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1.
Proc Natl Acad Sci U S A ; 117(45): 28183-28190, 2020 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-33109722

RESUMO

The idea that tropical forest and savanna are alternative states is crucial to how we manage these biomes and predict their future under global change. Large-scale empirical evidence for alternative stable states is limited, however, and comes mostly from the multimodal distribution of structural aspects of vegetation. These approaches have been criticized, as structure alone cannot separate out wetter savannas from drier forests for example, and there are also technical challenges to mapping vegetation structure in unbiased ways. Here, we develop an alternative approach to delimit the climatic envelope of the two biomes in Africa using tree species lists gathered for a large number of forest and savanna sites distributed across the continent. Our analyses confirm extensive climatic overlap of forest and savanna, supporting the alternative stable states hypothesis for Africa, and this result is corroborated by paleoecological evidence. Further, we find the two biomes to have highly divergent tree species compositions and to represent alternative compositional states. This allowed us to classify tree species as forest vs. savanna specialists, with some generalist species that span both biomes. In conjunction with georeferenced herbarium records, we mapped the forest and savanna distributions across Africa and quantified their environmental limits, which are primarily related to precipitation and seasonality, with a secondary contribution of fire. These results are important for the ongoing efforts to restore African ecosystems, which depend on accurate biome maps to set appropriate targets for the restored states but also provide empirical evidence for broad-scale bistability.


Assuntos
Clima , Ecossistema , Florestas , Pradaria , África , Incêndios , Chuva , Estações do Ano , Árvores , Clima Tropical
2.
Risk Anal ; 38(10): 2087-2104, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29772062

RESUMO

In the United Kingdom, dwelling fires are responsible for the majority of all fire-related fatalities. The development of these incidents involves the interaction of a multitude of variables that combine in many different ways. Consequently, assessment of dwelling fire risk can be complex, which often results in ambiguity during fire safety planning and decision making. In this article, a three-part Bayesian network model is proposed to study dwelling fires from ignition through to extinguishment in order to improve confidence in dwelling fire safety assessment. The model incorporates both hard and soft data, delivering posterior probabilities for selected outcomes. Case studies demonstrate how the model functions and provide evidence of its use for planning and accident investigation.

3.
Nat Ecol Evol ; 4(11): 1472-1476, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32839542

RESUMO

Forest restoration occupies centre stage in global conversations about carbon removal and biodiversity conservation, but recent research rarely acknowledges social dimensions or environmental justice implications related to its implementation. We find that 294.5 million people live on tropical forest restoration opportunity land in the Global South, including 12% of the total population in low-income countries. Forest landscape restoration that prioritizes local communities by affording them rights to manage and restore forests provides a promising option to align global agendas for climate mitigation, conservation, environmental justice and sustainable development.


Assuntos
Conservação dos Recursos Naturais , Florestas , Biodiversidade , Carbono , Humanos
4.
Exp Neurol ; 293: 144-158, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28412220

RESUMO

Peripheral inflammation induces sensitization of nociceptive spinal cord neurons. Both spinal tumor necrosis factor (TNF) and neuronal membrane insertion of Ca2+ permeable AMPA receptor (AMPAr) contribute to spinal sensitization and resultant pain behavior, molecular mechanisms connecting these two events have not been studied in detail. Intrathecal (i.t.) injection of TNF-blockers attenuated paw carrageenan-induced mechanical and thermal hypersensitivity. Levels of GluA1 and GluA4 from dorsal spinal membrane fractions increased in carrageenan-injected rats compared to controls. In the same tissue, GluA2 levels were not altered. Inflammation-induced increases in membrane GluA1 were prevented by i.t. pre-treatment with antagonists to TNF, PI3K, PKA and NMDA. Interestingly, administration of TNF or PI3K inhibitors followed by carrageenan caused a marked reduction in plasma membrane GluA2 levels, despite the fact that membrane GluA2 levels were stable following inhibitor administration in the absence of carrageenan. TNF pre-incubation induced increased numbers of Co2+ labeled dorsal horn neurons, indicating more neurons with Ca2+ permeable AMPAr. In parallel to Western blot results, this increase was blocked by antagonism of PI3K and PKA. In addition, spinal slices from GluA1 transgenic mice, which had a single alanine replacement at GluA1 ser 845 or ser 831 that prevented phosphorylation, were resistant to TNF-induced increases in Co2+ labeling. However, behavioral responses following intraplantar carrageenan and formalin in the mutant mice were no different from littermate controls, suggesting a more complex regulation of nociception. Co-localization of GluA1, GluA2 and GluA4 with synaptophysin on identified spinoparabrachial neurons and their relative ratios were used to assess inflammation-induced trafficking of AMPAr to synapses. Inflammation induced an increase in synaptic GluA1, but not GluA2. Although total GluA4 also increased with inflammation, co-localization of GluA4 with synaptophysin, fell short of significance. Taken together these data suggest that peripheral inflammation induces a PI3K and PKA dependent TNFR1 activated pathway that culminates with trafficking of calcium permeable AMPAr into synapses of nociceptive dorsal horn projection neurons.


Assuntos
Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Células do Corno Posterior/metabolismo , Radiculopatia/patologia , Receptores de AMPA/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Animais , Anti-Inflamatórios não Esteroides/uso terapêutico , Cálcio/metabolismo , Carragenina/toxicidade , Modelos Animais de Doenças , Inibidores Enzimáticos/farmacologia , Inibidores Enzimáticos/uso terapêutico , Etanercepte/uso terapêutico , Feminino , Masculino , Camundongos , Células do Corno Posterior/patologia , Células do Corno Posterior/ultraestrutura , Transporte Proteico/efeitos dos fármacos , Transporte Proteico/fisiologia , Radiculopatia/induzido quimicamente , Radiculopatia/tratamento farmacológico , Ratos Sprague-Dawley , Frações Subcelulares/efeitos dos fármacos , Frações Subcelulares/metabolismo , Sinaptofisina/metabolismo , Fator de Necrose Tumoral alfa/farmacologia
5.
Ir J Med Sci ; 175(3): 62-3, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17073250

RESUMO

BACKGROUND: Anal ulceration is uncommon. Patients are typically referred because of severe anal pain, bleeding, discharge, and ulceration. It is important to exclude anal carcinoma, and to consider more unusual causes. METHODS: A 74-year-old lady presented with severe anal pain and ulceration. This was subsequently noted to be related to nicorandil, a potassium channel activator used in the treatment of angina. Discontinuation of nicorandil and faecal diversion allowed symptom relief and ulcer healing. CONCLUSION: Knowledge of the association between nicorandil and anal ulceration is essential in order to appropriately diagnose and manage this condition.


Assuntos
Fissura Anal/induzido quimicamente , Isquemia Miocárdica/tratamento farmacológico , Nicorandil/efeitos adversos , Vasodilatadores/efeitos adversos , Idoso , Feminino , Fissura Anal/patologia , Fissura Anal/terapia , Humanos
6.
Exp Neurol ; 283(Pt A): 276-86, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27349406

RESUMO

Alterations in the neuro-immune balance play a major role in the pathophysiology of chronic neuropathic pain. MicroRNAs (miRNA) can regulate both immune and neuronal processes and may function as master switches in chronic pain development and maintenance. We set out to analyze the role of miR-132-3p, first in patients with peripheral neuropathies and second in an animal model of neuropathic pain. We initially determined miR-132-3p expression by measuring its levels in white blood cells (WBC) of 30 patients and 30 healthy controls and next in sural nerve biopsies of 81 patients with painful or painless inflammatory or non-inflammatory neuropathies based on clinical diagnosis. We found a 2.6 fold increase in miR-132-3p expression in WBC of neuropathy patients compared to healthy controls (p<0.001). MiR-132-3p expression was also slightly up-regulated in sural nerve biopsies from neuropathy patients suffering from neuropathic pain compared to those without pain (1.2 fold; p<0.001). These promising findings were investigated further in an animal model of neuropathic pain, the spared nerve injury model (SNI). For this purpose miR-132-3p expression levels were measured in dorsal root ganglia and spinal cord of rats. Subsequently, miR-132-3p expression was pharmacologically modulated with miRNA antagonists or mimetics, and evoked pain and pain aversion were assessed. Spinal miR-132-3p levels were highest 10days after SNI, a time when persistent allodynia was established (p<0.05). Spinal administration of miR-132-3p antagonists via intrathecal (i.t.) catheters dose dependently reversed mechanical allodyina (p<0.001) and eliminated pain behavior in the place escape avoidance paradigm (p<0.001). Intrathecal administration of miR-132-3p mimetic dose-dependently induced pain behavior in naïve rats (p<0.001). Taken together these results indicate a pro-nociceptive effect of miR-132-3p in chronic neuropathic pain.


Assuntos
Leucócitos/metabolismo , MicroRNAs/metabolismo , Neuralgia/sangue , Neuralgia/fisiopatologia , Regulação para Cima/fisiologia , Fator 3 Ativador da Transcrição/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Aprendizagem da Esquiva/fisiologia , Doença Crônica , Estudos de Coortes , Modelos Animais de Doenças , Feminino , Gânglios Espinais/efeitos dos fármacos , Gânglios Espinais/metabolismo , Humanos , Masculino , MicroRNAs/química , MicroRNAs/genética , Pessoa de Meia-Idade , Neuralgia/patologia , Oligonucleotídeos/farmacologia , Medição da Dor , Limiar da Dor/efeitos dos fármacos , Limiar da Dor/fisiologia , RNA Mensageiro/metabolismo , Ratos , Receptores de AMPA/metabolismo , Regulação para Cima/efeitos dos fármacos
7.
J Anim Sci ; 94(12): 5382-5392, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28046162

RESUMO

Three experiments evaluated the effects of ractopamine hydrochloride (RAC) dose and duration on growth performance and carcass characteristics of feedlot steers. In total, 1,509 crossbred steers (530 kg initial BW [SD 22]) were used in a randomized complete block design using a 3 × 3 factorial treatment structure. Treatments consisted of RAC dose (0, 100, or 200 mg/steer daily) and duration (28, 35, or 42 d) of RAC feeding prior to harvest. Initiation of RAC dose was staggered (7 d apart) based on RAC duration, which resulted in common days on feed among treatments. Data from the 3 experiments were combined for statistical analyses. There were no RAC dose × duration interactions ( ≥ 0.85) for growth performance. Live final BW was not different ( ≥ 0.24) as RAC dose increased. Dry matter intake linearly decreased ( < 0.01) as RAC dose increased. Live ADG and G:F linearly increased ( ≤ 0.01) as RAC dose increased. Carcass-adjusted ADG and G:F linearly increased ( ≤ 0.02) as RAC dose increased. Compared with steers fed 0 mg RAC/steer daily, G:F was improved by 5.0 and 13.0% when steers were fed 100 ( = 0.31) and 200 ( = 0.01) mg RAC/steer daily, respectively. Hot carcass weight tended ( = 0.10) to linearly increase as RAC dose increased, with carcasses from steers fed 100 ( = 0.38) and 200 ( = 0.10) mg RAC/steer daily being 2.2 and 4.1 kg heavier, respectively, than carcasses from steers fed 0 mg RAC/steer daily. Increasing RAC dose linearly ( < 0.01) increased LM area and linearly ( = 0.02) decreased marbling score. Live final BW was not different ( ≥ 0.60) among RAC durations. Carcass-adjusted final BW, ADG, and G:F were not different ( ≥ 0.41) as RAC duration increased. Carcass traits did not differ ( ≥ 0.18) among RAC duration. Feeding 200 mg RAC/steer daily improved ADG, feed efficiency, and HCW. Increasing the feeding duration of RAC had no effect of growth performance or carcass characteristics. These data indicate that feeding 200 mg RAC/steer daily for 28 d improves steer growth performance.


Assuntos
Composição Corporal/efeitos dos fármacos , Bovinos/crescimento & desenvolvimento , Fenetilaminas/farmacologia , Agonistas Adrenérgicos beta/administração & dosagem , Agonistas Adrenérgicos beta/farmacologia , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Dieta/veterinária , Relação Dose-Resposta a Droga , Masculino , Fenetilaminas/administração & dosagem , Aumento de Peso/efeitos dos fármacos
8.
Chem Commun (Camb) ; (12): 1531-3, 2005 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-15770249

RESUMO

The application of FTIR spectroscopy to concentrated solutions of tetrolic acid shows, for the first time, a direct relationship between molecular self association in solution and H-bonded motifs in the subsequently crystallised solid phases.


Assuntos
Ácidos Graxos Insaturados/química , Clorofórmio/química , Cristalização , Etanol/química , Ligação de Hidrogênio , Soluções/química , Espectroscopia de Infravermelho com Transformada de Fourier
9.
J Anim Sci ; 93(2): 786-93, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25548203

RESUMO

Research has suggested that maternal undernutrition may cause the development of a thrifty phenotype in the offspring, potentially resulting in greater adiposity and reduced muscle mass. These alterations in adipose and muscle development could have lasting impacts on offspring growth, carcass characteristics, and meat quality. However, limited research exists evaluating the impact of maternal energy status on these economically important traits of the offspring. Therefore, the objective of this study was to determine the influence of maternal energy status during midgestation on offspring carcass characteristics and meat quality. To alter maternal energy status, cows either grazed dormant, winter range (positive energy status [PES]) or were fed in a drylot at 80% of the energy requirements for BW maintenance (negative energy status [NES]) during a mean period of 102 ± 10.9 to 193 ± 10.9 d of gestation. Changes in BCS, BW, LM area (LMA), and 12th rib backfat were measured throughout midgestation. At the end of midgestation, cows in the NES group had a reduction (P ≤ 0.05) in BCS, BW, LMA, and 12th rib backfat when compared with PES dams. Cows and calves were managed similarly after midgestation through weaning and calves were managed and fed a common diet through the receiving, backgrounding, and finishing phases in the feedlot. Calves were harvested after 208 d in the feedlot, carcass characteristics were recorded, and strip loins were recovered for analysis of objective color and Warner-Bratzler shear force (WBSF). Maternal energy status had no influence on offspring HCW, dressing percent, LMA, percent KPH, marbling score, percent intramuscular fat, objective color, or WBSF (P > 0.10). Progeny of NES cows tended to have improvements in 12th rib backfat and USDA yield grade (P < 0.10). Greater ratio of marbling score to 12th rib fat thickness and ratio of percent intramuscular fat to 12th rib fat thickness (P < 0.05) were discovered in progeny from cows experiencing a NES during midgestation. These results suggest that maternal energy status during midgestation may impact fat deposition in intramuscular and subcutaneous fat depots without impacting muscle mass.


Assuntos
Animais Recém-Nascidos/fisiologia , Composição Corporal/fisiologia , Bovinos/fisiologia , Metabolismo Energético/fisiologia , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Carne/normas , Prenhez/fisiologia , Adiposidade/fisiologia , Animais , Animais Recém-Nascidos/crescimento & desenvolvimento , Peso Corporal/fisiologia , Bovinos/crescimento & desenvolvimento , Feminino , Desenvolvimento Fetal/fisiologia , Indústria Alimentícia/normas , Qualidade dos Alimentos , Masculino , Músculo Esquelético/fisiologia , Gravidez
10.
Meat Sci ; 110: 201-11, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26253836

RESUMO

The objective of this study was to determine if maternal energy status during mid-gestation influences the expression of genes regulating muscle and fat development, and muscle characteristics that may impact meat tenderness. Cows grazed dormant, native range (Positive Energy Status [PES]) or were fed at 80% of maintenance energy requirements (Negative Energy Status [NES]) during mid-gestation. Steer offspring were harvested after 21 d in the feedlot (weaning subsample) or after 208 d in the feedlot (final subsample). Greater 21-d tenderness was observed in NES steers, resulting from reduced collagen content in longissimus lumborum steaks. In the semitendinosus, NES steers had greater soluble collagen, and down-regulated expression of MHC-IIA and TIMP-3 at weaning, while MHC-IIA expression was up-regulated in NES steers in the final harvest. Data show mid-gestational maternal energy status may impact offspring tenderness and collagen, but differences were not detected in expression of genes important in myogenesis and adipogenesis in muscle samples obtained from steers at weaning or slaughter.


Assuntos
Metabolismo Energético , Regulação da Expressão Gênica/fisiologia , Carne/normas , Músculo Esquelético/fisiologia , Fenômenos Fisiológicos da Nutrição Animal , Animais , Bovinos , Feminino , Fenômenos Fisiológicos da Nutrição Materna , Gravidez
11.
Cancer Epidemiol Biomarkers Prev ; 5(11): 897-900, 1996 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-8922297

RESUMO

The epidemiology of large bowel cancer suggests an etiological role for dietary factors. Although the evidence is inconsistent, several studies have suggested an inverse association between dietary vitamin D or calcium and colorectal cancer risk. We conducted a population-based case-control study to examine the relationship between dietary vitamin D and calcium and colorectal cancer among residents of Stockholm, Sweden. Between January 1986 and March 1988, 352 cases of colon cancer and 217 cases of rectal cancer diagnosed among living persons residing in Stockholm County were identified via a cancer surveillance network established among all the hospitals in Sweden and the Stockholm Regional Cancer Registry. Controls (512) were randomly selected from a computerized population registry. Dietary intake was assessed using a quantitative food frequency questionnaire focusing on average consumption during the preceding 5 years. Supplemental intake of vitamin D and calcium was not ascertained. Logistic regression was used to calculate odds ratios (ORs) as the measure of association between the exposure of interest (vitamin D or calcium) and cancer risk. Increasing levels of dietary vitamin D were inversely associated with the risk of colorectal cancer. The association was somewhat more pronounced for cancers of the rectum [OR, 0.5; 95% confidence interval (CI), 0.3-0.9 between the highest and lowest quartiles] than for cancers of the colon (OR, 0.6; 95% CI, 0.4-1.0) after adjustment for age, sex, and total caloric and protein intake. Dietary calcium was not associated with the adjusted risk of colon (OR, 1.2; 95% CI, 0.7-2.1) or rectal cancer (OR, 1.0; 95% CI, 0.5-1.9). Further adjustments for fat and dietary fiber intake, body mass index, and physical activity had little or no effect on the results. These results suggest that dietary vitamin D may reduce the risk of large bowel cancer, particularly rectal cancer. In addition, although some of the previous data suggested a protective effect for calcium against cancers of the large bowel, we could not document such an effect.


Assuntos
Anticarcinógenos/farmacologia , Cálcio da Dieta/farmacologia , Neoplasias Colorretais/epidemiologia , Vitamina D/farmacologia , Idoso , Estudos de Casos e Controles , Neoplasias Colorretais/prevenção & controle , Dieta , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Inquéritos Nutricionais , Sistema de Registros , Fatores de Risco , Suécia/epidemiologia
12.
Br J Pharmacol ; 130(7): 1575-80, 2000 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10928960

RESUMO

Photorelaxation of vascular smooth muscle (VSM) is caused by the release of nitric oxide (NO) from a finite molecular store that can be depleted by irradiating pre-contracted arteries with visible light. The ability of an 'exhausted' vessel to respond to a further period of illumination is lost temporarily but then recovers slowly as the photosensitive store is reconstituted in the dark. The recovery process, termed repriming, displays an absolute requirement for endothelium-derived NO and is inhibited by pre-treating arteries with ethacrynic acid, a thiol-alkylating agent. Here we demonstrate that agents that up- or down-regulate glutathione (GSH) biosynthesis influence the extent to which the store is regenerated in the dark. Isolated rat tail arteries (RTAs) were perfused internally with Krebs solution containing phenylephrine (PE; mean [PE] +/- s.e.mean: 5. 78+/-0.46 microM) and periodically exposed to laser light (lambda=514.5 nm, 6.3 mW cm(-2) for 6 min). Photorelaxations of control RTAs were compared with those from either (a) vessels taken from animals previously injected i.p. with buthionine sulphoximine (BSO), an inhibitor of gamma-glutamylcysteine synthetase (three injections, 100 mg kg(-1) at 8 h intervals); or (b) isolated RTAs that were perfused ex vivo with oxothiazolidine (OXO), a precursor of cysteine (10(-4) M OXO for 60 min). RTAs from BSO-treated animals exhibited attenuated photorelaxations: the mean (+/-s.e.mean) amplitude of the response recorded after 72 min recovery in the dark was 12.4+/-1.6% versus 21.4+/-2.9% for control arteries (n=5; P<0. 01). Conversely RTAs treated with OXO and allowed to recover for a similar period showed enhanced photorelaxations, 32.6+/-6.3% as compared to 21.4+/-2.9% for control arteries (n=5; P<0.01). A hyperbolic curve fit to repriming curves for BSO-treated and control arteries returned asymptote values (maximum photorelaxations) of (mean +/- s.e.mean) 24.2+/-3.2% and 55.2+/-8.5%, respectively. The level of GSH in RTA extracts was measured by high-pressure liquid chromatography (HPLC). Injecting animals with BSO decreased GSH to 85% of control levels (P<0.05) while treatment of isolated vessels with OXO resulted in a 31% increase above control levels (P<0.05). Thus, drug-induced changes in RTA GSH levels were positively correlated with altered photorelaxations. The results lead us to postulate that the photosensitive store in VSM is generated, at least in part, from intracellular GSH which becomes converted to S-nitrosoglutathione (GSNO) by nitrosating species that are formed ultimately from endothelium-derived NO. The possible physiological significance of a photolabile store of NO in VSM is discussed briefly.


Assuntos
Butionina Sulfoximina/farmacologia , Glutationa/análogos & derivados , Glutationa/biossíntese , Relaxamento Muscular/efeitos dos fármacos , Músculo Liso Vascular/efeitos dos fármacos , Tiazóis/farmacologia , Animais , Antimetabólitos/farmacologia , Antioxidantes/química , Glutationa/metabolismo , Glutationa/fisiologia , Técnicas In Vitro , Masculino , Músculo Liso Vascular/fisiologia , Óxido Nítrico/fisiologia , Compostos Nitrosos/metabolismo , Fotoquímica , Ratos , Ratos Wistar , S-Nitrosoglutationa , Cauda/efeitos dos fármacos , Cauda/fisiologia
13.
Res Microbiol ; 142(2-3): 137-40, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-1925011

RESUMO

Starvation for isoleucine but not for other amino acids in an ilv- strain or the addition of valine in an ilv+ strain inhibits initiation of chromosome and minichromosome replication in stringent (Rel+) Escherichia coli, but it does not inhibit replication in relaxed (relA) mutants (Guzman et al, 1988). From these results, we concluded that, (1) oriC initiation of replication is inhibited by ppGpp, and (2) isoleucine is not needed for the protein synthesis required at initiation. These results led us to find an isoleucine-free protein whose de novo synthesis is the sole protein synthesis requirement for oriC initiation. We also present evidence that this protein may be a calcium-binding protein located at 73 min in the genetic map.


Assuntos
Proteínas de Ligação ao Cálcio/metabolismo , Replicação do DNA/fisiologia , Escherichia coli/metabolismo , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Proteínas de Ligação ao Cálcio/genética , Mapeamento Cromossômico , Cromossomos Bacterianos/metabolismo , Replicação do DNA/genética , DNA Bacteriano/biossíntese , Escherichia coli/genética , Genes Bacterianos , Isoleucina/metabolismo , Fases de Leitura Aberta
14.
Semin Arthritis Rheum ; 21(1): 24-9, 1991 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-1948098

RESUMO

As a result of better patient selection, implant design, and surgical technique, the long-term results of total elbow arthroplasty in patients with rheumatoid arthritis has improved significantly over the past 10 years. The semiconstrained hinge implant is used in the presence of severe bone and ligament destruction. The non-constrained surface replacement requires intact bone and ligamentous supports. Best results are obtained if surgery is undertaken before severe soft tissue contractures, muscle atrophy, and neurologic disability of the involved extremity develop.


Assuntos
Artrite Reumatoide/cirurgia , Artroplastia , Articulação do Cotovelo/cirurgia , Artrite Reumatoide/fisiopatologia , Artrografia , Articulação do Cotovelo/fisiologia , Articulação do Cotovelo/fisiopatologia , Desenho de Equipamento , Falha de Equipamento , Humanos , Prótese Articular , Movimento , Parestesia/etiologia , Complicações Pós-Operatórias , Nervo Ulnar
15.
J Am Geriatr Soc ; 46(10): 1242-50, 1998 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-9777906

RESUMO

OBJECTIVE: To examine the degree to which variation in place of death is explained by differences in the characteristics of patients, including preferences for dying at home, and by differences in the characteristics of local health systems. DESIGN: We drew on a clinically rich database to carry out a prospective study using data from the observational phase of the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT component). We used administrative databases for the Medicare program to carry out a national cross-sectional analysis of Medicare enrollees place of death (Medicare component). SETTING: Five teaching hospitals (SUPPORT); All U.S. Hospital Referral Regions (Medicare). STUDY POPULATIONS: Patients dying after the enrollment hospitalization in the observational phase of SUPPORT for whom place of death and preferences were known. Medicare beneficiaries who died in 1992 or 1993. MAIN OUTCOME MEASURES: Place of death (hospital vs non-hospital). RESULTS: In SUPPORT, most patients expressed a preference for dying at home, yet most died in the hospital. The percent of SUPPORT patients dying in-hospital varied by greater than 2-fold across the five SUPPORT sites (29 to 66%). For Medicare beneficiaries, the percent dying in-hospital varied from 23 to 54% across U.S. Hospital Referral Regions (HRRs). In SUPPORT, variations in place of death across site were not explained by sociodemographic or clinical characteristics or patient preferences. Patient level (SUPPORT) and national cross-sectional (Medicare) multivariate models gave consistent results. The risk of in-hospital death was increased for residents of regions with greater hospital bed availability and use; the risk of in-hospital death was decreased in regions with greater nursing home and hospice availability and use. Measures of hospital bed availability and use were the most powerful predictors of place of death across HRRs. CONCLUSIONS: Whether people die in the hospital or not is powerfully influenced by characteristics of the local health system but not by patient preferences or other patient characteristics. These findings may explain the failure of the SUPPORT intervention to alter care patterns for seriously ill and dying patients. Reforming the care of dying patients may require modification of local resource availability and provider routines.


Assuntos
Atitude Frente a Morte , Hospitais para Doentes Terminais/estatística & dados numéricos , Hospitais de Ensino/estatística & dados numéricos , Medicare/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Assistência Terminal/estatística & dados numéricos , APACHE , Idoso , Ocupação de Leitos/estatística & dados numéricos , Área Programática de Saúde/estatística & dados numéricos , Estudos Transversais , Bases de Dados Factuais , Tomada de Decisões , Atenção à Saúde/organização & administração , Feminino , Serviços de Assistência Domiciliar , Hospitalização , Humanos , Masculino , Análise Multivariada , Estudos Prospectivos , Fatores Socioeconômicos , Assistência Terminal/economia , Estados Unidos
16.
J Clin Pathol ; 33(9): 830-5, 1980 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-7430395

RESUMO

Results of investigations on typical specimens were circulated to Australian microbiologists, who were asked to draft reports on the basis of the data provided. Many laboratories were found simply to report the results of their activities without explanations. This was true whether the finding was that of a Gram-negative rod in a postoperative sputum or an anaerobic diphtheroid in a blood culture. There was diversity of views as to what constituted probable contamination in a urine specimen. Often no clearcut verdict was given, nor did the report indicate when no conclusion was possible. Remedial measures are discussed.


Assuntos
Comunicação , Laboratórios/normas , Microbiologia/normas , Austrália
17.
Chem Commun (Camb) ; (18): 1764-5, 2001 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-12240304

RESUMO

Three new 'Chinese lantern' complexes [XMn(mu-dppO2)4MnX](2+)2X-.4MeOH.Me2CO [X = Cl, Br, I; dppO2 = 1,3-bis(diphenylphosphinoyl)propane], have been structurally characterised using single-crystal X-ray diffraction and shown to have increasing affinity for SO2 across the series Cl < Br < I via thermogravimetric measurements.

18.
Pathology ; 16(3): 345-9, 1984 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-6334832

RESUMO

Routine sputum culture in microbiology laboratories is frequently a source of dissatisfaction to microbiologists and clinicians alike. Care should be taken to ensure that the investigations requested are appropriate and that an adequate specimen is collected. Co-operation between the microbiologist and the clinician is required if the laboratory's facilities are to be properly exploited for the etiological diagnosis of respiratory tract infection. In clinical conditions such as lung abscess and atypical pneumonia sputum is not an appropriate specimen for the laboratory to work on and early consideration should be given to obtaining lower respiratory tract secretions free of oropharyngeal contamination.


Assuntos
Infecções Respiratórias/diagnóstico , Escarro/microbiologia , Bactérias/isolamento & purificação , Bronquite/diagnóstico , Humanos , Doença dos Legionários/diagnóstico , Infecções por Mycobacterium/diagnóstico , Pneumonia/diagnóstico , Pneumonia por Mycoplasma/diagnóstico , Pneumonia por Pneumocystis/diagnóstico , Manejo de Espécimes , Síndrome
19.
Pathology ; 17(1): 20-23, 1985 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-4039811

RESUMO

Two hundred and eight isolates of Trichosporon beigelii were identified over the period January 1973 to July 1983. 45.7% of these were from skin, 25.0% from nail, 22.6% from tissues and fluids, 3.4% from hair and 3.4% from sputum. Tr. beigelii was isolated in association with a recognized pathogen in 23 cases, 9 with a yeast, 14 with a dermatophyte. In 38 cases, Tr. beigelii was the only organism isolated when direct microscopic examination of clinical material showed the presence of hyphae and/or yeast cells. Although Tr. beigelii could only be assigned a definite pathogenic role in 6 cases of genital white piedra, and in one case of peritonitis associated with chronic ambulatory peritoneal dialysis, we believe that this organism was pathogenic in many cases of skin infection. In most of the cases where it was isolated from tissue or fluids at Royal North Shore Hospital, Tr. beigelii was not considered to be significantly contributing to the disease process.


Assuntos
Candidíase/microbiologia , Fungos Mitospóricos/isolamento & purificação , Micoses/microbiologia , Dermatomicoses/microbiologia , Humanos
20.
Pathology ; 19(3): 281-4, 1987 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-3431915

RESUMO

Five hundred and fifty six dematiaceous hyphomycetes, the great majority referred from other laboratories, were identified by us over a five year period. Of these, thirty five were regarded as being of probable pathogenetic significance. These included seven isolates associated with chromoblastomycosis, and seven isolates thought to be causing phaeohyphomycosis. There were six strains of Phaeoannellomyces werneckii and five strains of Sporothrix schenckii. Seven isolates, all strains of Aureobasidium pullulans, were associated with fungal peritonitis in patients on chronic ambulatory peritoneal dialysis. Two Bipolaris isolates were associated with paranasal sinus fungus ball, a condition in which no evidence of tissue invasion by fungi could be found, even though pressure necrosis of bone could lead to very serious consequences. A further seven dematiaceous hyphomycetes, isolated from cases of paranasal fungus ball, keratitis and otitis externa, were thought to be of possible pathogenetic significance. Of the remaining 514 isolates thought to be of no pathogenetic significance, two thirds were made up of strains of Aureobasidium pullulans, Alternaria alternata, Cladosporium cladosporioides, Epicoccum purpurascens and Phoma species. In many cases it was thought that the referring laboratories had allowed insufficient time for development of conidiogenesis in these strains, before sending them to our laboratory for identification.


Assuntos
Fungos Mitospóricos/classificação , Humanos , Fungos Mitospóricos/patogenicidade , Estudos Retrospectivos
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