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1.
BMC Nephrol ; 20(1): 231, 2019 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-31238898

RESUMO

BACKGROUND: Maintenance dialysis is a costly and resource intense activity. In Australia, inadequate health infrastructure and poor access to technically skilled staff can limit service provision in remote areas where many Aboriginal dialysis patients live. With most studies based on urban service provision, there is little evidence to guide service development. However permanent relocation to an urban area for treatment can have significant social and financial impacts that are poorly quantified. This study is part of a broader project to quantify the costs and benefits of dialysis service models in urban and remote locations in Australia's Northern Territory (NT). METHODS: We undertook a micro-costing analysis of dialysis service delivery costs in urban, rural and remote areas in the NT from the payer perspective. Recurrent maintenance costs (salaries, consumables, facility management and transportation) as well as capital costs were included. Missing and centralised costs were standardised; results were inflated to 2017 values and reported in Australian dollars. RESULTS: There was little difference between the average annual cost for urban and rural services with respective median costs of $85,919 versus $84,629. However remote service costs were higher ($120,172 - $124,492), driven by higher staff costs. The inclusion of capital costs did not add substantially to annual costs. Annual home haemodialysis costs ($42,927) were similar to other jurisdictions despite the significant differences in program delivery and payment of expenses not traditionally borne by governments. Annual peritoneal dialysis costs ($58,489) were both higher than home and in-centre haemodialysis by recent national dialysis cost studies. CONCLUSION: The cost drivers for staffed services were staffing models and patient attendance rates. Staff salaries and transport costs were significantly higher in remote models of care. Opportunities to reduce expenditure exist by encouraging community supported services and employing local staff. Despite the delivery challenges of home haemodialysis including high patient attrition, the program still provides a cost benefit compared to urban staffed services. The next component of this study will examine patient health service utilisation and costs by model of care to provide a more comprehensive analysis of the overall cost of providing services in each location.


Assuntos
Análise Custo-Benefício , Atenção à Saúde/economia , Custos de Cuidados de Saúde , Serviços de Saúde/economia , Diálise Renal/economia , População Rural , Análise Custo-Benefício/tendências , Atenção à Saúde/tendências , Custos de Cuidados de Saúde/tendências , Serviços de Saúde/tendências , Humanos , Northern Territory/epidemiologia , Diálise Renal/tendências , População Rural/tendências
2.
Gene Ther ; 23(6): 548-56, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27052802

RESUMO

Adeno-associated virus (AAV) vector-based gene therapy is a promising treatment strategy for delivery of neurotrophic transgenes to retinal ganglion cells (RGCs) in glaucoma patients. Retinal distribution of transgene expression following intravitreal injection (IVT) of AAV is variable in animal models and the vitreous humor may represent a barrier to initial vector penetration. The primary goal of our study was to investigate the effect of prior core vitrectomy with posterior hyaloid membrane peeling on pattern and efficiency of transduction of a capsid amino acid substituted AAV2 vector, carrying the green fluorescent protein (GFP) reporter transgene following IVT in dogs. When progressive intraocular inflammation developed starting 4 weeks post IVT, the study plan was modified to allow detailed characterization of the etiology as a secondary goal. Unexpectedly, surgical vitrectomy was found to significantly limit transduction, whereas in non-vitrectomized eyes transduction efficiency reached upwards to 37.3% of RGC layer cells. The developing retinitis was characterized by mononuclear cell infiltrates resulting from a delayed-type hypersensitivity reaction, which we suspect was directed at the GFP transgene. Our results, in a canine large animal model, support caution when considering surgical vitrectomy before IVT for retinal gene therapy in patients, as prior vitrectomy appears to significantly reduce transduction efficiency and may predispose the patient to development of vector-induced immune reactions.


Assuntos
Dependovirus/genética , Vitrectomia , Animais , Cães , Vetores Genéticos , Proteínas de Fluorescência Verde/genética , Humanos , Retina/metabolismo , Transdução Genética , Transgenes
4.
Ir Med J ; 104(3): 71-3, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21667608

RESUMO

Worldwide, sexually transmitted infections (STls) are among the most common causes of disease. The aim of this study was to evaluate why people attend a community based sexual health clinic and the benefits and satisfaction levels of providing this service to them. Phase I of the study was a cross sectional survey. Phase II was a retrospective review. Phase 1: N ='80 (41 F, 39 M - mean age 24.8 (SD 6.49)), 45 (56.3%) requested a general sexual health screen. Phase 2: N = 273, (139 F, 134 M - mean age 23.7 (SD 5.87)) 47 (15.5%/) reported use of condoms, 126(41.6%) do not use condoms ever, while 73 (24.1%) reported using condoms sometimes. 47 individuals (17%) tested positive for chlamydia. Attendees to the clinic expressed a high level of satisfaction overall with the services provided. The low use of condoms amongst a subgroup of patients with several sexual partners and the high level of chlamydia are causes for concern.


Assuntos
Instituições de Assistência Ambulatorial , Adolescente , Adulto , Instituições de Assistência Ambulatorial/organização & administração , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Medicina Geral , Humanos , Masculino , Satisfação do Paciente , Fatores de Risco , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/prevenção & controle , População Urbana , Adulto Jovem
5.
Science ; 206(4421): 984-7, 1979 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-17733919

RESUMO

The Voyager 2 encounter has enhanced our understanding of earlier results and provided measurements beyond 160 Jupiter radii (R(J)) in the magnetotail. Significant fluxes of energetic sulfur and oxygen nuclei (4 to 15 million electron volts per nucleon) of Jovian origin were observed inside 25 R(J), and the gradient in phase space density at 12 R(J) indicates that the ions are diffusing inward. A substantially longer time delay versus distance was found for proton flux maxima in the active hemisphere in the magnetotail at Jovicentric longitudes lambda(III), = 260 degrees to 320 degrees than in the inactive hemisphere at lambda(III), = 85 degrees to l10 degrees . These delays can be related to the radial motion of plasma expanding into the magnetotail, and differences in the expansion speeds between the active and inactive hemispheres can produce rarefaction regions in trapped particles. It is suggested that the 10-hour modulation of interplanetary Jovian electrons may be associated with the arrival at the dawn magnetopause of a rarefaction region each planetary rotation.

6.
Science ; 204(4396): 1003-7, 1979 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-17800440

RESUMO

The observations of the cosmic-ray subsystem have added significantly to our knowledge of Jupiter's magnetosphere. The most surprising result is the existence of energetic sulfur, sodium, and oxygen nuclei with energies above 7 megaelectron volts per nucleon which were found inside of Io's orbit. Also, significant fluxes of similarly energetic ions reflecting solar cosmic-ray composition were observed throughout the magnetosphere beyond 11 times the radius of Jupiter. It was also found that energetic protons are enhanced by 30 to 70 percent in the active hemisphere. Finally, the first observations were made of the magnetospheric tail in the dawn direction out to 160 Jupiter radii.

7.
J Clin Invest ; 56(2): 366-75, 1975 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-1150877

RESUMO

COOH-terminal octapeptide of cholecystokinin (CCK-octapeptide) and the cholinergic agent carbamylcholine each produced a fourfold stimulation of calcium outflux in guinea pig isolated pancreatic acinar cells. Neither agent altered calcium influx. Stimulation of calcium outflux was rapid and specific, was abolished by reducing the incubation temperature to 4 degrees C, and was a saturable function of the secretagogue concentration. The concentrations of CCK-octapeptide and carbamylcholine that produced half-maximal stimulation of calcium outflux were 3.1 x 10(-10) M and 4.9 x 10(-5) M, respectively. The cholinergic antagonist antropine competitively inhibited carbamylcholine stimulation of calcium outflux but did not alter stimulation produced by CCK-octapeptide. Stimulation of calcium outflux by maximal concentrations of carbamycholine plus CCK-octapeptide was the same as that produced by a maximal concentration of either agent alone.Calcium outflux became refractory to stimulation by secretagogues, and incubation with either CCK-ostapeptide or carbamylcholine produced a refractoriness to both agents. The relative potencies with CCK and its related fragments stimulated calcium outflux were CCK-octapeptide greater than heptapeptide greater than CCK greater than hexapeptide = gastrin. Secretin, glucagon, and vasoactive intestinal peptide, at concentrations as high as 10(-5) M, failed to alter calcium outflux and did not affect stimulation by CCK-octapeptide or by carbamycholine.


Assuntos
Cálcio/metabolismo , Permeabilidade da Membrana Celular/efeitos dos fármacos , Colecistocinina/farmacologia , Pâncreas/enzimologia , Parassimpatomiméticos/farmacologia , Amilases/metabolismo , Animais , Carbacol/farmacologia , Glucagon/farmacologia , Cobaias , Técnicas In Vitro , Cinética , Fragmentos de Peptídeos/farmacologia , Secretina/farmacologia , Fatores de Tempo
8.
Biochim Biophys Acta ; 511(3): 408-18, 1978 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-687621

RESUMO

1. The activation energy of the diffusion water exchange in red blood cells increases with temperature. 2. Fetal blood has a higher activation energy for diffusion water exchange than adult blood. 3. Treatment of red cells with p-chloromercuribenzoate alters the activation energy and apparently allows a lipid and a protein pore pathway to be resolved. The permeability and activation energy of the treated cells is in the range found for lipid membranes; and the difference between treated and untreated cells, the "protein" pathway, has a diffusion activation energy comparable with that of free water. 4. A resolution of the discrepancies between the NMR methods of measuring diffusion water exchange is suggested.


Assuntos
Permeabilidade da Membrana Celular , Eritrócitos/metabolismo , Água/metabolismo , Adulto , Contagem de Células , Criança , Cloromercurobenzoatos/farmacologia , Difusão , Eritrócitos/citologia , Feminino , Sangue Fetal/metabolismo , Humanos , Masculino , Lipídeos de Membrana/metabolismo , Distrofias Musculares/sangue , Gravidez , Temperatura , Termodinâmica
9.
J Gen Physiol ; 60(5): 609-29, 1972 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-4644328

RESUMO

Ouabain binding by the human erythrocyte membrane is reversible, exhibits a high degree of chemical specificity, and can be detected at ouabain concentrations as low as 1 x 10(-10)M. The relation between ouabain binding and ouabain concentration can be described by a rectangular hyperbola permitting determination of the maximal binding (B(max)) and the ouabain concentration at which ouabain binding is half-maximal (K(B)). Reducing the external sodium concentration increased K(B), while reducing the external potassium concentration decreased K(B). Neither cation altered B(max) The reciprocal of K(B) was a linear function of the sodium concentration at sodium concentrations ranging from 0 to 150 mM. Conversely, the relation between the reciprocal of K(B) and the external potassium concentration was nonlinear, and raising the potassium concentration above 4 mM produced no further increase in K(B). These results are compatible with a model which postulates that the erythrocyte membrane contains a finite number of receptors each composed of a glycoside-binding site and a cation-binding site. When sodium occupies the cation-binding site, the affinity of the glycoside site for ouabain is increased; when potassium occupies the cation-binding site the affinity of the glycoside site for ouabain is decreased.


Assuntos
Eritrócitos/metabolismo , Ouabaína/metabolismo , Potássio/farmacologia , Sódio/farmacologia , Adolescente , Adulto , Sítios de Ligação/efeitos dos fármacos , Transporte Biológico , Membrana Celular/metabolismo , Eritrócitos/citologia , Feminino , Humanos , Masculino , Modelos Biológicos , Concentração Osmolar , Ligação Proteica , Receptores de Droga/efeitos dos fármacos , Trítio
10.
J Am Coll Cardiol ; 5(6): 1326-34, 1985 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-3923077

RESUMO

A hemodynamic-radionuclide study was performed to compare the relations between end-systolic pressure and volume in the left and right ventricles in 10 patients with biventricular failure, and to correlate the end-systolic pressure-volume slope with baseline variables of systolic function. During nitroprusside or nitroglycerin infusion, or a combination of both, linear relations were found between end-systolic pressure and volume for both ventricles. In 9 of 10 patients, the end-systolic pressure-volume slope was greater for the left ventricle (mean +/- SD 1.12 +/- 0.36 mm Hg X m2/ml) than for the right ventricle (0.46 +/- 0.27 mm Hg X m2/ml) (p less than 0.001). In all 10 patients, the volume-axis intercept of the pressure-volume relation was greater for the left ventricle (82 +/- 66 ml/m2) than for the right ventricle (2 +/- 30 ml/m2) (p less than 0.005). Right ventricular pressure-volume slope correlated weakly with baseline right ventricular ejection fraction (r = 0.69, p less than 0.05), strongly with the baseline right ventricular end-systolic pressure-volume ratio (r = 0.89) and inversely with baseline right ventricular end-systolic volume (r = -0.86). In conclusion, 1) in patients with severe biventricular failure, changes in systolic pressure influence end-systolic volume more strongly in the right than in the left ventricle. 2) For the right ventricle, the slope of the end-systolic pressure-volume relation is directly related to rest indexes of systolic function. 3) The greater the end-systolic volume at rest, the greater the predicted improvement in right ventricular emptying for any vasodilator-induced reduction in pulmonary artery end-systolic pressure.


Assuntos
Pressão Sanguínea , Débito Cardíaco , Insuficiência Cardíaca/fisiopatologia , Coração/fisiopatologia , Volume Sistólico , Adulto , Idoso , Pressão Sanguínea/efeitos dos fármacos , Débito Cardíaco/efeitos dos fármacos , Coração/diagnóstico por imagem , Insuficiência Cardíaca/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Nitroglicerina/farmacologia , Nitroprussiato/farmacologia , Cintilografia , Volume Sistólico/efeitos dos fármacos
11.
Am J Clin Nutr ; 44(6): 945-53, 1986 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-3024478

RESUMO

The relationship between diet and estrogens was studied in two groups of women with different dietary habits and breast cancer risks. Plasma estrogens and androgens and 24-h urinary and fecal excretion of estrogens were measured in premenopausal and postmenopausal Caucasians and recent Oriental immigrants from Southeast Asia to Hawaii. Premenopausal Caucasians had 30-75% higher plasma estrone and estradiol levels than their age-matched cohorts in Hawaii, and the postmenopausal Caucasians had 3-fold higher plasma levels of estradiol. The Oriental women excreted more than twice the amount of estrogen in their feces but they excreted significantly less in their urine. Thus, the ratio of urinary-to-fecal excretion was approximately 3-5 times higher in young Caucasian women. Analysis of dietary components and plasma estrogens in premenopausal women showed a positive correlation between daily intake of total fat and saturated fat and plasma estrone and estradiol concentrations.


Assuntos
Asiático , Dieta , Estrogênios/metabolismo , Adolescente , Adulto , Fatores Etários , Gorduras na Dieta/administração & dosagem , Fibras na Dieta/administração & dosagem , Estrogênios/sangue , Estrogênios/urina , Fezes/análise , Feminino , Humanos , Pessoa de Meia-Idade , Estados Unidos , População Branca
12.
Neurology ; 36(7): 937-41, 1986 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-3714055

RESUMO

Reliable measurements are needed to document the natural history of ALS and to determine therapeutic efficacy. We have devised a standardized protocol that generates interval data sensitive to change-the Tufts Quantitative Neuromuscular Exam (TQNE). The TQNE consists of the following four major categories: pulmonary function, oropharyngeal function, timed functional activities, and isometric strength using an electronic strain gauge. The 29-item exam takes about 1 hour to administer and has excellent test-retest reliability.


Assuntos
Esclerose Lateral Amiotrófica/fisiopatologia , Contração Isométrica , Medidas de Volume Pulmonar , Atividade Motora/fisiologia , Contração Muscular , Orofaringe/fisiopatologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neurônios Motores/fisiologia , Músculos/fisiopatologia
13.
Neurology ; 38(3): 405-8, 1988 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-3347344

RESUMO

The Tufts Quantitative Neuromuscular Exam (TQNE) consists of 28 items that were designed to measure voluntary motor deficit in amyotrophic lateral sclerosis (ALS) and related diseases. Individual raw data were converted to Z scores for standardization and then grouped into five megascores with statistical and clinical relevance. The derived megascores were Mega 1, pulmonary function; Mega 2, bulbar function; Mega 3, timed hand activities; Mega 4, isometric arm strength; and Mega 5, isometric leg strength. Megascores should enhance the usefulness of testing in therapeutic trials and in analyzing the natural history of ALS and related diseases.


Assuntos
Esclerose Lateral Amiotrófica/fisiopatologia , Avaliação da Deficiência , Humanos , Exame Neurológico , Junção Neuromuscular/fisiopatologia
14.
Neurology ; 38(3): 409-13, 1988 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-3347345

RESUMO

Using a quantitative, reliable, sensitive and valid measurement technique, we analyzed the rate and pattern of motor deterioration in 50 strictly defined ALS patients for up to 67 months. We observed that the rate of motoneuron loss was linear and symmetric. Bulbar function deteriorated more slowly than respiratory, arm, and leg function. The loss of leg strength was slower than in the arm. No correlation was observed between age at onset and rate of deterioration, or with different regions of onset. Arm strength changed more slowly in women, but other functions showed no male-female differences. These data should prove useful in the design of clinical trials and in generating testable hypotheses of the etiology of this disease.


Assuntos
Esclerose Lateral Amiotrófica/patologia , Neurônios Motores/patologia , Adolescente , Adulto , Idoso , Esclerose Lateral Amiotrófica/fisiopatologia , Sobrevivência Celular , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Junção Neuromuscular/fisiopatologia , Fatores Sexuais
15.
Am J Cardiol ; 59(12): 1131-7, 1987 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-3578055

RESUMO

Previous studies have failed to demonstrate the clinical relevance of radionuclide functional measurements during treatment of congestive heart failure (CHF). In the present study, data derived before and during nitroprusside infusion were analyzed in 16 patients with CHF to compare correlations of changes in left (LV) and right ventricular (RV) radionuclide measurements with simultaneous changes in 8 hemodynamic variables. Nitroprusside infusion decreased systemic artery pressure, pulmonary arterial wedge pressure, pulmonary artery pressure, right atrial pressure, and pulmonary and systemic vascular resistance, and increased cardiac output. Nitroprusside decreased LV and RV end-diastolic and end-systolic volumes and increased LV and RV ejection fraction and stroke volume. Changes in RV volumes exceeded changes in LV volumes. LV radionuclide measurements did not correlate significantly with any hemodynamic measurement except for a weak correlation between changes in LV end-systolic volume and right atrial pressure (r = 0.51). In contrast, the combination of changes in RV end-systolic volume and stroke volume predicted changes in pulmonary artery peak systolic (r = 0.90) and mean (r = 0.89) pressures. Changes in pulmonary arterial wedge pressure correlated with changes in RV end-diastolic (r = 0.78) and end-systolic (r = 0.71) volumes. In conclusion, LV radionuclide measurements are of limited value in predicting hemodynamic responses to vasodilator therapy in CHF, whereas RV volumes are strongly influenced by load changes. Their responses to nitroprusside correlate well with changes in pulmonary artery and pulmonary arterial wedge pressures.


Assuntos
Cardiomiopatia Dilatada/complicações , Ferricianetos/uso terapêutico , Insuficiência Cardíaca/tratamento farmacológico , Coração/diagnóstico por imagem , Hemodinâmica/efeitos dos fármacos , Nitroprussiato/uso terapêutico , Adulto , Idoso , Feminino , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Cintilografia
16.
Surgery ; 99(1): 26-35, 1986 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-3079928

RESUMO

The clinical courses of 106 patients with limb-threatening ischemia were traced for as long as 5 years to determine the cost of their care. Seventy-eight patients initially treated with vascular reconstruction accrued an average of $40,769 +/- $3726 in costs over a mean follow-up period of 805 +/- 57 days, during which they had an average of 2.4 +/- 0.2 hospitalizations or 67 +/- 6 inpatient days. Twenty-eight high-risk patients treated with primary amputation accrued $40,563 +/- $4729 in costs over a mean follow-up period of 663 +/- 97 days, during which they had an average of 2.2 +/- 0.3 hospitalizations or 85 +/- 10 inpatient days. Successful revascularization resulted in lower costs ($28,374) than did primary amputation ($40,563) or failed reconstruction ($56,809). Patients with ischemic tissue loss accrued costs more rapidly than did patients with rest pain only. The high cost of providing care for these patients and the advent of diagnosis related group reimbursement mandate that proposed treatment protocols be evaluated not only for their effectiveness but also for their cost-effectiveness.


Assuntos
Isquemia/cirurgia , Perna (Membro)/irrigação sanguínea , Procedimentos Cirúrgicos Vasculares/economia , Análise Atuarial , Idoso , Amputação Cirúrgica/economia , Análise Custo-Benefício , Custos e Análise de Custo , Grupos Diagnósticos Relacionados/economia , Feminino , Seguimentos , Humanos , Tempo de Internação/economia , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Fatores de Tempo
17.
Clin Chim Acta ; 130(2): 139-47, 1983 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-6872254

RESUMO

In many investigations of the hypothesis of a membrane defect in Duchenne muscular dystrophy, the erythrocyte has been the cell of choice, but reported abnormalities in the Duchenne erythrocyte are disputed. Techniques of microsieving, cell surface staining and measurement of cell water diffusion turnover rate have been used in this investigation to examine erythrocyte properties. Measurements of pressure drop-velocity relations were carried out in a capillary pore rheometer using pure erythrocyte suspensions. The study showed that Duchenne erythrocytes do not behave differently from normal, results which are in substantial agreement with similar microsieving studies. A nuclear magnetic resonance method was used to measure cell water diffusion efflux which, using our cell surface data, could be related to cell membrane permeability. Under normal conditions and conditions of chemical interference with the membrane protein, the results revealed that the membrane pathways involved in water diffusion in Duchenne erythrocytes are unaltered.


Assuntos
Membrana Eritrocítica/fisiologia , Eritrócitos/citologia , Eritrócitos/fisiologia , Distrofias Musculares/sangue , Adolescente , Adulto , Ação Capilar , Permeabilidade da Membrana Celular/efeitos dos fármacos , Criança , Pré-Escolar , Cloromercurobenzoatos/farmacologia , Difusão , Feminino , Humanos , Espectroscopia de Ressonância Magnética , Propriedades de Superfície , Cloreto de Tolônio/metabolismo , Água/metabolismo , Ácido p-Cloromercurobenzoico
18.
Ir J Med Sci ; 167(3): 145-8, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9780561

RESUMO

Symptomatic HIV infection was first diagnosed in an Irish child in 1985. A prospective study was initiated to determine the vertical transmission rate (VTR) of HIV and the average age of infant seroreversion and to monitor clinical, immunologic and virologic evidence for HIV infection in seroreverters. Ninety three HIV positive infants have been prospectively identified since 1985. The predominant underlying maternal risk factor for HIV infection is intravenous drug use (IVDU) (96 per cent). Of 93 infants, median gestational age was 40 weeks and median birth weight 3125 grams. Ninety-four per cent of infants were bottle fed. Currently 72 (77 per cent) infants are uninfected, 12 (13 per cent) are infected, 4 (4.5 per cent) are indeterminate and 5 (5.5 per cent) have been lost to follow up. The intermediate estimate of vertical transmission rate (VTR) is 14.3 per cent. The median age at documented seroreversion was 12 months. There are no significant differences between infected and non-infected children in male/female ratio, gestational age, mode of delivery or birth weight. Strategies to reduce the transmission of HIV among drug users in combination with routine antenatal screening and antiretroviral prophylaxis of vertical transmission are all measures which can reduce HIV infection in our children.


Assuntos
Infecções por HIV/congênito , Infecções por HIV/transmissão , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez , Sorodiagnóstico da AIDS , Peso ao Nascer , Feminino , Idade Gestacional , Infecções por HIV/epidemiologia , Humanos , Recém-Nascido , Irlanda/epidemiologia , Masculino , Gravidez , Estudos Prospectivos , Fatores de Risco , Abuso de Substâncias por Via Intravenosa
19.
J Small Anim Pract ; 54(7): 361-6, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23731226

RESUMO

OBJECTIVE: To evaluate retrograde coronary venous stem-cell delivery for Dobermanns with dilated cardiomyopathy. METHODS: Retrograde coronary venous delivery of adipose-derived mesenchymal stem cells transduced with tyrosine mutant adeno-associated virus 2 to express stromal-derived factor-1 was performed in Dobermanns with dilated cardiomyopathy. Cases were followed for 2 years and electrocardiograms (ECG), echocardiograms and Holter monitoring were performed. RESULTS: Delivery of cells was feasible in 15 of 15 dogs. One dog died following the development of ventricular fibrillation 24 hours after cell delivery. The remaining 14 dogs were discharged the following day without complications. Echocardiographic measurements of left ventricular size and function showed continued progression of disease. On the basis of Kaplan-Meier product limit estimates, median survival for dogs following stem-cell delivery was 620 days (range of 1-799 days). When including only the occult-dilated cardiomyopathy population and excluding those dogs already in congestive heart failure, median survival was 652 days (range of 46-799 days). CLINICAL SIGNIFICANCE: Retrograde venous delivery of tyrosine mutant adeno-associated virus 2-stromal-derived factor-1 adipose-derived mesenchymal stem cells appears safe. Stem-cell therapy in dogs with occult-dilated cardiomyopathy does not appear to offer advantage compared to recently published survival data in similarly affected Dobermanns.


Assuntos
Cardiomiopatia Dilatada/veterinária , Doenças do Cão/terapia , Transplante de Células-Tronco Mesenquimais/veterinária , Animais , Cardiomiopatia Dilatada/mortalidade , Cardiomiopatia Dilatada/terapia , Progressão da Doença , Doenças do Cão/mortalidade , Cães , Feminino , Estimativa de Kaplan-Meier , Masculino , Projetos Piloto , Resultado do Tratamento , Função Ventricular Esquerda/fisiologia
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