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1.
Perfusion ; 39(1_suppl): 81S-94S, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38651582

RESUMEN

Extracorporeal Cardiopulmonary Resuscitation (ECPR) has potential benefits compared to conventional Cardiopulmonary Resuscitation (CCPR) in children. Although no randomised trials for paediatric ECPR have been conducted, there is extensive literature on survival, neurological outcome and risk factors for survival. Based on current literature and guidelines, we suggest recommendations for deployment of paediatric ECPR emphasising the requirement for protocols, training, and timely intervention to enhance patient outcomes. Factors related to outcomes of paediatric ECPR include initial underlying rhythm, CCPR duration, quality of CCPR, medications during CCPR, cannulation site, acidosis and renal dysfunction. Based on current evidence and experience, we provide an approach to patient selection, ECMO initiation and management in ECPR regarding blood and sweep flow settings, unloading of the left ventricle, diagnostics whilst on ECMO, temperature targets, neuromonitoring as well as suggested weaning and decannulation strategies.


Asunto(s)
Reanimación Cardiopulmonar , Oxigenación por Membrana Extracorpórea , Humanos , Oxigenación por Membrana Extracorpórea/métodos , Reanimación Cardiopulmonar/métodos , Niño , Preescolar , Lactante , Masculino , Femenino
2.
Dis Aquat Organ ; 152: 73-83, 2022 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-36453456

RESUMEN

The Critically Endangered southern corroboree frog Pseudophryne corroboree is dependent upon captive assurance colonies for its continued survival. Although the captive breeding programme for this species has largely been successful, embryonic mortality remains high (40-90% per year). This study aimed to investigate the causes of mortality in P. corroboree embryos in the captive collection at Melbourne Zoo. During the 2021 breeding season, we investigated 108 abnormal embryos to determine the impact of infections and anatomical deformities on survival and used culture and molecular methods to identify microbes. Overall, 100% of abnormal embryos had fungal infections, and of these, 41.6% also had anatomical deformities. The mortality rate in abnormal embryos was 89.8%; however, we detected no difference in survival in any of the 3 observed fungal growth patterns or between deformed and non-deformed embryos. Sanger sequencing of the ITS region identified fungal isolates belonging to the genus Ilyonectria, the first record in a vertebrate host, and another as a Plectosphaerella sp., which is the first record of infection in an embryo. Dominant bacteria identified were of the genera Herbaspirillum and Flavobacterium; however, their role in the mortality is unknown. Fungal infection and deformities have a significant impact on embryo survival in captive-bred P. corroboree. In a species which relies on captive breeding, identifying and reducing the impacts of embryonic mortality can inform conservation efforts and improve reintroduction outcomes.


Asunto(s)
Anuros , Flavobacterium , Animales , Estaciones del Año
3.
J Microsc ; 283(1): 3-8, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-33471944

RESUMEN

In the geometric optics approximation, an image formed by an objective lens replicates the distribution of intensity at the front focal plane of the objective. Although this fact represents a fundamental optical principle, its application to analysis of bright-field microscopic images was developed only recently and has not been tested experimentally. In this paper, we applied simple ray tracing to compute an image of a glass cylinder at various positions of the objective and to compare it to the experiment. We obtained a close match between theory and observation, except for a slight underestimation of the intensity in the middle part of the cylinder. The likely reason for this minor difference was constructive interference due to lens-like properties of a cylinder, which could not be accounted for by geometric approximation. We expect that such artefacts would be negligible in imaging of live cells, and the geometric approach would successfully complement the existing quantitative phase methods.


It has become customary to analyse microscopic images in terms of diffraction theory. However, when one is not interested in resolving fine details of an image, a much simpler and more intuitive geometric analysis based on ray tracing can be adequate. We applied geometric approach to analysis of bright-field images of a small glass cylinder at different positions of the objective. Such an object would be very difficult to analyse using diffraction theory because of its high refractive index and steep boundaries. However, ray tracing produced a good match between theory and experiment. It can become a promising approach in bright-field applications, such as quantitative phase imaging.

4.
Bull Entomol Res ; 109(1): 90-101, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29665868

RESUMEN

Diuraphis noxia (Kurdjumov), Russian wheat aphid, is one of the world's most invasive and economically important agricultural pests of wheat and barley. In May 2016, it was found for the first time in Australia, with further sampling confirming it was widespread throughout south-eastern regions. Russian wheat aphid is not yet present in New Zealand. The impacts of this pest if it establishes in New Zealand, could result in serious control problems in wheat- and barley-growing regions. To evaluate whether D. noxia could establish populations in New Zealand we used the climate modelling software CLIMEX to locate where potential viable populations might occur. We re-parameterised the existing CLIMEX model by Hughes and Maywald (1990) by improving the model fit using currently known distribution records of D. noxia, and we also considered the role of irrigation into the potential spread of this invasive insect. The updated model now fits the current known distribution better than the previous Hughes and Maywald CLIMEX model, particularly in temperate and Mediterranean areas in Australia and Europe; and in more semi-arid areas in north-western China and Middle Eastern countries. Our model also highlights new climatically suitable areas for the establishment of D. noxia, not previously reported, including parts of France, the UK and New Zealand. Our results suggest that, when suitable host plants are present, Russian wheat aphid could establish in these regions. The new CLIMEX projections in the present study are useful tools to inform risk assessments and target surveillance and monitoring efforts for identifying susceptible areas to invasion by Russian wheat aphid.


Asunto(s)
Distribución Animal , Áfidos , Clima , Modelos Biológicos , Riego Agrícola , Animales , Nueva Zelanda
5.
Psychol Med ; 48(7): 1119-1127, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-28874218

RESUMEN

BACKGROUND: The clinical care of psychiatric patients is often guided by perceptions of suicide risk. The aim of this study was to examine the methods and results of studies reporting high-risk models for inpatient suicide. METHODS: We conducted a registered meta-analysis according to PRISMA guidelines. We searched for relevant peer-reviewed cohort and controlled studies indexed in Medline, EMBASE and PsychINFO. RESULTS: The pooled odds ratio (OR) among 18 studies reporting high-risk models for inpatient suicide was 7.1 [95% confidence interval (CI) 4.2-12.2]. Between-study heterogeneity in ORs was very high (range 0-94.8, first quartile 3.4, median 8.8, third quartile 26.1, prediction interval 0.80-63.1, I2 = 88.1%). The meta-analytically derived sensitivity was 53.1% (95% CI 38.2-67.5%, I2 = 95.9%) and specificity was 84.2% (95% CI 71.6-91.9%, I2 = 99.9%) with an associated meta-analytic area under the curve of 0.83. The positive predictive value of risk categorization among six cohort studies was 0.43% (95% CI 0.014-1.3%, I2 = 95.9%). A history of suicidal behavior and depressive symptoms or affective disorder was included in the majority of high-risk models. CONCLUSIONS: Despite the strength of the pooled association between high-risk categorization and suicide, the very high degree of observed heterogeneity indicates uncertainty about our ability to meaningfully distinguish inpatients according to suicide risk. The limited sensitivity and low positive predictive value of risk categorization suggest that suicide risk models are not a suitable basis for clinical decisions in inpatient settings.


Asunto(s)
Pacientes Internos/psicología , Medición de Riesgo/métodos , Suicidio/psicología , Depresión , Humanos , Trastornos del Humor/psicología , Factores de Riesgo
6.
BMC Med Genet ; 18(1): 83, 2017 08 03.
Artículo en Inglés | MEDLINE | ID: mdl-28774260

RESUMEN

BACKGROUND: Inactivating mutations of CDC73 cause Hyperparathyroidism-Jaw Tumour syndrome (HPT-JT), Familial Isolated Hyperparathyroidism (FIHP) and sporadic parathyroid carcinoma. We conducted CDC73 mutation analysis in an HPT-JT family and confirm carrier status of the proband's daughter. METHODS: The proband had primary hyperparathyroidism (parathyroid carcinoma) and uterine leiomyomata. Her father and daughter had hyperparathyroidism (parathyroid adenoma) but no other manifestations of HPT-JT. CDC73 mutation analysis (sequencing of all 17 exons) and whole-genome copy number variation (CNV) analysis was done on leukocyte DNA of the three affecteds as well as the proband's unaffected sister. RESULTS: A novel deletion of exons 4 to 10 of CDC73 was detected by CNV analysis in the three affecteds. A novel insertion in the 5'UTR (c.-4_-11insG) that co-segregated with the deletion was identified. By in vitro assay the 5'UTR insertion was shown to significantly impair the expression of the parafibromin protein. Screening for the mutated CDC73 confirmed carrier status in the proband's daughter and the biochemistry and ultrasonography led to pre-emptive surgery and resolution of the hyperparathyroidism. CONCLUSIONS: A novel gross deletion mutation in CDC73 was identified in a three-generation HPT-JT family emphasizing the importance of including screening for large deletions in the molecular diagnostic protocol.


Asunto(s)
Adenoma/genética , Fibroma/genética , Hiperparatiroidismo/genética , Neoplasias Maxilomandibulares/genética , Eliminación de Secuencia , Proteínas Supresoras de Tumor/genética , Regiones no Traducidas 5' , Adenoma/patología , Adolescente , Adulto , Alelos , Animales , Secuencia de Bases , Niño , ADN/química , ADN/aislamiento & purificación , ADN/metabolismo , Variaciones en el Número de Copia de ADN , Exones , Femenino , Fibroma/patología , Pruebas Genéticas , Células HEK293 , Humanos , Hiperparatiroidismo/patología , Neoplasias Maxilomandibulares/patología , Leucocitos/metabolismo , Masculino , Persona de Mediana Edad , Linaje , Alineación de Secuencia , Proteínas Supresoras de Tumor/metabolismo , Adulto Joven
7.
Faraday Discuss ; 202: 483-496, 2017 09 21.
Artículo en Inglés | MEDLINE | ID: mdl-28671222

RESUMEN

Data-mining of Reaxys and network analysis of the combined literature and in-house reactions set were used to generate multiple possible reaction routes to convert a bio-waste feedstock, limonene, into a pharmaceutical API, paracetamol. The network analysis of data provides a rich knowledge-base for generation of the initial reaction screening and development programme. Based on the literature and the in-house data, an overall flowsheet for the conversion of limonene to paracetamol was proposed. Each individual reaction-separation step in the sequence was simulated as a combination of the continuous flow and batch steps. The linear model generation methodology allowed us to identify the reaction steps requiring further chemical optimisation. The generated model can be used for global optimisation and generation of environmental and other performance indicators, such as cost indicators. However, the identified further challenge is to automate model generation to evolve optimal multi-step chemical routes and optimal process configurations.

8.
Violence Vict ; 32(4): 627-641, 2017 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-28516851

RESUMEN

The purpose of this study was to examine intimate partner abuse (IPA), parental attachment, and romantic attachment among college women. More specifically, IPA was examined such that women who had experienced abuse and those who had not were compared with respect to parental and romantic attachment using the lens of attachment theory. Undergraduate women (N = 502) completed an online survey assessing their experiences of IPA as well as their parental and romantic attachment styles. Bivariate correlations demonstrated that IPA was significantly associated with all study variables (i.e., love withdrawal, care, and overprotection from both mother and father; romantic anxiety) in the hypothesized directions with the exception of romantic avoidance not being associated with abuse. Regarding the comparison of women who had experienced abuse (n = 367) to women who had not experienced abuse (n = 135), one-way analyses of variance (ANOVAs) revealed significant group mean differences in the hypothesized directions between abused and nonabused women with respect to love withdrawal and overprotection from both mothers and fathers, and romantic anxiety. In addition, psychological IPA and physical IPA were examined separately, yielding additional group differences regarding care from father and care from both mother and father, respectively. This work begins to examine attachment and IPA in new ways because it examines both parental attachment and romantic attachment in relation to IPA.


Asunto(s)
Mujeres Maltratadas/psicología , Violencia de Pareja/psicología , Relaciones Padres-Hijo , Adolescente , Adulto , Femenino , Humanos , Internet , Encuestas y Cuestionarios , Adulto Joven
9.
Acta Psychiatr Scand ; 133(6): 481-8, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-27059615

RESUMEN

OBJECTIVE: Data suggest that adherence to religious beliefs is associated with lower rates of suicide. A number of mediating factors have been hypothesized to explain this association, including enhanced social support, less substance abuse, and lower rates of psychopathology. METHOD: We utilized data from a two-phase population-based, epidemiological study of mental disorders among young Jewish Israel born in a 10-year birth-cohort conducted in the 1980s. This study included data on religiosity and suicidal behaviour. Twenty-five years thereafter, mortality data were obtained from a national vital statistics registry. RESULTS: Rates of suicidal ideation were similar among secular, partially observant, and religious subjects (9.4%, 6.7%, and 6.2%, respectively; adjusted OR for linear trend: 0.80, 95% CI: 0.58-1.09). Rates of suicide attempts were significantly lower among religious subjects (2.4%, 2.5%, and 0.4% for secular, partially observant, and religious, respectively; adjusted OR for linear trend: 0.62, 95% CI: 0.43-0.88). Of the 4914 subjects, eight died by suicide: Seven of them were secular and one was partially observant (χ(2) = 2.52, P = 0.09). There were no differences in social functioning or rates of psychopathology among the study groups. CONCLUSION: Religiosity has a protective effect against suicide attempts, which is independent of social functioning, psychopathology, and substance use.


Asunto(s)
Religión , Intento de Suicidio/prevención & control , Intento de Suicidio/psicología , Adulto , Femenino , Humanos , Israel , Masculino , Factores Protectores , Factores de Riesgo , Ideación Suicida , Encuestas y Cuestionarios
10.
Horm Metab Res ; 47(4): 280-3, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25011019

RESUMEN

Low vitamin D levels are associated with minority subjects, the metabolic syndrome, and inflammation. The effect of vitamin D supplementation on markers of inflammation has not been well studied. The aim of the study was to evaluate the effects of high doses of vitamin D supplementation for 1 year on serum biomarkers of inflammation in Latino and African-American subjects with pre-diabetes and hypovitaminosis D. Latino (n=69) and African-American (n=11) subjects who had both pre-diabetes and hypovitaminosis D with a mean age of 52.0 years, a BMI of 32.7 kg/m(2), and 70% of whom were females, were randomized to receive weekly doses (mean±SD) of vitamin D (85 300 IU±16 000) or placebo oil for 1 year. Serum levels of interleukin-6, tumor necrosis factor, highly sensitive C-reactive protein), plasminogen activator inhibitor 1, and insulin-like growth factor-1 were measured at baseline, 6, and 12 months. Serum 25-OH vitamin D levels of 22 ng/ml at baseline quickly rose to nearly 70 ng/ml in subjects receiving vitamin D and did not change in the placebo group. Two-way repeated measures ANOVA showed no differences between the 2 groups in any of the 5 selected parameters. High dose vitamin D supplementation for 1 year in minority subjects with pre-diabetes and hypovitaminosis D failed to affect serum biomarkers of inflammation.Clinical trial reg. no.: NCT00876928, clinicaltrials.gov.


Asunto(s)
Negro o Afroamericano , Hispánicos o Latinos , Inflamación/sangre , Estado Prediabético/sangre , Deficiencia de Vitamina D/sangre , Vitamina D/administración & dosificación , Adulto , Biomarcadores/sangre , Índice de Masa Corporal , Proteína C-Reactiva/análisis , Suplementos Dietéticos , Femenino , Humanos , Factor I del Crecimiento Similar a la Insulina/análisis , Interleucina-6/sangre , Masculino , Persona de Mediana Edad , Placebos , Inhibidor 1 de Activador Plasminogénico/sangre , Vitamina D/análogos & derivados , Vitamina D/sangre
11.
J Appl Microbiol ; 118(2): 326-42, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25431276

RESUMEN

AIMS: To evaluate susceptibility of Pseudomonas aeruginosa veterinary isolates to antibiotics and disinfectants. METHODS AND RESULTS: Pseudomonas aeruginosa isolates collected from dogs (n = 155) and other animals (n = 20) from sixteen states during 1994-2003 were tested for susceptibility. Most isolates were resistant to twenty-one antimicrobials tested, and the highest prevalence of resistance was to ß-lactams (93.8%) and sulphonamides (93.5%). Fluoroquinolone resistance did not increase from 1994 to 2003. Ciprofloxacin and enrofloxacin had a 5 and 16% prevalence of resistance, respectively, while sarafloxacin and nalidixic acid had a prevalence of resistance of 97 and 98%, respectively. Strains were pan-resistant to triclosan and chlorhexidine, were highly resistant to benzalkonium chloride and demonstrated high susceptibility to other disinfectants. Didecyldimethylammonium chloride was the most active ammonium chloride. Inducible resistance was observed to cetyl ammonium halides, chlorhexidine and benzyl ammonium chlorides, which formulate disinfectants used in veterinary clinics and dairies. Organic acid inhibition was associated with the dissociated acid species. CONCLUSIONS: Dissociated organic acids appear able to inhibit Ps. aeruginosa, and rates of fluoroquinolone resistance merit sustained companion animal isolate surveillance. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first report of Ps. aeruginosa susceptibility to 24 disinfectants and illustrates the high resistance of Ps. aeruginosa to both antibiotics and disinfectants.


Asunto(s)
Antibacterianos/farmacología , Desinfectantes/farmacología , Pseudomonas aeruginosa/efectos de los fármacos , Animales , Ciprofloxacina/farmacología , Perros , Farmacorresistencia Bacteriana , Enrofloxacina , Fluoroquinolonas/farmacología , Pseudomonas aeruginosa/aislamiento & purificación , beta-Lactamas
12.
Psychol Med ; 44(14): 3051-7, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25065575

RESUMEN

BACKGROUND: Previous studies have found that patients with schizophrenia are more likely to be violent than the general population. The aim of this study was to investigate the association between schizophrenia and violent crime in the Israeli population. METHOD: Using the Israeli Psychiatric Hospitalization Case Registry we identified 3187 patients with a discharge diagnosis of schizophrenia. For each proband we identified parents and siblings, and gender- and age-matched controls for patients, parents and siblings. Information on violent crimes was obtained from police records. RESULTS: Patients with schizophrenia were at increased risk for violent crimes compared with controls [odds ratio (OR) 4.3, 95% confidence interval (CI) 3.8-4.9], especially women (OR 9.9, 95% CI 6.2-15.7). Risk for violent crimes was higher among patients with co-morbid substance misuse than in patients without such co-morbidity (OR 5.1, 95% CI 4.2-6.3). CONCLUSIONS: The results of this study suggest that increased risk of violence is part of the clinical picture of schizophrenia and needs to be recognized as a legitimate, essential, aspect of clinical management.


Asunto(s)
Crimen/estadística & datos numéricos , Sistema de Registros/estadística & datos numéricos , Esquizofrenia/epidemiología , Violencia/estadística & datos numéricos , Adulto , Femenino , Humanos , Israel/epidemiología , Masculino , Riesgo , Adulto Joven
13.
Int J Clin Pract ; 68(8): 950-62, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24754872

RESUMEN

OBJECTIVE: To systematically review the evidence for health coaching for patients with low back pain and describe the diversity of health coach training and interventions. METHODS: Electronic databases Medline, CINAHL, EMBASE, PsycINFO, AMED and the Cochrane Central Register of Controlled Trials were searched to 24 June 2013 using individually devised strategies. Randomised or quasi randomised controlled trials (RCTs) of health coaching for adults with low back pain of any duration were considered. The overall quality of the body of evidence was assessed using the GRADE approach. Treatment effects were presented as the difference in mean scores with 95% confidence intervals and standardised mean difference at follow-up between health coaching and control groups. Health coaching interventions were compared narratively by their theoretical principles and the training and assessment of heath coaches. RESULTS: Five publications describing three RCTs and one cluster RCT met the criteria for review. A rating of very low was assigned to the body of evidence using the GRADE approach. One RCT found significant improvements in lifting capacity and exercise compliance in favour of the health coaching group at both follow-up points with a large and moderate standardised mean difference. All included studies based health coaching interventions on the transtheoretical model of change however, the content of counselling programmes varied between studies and measures of treatment fidelity were inconclusive. DISCUSSION: Variability in health coaching interventions and a lack of assessment of treatment fidelity in addition to the very low rating of the overall body of evidence identified in the current review renders any estimates of the effect of health coaching on low back pain uncertain. Well-designed RCTs of patients with sub-acute low back pain are required that incorporate clearly described protocols for health coaching interventions and include standardised measures of treatment fidelity.


Asunto(s)
Ejercicio Físico , Educación en Salud/métodos , Dolor de la Región Lumbar/terapia , Cooperación del Paciente/psicología , Humanos , Dolor de la Región Lumbar/psicología
14.
Br J Oral Maxillofac Surg ; 62(2): 197-202, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38320922

RESUMEN

While healthcare should not be compared to other high reliability organisations (HROs), many lessons, attitudes, and transferable practices can be applied and adapted from them to improve patient safety and team morale. Despite briefings improving both patient safety and effective team working, some in healthcare have not valued or actively engaged with them, deeming them to be irrelevant. In this pilot study we explored the experiences of, and attitudes to, briefings using a 10-question Survey Monkey. This was promoted during a human factors session at the 2023 Association of Surgeons in Training Conference (ASiT) and at a large NHS trust. Questions were asked about the number of briefings per day, attitudes, engagement, and respondents' attitudes to them. In total, 109 responses were received. A total of 85% reported at least one briefing on a normal operating day, 65% felt them to be interactive, 67% reported that briefings were led by the most senior surgical team member, and 58% lasted four minutes or more. Eighteen per cent of respondents felt they were of little benefit, and 56% did not routinely de-brief at the end of the day. This study has highlighted variable attitudes to team briefings, with some colleagues still seeing them as a 'tick box' exercise. While culture has changed following the introduction of the WHO checklist, the importance of active engagement and education to improve the delivery and value of effective briefings cannot be overestimated. It is also an opportunity to create a 'safe space' for team members and to confirm zero tolerance for any inappropriate behaviour, including sexual misconduct.


Asunto(s)
Quirófanos , Cirujanos , Humanos , Proyectos Piloto , Reproducibilidad de los Resultados , Grupo de Atención al Paciente
15.
Lung Cancer ; 191: 107543, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38569279

RESUMEN

BACKGROUND: Interest in hereditary lung cancer is increasing, in particular germline mutations in the Epidermal Growth Factor Receptor (EGFR) gene. We review the current literature on this topic, discuss risk of developing lung cancer, treatment and screening options and describe a family of 3 sisters with lung cancer and their unaffected mother all with a rare EGFR germline mutation (EGFR p.R776H). METHODS: We searched PubMed, Medline, Embase, the Cochrane Library, Google Scholar and scanned reference lists of articles. Search terms included "EGFR germline" and "familial lung cancer" or "EGFR familial lung cancer". We also describe our experience of managing a family with rare germline EGFR mutant lung cancer. RESULTS: Although the numbers are small, the described cases in the literature show several similarities. The patients are younger and usually have no or light smoking history. 50% of the patients were treated with a tyrosine kinase inhibitor (TKIs) with OS over six months. CONCLUSION: Although rare, germline p.R776H EGFR lung cancer mutations are over-represented in light or never smoking female patients who often also possess an additional somatic EGFR mutation. Treatment with TKIs appears suitable but further research is needed into the appropriate screening regime for unaffected carriers or light/never smokers.


Asunto(s)
Receptores ErbB , Mutación de Línea Germinal , Neoplasias Pulmonares , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/patología , Receptores ErbB/genética , Femenino , Persona de Mediana Edad , Adulto , Inhibidores de Proteínas Quinasas/uso terapéutico , Predisposición Genética a la Enfermedad , Linaje , Masculino , Anciano , Mutación
16.
Br J Anaesth ; 111(5): 703-10, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23748199

RESUMEN

Patients in Intensive Care Unit (ICU) often require sedatives which commonly include midazolam and the more recently developed α2-receptor agonist, dexmedetomidine. It was our aim to compare the sedative and clinical effectiveness of dexmedetomidine vs midazolam in adults admitted to ICU, using an objective appraisal of randomized control trials. Medline, Embase, SCOPUS, Web of Knowledge, Cinhal, the United States National Library of Medicine, and the Cochrane Database of Systematic Reviews were searched using keywords: 'dexmedetomidine', 'midazolam', and 'intensive care'. These were limited to human studies and adults (>18 yr old). Six randomized controlled trials were found and were critically appraised using a standardized appraisal method. Two papers described the time spent by each intervention group within a specified target sedation range and both found no statistically significant difference between midazolam and dexmedetomidine (P=0.18 and P=0.15). A third paper found no statistically significant difference in the length of time that patients were sedated within a target zone (P=0.445). Two additional pilot studies did not report P values as they were insufficiently statistically powered. A final paper found that, of the eight occasions measured, patients on dexmedetomidine were more often within the target sedation range than patients on midazolam. The sedative benefits of dexmedetomidine vs midazolam remain inconclusive. While some secondary outcomes showed clinical effectiveness of dexmedetomidine, more research is needed to validate the findings of these studies.


Asunto(s)
Sedación Consciente , Dexmedetomidina/uso terapéutico , Hipnóticos y Sedantes/uso terapéutico , Midazolam/uso terapéutico , Adulto , Cuidados Críticos , Femenino , Hemodinámica/fisiología , Humanos , Tiempo de Internación , Embarazo , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
17.
J Dairy Sci ; 96(4): 2705-2712, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23462178

RESUMEN

Mycotoxins are naturally occurring environmental contaminants recognized worldwide in a variety of food and feed products. Produced as secondary metabolites by filamentous fungi, mycotoxins can have acute and chronic effects. Differing seasonal weather patterns and harvesting and storage conditions put corn grain at high risk for mycotoxin contamination. The objective of this study was to assess the risk of mycotoxin exposure posed to California livestock from whole corn. Random samples (n=50) of whole corn were collected and analyzed for 6 different mycotoxins, including aflatoxins, fumonisins, ochratoxins, trichothecenes (deoxynivalenol and T-2 toxin), and zearalenone. The samples represented a cross section of the corn entering California from various corn-growing states (n=43) as well as additional samples from California-grown corn (n=7). The experiment was a randomized sampling design. Over the course of a 6-mo period, 16 trains in California (100-110 railcars) and 5 California grain elevators were randomly sampled. Aflatoxins were detected in 14 samples, with 1 sample containing a concentration of 41.3 µg/kg (as-is basis), which was above the action level of 20 µg/kg for corn fed to dairy cattle. The average concentration of aflatoxins for the 13 samples below the regulatory action level was 8.69 µg/kg (range 4.67 to 13.82 µg/kg). Deoxynivalenol was found in 15 samples and averaged 553 µg/kg (range 340 to 1,072 µg/kg), which was below the federal advisory level of 5,000 µg/kg for grain fed to dairy cattle. Fumonisins were found in 38 samples and averaged 1,687 µg/kg (range 435 to 4,843 µg/kg), which was below the federal guidance level of 30,000 µg/kg in corn for dairy cattle. Ochratoxins, T-2 toxins, and zearalenone were not detected in any samples of whole corn. Fumonisins were the most prevalent mycotoxins found.


Asunto(s)
Alimentación Animal/análisis , Contaminación de Alimentos/análisis , Micotoxinas/análisis , Zea mays/química , Aflatoxinas/análisis , Animales , California , Bovinos , Industria Lechera , Femenino , Fumonisinas/análisis , Ganado , Tricotecenos/análisis
18.
J Couns Psychol ; 60(2): 239-50, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23458607

RESUMEN

Whereas sexual objectification has most commonly been studied among women, recent calls by counseling psychologists have urged for an extension of objectification research to more fully include men (e.g., Heimerdinger-Edwards, Vogel, & Hammer, 2011). The present study examined the factor structure of the Interpersonal Sexual Objectification Scale (ISOS; Kozee, Tylka, Augustus-Horvath, & Denchik, 2007) with men. Specifically, analyses included exploratory factor analysis (EFA) with a sample of 287 college men and confirmatory factor analysis (CFA) with an independent sample of 221 college men. A correlated 3-factor structure was suggested by multiple criteria in EFA and was further confirmed by CFA with a bifactor model illustrating the most item variance associated with a general interpersonal sexual objectification dimension for men.


Asunto(s)
Identidad de Género , Relaciones Interpersonales , Personeidad , Sexismo/psicología , Estudiantes/psicología , Encuestas y Cuestionarios , Adolescente , Adulto , Imagen Corporal , Humanos , Individualidad , Masculino , Modelos Psicológicos , Psicometría/estadística & datos numéricos , Reproducibilidad de los Resultados , Autoimagen , Acoso Sexual , Adulto Joven
19.
Nat Genet ; 23(3): 333-7, 1999 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-10545952

RESUMEN

Mammalian cytochrome c oxidase (COX) catalyses the transfer of reducing equivalents from cytochrome c to molecular oxygen and pumps protons across the inner mitochondrial membrane. Mitochondrial DNA (mtDNA) encodes three COX subunits (I-III) and nuclear DNA (nDNA) encodes ten. In addition, ancillary proteins are required for the correct assembly and function of COX (refs 2, 3, 4, 5, 6). Although pathogenic mutations in mtDNA-encoded COX subunits have been described, no mutations in the nDNA-encoded subunits have been uncovered in any mendelian-inherited COX deficiency disorder. In yeast, two related COX assembly genes, SCO1 and SCO2 (for synthesis of cytochrome c oxidase), enable subunits I and II to be incorporated into the holoprotein. Here we have identified mutations in the human homologue, SCO2, in three unrelated infants with a newly recognized fatal cardioencephalomyopathy and COX deficiency. Immunohistochemical studies implied that the enzymatic deficiency, which was most severe in cardiac and skeletal muscle, was due to the loss of mtDNA-encoded COX subunits. The clinical phenotype caused by mutations in human SCO2 differs from that caused by mutations in SURF1, the only other known COX assembly gene associated with a human disease, Leigh syndrome.


Asunto(s)
Cardiomiopatías/genética , Deficiencia de Citocromo-c Oxidasa , Miocardio/patología , Enfermedades Neuromusculares/genética , Proteínas/genética , Secuencia de Aminoácidos , Secuencia de Bases , Cardiomiopatías/enzimología , Cardiomiopatías/patología , Proteínas Portadoras , Clonación Molecular , Secuencia Conservada/genética , Cisteína/genética , Cisteína/metabolismo , Análisis Mutacional de ADN , Complejo IV de Transporte de Electrones/metabolismo , Resultado Fatal , Femenino , Humanos , Lactante , Recién Nacido , Isoenzimas/química , Isoenzimas/genética , Isoenzimas/metabolismo , Masculino , Proteínas Mitocondriales , Chaperonas Moleculares , Datos de Secuencia Molecular , Mutación , Miocardio/enzimología , Miocardio/metabolismo , Enfermedades Neuromusculares/enzimología , Enfermedades Neuromusculares/patología , Polimorfismo de Longitud del Fragmento de Restricción , Proteínas/química , Proteínas/metabolismo , ARN Mensajero/análisis , ARN Mensajero/genética , Proteínas de Saccharomyces cerevisiae
20.
Violence Vict ; 28(1): 36-49, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23520831

RESUMEN

This study examined intimate partner violence (IPV) and objectification. Specifically, the associations between psychological and physical abuse and self-objectification, body surveillance, and body shame for college women were considered through the lens of objectification theory. Consistent with Hypothesis 1, bivariate correlations showed that more psychological abuse was associated with more self-objectification, more body surveillance, and more body shame. As well, more physical abuse was associated with more body surveillance and more body shame. However, when the unique effects of psychological and physical abuse were considered in a path model, the links between psychological abuse and objectification remained while the links between physical abuse and objectification became nonsignificant. In addition, consistent with Hypothesis 2 and the model proposed by objectification theory, body surveillance and the combined effect of self-objectification and body surveillance explained relations between psychological abuse and body shame. This work fills an important gap in the current literature because it is the only study to date that examines relations between both psychological and physical abuse and self-objectification, body surveillance, and body shame. Implications and future directions are discussed.


Asunto(s)
Imagen Corporal/psicología , Autoimagen , Parejas Sexuales/psicología , Vergüenza , Maltrato Conyugal/psicología , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Funciones de Verosimilitud , Medio Oeste de Estados Unidos , Teoría Psicológica
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