects compared with scheduled visits (adjusted p = 0.04). CONCLUSIONS: Based on the duration of rhinitis symptoms, this study defined a subset of early childhood rhinitis which was associated with atopic predisposition and comorbidities. Persistent respiratory viral shedding may contribute to the symptomatology. Whether this entity is a precursor of subsequent childhood allergic rhinitis will require longer follow-up.


Asunto(s)
Infecciones del Sistema Respiratorio/epidemiología , Rinitis Alérgica/epidemiología , Virus/inmunología , Alérgenos/inmunología , Estudios de Cohortes , Susceptibilidad a Enfermedades , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Guías de Práctica Clínica como Asunto , Prevalencia , Recurrencia , Infecciones del Sistema Respiratorio/inmunología , Infecciones del Sistema Respiratorio/virología , Rinitis Alérgica/inmunología , Rinitis Alérgica/virología , Singapur , Pruebas Cutáneas , Virus/aislamiento & purificación
13.
Environ Monit Assess ; 187(5): 299, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25917186

RESUMEN

Dissipation and decontamination of chlorantraniliprole (Coragen 18.5 SC) in brinjal and okra fruits were studied following field application at single and double doses of 30 and 60 g ai ha(-1), and the residues of the insecticide was estimated using LC-MS/MS. Initial residues of chlorantraniliprole at single and double doses on the fruits of brinjal were 0.72 and 1.48 mg kg(-1), while on okra fruits, the residues were 0.48 and 0.91 mg kg(-1), respectively. The residues reached below detectable level of 0.01 mg kg(-1) on the 10th day. Half-life of chlorantraniliprole at 30 and 60 g ai ha(-1) on brinjal was 1.58 and 1.80 days with the calculated waiting period of 0.69 and 2.38 days, whereas on okra, the values were 1.60 and 1.70 and 0 and 1.20 days, respectively. The extent of removal of chlorantraniliprole using simple decontaminating techniques at 2 h and 3 days after spraying was 40.99-91.37% and 29.85-89.12%, respectively, from brinjal fruits and 47.78-86.10% and 41.77-86.48%, respectively, from okra fruits.


Asunto(s)
Abelmoschus/química , Manipulación de Alimentos/métodos , Residuos de Plaguicidas/análisis , Solanum melongena/química , ortoaminobenzoatos/análisis , Cromatografía Liquida , Descontaminación/métodos , Monitoreo del Ambiente , Contaminación de Alimentos , Frutas/química , Semivida , Insecticidas/análisis , Espectrometría de Masas , Espectrometría de Masas en Tándem
14.
Environ Monit Assess ; 186(7): 4499-506, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24682662

RESUMEN

Dissipation and decontamination of the semisynthetic macrolide emamectin benzoate and the natural insecticide spinosad on cowpea pods were studied following field application at single and double doses of 11.0 and 22 and 73 and 146 g ai ha(-1), respectively. Residues of these naturalytes were estimated using LC-MS/MS. The initial deposit of 0.073 and 0.153 mg kg(-1) of emamectin benzoate dissipated below quantitation level on the fifth and seventh day at single and double dosage, respectively. For spinosad, the initial deposits of 0.94 and 1.90 mg kg(-1) reached below quantitation level on the 7th day and 15th day at single and double dosage, respectively. The half-life of emamectin benzoate and spinosad was 1.13-1.49 and 1.05-1.39 days with the calculated safe waiting period of 2.99-6.12 and 1.09-3.25 days, respectively, for single and double dosage. Processing of the harvestable pods with different decontamination techniques resulted in 33.82 to 100 % removal 2 h after the application of emamectin benzoate and 100 % removal 3 days after spraying, while the removal was 42.05 to 87.46 % 2 h after the application of spinosad and 38.05 to 68.08 % 3 days after application.


Asunto(s)
Insecticidas/análisis , Ivermectina/análogos & derivados , Macrólidos/análisis , Residuos de Plaguicidas/análisis , Cromatografía Liquida , Descontaminación/métodos , Combinación de Medicamentos , Monitoreo del Ambiente , Semivida , Ivermectina/análisis , Cinética , Espectrometría de Masas , Espectrometría de Masas en Tándem
15.
Environ Monit Assess ; 186(9): 5429-37, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24816538

RESUMEN

A single laboratory UPLC-MS/MS method was developed and validated for the estimation of fipronil and its metabolites in fresh and dry chilli pepper fruits. Dissipation of fipronil on chilli fruits was studied following the application of fipronil (Jump 80 WG) at 40 and 80 g active ingredient (a.i.) ha(-1) in the fruiting stage of the crop. The initial deposits of total fipronil on fresh chilli fruits at single and double dose application were 0.69 and 1.43 µg g(-1), respectively, and were dissipated to below quantitation level at 27 days after application. The half-life of fipronil at single and double dose in fresh chilli pepper was 4.22 and 4.32 days and the waiting period was 25.9 and 30.6 days, respectively. Processing factor due to sun drying was calculated by measuring fipronil residues in dry chilli fruits, and it ranged from 2.96 to 3.50 during 0 to 21st day after application. Among the metabolites of fipronil, fipronil desulfenyl and fipronil sulfone had maximum residues in fresh and dried chilli, respectively, followed by fipronil sulfide. Dipping in solutions of tamarind, turmeric, vinegar and slaked lime and wet scrubbing could remove more than 90% of fipronil residues in fruits.


Asunto(s)
Capsicum/química , Insecticidas/análisis , Pirazoles/análisis , Contaminantes del Suelo/análisis , Monitoreo del Ambiente , Frutas/química , Semivida , Medición de Riesgo , Espectrometría de Masas en Tándem
16.
Singapore Med J ; 2024 Feb 16.
Artículo en Inglés | MEDLINE | ID: mdl-38363652

RESUMEN

ABSTRACT: Asthma is a major chronic disease affecting children, and children with difficult-to-treat asthma account for a disproportionate share of resource utilisation and healthcare costs. This review presents a comprehensive and up-to-date overview of the treatment strategies in difficult-to-treat paediatric asthma. Mimickers of asthma must first be ruled out, and the diagnosis confirmed with objective tests whenever possible. The effect of comorbid conditions such as obesity, smoking, other atopic conditions and psychosocial factors on asthma control and severity should be considered. Treatment can then be optimised by implementing personalised strategies, including the use of appropriate drug delivery devices and adherence monitoring. Biologics can be an alternative treatment option for selected patients but should not be a substitute for addressing poor adherence. Many patients with difficult-to-treat asthma may not have severe asthma, and the physician should work with patients and families to achieve good asthma control via an individualised approach.

17.
J Neurosci Methods ; 405: 110095, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38403001

RESUMEN

BACKGROUND: The retinotopic map property of the superior colliculus (SC) is a reliable indicator of visual functional changes in rodents. Electrophysiological mapping of the SC using a single electrode has been employed for measuring visual function in rat and mouse disease models. Single electrode mapping is highly laborious requiring long-term exposure to the SC surface and prolonged anesthetic conditions that can adversely affect the mapping data. NEW METHOD: To avoid the above-mentioned issues, we fabricated a fifty-six (56) electrode multi-electrode array (MEA) for rapid and reliable visual functional mapping of the SC. Since SC is a dome-shaped structure, the array was made of electrodes with dissimilar tip lengths to enable simultaneous and uniform penetration of the SC. RESULTS: SC mapping using the new MEA was conducted in retinal degenerate (RD) Royal College of Surgeons (RCS) rats and rats with focal retinal damage induced by green diode laser. For SC mapping, the MEA was advanced into the SC surface and the visual activities were recorded during full-filed light stimulation of the eye. Based on the morphological examination, the MEA electrodes covered most of the exposed SC area and penetrated the SC surface at a relatively uniform depth. MEA mapping in RCS rats (n=9) demonstrated progressive development of a scotoma in the SC that corresponded to the degree of photoreceptor loss. MEA mapping in the laser damaged rats demonstrated the presence of a scotoma in the SC area that corresponded to the location of retinal laser injury. COMPARISON WITH EXISTING METHODS AND CONCLUSIONS: The use of MEA for SC mapping is advantageous over single electrode recording by enabling faster recordings and reducing anesthesia time. This study establishes the feasibility of the MEA technique for rapid and efficient SC mapping, particularly advantageous for evaluating therapeutic effects in retinal degenerate rat disease models.


Asunto(s)
Escotoma , Colículos Superiores , Humanos , Ratas , Animales , Ratones , Colículos Superiores/fisiología , Retina/fisiología , Luz , Electrodos
18.
Bioengineering (Basel) ; 11(2)2024 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-38391660

RESUMEN

Functional ultrasound (fUS) flow imaging provides a non-invasive method for the in vivo study of cerebral blood flow and neural activity. This study used functional flow imaging to investigate rat brain's response to ultrasound and colored-light stimuli. Male Long-Evan rats were exposed to direct full-field strobe flashes light and ultrasound stimulation to their retinas, while brain activity was measured using high-frequency ultrasound imaging. Our study found that light stimuli, particularly blue light, elicited strong responses in the visual cortex and lateral geniculate nucleus (LGN), as evidenced by changes in cerebral blood volume (CBV). In contrast, ultrasound stimulation elicited responses undetectable with fUS flow imaging, although these were observable when directly measuring the brain's electrical signals. These findings suggest that fUS flow imaging can effectively differentiate neural responses to visual stimuli, with potential applications in understanding visual processing and developing new diagnostic tools.

19.
Front Oral Health ; 5: 1332980, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38433948

RESUMEN

Background: Periodontitis is initiated by a dysbiotic activity and furthermore leads to a chronic inflammatory response. The presence of pro-inflammatory markers plays an important role in the inflammatory load. Macrophage inflammatory protein-1 alpha (MIP-1α) and C-reactive protein (CRP) are pro- inflammatory biomarkers that quantify clinical and subclinical inflammation in cardiac ischemia in cardiac inflammation and disease. Adiponectin is an anti-inflammatory marker associated with good health. The susceptibility of periodontitis patients to cardiovascular events needs to be evaluated. Objective: This study aims to assess the levels of biomarkers in periodontitis patients with and without acute myocardial infarction (AMI) compared to controls. Material and methods: Pro-inflammatory and anti-inflammatory analytes were examined by collecting unstimulated saliva from three groups (n = 20/each): healthy individuals, individuals with stage III periodontitis, and post-myocardial infarction patients with stage III periodontitis. The samples were collected within 48 h of AMI. Results: Adiponectin levels were significantly lower in patients with periodontitis with and without AMI compared to controls, while CRP and MIP-1α were significantly higher in patients with periodontitis with and without AMI compared to controls. The highest titers for MIP-1α and CRP were detected among patients with periodontitis with and AMI. Conclusion: Our study provides possible evidence of the association between periodontitis and salivary analytes that occur in tandem with cardiovascular disease. The lower levels of Adiponectin and higher levels of CRP and MIP-1α in patients with periodontitis indicate that this condition is a potential risk factor for cardiovascular disease. The findings emphasize the importance of early detection and intervention for periodontitis patients to prevent cardiovascular events.

20.
Nat Commun ; 15(1): 4481, 2024 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-38802397

RESUMEN

Retinal degeneration, a leading cause of irreversible low vision and blindness globally, can be partially addressed by retina prostheses which stimulate remaining neurons in the retina. However, existing electrode-based treatments are invasive, posing substantial risks to patients and healthcare providers. Here, we introduce a completely noninvasive ultrasonic retina prosthesis, featuring a customized ultrasound two-dimensional array which allows for simultaneous imaging and stimulation. With synchronous three-dimensional imaging guidance and auto-alignment technology, ultrasonic retina prosthesis can generate programmed ultrasound waves to dynamically and precisely form arbitrary wave patterns on the retina. Neuron responses in the brain's visual center mirrored these patterns, evidencing successful artificial vision creation, which was further corroborated in behavior experiments. Quantitative analysis of the spatial-temporal resolution and field of view demonstrated advanced performance of ultrasonic retina prosthesis and elucidated the biophysical mechanism of retinal stimulation. As a noninvasive blindness prosthesis, ultrasonic retina prosthesis could lead to a more effective, widely acceptable treatment for blind patients. Its real-time imaging-guided stimulation strategy with a single ultrasound array, could also benefit ultrasound neurostimulation in other diseases.


Asunto(s)
Ceguera , Retina , Prótesis Visuales , Retina/diagnóstico por imagen , Retina/fisiología , Animales , Ceguera/terapia , Ceguera/fisiopatología , Degeneración Retiniana/terapia , Degeneración Retiniana/diagnóstico por imagen , Ondas Ultrasónicas , Humanos , Neuronas/fisiología , Ultrasonografía/métodos , Visión Ocular/fisiología
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