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1.
Heliyon ; 10(3): e25789, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38352775

RESUMO

Tickborne diseases (TBDs) are increasingly prevalent in Illinois and the Upper Midwest region. People who work in occupations that require time outdoors in agricultural or natural settings, such as some Extension workers, are at risk of tick bites and TBDs. Additionally, Extension workers are often a primary source of information about ticks and TBDs in rural communities. However, there is limited information on the level of awareness about ticks and TBDs in the Extension community. The goals of this study were to sequentially i) determine the baseline awareness of Extension workers in Illinois about ticks and TBDs using a knowledge, attitudes, and practices (KAP) survey tool, ii) provide comprehensive training on ticks and TBDs to this demographic, and iii) measure the uptake of knowledge after the training intervention through a post-training survey. The study period was from June 2022 until May 2023. We received 233 pre-training and 93 paired post-training survey responses. Most survey respondents were Extension volunteers, identified as women, and were over 50 years old. Knowledge about ticks and TBDs varied. We identified several gaps in their current tick awareness, most importantly, in tick prevention measures, tick identification, and TBDs in general. TBD knowledge, attitude, and practice scores all significantly improved after training (p < 0.001), with a mean difference of 10.47, 1.49, and 2.64 points, respectively. Additionally, both Extension professionals (79.2 %) and Extension volunteers (66.7 %) were more likely to feel confident in engaging with their stakeholders on ticks and TBDs after participating in training. Poisson models revealed that higher attitude and practice scores and greater self-reported knowledge were the factors most significantly associated with higher TBD knowledge. We found that greater concern for ticks and TBD (attitudes) and adherence to science-based prevention and management methods (practices) were also associated with higher knowledge scores. To our knowledge, this is the first study in Illinois to capture Extension workers' awareness of ticks and TBDs. The results highlight Extension workers' interest in filling knowledge gaps through learning, and the importance of training Extension workers to disseminate reliable and updated information on ticks and TBDs to their constituents, a critical step in preventing TBDs.

2.
Sci Rep ; 13(1): 1428, 2023 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-36697468

RESUMO

The ongoing COVID-19 pandemic is among the worst in recent history, resulting in excess of 520,000,000 cases and 6,200,000 deaths worldwide. The United States (U.S.) has recently surpassed 1,000,000 deaths. Individuals who are elderly and/or immunocompromised are the most susceptible to serious sequelae. Rising sentiment often implicates younger, less-vulnerable populations as primary introducers of COVID-19 to communities, particularly around colleges and universities. Adjusting for more than 32 key socio-demographic, economic, and epidemiologic variables, we (1) implemented regressions to determine the overall community-level, age-adjusted COVID-19 case and mortality rate within each American county, and (2) performed a subgroup analysis among a sample of U.S. colleges and universities to identify any significant preliminary mitigation measures implemented during the fall 2020 semester. From January 1, 2020 through March 31, 2021, a total of 22,385,335 cases and 374,130 deaths were reported to the CDC. Overall, counties with increasing numbers of university enrollment showed significantly lower case rates and marginal decreases in mortality rates. County-level population demographics, and not university level mitigation measures, were the most significant predictor of adjusted COVID-19 case rates. Contrary to common sentiment, our findings demonstrate that counties with high university enrollments may be more adherent to public safety measures and vaccinations, likely contributing to safer communities.


Assuntos
COVID-19 , Humanos , Estados Unidos/epidemiologia , Idoso , COVID-19/epidemiologia , Universidades , Pandemias , Estudos Longitudinais , Progressão da Doença
3.
J Med Entomol ; 59(2): 700-709, 2022 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-34875079

RESUMO

The range of ticks in North America has been steadily increasing likely, in part, due to climate change. Along with it, there has been a rise in cases of tick-borne disease. Among those medically important tick species of particular concern are Ixodes scapularis Say (Acari: Ixodidae), Dermacentor variabilis Say (Acari: Ixodidae), and Amblyomma americanum Linneaus (Acari: Ixodidae). The aim of this study was to determine if climate factors explain existing differences in abundance of the three aforementioned tick species between two climatically different regions of Illinois (Central and Southern), and if climate variables impact each species differently. We used both zero-inflated regression approaches and Bayesian network analyses to assess relationships among environmental variables and tick abundance. Results suggested that the maximum average temperature and total precipitation are associated with differential impact on species abundance and that this difference varied by region. Results also reinforced a differential level of resistance to desiccation among these tick species. Our findings help to further define risk periods of tick exposure for the general public, and reinforce the importance of responding to each tick species differently.


Assuntos
Ixodes , Ixodidae , Amblyomma , Animais , Teorema de Bayes , Illinois
4.
Aust Vet J ; 99(12): 541-546, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34569052

RESUMO

Objective comparative evidence of the time to onset and duration of effect provided by local anaesthetic (LA) agents for perineural blocks in the horse is lacking. Clear knowledge of these properties is required to guide clinically appropriate agent selection and aid interpretation of response to diagnostic blocks for lameness examinations. An interventional study, with complete, randomised crossover design was used to compare time to onset and duration of skin desensitisation provided by four LA agents applied to palmar digital nerve blocks in 12 horses. Effect at each time point was determined using a pressure gauge to measure the mechanical nociceptive threshold (MNT) over the heel bulbs. Complete desensitisation was defined when MNT was greater than four times the pre-block baseline. Onset and duration of complete desensitisation were recorded and compared across agents using a mixed linear model. When significant (P ≤ 0.05), post-hoc paired comparisons between agents were performed against a Tukey's corrected P ≤ 0.05. Onset of complete skin desensitisation for each agent was <5 min. Duration for lidocaine (mean 25 min; 95% confidence interval [CI] 9-42) was shorter than bupivacaine (53 min; 95% CI 39-65), which was shorter than both prilocaine (102 min; 95% CI 81-123) and mepivacaine (107 min; 95% CI 92-121), which were not different. Although onset of complete skin desensitisation was not different for the LA agents tested, duration varied from 25 min to nearly 2 h. Prilocaine and mepivacaine provided the most prolonged duration of effect, both exceeding bupivacaine.


Assuntos
Mepivacaína , Bloqueio Nervoso , Anestésicos Locais/efeitos adversos , Animais , Bupivacaína , Cavalos , Lidocaína/efeitos adversos , Bloqueio Nervoso/veterinária , Prilocaína
5.
Methods Mol Biol ; 2276: 397-407, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34060057

RESUMO

Caenorhabditis elegans is a highly versatile model system, intensively used for functional, genetic, cytometric, and integrative studies. Due to its simplicity and large muscle cell number, C. elegans has frequently been used to study mitochondrial deficiencies caused by disease or drug toxicity. Here we describe a robust and efficient method to visualize and quantify mitochondrial morphology in vivo. This method has many practical and technical advantages above traditional (manual) methods and provides a comprehensive analysis of mitochondrial morphology.


Assuntos
Caenorhabditis elegans/ultraestrutura , Proteínas de Fluorescência Verde/metabolismo , Processamento de Imagem Assistida por Computador/métodos , Microscopia Intravital/métodos , Microscopia Confocal/métodos , Mitocôndrias/ultraestrutura , Animais , Caenorhabditis elegans/citologia , Caenorhabditis elegans/metabolismo , Mitocôndrias/metabolismo
6.
PLoS One ; 16(5): e0251517, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34010306

RESUMO

BACKGROUND: Since 1999, West Nile virus (WNV) has moved rapidly across the United States, resulting in tens of thousands of human cases. Both the number of human cases and the minimum infection rate (MIR) in vector mosquitoes vary across time and space and are driven by numerous abiotic and biotic forces, ranging from differences in microclimates to socio-demographic factors. Because the interactions among these multiple factors affect the locally variable risk of WNV illness, it has been especially difficult to model human disease risk across varying spatial and temporal scales. Cook and DuPage Counties, comprising the city of Chicago and surrounding suburbs, experience some of the highest numbers of human neuroinvasive cases of WNV in the United States. Despite active mosquito control efforts, there is consistent annual WNV presence, resulting in more than 285 confirmed WNV human cases and 20 deaths from the years 2014-2018 in Cook County alone. METHODS: A previous Chicago-area WNV model identified the fifty-five most high and low risk locations in the Northwest Mosquito Abatement District (NWMAD), an enclave » the size of the combined Cook and DuPage county area. In these locations, human WNV risk was stratified by model performance, as indicated by differences in studentized residuals. Within these areas, an additional two-years of field collections and data processing was added to a 12-year WNV dataset that includes human cases, MIR, vector abundance, and land-use, historical climate, and socio-economic and demographic variables, and was assessed by an ultra-fine-scale (1 km spatial x 1 week temporal resolution) multivariate logistic regression model. RESULTS: Multivariate statistical methods applied to the ultra-fine-scale model identified fewer explanatory variables while improving upon the fit of the previous model. Beyond MIR and climatic factors, efforts to acquire additional covariates only slightly improved model predictive performance. CONCLUSIONS: These results suggest human WNV illness in the Chicago area may be associated with fewer, but increasingly critical, key variables at finer scales. Given limited resources, these findings suggest large variations in model performance occur, depending on covariate availability, and provide guidance in variable selection for optimal WNV human illness modeling.


Assuntos
Febre do Nilo Ocidental/epidemiologia , Vírus do Nilo Ocidental/isolamento & purificação , Chicago/epidemiologia , Clima , Humanos , Modelos Biológicos , Mosquitos Vetores/virologia , Fatores de Risco , Fatores Socioeconômicos
7.
Evid Policy ; 17(4): 689-707, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35586821

RESUMO

Background: There is growing interest in and recognition of the need to use scientific evidence to inform policymaking. However, many of the existing studies on the use of research evidence (URE) have been largely qualitative, and the majority of existing quantitative measures are underdeveloped or were tested in regional or context-dependent settings. We are unaware of any quantitative measures of URE with national policymakers in the US. Aims and objectives: Explore how to measure URE quantitatively by validating a measure of congressional staff's attitudes and behaviors regarding URE, the Legislative Use of Research Survey (LURS), and by discussing the lessons learned through administering the survey. Methods: A 68-item survey was administered to 80 congressional staff to measure their reported research use, value of research, interactions with researchers, general information sources, and research information sources. Confirmatory factor analyses were conducted on each of these five scales. We then trimmed the number of items, based on a combination of poor factor loadings and theoretical rationale, and ran the analyses on the trimmed subscales. Findings: We substantially improved our model fits for each scale over the original models and all items had acceptable factor loadings with our trimmed 35-item survey. We also describe the unique set of challenges and lessons learned from surveying congressional staff. Discussion and conclusions: This work contributes to the transdisciplinary field of URE by offering a tool for studying the mechanisms that can bridge research and policy and shedding light into best practices for measuring URE with national policymakers in the US.

8.
Int J Oral Maxillofac Surg ; 49(11): 1459-1463, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32278624

RESUMO

Temporomandibular joint (TMJ) arthrocentesis is considered an effective and minimally invasive procedure for certain conditions related to temporomandibular disorders. The ideal irrigation volume for arthrocentesis lavage has not yet been defined. Therefore, the aim of this study was to evaluate the efficacy of different saline solution volumes in removing methylene blue from the TMJ space of fresh human cadavers. Nineteen cadavers were selected and 1ml of 10µM methylene blue solution was injected into the upper joint space unilaterally. Conventional arthrocentesis was then conducted by infusion of 300ml of 0.9% saline solution, collecting a 1-ml sample from the drained quantity for every 25ml injected. Finally, the samples were assayed by measuring photo absorbance of the methylene blue solution. There was a statistically significant difference between the irrigation volumes regarding the removal of methylene blue solution from the joint space (P<0.001), specifically between the first 25 ml and 200 ml (P=0.014), 225 ml (P=0.001), 250 ml (P<0.001), and 275 ml (P=0.001). Based on this ex vivo study, a 25-ml perfusion volume appears to be sufficient for joint lavage in conventional arthrocentesis of the TMJ.


Assuntos
Artrocentese , Transtornos da Articulação Temporomandibular , Cadáver , Humanos , Amplitude de Movimento Articular , Articulação Temporomandibular/cirurgia , Transtornos da Articulação Temporomandibular/cirurgia , Irrigação Terapêutica , Resultado do Tratamento
9.
Prev Vet Med ; 176: 104906, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32014682

RESUMO

This paper explains how the methodologies of first and second order stochastic dominance, and expected utility using specific risk preferences, can be applied to epidemiology when choosing among control strategies that have stochastic outcomes. We provide a step-by-step guide on how epidemiologists can rank a number of control strategies based on their distribution of estimated benefits. We also explain how the expected utility model and decision maker's risk preferences can be used to select between outcomes when none stochastically dominates. To illustrate these techniques, we show the ranking of various control strategies for a dairy herd endemically infected with Mycobacterium avium subs. paratuberculosis (MAP) and mastitis, and explain how decision maker's risk preferences affect the ranking.


Assuntos
Controle de Doenças Transmissíveis/métodos , Mastite Bovina/prevenção & controle , Mycobacterium/fisiologia , Paratuberculose/prevenção & controle , Processos Estocásticos , Animais , Bovinos , Controle de Doenças Transmissíveis/estatística & dados numéricos
10.
Sci Rep ; 9(1): 19093, 2019 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-31836789

RESUMO

West Nile Virus (WNV) is a mosquito-borne infection that can cause serious illness in humans. Surveillance for WNV primarily focuses on a measure of infection prevalence in the Culex spp. mosquitos, its primary vectors, known as the Minimum Infection Rate (MIR). The calculation of MIR for a given area considers the number of mosquitos tested, but not the relative effort to collect mosquitos, leading to a potential underestimation of the uncertainty around the estimate. We performed Value of Information analysis on simulated data sets including a range of mosquito trap densities in two well-studied counties in Illinois between 2005 and 2016 to determine the relative error introduced into MIR associated with changing the density of mosquito traps. We found that low trap density increases the potential for error in MIR estimation, and that it does so synergistically with low true MIR values. We propose that these results could be used to better estimate uncertainty in WNV risk.


Assuntos
Culicidae/crescimento & desenvolvimento , Culicidae/virologia , Febre do Nilo Ocidental/epidemiologia , Febre do Nilo Ocidental/virologia , Vírus do Nilo Ocidental/fisiologia , Animais , Simulação por Computador , Intervalos de Confiança , Análise de Regressão
11.
Toxicol Res (Camb) ; 7(6): 1036-1047, 2018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-30542600

RESUMO

Unravelling the molecular basis of thalidomide embryotoxicity, which is remarkably species-specific, is challenging in view of its low toxicity in the mature animal. Employing data derived solely from proven sensitive primate species or susceptible strains of rabbit, the structure-activity relationship of over 50 compounds which are, arguably, congeners of thalidomide has been reviewed. The molecular requirement for 'thalidomide-type' teratogenicity was highly structure dependent. Both the phthalimide and glutarimide groups were essential for embryopathic activity, although minor substitutions in either or both rings could be tolerated without a loss of toxicity. An α-linkage between the two cyclic structures was essential; a ß-link resulted in a complete loss of embryopathic activity. Crucially, this α-configuration provided a centre of asymmetry enabling the existence of stereoisomers. The thalidomide molecule is not a static entity and under physiological conditions it undergoes a number of intra- and inter-molecular reactions. Besides irreversible hydrolysis, its keto-enol tautomerism, base-assisted proton transfer and glutarimide ring rotation lead to rapid interconversion of the thalidomide enantiomers. These enantiomers form equilibria between themselves and also between both homochiral and heterochiral dimers. It is proposed that the more energetically favourable and stable heterochiral dimer of thalidomide is an active agent that possesses the structural features of the paired nucleotides of the double-stranded DNA. Its capacity to enter into hydrogen bonding interactions affects DNA expression in a chaotic manner without causing permanent mutations. This disruption may well be concentrated at nucleotide sites known to be involved in specific promoter regions of the genome.

13.
Sci Rep ; 7(1): 11845, 2017 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-28928423

RESUMO

Johne's disease (JD) is a chronic enteric disease in cattle caused by Mycobacterium avian subsp. paratuberculosis (MAP). Eradicating JD is a difficult task due to the long incubation period of MAP, inefficient diagnostic tests, and delayed clinical signs. Effective control strategies can help farmers to reduce prevalence, but those most acceptable to farmers combine specific information about lactation performance and testing results, which existing models do not provide. This paper presents an individual-based model of MAP infection dynamics and assesses the relative performance of the applied alternative control strategies. The base dairy herd model included the daily life events of a dairy cow and reflects several current dairy management processes. We then integrated MAP infection dynamics into the model. The model adopted four different test-based control strategies based on risk-based culling decisions and three hygiene scenarios. The model tracked the source of each infection and quantified the efficacy of each control strategy in reducing the risks of different transmission routes. The results suggest that risk-based culling can reduce prevalence compared with no control, but cannot eliminate the infection. Overall, this work provides not only a valuable tool to investigate MAP transmission dynamics but also offers adaptability to model similar infectious diseases.


Assuntos
Doenças dos Bovinos , Modelos Biológicos , Mycobacterium avium subsp. paratuberculosis , Paratuberculose , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/prevenção & controle , Doenças dos Bovinos/transmissão , Paratuberculose/epidemiologia , Paratuberculose/prevenção & controle , Paratuberculose/transmissão
14.
J Dairy Sci ; 100(9): 7446-7454, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28711261

RESUMO

Endemic diseases can be counted among the most serious sources of losses for livestock production. In dairy farms in particular, one of the most common diseases is Johne's disease, caused by Mycobacterium avium ssp. paratuberculosis (MAP). Infection with MAP causes direct costs because it affects milk production, but it has also been suspected to increase the risk of clinical mastitis (CM) among infected animals. This might contribute to further costs for farmers. We asked whether MAP infection represents a risk factor for CM and, in particular, whether CM occurrences were more common in MAP-infected animals. Our results, obtained by survival analysis, suggest that MAP-infected cows had an increased probability of experiencing CM during lactation. These results highlight the need to account for the interplay of infectious diseases and other health conditions in economic and epidemiological modeling. In this case, accounting for MAP-infected cows having an increased CM occurrence might have nonnegligible effects on the estimated benefit of MAP control.


Assuntos
Lactação , Mastite Bovina/microbiologia , Mycobacterium avium subsp. paratuberculosis , Paratuberculose/microbiologia , Animais , Bovinos , Feminino
15.
J Phys Condens Matter ; 29(39): 395001, 2017 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-28685709

RESUMO

We used DFT to study the energetics of the decomposition of alane, AlH3, on the Si(0 0 1) surface, as the acceptor complement to PH3. Alane forms a dative bond with the raised atoms of silicon surface dimers, via the Si atom lone pair. We calculated the energies of various structures along the pathway of successive dehydrogenation events following adsorption: AlH2, AlH and Al, finding a gradual, significant decrease in energy. For each stage, we analyse the structure and bonding, and present simulated STM images of the lowest energy structures. Finally, we find that the energy of Al atoms incorporated into the surface, ejecting a Si atom, is comparable to Al adatoms. These findings show that Al incorporation is likely to be as precisely controlled as P incorporation, if slightly less easy to achieve.

16.
Prev Vet Med ; 138: 17-27, 2017 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-28237232

RESUMO

The cost of paratuberculosis to dairy herds, through decreased milk production, early culling, and poor reproductive performance, has been well-studied. The benefit of control programs, however, has been debated. A recent stochastic compartmental model for paratuberculosis transmission in US dairy herds was modified to predict herd net present value (NPV) over 25 years in herds of 100 and 1000 dairy cattle with endemic paratuberculosis at initial prevalence of 10% and 20%. Control programs were designed by combining 5 tests (none, fecal culture, ELISA, PCR, or calf testing), 3 test-related culling strategies (all test-positive, high-positive, or repeated positive), 2 test frequencies (annual and biannual), 3 hygiene levels (standard, moderate, or improved), and 2 cessation decisions (testing ceased after 5 negative whole-herd tests or testing continued). Stochastic dominance was determined for each herd scenario; no control program was fully dominant for maximizing herd NPV in any scenario. Use of the ELISA test was generally preferred in all scenarios, but no paratuberculosis control was highly preferred for the small herd with 10% initial prevalence and was frequently preferred in other herd scenarios. Based on their effect on paratuberculosis alone, hygiene improvements were not found to be as cost-effective as test-and-cull strategies in most circumstances. Global sensitivity analysis found that economic parameters, such as the price of milk, had more influence on NPV than control program-related parameters. We conclude that paratuberculosis control can be cost effective, and multiple control programs can be applied for equivalent economic results.


Assuntos
Doenças dos Bovinos/prevenção & controle , Indústria de Laticínios/economia , Paratuberculose/prevenção & controle , Animais , Bovinos , Doenças dos Bovinos/economia , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/microbiologia , Simulação por Computador , Análise Custo-Benefício , Ensaio de Imunoadsorção Enzimática/economia , Ensaio de Imunoadsorção Enzimática/veterinária , Feminino , Renda , Mycobacterium avium subsp. paratuberculosis/isolamento & purificação , Paratuberculose/economia , Paratuberculose/epidemiologia , Reação em Cadeia da Polimerase/economia , Reação em Cadeia da Polimerase/veterinária , Processos Estocásticos , Estados Unidos/epidemiologia
17.
N Z Vet J ; 65(1): 51-55, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27691906

RESUMO

CASE HISTORY: A group of 545 pregnant rising 2-year-old Coopdale ewes on a Southland sheep farm were grazed over winter on a fodder beet (Beta vulgaris) crop. Subsequently, 45 out of approximately 750 lambs were born with a variety of skeletal deformities, including shortened limbs, varus and valgus angular limb deformities, palmar grade stance and cranial bowing of the carpus. Analysis of the crop showed the fodder beet contained a low percentage of phosphorus. In addition, 60 out of 460 rising 2-year-old ewes that had been grazed on the fodder beet crop as 1-year-olds had incisor abnormalities and malocclusion. PATHOLOGICAL FINDINGS: Two affected lambs (1-day-old and 3-days-old) with representative clinical signs examined postmortem were found to have markedly enlarged costochondral junctions, and noticeably enlarged long bone metaphyses. In addition, one lamb had a dense band of metaphyseal sclerosis beneath the physes of all long bones examined. Histopathological findings included small islands and columns of chondrocytes and eosinophilic cartilage matrix present in the metaphysis. Metaphyseal trabeculae were disorganised and often lined by accumulations of pale pink osteoid; similar pale pink osteoid was also present in the cortices. Unerupted molar teeth in the affected lambs lacked a layer of enamel, and the dentine was irregular with globular basophilia. DIAGNOSIS: The gross and histopathological lesions were consistent with a diagnosis of rickets. CLINICAL RELEVANCE: Nutritional congenital rickets has not been previously diagnosed in sheep, but is a recognised disease of human infants with vitamin D deficient mothers. The rickets in affected lambs was most likely associated with phosphorus deficiency as a result of the pregnant ewes grazing fodder beet during gestation. While vitamin D deficiency was not definitively ruled out in these cases, practitioners are alerted to the possible effects of feeding phosphorus-deficient fodder beet to ewes for long periods during gestation and to 1-year-old sheep during important growth periods.


Assuntos
Raquitismo/veterinária , Doenças dos Ovinos/congênito , Anormalidades Múltiplas/patologia , Anormalidades Múltiplas/veterinária , Ração Animal , Fenômenos Fisiológicos da Nutrição Animal , Animais , Feminino , Anormalidades Musculoesqueléticas/patologia , Anormalidades Musculoesqueléticas/veterinária , Raquitismo/congênito , Ovinos , Doenças dos Ovinos/patologia
18.
Eur J Clin Pharmacol ; 72(9): 1099-104, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27353638

RESUMO

PURPOSE: Valproic acid (VPA) has an extensive interindividual pharmacokinetic variability. Published data regarding the impact of gender, age, and CYP2C9/2C19 genetics on VPA variability are conflicting, and the purpose of present study is to clarify the effect of these factors on dose-adjusted steady-state serum VPA concentration (C:D ratio) in a large, naturalistic patient material. METHODS: In patients who had been subjected to cytochrome P450 (CYP) genotyping and therapeutic drug monitoring of VPA, information about serum concentrations, dose, gender, age, and CYP2C9/2C19 genotypes was retrospectively collected from a routine TDM database during the period 2008-2012. The effects of age, gender, and CYP2C9/CYP2C19 genotypes on C:D ratios of VPA were investigated by multivariate analyses (mixed model) including sampling time as covariate. RESULTS: In total, 857 serum concentrations from 252 patients were included. A significant gender effect was observed with a 1.3-fold higher estimated C:D ratio in females than in males, i.e., geometric means 0.34 vs. 0.27 µM/mg/day, respectively (p < 0.001). A similar and significant difference in estimated geometric means was found between patients >65 vs. ≤65 years, i.e., 0.36 vs. 0.26 µM/mg/day (p < 0.001), respectively. Finally, no association between the various CYP2C9/2C19 variant genotypes and C:D ratio of VPA was observed (p > 0.1). CONCLUSION: The present study shows that age and gender significantly influence VPA serum concentration. In order to obtain similar drug exposure, our findings suggest that older female patients would generally require 30-50 % lower dosing of VPA compared to younger males. Moreover, we conclude that CYP2C9/2C19 genotype is not relevant for variability in VPA exposure.


Assuntos
Anticonvulsivantes/sangue , Citocromo P-450 CYP2C19/genética , Citocromo P-450 CYP2C9/genética , Ácido Valproico/sangue , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anticonvulsivantes/farmacocinética , Monitoramento de Medicamentos , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Ácido Valproico/farmacocinética , Adulto Jovem
19.
Radiat Prot Dosimetry ; 172(4): 327-332, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26598738

RESUMO

Production of radioisotopes in medical linear accelerators (linacs) is of concern when the beam energy exceeds the threshold for the photonuclear interaction. Staff and patients may receive a radiation dose as a result of the induced radioactivity in the linac. Gamma-ray spectroscopy was used to identify the isotopes produced following the delivery of 18 MV photon beams from a Varian 21EX and an Elekta Synergy. The prominent radioisotopes produced include 187W, 63Zn, 56Mn, 24Na and 28Al in both linac models. The dose rate was measured at the beam exit window (12.6 µSv in the first 10 min) following 18 MV total body irradiation (TBI) beams. For a throughput of 24 TBI patients per year, staff members are estimated to receive an annual dose of up to 750 µSv at the patient location. This can be further reduced to 65 µSv by closing the jaws before re-entering the treatment bunker.


Assuntos
Raios gama , Nêutrons/efeitos adversos , Exposição Ocupacional/análise , Exposição Ocupacional/prevenção & controle , Aceleradores de Partículas/instrumentação , Radioterapia de Alta Energia/efeitos adversos , Irradiação Corporal Total/métodos , Pessoal de Saúde , Humanos , Método de Monte Carlo , Fótons , Monitoramento de Radiação , Proteção Radiológica , Dosagem Radioterapêutica , Medição de Risco
20.
Child Care Health Dev ; 41(6): 873-81, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26119480

RESUMO

BACKGROUND: There is minimal literature on how parents experiencing intergenerational poverty view their role as parents and the value they place on children's play. The objective of this study was to examine how these parents view their parenting role and their beliefs about children's play. METHODS: Thirteen mothers of preschool-aged children who experienced intergenerational poverty were recruited to the study. Semi-structured interviews were conducted and were analysed using interpretive phenomenological analysis. RESULTS: Parents described their role as guiding their children to become 'good' people, to teach them skills and provide a routine within the home. There were two disconnections in the data including the view that whilst parenting was hard and lonely, it was also a private matter and participants preferred not to seek support. A second disconnection was in terms of their beliefs about play. Parents believed that whilst play was valuable to their child's development, it was not their role to play with children. However, if parents did play with their child, they noticed positive changes in their child's behaviour. CONCLUSION: The views of parents who experienced intergenerational poverty were similar to other reported findings in parenting studies. However, the current sample differed on not seeking help for support as well as not seeing their role as playing with their children, even though occasions of joining their child in play were associated with a positive change in their relationship with their child. This has implications for communicating about parenting issues with parents who have experienced intergenerational poverty.


Assuntos
Atitude Frente a Saúde , Desenvolvimento Infantil , Poder Familiar/psicologia , Pais/psicologia , Jogos e Brinquedos/psicologia , Adulto , Pré-Escolar , Feminino , Humanos , Relações Pais-Filho , Pobreza , Pesquisa Qualitativa , Classe Social , Televisão , Vitória
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