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1.
Heart Lung Circ ; 33(6): 828-881, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38702234

RESUMEN

Catheter ablation for atrial fibrillation (AF) has increased exponentially in many developed countries, including Australia and New Zealand. This Expert Position Statement on Catheter and Surgical Ablation for Atrial Fibrillation from the Cardiac Society of Australia and New Zealand (CSANZ) recognises healthcare factors, expertise and expenditure relevant to the Australian and New Zealand healthcare environments including considerations of potential implications for First Nations Peoples. The statement is cognisant of international advice but tailored to local conditions and populations, and is intended to be used by electrophysiologists, cardiologists and general physicians across all disciplines caring for patients with AF. They are also intended to provide guidance to healthcare facilities seeking to establish or maintain catheter ablation for AF.


Asunto(s)
Fibrilación Atrial , Ablación por Catéter , Humanos , Fibrilación Atrial/cirugía , Australia , Cardiología/normas , Ablación por Catéter/métodos , Ablación por Catéter/normas , Nueva Zelanda , Sociedades Médicas
2.
J Proteome Res ; 22(7): 2199-2217, 2023 07 07.
Artículo en Inglés | MEDLINE | ID: mdl-37235544

RESUMEN

Generating top-down tandem mass spectra (MS/MS) from complex mixtures of proteoforms benefits from improvements in fractionation, separation, fragmentation, and mass analysis. The algorithms to match MS/MS to sequences have undergone a parallel evolution, with both spectral alignment and match-counting approaches producing high-quality proteoform-spectrum matches (PrSMs). This study assesses state-of-the-art algorithms for top-down identification (ProSight PD, TopPIC, MSPathFinderT, and pTop) in their yield of PrSMs while controlling false discovery rate. We evaluated deconvolution engines (ThermoFisher Xtract, Bruker AutoMSn, Matrix Science Mascot Distiller, TopFD, and FLASHDeconv) in both ThermoFisher Orbitrap-class and Bruker maXis Q-TOF data (PXD033208) to produce consistent precursor charges and mass determinations. Finally, we sought post-translational modifications (PTMs) in proteoforms from bovine milk (PXD031744) and human ovarian tissue. Contemporary identification workflows produce excellent PrSM yields, although approximately half of all identified proteoforms from these four pipelines were specific to only one workflow. Deconvolution algorithms disagree on precursor masses and charges, contributing to identification variability. Detection of PTMs is inconsistent among algorithms. In bovine milk, 18% of PrSMs produced by pTop and TopMG were singly phosphorylated, but this percentage fell to 1% for one algorithm. Applying multiple search engines produces more comprehensive assessments of experiments. Top-down algorithms would benefit from greater interoperability.


Asunto(s)
Proteoma , Espectrometría de Masas en Tándem , Humanos , Proteoma/genética , Proteómica , Programas Informáticos , Procesamiento Proteico-Postraduccional
3.
Am J Hum Biol ; 35(11): e23943, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37358306

RESUMEN

OBJECTIVES: Breastfeeding is an energetically costly and intense form of human parental investment, providing sole-source nutrition in early infancy and bioactive components, including immune factors. Given the energetic cost of lactation, milk factors may be subject to tradeoffs, and variation in concentrations have been explored utilizing the Trivers-Willard hypothesis. As human milk immune factors are critical to developing immune system and protect infants against pathogens, we tested whether concentrations of milk immune factors (IgA, IgM, IgG, EGF, TGFß2, and IL-10) vary in response to infant sex and maternal condition (proxied by maternal diet diversity [DD] and body mass index [BMI]) as posited in the Trivers-Willard hypothesis and consider the application of the hypothesis to milk composition. METHODS: We analyzed concentrations of immune factors in 358 milk samples collected from women residing in 10 international sites using linear mixed-effects models to test for an interaction between maternal condition, including population as a random effect and infant age and maternal age as fixed effects. RESULTS: IgG concentrations were significantly lower in milk produced by women consuming diets with low diversity with male infants than those with female infants. No other significant associations were identified. CONCLUSIONS: IgG concentrations were related to infant sex and maternal diet diversity, providing minimal support for the hypothesis. Given the lack of associations across other select immune factors, results suggest that the Trivers-Willard hypothesis may not be broadly applied to human milk immune factors as a measure of maternal investment, which are likely buffered against perturbations in maternal condition.


Asunto(s)
Leche Humana , Estado Nutricional , Femenino , Lactante , Masculino , Humanos , Lactancia/fisiología , Lactancia Materna , Factores Inmunológicos , Inmunoglobulina G
4.
Annu Rev Nutr ; 41: 283-308, 2021 10 11.
Artículo en Inglés | MEDLINE | ID: mdl-34115518

RESUMEN

Because breastfeeding provides optimal nutrition and other benefits for infants (e.g., lower risk of infectious disease) and benefits for mothers (e.g., less postpartum bleeding), many organizations recommend that healthy infants be exclusively breastfed for 4 to 6 months in the United States and 6 months internationally. Recommendations related to how long breastfeeding should continue, however, are inconsistent. The objective of this article is to review the literature related to evidence for benefits of breastfeeding beyond 1 year for mothers and infants. In summary, human milk represents a good source of nutrients and immune components beyond 1 year. Some studies point toward lower infant mortality in undernourished children breastfed for >1 year, and prolonged breastfeeding increases interbirth intervals. Data on other outcomes (e.g., growth, diarrhea, obesity, and maternal weight loss) are inconsistent, often lacking sufficient control for confounding variables. There is a substantial need for rigorous, prospective, mixed-methods, cross-cultural research on this topic.


Asunto(s)
Lactancia Materna , Estado Nutricional , Niño , Femenino , Humanos , Lactante , Obesidad , Estudios Prospectivos , Estados Unidos
5.
Genomics ; 113(4): 1867-1875, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-33831438

RESUMEN

Human milk oligosaccharides (HMO), the third most abundant component of human milk, are thought to be important contributors to infant health. Studies have provided evidence that geography, stage of lactation, and Lewis and secretor blood groups are associated with HMO profile. However, little is known about how variation across the genome may influence HMO composition among women in various populations. In this study, we performed genome-wide association analyses of 395 women from 8 countries to identify genetic regions associated with 19 different HMO. Our data support FUT2 as the most significantly associated (P < 4.23-9 to P < 4.5-70) gene with seven HMO and provide evidence of balancing selection for FUT2. Although polymorphisms in FUT3 were also associated with variation in lacto-N-fucopentaose II and difucosyllacto-N-tetrose, we found little evidence of selection on FUT3. To our knowledge, this is the first report of the use of genome-wide association analyses on HMO.


Asunto(s)
Estudio de Asociación del Genoma Completo , Leche Humana , Oligosacáridos , Femenino , Humanos , Lactancia , Leche Humana/química , Oligosacáridos/química
6.
Ann Nutr Metab ; : 1-13, 2021 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-34515050

RESUMEN

Both undernutrition and overnutrition continue to represent enduring global health crises, and with the growing implications of both forms of malnutrition occurring simultaneously in individuals and populations (referred to as the double burden of malnutrition), understanding their biological and environmental causes is a primary research and humanitarian necessity. There is growing evidence of a bidirectional association between variation in the gastrointestinal (GI) microbiome and risk of/resilience to malnutrition during early life. For example, studies of siblings who discordantly do or do not develop severe malnutrition show clear differences in the diversity and composition of fecal microbiomes. These differences are transiently lessened during refeeding but re-emerge thereafter. These findings have been somewhat recapitulated using animal models, but small sample sizes and limited range complicate interpretation of results and applicability to humans. Mechanisms driving these differences are currently unknown but likely involve a combination of inflammatory pathways (and perhaps antioxidant status of the host) and effects on nutrient availability, requirements, and utilization by both host and microbe. A less robust literature also suggests that variation in GI microbiome is associated with risk for obesity during childhood. The putative impact of GI microbiomes on malnutrition is likely modified by a variety of important variables such as genetics (likely driven, in part, by evolution), environmental pathogen exposure and its timing, dietary factors, and cultural/societal pattern (e.g., use of antibiotics). Given the growing double burden of malnutrition, this topic demands a focused interdisciplinary approach that expands from merely characterizing differences and longitudinal changes in fecal microbes to examining their functionality during early life. Understanding the complex composition of human milk and how its components impact establishment and maintenance of the recipient infant's GI microbiome will also undoubtedly shed important light on this topic.

7.
Pacing Clin Electrophysiol ; 43(7): 746-753, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32495949

RESUMEN

AIMS: Sudden cardiac death (SCD) accounts for up to 25% of deaths in the adult congenital heart disease (ACHD) population. Current guidelines for defibrillator implantation are either extrapolated from acquired cardiac disease or are based upon single lesion studies, predominantly Tetralogy of Fallot (TOF). Defibrillator-related morbidity appears to be substantially higher in ACHD patients. METHODS: We retrospectively evaluated all patients in our ACHD database who received an implantable cardioverter-defibrillator (ICD) between 2000 and 2019, and who were ≥16 years old at time of implant. Patients were followed for appropriate shocks, inappropriate shocks, and complications. RESULTS: Of 4748 patients in our database, 59 patients (1.2%) underwent ICD implantation. ICDs were for primary prevention in 63% and secondary prevention in 37%. Over a median follow-up of 6.6 years, 24% received an appropriate shock, 27% an inappropriate shock, and 42% suffered a device-related complication (annualized risks of 3.2%, 3.6%, and 5.7%, respectively). There were no significant predictors of appropriate shocks or inappropriate shocks. All appropriate shocks in primary prevention patients occurred in TOF or transposition of the great arteries (TGA) with atrial switch, typically in the presence of multiple SCD risk factors. The majority of inappropriate shocks were due to supraventricular arrhythmias. Device-related mortality was 1.7% (0.3% per annum). CONCLUSIONS: Appropriate shocks were relatively common in an ACHD ICD population followed in the long term. Device-related morbidity was significant. Although risk factors have been established for TOF, and to a lesser extent TGA, risk stratification for ICD implantation in ACHD remains challenging.


Asunto(s)
Muerte Súbita Cardíaca/prevención & control , Desfibriladores Implantables , Cardiopatías Congénitas/terapia , Adolescente , Adulto , Anciano , Desfibriladores Implantables/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevención Primaria , Factores de Riesgo , Prevención Secundaria , Tetralogía de Fallot/terapia
8.
Matern Child Nutr ; 16(4): e13032, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32472745

RESUMEN

The novel coronavirus SARS-CoV-2 has emerged as one of the most compelling and concerning public health challenges of our time. To address the myriad issues generated by this pandemic, an interdisciplinary breadth of research, clinical and public health communities has rapidly engaged to collectively find answers and solutions. One area of active inquiry is understanding the mode(s) of SARS-CoV-2 transmission. Although respiratory droplets are a known mechanism of transmission, other mechanisms are likely. Of particular importance to global health is the possibility of vertical transmission from infected mothers to infants through breastfeeding or consumption of human milk. However, there is limited published literature related to vertical transmission of any human coronaviruses (including SARS-CoV-2) via human milk and/or breastfeeding. Results of the literature search reported here (finalized on 17 April 2020) revealed a single study providing some evidence of vertical transmission of human coronavirus 229E; a single study evaluating presence of SARS-CoV in human milk (it was negative); and no published data on MERS-CoV and human milk. We identified 13 studies reporting human milk tested for SARS-CoV-2; one study (a non-peer-reviewed preprint) detected the virus in one milk sample, and another study detected SARS-CoV-2 specific IgG in milk. Importantly, none of the studies on coronaviruses and human milk report validation of their collection and analytical methods for use in human milk. These reports are evaluated here, and their implications related to the possibility of vertical transmission of coronaviruses (in particular, SARS-CoV-2) during breastfeeding are discussed.


Asunto(s)
COVID-19/transmisión , COVID-19/virología , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Leche Humana/virología , SARS-CoV-2/aislamiento & purificación , Adulto , Anticuerpos Antivirales/análisis , Lactancia Materna , COVID-19/diagnóstico , Prueba de COVID-19 , Femenino , Edad Gestacional , Humanos , Inmunoglobulina G/análisis , Lactante , Recién Nacido , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/virología , SARS-CoV-2/inmunología
9.
J Nutr ; 149(6): 902-914, 2019 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-31063198

RESUMEN

BACKGROUND: Neonatal gastrointestinal (GI) bacterial community structure may be related to bacterial communities of the mother, including those of her milk. However, very little is known about the diversity in and relationships among complex bacterial communities in mother-infant dyads. OBJECTIVE: Our primary objective was to assess whether microbiomes of milk are associated with those of oral and fecal samples of healthy lactating women and their infants. METHODS: Samples were collected 9 times from day 2 to 6 mo postpartum from 21 healthy lactating women and their infants. Milk was collected via complete breast expression, oral samples via swabs, and fecal samples from tissue (mothers) and diapers (infants). Microbiomes were characterized using high-throughput sequencing of the 16S ribosomal RNA (rRNA) gene. Alpha and beta diversity indices were used to compare microbiomes across time and sample types. Membership and composition of microbiomes were analyzed using nonmetric multidimensional scaling and canonical correlation analysis (CCA). The contribution of various bacterial communities of the mother-infant dyad to both milk and infant fecal bacterial communities were estimated using SourceTracker2. RESULTS: Bacterial community structures were relatively unique to each sample type. The most abundant genus in milk and maternal and infant oral samples was Streptococcus (47.1% ± 2.3%, 53.9% ± 1.3%, and 69.1% ± 1.8%, respectively), whereas Bacteroides were predominant in maternal and infant fecal microbiomes (22.9% ± 1.3% and 21.4% ± 2.4%, respectively). The milk microbiome was more similar to the infant oral microbiome than the infant fecal microbiome. However, CCA suggested strong associations between the complex microbial communities of milk and those of all other sample types collected. CONCLUSIONS: These findings suggest complex microbial interactions between breastfeeding mothers and their infants and support the hypothesis that variation in the milk microbiome may influence the infant GI microbiome.


Asunto(s)
Microbiota/genética , Leche Humana/microbiología , Adulto , Bacterias/clasificación , Bacterias/genética , Bacterias/aislamiento & purificación , Biodiversidad , Heces/microbiología , Femenino , Microbioma Gastrointestinal/genética , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Lactante , Recién Nacido , Lactancia , Estudios Longitudinales , Masculino , Relaciones Madre-Hijo , Madres , Boca/microbiología , Análisis Multivariante , Periodo Posparto , Embarazo , Estudios Prospectivos , ARN Ribosómico 16S/genética , Streptococcus/genética , Streptococcus/aislamiento & purificación
10.
Am J Phys Anthropol ; 169(3): 526-539, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31012086

RESUMEN

OBJECTIVES: Establishment and development of the infant gastrointestinal microbiome (GIM) varies cross-culturally and is thought to be influenced by factors such as gestational age, birth mode, diet, and antibiotic exposure. However, there is little data as to how the composition of infants' households may play a role, particularly from a cross-cultural perspective. Here, we examined relationships between infant fecal microbiome (IFM) diversity/composition and infants' household size, number of siblings, and number of other household members. MATERIALS AND METHODS: We analyzed 377 fecal samples from healthy, breastfeeding infants across 11 sites in eight different countries (Ethiopia, The Gambia, Ghana, Kenya, Peru, Spain, Sweden, and the United States). Fecal microbial community structure was determined by amplifying, sequencing, and classifying (to the genus level) the V1-V3 region of the bacterial 16S rRNA gene. Surveys administered to infants' mothers identified household members and composition. RESULTS: Our results indicated that household composition (represented by the number of cohabitating siblings and other household members) did not have a measurable impact on the bacterial diversity, evenness, or richness of the IFM. However, we observed that variation in household composition categories did correspond to differential relative abundances of specific taxa, namely: Lactobacillus, Clostridium, Enterobacter, and Klebsiella. DISCUSSION: This study, to our knowledge, is the largest cross-cultural study to date examining the association between household composition and the IFM. Our results indicate that the social environment of infants (represented here by the proxy of household composition) may influence the bacterial composition of the infant GIM, although the mechanism is unknown. A higher number and diversity of cohabitants and potential caregivers may facilitate social transmission of beneficial bacteria to the infant gastrointestinal tract, by way of shared environment or through direct physical and social contact between the maternal-infant dyad and other household members. These findings contribute to the discussion concerning ways by which infants are influenced by their social environments and add further dimensionality to the ongoing exploration of social transmission of gut microbiota and the "old friends" hypothesis.


Asunto(s)
Bacterias , Composición Familiar/etnología , Microbioma Gastrointestinal/genética , Adolescente , Adulto , África , Américas , Antropología Física , Bacterias/clasificación , Bacterias/genética , Lactancia Materna , Comparación Transcultural , Europa (Continente) , Heces/microbiología , Humanos , Lactante , Recién Nacido , Madres , Hermanos , Adulto Joven
11.
Europace ; 20(FI_3): f451-f457, 2018 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-29036571

RESUMEN

Aims: Balloon cryoablation is an accepted method of achieving pulmonary vein isolation for the treatment of atrial fibrillation. The relationship between blood flow in the atrium and cryo energy delivery to the tissue remains poorly understood. Methods and results: Controlled cryoablations were performed in vitro using a pulmonary vein phantom constructed from bovine muscle, providing a 20 mm vein ostium. A temperature sensor was mounted within the 'vein wall' at a 1 mm tissue depth. Apparatus was constructed to assess the effect of incomplete pulmonary venous occlusion causing a leak, simulated atrial stasis, atrial circulation, and mitral regurgitation. Controlled ablations using the 2nd generation 28 mm cryoballoon catheter were repeated three times and mean values compared. Leak volume significantly affected both balloon temperatures and tissue temperatures. Simulated mitral regurgitation (MR) significantly impaired the effectiveness of cryo energy delivery resulting in significantly warmer balloon and tissue temperatures. With high leak volumes and moderate to severe MR there was a marked disparity between the cryoballoon temperature and the tissue temperature of approximately 60 degrees. Balloon warming times varied inversely with both leak volume and simulated MR flow volume. Conclusion: Incomplete venous occlusion and MR result in warmer balloon and tissue temperatures, and shorter balloon warming times, and are likely to significantly impair the effectiveness of cryoablation. Balloon temperature is poor indicator of tissue temperature under higher flow conditions.


Asunto(s)
Catéteres Cardíacos , Circulación Coronaria , Criocirugía/instrumentación , Atrios Cardíacos/cirugía , Hemodinámica , Venas Pulmonares/cirugía , Temperatura , Animales , Bovinos , Criocirugía/efectos adversos , Diseño de Equipo , Atrios Cardíacos/fisiopatología , Técnicas In Vitro , Insuficiencia de la Válvula Mitral/fisiopatología , Modelos Cardiovasculares , Venas Pulmonares/fisiopatología , Factores de Tiempo
12.
Am J Hum Biol ; 30(4): e23131, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29700885

RESUMEN

OBJECTIVES: We present the first available data on the human milk microbiome (HMM) from small-scale societies (hunter-gatherers and horticulturalists in the Central African Republic [CAR]) and explore relationships among subsistence type and seasonality on HMM diversity and composition. Additionally, as humans are cooperative breeders and, throughout our evolutionary history and today, we rear offspring within social networks, we examine associations between the social environment and the HMM. Childrearing and breastfeeding exist in a biosocial nexus, which we hypothesize influences the HMM. METHODS: Milk samples from hunter-gatherer and horticultural mothers (n = 41) collected over two seasons, were analyzed for their microbial composition. A subsample of these women's infants (n = 33) also participated in detailed naturalistic behavioral observations which identified the breadth of infants' social and caregiving networks and the frequency of contact they had with caregivers. RESULTS: Analyses of milk produced by CAR women indicated that HMM diversity and community composition were related to the size of the mother-infant dyad's social network and frequency of care that infants receive. The abundance of some microbial taxa also varied significantly across populations and seasons. Alpha diversity, however, was not related to subsistence type or seasonality. CONCLUSION: While the origins of the HMM are not fully understood, our results provide evidence regarding possible feedback loops among the infant, the mother, and the mother's social network that might influence HMM composition.


Asunto(s)
Crianza del Niño , Estilo de Vida , Microbiota , Leche Humana/microbiología , Medio Social , Adolescente , Bacterias/clasificación , República Centroafricana , Niño , Preescolar , Humanos , Lactante , Recién Nacido , Estaciones del Año
13.
J Nutr ; 147(9): 1739-1748, 2017 09.
Artículo en Inglés | MEDLINE | ID: mdl-28724659

RESUMEN

Background: The human milk microbiome has been somewhat characterized, but little is known about changes over time and relations with maternal factors such as nutrient intake.Objective: We sought to characterize the human milk microbiome and described associations with maternal nutrient intake, time postpartum, delivery mode, and body mass index (BMI; in kg/m2).Methods: Milk samples (n = 104) and 24-h diet recalls were collected 9 times from 21 healthy lactating women from day 2 to 6 mo postpartum. Women were classified by BMI as healthy weight (<25) or overweight or obese (≥25). Bacterial taxa were characterized with the use of the high-throughput sequencing of the 16S ribosomal RNA gene.Results: The milk microbiome was relatively constant over time, although there were small changes in some of the lesser-abundant genera. Relative abundances of several taxa were associated with BMI, delivery mode, and infant sex. For instance, overweight and obese mothers produced milk with a higher relative abundance of Granulicatella than did healthy-weight women (1.8% ± 0.6% compared with 0.4% ± 0.2%, respectively; P < 0.05). Relative abundances of several bacterial taxa were also associated with variations in maternal dietary intake. For example, intakes of saturated fatty acids (rs = -0.59; P = 0.005) and monounsaturated fatty acids (rs = -0.46; P = 0.036) were inversely associated with the relative abundance of Corynebacterium; total carbohydrates (rs = -0.54; P = 0.011), disaccharides (rs = -0.47; P = 0.031), and lactose (rs = -0.51; P = 0.018) were negatively associated with Firmicutes; and protein consumption was positively correlated with the relative abundance of Gemella (rs = 0.46; P = 0.037).Conclusions: Factors associated with variations in the human milk microbiome are complex and may include maternal nutrient intake, maternal BMI, delivery mode, and infant sex. Future studies designed to investigate the relation between maternal nutrient intake and the milk microbiome should strive to also evaluate dietary supplement usage and analyze the collected milk for its nutrient content.


Asunto(s)
Bacterias/efectos de los fármacos , Índice de Masa Corporal , Carbohidratos de la Dieta/farmacología , Grasas de la Dieta/farmacología , Proteínas en la Dieta/farmacología , Lactancia , Leche Humana/microbiología , Adulto , Bacterias/crecimiento & desarrollo , Parto Obstétrico , Dieta , Disacáridos/farmacología , Ácidos Grasos Monoinsaturados/farmacología , Conducta Alimentaria , Femenino , Humanos , Lactante , Lactosa/farmacología , Masculino , Fenómenos Fisiologicos Nutricionales Maternos , Obesidad/microbiología , Sobrepeso , Periodo Posparto
14.
J Dairy Sci ; 100(3): 2104-2118, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28041725

RESUMEN

During the periparturient period, elevated circulating nonesterified fatty acids (NEFA) from excessive lipid mobilization affect not only the circulating fatty acid (FA) composition, but also that of the peripheral blood mononuclear cells (PBMC) and polymorphonuclear leukocytes (PMNL). However, the changes to specific lipid fractions remain unknown. We hypothesized that elevated lipid mobilization will alter FA profiles and gene expression of selected proinflammatory mediators in PBMC and PMNL. Starting -28 d relative to expected calving (d 0), treatment cows (n = 18) received a dry cow ration plus an additional 10 kg of corn/head per day, while the control cows (n = 16) received the dry cow ration (no additional corn) supplemented with 400 mg of monensin/head per day to minimize lipid mobilization. Postpartum, treatment cows were feed deprived for 8 h on d +3. For FA analysis, serum was collected on d -28 and -7 relative to expected parturition and d +1, +3, +6, +15, and +21 postpartum, in addition to milk samples. Immune cells, PBMC and PMNL, were isolated on d -28, +3, +12, and +21 for FA analysis and gene expression analysis by reverse-transcription PCR. Serum, PBMC, and PMNL lipids were fractionated into NEFA and phospholipids (PL). The FA composition of milk, serum, PBMC, and PMNL was analyzed by gas chromatography. Data were analyzed as repeated measures ANOVA using mixed model procedures in SAS (9.3) with significance declared at P ≤ 0.05. Several FA varied by treatment and across time and parity. Within the serum PL fraction, FA associated with altered immune function, C18:3n-6, C20:4, C20:5, total n-3, and the ratio of n-6 to n-3 varied significantly by a treatment × parity × time interaction. Overall, FA composition of NEFA and PL fractions from PBMC and PMNL did not significantly reflect FA of serum. Gene expression for IL-1ß in PBMC was greater for control, whereas ICAM, IL-1ß, IL-6, and TNF-α were greater in primiparous than multiparous cows, without a detectable treatment effect. Whereas gene expression of CASP, IL-8R, and SELL in PMNL changed over time, no treatment effect was detected. In summary, high-energy prepartal diets altered FA profile in serum, milk, PBMC, and PMNL lipids; however, gene expression of selected proinflammatory mediators was not significantly affected.


Asunto(s)
Lactancia/metabolismo , Leucocitos Mononucleares/metabolismo , Animales , Bovinos , Dieta/veterinaria , Ácidos Grasos , Ácidos Grasos no Esterificados/sangre , Femenino , Leche/química , Grasa Subcutánea/metabolismo
15.
Heart Lung Circ ; 26(9): 950-959, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28652028

RESUMEN

Catheter ablation has become a standard technique for the treatment of atrial fibrillation. Pulmonary vein isolation (PVI) is the most important component of catheter ablation of atrial fibrillation. Radiofrequency (RF) ablation and balloon cryoablation can be used to achieve PVI. This review examines the biophysics and clinical efficacy of balloon cryoablation and discusses the potential advantages and disadvantages compared to RF ablation.


Asunto(s)
Fibrilación Atrial/cirugía , Criocirugía/métodos , Sistema de Conducción Cardíaco/cirugía , Humanos , Resultado del Tratamiento
16.
Heart Lung Circ ; 26(11): 1191-1199, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28501519

RESUMEN

BACKGROUND: Autopsy reports suggest that cardiac sarcoidosis occurs in 20 to 25% of patients with pulmonary sarcoidosis, yet the clinical ante-mortem diagnosis is made in only 5% of cases. Current diagnostic algorithms are complex and lack sensitivity. Cardiac Magnetic Resonance imaging (CMR) provides an opportunity to detect myocardial involvement in sarcoidosis. The aim of this study is to determine the prevalence and clinical significance of late gadolinium enhancement (LGE) on CMR in patients with sarcoidosis. METHODS: Consecutive patients with biopsy-proven sarcoidosis undergoing CMR were retrospectively evaluated for cardiac sarcoidosis. Medical records were correlated with CMR. RESULTS: Forty-six patients were evaluated. Late gadolinium enhancement was present in 22%, indicating myocardial involvement, and 70% had corresponding hyper-intense T2 signal indicating active inflammation. Late gadolinium enhancement was 18%+/-9.7% of overall left ventricular (LV) mass and most commonly located in the basal to mid septum. There was no association between LGE and cardiovascular symptoms or pulmonary stage. Eighty per cent of patients with LGE did not fulfill conventional diagnostic criteria for cardiac sarcoidosis. However, LGE was associated with clinically significant arrhythmia (p<0.01) and a lower LVEF (p=0.04). CONCLUSIONS: Using CMR, we identified a higher prevalence of cardiac sarcoidosis than previously reported clinical studies, a prevalence which is more consistent with autopsy data. The presence of LGE was highly correlated with clinically significant arrhythmias and lower LVEF.


Asunto(s)
Algoritmos , Cardiomiopatías/diagnóstico , Gadolinio/administración & dosificación , Imagen por Resonancia Magnética , Sarcoidosis/diagnóstico por imagen , Adulto , Anciano , Biopsia , Cardiomiopatías/patología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Sarcoidosis/patología
17.
J Pediatr ; 177: 140-143, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-27423174

RESUMEN

OBJECTIVE: To examine the integrity (pH, bacterial counts, host defense factors, nutrient contents, and osmolality) of freshly expressed and previously refrigerated human milk subjected to long-term freezer storage. STUDY DESIGN: Mothers donated 100 mL of freshly expressed milk. Samples were divided into baseline, storage at -20°C (fresh frozen) for 1, 3, 6, and 9 months, and prior storage at +4°C for 72 hours (refrigerated frozen) before storage at -20°C for 1 to 9 months. Samples were analyzed for pH, total bacterial colony count, gram-positive and gram-negative colony counts, and concentrations of total protein, fat, nonesterified fatty acids, lactoferrin, secretory IgA, and osmolality. RESULTS: Milk pH, total bacterial colony count, and Gram-positive colony counts decreased significantly with freezer storage (P < .001); bacterial counts decreased most rapidly in the refrigerated frozen group. The gram-negative colony count decreased significantly over time (P < .001). Nonesterified fatty acid concentrations increased significantly with time in storage (P < .001). Freezing for up to 9 months did not affect total protein, fat, lactoferrin, secretory IgA, or osmolality in either group. CONCLUSIONS: Freezer storage of human milk for 9 months at -20°C is associated with decreasing pH and bacterial counts, but preservation of key macronutrients and immunoactive components, with or without prior refrigeration for 72 hours. These data support current guidelines for freezer storage of human milk for up to 9 months for both freshly expressed and refrigerated milk.


Asunto(s)
Congelación , Leche Humana/química , Refrigeración/estadística & datos numéricos , Recuento de Colonia Microbiana , Femenino , Humanos , Proteínas de la Leche/análisis , Leche Humana/microbiología , Madres , Factores de Tiempo
19.
J Dairy Res ; 83(1): 20-7, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26869108

RESUMEN

Immune system and inflammatory responses are affected by α-linolenic acid (αLA: 18:3 ω-3). The objective of this study was to determine the effects of αLA-enriched rations on gene expression of systemic (blood) and local (mammary gland) inflammatory markers in Holstein dairy cattle. Further, the effect of dietary treatments was evaluated on the concentration of αLA in serum phospholipids. Camelina (Camelina sativa) meal (containing 24.2% αLA) was fed at 0, 3, 6, and 9% (dry matter basis) replacing canola meal (rich in 18:1 ω-9) to provide rations with incremental concentrations of αLA. Lactating primiparous Holstein cows (n = 18) were randomly assigned to a treatment sequence in a 4 × 4 Latin square design. Each period lasted 16 d and milk and blood samples were collected during the final 2 d of each period. Peripheral blood mononuclear cells (PBMC) and milk cells (MC) were harvested, and RNA extracted and converted to complementary DNA for quantitative real time PCR analysis. The effect of dietary treatments (αLA) on the relative abundance of pro- and anti-inflammatory genes in the PBMC and MC was tested by the MIXED procedure of SAS. Expression of pro-inflammatory tumour necrosis factor (TNF)-α in MC was linearly reduced (up to 40%) as dietary αLA increased. Expression of pro-inflammatory markers interleukin (IL)-1ß, IL-8, and TNF-α was reduced (29, 20, and 27%, respectively) in PBMC isolated from cows fed 6% camelina meal ration as compared with cows fed 0% (control). Expression of IL-6 was, however, increased with inclusion of camelina meal. Greater dietary αLA linearly increased serum phospholipids αLA contents, and when fed up to 6% DM down-regulated expression of some of the local (milk) and systemic (blood) pro-inflammatory markers in vivo.


Asunto(s)
Alimentación Animal/análisis , Dieta/veterinaria , Inflamación/veterinaria , Leche/citología , Ácido alfa-Linolénico/farmacología , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Bovinos , Citocinas/genética , Citocinas/metabolismo , Suplementos Dietéticos , Femenino , Regulación de la Expresión Génica/efectos de los fármacos , Inflamación/metabolismo , Ácido alfa-Linolénico/administración & dosificación , Ácido alfa-Linolénico/química
20.
J Environ Sci Health B ; 51(4): 254-9, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26786170

RESUMEN

Simple high-throughput procedures were developed for the direct analysis of glyphosate [N-(phosphonomethyl)glycine] and aminomethylphosphonic acid (AMPA) in human and bovine milk and human urine matrices. Samples were extracted with an acidified aqueous solution on a high-speed shaker. Stable isotope labeled internal standards were added with the extraction solvent to ensure accurate tracking and quantitation. An additional cleanup procedure using partitioning with methylene chloride was required for milk matrices to minimize the presence of matrix components that can impact the longevity of the analytical column. Both analytes were analyzed directly, without derivatization, by liquid chromatography tandem mass spectrometry using two separate precursor-to-product transitions that ensure and confirm the accuracy of the measured results. Method performance was evaluated during validation through a series of assessments that included linearity, accuracy, precision, selectivity, ionization effects and carryover. Limits of quantitation (LOQ) were determined to be 0.1 and 10 µg/L (ppb) for urine and milk, respectively, for both glyphosate and AMPA. Mean recoveries for all matrices were within 89-107% at three separate fortification levels including the LOQ. Precision for replicates was ≤ 7.4% relative standard deviation (RSD) for milk and ≤ 11.4% RSD for urine across all fortification levels. All human and bovine milk samples used for selectivity and ionization effects assessments were free of any detectable levels of glyphosate and AMPA. Some of the human urine samples contained trace levels of glyphosate and AMPA, which were background subtracted for accuracy assessments. Ionization effects testing showed no significant biases from the matrix. A successful independent external validation was conducted using the more complicated milk matrices to demonstrate method transferability.


Asunto(s)
Cromatografía Liquida/métodos , Glicina/análogos & derivados , Leche/química , Organofosfonatos/análisis , Espectrometría de Masas en Tándem/métodos , Animales , Bovinos , Femenino , Análisis de los Alimentos/métodos , Contaminación de Alimentos/análisis , Glicina/análisis , Glicina/orina , Humanos , Isoxazoles , Límite de Detección , Leche Humana/química , Organofosfonatos/orina , Tetrazoles , Glifosato
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