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1.
Hong Kong Med J ; 30(3): 209-217, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38769623

RESUMO

INTRODUCTION: This study aimed to develop the Healthy Eating Report Card for Pre-school Children in Hong Kong for evaluating the prevalence of healthy eating behaviours and favourable family home food environments (FHFEs) among pre-school children in Hong Kong. METHODS: In this cross-sectional study, 538 parent-child dyads from eight kindergartens in Hong Kong were recruited. Parents or guardians completed a questionnaire comprising Report Card items. The Report Card included two indicators of Children's Eating Behaviours (ie, Children's Dietary Patterns and Children's Mealtime Behaviours) and three indicators of FHFEs (ie, Parental Food Choices and Preparation, Avoidance of Unhealthy Foods, and Family Mealtime Environments). Each indicator and its specific items were assigned a letter grade representing the percentage of participants achieving the predefined benchmarks. The grades were defined as A (≥80%, Excellent); B (60%-79%, Good); C (40%-59%, Fair); D (20%-39%, Poor); and F (<20%, Very poor). Plus (+) and minus (-) signs were used to indicate the upper or lower 5% of each grade. RESULTS: Overall, Children's Eating Behaviours were classified as Fair (average grade of 'C'), whereas FHFEs were classified as Good (average grade of 'B'). The sub-grades ranged from 'C' to 'A-', as follows: Children's Dietary Patterns, 'C+'; Children's Mealtime Behaviours, 'C'; Parental Food Choices and Preparation, 'C+'; Avoidance of Unhealthy Foods, 'B'; and Family Mealtime Environments, 'A-'. CONCLUSION: The findings highlight areas for improvement in healthy eating among children. The Healthy Eating Report Card could offer novel insights into intervention tools that promote healthy eating.


Assuntos
Dieta Saudável , Comportamento Alimentar , Humanos , Hong Kong , Estudos Transversais , Masculino , Feminino , Pré-Escolar , Inquéritos e Questionários , Pais/psicologia , Refeições , Preferências Alimentares
2.
Ann R Coll Surg Engl ; 2023 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-37843095

RESUMO

INTRODUCTION: Laparoscopic fundoplication remains the standard treatment for patients with severe gastro-oesophageal reflux disease (GORD). Multiple randomised controlled trials (RCTs) have compared the two most commonly performed surgical techniques, total and posterior partial fundoplication (Nissen [NF] and Toupet [TF]), in terms of symptom control and treatment failure in patients without subsequent dysmotility disorders. We aimed to conduct a systematic review and meta-analysis of these two techniques with regard to the long-term effect on reflux control and associated dysphagia. METHODS: The MEDLINE®, Embase®, PubMed® and Cochrane Library databases were searched, and all the relevant published RCTs were shortlisted according to the inclusion criteria. The summated outcomes of long-term results relating to the recurrence of GORD and dysphagia were evaluated in a meta-analysis using RevMan software. RESULTS: Eight studies (all RCTs) on 1,545 patients undergoing NF or TF were eligible for inclusion in this meta-analysis. There were 799 patients in the NF group and 746 in the TF group. In the random effects model analysis, the incidence of long-term recurrence of GORD was not statistically different between the NF and TF cohorts (odds ratio [OR]: 0.69, 95% confidence interval [CI]: 0.34-1.41, z=1.01, p=0.31). However, the incidence of long-term dysphagia was statistically lower in the TF group (OR: 2.92, 95% CI: 1.49-5.72, z=3.13, p=0.002) with low between-study heterogeneity (I2=0%). CONCLUSIONS: The findings of this systematic review and meta-analysis on symptomatic GORD appear to be in favour of partial posterior fundoplication (TF) as the optimal treatment. It provides equivalent outcomes in reflux symptom control with a lower risk of postoperative dysphagia compared with total fundoplication (NF).

4.
Front Pharmacol ; 14: 1152611, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37251320

RESUMO

The cardioprotective effects of sodium-glucose cotransporter type 2 (SGLT2) inhibitors have been demonstrated in many studies. However, their benefits for end-stage kidney disease patients, particularly those on peritoneal dialysis, remain unclear. SGLT2 inhibition has shown peritoneal protective effects in some studies, but the mechanisms are still unknown. Herein, we investigated the peritoneal protective mechanisms of Canagliflozin in vitro by simulating hypoxia with CoCl2 in human peritoneal mesothelial cells (HPMCs) and rats by intraperitoneal injection of 4.25% peritoneal dialysate simulating chronic high glucose exposure. CoCl2 hypoxic intervention significantly increased HIF-1α abundance in HPMCs, activated TGF-ß/p-Smad3 signaling, and promoted the production of fibrotic proteins (Fibronectin, COL1A2, and α-SMA). Meanwhile, Canagliflozin significantly improved the hypoxia of HPMCs, decreased HIF-1α abundance, inhibited TGF-ß/p-Smad3 signaling, and decreased the expression of fibrotic proteins. Five-week intraperitoneal injection of 4.25% peritoneal dialysate remarkably increased peritoneal HIF-1α/TGF-ß/p-Smad3 signaling and promoted peritoneal fibrosis and peritoneal thickening. At the same time, Canagliflozin significantly inhibited the HIF-1α/TGF-ß/p-Smad3 signaling, prevented peritoneal fibrosis and peritoneal thickening, and improved peritoneal transportation and ultrafiltration. High glucose peritoneal dialysate increased the expression of peritoneal GLUT1, GLUT3 and SGLT2, all of which were inhibited by Canagliflozin. In conclusion, we showed that Canagliflozin could improve peritoneal fibrosis and function by ameliorating peritoneal hypoxia and inhibiting the HIF-1α/TGF-ß/p-Smad3 signaling pathway, providing theoretical support for the clinical use of SGLT2 inhibitors in patients on peritoneal dialysis.

5.
Expert Rev Med Devices ; 20(2): 151-160, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36715659

RESUMO

PURPOSE: A previous study reported a shorter time to tracheal intubation by reducing percentage of glottic opening (POGO) view to <50% when intubating a normal adult airway using the GlidescopeTM blade. We evaluate the efficacy of reducing POGO to <50% when intubating patients with rigid cervical immobilization using CMACTM D blade. METHODS: One hundred and four adult patients were randomized to group POGO 100% or POGO <50% . Laryngoscopy was performed by advancing tip of the D blade at vallecula. POGO 100% was achieved by exerting upward force to displace epiglottis until glottic opening from the anterior commissure to inter arytenoid notch. POGO < 50% was acquired by withdrawing the D blade tip dorsally from vallecula. The primary outcome was time to intubation. RESULTS: The median time (IQR) to successful intubation was 29 (25-35) seconds for group POGO < 50% and 34 (28-40) seconds for group with POGO 100% (difference in medians, 5 seconds; 95% confidence interval, 2 to 8, p = 0.003). Complications were minor. CONCLUSION: Using the CMACTM D blade with a reduced POGO in patients with cervical spine immobilization resulted in faster tracheal intubation. TRIAL REGISTRATION: The trial is registered at ClinicalTrial.gov (CT.gov identifier: NCT04833166).


Assuntos
Laringoscópios , Adulto , Humanos , Laringoscopia/métodos , Intubação Intratraqueal/métodos , Glote , Vértebras Cervicais
6.
NPJ Biofilms Microbiomes ; 8(1): 36, 2022 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-35508464

RESUMO

It is difficult to disentangle the many variables (e.g. internal or external cues and random events) that shape the microbiota in the gastrointestinal tract of any living species. Ecological assembly processes applied to microbial communities can elucidate these drivers. In our study, farmed Atlantic cod (Gadus morhua) were fed a diet of 10% macroalgae supplement (Ulva rigida [ULVA] or Ascophyllum nodosum [ASCO] or a non-supplemented control diet [CTRL]) over 12 weeks. We determined the influence of ecological assembly processes using a suite of null-modelling tools. We observed dissimilarity in the abundance of common OTUs over time, which was driven by deterministic assembly. The CTRL samples showed selection as a critical assembly process. While dispersal limitation was a driver of the gut microbiome for fish fed the macroalgae supplemented diet at Week 12 (i.e., ASCO and ULVA). Fish from the ASCO grouping diverged into ASCO_N (normal) and ASCO_LG (lower growth), where ASCO_LG individuals found the diet unpalatable. The recruitment of new taxa overtime was altered in the ASCO_LG fish, with the gut microbiome showing phylogenetic underdispersion (nepotistic species recruitment). Finally, the gut microbiome (CTRL and ULVA) showed increasing robustness to taxonomic disturbance over time and lower functional redundancy. This study advances our understanding of the ecological assembly and succession in the hindgut of juvenile Atlantic cod across dietary treatments. Understanding the processes driving ecological assembly in the gut microbiome, in fish research specifically, could allow us to manipulate the microbiome for improved health or resilience to disease for improved aquaculture welfare and production.


Assuntos
Gadus morhua , Microbioma Gastrointestinal , Animais , Dieta/veterinária , Suplementos Nutricionais , Filogenia
7.
Conserv Biol ; 2022 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-35098582

RESUMO

An important rationale for legally-farmed and synthetic wildlife products are that they reduce illegal wild-sourced trade by supplying markets with sustainable alternatives. For this to work, more established illegal-product consumers must switch to legal alternatives than new legal-product consumers drawn to illegal wild products. Despite widespread debate on the magnitude and direction of switching, studies among actual consumers are lacking. We used an anonymous online survey of 1421 Traditional Chinese Medicine consumers in China to investigate switching between legal farmed, synthetic, and illegal wild bear bile. We examined past consumption behaviour, and applied a discrete choice experiment framed within worsening hypothetical disease scenarios, using latent class models to investigate groups with shared preferences. Bear bile consumers (86% respondents) were wealthier, more likely to have family who consumed bile, and less knowledgeable about bile treatments than non-consumers. Consumer preferences were heterogenous but most consumers preferred switching between bile types as disease worsened. We identified five distinct latent classes within our sample: 'law-abiding consumers' (34% respondents), who prefer legal products and were unlikely to switch; two 'all-natural consumer' groups (53%), who dislike synthetics but may switch between farmed and wild products; and two 'non-consumer' groups (12%) who prefer not to buy bile. People with past experience of bile consumption had different preferences than those without. Willingness to switch to wild products was related to believing they were legal, although the likelihood of switching was mediated by preferences for cheaper products sold in legal, familiar places. We show that consumers of wild bile may switch, given the availability of a range of legal alternatives, while legal-product consumers may switch to illegal products if the barriers to doing so are small. Understanding preferences that promote or impede switching should be a key consideration when attempting to predict consumer behaviour in complex wildlife markets. This article is protected by copyright. All rights reserved.


Wildlife consumer characteristics and preferences determine their likelihood and direction of switching between legal and illegal products.

9.
Anim Microbiome ; 3(1): 7, 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33500003

RESUMO

BACKGROUND: Aquaculture successfully meets global food demands for many fish species. However, aquaculture production of Atlantic cod (Gadus morhua) is just 2.5% of total market production. For cod farming to be a viable economic venture specific challenges on how to increase growth, health and farming productivity need to be addressed. Feed ingredients play a key role here. Macroalgae (seaweeds) have been suggested as a functional feed supplement with both health and economic benefits for terrestrial farmed animals and fish. The impact of such dietary supplements to cod gut integrity and microbiota, which contribute to overall fish robustness is unknown. The objective of this study was to supplement the diet of juvenile Atlantic cod with macroalgae and determine the impacts on fish condition and growth, gut morphology and hindgut microbiota composition (16S rRNA amplicon sequencing). Fish were fed one of three diets: control (no macroalgal inclusion), 10% inclusion of either egg wrack (Ascophyllum nodosum) or sea lettuce (Ulva rigida) macroalgae in a 12-week trial. RESULTS: The results demonstrated there was no significant difference in fish condition, gut morphology or hindgut microbiota between the U. rigida supplemented fish group and the control group at any time-point. This trend was not observed with the A. nodosum treatment. Fish within this group were further categorised as either 'Normal' or 'Lower Growth'. 'Lower Growth' individuals found the diet unpalatable resulting in reduced weight and condition factor combined with an altered gut morphology and microbiome relative to the other treatments. Excluding this group, our results show that the hindgut microbiota was largely driven by temporal pressures with the microbial communities becoming more similar over time irrespective of dietary treatment. The core microbiome at the final time-point consisted of the orders Vibrionales (Vibrio and Photobacterium), Bacteroidales (Bacteroidetes and Macellibacteroides) and Clostridiales (Lachnoclostridium). CONCLUSIONS: Our study indicates that U. rigida macroalgae can be supplemented at 10% inclusion levels in the diet of juvenile farmed Atlantic cod without any impact on fish condition or hindgut microbial community structure. We also conclude that 10% dietary inclusion of A. nodosum is not a suitable feed supplement in a farmed cod diet.

10.
BMC Anesthesiol ; 20(1): 184, 2020 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-32736516

RESUMO

BACKGROUND: The 4th National Audit Project of The Royal College of Anaesthetists and The Difficult Airway Society (NAP4) reported a higher incidence of supraglottic airway device (SAD) related pulmonary aspiration in obese patients especially with the first-generation SADs. The latest single-use SAD, the Protector™ provides a functional separation of the respiratory and digestive tracts and its laryngeal cuff with two ports allowing additional suction in tandem with the insertion of a gastric tube. The laryngeal cuff of LMA Protector™ allows a large catchment reservoir in the event of gastric content aspiration. METHODS: We evaluated the performance characteristics of the LMA Protector™ in 30 unparalysed, moderately obese patients. First attempt insertion rate, time for insertion, oropharyngeal leak pressure (OLP), and incidence of complications were recorded. RESULTS: We found high first and second attempt insertion rates of 28(93%) and 1(33%) respectively, with one failed attempt where no capnography trace could be detected, presumably from a downfolded device tip. The LMA Protector™ was inserted rapidly in 21.0(4.0) seconds and demonstrated high OLP of 31.8(5.4) cmH2O. Fibreoptic assessment showed a clear view of vocal cords in 93%. The incidence of blood staining on removal of device was 48%, postoperative sore throat 27%, dysphagia 10% and dysphonia 20% (all self-limiting, resolving a few hours postoperatively). CONCLUSIONS: We conclude that the LMA Protector™ was associated with easy, expedient first attempt insertion success, demonstrating high oropharyngeal pressures and good anatomical position in the moderately obese population, with relatively low postoperative airway morbidity. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12617001152314 . Registered 7 August 2017.


Assuntos
Intubação Intratraqueal/métodos , Máscaras Laríngeas , Obesidade/complicações , Adulto , Transtornos de Deglutição/epidemiologia , Transtornos de Deglutição/etiologia , Disfonia/epidemiologia , Disfonia/etiologia , Desenho de Equipamento , Feminino , Tecnologia de Fibra Óptica , Humanos , Intubação Intratraqueal/instrumentação , Masculino , Pessoa de Meia-Idade , Faringite/epidemiologia , Faringite/etiologia
11.
Sci Rep ; 10(1): 4194, 2020 03 06.
Artigo em Inglês | MEDLINE | ID: mdl-32144276

RESUMO

The effects of feeding an 80% plant protein diet, with and without fish protein hydrolysate (FPH) supplementation, on the growth and gut health of Atlantic salmon were investigated. Fish were fed either (A) a control diet containing 35% fishmeal, (B) an 80% plant protein diet with 15% fishmeal, (C) an 80% plant protein diet with 5% fishmeal and 10% partly hydrolysed protein, or (D) an 80% plant protein diet with 5% fishmeal and 10% soluble protein hydrolysate. Fish on the 80% plant- 15% fishmeal diet were significantly smaller than fish in the other dietary groups. However, partly-hydrolysed protein supplementation allowed fish to grow as well as fish fed the control 35% fishmeal diet. Fish fed the FPH diets (diets C and D) had significantly higher levels of amino acids in their blood, including 48% and 27% more branched chain amino acids compared to fish on the 35% fishmeal diet, respectively. Plant protein significantly altered gut microbial composition, significantly decreasing α-diversity. Spirochaetes and the families Moritellaceae, Psychromonadaceae, Helicobacteraceae and Bacteroidaceae were all found at significantly lower abundances in the groups fed 80% plant protein diets compared to the control fishmeal diet.


Assuntos
Proteínas de Peixes , Proteínas de Plantas , Salmo salar/crescimento & desenvolvimento , Animais , Microbioma Gastrointestinal , Hidrolisados de Proteína
12.
Saudi J Kidney Dis Transpl ; 31(6): 1403-1406, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33565454

RESUMO

Anticoagulant-related nephropathy (ARN) is a recently described disease entity which is an underdiagnosed complication of anticoagulation. Despite widespread usage of anticoagulants, ARN is not commonly reported. We report a case of a 64-year old man with biopsy-proven ARN who presented with over anticoagulation and acute chronic kidney injury while on warfarin therapy for his left lower limb deep-vein thrombosis. Various investigations were performed and renal biopsy confirmed the diagnosis of anticoagulant-related nephropathy.


Assuntos
Injúria Renal Aguda/induzido quimicamente , Anticoagulantes/efeitos adversos , Trombose Venosa/tratamento farmacológico , Varfarina/efeitos adversos , Humanos , Coeficiente Internacional Normatizado , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/fisiopatologia
13.
EuroIntervention ; 15(11): e990-e998, 2019 12 06.
Artigo em Inglês | MEDLINE | ID: mdl-31422929

RESUMO

AIMS: The optimal duration of DAPT in ACS patients treated with DES is still unclear. Therefore, the aim of the current study was to investigate a short versus a standard 12-month DAPT regimen in ACS patients undergoing new-generation DES implantation. METHODS AND RESULTS: REDUCE was a prospective, open-label, multicentre, investigator-initiated study that randomised 1,496 ACS patients after treatment with the COMBO stent to either three (n=751) or 12 months (n=745) of DAPT. The primary study endpoint was a composite of all-cause mortality, myocardial infarction, stent thrombosis, stroke, target vessel revascularisation and bleeding at 12 months. No difference was observed in the demographic and clinical characteristics between the two groups, except for gender (p=0.01). At one-year follow-up, non-inferiority of three- versus 12-month DAPT in the primary endpoint was met (8.2% vs 8.4%, pnon-inferiority<0.001). The similar outcome between the two groups was confirmed at two-year follow-up (11.6% vs 12.1%, p=0.76), with no significant difference in overall mortality (3.1% vs 2.2%, p=0.27), cardiac mortality (1.8% vs 1.1%, p=0.28), stent thrombosis (1.6% vs 0.8%, p=0.16) and major bleeding (3.3% vs 4.0%, p=0.46). CONCLUSIONS: The results show that, among ACS patients treated with the COMBO stent, three months is non-inferior to 12 months of DAPT. However, given the numerically higher rates of mortality and ST in the three-month DAPT group, one-year DAPT should still be recommended in ACS until more information becomes available. A three-month DAPT strategy should be considered only if clinically mandated.


Assuntos
Síndrome Coronariana Aguda , Inibidores da Agregação Plaquetária , Quimioterapia Combinada , Características da Família , Humanos , Pacientes , Intervenção Coronária Percutânea , Estudos Prospectivos , Stents , Resultado do Tratamento
14.
Curr Oncol ; 26(3): e410-e413, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31285686

RESUMO

Two guidelines about opioid use in chronic pain management were published in 2017: the Canadian Guideline for Opioids for Chronic Non-Cancer Pain and the European Pain Federation position paper on appropriate opioid use in chronic pain management. Though the target populations for the guidelines are the same, their recommendations differ depending on their purpose. The intent of the Canadian guideline is to reduce the incidence of serious adverse effects. Its goal was therefore to set limits on the use of opioids. In contrast, the European Pain Federation position paper is meant to promote safe and appropriate opioid use for chronic pain. The content of the two guidelines could have unintentional consequences on other populations that receive opioid therapy for symptom management, such as patients with cancer. In this article, we present expert opinion about those chronic pain management guidelines and their impact on patients with cancer diagnoses, especially those with histories of substance use disorder and psychiatric conditions. Though some principles of chronic pain management can be extrapolated, we recommend that guidelines for cancer pain management should be developed using empirical data primarily from patients with cancer who are receiving opioid therapy.


Assuntos
Analgésicos Opioides/uso terapêutico , Dor do Câncer/tratamento farmacológico , Dor Crônica/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Guias de Prática Clínica como Assunto , Analgésicos Opioides/efeitos adversos , Canadá , Europa (Continente) , Humanos , Manejo da Dor
15.
Br J Anaesth ; 120(2): 264-273, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29406175

RESUMO

Competency-based assessment tools are used in regional anaesthesia to measure the performance of study participants, trainees, and consultants. This narrative review was performed to appraise currently published assessment tools for regional anaesthesia. A literature search found 397 citations of which 28 peer-reviewed studies met the inclusion criteria of primary psychometric evaluation of assessment tools for regional anaesthesia. The included studies were diverse in the type of assessment and the skill set being assessed. The types of assessments included multiple-choice questions, hand-motion analysis, cumulative sum, visuospatial and psychomotor screening, checklists, and global rating scales. The skill sets that were assessed included holistic regional anaesthesia technical and non-technical performance observed at the bedside, to isolated part-tasks, such as needle tip visualisation under ultrasound. To evaluate validity and reliability, we compared the studies against published medical education consensus statements on ideal assessment tools. We discuss the relative merits of different tools when used to assess regional anaesthesia, the importance of psychometrically robust assessment tools in competency-based anaesthesia education, and directions for future education research in regional anaesthesia.


Assuntos
Anestesia por Condução/normas , Anestesiologia/normas , Competência Clínica/normas , Anestesia por Condução/métodos , Anestesiologia/educação , Avaliação Educacional , Humanos , Psicometria , Reprodutibilidade dos Testes
17.
Asian Pac J Trop Med ; 10(8): 819-826, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28942832

RESUMO

OBJECTIVE: To report the chemical composition and bioactivity (including antioxidant and antimicrobial activity) of essential oils from the rhizomes, stems, and leaves of Etlingera sayapensis (E. sayapensis) A.D. Poulsen & Ibrahim for the first time. METHODS: First, the essential oils were obtained using a Clevenger-type apparatus. Then, the essential oils compositions were identified by chromatography methods including GC-FID and GC-MS. For the next step, DPPH radical scavenging activity (RSA), ß-carotene bleaching (BCB), and ferrous ion chelating ability (FIC) were chosen to evaluate the essential oils antioxidant activity. Finally, disc diffusion assay and minimum inhibitory concentration method (MIC) was applied to investigate antimicrobial activity of the rhizomes and leaves oils of E. sayapensis against 18 microorganisms. RESULTS: All of the oils contained oxygenated monoterpenes (leaves: 74.18%, stems: 75.60%, and rhizome: 54.61%), The essential oil obtained from leaves contained high amount of carvone (21.38%), cis-carveol (13.49%); The rhizomes oil was rich in linalool formate (25.47%), eugenol (11.84%); and the stems oil was dominated by α-terpineol (39.86%), linalool formate (30.55%). The leaves oil represented the highest ability in all of the antioxidant activity tests. For antimicrobial activity, the rhizome oil presented more active when compared to leaves oil against Bacillus subtilis, Bacillus thuringiensis, Staphylococcus aureus, methicillin resistant Staphylococcus aureus (MRSA), Aeromonas hydrophila, Escherichia coli, Enterobacter aerogenes, Proteus mirabilis, Shigella sonnei, Serratia marcescens, Vibrio parahaemolyticus, Candida albicans, and Candida parapsilosis. CONCLUSIONS: The most components of the essential oils belong to oxygenated monoterpenes. Linalool formate, carvone, and α-terpineol are found as the most abundant compounds in the oils of the different parts of E. sayapensis. The rhizomes oil can prevent the growth of wide spectrum microorganisms; however, the oils are not highly potent in antioxidant assays.

18.
Mol Microbiol ; 103(5): 829-844, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27935141

RESUMO

Most Ensifer strains are comparatively acid sensitive, compromising their persistence in low pH soils. In the acid-tolerant strain Ensifer medicae WSM419, the acid-activated expression of lpiA is essential for enhancing survival in lethal acidic conditions. Here we characterise a multi-step phosphorelay signal transduction pathway consisting of TcsA, TcrA, FsrR, RpoN and its cognate enhancer-binding protein EbpA, which is required for the induction of lpiA and the downstream acvB gene. The fsrR, tcrA, tcsA and rpoN genes were constitutively expressed, whereas lpiA and acvB were strongly acid-induced. RACE mapping revealed that lpiA/acvB were co-transcribed as an operon from an RpoN promoter. In most Ensifer species, lpiA/acvB is located on the chromosome and the sequence upstream of lpiA lacks an RpoN-binding site. Nearly all Ensifer meliloti strains completely lack ebpA, tcrA, tcsA and fsrR regulatory loci. In contrast, E. medicae strains have lpiA/acvB and ebpA/tcrA/tcsA/fsrR co-located on the pSymA megaplasmid, with lpiA/acvB expression coupled to an RpoN promoter. Here we provide a model for the expression of lpiA/acvB in E. medicae. This unique acid-activated regulatory system provides insights into an evolutionary process which may assist the adaptation of E. medicae to acidic environmental niches.


Assuntos
Proteínas de Ligação a DNA/metabolismo , Evolução Molecular , Regulação Bacteriana da Expressão Gênica , Fator sigma/metabolismo , Sinorhizobium/genética , Sinorhizobium/metabolismo , Ácidos , Animais , Sítios de Ligação , DNA Bacteriano/genética , Proteínas de Ligação a DNA/genética , Genes Bacterianos , Fixação de Nitrogênio , Regiões Promotoras Genéticas , Fator sigma/genética , Transdução de Sinais
19.
Ann R Coll Surg Engl ; 98(8): e181-e383, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27502341

RESUMO

Gastric perforation into the thoracic cavity through a diaphragmatic hernia is rare but, when it occurs, patients present in severe distress, with mortality approaching 50%. We present a unique case in which a fibrotic reaction between the stomach and the parietal pleura led to a subacute presentation upon perforation. The extra time that this afforded led to more effective multidisciplinary team management and ultimately an excellent outcome for the patient.


Assuntos
Hérnia Diafragmática/complicações , Perfuração Espontânea/etiologia , Gastropatias/etiologia , Idoso , Dor no Peito/etiologia , Hérnia Diafragmática/diagnóstico por imagem , Hérnia Diafragmática/cirurgia , Humanos , Masculino , Perfuração Espontânea/diagnóstico por imagem , Perfuração Espontânea/cirurgia , Estômago/diagnóstico por imagem , Estômago/cirurgia , Gastropatias/diagnóstico por imagem , Gastropatias/cirurgia , Tomografia Computadorizada por Raios X
20.
Electrophoresis ; 37(20): 2649-2656, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27434368

RESUMO

Online preconcentration using electrokinetic supercharging (EKS) was proposed to enhance the sensitivity of separation for endocrine disrupting chemical (methylparaben (MP)) and phenolic pollutants (2-nitrophenol (NP) and 4-chlorophenol (CP)) in water sample. Important EKS and separation conditions such as the concentration of BGE; the choice of terminating electrolyte (TE); and the injection time of leading electrolyte (LE), sample, and TE were optimized. The optimum EKS-CE conditions were as follows: BGE comprising of 12 mM sodium tetraborate pH 10.1, 100 mM sodium chloride as LE hydrodynamically injected at 50 mbar for 30 s, electrokinetic injection (EKI) of sample at -3 kV for 200 s, and 100 mM CHES as TE hydrodynamically injected at 50 mbar for 40 s. The separation was conducted at negative polarity mode and UV detection at 214 nm. Under these conditions, the sensitivity of analytes was enhanced from 100- to 737-fold as compared to normal CZE with hydrodynamic injection, giving LOD of 4.89, 5.29, and 53 µg/L for MP, NP and CP, respectively. The LODs were adequate for the analysis of NP and CP in environmental water sample having concentration at or lower than their maximum admissible concentration limit (240 and 2000 µg/L for NP and CP). The LOD of MP can be suitable for the analysis of MP exists at mid-microgram per liter level, even though the LOD was slightly higher than the concentration usually found in water samples (from ng/L to 1 µg/L). The method repeatabilities (%RSD) were in the range of 1.07-2.39% (migration time) and 8.28-14.0% (peak area).


Assuntos
Eletroforese Capilar/métodos , Disruptores Endócrinos/isolamento & purificação , Fenóis/isolamento & purificação , Poluentes Químicos da Água/isolamento & purificação , Disruptores Endócrinos/análise , Disruptores Endócrinos/química , Limite de Detecção , Fenóis/análise , Fenóis/química , Reprodutibilidade dos Testes , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/química
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