RESUMO
It is widely accepted, based on data from the last few decades and on model simulations, that anthropogenic climate change will cause increased fire activity. However, less attention has been paid to the relationship between abrupt climate changes and heightened fire activity in the paleorecord. We use 35 charcoal and pollen records to assess how fire regimes in North America changed during the last glacial-interglacial transition (15 to 10 ka), a time of large and rapid climate changes. We also test the hypothesis that a comet impact initiated continental-scale wildfires at 12.9 ka; the data do not support this idea, nor are continent-wide fires indicated at any time during deglaciation. There are, however, clear links between large climate changes and fire activity. Biomass burning gradually increased from the glacial period to the beginning of the Younger Dryas. Although there are changes in biomass burning during the Younger Dryas, there is no systematic trend. There is a further increase in biomass burning after the Younger Dryas. Intervals of rapid climate change at 13.9, 13.2, and 11.7 ka are marked by large increases in fire activity. The timing of changes in fire is not coincident with changes in human population density or the timing of the extinction of the megafauna. Although these factors could have contributed to fire-regime changes at individual sites or at specific times, the charcoal data indicate an important role for climate, and particularly rapid climate change, in determining broad-scale levels of fire activity.
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PURPOSE: The incidence of complex hernias with loss of domain (CHLD) has been increasing and the treatment of these cases may require auxiliary techniques in addition to surgery. This study aims to refine the progressive preoperative pneumoperitonium (PPP) in patients with CHLD, to achieve an increased in wall dimensions. METHODS: Patients presented with a CHLD undergoing PPP protocol were analyzed between May 2017 and May 2019. Our PPP protocol was to use two daily insufflations of 1000 ml of ambient air during a period of 14 days. We compared the abdominal cavity volume (ACV), the hernial sac volume (HSV) and the volume ratio (VR), before and after our refined PPP. RESULTS: During our evaluation period, the protocol was performed on 16 patients. The mean age was 55.73 (± 12.87), and the mean BMI was 31.35 (± 7.33). The median of HSV was 2104.53 ml; Mean ACV was 6722.36 ml, and median of VR was 29.97% (27.46-34.38 IIQ). The averages were: daily volume of gas ± 1526.66 ml, total volume ± 17,350 ml, and the PPP period of ± 10.7 days. The increase in post-PPP ACV was 52.13% (p < 0.0001), and the VR decreased to 26.9% (p < 0.609). All patients' symptoms and complications were mild (according Clavien-Dindo grades I and II), and there were no loop injuries, no catheter complications, or any surgical re-interventions. CONCLUSION: The study suggests that the use of this method results in a significant increase in ACV, and reduction of the herniated content in a safe and efficient manner, with mild complications.
Assuntos
Hérnia Ventral , Insuflação , Pneumoperitônio , Estudos de Coortes , Hérnia Ventral/cirurgia , Herniorrafia/efeitos adversos , Herniorrafia/métodos , Humanos , Pessoa de Meia-Idade , Pneumoperitônio/cirurgia , Pneumoperitônio Artificial/efeitos adversos , Pneumoperitônio Artificial/métodos , Cuidados Pré-Operatórios/métodos , Estudos RetrospectivosRESUMO
The late Quaternary marine terraces near Santa Cruz, California, reflect uplift associated with the nearby restraining bend on the San Andreas fault. Excellent correspondence of the coseismic vertical displacement field caused by the 17 October 1989 magnitude 7.1 Loma Prieta earthquake and the present elevations of these terraces allows calculation of maximum long-term uplift rates 1 to 2 kilometers west of the San Andreas fault of 0.8 millimeters per year. Over several million years, this uplift, in concert with the right lateral translation of the resulting topography, and with continual attack by geomorphic processes, can account for the general topography of the northern Santa Cruz Mountains.
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Saltation is important in the transport of sand-sized granular material by wind and in the ejection of dust from the bed both on Earth and on Mars. The evolution of the saltating population and all its characteristic profiles is calculated from inception by pure aerodynamic entrainment through to steady state. Results of numerical simulations of single-grain impacts into granular beds are condensed into analytic expressions for the number and speeds of grains rebounding or rejected (splashed) from the bed. A model is combined with (i) this numerical representation, (ii) an expression for the aerodynamic entrainment rate, and (iii) the modification of the wind velocity profile by saltating grains. Calculated steady state mass fluxes are within the range of mass fluxes measured in wind tunnel experiments; mass flux is nonlinearly dependent on the shear velocity. Aerodynamically entrained grains in the system are primarily seeding agents; at steady state, aerodynamic entrainment is rare. The time for the entire system to reach steady state is roughly 1 second, or several long-trajectory hop times.
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AIM: To investigate whether two methods of measuring macular pigment-namely, heterochromatic flicker photometry (HFP) and resonance Raman spectroscopy (RRS)--yield comparable data. METHODS: Macular pigment was measured using HFP and RRS in the right eye of 107 participants aged 20-79 years. Correlations between methods were sought and regression models generated. RRS was recorded as Raman counts and HFP as macular pigment optical density (MPOD). The average of the top three of five Raman counts was compared with MPOD obtained at 0.5 degrees eccentricity, and an integrated measure (spatial profile; MPODsp) computed from four stimulus sizes on HFP. RESULTS: The coefficient of variation was 12.0% for MPODsp and 13.5% for Raman counts. MPODsp exhibited significant correlations with Raman counts (r = 0.260, p = 0.012), whereas MPOD at 0.5 degrees did not correlate significantly (r = 0.163, p = 0.118). MPODsp was not significantly correlated with age (p = 0.062), whereas MPOD at 0.5 degrees was positively correlated (p = 0.011). Raman counts showed a significant decrease with age (p = 0.002) and were significantly lower when pupil size was smaller (p = 0.015). CONCLUSIONS: Despite a statistically significant correlation, the correlations were weak, with those in excess of 90% of the variance between MPODsp and Raman counts remaining unexplained, meriting further research.
Assuntos
Macula Lutea/química , Pigmentos da Retina/análise , Adulto , Distribuição por Idade , Idoso , Envelhecimento/fisiologia , Técnicas de Diagnóstico Oftalmológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fotometria/métodos , Reprodutibilidade dos Testes , Fatores de Risco , Análise Espectral Raman/métodosRESUMO
Terminal transferase (TdT), when incubated with a purified(32)P-5"-end-labeled oligonucleotide of defined length in the presence of Co(2+), Mn(2+)or Mg(2+)and 2-mercaptoethanol in cacodylate or HEPES buffer, pH 7.2, exhibits the ability to remove a 3"-nucleotide from one oligonucleotide and add it to the 3"-end of another. When analyzed by urea-PAGE, this activity is observed as a disproportionation of the starting oligonucleotide into a ladder of shorter and longer oligonucleotides distributed around the starting material. Optimal metal ion concentration is 1-2 mM. All three metal ions support this activity with Co(2+)> Mn(2+) congruent with Mg(2+). Oligonucleotides p(dT) and p(dA) are more efficient substrates than p(dG) and p(dC) because the latter may form secondary structures. The dismutase activity is significant even in the presence of dNTP concentrations comparable to those that exist in the nucleus during the G(1)phase of the cell cycle. Using BetaScope image analysis the rate of pyrophosphorolytic dismutase activity was found to be only moderately slower than the poly-merization activity. These results may help explain the GC-richness of immunoglobulin gene segment joins (N regions) and the loss of bases that occur during gene rearrangements in pre-B and pre-T cells.
Assuntos
DNA Nucleotidilexotransferase/metabolismo , Difosfatos/metabolismo , Oligodesoxirribonucleotídeos/metabolismo , Animais , Soluções Tampão , Catálise/efeitos dos fármacos , Cátions Bivalentes/farmacologia , Bovinos , DNA/biossíntese , DNA/genética , DNA/metabolismo , Nucleotídeos de Desoxiadenina/genética , Nucleotídeos de Desoxiadenina/metabolismo , Didesoxinucleotídeos , Difosfatos/farmacologia , Eletroforese em Gel de Poliacrilamida , Temperatura Alta , Humanos , Pirofosfatase Inorgânica , Cinética , Metais/farmacologia , Peso Molecular , Oligodesoxirribonucleotídeos/genética , Polímeros , Pirofosfatases/metabolismo , Especificidade por SubstratoRESUMO
The Protein Identification Resource (PIR) protein sequence data bank was searched for sequence similarity between known proteins and human DNA polymerase beta (Pol beta) or human terminal deoxynucleotidyltransferase (TdT). Pol beta and TdT were found to exhibit amino acid sequence similarity only with each other and not with any other of the 4750 entries in release 12.0 of the PIR data bank. Optimal amino acid sequence alignment of the entire 39-kDa Pol beta polypeptide with the C-terminal two thirds of TdT revealed 24% identical aa residues and 21% conservative aa substitutions. The Monte Carlo score of 12.6 for the entire aligned sequences indicates highly significant aa sequence homology. The hydropathicity profiles of the aligned aa sequences were remarkably similar throughout, suggesting structural similarity of the polypeptides. The most significant regions of homology are aa residues 39-224 and 311-333 of Pol beta vs. aa residues 191-374 and 484-506 of TdT. In addition, weaker homology was seen between a large portion of the 'nonessential' N-terminal end of TdT (aa residues 33-130) and the first region of strong homology between the two proteins (aa residues 31-128 of Pol beta and aa residues 183-280 of TdT), suggestive of genetic duplication within the ancestral gene. On the basis of nucleotide differences between conserved regions of Pol beta and TdT genes (aligned according to optimally aligned aa sequences) it was estimated that Pol beta and TdT diverged on the order of 250 million years ago, corresponding roughly to a time before radiation of mammals and birds.
Assuntos
DNA Nucleotidilexotransferase/genética , DNA Nucleotidiltransferases/genética , DNA Polimerase I/genética , Sequência de Aminoácidos , Evolução Biológica , Computadores , Humanos , Dados de Sequência Molecular , Método de Monte Carlo , Homologia de Sequência do Ácido Nucleico , Fatores de TempoRESUMO
A number of cytochemical parameters of the hemocytes of larval Galleria mellonella, an insect frequently used as a model by comparative cellular immunologists, are described. Cytochemical methods were used to quantify hemocyte granule-associated components, the results are compared to those obtained for leukocytes from higher animals. Granulocytes contained a population of nonlysosomal granules rich in mucopolysaccharide not seen in plasmatocytes. The numbers and dimensions of these granules showed a positive correlation to cell size, probably reflecting a developmental sequence in granulocyte maturation. Both granulocytes and plasmatocytes had other granules containing the typical lysosomal enzymes, acid phosphatase, beta-glucuronidase, esterase, and lysozyme. The nonlysosomal enzyme alkaline phosphatase was not found in Galleria hemocytes; it is also absent from vertebrate monocytes, macrophages, and immature polymorphonuclear leukocytes. Insect hemocytes appear to lack certain components of antibacterial systems typical of mammalian blood cells, such as H2O2-generating systems, cationic proteins, and myeloperoxidase. The bactericidal mechanisms of hemocytes probably involve lysozyme, as well as other biologically active cellular and humoral factors unique to insects.
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Células Sanguíneas/análise , Hemócitos/análise , Lepidópteros/citologia , Mariposas/citologia , Animais , Atividade Bactericida do Sangue , Granulócitos/análise , Granulócitos/enzimologia , Hemócitos/enzimologia , Hemócitos/fisiologia , Histocitoquímica , Larva , Leucócitos/enzimologia , Lisossomos/enzimologia , Coloração e RotulagemRESUMO
Massive cortical cataract was produced 15-30 days after a single injection of an overdose of sodium selenite into 14-day-old rats. Most of the cortical cataract appeared to be due to extensive liquefaction of cortical fibers. Water influx, following initial damage to the epithelium by selenium, and action of lens proteases were probable mechanisms for the extensive liquefaction. Remarkably, selenite cortical cataract spontaneously cleared after several months, restoring essentially normal cells to the epithelium and outer and mid-cortex. Major mechanisms for clearing probably involved: (1) removal of damaged proteins from the lens by extensive proteolysis; and (2) replacement of fibers by resumption of normal fibergenesis. The data emphasized the remarkable reparative potential of the lens, and indicated the usefulness of the selenite cortical cataract as a model to study such processes.
Assuntos
Catarata/induzido quimicamente , Selênio/farmacologia , Animais , Água Corporal/metabolismo , Catarata/metabolismo , Catarata/patologia , Cristalino/patologia , Tamanho do Órgão , Ratos , Ratos Endogâmicos , Remissão Espontânea , Ácido Selenioso , Fatores de TempoRESUMO
The purposes of these experiments were to measure the influence of 14 trace elements on cataractogenesis and to test if these trace elements could prevent cataracts induced by selenium. On days 5-9 postpartum, suckling white rats received daily subcutaneous injections of either selenium (0.15 mumoles Se, as Na2SeO3, per pup) or selenium plus one of 14 other trace elements (separate subcutaneous injection) at one to five times the molar concentration of selenium. The frequency and severity of cataracts at three locations in the lens were assessed by slit-lamp examination on day 26-28 postpartum. Seven ions were found to be effective in preventing selenium-induced cataracts (% protection): mercuric (100%), silver (80%), cyanide (75%), arsenite (75%), cadmium (60%), and cupric (44%). Tellurite ion offered only 20% protection, while ferrous, zinc, lead, chromic, molybdate, tungstate, and vanadate ions provided no protection against selenium-induced cataract. No significant differences were found between the concentration of selenium in the lenses of control and cataractous lenses when measured approximately three weeks after selenium injection. Except for selenium, none of the trace minerals alone caused cataracts under our experimental conditions. In addition to subcutaneous injection of selenium, oral administration of this element was also found to cause cataract. It was concluded that among the ions studied, selenite was a powerful and rapid promoter of nuclear cataract formation, and that the protection ions may serve as useful probes for elucidating the mechanism of selenium-induced cataracts.
Assuntos
Catarata/induzido quimicamente , Selênio/farmacologia , Oligoelementos/farmacologia , Administração Oral , Fatores Etários , Animais , Catarata/patologia , Catarata/prevenção & controle , Relação Dose-Resposta a Droga , Feminino , Injeções Subcutâneas , Cristalino/patologia , Tamanho do Órgão , Ratos , Ratos Endogâmicos , Ácido Selenioso , Selênio/administração & dosagemRESUMO
Lenses of cataract-webbed (cw) Peromyscus maniculatus were examined by electron microscopy and compared to age-matched normal deer mouse lenses. Precataractous lenses of offspring of cw/cw matings were examined and compared to early cataract development in the opposite eye of the same animal. The earliest ultrastructural change leading to disturbance of lens transparency was cell fusion and formation of fiber cell syncytia in the posterior subcapsular region. Fiber cells lost their regular hexagonal packing. Small osmiophilic densities on the plasma membrane coincided with many of the sites of cell confluency. Larger osmiophilic whorls were usually localized in ball-and-socket interlocking junctions after the opacity spread. Epithelial cells from the nasal ventral equator migrated to the posterior pole. Later when underlying cortical fibers ruptured, the migrated cells phagocytized lens proteins and incorporated them in acid-phosphatase positive lysosomes. Fiber cells 3 to 20 layers deep in the cortex of normal and cataractous lenses had acid phosphatase reaction product coating the plasma membrane; the possible significance of this finding is discussed. We postulate that this hereditary cataract results from a defect in turnover and control of plasma membrane components.
Assuntos
Catarata/patologia , Cristalino/ultraestrutura , Peromyscus/fisiologia , Fosfatase Ácida/análise , Animais , Catarata/enzimologia , Catarata/genética , Feminino , Cristalino/enzimologia , Masculino , Camundongos , Camundongos Endogâmicos , Microscopia Eletrônica , Tetróxido de ÓsmioRESUMO
A longitudinal biomicroscopic study of lenses and fundi of over 2,000 Peromyscus maniculatus (deer mice) which have cataracts as an autosomal recessive trait has been correlated with histologic development of cataracts. By selective breeding, early-onset cataracts (Type I), which are frequently associated with abnormal closure of the fetal fissure and hyaloid vascular abnormalities, have been separated from later-onset (Type II) cataracts, which are more heterogeneous. Type I cataracts occur in syndactylous deer mice, develop rapidly, and histologically may show backward migration of disrupted lens bow cells before lens opacity is apparent biomicroscopically. Posterior subcapsular cataracts then develop and spread centrally and inferonasally to the equatorial area and then to the entire equator. The nucleus opacifies in either a "shell" pattern or as isolated dots. Anterior cortical opacification progresses to mature cataract. Histologically, abnormal migration and proliferation of lens epithelium and enlargement and vacuolar degeneration of the basal (posterior) process of cortical lens fibers are early changes in Type I cataracts. Disruption of the lens bow with failure of differentiation and inward turning of lens epithelium to become lens fibers occurs concurrently. Type II cataracts may follow the developmental pattern of Type I but are rarely associated with severe hyaloid vascular abnormalities and progress more slowly. About 6% of animals develop diabetes, which is not associated with the cataract-webbed trait.
Assuntos
Catarata/genética , Olho/patologia , Peromyscus/genética , Animais , Catarata/complicações , Catarata/patologia , Coloboma/complicações , Complicações do Diabetes , Feminino , Masculino , Camundongos , Doenças do Nervo Óptico/complicaçõesRESUMO
This study was conducted to provide a description of calpain proteolytic enzyme (EC 3.4.22.17) in normal rat cornea and to document immunohistochemical changes in calpain distribution during maturation. Corneal soluble proteins were fractionated by diethylaminoethyl chromatography on high-performance liquid chromatography. Fractions were analyzed for calpain by enzyme-linked immunosorbent assay, immunoblotting, and caseinolytic enzyme activity with fluorescein isothiocyanate-labeled casein. Calpain II from the soluble fraction of 2-week-old and 3-month-old rat corneas eluted at a similar NaCl concentration (220-240 mmol/l) as calpain II from other tissues, was inhibited by E64, contained an 80-kilodalton subunit in immunoblots, and was present at specific activity of 473 units per gram of protein in 3-month-old rats and 801 units per gram of protein in 2-week-old rats. Calpain antigen also was present in the ethylenediaminetetraacetic acid and EGTA washed insoluble fraction of cornea. Calpain was found (by immunohistochemical analysis) in all layers of the epithelium but not in the stroma. Enzyme-linked immunsorbent assay, immunoblots, and immunohistochemical analysis showed that calpain in the whole cornea did not change with corneal maturation. It was hypothesized that calpain in the cornea may be involved in the turnover of epithelial cells during normal maturation.
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Calpaína/metabolismo , Córnea/enzimologia , Animais , Calpaína/isolamento & purificação , Cromatografia Líquida de Alta Pressão , Córnea/crescimento & desenvolvimento , Eletroforese em Gel de Poliacrilamida , Ensaio de Imunoadsorção Enzimática , Epitélio/enzimologia , Epitélio/crescimento & desenvolvimento , Imunofluorescência , Immunoblotting , Técnicas Imunoenzimáticas , Ratos , Ratos EndogâmicosRESUMO
Luminol-dependent chemiluminescence (LDCL) and nitroblue tetrazolium (NBT) reduction assays have been used to measure reactive oxygen intermediate (ROI) production by oyster (Crassostrea virginica) hemocytes, as well as ROI modulation caused by disease or exposure to environmental toxicants. However, ROI responses measured by these tests apparently vary considerably among other bivalve species. In all species tested, unstimulated hemocytes produced small quantities of ROIs. In C. virginica and Geukensia demissa phagocytosis or treatment with phorbol myristate acetate triggered significantly augmented, but kinetically dissimilar, ROI responses; however, no induction was recorded in two clam species (Mya arenaria and Mercenaria mercenaria). This was supported by both LDCL and NBT assays, measuring activity of the myeloperoxidase/hydrogen peroxide system and production of intracellular superoxide anion, respectively. The failure of the clams to respond to standard ROI-eliciting procedures is possibly indicative of interspecies differences in hemocyte-mediated antimicrobial defense mechanisms.
Assuntos
Hemócitos/metabolismo , Moluscos/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Animais , Medições Luminescentes , Nitroazul de Tetrazólio/metabolismoRESUMO
Luminol- and lucigenin-augmented chemiluminescence (CL) were used to evaluate the ability of Listonella (formerly Vibrio) anguillarum to stimulate the production of reactive oxygen species (ROS) by Crassostrea virginica hemocytes. Whereas heat-killed L. anguillarum stimulated hemocyte CL in the lucigenin system, viable L. anguillarum did not. Neither viable nor heat-killed bacteria stimulated hemocyte production of luminol CL. Metabolically active L. anguillarum generated ROS, as indicated by luminol and lucigenin CL. It is proposed that bacterial catalase suppressed hemocyte-derived luminol CL. L. anguillarum, which possesses the antioxidant enzyme catalase, suppressed luminol CL generated by zymosan-stimulated hemocytes. Conversely, the catalase negative bacterium Carnobacterium piscicola had no effect on hemocyte-derived luminol CL elicited by zymosan. The inability of viable L. anguillarum to stimulate hemocyte ROS production, as measured by CL, does not support the proposed role for ROS in hemocyte-mediated bactericidal activity.
Assuntos
Hemócitos/fisiologia , Ostreidae/imunologia , Espécies Reativas de Oxigênio/metabolismo , Vibrio/fisiologia , Animais , Medições Luminescentes , FagocitoseRESUMO
If reactive oxygen species (ROS) produced by hemocytes of the eastern oyster, Crassostrea virginica, impart bactericidal activity, exposure of hemocytes to bacteria should result in increased ROS generation. In an earlier study, this hypothesis was tested using luminol- and lucigenin-augmented chemiluminescence (CL) to measure ROS production. The bacterium Listonella anguillarum did not stimulate a net increase in hemocyte-derived CL, and it was suggested that bacterial antioxidants might suppress hemocyte CL. In the present study a comparison was made, under identical assay conditions, of the zymosan- and bacteria-enhanced luminol CL produced by eastern oyster hemocytes and by striped bass (Morone saxatilis) macrophages, for which L. anguillarum has been shown to be a stimulus in CL reactions. The response to zymosan produced by bass phagocytes was two orders of magnitude greater than that generated by eastern oyster hemocytes. Whereas an increase in net ROS production was not evident when oyster hemocytes were exposed to L. anguillarum, significant stimulation of striped bass macrophage-derived CL occurred. These data suggest that striped bass macrophages have a greater capacity to generate ROS than oyster hemocytes, enabling them to surpass the antioxidant capability of L. anguillarum and produce a luminol CL response.
Assuntos
Bass/imunologia , Ostreidae/imunologia , Fagócitos/imunologia , Espécies Reativas de Oxigênio/metabolismo , Animais , Hemócitos/imunologia , Medições Luminescentes , Macrófagos/imunologia , Vibrio/imunologia , Zimosan/imunologiaRESUMO
In order to better understand the interplay between metallothionein (MT) and reactive oxygen species (ROS) in oyster hemocytes, studies of the hydrogen peroxide (H2O2) scavenging properties of MT were carried out in a cell-free system. Mammalian MT is involved in protection against oxidative stress by virtue of its ability to scavenge free radicals; therefore, the H2O2 scavenging potentials of Crassostrea virginica and rabbit MTS were compared. Oyster and rabbit MTs showed similar dose-dependent suppression of H2O2-stimulated, luminol-augmented chemiluminescence (CL); the EC50 for CL (25 microM H2O2) was approximately 1.0 microM MT for both species. The interaction of ROS with MT in hemocytes could play a role in protection of the cells and surrounding tissues from oxidants associated with antimicrobial responses. Mobilization of bound zinc from MT by hemocyte-derived ROS may produce aberrant regulatory effects on various cellular processes. The data suggest that MT may be involved in immunoregulatory pathways in oyster hemocytes as a result of its ability to scavenge antimicrobial ROS.
Assuntos
Sequestradores de Radicais Livres/metabolismo , Hemócitos/fisiologia , Metalotioneína/fisiologia , Ostreidae/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Animais , Fígado/metabolismo , CoelhosRESUMO
A number of carcinogenic aromatic amines when activated by liver microsomes from a salamander, Ambystoma tigrinum, are mutagenic for Salmonella tester strains sensitive to frameshift mutagens. However, 2 polycyclic aromatic hydrocarbons (PAH) (benzo[alpha]pyrene (BaP) and perylene) that are rendered mutagenic by mammalian microsomes are not activated by Ambystoma mixed-function oxidases. BaP was chosen for study because it is a well-known environmental carcinogen; perylene, an isomer of BaP, has been implicated as a etiological agent in cutaneous neoplasia in Ambystoma. These results support the observation that amphibians are quite resistant to PAH carcinogenesis and suggest that aromatic amines may be more appropriate model carcinogens.
Assuntos
Carcinógenos/metabolismo , Microssomos Hepáticos/metabolismo , Testes de Mutagenicidade , Animais , Benzo(a)pireno , Benzopirenos/metabolismo , Biotransformação , Modelos Animais de Doenças , Oxigenases de Função Mista/metabolismo , Perileno/metabolismo , Ratos , Salmonella typhimurium/efeitos dos fármacos , Salmonella typhimurium/genética , UrodelosRESUMO
This double blind, placebo-controlled trial was designed to determine whether intervention with a stepped regimen of trimethoprim-sulfamethoxazole (TMP-SMX) and prednisone would prevent high risk children from developing chronic otitis media with effusion (OME) and recurrent acute otitis media. Forty-two children were enrolled, assigned to treatment with active drug or placebo and then examined at 2-week intervals. They received TMP-SMX (or placebo) during the first 2 weeks, TMP-SMX and prednisone (or placebo) during Weeks 3 and 4 for persistent OME and TMP-SMX (or placebo) for Weeks 5 and 6 if OME was still unresolved. After treatment 48% of active drug and 14% of placebo subjects resolved OME bilaterally (P less than 0.05). Active drug subjects also had fewer acute otitis media episodes than placebo subjects while receiving study treatment (P less than 0.01). Although this treatment regimen produced short term OME resolution, long term benefits were not demonstrated.
Assuntos
Otite Média com Derrame/prevenção & controle , Prednisona/uso terapêutico , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Criança , Pré-Escolar , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Lactente , Masculino , Fatores de Risco , Estatística como AssuntoRESUMO
Chronic otitis media with effusion (OME) has been observed in 10 to 20% of children following acute, symptomatic otitis media. To determine factors that place children at increased risk of chronic OME, we conducted a 6-week prospective study of 386 children who had 3 or more recent episodes of otitis media and who had middle ear effusion present for at least 2 weeks. Of these children 23% developed chronic OME (i.e. effusion lasting 8 continuous weeks or more), and 26% developed chronic OME complicated by acute, symptomatic otitis media. Predictors for chronic OME were (1) bilateral OME, (2) duration of effusion for greater than 2 weeks at enrollment and (3) day care attendance. Children with these 3 factors had twice the risk of developing chronic OME as children lacking all 3 factors. These risk factors can be used to target children for early, aggressive OME therapy.