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1.
J Environ Manage ; 317: 115411, 2022 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-35751248

RESUMEN

Coastal suburban watersheds are under heavy pressure from human activity. This pressure has yielded an extensive effort to protect, mitigate, and restore watershed ecosystem services. Assessment of restoration investments would be greatly improved by a standard approach for estimating change in ecosystem service production combined with a well-defined baseline for assessment of restoration effects. Here we take a model-based approach to both objectives by applying two established ecosystem service models in a representative coastal watershed. This watershed has undergone extensive suburbanization resulting in a loss of ecosystem services, which has resulted in heavy restoration investments. We used models to estimate loss of the ecosystem services; clean air, clean water, stable climate, and water storage resulting from suburbanization. We then applied these model-based estimates as a baseline for assessment of restoration focusing on the appropriate restoration scale and considering downstream watershed impacts. The results suggest that losses of ecosystem services, such as flood water storage, from suburbanization have been extensive since 2001, but a comparison of restoration value suggests that restoration has been effective in recouping ecosystem services in some but not all local regions suggesting there are trade-offs to be made in these efforts. These benefits were most evident for the services of clean water and water storage. Models can inform decisions by clarifying what has been lost and estimating what can be regained through restoration action. The former sets a baseline for the latter and allows for a functional equivalency approach to assessment.


Asunto(s)
Ecosistema , Agua , Conservación de los Recursos Naturales/métodos , Humanos
2.
Philos Trans A Math Phys Eng Sci ; 378(2184): 20200031, 2020 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-33040651

RESUMEN

Argon fluoride (ArF) is currently the shortest wavelength laser that can credibly scale to the energy and power required for high gain inertial fusion. ArF's deep ultraviolet light and capability to provide much wider bandwidth than other contemporary inertial confinement fusion (ICF) laser drivers would drastically improve the laser target coupling efficiency and enable substantially higher pressures to drive an implosion. Our radiation hydrodynamics simulations indicate gains greater than 100 are feasible with a sub-megajoule ArF driver. Our laser kinetics simulations indicate that the electron beam-pumped ArF laser can have intrinsic efficiencies of more than 16%, versus about 12% for the next most efficient krypton fluoride excimer laser. We expect at least 10% 'wall plug' efficiency for delivering ArF light to target should be achievable using solid-state pulsed power and efficient electron beam transport to the laser gas that was demonstrated with the U.S. Naval Research Laboratory's Electra facility. These advantages could enable the development of modest size and lower cost fusion power plant modules. This would drastically change the present view on inertial fusion energy as being too expensive and the power plant size too large. This article is part of a discussion meeting issue 'Prospects for high gain inertial fusion energy (part 1)'.

3.
J Genet Couns ; 26(3): 355-360, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28236280

RESUMEN

As the demand for evidence to support the value of genetic counseling increases, it is critical that reporting of genetic counseling interventions in research and other types of studies (e.g. process improvement or service evaluation studies) adopt greater rigor. As in other areas of healthcare, the appraisal, synthesis, and translation of research findings into genetic counseling practice are likely to be improved if clear specifications of genetic counseling interventions are reported when studies involving genetic counseling are published. To help improve reporting practices, the National Society of Genetic Counselors (NSGC) convened a task force in 2015 to develop consensus standards for the reporting of genetic counseling interventions. Following review by the NSGC Board of Directors, the NSGC Practice Guidelines Committee and the editorial board of the Journal of Genetic Counseling, 23 items across 8 domains were proposed as standards for the reporting of genetic counseling interventions in the published literature (GCIRS: Genetic Counseling Intervention Reporting Standards). The authors recommend adoption of these standards by authors and journals when reporting studies involving genetic counseling interventions.


Asunto(s)
Comités Consultivos , Asesoramiento Genético/normas , Informe de Investigación/normas , Sociedades Médicas , Femenino , Humanos , Masculino , Estados Unidos
4.
J Vet Pharmacol Ther ; 40(4): 356-362, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27654900

RESUMEN

Twelve healthy swine were dosed with penicillin G intramuscularly. Fluids and tissues samples were collected at the end of two periods of general anesthesia, performed 24 h apart. Tissue samples were collected by minimally invasive laparoscopy under general anesthesia at 8 and 28 h postdose. Four nonanesthetized, penicillin-treated pigs were euthanized at 8 h postdose, and a second set of four similarly treated control pigs were sacrificed 28 h postdose. Liver penicillin tissue concentrations from animals that underwent anesthesia and laparoscopic tissue collection had tissue concentrations that were higher than nonanesthetized pigs at both time points. Urine, plasma, kidney, skeletal, and cardiac muscle showed no differences between the two groups. Laparoscopic tissue collection under general anesthesia in swine induces physiological changes that cause alterations in tissue pharmacokinetics not seen in conscious animals.


Asunto(s)
Isoflurano/farmacología , Penicilinas/metabolismo , Porcinos/metabolismo , Anestesia General , Anestesia por Inhalación/veterinaria , Anestésicos por Inhalación , Animales , Interacciones Farmacológicas , Hígado
5.
Public Health ; 141: 232-240, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27932008

RESUMEN

BACKGROUND: Smoking, insufficient physical activity (PA), sedentary behaviour (SB) and obesity are leading risk factors for morbidity and premature mortality. Few studies examining the relationship between these behavioural risk factors and quitting behaviours among cohorts of smokers have been published. PURPOSE: The goals of this study are to examine the cross-sectional relationships among behavioural health risk factors (insufficient PA, SB and obesity) and past year quitting behaviours within a sample of smokers. METHODS: The California Smokers Cohort, conducted from 2011 through 2013, is a population-based survey of adult smokers in California. Using follow-up data (n = 1050), participants' self-reported health behaviours and past year quitting behaviours were examined in univariate analyses and multivariate logistic regression analyses controlling for demographic covariates. RESULTS: In univariate analyses examining health behaviours among smokers, all three health behaviours examined (PA, SB and obesity) were related, and significantly more obese smokers with high PA and low SB reported a ≥20% smoking rate reduction than smokers with other combinations of health behaviours (48.8%, Chi-squared = 4.765, P = 0.045). In multivariate models adjusted for sociodemographic characteristics, obese smokers (odds ratio [OR] = 1.450, 95% confidence interval [CI]: 1.088-1.932, P = 0.011) and smokers with higher levels of PA (OR = 1.448, 95% CI: 1.111-1.887, P = 0.006) were more likely to report a past year ≥24-hour quit attempt regardless of SB, and obese smokers (OR = 1.760, 95% CI: 1.095-2.828, P = 0.019) were more likely to report being quit for ≥30 days regardless of PA and SB. CONCLUSIONS: Overall, the results demonstrated that more physically active and obese smokers were more likely to report positive strides towards quitting. These findings support the potential positive effect of addressing multiple health behaviours along with smoking.


Asunto(s)
Ejercicio Físico/psicología , Obesidad/psicología , Conducta Sedentaria , Cese del Hábito de Fumar/psicología , Fumar/psicología , Adulto , California/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Fumar/epidemiología , Cese del Hábito de Fumar/estadística & datos numéricos
6.
Plant Dis ; 100(12): 2442-2447, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30686171

RESUMEN

Antimicrobial activity of experimental formulations of two structurally different nano-zinc oxide materials, plate-like Zinkicide SG4 and particulate Zinkicide SG6, was evaluated against Xanthomonas citri subsp. citri, the cause of citrus canker. In vitro assay demonstrated Zinkicide SG4 had a twofold lower minimum inhibitory concentration (MIC) against Escherichia coli and X. alfalfae subsp. citrumelonis (62.5 to 250 µg/ml) compared with copper sulfate (250 µg/ml), copper hydroxide (250 to 500 µg/ml), or cuprous oxide/zinc oxide (125 to 250 µg/ml). Zinkicide SG6 had a sevenfold to eightfold lower MIC against Escherichia coli and X. alfalfae subsp. citrumelonis (31 to 250 µg/ml). Leaves of sweet orange (Citrus sinensis) and fruit of 'Ruby Red' grapefruit (C. paradisi) were evaluated for citrus canker disease control. A greenhouse assay with foliage demonstrated that spray treatment with Zinkicide reduced citrus canker lesion development after injection-infiltration of X. citri subsp. citri into the leaf intercellular space. In field trials conducted in Southeast Florida in 2014 and 2015, Zinkicide SG4 and SG6 reduction of grapefruit canker incidence exceeded that of cuprous oxide and cuprous oxide/zinc oxide bactericides. Zinkicide formulations were also effective against the fungal diseases, citrus scab (Elsinoe fawcetti) and melanose (Diaporthe citri), on grapefruit. No sign of phytotoxicity to the fruit rind was observed during either season. Antimicrobial activity of Zinkicide for protection of leaves and fruit against X. citri subsp. citri was comparable or exceeded that for commercial copper and zinc oxide formulations which may be attributed to translaminar movement of Zinkicide.

7.
J Vet Pharmacol Ther ; 39(2): 131-7, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26471945

RESUMEN

This study evaluated the impact of the ABCB1-1Δ mutation in Collies which exhibited toxicity toward ivermectin, on changes in gene expression when given the unrelated ABCB1 substrate loperamide, to identify potential biomarkers predictive of drug safety. Thirty-two healthy intact Collies consisting of dogs with either a wild-type, heterozygous mutant, or homozygous mutant genotype were used. Whole blood samples were collected from Collies at 0 or 5 h following administration of loperamide at a dose of 0.10 mg/kg. Whole-genome gene expression microarray was conducted to examine for changes in gene expression. Microarray analysis identified loperamide-induced changes in gene expression which were specifically associated with ivermectin-sensitive phenotypes in Collies possessing the ABCB1-1Δ mutation. Gene pathway analysis further demonstrated that the altered genes are involved in immunological disease, cell death and survival, and cellular development. Thirteen genes, including CCL8 and IL-8, were identified. Collie dogs harboring ABCB1-1Δ mutation which also exhibited toxicity toward ivermectin demonstrated systematic responses following loperamide treatment exhibited by altered expression of genes involved in immune and inflammatory signaling pathways. Genes such as CCL8 and IL-8 are potential biomarkers in whole blood that may predict the safety of loperamide in dogs with ABCB1-1∆ mutation associated with ivermectin sensitivity.


Asunto(s)
Enfermedades de los Perros/inducido químicamente , Hipersensibilidad a las Drogas/veterinaria , Regulación de la Expresión Génica/efectos de los fármacos , Inflamación/veterinaria , Ivermectina/efectos adversos , Loperamida/farmacología , Miembro 1 de la Subfamilia B de Casetes de Unión a ATP/genética , Miembro 1 de la Subfamilia B de Casetes de Unión a ATP/metabolismo , Animales , Enfermedades de los Perros/sangre , Enfermedades de los Perros/genética , Enfermedades de los Perros/metabolismo , Perros , Femenino , Regulación de la Expresión Génica/inmunología , Inflamación/inducido químicamente , Inflamación/genética , Inflamación/metabolismo , Masculino , Mutación
8.
J Vet Pharmacol Ther ; 39(6): 602-611, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27189015

RESUMEN

Eighteen Holstein dairy cows ranging in body weight from 500-700 kg and with an average milk yield of 37 ± 6 kg/day were used to investigate the depletion of florfenicol (FFL) in milk and plasma of dairy cows. Three groups of six were administered FFL: Group A, intramammary (IMM) infusion of ~2.5 mg FFL/kg BW at three consecutive milking intervals (total amount of ~7.5 mg/kg BW); Group B, one IMM infusion (20 mg/kg BW) into one quarter and Group C, one subcutaneous (SC) treatment (40 mg/kg BW). IMM infusions were into the right front quarter. Cows were milked daily at 06:00 and 18:00 h. The highest concentrations (Cmax ) and time to Cmax (Tmax ) were: 1.6 ± 2.2 µg·FFL/mL milk at 22 h (Group A), 5.5 ± 3.6 µg·FFL/mL milk at 12 h (Group B), and 1.7 ± 0.4 µg·FFL/mL milk at 12 h (Group C). The half-lives (t1/2 ) were ~19, 5.5, and 60 h, for Groups A, B, and C, respectively. FFL was below the limit of detection (LOD) by 60 h in three Group B cows, but above the LOD at 72, 84, and 120 h in three cows. FFL was above the LOD in milk from Group C's cows for 432-588 h. Plasma values followed the same trends as milk. The results demonstrate that IMM-infused FFL is bioavailable and below the LOD within 72-120 h. The concentration of FFL was detectable in both plasma and milk over the course of 2-3 weeks after SC administration. The absence of residue depletion data presents problems in determining safe levels of FFL residues in milk and edible tissues. The data presented here must not be construed as approval for extra-label use in food animals.


Asunto(s)
Antibacterianos/farmacocinética , Bovinos/sangre , Glándulas Mamarias Animales/metabolismo , Tianfenicol/análogos & derivados , Animales , Antibacterianos/administración & dosificación , Antibacterianos/química , Bovinos/metabolismo , Vías de Administración de Medicamentos , Femenino , Leche/química , Tianfenicol/administración & dosificación , Tianfenicol/química , Tianfenicol/farmacocinética
9.
Acta Paediatr ; 104(7): 670-7, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25772627

RESUMEN

AIM: To assess the impact of Family Nurture Intervention (FNI) on cortical function in preterm infants at term age. METHODS: Family Nurture Intervention is a NICU-based intervention designed to establish emotional connection between mothers and preterm infants. Infants born at 26-34 weeks postmenstrual age (PMA) were divided into two groups, standard care (SC, N = 49) and FNI (FNI, N = 56). Infants had EEG recordings of ~one hour duration with 124 lead nets between 37 and 44 weeks PMA. Coherence was measured between all pairs of electrodes in ten frequency bands. Data were summarised both within and between 12 regions during two sleep states (active, quiet). RESULTS: Coherence levels were negatively correlated with PMA age in both groups. As compared to SC infants, FNI infants showed significantly lower levels of EEG coherence (1-18 Hz) largely within and between frontal regions. CONCLUSION: Coherence in FNI infants was decreased in regions where we previously found robust increases in EEG power. As coherence decreases with age, results suggest that FNI may accelerate brain maturation particularly in frontal brain regions, which have been shown in research by others to be involved in regulation of attention, cognition and emotion regulation; domains deficient in preterm infants.


Asunto(s)
Corteza Cerebral/fisiopatología , Cuidados Críticos , Enfermedades del Prematuro/terapia , Conducta Materna , Madres/psicología , Relaciones Padres-Hijo , Factores de Edad , Electroencefalografía , Emociones , Femenino , Humanos , Recién Nacido , Recien Nacido Prematuro , Enfermedades del Prematuro/fisiopatología , Enfermedades del Prematuro/psicología , Masculino , Sueño
10.
Phys Rev Lett ; 113(2): 021301, 2014 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-25062161

RESUMEN

Gravitational lensing due to the large-scale distribution of matter in the cosmos distorts the primordial cosmic microwave background (CMB) and thereby induces new, small-scale B-mode polarization. This signal carries detailed information about the distribution of all the gravitating matter between the observer and CMB last scattering surface. We report the first direct evidence for polarization lensing based on purely CMB information, from using the four-point correlations of even- and odd-parity E- and B-mode polarization mapped over ∼30 square degrees of the sky measured by the POLARBEAR experiment. These data were analyzed using a blind analysis framework and checked for spurious systematic contamination using null tests and simulations. Evidence for the signal of polarization lensing and lensing B modes is found at 4.2σ (stat+sys) significance. The amplitude of matter fluctuations is measured with a precision of 27%, and is found to be consistent with the Lambda cold dark matter cosmological model. This measurement demonstrates a new technique, capable of mapping all gravitating matter in the Universe, sensitive to the sum of neutrino masses, and essential for cleaning the lensing B-mode signal in searches for primordial gravitational waves.

11.
Phys Rev Lett ; 112(13): 131302, 2014 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-24745402

RESUMEN

We reconstruct the gravitational lensing convergence signal from cosmic microwave background (CMB) polarization data taken by the Polarbear experiment and cross-correlate it with cosmic infrared background maps from the Herschel satellite. From the cross spectra, we obtain evidence for gravitational lensing of the CMB polarization at a statistical significance of 4.0σ and indication of the presence of a lensing B-mode signal at a significance of 2.3σ. We demonstrate that our results are not biased by instrumental and astrophysical systematic errors by performing null tests, checks with simulated and real data, and analytical calculations. This measurement of polarization lensing, made via the robust cross-correlation channel, not only reinforces POLARBEAR auto-correlation measurements, but also represents one of the early steps towards establishing CMB polarization lensing as a powerful new probe of cosmology and astrophysics.

12.
Muscle Nerve ; 47(1): 1-11, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23192899

RESUMEN

Although there has been extensive research on small, unmyelinated fibers in the skin, little research has investigated dermal myelinated fibers in comparison. Glabrous, nonhairy skin contains mechanoreceptors that afford a vantage point for observation of myelinated fibers that have previously been seen only with invasively obtained nerve biopsies. This review discusses current morphometric and molecular expression data of normative and pathogenic glabrous skin obtained by various processing and analysis methods for cutaneous myelinated fibers. Recent publications have shed light on the role of glabrous skin biopsy in identifying signs of peripheral neuropathy and as a potential biomarker of distal myelin and mechanoreceptor integrity. The clinical relevance of a better understanding of the role of dermal myelinated nerve terminations in peripheral neuropathy will be addressed in light of recent publications in the growing field of skin biopsy.


Asunto(s)
Fibras Nerviosas Mielínicas/patología , Enfermedades del Sistema Nervioso Periférico/patología , Piel/inervación , Biopsia , Humanos , Piel/patología
13.
J Peripher Nerv Syst ; 18(2): 162-7, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23781963

RESUMEN

Skin biopsies have primarily been used to study the non-myelinated nerve fibers of the epidermis in a variety of neuropathies. In this study, we have expanded the skin biopsy technique to glabrous, non-hairy skin to evaluate myelinated nerve fibers in the most highly prevalent peripheral nerve disease, diabetic polyneuropathy (DPN). Twenty patients with DPN (Type I, n = 9; Type II, n = 11) and 16 age-matched healthy controls (age 29-73) underwent skin biopsy of the index finger, nerve conduction studies (NCS), and composite neuropathy scoring. In patients with DPN, we found a statistically significant reduction of both mechanoreceptive Meissner corpuscles (MCs) and their afferent myelinated nerve fibers (p = 0.01). This myelinated nerve fiber loss was correlated with the decreased amplitudes of sensory/motor responses in NCS. This study supports the utilization of skin biopsy to quantitatively evaluate axonal loss of myelinated nerve fibers in patients with DPN.


Asunto(s)
Neuropatías Diabéticas/patología , Fibras Nerviosas Mielínicas/patología , Adulto , Anciano , Biopsia , Diabetes Mellitus Tipo 1/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Femenino , Dedos/inervación , Dedos/patología , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Conducción Nerviosa , Piel/inervación , Piel/patología
14.
Curr Neurol Neurosci Rep ; 13(1): 323, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23250768

RESUMEN

Skin biopsy is a valuable diagnostic tool for small-fiber-predominant neuropathy by the quantification of intraepidermal nerve fiber density (IENFD). It has the unique advantage of being a minimally invasive procedure with the potential for longitudinal evaluation of both sensory and autonomic fibers. Unmyelinated small fibers are not otherwise quantified objectively with such a level of sensitivity as has been reported with IENFD. Recent advances include an expansion of the skin punch biopsy technique to evaluate larger myelinated fibers and mechanoreceptors, and recent work has also focused on additional methods of quantifying dermal fibers and densely innervated autonomic structures. This review discusses current work using skin biopsy for the pathologic analysis of peripheral nerve fibers in neuropathy of various causes as well as its use in clinical trials.


Asunto(s)
Biopsia/métodos , Fibras Nerviosas/patología , Enfermedades del Sistema Nervioso Periférico/diagnóstico , Piel/patología , Axones/metabolismo , Axones/patología , Humanos , Microscopía Inmunoelectrónica , Proteína Básica de Mielina/metabolismo , Fibras Nerviosas/ultraestructura , Proteínas del Tejido Nervioso/metabolismo , Enfermedades del Sistema Nervioso Periférico/clasificación , Piel/inervación , Ubiquitina Tiolesterasa/metabolismo
16.
SLAS Discov ; 28(5): 223-232, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37307989

RESUMEN

Small molecules that bind to allosteric sites on target proteins to alter protein function are highly sought in drug discovery. High-throughput screening (HTS) assays are needed to facilitate the direct discovery of allosterically active compounds. We have developed technology for high-throughput time-resolved fluorescence lifetime detection of fluorescence resonance energy transfer (FRET), which enables the detection of allosteric modulators by monitoring changes in protein structure. We tested this approach at the industrial scale by adapting an allosteric FRET sensor of cardiac myosin to high-throughput screening (HTS), based on technology provided by Photonic Pharma and the University of Minnesota, and then used the sensor to screen 1.6 million compounds in the HTS facility at Bristol Myers Squibb. The results identified allosteric activators and inhibitors of cardiac myosin that do not compete with ATP binding, demonstrating high potential for FLT-based drug discovery.


Asunto(s)
Transferencia Resonante de Energía de Fluorescencia , Ensayos Analíticos de Alto Rendimiento , Ensayos Analíticos de Alto Rendimiento/métodos , Transferencia Resonante de Energía de Fluorescencia/métodos , Miosinas Cardíacas , Descubrimiento de Drogas/métodos
17.
Reproduction ; 143(4): 469-76, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22301887

RESUMEN

Reports indicate that germ-line stem cells present in adult mice can rapidly generate new oocytes and contribute to the primordial follicle reserve following conditions of ovotoxic stress. We further investigated the hypothesis that adult mice have the capacity to generate new oocytes by monitoring primordial follicle numbers throughout postnatal life and following depletion of the primordial follicle reserve by exposure to doxorubicin (DXR), trichostatin A (TSA), or whole-body γ-irradiation. We show that primordial follicle number remains stable in adult C57BL/6 mice between the ages of 25 and 100 days. However, within 2 days of treatment with DXR or TSA, primordial follicle numbers had declined to 65 and 51% respectively (P<0.05-0.01 when compared to untreated controls), with no restoration of follicle numbers evident after 7 days for either treatment. Furthermore, ovaries from mice subjected to sterilizing doses of γ-irradiation (0.45 or 4.5 Gy) revealed complete ablation of all primordial follicles 5 days after treatment, with no indication of follicular renewal. We conclude that neo-folliculogenesis does not occur following chemical or γ-irradiation mediated depletion of the primordial follicle reserve.


Asunto(s)
Folículo Ovárico/efectos de la radiación , Animales , Antibióticos Antineoplásicos , Doxorrubicina , Femenino , Rayos gamma , Ácidos Hidroxámicos , Ratones , Ratones Endogámicos C57BL , Folículo Ovárico/efectos de los fármacos , Inhibidores de la Síntesis de la Proteína
18.
Phys Rev Lett ; 109(9): 095502, 2012 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-23002846

RESUMEN

Under ion irradiation, all crystalline materials display some degree of dynamic annealing when defects experience evolution after the thermalization of collision cascades. The exact time scales of such defect relaxation processes are, however, unknown even for Si at room temperature. Here, we use a pulsed ion-beam method to measure a characteristic time constant of dominant dynamic annealing processes of about 6 ms in Si bombarded at room temperature with 500 keV Ar ions.

19.
Ultrasound Obstet Gynecol ; 40(3): 304-9, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22351034

RESUMEN

OBJECTIVES: The purpose of this study was to investigate early markers of risk for neurobehavioral compromise in survivors with congenital heart disease (CHD). METHODS: Pregnant women in whom a fetal CHD had been diagnosed before 24 weeks' gestational age (GA) were enrolled in this prospective pilot study for serial Doppler ultrasound assessment of the fetal middle cerebral artery (MCA) and umbilical arteries. The cerebral-to-placental resistance ratio (CPR) and MCA pulsatility index (PI) Z-scores for GA were calculated. After birth, subjects underwent high-density (128-lead) electroencephalography (EEG), and beta frequency (12-24 Hz) band EEG power, a measure of local neural synchrony, was analyzed. Neurodevelopment was assessed at 18 months with the Bayley Scales of Infant Development (BSID)-III. RESULTS: Thirteen subjects were enrolled: four with hypoplastic left heart syndrome (HLHS), four with transposition of the great arteries (TGA) and five with tetralogy of Fallot (TOF). Compared with subjects with normal CPR, those with CPR < 1 (n = 7) had lower mean BSID cognitive scores (91.4 ± 4.8 vs. 99.2 ± 3.8, P = 0.008). Fetal MCA-PI Z-score also correlated with BSID cognitive score (r = 0.589, P = 0.03) as did neonatal EEG left frontal polar (r = 0.58, P = 0.037) and left frontal (r = 0.77, P = 0.002) beta power. Furthermore, fetal Doppler measures were associated with EEG power: fetuses with CPR < 1 had lower left frontal polar (t = 2.36, P = 0.038) and left frontal (t = 2.85, P = 0.016) beta power as newborns than did fetuses with normal CPR, and fetal MCA-PI Z-score correlated with neonatal EEG left frontal polar (r = 0.596, P = 0.04) and left frontal (r = 0.598, P = 0.04) beta power. CONCLUSION: In fetuses with HLHS, TGA and TOF, abnormal cerebrovascular resistance predicts decreased neonatal EEG left frontal beta power and lower 18-month cognitive development scores.


Asunto(s)
Sistema Nervioso Central/crecimiento & desarrollo , Circulación Cerebrovascular/fisiología , Electroencefalografía/métodos , Cardiopatías Congénitas/diagnóstico por imagen , Arteria Cerebral Media/diagnóstico por imagen , Ultrasonografía Doppler/métodos , Ultrasonografía Prenatal/métodos , Arterias Umbilicales/diagnóstico por imagen , Sistema Nervioso Central/fisiopatología , Femenino , Feto , Humanos , Recién Nacido , Masculino , Proyectos Piloto , Embarazo , Estudios Prospectivos
20.
J Neonatal Perinatal Med ; 14(4): 583-590, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33843700

RESUMEN

BACKGROUND: Micro-premature newborns, gestational age (GA) ≤ 25 weeks, have high rates of mortality and morbidity. Literature has shown improving outcomes for extremely low gestational age newborns (ELGANs) GA ≤ 29 weeks, but few studies have addressed outcomes of ELGANs ≤ 25 weeks. OBJECTIVE: To evaluate the trends in outcomes for ELGANs born in New Jersey, from 2000 to 2018 and to compare two subgroups: GA 23 to 25 weeks (E1) and GA 26 to 29 weeks (E2). METHODS: Thirteen NICUs in NJ submitted de-identified data. Outcomes for mortality and morbidity were calculated. RESULTS: Data from 12,707 infants represents the majority of ELGANs born in NJ from 2000 to 2018. There were 3,957 in the E1 group and 8,750 in the E2 group. Mortality decreased significantly in both groups; E1, 43.2% to 30.2% and E2, 7.6% to 4.5% over the 19 years. The decline in E1 was significantly greater than in E2. Most morbidities also showed significant improvement over time in both groups. Survival without morbidity increased from 14.5% to 30.7% in E1s and 47.2% to 69.9% in E2s. Similar findings held for 501-750 and 751-1000g birth weight strata. CONCLUSIONS: Significant declines in both mortality and morbidity have occurred in ELGANs over the last two decades. These rates of improvements for the more immature ELGANs of GA 230 to 256 weeks were greater than for the more mature group in several outcomes. While the rates of morbidity and mortality remain high, these results validate current efforts to support the micro-premature newborn.


Asunto(s)
Enfermedades del Prematuro , Edad Gestacional , Humanos , Lactante , Recién Nacido de Bajo Peso , Recién Nacido , Recien Nacido Prematuro , Morbilidad , New Jersey/epidemiología
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