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1.
Trends Genet ; 40(9): 731-733, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39079786

RESUMEN

The gastric stomach is a hallmark of vertebrate evolution, yet is missing in nearly 25% of living fish species and some mammals. New work by Kato et al. shows how a cassette of genes relating to acid production, pepsins, cell adhesion, and developmental control are repeatedly lost in animals that have also lost their stomachs.


Asunto(s)
Peces , Estómago , Animales , Peces/genética , Peces/clasificación , Evolución Biológica
2.
Magn Reson Med ; 2024 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-39075868

RESUMEN

PURPOSE: To develop a framework for simultaneous three-dimensional (3D) mapping of T 1 $$ {\mathrm{T}}_1 $$ , T 2 $$ {\mathrm{T}}_2 $$ , and fat signal fraction in the liver at 0.55 T. METHODS: The proposed sequence acquires four interleaved 3D volumes with a two-echo Dixon readout. T 1 $$ {\mathrm{T}}_1 $$ and T 2 $$ {\mathrm{T}}_2 $$ are encoded into each volume via preparation modules, and dictionary matching allows simultaneous estimation of T 1 $$ {\mathrm{T}}_1 $$ , T 2 $$ {\mathrm{T}}_2 $$ , and M 0 $$ {M}_0 $$ for water and fat separately. 2D image navigators permit respiratory binning, and motion fields from nonrigid registration between bins are used in a nonrigid respiratory-motion-corrected reconstruction, enabling 100% scan efficiency from a free-breathing acquisition. The integrated nature of the framework ensures the resulting maps are always co-registered. RESULTS: T 1 $$ {\mathrm{T}}_1 $$ , T 2 $$ {\mathrm{T}}_2 $$ , and fat-signal-fraction measurements in phantoms correlated strongly (adjusted r 2 > 0 . 98 $$ {r}^2>0.98 $$ ) with reference measurements. Mean liver tissue parameter values in 10 healthy volunteers were 427 ± 22 $$ 427\pm 22 $$ , 47 . 7 ± 3 . 3 ms $$ 47.7\pm 3.3\;\mathrm{ms} $$ , and 7 ± 2 % $$ 7\pm 2\% $$ for T 1 $$ {\mathrm{T}}_1 $$ , T 2 $$ {\mathrm{T}}_2 $$ , and fat signal fraction, giving biases of 71 $$ 71 $$ , - 30 . 0 ms $$ -30.0\;\mathrm{ms} $$ , and - 5 $$ -5 $$ percentage points, respectively, when compared to conventional methods. CONCLUSION: A novel sequence for comprehensive characterization of liver tissue at 0.55 T was developed. The sequence provides co-registered 3D T 1 $$ {\mathrm{T}}_1 $$ , T 2 $$ {\mathrm{T}}_2 $$ , and fat-signal-fraction maps with full coverage of the liver, from a single nine-and-a-half-minute free-breathing scan. Further development is needed to achieve accurate proton-density fat fraction (PDFF) estimation in vivo.

3.
Eur J Pediatr ; 183(7): 2899-2904, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38609653

RESUMEN

School teachers are often inadequately prepared to use an adrenaline auto-injector (AAI), resulting in potentially dangerous treatment delays. The purpose of this study was to assess the observed competence, and self-reported confidence, of primary school teachers in the Republic of Ireland (RoI) to use an AAI. An evaluation of whether there was a link between confidence and competence was also assessed. Teachers from four primary schools in the RoI completed a questionnaire to assess their prior level of experience, training, and confidence levels with AAI administration. The four steps in administrating trainer AAI to a mannequin simulator were then assessed. A total of 61 teachers participated (out of a population of 80). The mean self-reported confidence was 1.82 out of 5 (SD = 0.96). There was no significant difference in confidence between trained and untrained participants (U = 240.5, NS). Participants who had received AAI administration training performed significantly more of the steps correctly (mean = 3.85, SD = 0.95) as compared to those who had received no training (mean = 2.97, SD = 1.10; U = 180.5, p = 0.008). There was no correlation between confidence in administrating AAI and the percentage of steps in the procedure performed correctly (rho = -0.17, NS).  Conclusion: Improvements in readiness to administer AAIs can be achieved through the application of more effective approaches to teaching clinical skills, changes to school policies and practices, and consideration of the design of AAIs in order to make their operation safer and simpler. It is important that teachers have the confidence and competence to safely administer an AAI. What is Known: • Poor ability in adrenaline auto-injector use seen across population groups-healthcare professionals, patients, carers, and school staff • Training in the use of adrenaline auto-injectors has positive impact on competency What is New: • Irish school teachers show poor levels of competency in adrenaline auto-injector use • No observed correlation between reported confidence and competency.


Asunto(s)
Epinefrina , Maestros , Humanos , Epinefrina/administración & dosificación , Irlanda , Femenino , Masculino , Maniquíes , Encuestas y Cuestionarios , Adulto , Autoadministración/instrumentación , Anafilaxia/tratamiento farmacológico , Instituciones Académicas , Competencia Profesional , Niño , Inyecciones Intramusculares/instrumentación , Formación del Profesorado/métodos , Persona de Mediana Edad
4.
Mol Genet Genomics ; 298(6): 1419-1434, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37690047

RESUMEN

Digestion is driven by digestive enzymes and digestive enzyme gene copy number can provide insights on the genomic underpinnings of dietary specialization. The "Adaptive Modulation Hypothesis" (AMH) proposes that digestive enzyme activity, which increases with increased gene copy number, should correlate with substrate quantity in the diet. To test the AMH and reveal some of the genetics of herbivory vs carnivory, we sequenced, assembled, and annotated the genome of Anoplarchus purpurescens, a carnivorous prickleback fish in the family Stichaeidae, and compared the gene copy number for key digestive enzymes to that of Cebidichthys violaceus, a herbivorous fish from the same family. A highly contiguous genome assembly of high quality (N50 = 10.6 Mb) was produced for A. purpurescens, using combined long-read and short-read technology, with an estimated 33,842 protein-coding genes. The digestive enzymes that we examined include pancreatic α-amylase, carboxyl ester lipase, alanyl aminopeptidase, trypsin, and chymotrypsin. Anoplarchus purpurescens had fewer copies of pancreatic α-amylase (carbohydrate digestion) than C. violaceus (1 vs. 3 copies). Moreover, A. purpurescens had one fewer copy of carboxyl ester lipase (plant lipid digestion) than C. violaceus (4 vs. 5). We observed an expansion in copy number for several protein digestion genes in A. purpurescens compared to C. violaceus, including trypsin (5 vs. 3) and total aminopeptidases (6 vs. 5). Collectively, these genomic differences coincide with measured digestive enzyme activities (phenotypes) in the two species and they support the AMH. Moreover, this genomic resource is now available to better understand fish biology and dietary specialization.


Asunto(s)
Carnivoría , Perciformes , Animales , Tripsina/metabolismo , Filogenia , alfa-Amilasas Pancreáticas/metabolismo , Peces , Dieta , Lipasa/metabolismo , Ésteres/metabolismo
5.
J Hered ; 114(1): 52-59, 2023 03 16.
Artículo en Inglés | MEDLINE | ID: mdl-36321765

RESUMEN

Pricklebacks (Family Stichaeidae) are generally cold-temperate fishes most commonly found in the north Pacific. As part of the California Conservation Genomics Project (CCGP), we sequenced the genome of the Monkeyface Prickleback, Cebidichthys violaceus, to establish a genomic model for understanding phylogeographic patterns of marine organisms in California. These patterns, in turn, may inform the design of marine protected areas using dispersal models based on forthcoming population genomic data. The genome of C. violaceus is typical of many marine fishes at less than 1 Gb (genome size = 575.6 Mb), and our assembly is near-chromosome level (contig N50 = 1 Mb, scaffold N50 = 16.4 Mb, BUSCO completeness = 93.2%). Within the context of the CCGP, the genome will be used as a reference for future whole genome resequencing projects, enhancing our knowledge of the population structure of the species and more generally, the efficacy of marine protected areas as a primary conservation tool across California's marine ecosystems.


Asunto(s)
Ecosistema , Perciformes , Animales , Genoma , Perciformes/genética , Peces/genética , Genómica , Cromosomas
6.
Artículo en Inglés | MEDLINE | ID: mdl-36646309

RESUMEN

Digestion and assimilation of nutrients and energy is central to survival. At its most basic level, investigations of digestion in animals must examine digestive efficiency, or how much of a given meal (i.e., energy) or a specific nutrient an organism can acquire from its food. There are many studies examining this in reptiles, but there is large variation in methodology, and thus, in the conclusions drawn from the gathered data. The majority rely on ratio-based analyses that can jeopardize the reliability of their findings. Therefore, we reviewed the literature to identify common themes in the digestive efficiency data on reptiles. Due to the sheer number of available studies, we largely focused on lizards, but included data on all reptilian groups. As an example of what the current data can reveal, we performed a meta-analysis of digestive efficiency in lizards as a function of temperature using regression analyses. We detected a weak positive trend of soluble carbohydrate digestibility as a function of temperature, but no similar trend in broad-scale digestive efficiency, and propose that these patterns be reevaluated with non-ratio data. We conclude with calls to end conducting analyses on ratios and instead employ covariate methods, for more studies of reptilian digestive efficiency and related processes using consistent methodology, more representation of each population (e.g., many studies focus on males only), and more detailed studies examining the effects of temperature on digestion (since the current data are inconclusive).


Asunto(s)
Digestión , Lagartos , Masculino , Animales , Digestión/fisiología , Reproducibilidad de los Resultados , Lagartos/fisiología , Temperatura , Dieta
7.
Artículo en Inglés | MEDLINE | ID: mdl-37625480

RESUMEN

What an animal ingests and what it digests can be different. Thus, we examined the nutritional physiology of Lumpenus sagitta, a member of the family Stichaeidae, to better understand whether it could digest algal components like its better studied algivorous relatives. Although L. sagitta ingests considerable algal content, we found little evidence of algal digestion. This fish species has a short gut that doesn't show positive allometry with body size, low amylolytic activity that actually decreases as the fish grow, no ontogenetic changes in digestive enzyme gene expression, elevated N-acetyl-glucosaminidase activity (indicative of chitin breakdown), and an enteric microbial community that is consistent with carnivory and differs from members of its family that consume and digest algae. Hence, we are left concluding that L. sagitta is not capable of digesting the algae it consumes, and instead, are likely targeting epibionts on the algae itself, and other invertebrates consumed with the algae. Our study expands the coverage of dietary and digestive information for the family Stichaeidae, which is becoming a model for fish digestive physiology and genomics, and shows the power of moving beyond gut content analyses to better understand what an animal can actually digest and use metabolically.


Asunto(s)
Carnivoría , Perciformes , Animales , Dieta , Fenómenos Fisiológicos del Sistema Digestivo , Tamaño Corporal
8.
Eur Respir J ; 60(5)2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-35728977

RESUMEN

BACKGROUND: Bronchiectasis can result from infectious, genetic, immunological and allergic causes. 60-80% of cases are idiopathic, but a well-recognised genetic cause is the motile ciliopathy, primary ciliary dyskinesia (PCD). Diagnosis of PCD has management implications including addressing comorbidities, implementing genetic and fertility counselling and future access to PCD-specific treatments. Diagnostic testing can be complex; however, PCD genetic testing is moving rapidly from research into clinical diagnostics and would confirm the cause of bronchiectasis. METHODS: This observational study used genetic data from severe bronchiectasis patients recruited to the UK 100,000 Genomes Project and patients referred for gene panel testing within a tertiary respiratory hospital. Patients referred for genetic testing due to clinical suspicion of PCD were excluded from both analyses. Data were accessed from the British Thoracic Society audit, to investigate whether motile ciliopathies are underdiagnosed in people with bronchiectasis in the UK. RESULTS: Pathogenic or likely pathogenic variants were identified in motile ciliopathy genes in 17 (12%) out of 142 individuals by whole-genome sequencing. Similarly, in a single centre with access to pathological diagnostic facilities, 5-10% of patients received a PCD diagnosis by gene panel, often linked to normal/inconclusive nasal nitric oxide and cilia functional test results. In 4898 audited patients with bronchiectasis, <2% were tested for PCD and <1% received genetic testing. CONCLUSIONS: PCD is underdiagnosed as a cause of bronchiectasis. Increased uptake of genetic testing may help to identify bronchiectasis due to motile ciliopathies and ensure appropriate management.


Asunto(s)
Bronquiectasia , Trastornos de la Motilidad Ciliar , Ciliopatías , Síndrome de Kartagener , Humanos , Mutación , Bronquiectasia/diagnóstico , Bronquiectasia/genética , Cilios , Trastornos de la Motilidad Ciliar/diagnóstico , Trastornos de la Motilidad Ciliar/genética , Ciliopatías/complicaciones , Síndrome de Kartagener/diagnóstico , Síndrome de Kartagener/genética
9.
Artículo en Inglés | MEDLINE | ID: mdl-35961610

RESUMEN

Alterations to ratios of protein and fiber in an organism's diet have been shown to structurally and functionally alter its individual digestive physiology. However, it is unclear how these dietary changes may affect phenotypic changes across generations. We utilized feeding trials, morphological analyses, enzyme activities, and 16S rRNA sequencing of the gut microbiome of zebrafish (Danio rerio) to determine how variations to fiber and protein concentrations, kept consistent across sequential generations, affect phenotypic changes. Our results show that Parental (P) and first generation (F1) fish did not differ from each other in terms of their intestine length, intestine mass, enzyme activity levels, and microbial community composition for any of the three experimental diets (high-protein/low-fiber, moderate-protein/fiber, and low-protein/high-fiber). However, each of the three experimental diets for the P and F1 fish, as well as the ancestral diet fish, did have distinct microbial community structure from one another. This indicates that there is a strong dietary effect on digestive physiology and gut microbial community and that these effects are consistent when the diet is kept homogenous across generations.


Asunto(s)
Microbioma Gastrointestinal , Pez Cebra , Animales , Dieta , Fibras de la Dieta , Fenómenos Fisiológicos del Sistema Digestivo , ARN Ribosómico 16S/genética , Pez Cebra/genética
10.
Artículo en Inglés | MEDLINE | ID: mdl-35537602

RESUMEN

Abalone around the world are subject to increasing frequency of marine heatwaves, yet we have a limited understanding of how acute high temperature events impact the physiology of these commercially and ecologically important species. This study examines the impact of a 5 °C temperature increase over ambient conditions for six weeks on the metabolic rates, digestive enzyme activities in the digestive gland, and digestive efficiency of Red Abalone (Haliotis rufescens) and Paua (H. iris) on their natural diets. We test the hypothesis that abalone digestive function can keep pace with this increased metabolic demand in two separate experiments, one for each species. H. iris had higher food intake in the heat treatment. Both species had higher metabolic rates in the heat treatment with Q10 = 1.73 and Q10 = 2.46 for H. rufescens and H. iris, respectively. Apparent organic matter digestibility, protein digestibility, and carbohydrate digestibility did not differ between the heat treatment and the ambient (control) treatment in either experiment. H. rufescens exhibited higher maltase, alanine-aminopeptidase, and leucine-aminopeptidase activities in the heat treatment. Amylase, ß-glucosidase, trypsin, and alkaline phosphatase activities in the digestive gland tissue did not differ between temperature treatments. H. iris exhibited lower amylase and ß-glucosidase activities in the heat treatment, while maltase, trypsin, leucine-aminopeptidase, and alkaline phosphatase activities did not differ between treatments. We conclude that over six weeks of moderate heat stress both abalone species were able to maintain digestive function, but achieved this maintenance in species-specific ways.


Asunto(s)
Celulasas , Gastrópodos , Fosfatasa Alcalina/metabolismo , Aminopeptidasas/metabolismo , Amilasas/metabolismo , Animales , Celulasas/metabolismo , Gastrópodos/metabolismo , Respuesta al Choque Térmico , Leucina/metabolismo , Tripsina/metabolismo , alfa-Glucosidasas/metabolismo
11.
Proc Biol Sci ; 288(1955): 20211359, 2021 07 28.
Artículo en Inglés | MEDLINE | ID: mdl-34284626

RESUMEN

Looking to nature for inspiration has led to many diverse technological advances. The spiral valve intestine of sharks has provided the opportunity to observe the efficiency of different valve systems. It is supposed that the spiral intestine present in sharks, skates and rays slows the transit rate of digesta through the gut and provides increased surface area for the absorption of nutrients. In this investigation, we use a novel technique-creating three-dimensional reconstructions from CT scans of spiral intestines-to describe the morphology of the spiral intestine of at least one species from 22 different shark families. We discuss the morphological data in an evolutionary, dietary and functional context. The evolutionary analyses suggest that the columnar morphology is the ancestral form of the spiral intestine. Dietary analyses reveal no correlation between diet type and spiral intestine morphology. Flow rate was slowed significantly more when the two funnel-shaped spiral intestines were subjected to flow in the posterior to anterior direction, indicating their success at producing unidirectional flow, similar to a Tesla valve. These data are available to generate additional three-dimensional morphometrics, create computational models of the intestine, as well as to further explore the function of the gastrointestinal tract of sharks in structural and physiological contexts.


Asunto(s)
Tiburones , Rajidae , Animales , Evolución Biológica , Tracto Gastrointestinal , Humanos , Intestinos
12.
Proc Biol Sci ; 287(1921): 20192327, 2020 02 26.
Artículo en Inglés | MEDLINE | ID: mdl-32070255

RESUMEN

Adopting a new diet is a significant evolutionary change, and can profoundly affect an animal's physiology, biochemistry, ecology and genome. To study this evolutionary transition, we investigated the physiology and genomics of digestion of a derived herbivorous fish, Cebidichthys violaceus. We sequenced and assembled its genome (N50 = 6.7 Mb) and digestive transcriptome, and revealed the molecular changes related to digestive enzymes (carbohydrases, proteases and lipases), finding abundant evidence of molecular adaptation. Specifically, two gene families experienced expansion in copy number and adaptive amino acid substitutions: amylase and carboxyl ester lipase (cel), which are involved in the digestion of carbohydrates and lipids, respectively. Both show elevated levels of gene expression and increased enzyme activity. Because carbohydrates are abundant in the prickleback's diet and lipids are rare, these findings suggest that such dietary specialization involves both exploiting abundant resources and scavenging rare ones, especially essential nutrients, like essential fatty acids.


Asunto(s)
Adaptación Fisiológica/fisiología , Dieta , Peces/fisiología , Herbivoria , Adaptación Fisiológica/genética , Animales , Digestión/fisiología , Genómica
13.
Proc Biol Sci ; 285(1886)2018 09 05.
Artículo en Inglés | MEDLINE | ID: mdl-30185641

RESUMEN

What an animal consumes and what an animal digests and assimilates for energetic demands are not always synonymous. Sharks, uniformly accepted as carnivores, have guts that are presumed to be well suited for a high-protein diet. However, the bonnethead shark (Sphyrna tiburo), which is abundant in critical seagrass habitats, has been previously shown to consume copious amounts of seagrass (up to 62.1% of gut content mass), although it is unknown if they can digest and assimilate seagrass nutrients. To determine if bonnetheads digest seagrass nutrients, captive sharks were fed a 13C-labelled seagrass diet. Digestibility analyses, digestive enzyme assays and stable isotope analyses were used to determine the bonnethead shark's capacity for digesting and assimilating seagrass material. Compound-specific stable isotope analysis showed that sharks assimilated seagrass carbon (13.6 ± 6.77‰ δ13C mean ± s.d. for all sharks and all amino acid types analysed) with 50 ± 2% digestibility of seagrass organic matter. Additionally, cellulose-component-degrading enzyme activities were detected in shark hindguts. We show that a coastal shark is digesting seagrass with at least moderate efficiency, which has ecological implications due to the stabilizing role of omnivory and nutrient transport within fragile seagrass ecosystems.


Asunto(s)
Alismatales/química , Fenómenos Fisiológicos Nutricionales de los Animales , Digestión , Tiburones/fisiología , Animales , Isótopos de Carbono/análisis , Cadena Alimentaria , Nutrientes/metabolismo
14.
World J Surg ; 42(2): 514-520, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-29124354

RESUMEN

INTRODUCTION: The parathyroid gland was first identified in the Indian rhinoceros in 1849 by Sir Richard Owen. We performed a necropsy in an Indian rhinoceros, recapitulating Owen's dissection and display what appear to be the initial identification of the recurrent laryngeal nerve in situ and the anatomy and histology of the largest rhinoceros parathyroid glands yet identified. MATERIALS AND METHODS: Patrick T. Rhino, a 41-year-old Indian rhinoceros was born in 1974. His early years were unremarkable. In 2006, he was donated to White Oak Conservation in Yulee, Florida, where he bred and sustained minor injuries. In his geriatric years, he developed a cataract and degenerative joint disease (DJD). At age 41, he developed progressive ataxia and lameness and was euthanized to minimize suffering when he was unable to stand. ROS, FH, SH and medication history were unremarkable. Physical exam was age and species appropriate. Pre-mortem serum demonstrated: creat 1.8 mg/dL (0.8-2.1), calcium 10.6 mg/dL (9.7-13.1), phos 3.8 mg/dL (2.5-6.7), alk phos 69 U/L (26-158) and intact PTH 44.1 pg/mL (rhinoceros reference range: unknown). Necropsy revealed intervertebral DJD with thoracic spondylosis, which combined with osteoporosis, resulted in thoracic myelopathy and ataxia. The neck block was sent in formalin to the Yale University School of Medicine. RESULTS: Detailed dissection was performed under loupe magnification. Presumed structures were photographed in situ and biopsied. The thyroid was identified deep to the strap muscles, received its blood supply from the inferior and superior thyroid arteries and was blue in color. The right recurrent laryngeal nerve, identified and photographed in situ for the first time in the rhinoceros, was deep to the inferior thyroid artery and was traced throughout its cervical course. Single parathyroid glands identified on the lateral thyroid lobes received their blood supply from the inferior thyroid arteries and were confirmed histologically. They appear to be the largest parathyroids yet identified in the rhinoceros with estimated weights of 6,280 and 11,000 mg, respectively. Although the etiology of the parathyroid gland enlargement is unknown, the specimen has been preserved recapitulating the dissection performed by Sir Richard Owen. CONCLUSION: The parathyroids, thyroid and recurrent laryngeal nerve were identified in an Indian rhinoceros. This appears to be the first display of the rhinoceros recurrent laryngeal nerve in situ, and the parathyroid glands are the largest yet identified in the rhinoceros.


Asunto(s)
Glándulas Paratiroides/anatomía & histología , Perisodáctilos/anatomía & histología , Nervio Laríngeo Recurrente/anatomía & histología , Glándula Tiroides/anatomía & histología , Animales , Autopsia , Biopsia , Disección , Masculino
16.
J Fish Biol ; 93(2): 282-289, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29956315

RESUMEN

Apparent egg cannibalism was investigated in the beach-spawning California grunion Leuresthes tenuis. Three hypotheses were tested to determine whether L. tenuis regularly consumes and efficiently digests conspecific eggs. First, examination of the gut contents of adults collected at four spawning sites over two seasons showed that the intestines of most fish from all the sites (57-87%, n ≥ 30, each site) contained L. tenuis eggs. The two other hypotheses focused on digestion of the eggs. First, the force required to crush cannibalized eggs was significantly less than that for uncannibalized eggs (fertilized or unfertilized), indicating that ingestion weakens the egg chorions. Second, conspecific eggs fed to fish held in the laboratory visibly degraded as they passed through the gut. The eggs lost c. half of their protein content and about two-thirds of their lipid content as they passed from proximal to distal regions of the gut, indicating that digestion occurred. Digestive enzyme activities of the gut further confirmed that L. tenuis can break down the contents of ingested eggs. Trypsin activity decreased and aminopeptidase activity increased posteriorly along the gut, whereas amylase and lipase activities exhibited less clear patterns by gut region. As far as is known, this study is the first to show that L. tenuis is an egg cannibal.


Asunto(s)
Canibalismo , Digestión , Ingestión de Alimentos , Peces , Óvulo , Animales , California , Femenino , Masculino , Estaciones del Año
18.
Intern Med J ; 46(7): 812-8, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27087277

RESUMEN

BACKGROUND: The new oral anticoagulants (NOAC) have been extensively studied in the clinical trial setting; however, concerns remain about the safety of prescribing in the elderly and patients with renal impairment. AIM: The aim of this study was to assess the appropriateness of NOAC prescribing in a real-world setting in terms of patient selection and to compare patient demographics to those included in pivotal clinical trials. METHODS: One hundred and seventy-six patients from three tertiary university teaching hospitals were identified over 3 months in 2014. RESULTS: Median age of the cohort was 74 years (interquartile range: 61-81 years), with a range of 23-96 years. Overall, 34% of the study population were prescribed a NOAC inappropriately. Of these, treatment was contraindicated in 40%, predominantly due to severe renal impairment, 22% were prescribed an excessively high dose, while 38% were under dosed. Although community-initiated patients had poorer renal function (glomerular filtration rate 91.7 ± 55.7 vs 69.3 ± 38.9, P = 0.024), appropriateness of prescription was no different compared to hospital-initiated patients (78% during admission cf. 61% prior, P = 0.061). Appropriate prescribing was better in patients with venous thromboembolism compared to AF (85% appropriate cf. 60%, P = 0.021). CONCLUSION: Our findings imply that there remains considerable uncertainty about appropriate prescribing and dosing of NOAC, particularly in patients with impaired renal function. We recommend judicious prescribing and regular monitoring of renal function in patients at high risk of complications from NOAC therapy.


Asunto(s)
Anticoagulantes/uso terapéutico , Fibrilación Atrial/tratamiento farmacológico , Prescripción Inadecuada/estadística & datos numéricos , Insuficiencia Renal/complicaciones , Tromboembolia Venosa/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Anticoagulantes/administración & dosificación , Australia , Contraindicaciones , Femenino , Tasa de Filtración Glomerular , Hospitalización , Hospitales de Enseñanza , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
19.
Oecologia ; 177(1): 245-57, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25430044

RESUMEN

A trophic niche shift can occur as an adaptive response to environmental change such as altered resource quality, abundance or composition. Alterations in digestive traits such as gut morphology and physiology may enable these niche shifts and affect the persistence of populations and species. Relatively few studies, however, have assessed how niche shifts influence suites of digestive traits through phenotypic plasticity and evolutionary mechanisms, and how these trait changes can subsequently alter the nutrition, fitness and life history of organisms. We investigated how population divergence and plasticity alter the gut physiology of wild Trinidadian guppies (Poecilia reticulata), assessing whether variation in digestive traits correspond with enhanced nutrient assimilation under a pronounced dietary shift. We examined gut enzyme activity, and gut size and mass of wild guppies from both high-predation (HP) and low-predation (LP) habitats when reared in the laboratory and fed on high- or low-quality diets designed to reflect their dietary differences previously found in nature. After 10 weeks on the experimental diets, HP guppies maintained shorter and lighter guts than LP guppies on either diet. Guppies also differed in their digestive enzymatic profiles, more often reflecting nutrient balancing so that increased enzyme expression tended to correspond with more deficient nutrients in the diet. LP guppies had increased somatic phosphorus at the end of the experiment, possibly related to the higher alkaline phosphatase activity in their guts. Our results suggest that differences in gut physiology exist among populations of Trinidadian guppies that may reflect local adaptation to their disparate environments.


Asunto(s)
Adaptación Fisiológica , Dieta , Digestión , Ecosistema , Estado Nutricional , Poecilia/fisiología , Conducta Predatoria , Adaptación Fisiológica/genética , Fosfatasa Alcalina/metabolismo , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Evolución Biológica , Composición Corporal , Digestión/genética , Tracto Gastrointestinal/anatomía & histología , Tracto Gastrointestinal/enzimología , Fenotipo , Trinidad y Tobago
20.
Artículo en Inglés | MEDLINE | ID: mdl-26239220

RESUMEN

Few investigations have studied digestive enzyme activities in the alimentary tracts of sharks to gain insight into how these organisms digest their meals. In this study, we examined the activity levels of proteases, carbohydrases, and lipase in the pancreas, and along the anterior intestine, spiral intestine, and colon of the bonnethead shark, Sphyrna tiburo. We then interpreted our data in the context of a rate-yield continuum to discern this shark's digestive strategy. Our data show anticipated decreasing patterns in the activities of pancreatic enzymes moving posteriorly along the gut, but also show mid spiral intestine peaks in aminopeptidase and lipase activities, which support the spiral intestine as the main site of absorption in bonnetheads. Interestingly, we observed spikes in the activity levels of N-acetyl-ß-D-glucosaminidase and ß-glucosidase in the bonnethead colon, and these chitin- and cellulose-degrading enzymes, respectively, are likely of microbial origin in this distal gut region. Taken in the context of intake and relatively long transit times of food through the gut, the colonic spikes in N-acetyl-ß-D-glucosaminidase and ß-glucosidase activities suggest that bonnetheads take a yield-maximizing strategy to the digestive process, with some reliance on microbial digestion in their hindguts. This is one of the first studies to examine digestive enzyme activities along the gut of any shark, and importantly, the data match with previous observations that sharks take an extended time to digest their meals (consistent with a yield-maximizing digestive strategy) and that the spiral intestine is the primary site of absorption in sharks.


Asunto(s)
Digestión/fisiología , Sistema Digestivo/metabolismo , Microbiota/fisiología , Tiburones/fisiología , Acetilglucosaminidasa/metabolismo , Aminopeptidasas/metabolismo , Animales , Metabolismo de los Hidratos de Carbono , Colon/enzimología , Colon/metabolismo , Colon/microbiología , Sistema Digestivo/enzimología , Sistema Digestivo/microbiología , Mucosa Intestinal/metabolismo , Intestinos/enzimología , Intestinos/microbiología , Lipasa/metabolismo , Páncreas/enzimología , Páncreas/metabolismo , Péptido Hidrolasas/metabolismo , Tiburones/metabolismo , Tiburones/microbiología , Factores de Tiempo , beta-Glucosidasa/metabolismo
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