RESUMEN
Daily language interactions predict child outcomes. For multilingual families who rear neurodiverse children and who may be minoritized for their language use, a dearth of research examines families' daily language interactions. Utilizing a language socialization framework and a case study methodology, 4,991 English and Spanish utterances from a 5-year old autistic child and his family were collected during naturally occurring interactions over 10 days. Utterances were analyzed for patterns of code-switching by speaker, activity setting, English or Spanish initial language, and code-switch function. Spanish was spoken in most activities. For reading, both languages were equally employed by the father. While participants used both languages across all activity settings, significant variations in code-switching type and function were observed by activity setting and speaker. We discuss implications for how home language resources can be integrated into autism interventions.
RESUMEN
BACKGROUND: Given its widely accepted efficacy, androgen blockade therapy for hidradenitis suppurativa (HS) has become a standard of care. Although much less frequently used than spironolactone, a small number of HS studies have reported finasteride as an alternative treatment for women. In this study, we describe the response to and perception of finasteride therapy in a diverse cohort of women with HS. AIM: To describe finasteride therapy in a diverse cohort of female patients with HS. METHODS: We conducted an institutional review board-approved retrospective chart review and telephone survey of 20 female patients aged ≥ 18 years with a diagnosis of HS. Finasteride was prescribed by a single provider at a specialized HS centre. RESULTS: The mean age of the patients was 34.3 ± 13.5 years. Finasteride was initiated predominantly because of one or more contraindications or poor responsiveness to spironolactone. Most patients interviewed (90%; n = 18) were willing to take finasteride again or continue with therapy if indicated. Of the 20 patients, 10 (50%) reported overall satisfaction with finasteride, while 7 (35%) were neutral and 3 (15%) were dissatisfied. No patient reported worsening disease activity while on finasteride and only one (5%) reported decreased quality of life. When asked about adverse effects of finasteride, 80% (n = 16) reported none, while 20% (n = 4) experienced ≥ 1 of the following: headache, nausea, menstrual irregularities, breast tenderness or reduced libido/sexual function. CONCLUSIONS: Our study suggests that androgen blockade therapy with finasteride is a safe and effective alternative for female patients with HS who have contraindication(s) or intolerance to spironolactone.
Asunto(s)
Antagonistas de Andrógenos/uso terapéutico , Finasterida/uso terapéutico , Hidradenitis Supurativa/tratamiento farmacológico , Adulto , Femenino , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Smoking induces complications in plastic surgery, in particular wound healing delays. Despite a 4-weeks' abstinence asking before and after surgery, some patients denied or hid their consumption. The aim of this study was to evaluate the effectiveness of a cotininury detection test in terms of improvement in outcomes after an abdominoplasty. MATERIAL AND METHODS: This retrospective cohort study included patients who underwent an abdominoplasty with umbilical transposition and lipoaspiration. Current smokers were asked to stop smoking 4 weeks before and after surgery. After 2013, we performed a preoperative cotininury test for patients having abdominoplasty, with a cancellation of surgery in case of positive result. We analyzed the test's effectiveness on delayed healing and on other complications. RESULTS: Two hundred and thirty-five patients were included; 80 were tested and 21,3% had a positive test. There was significantly less delayed healing in the "screening" group than in the "no screening": 20,3% versus 41,5% (P=0,002). Alike, complications were significantly less frequent in the "screening" group than in the "no screening": 18,1% versus 42,3% (P<0,001). CONCLUSION: The routine use of the cotininury test in preoperative abdominoplasties significantly reduces risk of delayed healing and other serious complications. It is an objective test, which is simple, quick and non-invasive. Smoking cessation must be at least 4 weeks before and after the surgery. Following medical advice to cease smoking by the surgeon and anesthetist, referral to an appropriate tobacco-addiction specialist clinic may be helpful for the patient who has difficulty stopping smoking.
Asunto(s)
Abdominoplastia , Cotinina/orina , Cooperación del Paciente , Complicaciones Posoperatorias/prevención & control , Fumar/orina , Adulto , Estudios de Cohortes , Femenino , Humanos , Masculino , Cuidados Preoperatorios , Estudios Retrospectivos , Fumar/efectos adversosRESUMEN
BACKGROUND: Researchers have primarily relied on mother report to understand the parenting contexts of rearing children with intellectual disabilities. Fathers are increasingly being considered as equally important reporters of their child's behaviours, as they have unique and independent relationships with their children. The purpose of this study was to understand how one source of stress - reports of child behaviour problems - along with spousal support related to parenting tasks, associated with fathers' reports of psychological symptoms over time. METHOD: One hundred eighty-two father participants completed measures of child behaviour problems, spousal support and psychological symptoms. Growth curve modelling was employed to examine paternal psychological symptoms over the child's developmental trajectory. RESULTS: Fathers' reports of child behaviour problems predicted initial levels of paternal psychological symptoms but did not predict change in paternal psychological symptoms over time. Spousal support further reduced initial levels of paternal psychological symptoms. CONCLUSIONS: Child behaviour problems are more important than disability status in predicting father's psychological symptoms. Spousal support predicts paternal psychological symptoms and can be viewed as an additional resource for fathers. Implications for research and practice are discussed.
RESUMEN
BACKGROUND: Previous studies have identified the role of family support in mitigating the stress of parents caring for a child with intellectual disability. Less is known about families whose members are willing but unable to support each other because of geographical, structural and economic barriers. Our study examined the contribution to family quality of life (FQL) of family support beliefs, actual assistance from family members, as well as the moderating effects of ethnicity and household income. METHOD: We conducted telephone interviews with 84 Latino and 61 non-Latino mothers. RESULTS: Mothers who received more emotional support from partners and other family members reported a higher FQL, controlling for family characteristics. Familism beliefs were also associated with FQL, particularly for Latino mothers. Income was not a significant moderator. CONCLUSIONS: These findings suggest that some predictors of FQL are partially moderated by ethnicity, while others may be powerful across diverse communities.
Asunto(s)
Familia/etnología , Hispánicos o Latinos/etnología , Discapacidad Intelectual/enfermería , Calidad de Vida/psicología , Apoyo Social , Adulto , Niño , Preescolar , Estudios Transversales , Cultura , Familia/psicología , Femenino , Humanos , Masculino , Madres/psicologíaRESUMEN
Silk is a unique, remarkably strong biomaterial made of simple protein building blocks. To date, no synthetic method has come close to reproducing the properties of natural silk, due to the complexity and insufficient understanding of the mechanism of the silk fiber formation. Here, we use a combination of bulk analytical techniques and nanoscale analytical methods, including nano-infrared spectroscopy coupled with atomic force microscopy, to probe the structural characteristics directly, transitions, and evolution of the associated mechanical properties of silk protein species corresponding to the supramolecular phase states inside the silkworm's silk gland. We found that the key step in silk-fiber production is the formation of nanoscale compartments that guide the structural transition of proteins from their native fold into crystalline ß-sheets. Remarkably, this process is reversible. Such reversibility enables the remodeling of the final mechanical characteristics of silk materials. These results open a new route for tailoring silk processing for a wide range of new material formats by controlling the structural transitions and self-assembly of the silk protein's supramolecular phases.
Asunto(s)
Fibroínas , Seda , Seda/química , Materiales Biocompatibles/química , Microscopía de Fuerza Atómica , Espectrofotometría Infrarroja , Fibroínas/químicaRESUMEN
Inorganic layered materials can form hollow multilayered polyhedral nanoparticles. The size of these multi-wall quasi-spherical structures varies from 4 to 300 nm. These materials exhibit excellent tribological and wear-resisting properties. Measuring and evaluating the stiffness of individual nanoparticle is a non-trivial problem. The current paper presents an in situ technique for stiffness measurements of individual WS(2) nanoparticles which are 80 nm or larger using a high resolution scanning electron microscope (HRSEM). Conducting the experiments in the HRSEM allows elucidation of the compression failure strength and the elastic behavior of such nanoparticles under uniaxial compression.
RESUMEN
Morphological, autoradiographic, and biochemical methods were used to study the time of appearance, distribution, and nature of sulfated constituents in the developing rat optic nerve. Electron microscope studies showed that myelination begins (6 days postnatal) shortly after the appearance of oligodendroglia (5 days postnatal). Over the ensuing 3 wk, myelination increased rapidly. During the 1st postnatal wk, mucopolysaccharides and glycoproteins were labeled with 35S and autoradiographs showed grains over arachnoidal cells, astroglia, and the glia limitans. These results indicated that astroglia synthesize sulfated mucopolysaccharides of the glia limitans. After the onset of myelination, however, the major portion of [35S]sulfate was incorporated into sulfatide. Autoradiographs showed a shift of radioactive grains from astroglia and arachnoidal cells to myelin, indicating that actively myelinating oligodendroglia incorporate [35S]sulfate into myelin sulfatide; there was a concomitant increase in the activity of cerebroside sulfotransferase. In addition, the increasing amounts of proteolipid protein and myelin basic protein corresponded with the morphological appearance of myelin. These results point to a strict correlation between the structural and biochemical changes occurring during myelination. This system provides a useful model for studies designed to evaluate the effects of various perturbations on the process of myelination.
Asunto(s)
Vaina de Mielina , Nervio Óptico/crecimiento & desarrollo , Animales , Autorradiografía , Axones/citología , Cerebrósidos , Glicoproteínas/biosíntesis , Glicosaminoglicanos/biosíntesis , Proteínas de la Mielina/biosíntesis , Neuroglía/citología , Nervio Óptico/citología , Nervio Óptico/metabolismo , Tamaño de los Órganos , Ratas , Sulfatos/metabolismo , Sulfoglicoesfingolípidos/metabolismo , Sulfurtransferasas/metabolismoRESUMEN
To localize basic protein (BP) in the lamellar structure of central and peripheral myelin, we perfused newborn and 7-11-day rat pups with a phosphate-buffered fixative that contained 4% paraformaldehyde and 0.05 or 0.2% glutaraldehyde. Teased, longitudinally split or "brush" preparations of optic and trigeminal nerves were made by gently teasing apart groups of myelinated fibers with fine forceps or needles. Some of these preparations were immunostained without pretreatment in phosphate-buffered antiserum to BP according to the peroxidase-antiperoxidase method. Others were pretreated in ethanol before immunostaining. Then, all of them were dehydrated, embedded in Epon, and sectioned for electron microscopic study. In optic and trigeminal nerves that were not pretreated, myelin, glial cells, and their organelles were well preserved. BP immunostaining was present on cytoplasmic faces of oligodendroglial and Schwann cell membranes that formed mesaxons and loose myelin spirals. In compact central and peripheral myelin, reaction product was located in major dense line regions, and the myelin periodicity was the same as that observed in unstained control myelin that had been treated with preimmune serum. In ethanol-pretreated tissue, the myelin periodicity was reduced but dense line staining still was present. Our immunocytochemical demonstration of dense line localization of BP in both CNS and PNS myelin that was not disrupted or pretreated with solvents is important because of conflicting evidence in earlier immunostaining studies. Our results also support biochemical and histochemical evidence suggesting that BP exists in vivo as a membrane protein interacting with lipids on the cytoplasmic side of the bilayer in the spirally wrapped compact myelin membrane.
Asunto(s)
Proteína Básica de Mielina/metabolismo , Vaina de Mielina/ultraestructura , Nervio Óptico/ultraestructura , Animales , Sistema Nervioso Central/ultraestructura , Técnicas Inmunológicas , Microscopía Electrónica , Proteína Básica de Mielina/inmunología , Nervios Periféricos/ultraestructura , RatasRESUMEN
The spinal fluid of sheep with experimental allergic encephalomyelitis contains myelin basic protein (6 to 18 nanograms per milliliter) bound to antibody as well as excess free antibody. This bound myelin basic protein appeared concurrently with the onset of the disease and remained elevated until death. In contrast, in active multiple sclerosis, the spinal fluid contains free myelin basic protein and there are no detectable levels of antibody. The results indicate that the antibodies enter the spinal fluid from the serum by passive diffusion. This mechanism may also explain the presence of viral antibodies in the spinal fluid of multiple sclerosis patients.
Asunto(s)
Autoanticuerpos/líquido cefalorraquídeo , Encefalomielitis Autoinmune Experimental/líquido cefalorraquídeo , Esclerosis Múltiple/líquido cefalorraquídeo , Proteínas de la Mielina/líquido cefalorraquídeo , Animales , Complejo Antígeno-Anticuerpo , Encefalomielitis Autoinmune Experimental/inmunología , Humanos , Esclerosis Múltiple/inmunología , Proteínas de la Mielina/inmunología , OvinosRESUMEN
The McGill Quality of Life Questionnaire (MQOL) is a widely used tool that has been specifically developed to measure the quality of life of patients facing a life-threatening illness. Preferably, a self-report instrument has an equal number of items worded positively and negatively. However, all the psychological scales of the MQOL are worded so that a high score is negative, whereas the existential scales are worded so that a high score is positive. The goal of this study was to investigate the influence of MQOL item formatting on patient responses. In order to do so, a modified version of the questionnaire was distributed to and completed by 205 patients in two oncology clinics. The modified version had an equal amount of items worded in a positive direction and negative direction in each of the domains. Results of this study were found to be different from those of other studies: the loading of the items was partly based on scale direction. These changes support the idea that the MQOL formatting has some impact on patient responses. However, factors were also determined by content. Given that MQOL has been widely used and the original formatting provides conceptually clearer subscales, we suggest maintaining the original format, keeping in mind the effect of formatting when interpreting scores.
Asunto(s)
Neoplasias/psicología , Cuidados Paliativos , Calidad de Vida , Encuestas y Cuestionarios/normas , Enfermo Terminal/psicología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría/métodos , Adulto JovenRESUMEN
Drug-related kidney stones are a diagnostic problem, since they contain a large matrix (protein) fraction and are frequently incorrectly identified as matrix stones. A urine proteomics study patient produced a guaifenesin stone during her participation, allowing us to both correctly diagnose her disease and identify proteins critical to this drug stone-forming process. The patient provided three random midday urine samples for proteomics studies; one of which contained stone-like sediment with two distinct fractions. These solids were characterized with optical microscopy and Fourier transform infrared spectroscopy. Immunoblotting and quantitative mass spectrometry were used to quantitatively identify the proteins in urine and stone matrix. Infrared spectroscopy showed that the sediment was 60 % protein and 40 % guaifenesin and its metabolite guaiacol. Of the 156 distinct proteins identified in the proteomic studies, 49 were identified in the two stone-components with approximately 50 % of those proteins also found in this patient's urine. Many proteins observed in this drug-related stone have also been reported in proteomic matrix studies of uric acid and calcium containing stones. More importantly, nine proteins were highly enriched and highly abundant in the stone matrix and 8 were reciprocally depleted in urine, suggesting a critical role for these proteins in guaifenesin stone formation. Accurate stone analysis is critical to proper diagnosis and treatment of kidney stones. Many matrix proteins were common to all stone types, but likely not related to disease mechanism. This protocol defined a small set of proteins that were likely critical to guaifenesin stone formation based on their high enrichment and high abundance in stone matrix, and it should be applied to all stone types.
Asunto(s)
Expectorantes/efectos adversos , Guaifenesina/efectos adversos , Cálculos Renales/química , Cálculos Renales/etiología , Orina/química , Adulto , Femenino , Humanos , Proteómica , Espectroscopía Infrarroja por Transformada de FourierRESUMEN
The electrical conduction through three short oligomers (26 base pairs, 8 nm long) with differing numbers of GC base pairs was measured. One strand is poly(A)-poly(T), which is entirely devoid of GC base pairs. Of the two additional strands, one contains 8 and the other 14 GC base pairs. The oligomers were adsorbed on a gold substrate on one side and to a gold nanoparticle on the other side. Conducting atomic force microscope was used for obtaining the current versus voltage curves. We found that in all cases the DNA behaves as a wide band-gap semiconductor, with width depending on the number of GC base pairs. As this number increases, the band-gap narrows. For applied voltages exceeding the band-gap, the current density rises dramatically. The rise becomes sharper with increasing number of GC base pairs, reaching more than 1 nA/nm2 for the oligomer containing 14 GC pairs.
Asunto(s)
Citosina/química , ADN/química , Guanina/química , Composición de Base , Secuencia de Bases , ADN de Cadena Simple/química , Conductividad Eléctrica , Oro/química , Nanopartículas del Metal/química , Microscopía de Fuerza Atómica , Datos de Secuencia MolecularRESUMEN
Local cutaneous injuries induced by ionizing radiation (IR) are difficult to treat. Many have reported local injection of adipose-derived stromal vascular fraction (SVF), often with additional therapies, as an effective treatment of IR-induced injury even after other local therapies have failed. The authors report a case of a locally recurrent, IR-induced wound that was treated with autologous, non-cultured SVF without other concurrent therapy. A nondestructive testing technician was exposed to 130 kVp x rays to his non-dominant right thumb on 5 October 2011. The wound healed 4 mo after initial conservative therapy with oral/topical α-tocopherol, oral pentoxifylline, naproxen sodium, low-dose oral steroids, topical steroids, hyperbaric oxygen therapy (HBOT), oral antihistamines, and topical aloe vera. Remission lasted approximately 17 mo with one minor relapse in July 2012 after minimal trauma and subsequent healing. Aggressive wound breakdown during June 2013 required additional therapy with HBOT. An erythematous, annular papule developed over the following 12 mo (during which time the patient was not undergoing prescribed treatment). Electron paramagnetic resonance (EPR) done more than 2 mo after exposure to IR revealed dose estimates of 14 ± 3 Gy and 19 ± 6 Gy from two centers using different EPR techniques. The patient underwent debridement of the 0.5 cm papular area, followed by SVF injection into and around the wound bed and throughout the thumb without complication. Eleven months post SVF injection, the patient has been essentially asymptomatic with an intact integument. These results raise the possibility of prolonged benefit from SVF therapy without the use of cytokines. Since there is currently no consensus on the use of isolated SVF therapy in chronic, local IR-induced injury, assessment of this approach in an appropriately powered, controlled trial in experimental animals with local radiation injury appears to be indicated.
Asunto(s)
Trasplante de Células Madre Mesenquimatosas/métodos , Enfermedades Profesionales/terapia , Traumatismos por Radiación/etiología , Traumatismos por Radiación/terapia , Enfermedades de la Piel/etiología , Enfermedades de la Piel/terapia , Accidentes de Trabajo , Humanos , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/etiología , Traumatismos por Radiación/diagnóstico , Liberación de Radiactividad Peligrosa , Enfermedades de la Piel/diagnóstico , Pulgar/lesiones , Pulgar/efectos de la radiación , Trasplante Autólogo/métodos , Resultado del Tratamiento , Rayos X/efectos adversosRESUMEN
Cerebrospinal fluid was examined from 70 children with acute lymphoblastic leukemia for evidence of active myelin breakdown based on the release of myelin basic protein (MBP). Fifty-three asymptomatic children were followed from diagnosis with serial MBP determinations. Eight (15.1%) of 53 children had abnormal elevations of MBP, six of eight before receiving presymptomatic central nervous system therapy. Long-term observations are in progress. For comparison, six children with clinical and radiologic findings of leukoencephalopathy had abnormal MBP determinations, whereas no abnormalities were detected in 11 children with meningeal leukemia.
Asunto(s)
Enfermedades del Sistema Nervioso Central/diagnóstico , Leucemia Linfoide/líquido cefalorraquídeo , Proteína Básica de Mielina/líquido cefalorraquídeo , Adolescente , Enfermedades del Sistema Nervioso Central/líquido cefalorraquídeo , Enfermedades del Sistema Nervioso Central/etiología , Niño , Preescolar , Humanos , Leucemia Linfoide/complicaciones , Leucemia Linfoide/terapia , Neoplasias Meníngeas/diagnóstico , Necrosis , Estudios ProspectivosRESUMEN
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.